Elliot Cohen—PillPack co-founder and now co-founder of General Medicine—joins Jacob Effron and Nikhil (Out-of-Pocket) to unpack what “best care” really means in 2025. He explains why General Medicine is building a broad front door to care. Elliot also revisits the PillPack vs. PBMs saga, what Amazon Pharmacy got right (and what was unexpectedly hard), and how AI is already raising the bar in intake, clinical prep, and follow-up.

(0:00) Intro
(0:58) Simplifying Healthcare with General Medicine
(1:53) The Importance of Triage in Healthcare
(3:22) Consumer Empowerment in Healthcare
(5:10) Patient Experience and Structured Forms
(6:27) Challenges in Healthcare Pricing Transparency
(8:28) Diverse Patient Needs and Quality of Care
(10:00) The Philosophy Behind General Medicine
(16:43) Consumer Directed Care: Pros and Cons
(18:57) PillPack
(35:53) Debating Insulin Search Results
(38:16) AI in Healthcare: A New Era
(39:15) Integrating AI with Clinical Teams
(41:39) Challenges and Opportunities in Digital Therapeutics
(58:21) Building a Healthcare Company: Lessons from Amazon
(1:01:25) Quickfire

Out-Of-Pocket: https://www.outofpocket.health/

Flashback episode in honor of Hinge Health's IPO this week. In the episode, Jacob and Nikhil sit down with Daniel Perez, the Co-Founder and CEO of Hinge Health, a digital clinic for patients with joint and muscle pain. They discuss Hinge Health’s strategy for selling to employers, how digital health solutions can reach and retain users, the role of software x hardware in disrupting healthcare, and more.

(0:00) Intro
(2:34) The Evolution of Employer Health Solutions
(4:03) Challenges and Strategies in Digital Health
(7:07) Focus on Musculoskeletal Care
(9:51) Engaging and Retaining Patients
(16:17) Marketing and Awareness Strategies
(19:31) The Role of Independent Validators
(22:27) Clinical Validation and R&D Excellence
(23:04) Healthy Competition and Market Differentiation
(23:59) Product Superiority and Customer Validation
(26:05) Team Dynamics and Tough Decisions
(29:49) Future of Hinge Health and Healthcare Automation
(31:44) AI and Technology Integration
(36:18) Hardware Innovations and Market Impact
(39:19) Value-Based Care and Outcome Guarantees
(41:14) Regulatory Challenges and Innovation Constraints
(43:38) Closing Thoughts and Entrepreneurial Advice

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Otto Sipe. Otto is the CEO and Co-Founder of Photon Health, which enables patients to select their own pharmacies with price and inventory transparency. The company has raised over $16 million from investors including Flare Capital Partners and Notation Capital. They discuss where pharmacies and PBMs are headed, the evolution of E-Prescribing, the impact of GLP-1s & AI, and more.

(0:00) Intro
(0:51) History and Evolution of E-Prescribing
(3:02) Challenges in Current E-Prescribing Systems
(6:28) Photon Health's Innovative Approach
(8:17) Patient and Provider Behavior Changes
(11:21) Pharmacy Industry Landscape and Future
(13:43) Interactions with PBMs and Market Dynamics
(16:48) Future of PBMs and Drug Pricing
(20:38) Quality and Marketplace Experience in Pharmacies
(23:30) Advising Independent Pharmacies for Future Success
(24:24) Challenges and Strategies in Retail Pharmacy
(25:45) Pharmacy Economics and Supply Chain Issues
(30:21) The Role and Potential of Pharmacists
(36:01) AI in Pharmacy: Photon’s Approach
(38:28) Quickfire

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Dr. Rushika Fernandopulle. Rushika is the former CEO and Co-Founder of Iora Health, a primary care provider centered around value-based care and Medicare that One Medical acquired for $2.1 billion. They discuss why we’re still in the second inning of value-based care, intersections of tech and healthcare, what it takes for VBC to succeed, and more.

[0:00] Intro
[0:29] Early Days of Value-Based Care
[2:34] Challenges in Commercial Value-Based Care
[5:20] Adapting Care Models for Different Populations
[13:08] Medicaid and Long-Term Care Issues
[16:30] Big Tech's Foray into Healthcare
[20:37] Amazon's Healthcare Strategy
[21:09] Challenges in Serving Low-Income Seniors
[21:43] Innovative Solutions for Patient Transportation
[22:16] The Economics of Healthcare Visits
[23:22] Building a Custom EHR System
[27:34] The Role of AI in Modern Healthcare
[33:17] Future of Primary Care and Policy Implications

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Frank Wu, the Co-Founder and CEO of Taro Health. Taro Health is a health insurance plan currently live in Maine and Oklahoma that offers unlimited primary care and mental health visits. The company has raised over $18m from investors like Hummingbird Ventures, Quiet Capital, and FPV Ventures. They discuss creating value in InsurTech, building a health plan for Direct Primary Care providers, what’s next for health insurance, and more.

[0:00] Intro
[0:18] Frank’s Background and Journey
[1:17] Introduction to Taro Health
[2:50] Challenges and Strategies in Health Insurance
[7:24] Direct Primary Care Model
[13:01] Patient and Doctor Archetypes in DPC
[17:01] Enrollment and Market Strategies
[28:56] Generative AI in Health Insurance
[35:31] Quickfire

Out-Of-Pocket: https://www.outofpocket.health/

Jacob sits down with Erik Wexler, the President and CEO of Providence. Providence is a non-profit, faith-based health system with 51 hospitals and 1,000 clinics across seven states. They discuss how to think about new AI opportunities with discipline, the value of health system partnerships, programs to support health equity, and more.

[0:00] Intro
[2:07] Challenges and Opportunities with AI
[3:38] Leadership and Organizational Focus
[5:30] Whole Person Care and Health Equity
[7:23] Financial Challenges in Healthcare
[9:25] Collaborations and Partnerships
[13:38] Innovations in Healthcare Delivery
[15:12] Tech Integration in Healthcare
[16:55] Choosing the Right Innovations
[17:48] Policy Landscape and Concerns
[19:33] Handling Wildfires and Crisis Management
[21:59] Commitment to Climate Change and Sustainability
[24:14] Health Equity and Community Investment
[27:14] Challenges and Successes in Healthcare Innovation
[29:18] Future of Healthcare and Final Thoughts

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Daniel Perez, the Co-Founder and CEO of Hinge Health. Hinge Health is a digital clinic for patients with joint and muscle pain, having raised $800M+ from investors like Coatue and Tiger Global. They discuss Hinge Health’s strategy for selling to employers, how digital health solutions can reach and retain users, the role of software x hardware in disrupting healthcare, and more.

[0:00] Intro
[2:34] The Evolution of Employer Health Solutions
[4:03] Challenges and Strategies in Digital Health
[7:07] Focus on Musculoskeletal Care
[9:51] Engaging and Retaining Patients
[16:17] Marketing and Awareness Strategies
[19:31] The Role of Independent Validators
[22:27] Clinical Validation and R&D Excellence
[23:04] Healthy Competition and Market Differentiation
[23:59] Product Superiority and Customer Validation
[26:05] Team Dynamics and Tough Decisions
[29:49] Future of Hinge Health and Healthcare Automation
[31:44] AI and Technology Integration
[36:18] Hardware Innovations and Market Impact
[39:19] Value-Based Care and Outcome Guarantees
[41:14] Regulatory Challenges and Innovation Constraints
[43:38] Closing Thoughts and Entrepreneurial Advice

Out-Of-Pocket: https://www.outofpocket.health/

Jacob sits down with Hemant Taneja, the CEO & Managing Director of General Catalyst. GC is one of the world’s largest venture capital firms, most recently raising an $8B fund in 2024. The firm has invested in companies like Livongo, Cityblock Health, and Hippocratic AI. They discuss the possibility of a $100B healthcare company, how buying a health system can accelerate partnerships, what will succeed in AI, and more.

[0:00] Intro
[0:54] Hemant’s Healthcare Journey
[2:25] A Vision for 2030
[3:36] Transforming Healthcare Systems
[6:03] The Role of AI and Technology in Healthcare
[9:04] Incubation and Investment Strategies
[13:43] Platform Focus in Health Tech
[21:42] Exploring International Healthcare Opportunities
[24:48] AI Transformations Across Industries
[25:51] Innovative Financing in Venture Capital
[34:41] The Future of AI and Venture Capital
[38:18] Quickfire

Out-Of-Pocket: https://www.outofpocket.health/

Jacob sits down with Stef van Grieken, Co-Founder & CEO of Cradle. Cradle has raised over $100M from investors like IVP and Index Ventures to build and expand their AI-enabled protein engineering platform. They discuss how Cradle plans to use their new Series B funding, what’s been happening in AI bio, the technical underpinnings of Cradle’s platform, and more.

[0:00] Intro
[0:22] Cradle Bio's Rapid Growth and AI Innovations
[0:53] The State of AI in Drug Development
[1:15] Challenges and Opportunities in AI Biospace
[2:21] Cradle Bio's Approach to Biologics Development
[3:11] AI's Role in Hit Identification and Lead Optimization
[7:42] Cradle Bio's Software and Customer Base
[10:33] Inside Cradle Bio's Lab and Data Strategy
[24:10] Future Directions and Protein Modalities
[26:21] Navigating the Pharma SaaS Market
[28:48] Challenges in Adopting New Protocols
[30:15] Software vs. Service Companies
[31:47] Gaps in Drug Development
[33:46] Advances in AI and Bio
[41:28] Future of Drug Discovery
[44:18] Advice for Aspiring Bio Entrepreneurs
[48:03] Quickfire

Out-Of-Pocket: https://www.outofpocket.health/

Jacob sits down with Dr. Angela Fitch, the Founder and CMO of knownwell. knownwell has raised $25 million from investors like a16z and Flare Capital Partners to provide weight-inclusive primary care and metabolic health care. They discuss the future of obesity care, where we are with GLP-1s, the need to expand coverage, and more.

[0:00] Intro

[1:06] Current State of Obesity Medicine

[2:47] The knownwell Approach

[6:06] Challenges in Obesity Treatment

[7:23] The Future of Obesity Medication

[12:40] Insurance and Access Issues

[32:19] Supply Chain and Distribution

[35:38] Final Thoughts and Resources

Out-Of-Pocket: https://www.outofpocket.health/