Adam Wolfberg

For all the talk about value-based care, progress still is very slow. Advisory Board data shows the small amount of progress made from 2017 to 2022, which varies drastically by line of business. Medicare Advantage is the primary segment driving VBC, mainly due to aligned incentives where plans and providers could get paid more through upcoding (or "appropriate coding") of patients to drive more revenue & margin through the entire system. That drove penetration of VBC in MA, and CMS has paid attention, releasing significant headwinds (v28, RADV, Stars) aimed at reducing these perceived overpayments. In other segments, VBC has been very slow to grow. Commercial VBC arrangements were essentially stagnant. Anecdotally, this is starting to change. Plan sponsors (employers) -- especially large, sophisticated ones -- are demanding more from their carriers. They want to see network arrangements that impact quality & cost. Will that be enough to drive VBC activity in the commercial space? We'll see. Employers -- the customers -- will be the ones who will drive VBC forward here. TPAs alone don't have the incentive to make changes. I remain hopeful, but skeptical. #valuebasedcare #healthtech #digitalhealth

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Here’s your recap of last week’s healthcare technology news 🗞️ 👇 🤖 AI Clinician Assistant • Carle Health is beginning a full-scale adoption of Nabla through their Epic integration.    • UVM Health Network signed an enterprise-wide agreement with Abridge.    • Regard closed a $61M Series B with an investment from Cedars-Sinai Health Ventures among others.    • Mass General Brigham published a Q&A discussing the results of its initial AI ambient scribe pilot and plans to roll out a wider implementation.    🔁 RCM • Greenway Health released a patient payment solution that integrates cost estimates, patient payments, and payment plans.    💼 Provider and Practice Administration • Kontakt.io released a new wearable tag that aims to enable understanding of patient journey, estimated wait times, room availability, physician time with patient, and more.    📋 Patient Administration • Cone Health is partnering with Lirio on an AI-driven intervention for patients with diabetes.    • SAIGroup acquired Get Well, giving it access to the firm’s AI platform. 🍎 VBC • P3 Health Partners is partnering with Innovaccer to leverage its physician engagement solution as well as its AI-driven analytics.    • HSBlox, Inc released an update to its CureAlign platform that includes tooling for improved care coordination and patient outreach.    • GrayHawk Health is implementing Innovaccer to optimize operations and improve efficiency. 🧠 Food for Thought • We’ve covered numerous studies in our newsletter highlighting the impact of tech on reducing physician burnout. It appears we’re finally seeing signs of widespread impact from these workflow and workload interventions: physician burnout dropped below 50% for the first time since 2020, according to the AMA. https://lnkd.in/eWhj94NB    • ONC released the new, proposed rule HTI-2 to advance interoperability and patient information access and sharing. We're looking forward to more expert takes in the coming days—feel free to send any good ones our way! https://lnkd.in/eyM7eDyq --- Reminder: you can sign up for the Elion Briefing to get the latest healthcare tech news delivered to your inbox each week 📬 👉 https://lnkd.in/e2UJ3ckP

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Alot of bad actors and a few good actors. $2.5T HC capital raised & $1T invested by PE in last decade. $31B in 2013 vs. $217B in 2021. We know the story. Misaligned incentives - unrealistic multiples, short-term profit focus, aggressive cost-cutting, unrealistic scaling, misunderstood market dynamics, just to name a few. However, our industry needs money. But our industry is more infrastructure asset class than tech start-up (James Nicholls gave me that epiphany). Mic drop on the lyrical genius of Alex Fair of MedStartr Ventures as he literally gives the whole story poetic justice as he reads HIS POEM on this "On The Road at VIVE" episode of The Reverse Mullet Healthcare Podcast w/BP2 Health. This is the perfect episode for a Friday afternoon! He and Paulo J Machado donned the actual reverse mullets and joined us back in February at #VIVE2024 to talk about the need for REAL change in healthcare, startup focus and investor expectations. It was one to remember and one that is in desperate need of a full-length follow-up episode. Give us a like and a watch or a listen https://lnkd.in/e4w4mjkv https://lnkd.in/egmK3kMB

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🎥 Exciting update: I recently joined Jody Tropeano Greene to discuss the DiMe Seal, a milestone in building trust and accountability in digital health. Check out our conversation here: https://lnkd.in/epMHYU5x 🌟 Launched at HLTH 2024, the DiMe Seal recognizes high-quality, trustworthy digital health software products. Since its debut, we’ve seen incredible momentum: 🏥 Healthcare systems and payers across the US are looking to the DiMe Seal to help de-risk their digital health software purchases 🌍 Digital health software developers across the world are recognizing the value of the DiMe Seal to distinguish their products in a crowded market 👉 Are you a developer of digital health software products? Pursue the DiMe Seal and join the leaders setting the standard for quality and trust in healthcare innovation. Register today and use the code HLTH25 for a 25% discount https://lnkd.in/eTb6rRbj Let’s continue to raise the bar for digital health together! 🚀 #DigitalHealth #DiMeSeal #HLTH2024 #Innovation #TrustInHealth

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Peter Birch from Talking HealthTech and I get down to the nitty-gritty of why 2025 might be the year of healthcare #interoperability.

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This 👂 podcast episode and insight’s from a16z Bio + Health's Julie Yoo spoke so clearly to the fundamental challenge facing both 🩺 clinicians and 🏥 healthcare systems.  There is a huge disconnect between supply, in the availability of clinicians, and demand, in the increasing volume and complexity of healthcare needs. -     36% of physicians plan to reduce their hours next year according to the AMA -     48% of physicians reported feeling burned out in a 2024 Medscape survey At the same time, the demographic baby boomer bubble and steady increase in the prevalence of major chronic disease, which consumes up to 90% of healthcare expenditures according to some estimates, is driving demand. With this context, Yoo points to a major opportunity for AI adoption in healthcare in 2025. Yeah, a VC hyping a wave of new AI companies that will replace the decades of training and experience of clinicians, the skeptic would say.  But Yoo is thoughtful in pointing to the role AI can play, and is already playing, through solutions such as ambient, autonomous scribe solutions (of which local star Abridge is leading the pack) in not replacing, but freeing up productivity for clinicians. There is so much unstructured context in both the complexity of disease and treatment options and the social/emotional considerations that we shouldn't be looking for AI to *replace* clinicians. But companies are getting better at finding the structured, repetitive and time-consuming places where AI tools can *help* clinicians. Nearly two-thirds of doctors cited bureaucratic tasks as the leading contributor to burnout. Rigorously trained-AI driven solutions can be a force multiplier for clinicians, and I’ve seen several interviews where nurses and doctors go as far as to say some of these solutions are ”restoring their joy in practicing medicine”. Our health is precious; and we rightly want any technology engaging with it to be developed thoughtfully and thoroughly tested. This requires top AI talent and diverse and realistic training data. Pittsburgh’s strengths in both areas is why we are an emerging hub for data-driven healthcare. #AIinhealthcare #clinicianburnout #healthinnovation #digitalhealth

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When the Digital Health Awards categories came out this year, we were thrilled to see one called "Biggest Healthcare Savings Story". Oshi Health continues to demonstrate total cost of care savings: first in a clinical trial, then in 18 months of a value-based contract with a national payer and now with dozens of employers over multiple years. When you provide high-touch care that identifies root causes of #digestivehealth conditions and helps patients gain control of their condition, the cycle of repeated diagnostic testing and emergency room visits stops and total cost goes down. We are honored to be a finalist in this important category! #valuebasedcare #wholepersoncare

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Here's another fundraising roundup spotted in the healthcare wilds 👀 🍃 ✅ Sword Health raised $130M (new valuation: $3B). ✅ Better Health raised $14M to deploy expanded payer partnerships. ✅ Alzheon, Inc. | Preserving Future Memories raised $100M Series E to advance development & commercialization of its Alzheimer’s treatment. ✅ CinRx Pharma raised $73M to continue its ‘Hub and Spoke’ model of startup formation. ✅ Eko Health raised $41M to scale AI-driven heart and lung disease detection. ✅ Anterior (formerly Co:Helm) secured a $20M Series A to unlock admin efficiencies for healthcare payers. ✅ SamaCare raised a $17M Series B to scale specialty drug prior authorization platform. ✅ Plenful secured a $17M Series A to streamline pharmacy operations with AI-powered workflow automation. ✅ Grayce raised a $10.4M Series A led by Maveron amid a caregiving crisis. ✅ Stitch Employment Services Inc PEO raised $8.75M in seed to support independent medical practices. ✅ Posterity Health secured $6M to fund expansion and technology acceleration. ✅ Sware raised $6M to accelerate life sciences innovation by automating FDA-mandated software validation. ✅ Keragon raised $3M, as announced in @Conno Christou’s LinkedIn post. As always, if I missed you, let me know! Each week I'm spotlighting an innovative healthcare startup. I just ask for a bit more transparency. All submissions are confidential; submit yours here 👇 https://lnkd.in/gF4DrAvJ Looking for more fundraising roundups, alongside healthcare industry news and analysis? Subscribe to Hospitalogy, my 2x/week newsletter. Join 33K+ other investors, executives, and healthcare professionals: https://lnkd.in/g-nfRqW6

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Which founders fit the mold for success in healthcare? I spoke with Anne DeGheest, Founder and Managing Director at HealthTech Capital, about the key characteristics of successful #healthtech entrepreneurs. Listen to the full conversation here: https://lnkd.in/eqwUCkPx

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I'm incredibly proud of the overwhelming positive response I’ve received to our new Counterpart Health offering. We’ve already had positive inbound interest from ecosystem partners with  ideas on how to collaborate and integrate our Counterpart technology into their customer workflows. It’s very clear that now is a critical time to bring our technology-first Medicare Advantage approach to market as there’s a clear gap that needs filling.  Why are we seeing such excitement? Proven Success and Strong Demand: From day one, our goal has been to leverage technology to deliver better healthcare outcomes. Counterpart Assistant is built on the success of Clover Assistant, which has already made a significant impact within our own Medicare Advantage plans. Clinicians using our platform  see over 1,000 basis point improvements in Medical Cost Ratios and substantial improvements in early diagnosis and chronic disease management. This track record speaks volumes, and the market has taken notice. Easy Implementation: What sets Counterpart Assistant apart is its lightweight implementation and user-centric design. This isn’t about years-long projects to replace outdated insurance technologies or cumbersome EHR systems. Our platform is quick to deploy, and designed to enhance the clinician-patient interaction. It's the same cloud based and AI-powered software we've successfully deployed across hundreds of practices and systems, and thousands of doctors, now with a new SaaS and shared savings business model that allows us to reach more people rapidly. Real Impact, Real Results: At the end of the day, the beauty of Counterpart Assistant lies in its simplicity and effectiveness. It empowers primary care physicians to deliver better care, improve patient outcomes, and reduce costs. This isn't a theoretical solution—it's proven, it's practical, and it's already making a difference. Looking Ahead: The future of healthcare is here, and we’re leading the way. Counterpart Health is set to revolutionize how care is delivered and managed. Thank you to all our partners and supporters for believing in our vision and joining us on this journey. Let's continue to innovate and improve healthcare for everyone. https://lnkd.in/g53FmQ8u #HealthcareInnovation #AI #MedicareAdvantage #VaueBasedCare #CloverHealth #CounterpartHealth

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It's wild to think in 2024 we're FIRST seeing the DOJ accuse telemedicine conglomerates of criminal drug distribution. How long have we known about these practices in brick and mortar care...? Answer: decades! Take it from someone who prescribed stimulants and other psychotropics to kids over the years - painstakingly measuring and documenting the need and impact - these appalling abuses by Done and Cerebral mean we need more calls for thoughtful pause when it comes to working with startups. Particularly about funding's role - my favorite topic! 🤑 How did we end up with venture capital and PE financing in healthcare that risk the safety of kids in the name of exorbitant returns? Not that all VC or PE dollars are bad, of course, but they're certainly key drivers who shouldn't be in that seat. Did we underestimate these funders as 'barbarians at the gate', much like the pharma reps of the 90's and early 2000's heyday? Have we not learned from Purdue Pharma's aggressive and deadly Oxoycontin marketing? Purdue pleaded guilty to criminal charges and paid $600 million in fines in 2007. Or TAP Pharmaceutical Products's Lupron kickback scheme for the prostate cancer drug? TAP also pleaded guilty to criminal charges and paid $875 million in fines in 2001. Or Pfizer marketing Neurontin, an anti-seizure drug, for off-label uses, such as treating pain and bipolar disorder, even though the drug was not approved for these purposes, and paying physicians kickbacks. In 2004, Pfizer pleaded guilty to criminal charges and paid $430 million in fines. Cerebral and Done's playbooks were practically the same thing, just with a modern mid-pandemic, low-regulatory scrutiny, digital-platform twist. Will appropriate regulation ever outpace American venture greed? Is it even possible to ensure patient safety AHEAD of tragedies driven by the intersection of innovation and venture funding? If you're keeping score, healthcare regulatory reactivity: 1 million. Healthcare ounces of smartly preventive policy: 3. Blech. 😖 When will we finally own that prevention in-house? #healthcare #overdoseprevention #suicideprevention

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Excited for our webinar tonight: Investing in Healthcare Startups: An Angel Perspective When: tonight at 6 pm eastern Where: https://lnkd.in/dPUFNbhe We had had a couple last minute changes and I am very excited to have an engaging conversation with Thanasi Tsiodras, Dr. Shaun Kuan and Regina Prasad, MS. We will be discussing: 1. How to start investing in startups 2. Lessons from your winners and losers 3. What are some red flags in a startup 4. What is your diligence process like? 5. How do you get deal flow?  6. What is the ideal angel investor archetype? Who should invest in startups and who shouldn't. #healthcare #venturecapital #angelinvesting

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***From Best Practices to Next Practices*** Digital Health is an Emerging Determinant of Health says OCED's first-ever chapter on Digital Health in their annual Health-at-a-Glance report. Digital health readiness is considered a determinant of health as it influences health data usage, healthcare service delivery, and health outcomes through digital transformation. Countries with higher digital health readiness have better responses to health crises, improved resource utilization, lower costs, and enhanced patient experiences. Perhaps the most important point is featured in the image below, where the HUMAN FACTORS live. We have over-invested the last decade in the technologies and data systems to support Digital Health, however, we have heavily under-invested in the capacity and literacy building, community collaboration, transparent governance, and systems thinking that is required to take advantage of said technology and data. I liken it to 100 years ago, in 1924 when the automobile first arrived. At that time 95% of the world was still operating the horse and buggy, it took 40-50 years later to harness the power of the automobile to transport goods and services to every community. It's time we realize our healthcare system is the HORSE and BUGGY of this century... Here is a link to the copy of the chapter: https://lnkd.in/gzJ-GQbp #DigitalHealth #HealthTech #HealthData #HealthcareInnovation #HealthcareTransformation #DataSecurity #Interoperability #PatientEngagement #AIinHealthcare #PublicHealthImpact #digitalreadiness #communityimpact

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I get Dr. Yang's concern about large, wealthier health systems adopting AI sooner than smaller, poorer organizations, but this is actually a good thing...unless your time horizon is myopically short. Big organizations, with much larger budgets and sophisticated IT teams, can afford to take risks, make mistakes, and test out exciting (but still unproven) emerging tech while smaller organizations certainly can't (for the most part). So let the behemoths take all the risk, do the heavy lifting first, and then smaller organizations get to adopt truly proven solutions at lower risks/prices...once these have run the Kaiser, Mayo, Intermountain, etc., gauntlet. It's all part of the plan... #healthcare #startups #startup #ai #generativeai #digitalhealth #emergingtech Kaiser Permanente Cleveland Clinic Mayo Clinic Risant Health Intermountain Health https://lnkd.in/gckgQB_q

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Following up on my recent podcast with Spencer Dorn, there is a growing market for an AI guided clinical summarization tool. One of the best in this space and one we invested in last year is Abstractive Health. As clinicians we spend countless hours looking through previous records, an accurate tool which summarizes these records and minimizes hallucinations is needed. Abstractive Health is currently seeking outpatient practices and clinicians for beta testing their tool. This is a great opportunity for anyone looking to test an excellent clinical record summarization tool. Please reach out to myself or Vince Hartman if you’re interested! #aiinhealthcare #medicine #clinicalrecords #outpatientmedicine

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🤔 How do (US) hospitals spend money 101? Salaries, Wages, Benefits: 45-55% Professional Services: 12-22% Supplies: 12-18% Depreciation/Amortization: 3-6% Other Expenses: 5-20% 8 key insights: n°1. Hospitals consume 31% of US healthcare spending: Despite being the largest spending category, many hospitals struggle with low operating margins, often below 2%. n°2. Labor costs dominate hospital expenses: Salaries, wages, and benefits account for 45-55% of a hospital’s expenditures, with front-line staff making up 75-82% of the workforce. n°3. Contract labor adds significant costs: Hospitals often resort to staffing agencies due to labor shortages, paying 2-3 times more for contract workers compared to employed staff. n°4. Supplies account for 12-18% of expenses: This includes medical equipment, drugs, and personal protective equipment. n°5. For-profit vs. non-profit hospitals: For-profit hospitals tend to manage costs more efficiently, keeping salaries and expenses lower, but often at the expense of services like Medicaid or charity care. n°6. Economies of scale in larger health systems: Larger systems benefit from negotiating better prices for supplies and services. n°7. Rural hospitals face unique challenges: Limited access to talent and capital means rural hospitals must rely more heavily on expensive outsourced labor and struggle to offer high-margin services. n°8. Staffing shortages remain a key issue: Despite financial recovery post-COVID for many hospitals, staffing shortages continue, driving hospitals to explore different revenue models and operational changes to sustain profitability.​ Great post by the Out-Of-Pocket team Nikhil Krishnan & Ben Chao #healthcare

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