Beth Houck

This is quite incredible to see. Very few #CMMI demonstrations can point to any savings at all. And “…MSSP savings go further than savings generated by Medicare Advantage…” #ACO #VBP #Primarycare #MSSP #healthcareinnovation

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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 times at 4C Digital Health! Wilmington, Delaware - 4C Digital Health (4C), the preeminent organization delivering independent financial oversight and control solutions for self-funded employee health plans, recently announced the strategic expansion of its services into the Commonwealth of Kentucky. In late 2023, 4C successfully competed for an initial award issued by Kentucky’s Department of Employee Insurance, and Kentucky has since extended the initial contract to allow 4C to continue its important work on behalf of the Commonwealth, its employees, and its taxpayers. The Kentucky Employee Health Plan (KEHP) serves more than 288,000 members, which amounts to 1 in 16 Kentuckians. In addition, KEHP spends over $1.8 billion dollars in total healthcare benefits on behalf of its members per year and covers over 8.2 million claims per year. KEHP objectives include “improving employee health and well-being” and “providing state-of-the-art benefits while maintaining reasonable premiums.” Recognizing its important fiduciary responsibilities to its employees and its state health plan, the Commonwealth of Kentucky enacted Senate Bill 42 (2023) introduced by Senator Stephen Meredith for the purpose of ensuring that critical health plan dollars are being spent properly on behalf of state employees. The legislation requires that 4C analyze 100% of medical claims submitted for payment to KEHP; identify erroneous overpayments; and identify inappropriate or erroneous fees imposed by KEHP’s third-party administrator. Ron Templeton CEO of 4C Digital Health stated: “4C Digital Health is grateful to the Commonwealth of Kentucky for recognizing the fiduciary responsibility that state and local governments have to their employee health plans and for the opportunity to provide our services in support of this mission. We appreciate Kentucky’s goal of using 4C’s expertise and innovative solutions to improve healthcare outcomes and reduce healthcare costs for the Commonwealth, its employees, and its taxpayers.” About 4C Digital Health: 4C Digital Health (https://lnkd.in/eB-fJg4X) is a healthcare data analytics company that was founded for the purpose of developing a disruptive technology targeted at bringing transparency and honesty to the healthcare marketplace.

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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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Hospitals, Medicare's 2030 goal is clear: 100% of payments in Value-Based Care (VBC). No one’s off the hook. CMS struggled to get specialists and hospitals into programs like Bundled Payments, so now participation is mandatory. Hospitals that resisted VBC have no choice. The Transforming Episode Accountability Model (TEAM) locks them into a system where every dollar is tied to patient outcomes. This isn’t a suggestion; it’s a mandate. Care coordination, cost control, and patient health are now non-negotiable. The era of fragmented care is ending. Hospitals must adapt or face the financial consequences. If you're navigating these changes and need a partner who understands the landscape, let’s connect. Medicare’s vision is clear, and the path to 2030 just got a lot more serious. https://lnkd.in/eT8GQqd4

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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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Taking stock of primary care today and looking ahead.... Increasing presence, market share for non-traditional providers - payers, advanced primary care providers, primary care enablers. Question marks over retail's presence in primary care and what care models and patient populations they might need to focus on to be a force. #VBC #populationhealth #primarycare #caremodels

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Redesign Health has launched its largest fund to date, securing $175M to support over 20 new healthcare startups. Founded in 2018, the venture builder has previously incubated more than 60 companies, including Scriptology and Vivid Health. The new fund aims to address challenges such as healthy aging, interoperability, and expanding sites of care. This funding underscores investor confidence in tackling the $4T healthcare market's persistent challenges.

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I've heard my boss, Sean Duffy talk many times about Omada Health's 13+ year journey, but each time I learn something new. Sean recently spoke on the Big Picture Medicine podcast, and he provides great insights for anyone in the healthcare sector, but also has some valuable nuggets for leaders in any industry... One fun segment of the podcast begins around the 25:30 minute mark, when Sean talks about some of his "boss moves" and highlights the importance of hiring the right executives into the right roles at the right time. He recalls doing some pretty unique things in recruiting and hiring key talent. His reflections brought me back 3 years when Sean Duffy recruited and hired me. He knew I had two other highly competitive offers from some great companies, but Sean 'went to extremes' as he says on the podcast. He wrote me every day for 7 days, spelling out the top 7 reasons why I should join Omada Health. On the 7th and final day, he sent me a picture of himself dressed head to toe, donning PJs of my favorite sports team (my alma mater). I sent that photo to my BFF who said, "I assume you are accepting his offer?" The rest is history. Sean is an incredible CEO. He is a great story teller and an amazing leader. Check out the podcast link below to learn more... #BossMoves #Healthcare #RecruitingInsights https://lnkd.in/g--nTXgS

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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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In a recent op-ed, Jeff Bezos highlighted that "Reality is an undefeated champion." In healthcare, reality shows that many organizations still face challenges with retention. There's a clear link between trust (or the lack thereof) and declining retention rates. Excited to share news of a 5-part podcast series on Emotional Onboarding. Stay tuned as I share discussions with healthcare leaders who have successfully implemented emotional onboarding strategies to not just hire but retain staff. #Healthcare #Retention #EmotionalOnboarding

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“I think it’s important that the person running the organization understands the core thing that the company does.” - Ben Horowitz, GP at a16z. Totally agree, but we actually see the opposite in healthcare. As care delivery businesses are mostly run by people who have no prior knowledge of how to deliver care. The ACA actually prohibits doctors from even owning hospitals. Which completely enables MBAs and other non-clinical administrators to influence how patients receive care. Call me old fashioned but shouldn’t the people trained and licensed to provide care delivery services be the ones running businesses where care services are delivered? 🤷🏽‍♂️ —— Hi, I'm Dr. Mario Amaro, Founder and CEO Ease and I talk about all things starting, running, and growing a private practice with AI. Follow me, if you are planning to start one or are currently figuring out creative ways to grow one. #PrivatePractice #SelfEmployment #HealthcareOnLinkedin #HeyEase #IndependentTogether

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Another large funding round in the virtual behavioral health space. It's interesting to note Talkiatry's focus on a physician-centric care model with W-2 providers, as opposed to most of the other players who are delivering care with 1099 mid-level therapists. However, it's still not clear to me how they are measuring care quality and outcomes, which is the foundation of true value-based care.

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The 'payvider' becoming a healthcare delivery niche player. It appears all outpatient...infusion, pharma, home health, urgent care, etc. Seeing more signs of consumers being directed by payers. No real, big box hospital purchases. Are beds being isolated and commoditized? #hospitals #healthcare #business #payers

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What does the future hold for retail medicine and virtual care? Walmart is the latest to announce their health center closure. https://lnkd.in/geZpMTkS. This following Optum news, VillageMD closing in Nevada, Teladoc Health problems, etc. What comes next? This is another in a long line of examples that technology and even consumer willingness are not enough when the reimbursement environment does not support particular care models. Are we getting ready to lose all the lessons painfully learned during the pandemic? Or will new virtual care models emerge following this round of closures?

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Today I've been reflecting on where the healthcare industry was when we launched Wheel, and the incredible advancements in care delivery and access that we've seen in just a matter of years. I believe this news is really about innovation, and underscores why organizations partner with companies like Wheel. When providing care is not a core competency, experienced teams play a vital role in helping drive integrated care strategies, rather than a stand alone approach. Those who deliver holistic models — centered on trust, loyalty, and great experiences — will be the transformative forces driving healthcare consumer adoption. Ultimately this is about the players who will drive transformation, and the types of companies that can and will power the next generation of care.

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Here’s your recap of last week’s health IT news 🗞️ 👇 💼 Administrative • Pager + League: The care orchestration solution will be embedded into the patient engagement platform for maternity care.    • Veradigm®: The ambulatory care solutions vendor has announced that it is exploring a merger, sale, or other transaction.    • Kyruus Health: The provider search and scheduling solution said it would add MEDITECH to its list of EHR partners which already includes Epic , Oracle (Cerner), athenahealth , and others.   🥼 Clinical • Clover Health: The physician enablement technology company launched its previously internal-facing clinical decision support tool via its subsidiary Counterpart Health as a standalone solution for external Medicare-focused payers and providers.    • Children's Minnesota + ShiftMed: The pediatric health system is partnering with the on-demand workforce tech platform. 🤝 VBC • Innovaccer: The VBC data & analytics company launched its quality management and reporting platform for health plans. 🤖 AI • Plenful: The AI workflow automation company focused on streamlining pharmacy operations announced a $17M Series A.    • SamaCare: The AI prior auth platform announced a $17M Series B. 💡 Things We Found Interesting • In our view, there’s not enough discussion about why technology pilots in health systems fail. So we appreciated this perspective from Justin R. Brueck at Endeavor Health, on three of the most common reasons he sees things go awry. https://lnkd.in/eKBZ_g2N    • We’re continuing to see stories illustrating both the promise and perils of leveraging generative AI in the practice of clinical medicine. Given the pace of progress, it seems clear that AI will play a significant role in clinical care sooner than later. Lots of thorny questions to work through in a short amount of time. (Here are a couple examples from Yudara Kularathne MD, FAMS(EM) and Graham Walker, MD we appreciated: https://lnkd.in/ePUr2SgE, https://lnkd.in/ej9UpfYg)    • On that note, we’re always interested to read the latest research on how AI solutions are performing in the field. One recent study published in JAMA found that AI scribes significantly reduced time spent in the EHR. Researchers of another, however, cautioned that providers must remain vigilant when using GenAI, based on the fact that Chat-GPT produced different outputs when asked to simplify radiology reports for patients of different races. https://lnkd.in/emNi-_Ai, https://lnkd.in/ejH4KHsq  

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