Patty Sipes

Employees are the heart and soul of your organization. Learn how to treat them like they deserve

3

What does calling my cable company have to do with Medicaid? I had to call a certain notorious cable/internet provider recently. The one with customer service so bad that it was skewered in a classic South Park episode. I blocked out an hour and braced for my inevitable PCOM aneurysm rupture. Shockingly, it was a breeze. The rep was friendly, and my issue vanished in minutes—a far cry from their usual 'dial-one-to-scream-into-the-void' reputation. So, what changed? Competition happened. A decade ago, our choices for cable and internet were as limited as the soda options in a health spa. Now, thanks to a buffet of streaming services—even including live local TV—the old cable giants had to step up their game or step aside. Turns out, competition is more effective than caffeine at improving service quality. Why can't Medicaid beneficiaries get the same treatment? Currently, most Medicaid coverage is through Managed Care Organizations (MCOs), where the state pays a fixed monthly rate per patient. This model should spur cost-efficiency, but it often just limits the scope of care. Low payments to doctors, restricted access to necessary services—who does that help? Could strict government regulations guarantee better service? Maybe, but FA Hayek (and a basic reading of history) prove that bureaucracy alone can't engineer excellence. And choice for Medicaid patients? Virtually non-existent. Many areas offer just one MCO. If you're dissatisfied, too bad—there's no alternative. It's like being stuck with dial-up in the era of fiber optics. Long wait times for basic procedures, no freedom to seek better coverage... It's eerily reminiscent of the old cable monopoly days. In the private sector, at least there's a semblance of choice: HMOs, PPOs, HSAs... But for Medicaid recipients? Sorry, the state chooses for you. Hope you like it. Our Medicaid system desperately needs a dose of competition. Isn't it time we offer Medicaid patients the luxury of choice that drives quality up and costs down? https://t.co/C7XE6CpIIP Joe Grogan Lisa Grabert Joanne Spetz Cheerag Upadhyaya, MD, MBA, MSc, FAANS, FACS Brian R. Gantwerker, MD, FAANS, FACS Sanjay Dhall Larry Bucshon, M.D.

15

6 Comments

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

15

Health systems everywhere are prioritizing supply chain optimization to drive cost savings. But to go beyond just the financials, what’s the secret to long-term success? In Advantus Health Partners ebook, we reveal how high-performing supply chains are built with: 1. Long-term, stable supplier relationships 2. KPIs that hold hospitals and suppliers mutually accountable 3. Ongoing value chain analysis These strategies ensure not only cost reduction but also lasting value and operational excellence. Download the ebook to learn how your health system can unlock these insights and create a high-performing supply chain in partnership with the right GPO. https://lnkd.in/gavG4csm #Healthcare #SupplyChain #GPO #CostSavings

26

California Bill Would Require State Review of Private Equity Deals in Healthcare — Consumer advocates and labor unions are enthusiastic about the plans, but hospitals are not A bill pending in California's legislature to ratchet up oversight of private equity investments in healthcare is receiving enthusiastic backing from consumer advocates, labor unions, and the California Medical Association, but drawing heavy fire from hospitals concerned about losing a potential funding source. Hopefully, more states will initiate the same approach to keeping close tabs on private equity buying healthcare-related entities. Private equity firms raise money from institutional investors such as pension funds and typically acquire companies they believe can be run more profitably. Then they look to boost earnings and sell the assets for multiples of what they paid for them Critics say the profit-first approach isn't good for healthcare. Look to Stewart Health Care where the CEO and C suite lined their pockets while driving the health system into the ground. "Almost all of the most distressed U.S. healthcare companies are owned by private equity firms." Time to rein in private equity vultures out there in healthcare trying to make a quick profit, raising the costs of healthcare in their quest to generate profits. #privateequity, #runningthehospitalintotheground, #vulturecapitalist, #forprofithealthcare https://lnkd.in/ea3pFz43

5

Interview of David Benshoof Klein, CEO Click Therapeutics, Inc. by Marc Sluijs at Tech Tour's Mental and Brain Health event We create, discover, develop PDTx, 160 people, currently in the US, expanding into Asia and Europe. How does Click look at patient-centricity? There has been a move in that direction in pharma. I thought pharma would love DTx straightaway. They didn't. But things are moving and we had a lot to learn ourselves. In our first programme you had to answer 40 questions. People just dropped out. Now we are down to 7. Engagement science needs to be a core competency. You have to give back to patients. We created a patient alliance. You have to tell that why they are doing something and what they can get out of it. Timing is key as well. When do you notify someone and how? We learned early on that patients learn to ignore notifications. Well-calibrated SMS on the other hand work. You have a number of major pharma-partnerships. How did that happen? We are more structured like a biotech company. On our team 40 are in the clinical, 75 in the technology and 10 in the regulatory team. With a partner that is much like them, they can leverage a lot of their existing infrastructure, assets and capabilities. If you look at our clinical trials, they are very robust and target the same endpoints that a drug trial would target, using very strong controls (that control for time on task etc.). You said that pharma will become obsolete if it does not become digital. How do you see DTx and drugs coming together? We have seen new FDA guidance recently. Should a software show that a drug delivers better outcomes in combination with that software that can get it's own approval. This could prevent loss of exclusivity. We will see a digitalisation of drug portfolios. It might not be as quick as I think, but it will happen. Many drugs will be developed with a companion app attached to it. You can call providers and ask them if adding a certain outcome would affect their prescribing behaviour to understand the impact.

26

Since '21 Nishon Jones has helped lead the shift in how UC Davis evaluates and reviews pharmacy purchase data. "I can pull any data I need from the platform. There’s no need for downloading and running and rerunning data, loading new NDCs, or manually looking up prices." Stay tuned for more on Nishon. In the meantime, read more about UC Davis, Nishon, and their team's success here

14

"Labor costs are also on the rise despite health systems offloading expensive travel nurse contracts. Fierce competition for talent has forced organizations to offer signing and retention bonuses, increase salaries and redesign benefits. Strata's Monthly Healthcare Industry Financial Benchmarks report in late July showed labor expenses grew 5.2% year over year in June." SPOT Imaging's PathTracker™ allows operators to complete all of their daily check-out or check-in scans in the time it would normally take to hand-scan just one bulk container, freeing up personnel to complete other critical functions. Automation is a cost-saving, long-term solution. https://lnkd.in/gR6Z7YnA #Histology #ROI #Increaselaboratorymargins #anatomicalpathology

9

🎙️New Podcast Episode: Beyond LDL and HDL On episode#4 of The Healthspan Project, we talk about why the standard cholesterol panel just isn’t enough to evaluate heart health completely. We dive into additional markers that can not only provide a better understanding of cardiovascular risk, but also help preserve quality of life (healthspan) as we age, by preventing adverse age-related events such as a heart attack. Listen to this full episode of The Healthspan Project wherever you get your podcasts 🎙️ #thehealthspanproject #longevitypodcast #peterattia #apob #ldlparticles #healthspan #longevity #northernvirginia #longevitydoctorsnearme

8

🤔 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

5

Each year, Modern Healthcare's Top 100 includes numerous CEOs from massive hospital systems, PBMs, digital health/technology companies and carriers whose actions have played a significant role in creating the most expensive healthcare system in the world, one that delivers shockingly poor outcomes. It’s no surprise, given that many of these institutions are prioritizing profits over patient care, and in some cases, they’ve been found guilty of practices that harm both taxpayers and vulnerable populations. Let's take a look at some of the past honorees—leaders from companies like Tenet Healthcare, which paid over $500 million in fines for defrauding Medicaid and exploiting pregnant women through illegal kickback schemes, or Pfizer, whose $2.3 billion settlement for fraudulent marketing was the largest healthcare fraud case in history. UnitedHealth Group leadership always makes the list and has faced multiple False Claims Act lawsuits for inflating Medicare Advantage payments, and Oak Street Health, under Annie Lamont, recently agreed to pay $60 million to resolve allegations of kickbacks in Medicare Advantage recruitment. Centene Corporation, led by Sarah M. London, has paid billions to settle claims of overcharging state Medicaid programs. UPMC, RWJBarnabas Health, AdventHealth, Ascension and other hospitals' leaders are always on the list. And we cannot leave out Steward Health Care's Ralph de la Torre. He has made the list multiple times, including as recently as 2021. In all fairness, the list is "most influential," not necessarily "most influential in a good way..." Look, It’s not about the list itself, but imagine the powerful statement we could make if those who want real change inundated Modern Healthcare with a new kind of nominee. It would serve as an indictment of the current system—a call for leaders like Marilyn Bartlett, Cynthia Fisher, Dave Chase, Health Rosetta-discovering archaeologist, Kevin Lyons, Dave Chase, Health Rosetta-discovering archaeologist, Hugh O'Toole, Ryan Kline, Mark Cuban, Scott Conard, MD, Stacey Richter, Ann Lewandowski.... those who are genuinely working to reshape healthcare for the better. Let’s show that we demand integrity, transparency, and results—not just shareholder returns and growth. Make your voice heard- it’s time to send a message to the industry that we want a different kind of influence—one that is about integrity, transparency, and results for the American people. #healthcare #leadership #changemakers #modernhealthcare #nominate #transparency

35

12 Comments

Critical Issues in Renal Care Marketing Practices Demand Immediate Attention The renal care community is confronting a critical challenge as predatory marketing practices by companies like NxStage Medical, Inc. and Fresenius Medical Care come to light. These organizations exploit brand ambassadors and champions, who misuse the term “advocate” to promote biased, product-focused narratives under the guise of patient support. This troubling tactic undermines trust and raises serious legal and ethical concerns. Brand ambassadors often use their journeys to appear as impartial advocates while covertly promoting company products. This deceptive blending of advocacy and marketing misleads patients and caregivers, who may mistake biased endorsements for genuine guidance. Such practices erode the trust foundational to our community and hinder patients’ ability to make informed decisions about their care. Why This Matters 🔍 Deceptive Advocacy: Presenting marketing as genuine support damages the credibility of patient advocates and creates an environment where misinformation thrives. 🤝 Trust Erosion: Patients rely on transparency to navigate complex decisions. Misleading tactics harm vulnerable populations who deserve unbiased resources. ⚖️ Legal and Ethical Implications: These actions may violate Federal Trade Commission (FTC) guidelines on disclosure and advertising, as well as Medicare and ESRD standards. Regulatory agencies are now investigating the breadth of these issues. 🌍 Systemic Risks: If unaddressed, these practices will normalize unethical behaviors, creating widespread barriers to equitable care and advocacy. The Federal Trade Commission Centers for Medicare & Medicaid Services, and #ESRD networks are stepping in to address these violations and hold organizations accountable. These investigations clearly show that predatory marketing practices and deceptive advocacy will not be tolerated in renal care. This oversight is critical to restoring transparency and ensuring patients receive the ethical, patient-centered support they deserve. The renal community must unite to demand accountability and prevent further harm. Advocacy is a cornerstone of renal care—built on trust, authenticity, and an unwavering commitment to patient well-being. Misusing advocacy for profit undermines the efforts of true patient champions and weakens the entire care ecosystem. It’s time for meaningful dialogue. Providers, policymakers, and patients must collaborate to enforce stricter disclosure requirements, stronger compliance standards, and a renewed focus on ethical practices. #RenalCare #TransparencyMatters #EthicsInHealthcare #AccountabilityNow Andy Pate Joe Turk #JamieBull Craig Cordola, Ed.D, MBA, MHA #HelenGiza Brigitte Schiller, MD Michael / Christina Gilchrist Jimmie and Dawn Bates

1

CompassPoint Health Introduces Healthcare 2.0 26 December, 2024 SACRAMENTO, CA CompassPoint Health (CPH) is set to introduce its revolutionary technology that will allow everyday Americans universal access to care. "America's healthcare system is broken, and patients' rights are at a historic low point" stated Founder and CEO Gary Brant. "I am proud to put CPH at the forefront of change, having a direct impact on millions of patients who will have the power in their hands to access life-saving care during medical emergencies". The California company is planning the first trials of its ground-breaking technology during the first quarter of 2025. Interested parties may sign up to be first in line for access to the CPH System by visiting https://lnkd.in/eC-C7hTC #healthcare #nursing #patients #california #medical #ambulance #emt #emergencyroom #hospital #clinic #doctors #medicalemergency

12

10 mid-market PE deals from the past week: ➡️ Vector Capital Management has acquired Bigtincan Holdings, which provides sales enablement software and AI solutions. ➡️ Argosy Healthcare Partners sponsored a recap of Nicklas Medical Staffing, a FL-based staffing firm for pathology and histology labs ➡️ Platinum Equity invested in Global the Source, a master distributor of HVAC/R components, with will be merged with existing Platinum portfolio company MARS ➡️ RECOGNIZE invested in SDG Corporation, a CT-based provider of cybersecurity services ➡️ CES Power, a live events infrastructure firm owned by Allied Industrial Partners, acquired Base Craft | Nationwide TV and Film Equipment Leasing, a provider of services and equipment for the motion picture industry ➡️ OpenClinica, a MA-based portfolio company of Thompson Street Capital Partners, acquired BuildClinical, a NY-based provider of patient recruitment software for academic researchers ➡️ Comvest Private Equity bought Bland Landscaping Company, an NC-based provider of commercial landscaping services ➡️ Morgan Stanley Capital Partners agreed to buy Prescott's, a CO-based provider of outsourced clinical engineering services ➡️ Priority Courier Experts Express, a Minneapolis-based portfolio company of TRIDENT acquired Indiana's NOW Courier Inc. ➡️ TTDS Thermal Technology Distribution Solutions, a Cincinnati-based portfolio company of Gryphon Investors, acquired Applied Thermal Systems of Minneapolis ➡️ Echo AI (acquired by Calabrio), which uses generative AI in a customer conversation platform, was acquired by Thoma Bravo-backed customer interaction analytics specialist Calabrio, Inc. ➡️ Amulet Capital Partners, LP acquired Theoria Medical, a managing service org for senior living communities #PrivateEquity #MergersandAcquisitions #Acquisitions #PE #Acquisitions

74

2 Comments

Transforming Access to Medications with BioMed Skyward Rx is proud to share the BioMed program, a game-changing solution for both employees and employers. With BioMed: ✅ Employees enjoy zero copays on all medications, including many high-cost specialty drugs. ✅ Employers save significantly on pharmacy costs—without sacrificing quality or coverage. ✅ No insurance changes required: the program seamlessly integrates with your current healthcare plan, so implementation is simple and stress-free. ✅ Employers can add the program anytime, offering immediate value without disruption. Add in unlimited telemedicine for primary care, urgent care, mental health care, Precision medicine, hospital indemnity, and more that further enhances the benefits to the employees. All this is done at zero net cost to our employer partners and their employees. Attention Brokers! Are you looking to enhance your offerings and deliver even more value to your employer clients? Adding BioMed to your portfolio is a great way to differentiate yourself and help employers tackle rising healthcare costs while boosting employee satisfaction. This innovative program is a win-win for everyone. Let’s revolutionize how we think about healthcare benefits—together. Curious to learn more? Let’s connect! #precisionmedicine #lowerhealthcarecost #employergroups

10

The first 10 drugs selected for Medicare price negotiations based on the Inflation Reduction Act passed in 2022 by the Biden-Harris administration will soon publish negotiated prices. Prior to this act, the government was forbidden to negotiate drug prices. Each year, more drugs will be added to the list as this legislation focuses on making medications more affordable. I'm hoping that asthma medications make the list soon. #reducemedicationcosts #medicare #inflationreductionact #supportourretirees #drugcosts

1

Great Post Bob ... I have said a few times... "The role of Supply Chain in healthcare is evolving significantly, shifting from a transactional role to a strategic function with a direct impact on financial performance. Supply Chain now has a presence at the C-level, underscoring its importance in driving margins and supporting sustainable financial models. By adopting a holistic approach to expense management and overseeing all non-labor spending, Supply Chain leaders can create substantial value.And its not all created equal. Exmaple: reducing costs by just 5% can yield the same profit impact as increasing revenue by 100%, highlighting the efficiency of cost management over revenue initiatives in improving profitability. This transformation aligns closely with strategic imperatives around delivering higher value with fewer resources, supporting revenue generation, and enhancing competitive advantage. Moving towards clinically integrated, population health-focused, and value-based contracting models is critical for the future."

7