Editorial Spotlights
Written by Anne DeGheest // 14 October 2014 //

Fixing the Health Care System: The Journey to Value-Based Care
by Seth Frazier, Chief Transformation Officer Evolent Health

There is broad consensus that the current health care system is under immense pressure, and is especially inadequate for an aging and unwell patient population. With premiums and the cost of delivering care increasing rapidly, and with payment reform well underway, health systems are moving from fee-for-service to a value-based model – managing outcomes and assuming financial risk for populations. There is no question that most health systems are in a tough spot during this fundamental transformation. The industry has one foot in today’s volume-based world, and another in value-based care.

Transformation can’t happen overnight. These changes take time and intensive effort on the part of hospitals and physician groups. But the broad implications are clear – more payments will be derived from value-based formulas, where quality and efficiency of care are rewarded. Those that adapt now will reap great benefits, including the freedom to do what’s right for the patient over the long-term. Those that “wait and see” may stand to find access to patients and/or capture of the premium dollar highly restricted.

As a long-term operating partner to leading health care systems, Evolent Health provides the technology, platforms and on-the-ground resources needed to execute on clinical and financial transformation objectives. Health systems require an efficient and scalable approach to infrastructure and analytics tools, and to established expertise on how best to make the shift. Evolent’s role is to provide a tailored payer-neutral and clinician-centric solution – helping its partner systems thrive under a new clinical and business model.

Engaging the physician enterprise is essential to the success of any value-based care model. Physicians, whether affiliated or employed, must be skillfully aligned not only as part of the effort but as its leaders. Enlisting the physician enterprise involves extending physician reach and re-engineering incentives. A fruitful model outfits the physician with better information, support and tools so they can engage with patients in a meaningful way, and vice versa. It is this relationship that is and will remain central to delivering on the promise of value-based care.

As providers look to improve the quality and experience of care, they must also carefully determine how they can take on financial risk for populations in a sequenced, safe manner. A natural starting point is with an organization’s own employees. Starting this way can deliver immediate benefit, and demonstrate executional skill to the market against future vertical integration plans. Providers should also look to structure value-based contracts as a demonstrated approach to growing total risk lives rapidly, and to capturing the returns generated from effective population health management.

Applying a proven model, one that allows rapid mobilization from a standing start, is critical as organizations look for ways to navigate from an uncertain health care present to a brighter, value-based tomorrow that functions better for patients, providers and the community at large.

Adding Efficacy to Large Scale Diabetes Management
By Rick Altinger, CEO Glooko

At Glooko, our mission is to lower costs and create positive outcomes for patients, health systems, and payers through the right combination of patient engagement, provider engagement and population management analytics. We aim to deliver the right care solution, by the right person, at the right time and at the right cost.

Our first challenge is to make things easier for people with diabetes. What we're solving for is finding and helping the high-risk, high-dollar patient - the patient that has diabetes complications and needs more than just two to three face-to-face visits to a clinic per year. To do that, we created a platform that connects to all the major glucose meters and different Android and Apple devices. We are bringing that data together, putting it in the cloud, integrating it into EHR/Care management systems, and then letting providers and payers drill down on their at-risk patients via the Glooko Population Tracker. In addition to connecting the patient to their healthcare team (e.g. physicians, nurses, family members), Glooko also efficiently engages the patient by leveraging their mobile device.

The meter to mobile device connection occurs through the Glooko MeterSync Blue, featuring Bluetooth Smart and our FDA-cleared technology, which provides health systems and payer groups the ability to more cost-effectively enroll diabetes patients into remote monitoring programs without the need for patients to switch to more costly glucose meters. Instead, health systems and payer groups can leverage the tens of millions of meters already deployed to patients worldwide.

From there, we’re transforming the way patients and their healthcare team interact and manage their diabetes. We facilitate remote monitoring by delivering algorithms and flags for providers to easily identify patients experiencing potentially harmful amounts of hyperglycemic (high blood glucose) or hypoglycemic (low blood glucose) events in between clinic visits. By allowing patients to wirelessly download their trusted blood glucose readings, the Glooko diabetes management platform opens the door for health systems and payers to deliver more real-time reminders and recommendations to patients with diabetes. With data also coming from connected blood pressure cuffs, scales and activity devices, (e.g., Fitbit, Moves, etc.), Glooko can also offer additional algorithm-based solutions to help physicians and patients manage the constant dose changes that is inherent in increasingly complex insulin prescriptions.

Moving from Descriptive Data to Predictive Data
By Murray Brozinsky, Chief Strategy Officer Healthline

Data analytics in healthcare has come a long way. However, most data and quality reporting tools often don’t go beyond simply reporting outcomes. Measuring outcomes is important, but to really impact healthcare and bend the cost curve, we need to go from understanding what has happened to understanding what will happen.

In order to get to this next stage of predictive healthcare where clinicians can identify risk and deliver targeted interventions before a patient gets sick, we need to take a comprehensive look at both structured and unstructured patient data – not only the clinical information provided in a patient record but also any relevant non-clinical data (i.e., psycho-social, socioeconomic and environmental factors) often found in unstructured formats, such as free-text physician notes, patient histories and hospital admission notes. It’s estimated that 80 percent of today’s health data is in unstructured formats and therefore not being leveraged by current analytics solutions. Clinical natural language processing (NLP) technologies, combined with rich health taxonomies and rules engines that intelligently map medical concepts to clinical terminology, can help clinicians tap into valuable information locked in unstructured data.

This would considerably enhance the power of predictive factors to stratify patient populations by risk level so clinicians can effectively identify those patients who are at high-risk for certain conditions and take appropriate actions. Take Congestive Heart Failure (CHF) for example – CHF is one of the seven conditions that account for 30 percent of potentially preventable readmissions and classified as a “high avoidable readmission” currently penalized by the CMS. Having the ability to “read” the narrative information and use the insights to more accurately identify CHF patients at high risk of being readmitted to the hospital is the first step in matching the right care team with the right interventions to the right patients.

It comes down to being able to turn relevant data into actionable insights that will allow clinicians to make better, more informed decisions and ultimately make a difference in patient outcomes.

Owen Tripp: Can Quality Data Mend Healthcare?
Written by Anne DeGheest // 31 August 2014 // Conferences, НealthTech Capital

Conference spotlight By Owen Tripp, Grand Rounds Health

At the Healthtech Conference on October 15, 2014, Owen Tripp, Co-Founder and CEO of Grand Rounds will be joining our much anticipated panel, “Business Lessons Learned from Winners,” along with Bryan Roberts of Venrock, Jeff Tangney of Doximity, Peter Hudson of iTriage and Jeff Arnold of ShareCare, WebMd.

What makes a winner? This panel will discuss how to build companies from the idea stage to a sustainable revenue model. HealthTech companies have high market risk and there are a number of factors to consider to ensure success. Who are the stakeholders? Who will pay? How do you best iterate, quickly, to define the right value proposition? Why is it one of the greatest challenges to explore new and unproven revenue models in a changing payment system? What is the best time to partner to scale up? What are the pitfalls and hard lessons learned in scaling up too quickly?

Mending healthcare using quality data by Owen Tripp, co-founder and CEO of Grand Rounds

When people ask me about my favorite career accomplishment to date, I think they expect me to talk about co-founding or pioneering eBay’s approach to big data. But what we’ve done with Grand Rounds, even in just the few short years that we’ve been in existence, is much more meaningful and important to me. Our healthcare system is broken, and although we haven’t fixed it yet--that will take years, and a lot more solutions than just Grand Rounds--we’re putting pieces of it back together every day. It’s a worthy cause, and I’m willing to devote my life to it.

As an entrepreneur, I want to solve the problems that really matter. Grand Rounds is about tackling one of the biggest challenges our country is facing: people’s inability to find and access the best medical care when they need it most. I’ve been more energized and received more satisfaction in figuring out how to knock down the enormous walls that separate people from the doctors they need than anything else I’ve done.

Right now, when people need a top medical specialist, they search online or ask friends and family. If they really want to take their lives in their hands, they’ll look on review sites—which is notoriously unreliable when it comes to specialty care (one Stanford study noted an inverse correlation between the scores on a well-known review site and surgical outcomes!). But now, due to the confluence of big data and the ability to use it, we can leverage a proprietary algorithm that scores medical specialists using many different factors, including institution, publication history and outcomes. In doing so, we’re able to truly demystify which doctors are practicing the best care. That helps our patients get to the right specialist at a critical moment in their healthcare cycle. This couldn’t have been done just a few years ago.

But it’s not just data we need--it’s services that make people feel as though that they have a fighting chance when they’re inside the healthcare system, instead of consistently feeling beaten down, misled, and dehumanized (haven’t we all felt like “a number” at some point?). There’s no reason that every person in the country shouldn’t have access to their own medical records, or be able to interact with the healthcare system under their own terms. We have to build these foundations with patients—ourselves, our friends, our families, our neighbors—in mind. We constantly hear from our patients that Grand Rounds was the only bright part of an otherwise difficult patient journey.

It’s been hugely rewarding to build a team of people that are as deeply passionate about solving these problems as I am. Our sense of mission pervades the organization, and drives everything we do. It’s not necessarily a problem that we’ll solve in our lifetimes, but that doesn’t detract from the immense pleasures of the journey.”

One of the main themes of HealthTech Conference 2014 is what really makes a winner? The answer is to build a sustainable business, not just a product. Successful HealthTech companies deliver a value proposition with a provable ROI for the customer. As our healthcare industry evolves, these disruptive companies continuously investigate customer unmet needs. The driver is to provide an ongoing solution for these critical pain is just the enabler.

"The HealthTech Conference uniquely brings together healthcare systems, payors, suppliers, entrepreneurs, and investors in practical engagement and conversation to advance innovation and technology for the betterment of humanity."
 –Amir Dan Rubin, President and CEO, Stanford Health Care

Among our many panels, we’ll also investigate the unmet needs of the key players in the evolving healthcare ecosystem. For startups and large corporation, understanding the unmet needs of ALL the stakeholder is essential. How important are these unmet needs for potential buyers and users? What will it take for them to pilot or buy new solutions? How do they fit in the existing clinical workflows? Are they conflicting with other stakeholders? Are they changing? Do they need to integrate with other solutions?

Join us at the HealthTech Conference where we bring the key healthcare stakeholders together:

  • Providers (Stanford hospitals, UCSF, Sutter Health, Cedars Sinai, Kaiser and VNA)
  • Employers (Chief medical officers from Target, Cognizant and Safeway)
  • Third party payers (CMS/Medicare, United Health/Optum, and Blue shield California)
  • Patients/Consumers ( AARP, Adidas, ShareCare, iTriage, HealthLinkNow, Omada Health)
  • Physicians (Doximity, Doctor on Demand, GrandRounds Health, MedHelp/Physicians Interactive)
  • Leading Investors (Canaan, Interwest, USVP, Venrock, Norwest, CHCF, Merck Global Innovation Fund)

Come collaborate with our 50 speakers on evaluating our progress in changing healthcare delivery and working together to build the new HealthTech economy. We are all counting on your input - every patient, entrepreneur, provider, payer, established corporation, service provider, and investor – to drive the exploding healthtech sector in the coming year.

Check our agenda at The HealthTech Conference 2014, and register before our September 15 price increase.

HealthTech Conference 2014: What new HealthTech companies will be the winners?
Written by Anne DeGheest // 30 August 2014 // Conferences, НealthTech Capital

HealthTech and Digital Health investment doubled in 2013 to over $2 billion. That’s enough to prove that the healthcare revolution of the century is definitely here bringing massive changes that are affecting healthcare providers and payers alike. You just have to look at the transition from fee for services to value-based healthcare delivery services to know we’ve arrived at the age of Retail Medicine with the growing empowerment of patients.


Above: Anne DeGheest, Founder & Managing Director, HealthTech Capital

Recent healthcare IPOs by Castlight Health and have captured the curiosity of consumers, technologists, and investors. Without question, healthcare as an industry is gaining recognition as one of the hottest sectors for start-ups. This is how Anne DeGheest, Founder & Managing Director of HealthTech Capital, puts it:


“Right now, there is a tsunami of opportunities to create very disruptive healthcare companies. The country is re-shaping its largest industry, and it’s the biggest experiment we’ve ever done with the American economy.”

With other epic changes in our healthcare system — things such as accountable care organization and public or private health insurance exchanges — there are massive opportunities to develop new tools and services to provide better healthcare anywhere and at lower cost. The practical issues are how to successfully grow a sustainable HealthTech business.

This won’t just affect existing players: providers — providers, healthcare manufacturers, and payers — but also new entrants from big companies like Qualcomm, Apple and Samsung to a plethora of successful start-ups.

Along with these changes come new business models:

  • Investment Dynamics – Investments in HIT/digital health have been doubling every year. In Q2, 2014, Venture capital (VC) funding in the sector more than doubled with $1.8 billion raised in 161 deals — a 104 percent increase compared to the $861 million raised in Q1 2014. Ten of those deals were for more than $50 million each.This was the first billion dollar quarter for the sector. And the $2.6 billion raised so far this year has already exceeded the $2.2 billion raised in all of 2013. It was the first billion dollar fundraising quarter for the sector which has now raised almost $7 billion in venture funding since 2010. Healthcare IT funding rounds have now crossed 1,000. Some of the most active venture investors include the 2014 Healthtech conference panelists from Venrock, Canaan, Interwest, Norwest, HLM, USVP and Merck Global Health Innovation fund.
  • Diagnostics – The “Retail Medicine revolution” is being enabled by new business models where diagnostic technologies are being decentralized and brought directly to the consumer. Theranos now delivers disruptive blood diagnostic tests via Walgreens drug stores at a lower cost, requiring only a simple finger prick. Emerging Companies like Doctor On Demand and Grand Rounds bring the doctor expertise directly to the consumers when needed. There are an increasing number of higher medical-grade sensors and quantified-self technologies that are becoming more accurate or FDA-approved like AliveCor EGG mobile device.
  • Care Anywhere – Value-based care will replace Fee for Services volume-driven payment system. This realignment of incentives is opening a multitude of opportunities for providing care anywhere and identifying patients that could benefit from more proactive management of their chronic disease at home via technology enabled healthcare services. However, as we’re currently in the middle of a hybrid payment system, U.S. providers are still exploring new ways to understand and control their costs better via population management. These capitated business models are still being proven.
  • Aging at Home – This is one of the hottest area with new approaches using smart sensors at home, wearable technologies and smart analytics to trigger escalating alerts and intervention. These technology-enabled services are still validating their business models with multiple target customers: family/patients, capitated provider system, post discharged hospitals, and payers.
  • Digital Therapeutics – Omada Health is one of the pioneers in a new category of medicine: digital therapeutics to change chronic patient behavior in order to improve outcomes and reduce costs. By validating their effectiveness with clinical trials for pre-diabetic patients, they are engaging physicians to prescribe these therapeutic apps. Third-party payers and self-insured employers are actively looking for more cost-effective solutions with validated outcomes.

There’s nothing we want more in this innovation economy than new business models. But what makes the difference between a sustainable healthcare business and simply building a product?

Successful HealthTech companies will be those that deliver a value proposition with a proven ROI for the customer. As our industry evolves, these disruptive companies continuously investigate the customer’s unmet needs, and find ways to meet them.

Amir Dan Rubin, President and CEO, Stanford Health Care

Above: Amir Dan Rubin, President and CEO, Stanford Health Care

The key to success is to provide an ongoing solution for these critical pain points that a lot of people are willing to pay for. And technology is just the enabler.

HealthTech Conference is back on October 14 and 15, 2014 in San Mateo, CA — but this year with two full days of collaboration and workshops. Join the leaders in the healthcare industry as we discuss next steps in working together to grow successful businesses in the changing healthcare ecosystem.

“The HealthTech Conference uniquely brings together healthcare systems, payors, suppliers, entrepreneurs, and investors in practical engagement and conversation to advance innovation and technology for the betterment of humanity.” – Amir Dan Rubin, President and CEO, Stanford Health Care

Join us October 14-15 in San Mateo, Ca. Save 10% off with code VENTUREBEATHTC14.

Metrics for a Successful Startup is Revenue & Sustainability, Not How Much Money They Have Raised!
Written by Anne DeGheest // 29 June 2014 // startups, Angel funding

Digital Health funding is exploding. Last year, startups received more than $2 billion and that amount is expected to double this year. Please check my video interview at the Digital Health Summer Summit on How the HealthTech Conference on October 14 and 15, 2014 will address the Right Impact Metrics to build sustainable companies.

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Digital Health Summer Summit - Jill Gilbert and Anne DeGheest talk “Digital Health Markets to Watch”
Written by Anne DeGheest // 16 June 2014 // Conferences, digital health

As we ramp up for Digital Health Summer Summit 2014, Anne DeGheest, who will moderate the “Gaining Traction: The Markets to Watch” panel, shares answers to five burning digital health questions:

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