HealthBiz with David E. Williams

Menthol cigarettes, the FTC's attempts to boost competition in healthcare, the mental health of Jewish college students, and the TikTok ban. What do they all have in common? Not much, except that they were all in the news this week and I chose to discuss them on a rare solo episode. Don't like what you hear? Don't worry, I'll be back next week with a fresh guest. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Massachusetts Association of Health Plans (MAHP) leader Lora Pellegrini got interested in policy and politics at a young age. She had the opportunity to work with luminaries like Ted Kennedy and John Kerry early in her career, as she rose to prominence in healthcare policy. Our discussion focuses on critical issues such as pharmaceutical pricing and hospital efficiency in Massachusetts. We explore the regulatory challenges in drug pricing and the necessity for hospital systems to innovate and enhance performance. Lora provides expert analysis on the impact of major players like Steward Healthcare and Optum in the Massachusetts healthcare sector. She also shares the historical perspective on healthcare reform in Massachusetts, and issues a call for employers to re-engage in support of affordability as they did back in the days of RomneyCare. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Ironically, patient care coordination itself is often uncoordinated. It's spread across multiple providers and administrators, causing frustration for care teams and patients. Lumeon founder and CEO Robbie Hughes has developed an approach that makes the care journey more reliable rather than settling for the current craziness, where patients are expected to be satisfied as long as they get some time with a doctor. One of the really interesting elements of this interview was the discussion of whether we should be willing to trade off some efficacy for reliability. For example, if we had a treatment path that was 80 percent as good but could be followed by 100 percent of the patients, would that be better than striving for the perfect solution that only 1 percent can attain? From a population health perspective, the 80/100 calculus is probably correct, but most of us want to be in that 1 percent. I've certainly had that experience myself of navigating the system with help from well-placed insiders plus my own knowledge of how things work. Robbie is an avid reader who recommends The Experience Machine, Chip Wars, and Ultra-Processed People. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Matthias Hoffman first became conscious of his vision as a teenager. He and his friends in Switzerland dreamed of becoming pilots (none actually did) but Matthias's hopes were dashed early on due to inadequate vision. While pursuing electrical engineering degrees, he realized his strength was in building things. So he left academia and worked in a variety of vision and optical startups, eventually leading significant teams. Many people who could benefit skip their eye exams, and for more than a decade entrepreneurs have been trying smartphone based eye exams and online eyeglass sales, often with virtual try-ons. But those have been failures. The exam interface is too complex and burdensome, and people want to try on their glasses at retail. Eyebot is an automated eye exam designed to produce a prescription at the point of sale, i.e., retail stores. It takes 90 seconds and doesn't require the person being examined to do anything special. Eyebot has developed its own technology and eventually plans to expand beyond the basic exam to more advanced screening for things like glaucoma. But Matthias stresses that Eyebot has no intention of taking away the jobs of eye care professionals. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Most medical bills contain errors. Over-billing and outright fraud are far too common. What's a consumer to do? In this episode, CEO Scott Speranza shares how HealthLock performs automated audits of medical bills by seamlessly connecting with the patient's health plan portal. We also discuss an exciting new partnership with MasterCard that gives many cardholders (including me) free access. I connected my insurance to HealthLock and soon got a helpful audit of my claims (which turned out to be clean --thanks Harvard Pilgrim!) Scott unravels the complexities of coordination of benefits --where he offers reflection on my experience with my dependents--, the significance of automated HIPAA authorizations, and provides practical insights for managing family healthcare. And he shares his views on the delicate balance of privacy and oversight. One thing he recommends (which providers hate) is to wait for a while to pay your medical bills since charges initially attributed to the patient may actually be covered in the end. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Caresyntax CEO Dennis Kogan wants to introduce value based care to the operating room. It's a tall order but Caresyntax thinks they have a formula to benefit the patient, provider and payer. Kogan's parents are surgeons from the former Soviet Union, which gave him a foundational perspective. He studied technology and then business at Carnegie Mellon and Harvard Business School. One of his key takeaways is that quality and efficiency are highly related. Unlike many healthcare entrepreneurs I interview, Dennis's company is active all over the world. There are geographic differences, but they're not as profound as I imagined. The episode explores the impact of AI, including generative AI, on value-based care and the potential for surgical Accountable Care Organizations to more effectively manage quality and total cost of care. It also covers the challenges of entrepreneurship in the healthcare sector, referencing insights from Ben Horowitz's "The Hard Thing About Hard Things," and discusses Caresyntax's efforts to leverage AI in clinical decision-making to transform healthcare delivery. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Growing up with a father whose academic dreams were cut short, and a mother whose resilience in the face of disability was inspiring, Julia Paget's story is not just about her own path but also a tribute to those who shaped her. This seasoned clinical embryologist from the Isle of Wight shares the rich tapestry of experiences that led her from a zoology degree to the forefront of IVF technology. Julia's journey is a compelling narrative of personal growth, family influence, and the pursuit of a career that intertwines human emotion with scientific rigor. Navigating the world of IVF is no small feat, and Julia offers an honest look at the highs and lows of working within the fertility sector. From New Jersey to New Zealand to the stark differences in practice she encountered upon her return to the UK, her insights reveal the impact that culture, teamwork, and innovation have on patient outcomes. Julia's transition from clinician to entrepreneur, facing resistance and complacency head-on, is a testament to the perseverance required in this field. Her stories of building and selling an IVF clinic on the UK's South Coast resonate with anyone who has strived to create something meaningful amidst adversity. Julia casts a visionary eye toward the future of reproductive medicine with her concept for a global IVF network. This innovative approach seeks to connect patients with remote embryologists and fertility nurses, offering guidance and support outside the traditional clinic setting. The recent legal challenges faced by the fertility community, including a significant court ruling in Alabama, also come under scrutiny. Julia Paget's experience as both founder and CEO of The IVF Guide serves as a beacon, guiding listeners through the ethical and practical complexities of a field that is as challenging as it is rewarding. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Explore the transformative art of storytelling in healthcare, featuring Outcomes Rocket founder Saul Marquez. Uncover the compelling journey from Saul's immigrant family roots to his rise as a healthcare influencer, where optimism and a robust work ethic forge a path that challenges the conventional. Our discussion brings to life the nuances of personal narratives in healthcare branding, and how these stories bridge the gap between industry professionals and the communities they serve. Join us as Saul describes his voyage in healthcare marketing, from the classical influences of Cicero and Aristotle stirring a passion for the persuasive arts, to the birth of Outcomes Rocket—a platform for celebrating contemporary healthcare innovation. Saul shares his formative experiences at leading med tech companies and delves into the strategic leap to a podcasting venture that elevates the craft of storytelling to inspire change. Tune in for a thought-provoking discussion on the broader impact of storytelling in healthcare, as Saul and I analyze practical strategies for raising awareness on pivotal issues like transparent healthcare costs and the No Surprises Act. We'll reflect on how data-backed, right thinking in storytelling can foster connection and serve as a catalyst for meaningful progress. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Clinical registries can provide profound insights into disease patterns and treatment effectiveness, and ultimately improve patient outcomes. New technology, including AI enables faster and better data collection and analysis. Today’s guest, Matt Hollingsworth is co-founder of Carta Healthcare, which fuses technology, data, and human expertise in a quest to radically improve outcomes. Matt shares how his mother's battle with cancer ignited his quest to marry tech prowess with a heartfelt mission to improve patient outcomes. I like it when he says he didn't actually plan to start a company.! Matt strongly recommends the book “The Worlds I See” by Fei-Fei Li. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Listen in as Brian Lobley, the innovative CEO of Tango, joins me to unravel the complexities of post-acute care and its crucial role in patient recovery and healthcare economics. Brian shares his journey from his Philadelphia roots to reshaping healthcare through technology (with a passionate nod to Philly sports teams along the way). We explore Tango's mission to revolutionize home-based care for seniors, especially within the Medicare Advantage space, and how this aligns with the growing preference for patients to recuperate in the comfort of their own homes, potentially reducing costly hospital readmissions. As the conversation unfolds, we examine the transformative potential of redirecting resources from financially strained hospitals to more community-centric and home-based healthcare services. We dissect the intricate balance between the need for accessible critical beds and the service demands of diverse patient demographics, encompassing Medicare Advantage, commercial insurance, Medicaid, and dual eligibles. I highlight the vital role of patient and caregiver engagement in the realm of home health, and Brian sheds light on the importance of effective communication and robust support throughout the continuum of care. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Medical records are finally digital, but so much of the valuable data is buried in unstructured form in theclinical narrative that it can be hard to make use of it. It’s a great use case for artificial intelligence. My guest, Chris Tackaberry is a physician and computer scientist turned entrepreneur whose company, Clinithink develops AI software to enable health care and life sciences customers to gain insight from that unstructured information. Clinithink provides applications in rare disease, population health, real world evidence, and revenue cycle management. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Dan Caron takes us on an inspiring journey through the landscape of healthcare tech innovation. When Dan hacked an insulin pump to create a groundbreaking automated pancreas, he not only changed the game for diabetes management but also shined a spotlight on the potential of open source technology to redefine our health experiences. From his father's ingenious barter system sparking a young Dan's tech curiosity to the evolution of his career, merging the worlds of internet business and healthcare, his story is one of relentless passion and the drive to make a tangible difference. Healthcare is on the cusp of a revolution, and AI and open-source technology are key enablers. Dan and I dissect how cooperative platforms like Health Universe are dismantling the walls that have kept life-saving algorithms in academic limbo, instead ushering them into hands-on clinical use. Understanding how this technology evolves from concept to real-world application underscores the vital role of platforms that provide immediate access to advanced tools, and Dan's insights guide us through this new age of medical innovation. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Digitization and AI are transforming pathology by accelerating research and modernizing the clinical workflow. Proscia co-founder and CEO David West's entrepreneurial journey --and experience with digitization and handling personal information-- began with a business converting VHS tapes to disc. We explore David's multidisciplinary approach, combining software, biology, and physics, which led to the creation of Proscia and its flagship platform, Concentriq. This conversation traces his path from academic research at Johns Hopkins University to becoming a key figure in medical technology innovation, highlighting the transition of pathology from traditional methods to digital solutions. The discussion includes an examination of digital pathology's impact on the medical field, emphasizing how Proscia's cloud-based system enhances data management and algorithm development capabilities for pathologists. We also address the broader implications of integrating AI into pathology, including challenges related to healthcare reimbursement and the potential for AI to revolutionize laboratory economics and patient care. Lastly, David provides insights into the future of AI in life sciences and healthcare, predicting its role in biomarker discovery and therapy recommendations. He concludes by recommending the book, The Fish That Ate the Whale --about the Banana King, Samuel Zemurray. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Rajesh Subramaniam has always been the "numbers guy." He leveraged his early aptitude into professional success, currently as CEO of ResultsCX. The discussion delves into the challenges and advancements in customer experience within the healthcare sector. Emphasizing the industry's shift towards a more consumer-centric model, we explore critical topics such as customer retention, the integration of omnichannel strategies, and balancing digital and personal customer interactions. This episode provides a comprehensive examination of the methods employed to maintain customer satisfaction and loyalty, showcasing the pivotal role of companies like Results CX in guiding the healthcare industry's future. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Tom Cotter from Healthcare Ready joins the podcast to discuss the impact of disasters on vulnerable communities. Tom brings a combination of professional expertise and humanitarian insight to the conversation. We delve into the complex interplay of social and economic factors that make certain populations more vulnerable to emergencies, drawing upon his experiences and academic research, including his time in Manila and his long-ago encounter with Dr. Paul Farmer. The episode explores the evolution of Healthcare Ready, an organization formed in the wake of Hurricane Katrina and further developed during the COVID-19 pandemic. We examine how Healthcare Ready has effectively utilized public-private partnerships to create equitable health solutions in crisis situations. We discuss the response to the recent Maui wildfire, illustrating successful collaboration between non-governmental organizations and the importance of pooling resources and knowledge for community benefit. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Julia Regan, CEO of Rx Lightning discusses her leadership in the healthcare technology sector. Julia attributes her success in the entrepreneurial landscape to the discipline and competitiveness honed during her early athletic career in Pennsylvania. The conversation traces Julia's career progression, from her initial role in insurance sales to a strategic position at Novo Nordisk, where she began to blend her passion for healthcare with innovative technology. We delve into the challenges and opportunities in the specialty medication sector, highlighting Julia's role in founding RxLightning. The company streamlines the specialty medication onboarding process, addressing the complex interactions between payers, manufacturers, and healthcare providers. This episode offers insights into the MedAccess ecosystem, likening its functionalities to a CRM system but specifically designed for specialty medications. Julia's journey is a testament to the transformative role of technology in healthcare, emphasizing its ability to provide efficient, patient-centered solutions that improve the quality of care. In what may be a first on HealthBiz, Julia also shows off her company-themed earrings. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Dr. Aasim Saeed, CEO of Amenities Health shares his distinctive insight into the challenges faced by provider organizations post-pandemic and how to solve them. The interview focuses on the technological evolution in healthcare, highlighting Amenities Health's initiatives that are influenced by companies like Amazon and Costco to enhance patient experiences. Key topics include the strategic importance of operational decisions in improving digital healthcare services, such as open primary care schedules and the development of consumer-oriented digital interfaces. We delve into the economics of patient experience prioritization and explore advancements in healthcare technology, including the use of provider directories and the integration of open scheduling with Electronic Medical Records (EMR). Our conversation also covers the emerging concept of a membership model in healthcare, drawing parallels with Amazon Prime, and its implications for patient engagement and financial success. We conclude with a discussion on the potential and challenges of AI in healthcare. The episode also highlights the growth of Amenities Health and its efforts to implement membership models and streamline healthcare services. The book "The Rational Optimist" is recommended for its perspective on challenging conventional thinking, a viewpoint that aligns with Aasim's vision for transforming healthcare systems. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Join me for a great discussion with Diana L. Nole, as she shares her progression from first-generation college graduate to Corporate Vice President of Microsoft Health & Life Sciences and General Manager of the Nuance Healthcare Division. The discussion outlines the pivotal moments and guiding principles of Diana's career, highlighting her evolution within the dynamic field of healthcare technology. From her pivotal role in Carestream's transition to advanced health solutions, to her leadership of Wolter Kluwer Health, Diana's journey illustrates a commitment to technological progress through dedication and innovation. This episode provides a detailed examination of Nuance's strategic integration into Microsoft, emphasizing the profound effects on healthcare technology. Diana emphasizes the enhancement of scalability, security, and compliance in AI applications, positioning Nuance as a leader in shaping the future of healthcare. The conversation concludes by addressing the revolutionary impact of AI in clinical documentation, particularly focusing on the Dragon Ambient Experience (DAX). This segment outlines how generative AI and DAX are transforming physician workflows and patient care by automating documentation and reducing administrative burdens. The episode considers the future of cloud-based solutions and AI integration in improving operational efficiency and security while revitalizing physicians' dedication to clinical practice. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Clinical trials must recruit and retain patients to succeed. But it’s easier said than done –and as a result many trials are delayed, scaled back or even scrapped completely especially when they involve international travel. Today’s guest, Scott Gray founded Clinicierge to reduce logistical and financial challenges for patient to enhance enrollment and reduce attrition. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Ryan Hanna, founder of Sworkit Health, discusses his personal and professional journey, highlighting how his upbringing, combined with his experience in the Army, influenced the core values and mission of Sworkit Health. The conversation explores the company's focus on promoting health and wellness, and how Ryan's leadership has shaped the business. We examine the runaway success of the Sworkit app, including its approach to addressing common gym-related apprehensions. The episode features a case study of a user whose life was positively impacted by Sworkit, underscoring the app's emphasis on personalized wellness and its expansion into the health sector. The discussion concludes with an exploration of digital health's role in today's society, particularly in light of the recent pandemic and its effects on corporate wellness programs. Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.