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Health Affairs This Week places listeners at the center of health policy’s proverbial water cooler. Join editors from Health Affairs, the leading journal of health policy research, and special guests as they discuss this week’s most pressing health policy news. All in 15 minutes or less.
Hello, and welcome to Health Affairs This Week. I'm your host, Beyers. We are recording on 03/16/2026, which will go live a couple weeks later. So hopefully, we all survive the East Coast storm. Today on the pod to talk about their new book, Massively Better Healthcare, The Innovator's Guide to Tackling Healthcare's Biggest Challenges, we have Halle Halle, welcome to the program.
Halle Tecco:Hey Jeff, good to be here. Thanks for having me.
Jeff Byers:So, we're gonna talk about the book. Read it, it was a fun read. I really thought there were some great insights in it, you know. But one of things I wanna talk about before we get into the actual content of the book, I noticed you are on the one word healthcare divide. Any comments on that?
Halle Tecco:Yeah. You know, that's interesting. I think that, like, what you can fit more in if you use health care as one word. Right? That's like one less space.
Halle Tecco:So over time, my character count is more efficient.
Jeff Byers:Yeah. Yeah. Well, don't tell it to freelance writers that are getting paid by the word, but
Halle Tecco:Yeah.
Jeff Byers:Thanks for weighing
Halle Tecco:in. That's true. True. They are the other on the other side of the debate.
Jeff Byers:Yeah. Well, thanks for weighing in on that debate. Moving on to the book. Very quickly, who is this book written for?
Halle Tecco:Yeah. So the subtitle of the book is The Innovator's Guide to Tackling Healthcare's Biggest Challenges, and we very intentionally chose the word innovator rather than entrepreneur. The definition of innovation is using new ideas, products, or processes to create value and solve problems. And while all good entrepreneurs are innovators, not all innovators are entrepreneurs. You can, of course, develop new ideas, products, or processes in all sorts of environments.
Halle Tecco:Doesn't have to be a new company, a new venture. So that's a long way of saying this book is for anyone who wants to understand how the health care system works and help make it massively better regardless of their current role.
Jeff Byers:In the book, you write about consumers being a sleeping giant in health care, and I thought this was a pretty interesting thought. But do you see this giant through, like, more of a cultural or economic lens?
Halle Tecco:You're not gonna like the answer, but can I say both? I think historically, health care has been very paternalistic. There's information asymmetries, and doctors and institutions have historically held the decision making authority, but that has and and will continue to change. Patients can better research conditions, track their health with devices, access their medical records, connect with communities facing similar conditions. We're also seeing more tools that help people actively manage their health from remote monitoring, at home diagnostics, digital health platforms that inevitably give people more control.
Halle Tecco:But I think that the real driver so that's cultural, but I think the real driver of the consumer awakening is an economic one. As all of your listeners know, health care costs are spiraling and people feel it. Research shows that the majority of Americans of working age struggle to afford their health care, and this financial pressure is pushing consumers to act more like traditional consumers, asking questions about price, quality, alternatives. And in fact, while I was writing the book, employees at Johnson and Johnson and Wells Fargo actually filed lawsuits against their own employers over how their health benefits were managed. They argued that their employers who are fiduciaries of their health plans failed to properly manage health care spending, and they overpaid for prescription drugs, which raised costs for employees.
Halle Tecco:And that sort of sophistication that we're seeing amongst employees and having them speak out and sue their own employers to me, shows that this is changing from an economic, pressure.
Jeff Byers:Yeah. I'm glad you brought up that case because that was the one of the more wilder examples, in the book of, like, recent things. So Yeah. So it was kinda interesting. But when you think about the, sleeping giant, like, when you think of okay.
Jeff Byers:So it's both. It's economic and it's cultural. You know, wearables are not new. You know, I'm wearing an Apple watch to out myself with that. Telehealth has been around for some time.
Jeff Byers:Like, these things have had a lot of run rate up to that. So, like, is the economic lens really shaping behavioral change that we're seeing now is kinda what I'm
Halle Tecco:trying
Jeff Byers:to get to.
Halle Tecco:But I think on the cultural side and what you're saying they've been around, but they haven't been really used at scale. I mean, even like telehealth, it really took COVID to get us comfortable with using telehealth for a lot of specialties and to get the reimbursement in line with it. So I would say while telehealth has been around as a technology, as something that is used commonly is not until the last five or six years. I would say the same thing about wearables. Well, you know, the Apple Watch has been around for eight years, ten years.
Halle Tecco:I don't know how long it's been around. You know, AuriRing, that's also kind of a company that's over a decade old, but really only seeing the sort of market penetration in the last few years where it's becoming more mainstream and not just, like, for biohackers, wealthy biohackers. These tools are becoming more mainstream. So there has been a buildup. It's not like a surprise.
Halle Tecco:Like, surprise, we have these options. It's like, we're we're at the point where they've become more sophisticated so that their their use case is actually way more valuable than they were when they were first introduced.
Jeff Byers:And so moving on with that, you write about impermanence as a challenge and an opportunity. Can you expand on that in the context for a potential innovator?
Halle Tecco:Well, so what I mean by that is that healthcare can feel immovable because the stakeholders are so large and so entrenched, but we don't have to treat that like an inevitability. I think the exact words I say in the book are systems built by humans can be changed by humans. We have this patchwork system that was built over time, and I think that it can also be rebuilt over time. And we think about it like policymakers have limited terms, companies rise and fall. We've seen what's happening to all the health plans now.
Halle Tecco:You know, new inventions replace the old, the balance of power changes, incentives change, consumer demands change. So nothing is inevitable or fixed forever. And so for innovators, I would say this means two things. First, it's helpful to understand how the current system came to be. And second, you should recognize that windows for change do open as policies shift, technologies emerge, or just simply with time.
Halle Tecco:So while health care can feel static, it's actually constantly in motion, and that motion is really where innovation can happen.
Jeff Byers:Kinda off the cuff is when you look at the past ten years, whether it you know, we don't have to go into wearables or telehealth. Like, what what has been, like, a an opportunity that you think has been like, window has been opened?
Halle Tecco:Let's just talk about EMRs or EHRs. Right? We you know, that was something that we had to use a lot of incentives, a lot of money to get what was 36,000,000,000 was meaningful use. So we had to literally pay hospitals and providers to adopt the HR, but now, you know, now it's ubiquitous. I don't think there are many doctors that are still working on paper today.
Halle Tecco:And so now kind of the next frontier there would be more, like, really getting to interoperability and really making that seamless so that we own our data, that we're able to share our data. And so I think that would be a a good example that is, like, broad and touches every single one of us.
Jeff Byers:So in the book, you write about the four ingredients of innovation. So I don't wanna take away sales from the book. So can you quickly go over those four ingredients?
Halle Tecco:Yes. So I call them rules, the rules of Mass Living Better Healthcare. And the first rule is to work from the inside out, not the outside in. So instead of starting with a shiny technology like AR or VR, or AI, and then hunting for a use case, you start with the problem you're trying to solve and you become, the word I like to use is, an anthropologist of that problem. So the problem is generally more fixed than the solution.
Halle Tecco:You may try out a few solutions before you find the right one, and that right one might change over time, and you have to be willing to be agile and change your product in the face of of new information. So that's how you really build solutions that solve problems by focusing on the problem, becoming an expert in the problem, and and build for tangible results instead of just adding complexity and cost. The rule two is to align the margin and the mission, and as public health folks, this is one that I think is right up our wheelhouse. We know that health care is full of misaligned incentives, and so many organizations profit from making health care worse. And so this rule is really encouraging people to realign those incentives so that the margin and the mission of the business become two sides of the same virtuous cycle, financial sustainability and scalability that's rooting in actually making health care better.
Halle Tecco:Rule three is to be a good steward of health data. And in the book, I point out that health care data is simultaneously underused and misused. Underused meaning it is, as I was sharing earlier, locked in silos, not accessible to those who need it, whether it's the patient or researchers, misused, and that health data is a prime target for cyber attacks. And so being a good steward of data is treating it as a moral responsibility, protecting it like it's your own, making it interoperable, using it to improve care, to empower patients, accelerate research, etcetera. And then the last rule is invest in evidence.
Halle Tecco:Massively better health care has to mean measurably better health care. Again, something that we've been screwing from the rooftops in public health for many years. You need proof that what you're building actually improves outcomes, access, experience, or costs, would we, call this the quadruple aim. And so this is an ongoing process that I talk about in that chapter that grows with your organization, and it uses everything from qualitative feedback that you can build into the product, to gathering real world data, to RCTs, whatever it takes to show that you're actually moving the needle. And it's something, as I said, it kind of grows throughout the process of building your organization.
Halle Tecco:Like, it's you're constantly investing in building that evidence.
Jeff Byers:Halle, you I kinda glossed over. I didn't do a big bio, but you are the cofounder of Rock Health, a professor at Columbia Business School. So you current investor. Correct?
Halle Tecco:Yeah. I've invested in over 50 digital health companies.
Jeff Byers:Yeah. So you've been in the room where it happens. I've been curious reading this book in preparation to speak with you. You know, what's more important when looking into investing in companies? So like, is there is it the good business idea?
Jeff Byers:Is it the location of the founder and company? Or is it persistence and patience?
Halle Tecco:Oh, what a good question. Definitely not the founder's location. While, you know, well, there are startup hubs like San Francisco, Boston, Nashville. You know, successful companies have come from all over map. I mean, just thinking about Epic, one of, if not, like, the largest health care technology companies, it's in Madison, Wisconsin.
Halle Tecco:So location is, I think, irrelevant. Between the other two, I would 100% choose the founders' persistent and patience. There's a saying in venture investing, back the jockey, not the horse. The idea of course matters, but the team executing matters the most. And this is especially true in health care.
Halle Tecco:Everything takes longer than people expect. Founders have to navigate regulation, reimbursement, clinical validation, and exceptionally long sales cycle. And so I wanna be confident that the founder has the persistence to do that.
Jeff Byers:Going back to location, because I find Yeah. I find this kinda fascinating. You know, I'm in Richmond, Virginia, not a cultural hub for health care per se. What might you tell you know, you are in New York City with Columbia. Is that right?
Halle Tecco:Mhmm.
Jeff Byers:What might you tell someone if they think about they want to move to Richmond or, like, Omaha, Nebraska or so anywhere that's not, you know, New York, DC, Chicago, San Francisco?
Halle Tecco:Health care customers, patients are equally distributed across The US. So I don't think that while while investors are obviously more concentrated in certain areas, I think the most important thing is your stakeholder, and your stakeholder is going to be wherever you are because health care is is still very regional. It's still very local. And so in a lot of ways, I think there's an advantage to being somewhere that's not a hub because you probably are, competing with fewer companies that are trying to get the attention of, say, you're building something for a health system. I'm sure your local health system doesn't have a ton of startups that are literally at their door working in their backyard and ready to partner with them.
Halle Tecco:So, you know, I I really think that you should you should live where you wanna live, near your family, whatever. There are smart people everywhere, and health care customers are, again, just everywhere. And in fact, I think there are certain areas that probably need your help and your innovation more than others. So make it work. And, you know, teams are you know, I'm on a board of a company that's small company, 25 people, but it's like completely a 100% remote.
Halle Tecco:So people are across the country and that's actually become an advantage because we have people in every time zone to talk to customers. You know, it's it's it's become a actually, I think a positive for the company. And then you're saving on, you know, you're saving on rent and you can use that to put into annual retreats or quarterly retreats. So it's I don't know. It's 2026.
Halle Tecco:Live where you wanna live. You know?
Jeff Byers:Yeah. Yeah. I get I always think it from a a networking perspective. Yeah. But maybe
Halle Tecco:Yeah. I mean, go to the conferences. Right? Like, I think that's a great way to network with folks and and meet people from across the country. You know, go to, like, three or four conferences a year.
Halle Tecco:I'm sure there are people there, you know, there are people network. And in fact, I think a lot of the networking can be a distraction. If you're just focused on going to every happy hour, every, you know, event in your city, it it could be a distraction. So
Jeff Byers:So you went to HIMSS. Do you have a ground report from HIMSS this year?
Halle Tecco:HIMSS was exhausting, but it was it was really good. You know, it was interesting to walk the floor and see all the companies that are investing in you know, it's funny because there weren't I I didn't meet as many potential buyers there, but they you know, obviously, spending a ton to just, like, wheel in the buyer and and, you know, win them over with their demos. But, you know, a lot of AI, revenue cycle management AI, that feels like the unsurprising headline of of HIMSS this year.
Jeff Byers:Yeah. The hits.
Halle Tecco:The hits. Yeah.
Jeff Byers:So you bring up in the book this idea of the novel becoming standard. And I think there's this really nice through line throughout the book of, like, impermanence is a challenge and an opportunity. The novel becomes standard. A nice, you know, kind of through line of lifelong learning comes through the book. So this commitment to lifelong learning and sharing what you've learned as the proverbial you continue to grow professionally, you know, so drawing from your own experience, what might suggest to someone, you know, just starting their career in health care?
Halle Tecco:I'd I'd probably give someone just starting their career in health care the same advice that I give someone who's a health care veteran, and that is, like, stay in learning mode. In the book, I talk about the concept of Shoshin, which is a Zen Buddhist concept that translates literally to the beginner's mind. And the idea is that when you approach something with the beginner's mind, you stay open, curious, and humble about what you don't understand. And I think that that's like a way we should something we should all embody in health care because what happens the the alternative is that you think you're an expert and there's nothing else to learn. And then you miss that things are constantly changing.
Halle Tecco:So that that would be the advice. And I would also say, you know, pick a corner of health care that you're especially passionate about, whether that's a disease area, cancer, obesity, mental health, and or an expertise like health policy, data delivery, because no one can really be an expert in all things, but you can really become a leader in your specific area. So pick something that you're really passionate about and just wanna wake up every day and try to solve.
Jeff Byers:Yeah. So what are you excited about as you
Halle Tecco:continue your career? I'm excited because we're seeing more people from different disciplines entering health care who wanna tackle these problems, and health care hasn't traditionally been, you know, open and welcoming to newcomers or outsiders. But I I have, like, personally appointed myself as, like, the welcome committee. I'm, like, the neighbor who brings cookies to the people moving in because I think we need all the help we can get to solve some pretty big problems. So I'm always, like, excited to see new folks be interested in giving their talents to health care.
Halle Tecco:And then on a separate note, I'm excited by being able to keep learning and sharing what I'm learning along the way. I think especially AI, there's just so much. There's such a steep learning curve for all of us. This is all new and it's happening in real time. So it's it's fun.
Halle Tecco:Like, that process is really fun. I love school, obviously. I've spent a lot of my time in school. So be being able to have these new technologies that are coming in and really changing health care rather quickly is is exciting from just a learning opportunity.
Jeff Byers:You write early in the book, it takes seventeen years of health research findings to translate into clinical practice. I thought this was fascinating, and so it makes me, you know, at the passage of time, you know, I'm middle aged now thinking about it. As a fun exercise, you know, what do you think you'd be surprised about in 2043 if current health care trends continue? You know, what might not surprise you?
Halle Tecco:You know, if you had told me or if someone had told me ten years ago that we'd have a weekly injection that's an effective treatment for obesity, and that you could order it online without seeing a doctor, or that the cost of sequencing a whole human genome would drop from 1,000,000 to under 200, or that Apple would make a watch that can detect A fib and headphones that can function as hearing aids. I would have thought that they were overly optimistic or maybe even crazy, but all of that happened just in the last decade. So, you know, we health care feels like it moves slowly, but when you actually look at, like, the arc of what's happening, we've seen a ton of progress just in the last ten or fifteen years. So what might surprise me by what is it? Twenty forty three?
Halle Tecco:I hope that we're able to see finally, you know, much earlier detection of disease. You know, I think that we will see more care delivered outside of hospitals and clinics and in people's homes. This is something we've been talking about for a long time, but hopefully, we we can get there. Going back to some of the stuff around data and data ownership, I think by then, it'll be clear who health data belongs to, and that is the patients. And hopefully, we'll have sound policies in place to make sure that companies know and respect that.
Halle Tecco:You know, AI obviously will have really changed the administrative side of health care, which today consumes just an enormous amount of time and cost and waste. What might not surprise me, you know, I think health care is gonna still be largely tied to employment for better or worse. I don't know. I don't think we'll be able to have reversed the corporatization of health plans or providers, but hopefully, there's, you know, a little bit some anti competition stuff that moves forward. Hopefully, there's more guardrails to ensure access to affordable quality care, But who knows?
Halle Tecco:We'll probably be having the same conversations around how to align policy and outcomes. But I think overall, I'm I'm really hopeful and optimistic. And I do think when we look back at where we were, you know, fifteen years ago, we should be really proud of the progress that we've made.
Jeff Byers:Well, I look forward Tecco, to the new book in twenty forty forty. Yeah. 2044. 2040 Yeah. Yeah.
Jeff Byers:Thank you again for joining us today on Health Affairs This Week. We covered a lot of ground in this conversation. The book is Massively Better Healthcare. It is out now. Holly, is there anything else you wanna plug that, you know, I know you do a lot, so anything
Halle Tecco:else Well, you I also have a podcast. So if you are someone who loves podcasts, I have one called the Heart of Healthcare podcast. It's more on the business side, but I think really interesting learnings from CEOs and founders in the space. So we'll plug that.
Jeff Byers:Everyone check that out. And to you, the listener, if you enjoyed this episode, please send it to a friend and we will see you next week. Thanks all.