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Vic and guest host Dr. Kam Matthews cover the week’s major healthcare, policy, and AI stories, including Medicaid funding threats, provider-network gaps, economic updates, new VC raises, and major clinical and pharma developments. They discuss wealth-tax proposals, insurer policy changes, hospital system financials, new maternal and SDOH AI tools, obesity-drug price cuts, and breakthroughs in cancer and antiviral treatments, closing with updates on AI market shifts, Nvidia’s earnings, and Goo...
Vic and guest host Dr. Kam Matthews cover the week’s major healthcare, policy, and AI stories, including Medicaid funding threats, provider-network gaps, economic updates, new VC raises, and major clinical and pharma developments. They discuss wealth-tax proposals, insurer policy changes, hospital system financials, new maternal and SDOH AI tools, obesity-drug price cuts, and breakthroughs in cancer and antiviral treatments, closing with updates on AI market shifts, Nvidia’s earnings, and Google’s Gemini release.
Links
4:25 - Hiring Defied Expectations in September, With 119,000 New Jobs WSJ
6:51 - WellBeam closes $10 Million Series A to Transform Clinical Interoperability and Care Coordination between Acute and Post-Acute Providers GlobeNewswire
9:01 -FamilyWell Health Secures $8 M Series A Led by Maryland’s New Markets Venture Partners Amid National Expansion CityBiz
10:22 - Thrivory Raises $3.5M in Equity Funding; Up To $25M in Credit Funding FinSMES
11:36 - Function Health Hits $2.5B Valuation With $298M Series B MedCity
14:40 - The California Campaign to Introduce a First-of-Its-Kind Billionaire’s Tax WSJ
21:25 - When the G.O.P. Medicaid Cuts Arrive, These Hospitals Will Be Hit Hardest NYT
23:38 - Jury orders Apple to pay Masimo $634M in patent fight Healthcare Dive
25:31 - Humana, Epic collaborate to automate insurance verification, patient check-in Fierce Healthcare
27:22 - Medical orgs press Anthem to pull back out-of-network care policy Fierce Healthcare
29:41 - Aetna unveils new conversational AI navigation tool for members Fierce Healthcare
31:48 - Medicaid Insurers Promise Lots of Doctors. Good Luck Seeing One. WSJ
36:30 -Cigna to launch new transparent health plan called Clearity Fierce Health
Every week, healthcare VCs and Jumpstart Health Investors co-founders Vic Gatto and Marcus Whitney review and unpack the happenings in US Healthcare, finance, technology and policy. With a firm belief that our healthcare system is doomed without entrepreneurship, they work through the mud to find the jewels, highlight headwinds and tailwinds, and bring on the smartest guests to fill in the gaps.
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Your feedback will greatly impact our ability to reach more people.
Thank you.
Okay, welcome everyone to Health further the weekly rollup this week.
Marcus is off.
He is relaxing, recuperating.
I'm not sure where he is, but, uh, but we have Dr.
Kim Matthews here camp.
Thanks for joining.
Appreciate you doing this.
Of course.
Hey, thanks for, thanks for inviting me back.
I know I didn't make it that last time.
Yeah.
Yeah.
I've ha I wanted to have you as a guest host for a while, and we had scheduling issues and, and things previously, but you're here now, excited about it.
Yes.
I, I'm excited.
I'm excited.
I enjoy this conversation every week.
I really do.
So, yeah, you're a li, you're a longtime listener, but we have not been able to have you on and get your wisdom for everyone yet.
So I'm excited for this week.
So maybe, uh, hopefully a little, give the audience a little of your background.
You actually are qualified.
You're, you're an md, um, but you've done lots of things, so, and you have some new stuff upcoming.
I don't know how much we can share, but, uh, maybe talk about where you've been the last few years.
Sure, sure.
So, uh, again, cam Matthews, I am a family physician by training, and the last four years I served as Chief Health Officer with Citi Black Health.
Uh, of course.
Probably most of your listeners, uh, are familiar with it.
But we are a, uh, value-based advanced primary care practice focused on Medicaid and dual eligible populations across 10 markets.
Um, it was an unbelievable experience for me.
My first time with a startup, my first time, um, working in the value-based space prior to Citi Block.
I was actually with the Veterans Health Administration for several years, helping, uh, lead them through multiple different transformations as well as the, the COVID Pandemic.
So that was an interesting, uh, transition, you could say, uh, to say the least, uh, from government to startup.
Uh, uh, but, uh, I am looking forward to my next transition.
Uh, starting in, in January of 26.
I'll be, uh, working with another startup as chief health officer as well, uh, focused on a kind of a different perspective of primary care, leaning more into the public health.
Space.
I, I would argue.
Um, but I'm really excited.
I'm, I'm glad that my career has been able to focus on underserved populations.
So I'm definitely continuing with that, with, with my new, uh, opportunity.
Yeah.
Yeah.
Excellent.
So, I mean, I, I wanna weave it in through the stories this week.
'cause we have a, you know, there's a lot of issues around, um, Medicaid today and public health broadly.
I think we're all, um, at least from my point of view, we're struggling with what does public health even mean post pandemic.
Mm-hmm.
Um, and how should we take care of, as a society, how do we take care of our community, all of our people.
And where does the responsibility lie?
I think that's the bigger, uh, question right now, especially coming out of this administration.
There's a lot of focus, obviously on, on, uh, self-empowerment and, and, um, I, I think from a public health standpoint, that has been at a little bit of a juxtaposition of, of where we've tended to lean as a, as a country.
Yeah.
So, yeah.
Yeah, I think that's right.
So, um, and I'm all in favor of self-empowerment and in addition to that, yes, we as a society have to pay for services so that people can be empowered to take care of themselves.
Exactly.
So there's a balance there where, um, it's not fair to say.
To the population.
You have to take care of yourself, but not give them any resources to do that.
Exactly.
Yeah.
Yeah.
Um, it's, uh, really about allowing for there to be some empowerment, uh, so that people can, can actually take advantage of the new science, the new technology, if it's available in someone's network, but they don't have the, the ability to actually access it.
That's a completely different, uh, um, obviously sense of ownership of how that person can then continue.
Yeah.
It's not realistic for them to be, they're not empowered if they don't have the resources, so No.
So, no, no, exactly.
Okay, well let's jump in.
We have a lot of stories, uh, to cover.
Excited to, to dig into it.
We finally got the September jobs report.
Yes, of course.
We are talking on November 20th, and so it's quite, with the government shut down and everything, quite outdated, but it was a surprise to the upside.
So 119,000 jobs.
People were hired in September.
Um, so that was slightly good, but the unemployment rate also ticked up and then they revised August down.
So for people that are watching here, um, you know, the August number was just minuscule negative.
It looks pretty flat on the chart here, but it's been anemic Job growth, you know, for the summer.
September was, was better of course, than.
Slightly negative.
I don't know.
I know you're not an economist.
Um, it's pretty outdated.
Any, any feedback from this?
It's, I mean, it's positive, I guess it's sort of lukewarm.
Yeah.
Yeah.
I mean, for the unemployment rate to be going up as well, that means jobs are being created where people aren't able to take advantage of it.
I'm, I'm assuming, so I'm, I'm wondering Well, yeah.
Thousand new jobs were created Yep.
But I think maybe slightly more than that number of people lost their jobs or mm-hmm.
So somehow the, the unemployment rate, uh, ticked up slightly to 4.4%.
Exactly.
Um, I, you know, fairly stock at that 4%.
Exactly.
I can't wait to see what sectors were impacted.
Yeah.
I mean, healthcare has been, by all the numbers Exactly.
You know, pretty strong.
Mm-hmm.
Uh, because we need a lot of, we need a lot of people.
We, we are in a shortage healthcare really, so.
Mm-hmm.
Um, so I don't know.
The economy is still, Marcus and I talk all the time about the kha economy.
Yeah.
You know, if you have a lot of wealth in, um, financial assets in stock market and real estate, you're doing well, maybe, maybe better than well right now.
Yeah.
But if you don't have significant net worth and you're living, you know, either it's paycheck to paycheck or you have a 401k, but it's not that significant.
It's hard out there.
It's hard to keep up with the cost of living increases.
So I guess it's positive the government is issuing reports again, but it is it, they didn't update anything in October.
They had talked about that as recently, it was Tuesday.
Mm-hmm.
And then they yesterday decided, no, we're just gonna, we're just gonna do September, no October information.
So, um, so with that, let's move into the, to the VC raises a company called Well Beam raised $10 million Series A to.
Transform interoperability, care coordination from the acute in, in ho inpatient hospitals to the post-acute setting.
Mm-hmm.
This is a space I've done a lot of work in.
It's, it's a huge problem.
What'd you think of this deal?
I mean, I think it's exciting.
I mean, to me though, it's, there's extreme sensitivity to success of this based on who's actually adopting their platform, right?
So in any given geography, there could be a, a number of post-acute providers, and if it's only.
Really being adapted by one or two of them along with the major health system in the area that could lead to some real, uh, inequities of, of coordination and interoperability.
Yes.
Right.
Yeah.
So I was looking on their website to see like if they're even, you know, describing any of the big national post-acute players or, or any, they're, they're not listing any, but it's exciting.
It, I agree with you.
It's a huge area of concern.
There's very little communication back and forth, and that's why you see the readmissions.
That's why, um, there's unfortunately, uh, increased unplanned post-acute care, uh, because they're not able to communicate and really plan ahead.
But if well Beam doesn't have broad kind of adoption, then yeah.
I mean, it's fine to say break down the silos of data, but if you are creating a, a new, pretty small.
You know, connection point.
Mm-hmm.
It is sort of another silo kind of, I mean, you position like that in the public press release of course, but I'm, it require some significant, yeah.
Yeah.
It requires sign biased because significant vertical integration to, for it to really work and reach the, the outcomes they were describing, so Yeah.
Yeah.
I was gonna.
Sort of a Slack or teams like competitor for, for all of care mm-hmm.
Across, uh, providers.
Mm-hmm.
Which is designed to not be any one silo, but sort of cut across everything in the messaging layer.
Um, but I think, you know, and all the above solution for this issue is probably, probably good.
So.
Mm-hmm.
Um, happy to see them at least working on it.
And then family, well Health raised $8 million and this is a women's mental health provider.
Yeah.
And they have been sort of up in New England, Massachusetts, New Hampshire, and this is gonna allow 'em to go nationwide.
Mm-hmm.
A lot of attention in women's health.
Mm-hmm.
Uh, recently.
But this, there's a lot needed.
There's a lot of, lot of, uh.
Demand.
What are your thoughts about family?
Well, yeah, I was excited about this.
The, the, um, founder is a neonatologist who had some personal experience, um, around postpartum depression.
She shared, and, you know, this is, this is a critical space where we need this level of integration.
Again, as the operator, my mind immediately goes to where is this being implemented?
Being that the majority of postpartum care isn't actual, sorry, postpartum depression isn't necessarily diagnosed in the ob gyn office.
It's actually in the pediatrician office.
So where is the integration actually occurring?
You know, how are we making sure we're thinking even beyond just the immediate spaces where family well, and the, the ob gyn services are being provided, but more holistically primary care practices, pediatrics offices.
So, I love this.
It's the right direction, but I, I think it's, it's.
None of these solutions are, are meant to be a panacea, but, uh, it, it may still leave some gaps depending on who's actually receiving the services in these clinics.
Right.
Okay.
And then rivalry raises three and a half million dollars.
And in addition, uh, credit funding, uh, facility rivalry is an interesting, uh, company that they, basically, it's in the revenue cycle management, uh, space, I'd say where they're, they sort of are submitting claims, but they have this option to, to get paid immediately for physicians where they take on the risk of collection, which is why they needed the credit facility.
What did you think of this?
It, it's, uh, I'm torn.
I, I'm.
It's interesting.
Uh, but there're obviously there's a spread there where they're gonna pay the docs less if they are taking the risk, which, you know, obviously the doc can choose, but it mm-hmm.
I don't know.
I'm torn about this, this one.
Yeah, same, same exact feeling there.
I, I think maybe for some of our smaller hospitals, safety net hospitals that could benefit from getting paid today, just 'cause their cash flow is so strict, this, this could unfortunately not necessarily be as positive for them because of that additional piece that, that thriver is gonna have to maintain.
Yeah.
Um, I think the, the larger hospitals that could really use this are, are probably a bit more integrated with their payers in the first place.
So would they even, would they even need this?
I'm not sure.
Okay.
And then function health, which is of course already a unicorn.
Very large, I think of them in the longevity space for wealthy folks to get a full.
Full evaluation, huge kind of preemptive screening.
Mm-hmm.
Uh, they raised almost $300 million, $298 million a huge round in a company that already, you know, has a lot of traction.
What, what's your thought about function?
Maybe broadly, not necessarily this round, but just the, I'm a bit weary around these.
Uh, just kind of, I, I like the word you used, preemptive, preemptive kind of pre preventive care.
I mean, Amal as a primary care doc in favor of this, I, I think it, it obviously they function as well as any others that are, are in this space.
Need to make sure, again, that concept of integration back with an individual patient's provider.
Like how is this gonna be managed?
Uh, you know, what sort of support is there really gonna be for the patients that are taking advantage of this lab work?
I'd be a bit nervous.
There's a, uh, also, you know, some waxing and waning evidence around, you know, the, the, the need to do this amount of screening and whether the cost benefit is really there.
I, I think this will, yeah.
Uh, well, and the cost, yeah.
I would take the cost benefit in a, in even a. Broader sense than just financially.
Mm-hmm.
There is, there is a financial cost.
Clearly these are wealthy people typically that are paying out of pocket.
Exactly.
Um, but there's also an emotional, physical sort of cost of, you know, you find something that needs to then be looked into and so then you have to do additional labs, maybe take a biopsy, and it is more than just financial cost there, there's the stress of like feeling that, you know, maybe I have cancer somewhere and then you don't have it.
So yeah, there's a lot of different costs that have to be balanced against the benefit.
Obviously there's a huge benefit if you catch something that's treatable.
Mm-hmm.
But, um, I think it's up in the air as far as is the overall cost worth the overall benefit in this case?
I haven't done one of these.
It's not a financial decision.
I'm just not sure that I want all of this.
Yeah.
Uh, information.
I haven't done the lab work.
I've done the full body M-R-I-I-I was able to take advantage of, uh, and function is offering that, that sort of imaging as well too.
Yeah, I've done that and the data that came forward was definitely something I personally needed to parse through because they made recommendation for a significant amount of follow up care and little pieces.
Right.
And I was able to personally reevaluate, look at that data.
The average person is not gonna have that capability.
Right.
Um, and will they have the ongoing support to help them through that as opposed to just the initial, you know, data review that, that, uh, the, the ordering company might be making?
I'm not sure I'd, I'd be nervous.
Many people won't me.
I mean, you have the, the medical knowledge and experience to parse through that.
Exactly.
It.
There's very few people that can do that.
Yeah.
Okay.
Moving into policy, California's campaign to introduce a wealth tax, it would only tax billionaires.
Mm-hmm.
So if you have a wealth, not earnings, you know, accumulated wealth, both liquid and importantly, illiquid artwork, intellectual property rights, uh, real estate that exceeds 1000000005% would be a one-time tax.
And, you know, interestingly, in order to pay for everything in, in, in California, but, but healthcare being, um, you know, top of the list.
What, what are your thoughts about, about this now?
It's just, it's just a, um, proposal.
It'll be voted on next year.
I think that's what they're trying to do is get it on the ballot.
Yeah.
I don't, I don't know, I, I don't call myself the Democratic socialist, but I think it's starting to come out when I read stuff like this about what's happening around the country, about kind of the, uh, redistribution, um, of wealth, I would say is, is necessary in times where we're really having questions around healthcare services and, and other social needs and the like.
Um, I think this is an exciting conversation to be had.
I think it's worth acknowledging broader concepts of wealth beyond just income.
Uh, 'cause we know that there's a lot of, uh, kind of shepherding of, of persons wealth into these kind of protected spaces.
And, and, uh, I think there needs to be some redistribution so that, that everyone can at least have the baseline of healthcare, of food, of housing.
And that's, that's what the state would presumably be redistributing to.
So, yeah.
You know.
Yeah.
I look forward to the conversation there.
No question on the.
The intent, I think.
Mm-hmm.
I agree completely that we have to find a way to pay for healthcare and other basic services in our community that the government needs to provide.
I mean, I wrote an entire book trying to wrestle with us.
I think it's gonna be the issue in the next 10 years in our country.
I mean, we see it with the New York Mayor race.
Mm-hmm.
Um, so you, you're getting both coasts now.
New York certainly is moving in that direction.
California is as well.
It almost doesn't matter the an the result of this particular vote.
We have this trend going on.
Mm-hmm.
Um, I, I think it's gonna be a huge issue between generations, basically.
So, like the boomer generation, that's how I think about this.
The boomer generation has a lot of wealth.
They will stop working over the next, many have already stopped working, but over the next 10 years they'll, they'll age out of working.
And the estate tax, you know, has been the way that our country has sort of corrected for this, where, when, when you passed away, they, it's a wealth tax.
The state, the state tax is a wealth tax.
Um, but there's been so much effort at, um, you know, tax sheltering around that, that it's not, it's not that effective anymore, actually putting money into the system and sort of correcting for this, this generational issue.
Mm-hmm.
Um, so in my book, I kind of started with a discussion of values like I, I, and now this is not this story, this is my personal opinion, which I'll get off my soapbox in a minute, but I, I sort of think that.
Healthcare should be a, a human right.
Yeah.
Like you, you have a right to healthcare.
And then we quickly get to, well, you know, what are the limits to that?
Um, and so my second value was that it should be allocated equally across generations.
It's, it's not fair for the boomers to take more than their share of the available resources and then take that away from the millennials basically.
And the millennials I think, are driving this, this trend.
I mean, I think they certainly drove the New York mayoral election.
Mm-hmm.
And they're a huge, powerful generation as far as voting block.
And we need to, we need to resolve this issue and it's going to be, um.
You can read my book for more.
There's gonna be 10 years, maybe 20 years of discussions around what is, what is the right way to kind of divvy up the pie.
But it's not, the status quo is not gonna work.
And so, um, I, I think we have to solve this.
The, the thing I worry about is the slippery slope.
Like no one is gonna cry for a billionaire having to pay 5% one time.
Mm-hmm.
I'm certainly not going to, but the worry I have is that, um, someone with a billion dollars in net worth has lots of options of where they kinda call themselves as primary located, even if they are in California for, you know, lots of things that California's great at, I mean, incredible beaches, you know, great opportunities there, but the, the building just may decide to put their residence somewhere else.
Mm-hmm.
In Tennessee, for instance, there's no state income tax.
A lot of people already have moved to Tennessee and Texas and Florida and you know, the typical tax havens.
So I just don't know if it will have the effect that, you know, is intended.
Mm-hmm.
But, but we'll see.
I think it's certainly gonna be very popular.
It would likely pass if it gets on the ballot.
So I don't know.
It's gonna be something just to, to monitor over time.
And maybe the millennial population in states like Tennessee will start to reconsider this as well too.
Yes.
I mean, if the, if the is, is really shifting, I, I, I agree with you.
As you say, generationally, uh, Tennessee won't be exempt from it as well too.
It's a worthy conversation to have as the billionaires will be looking for places for more shelters that maybe, uh, there there's a larger trend that needs to occur more broadly.
Yeah, I mean, I came to, um, in my book that we should try to figure out a way that about 10% of all healthcare spending should be spent in.
Public health, primary care, sort of taking care of people in uh, ways that are not cutting edge.
Don't need to be high margin.
Yep.
But we have to deliver these services.
I'm calling them healthcare utilities, but we have to figure out a way to take a significant amount of the 5 trillion we spend in healthcare.
I pick 10% just 'cause it's double with the 5% we pay for primary care now.
Yeah.
And there's, there's, I'm sure double now, but it needs to be more than we spend now on primary care.
Exactly.
There's some state proposals they're pushing for 15%.
Yeah, I agree with you.
Yeah, yeah, yeah.
It might be 15%.
So, um, anyway, that's going on in California.
That will continue.
And then this was, I thought, a really good article from the New York Times, uh, really focusing on the Medicaid cuts coming next year that have been talked about.
You know, a lot we've talked about here on the show is gonna be, you know, the, basically the supplemental payments, the tax structure that has been used for.
30 years by red states, blue states, every state to help fund Medicaid is not gonna be able to be growing at all.
And it might face cuts over time.
The Republicans, after feedback, people being upset about that, offered a $50 billion fund to help rural communities, rural hospitals, which I, you know, I'm in, I'm in favor of.
But of course there's a lot of Medicaid recipients.
City block where you, you worked for four years is focused, I think primarily in urban areas and there's a lot of need in urban areas that.
Just by the title of it, the Rural Fund Won't, won't help.
I don't know, this was a good article, but kind of a sad article.
So, I mean, what are your, you live, you've lived this for a long time.
Yeah.
So what, what are your thoughts about this?
Yeah, even before City Block, I've, I've always worked in, in urban underserved areas.
And I think the, the safety net hospitals are, are clearly gonna be impacted regardless of rural versus urban.
And I think there's a bit of a political slant, uh, in creating the rural transformation fund.
Uh, I think there's a, a bit of an overrepresentation there of how solely, or even to the exclusion of urban hospitals that rural hospitals will be impacted.
And this article just speaks to the larger impact.
It says 85% of the hospitals stay surveyed, were in urban areas.
So yeah, I mean, that's where a lot of the people are.
So, I mean, I think it is, I don't think that's controversial.
Mm-hmm.
Most of the population.
By numbers.
Yeah.
Lives in urban areas.
I mean, I think that's factual.
So the Times did a good job sort of digging into it.
The more I learn about it, the more I am concerned about our Medicaid population.
But, but I don't know.
It's, it's, it's an ongoing worry.
And then to, to sort of finish the policy, a jury awarded Massimo$634 million for, for them mm-hmm.
Um, violating Apple.
Apple is in violation of Massimo's patent around Pulse.
I think it's a pulse ox patent.
Yep.
And I think they clearly are.
And, and the jury awarded this, that Apple's gonna, um, they're gonna appeal but.
I think justice was served here.
I don't know if 600 is the right number or not, but they clearly didn't do the right thing mm-hmm.
Against Mossi Mill.
So, yeah.
You know, this, uh, this tied along with the conversation over the past couple years around pulse ox and pulse oximetry and, and how, uh, there is a, a bit of concern around the ability of, of pulse oxes.
I think you guys might have talked about this on the show, the, the ability of pulse ox to, to have accuracy with darker skin and mm-hmm.
So what I'd be nervous about, you know, if there isn't the additional conversation of how these sort of wearables are then going to be able to address.
The, the inequities that we see in this type of monitoring.
Um, you know, I'd be, I'd be nervous, apple continuing to fight this and the like, you know, are we holding Apple even more accountable for the accuracy of, of this, and even Massimo, um, like we, it can't get lost that, uh, this technology is still not exactly as accurate as, uh, as we need it to be.
Yeah, no question.
And, and we need to do more studies on that, I think to Yeah.
To understand Yeah.
Where does it fall down and, and more importantly, how can we adjust mm-hmm.
Adjust the technology so that it can serve all the whole population no matter what your skin color.
So, but Im, I'm glad, I'm glad, uh, Apple's being held accountable.
I'll say.
I'll say that much now.
Let's continue with that.
I guess I'm arguing That's right.
Yeah.
In Fierce Healthcare, we're switching to payers here, Humana and Epic collaborate to automate the insert verification.
Process that patient check-in.
And so Humana is, uh, working with Epic.
If you are a Humana customer and you go to an Epic, uh, facility, which is, you know, probably 70% of the hospitals mm-hmm.
Uh, you no longer will have to do that clipboard and show your insurance card.
And that is, that's great for that population.
It's sort of a subset of.
The overall population.
So I don't know, what are your thoughts about this?
I thought it was, it's great for that population.
I'd like to see it more broadly.
That's exactly what I thought.
Like this is great, this is necessary.
It's, it's a huge, uh, uh, dissatisfier for patients at, at check-in.
But, uh, how is this gonna fare for broader populations where perhaps where they have multiple coverages?
Um, I'm thinking of the veteran population, the Medicaid populations.
Yeah.
Uh, and, and even the traditional, uh, Medicare with supplemental coverage and everything, like, it's, it's nice and, and neatly packaged for ma, which of course is where they need it to start, but what's this gonna look like the next step?
So, right.
And if you are, I mean, here in, in Nashville, Vanderbilt, they're on Epic, but is the medical, uh, kind of administrators there a check-in?
Are they gonna.
Change their entire workflow because the Humana MA patients don't need to.
Yeah.
I mean, maybe they will, but, but there's a lot of other payers and so Exactly the person, it's a human at the check-in.
He or she's gonna have to figure out, okay, I give the clipboard to, to eight outta 10 people, but these two, I don't.
That seems like it's putting a burden on our workers where they already are kind of busy.
I don't know.
It's a good step, but you know, I don't know how much it's gonna be impactful.
Okay.
And then medical groups are pushing Anthem to kind of come back to their, uh, outof network policy.
So in about a month, Anthem's new policy of, you know, penalizing the patients.
Uh, when they get an anesthesiologist that is not in network with Anthem, that's gonna be really difficult.
Mm-hmm.
And the hospitals and other medical groups are pushing Anthem to, you know, rethink this, but so far they haven't.
Um, this is an ongoing issue of.
In network, outer network.
What are your thoughts about this?
Do you have experience in this space?
Yeah, I mean, I, I have to side with the patient on this and, and the protections that we need from no surprises, right?
Yeah.
Like, this is, this is wholly, uh, a, a a difficult piece that the patient has absolutely no control of.
And the controlling party is the hospital.
They are the ones that make the referral.
They are the ones, uh, that can, can, and otherwise really have an understanding from a network standpoint of how to, how to place these orders and make these referrals.
I, I think it has to sit on the, on the hospitals and, and it's, yes, it's gonna be difficult for them, uh, but the burden should not be on the patient.
It can't be on the patient.
That's not gonna work.
Yeah.
I think there's a real issue, and we'll have another story later about how the payers are building their provider networks.
Mm-hmm.
And they, they must be sufficient.
Yes.
Like, I don't think it has to include every anesthesiologist, but you have to have.
Appropriate coverage or you agreed, or you shouldn't be a payer in that geography.
Agreed.
Um, but then the, the health systems need to sort of make referrals, you know, within reason to in-network anesthesiologist.
So if I'm getting my hip replaced, I don't get to choose the anesthesiologist.
That's what you're saying.
Like I, that's what I'm the surgeon typically, but then it is, it's opaque to me who the anesthesiologist is, and even if I wanted to choose the, the hospital would let me, that they don't have that latitude.
So Yeah, it's a huge, that's issue.
That's exactly, but I, I agree with you some, the, the burden also needs to, to be on the, on the payer from a network standpoint.
Um, or else the, the health systems won't have any ability to control this either.
Um, yeah.
And then Aetna unveiled AI navigation tool.
So it's like an AI assistant that helps, uh, the Aetna patients understand.
Their coverage and what their financial responsibility would be.
What'd you think of this?
I thought this was a great approach, but again, it's, it's only one population, but in this case, if I have Aetna, I can now use this tool and it will help bring me hopefully more transparency to what is a very confusing, opaque space.
Yeah.
I think it's, and maybe a few people would join Aetna more because they Exactly.
They opt into it.
I think it's exciting.
I can think of a time when I had the call and I, I just got directed to multiple different offices 'cause they weren't sure whether it's medical benefit or pharmaceutical benefit and all these different things.
Like hopefully that one AI.
Is as integrated as possible across the different pieces of their, of the individual patient's contract.
I think that would be the piece I'd be nervous about, you know, and, and how really personally adapted it is.
'cause they say it's full and personalized breakdown of their contract.
I was like, I, I hope yeah, that it really does get into the weeds of an individual patient's, uh, uh, coverage.
Um, and, and if it does, very exciting.
But if not, it, it could be a a, a big source of just escalation to, you know, someone's just gonna keep clicking through to customer service.
Yeah.
Yeah.
I mean, I, I'm gonna take the positive, uh, take here.
I think that Aetna trying to actually help its members mm-hmm.
Understand the benefits that at the end of the day they are buying, or their employer or a government group someone has paid for them to have.
That's a good thing.
Now it needs to work.
But the fact that they're working on it, um, if it is really good, more people will go and then, you know, that's the American Way.
Competitive competition will drive every payer to have a tool like this eventually.
Completely agree.
Yeah.
Okay.
So the last story on the payer side is, uh, in the Wall Street Journal, pretty long, almost like investigative piece called Medicaid Insurers Promise.
Lots of doctors good luck in seeing one.
And they went through many states Medicaid provider networks and found a pretty shocking, and, and at least for me, it was shocking and, and sad.
It's a, there's a list of lots of docs that are available that take Medicaid patients in the provider kind of network.
But when you actually try to book an appointment.
There becomes very difficult to do.
So.
So this is your, this is your market.
So, yeah.
Have you experienced this?
Is this, uh, what, what do you think of this article every day, Vic?
This was, this was my entire residency training and, and initial sort of, uh, experiences in FQHCs where I, I really felt, uh, you know, my, my care team and I, we were ended up being just kind of referral coordinators trying to make our way through these, these network directories.
Trying to, right, because, because in primary care you, you refer them like, you need to go see a, a orthopedic surgeon.
Mm-hmm.
And then.
They have trouble even finding one.
Yeah.
Calling through the, oh, it's, and I'm, I'm glad they highlighted psychiatry.
That's definitely the, the most difficult, uh, space, uh, where, you know, we just did not have enough integrated behavioral health, uh, capability within our own practice.
So I needed to refer out.
I mean, it, it just is unfortunately nothing new.
I think when I read this, I loved that, uh, the journal went into this depth, but it's absolutely nothing new.
It's not something, uh, that unfortunately, uh, we've seen a lot of change in not only are the network directories not updated, uh, but you're also seeing a lot of practices that just aren't taking Medicaid patients.
Um, so this is, this is what unfortunately, primary care as well as other fields and, uh, all of us that are needing to coordinate care for our patients, we see this every day.
Yeah.
I mean, I think that is kind of a recurring theme in my discussions with physicians and hospital administrators and, and even.
Payers.
Yeah.
There have been kind of chronic, systematic issues in the US healthcare system for, unfortunately, for decades.
Yeah.
And at the same time, I think it is helpful for the Wall Street Journal to dig into this and then publish, you know, pretty long article because it, it, you know, reminded me of this and they did a good job sort of stacking up.
Yeah.
Fact, fact, fact, fact, fact.
Which is hard to deny.
It is not right to say that in, in all of these areas, the provider networks are sufficient.
They're just not sufficient.
Yeah.
Yeah.
And we need to figure out a way to, to solve for that.
Unfortunately, from our fir, from our early stories, Medicaid is going the wrong direction.
It's gonna be less reimbursement, not more.
So I think this is going the wrong direction, but.
Yeah, it's a hard story, but I think worth reading, we'll have a link in the show notes about it.
I think, I think every state needs to take a policy lens to this exact topic.
They talk about South Carolina in, in the article.
Um, I think they need to be digging in to what network adequacy actually is.
How are they actually holding payers accountable to prove that there is, there's adequacy.
This is actually a, a huge area of my focus when I worked, uh, in the VA because we had to build network adequacy in the, in the network for veterans under the community care program.
Uh, and the transparent, the VA kind of is a great place to learn about it.
'cause you have the full stack, you're the payer.
Yeah.
You know, the original payvider is the va. Yeah.
And was it, uh, was it difficult to find physicians in certain subspecialties or certain areas?
There definitely is.
I mean, there's, there's definitely, uh, just geographic gaps as, as well as, uh, just volume issues there.
There may be a, a single orthopedic surgeon in a, in a rural, uh, uh, geography, but there they just have a ridiculous wait time.
So we had a lot of conversation around how we think about telehealth to actually address some of, uh, the network adequacy issues.
I think that's one thing that we were really leaning in within VA to assure that we could offer as much services as possible virtually so that we could even back down some of the volume that we're, we're patients are actually physically scheduled, but that takes like an upheaval of, of everyone's schedules, of, of everyone's network, and, and at least in VA, we could drive that.
I don't see that being a larger trend for, for Medicaid unfortunately, how we actually think about which patients are being seen and which are, are virtual.
Right.
Uh, so then Cigna is launching a new transparency plan called Clarity.
So this is a, a kind of a new approach by Cigna, and again, for the listener.
Cigna has moved out of government backed healthcare, so they really only do employer based care.
And it seems like an interesting model for that, where an employer now will have an option to choose from, you know, cost sharing options.
But then.
They're sharing it with the, the employee.
Uh, but it's fully transparent as far as like what, uh, what everything costs.
What is your thought about this?
Yeah, I mean, we'll see, I, I think a lot of the cost sharing options, this being only copayment versus kind of the deductibles and the like.
Mm-hmm.
Uh, I think different types of patients will feel comfortable with co-payment versus the deductible conversation.
I, I'd need to see the math.
I don't know.
I think it's, it's just another shuffling of the deck chairs to be honest.
Uh, to try to drive patients to have a bit more accountability.
But I like getting rid of co-insurance.
I don't mind, I think people understand the deductible.
Mm-hmm.
Co-insurance is where, yeah.
Patients did not understand and it drives a ton of bankruptcies, unfortunately.
It's really sad.
Agree.
They just don't agree.
Getting rid of that is, was the key for me.
But yeah, the transparency piece, uh, will help with.
Hopefully, you know, those patient populations that, that are, are able to, to actually dig through a lot of the cost involved and everything and, and make those decisions with the, the information being provided.
I can't say that would be a positive move for all populations though.
Yeah.
Well in, in, in Cigna's case, because they're really only working with employer and sponsored plans, I think.
Exactly.
It could be designed where there's, it could be really positive.
Yeah.
Like we are, right.
It wouldn't work for, for every population.
Mm-hmm.
Okay.
And then a story from Healthcare Dive Ascensions investing $530 million into Middle Tennessee here, right where we are in Nashville.
Uh, so, you know, it would be an interesting story, uh, no matter where, 'cause $500 million is a lot of investment into one geography.
Um, but because where, where I live, it caught my attention as well, Ascension's in investing in sort of upgrading their facilities and bringing technology and, and improving the, the, the hardscape, the buildings.
It would be good.
What, what are your thoughts about this?
I think my bias is gonna come through with every story, but my first question was, is always gonna be how much of this is gonna be invested into, to primary care and to, to ambulatory and community-based care?
You know, that's where, yeah.
Uh, we can actually think about prevention, we can think about, you know, uh, thinking upstream about solutions and the, like, if this is just more bed space, um, you know, which is needed in, in some geography.
So I'm not, you, you do have a much better sense of, of what's going on there in the middle of the state.
But, um, I'm wondering how much of this will be built into more ambulatory services for, for patients.
Uh, it talks about decreasing travel time, but if that's only for acute care, uh, then we're still just gonna see Yeah.
I don't know the answers, but my, my observation over many years is that most commonly health systems invest in new surgery centers or new, uh, new diagnostic imaging or, uh, things that are not necessarily primary care.
Yeah, exactly.
So positive, but maybe not.
I agree.
Maybe not where it's most needed.
It, it probably is more where the, the reimbursement is the best Can't fault in general.
That's, yeah.
Right.
Yeah.
Can't fault them, but I, I think they, we need to right size how we're, we're assuring utilization leans in the future and, and continuing to be build these massive campuses and the like, I, I would argue is not necessarily right.
So common spear release their operations.
Report.
So they're, you know, they're a nonprofit, but they come out with their, uh, financials every quarter and they had an operating loss.
They're still kind of, uh, navigating these, you know, pretty challenging times.
Seems like they're holding on.
Okay.
But, but they have challenges in all fronts.
What did you think of Common Spirit?
Yeah, they said, uh, it was some supply issues, definitely salaries and benefits.
I'm wondering, you know, as, as much as, um, uh, uh, different systems are bringing on, uh, AI solutions, like how much of this, especially on the supply side, they could actually look at, uh, addressing through, you know, maybe some increased efficiencies with, you know, how they're thinking about supply chain, how they're actually, um, addressing their labor issues.
Mm-hmm.
Yeah.
So maybe, maybe in another year or so this could be different.
Yeah.
Yeah.
I think they're making progress.
The Common Spirit has a, has a hard sort of footprint and a lot of challenges.
In making this turn.
And so I applaud them for, for working on it.
But there's a, there's a lot to work through.
They have a significant, you know, kind of fixed expense with all the buildings and people that they, they need to deliver the care.
Oh, definitely.
Um, and so they have a lot of challenges, but it, you know, good, that good that they're still working on it.
And then Providence's operations also came out, they were slightly positive.
They, they made a little money, a little positive income, so Good, good to see.
Um, there may be like a step or two ahead in this transition.
That's also a more, it's a smaller system and, and.
Maybe slightly better markets than Common Spirit.
So yeah, the one statistic that jumped out to me about Providence, 33% decrease in contract labor spend, which meant they're really trying to think more of, you know, long term, um, maybe not so much of the, the kind of travel nursing sort of concept and everything.
Maybe this is them coming out of, you know, the, the growth that was necessary during COVID and things like that.
Like it, it sounds like they are in that transformational space.
Yeah.
Right.
Yeah.
I mean, you can't, you can't have too high a percentage of travel nurses and make it work.
Yeah.
Okay.
And then getting, uh, away from the systems to more the, the telehealth kind of platforms, hims and hers is expanding, embedding on lab testing to, uh, sort of accelerate their growth.
And so I've been watching hims and hers along with others really begin to sort of build a, a nationwide health.
Brand for end consumers.
Mm-hmm.
Uh, so it, I'm watching this, but you and I were talking before this, this is, um, not necessarily lab tests related to a diagnosis.
It's more that proactive, preventative, let me run sort of the function like.
Uh, very large testing ahead of, ahead of like some actual symptoms appearing.
What are your thoughts about this?
I'm all for prevention, but again, as we discussed with function, um, you know, uh, making sure that they're connected back to a team that can help them interpret, understand the false positives, false negatives, um, and make sure they're, they're connected ongoing so that, you know, it's not just labs and biomarkers that allow us to diagnose a lot of times.
So, you know, are they, are they connected to care teams To actually, uh, meet real diagnostic criteria, I think is a question I would have.
So how is HIMSS and hers really supporting these patients beyond just the lab test?
Yeah, it's exciting that they're offering this, but it needs to be part of a more robust spectrum of services.
Mm-hmm.
Yeah, I mean, I think where it could get industry is.
There's a partnership with Quest Diagnostics to execute this.
So they would send you to Quest to get the blood drawn.
Quest does lots of things.
And so that relationship could then also be in place for diagnostic screenings, uh, over time.
But that's not where it's starting right now.
No.
No.
And then again, where's who's, who's gonna be the, that patient's partner for, for the interpretation of all of this?
Mm-hmm.
This new data?
Yeah.
It's important that we have access to this, but again, the empowerment after the access to just the initial lab test, um, and how patients can then address issues as they come up.
It's not that we shouldn't be doing that testing, but it needs to be part of a larger plan.
Okay.
Then in Fierce health, PYX health, I guess is how you say it.
Um, a second pick.
I mean, Pix Health rolled out AI Power Navigator for social needs.
Among, you know, sort of in and around all of these, uh, issues, Medicaid issues.
You read it ahead, I think.
What'd you think about this story?
Yeah, I mean, I, I, this is exciting.
I mean, this is a, a, a difficult space, um, for a lot of care teams because we don't necessarily, uh, have the, the full, um, social work or community health worker staff at times to, to really make sure we're directing patients to different services around their, their transportation, their housing, their, their food insecurity and the like.
Um, so I, I think making this more accessible, uh, through a AI solution is always positive.
I'm wondering how they're differentiating themselves, though.
There's other databases that, that bring this information together.
So having an AI chat bot on top of that is great, but is that the only differentiating piece?
I'm not sure, but this, I think this is, this is a great, uh, solution for a lot of.
Again, from my PCP standpoint, a lot of providers to partner with their patient on to make sure that they're Yeah.
Using, uh, the right services.
Yeah.
And the, and the PCP should be their, uh, first place where they call or talk to about, gosh, how do I, how do I meet these work work requirements?
Yeah.
I have a job.
Like where do I, uh, send my information?
So, I mean, part of this is that they're gonna sort of have.
Technology tool that the doc can point people to saying this will help you sort of meet those, because each state probably is a little different, et cetera.
It's hard to, yeah, hard to navigate that.
Yeah.
Okay.
And then Millie introduced an AI solution for maternity care.
So Millie is a woman's health clinic and they are bringing this AI agent sort of focused on maternity care.
Interesting.
Uh, what, what are your thoughts about it?
I, I've been watching Millie, I, I know the CEO.
She and I, I talk a news and I'm, I'm, I'm excited for this.
I think a lot of, uh, women need this sort of support.
I think it's very difficult in the typical kind of prenatal space to get your questions answered to, to, uh, be able to, to really feel supported.
So I think this is, this is gonna be strong again, you know, hopefully this can, can be accessible more broadly and not just for those boutique type OB practices that are opening up and, you know, who can afford this solution?
Is there a direct patient access?
Uh, particularly when we're thinking about the inequities and maternity care.
Uh, if it's only available for certain patient populations, they were probably a lot more likely to get this sort of support anyway.
Mm-hmm.
Um, so how do we get this more broadly?
But I'm, I'm excited for this type of solution and I'm, I'm really proud of and new here.
Yeah.
And I, and I think that that's gonna be, uh, a way that we judge them over time.
Mm-hmm.
But the AI tool certainly is at a cost point that you could offer it to every population, and we just need to see them execute on that.
Exactly.
But yes, a lot easier than sort of in person explaining everything.
Mm-hmm.
Which is hard to scale.
Okay.
Moving into the, uh, pharmaceuticals, Roach had a really good, uh, result in a breast cancer trial and their stock's done really well.
Have you followed this story?
I can't pronounce it, cent exactly.
Something close to that.
Exactly.
Yeah.
No, this is, this is exciting.
I mean, uh, you know, the, the estrogen sensitive breast cancer, um, that's a significant, it says up to 70%.
Exactly.
It's a lot of breast cancer is tied to that.
No, this is, this is huge.
Yeah.
I don't know what else to say.
It's huge, you know, again, uh, you know, I'm always thinking access issues, like, is this gonna get to the people, uh, that need it?
But yeah, this is exciting and a big deal and a lot of women that need a better treatment than exists today.
Yeah.
So, yeah.
Can't wait to see kind of who's involved, what the demographics of that, what did they say?
4,100? Yeah.
4,100 patients involved.
Like what's the, the characteristics of that patient population that it was tested on?
Um, yeah.
They didn't give a lot of details about, got a diverse population.
Right.
But, yeah.
Right.
Okay.
And then Merck bought Sudara.
Mm-hmm.
Uh, after j and j sort of.
So that was, it's an interesting sort of, uh, trade.
It's, it is a flu, uh, antiviral, influenza antiviral.
I don't know much about it, but it was interesting that, uh.
One huge company decided not to follow up, and then Merck picked it up for 9 billion.
So it's clearly, it has some, some efficacy.
I have no idea what, uh, happened with, with j and j last year.
Um, this is exciting.
I mean, you know, I had to, I had to read a little bit about this as well too, but just, um, how this can be used as a, a counter to, I hate to say this, that kind of anti-vaccination sort of conversations going around.
It's, it's meant to be more of a. They call it, even in the article, a prophylactic.
So it's actually editing the virus itself as opposed to preventing transmission of the virus, which of course has public health concerns because, you know, part of our desire is to prevent flu from being transmitted as opposed to treating it directly, uh, when someone gets it.
But this is an ex exciting additional option to have as part of our, our tool belt.
So I'm, you know, yeah.
Hopeful it's not the first line, obviously.
Yeah.
But, but once I have the flu, this, yeah, there hasn't been a lot of solutions.
So adding this that's exactly, adding is a great, great option.
Yeah, that's exactly it.
That's exactly it.
So, yeah.
I wonder what happened with Jen and Jay last year.
Yeah.
I don't know.
And then they bought, uh, Halda Halda.
Yeah.
Uh, therapeutics, do you know this technology?
Have you seen this?
Uh, I do.
I, I mean, I, I read a little bit in more detail, but it's exciting.
It's, it's gonna go across multiple different solid tumors starting with prostate cancer.
Um, this is, this came out of, uh, the Yale Ventures team.
I don't know if you're familiar with them.
No, I don't know that Yale, Yale, uh, university has, has really leaned into the innovation space and has their own ventures studio and Halda spun out of that.
Um, so this is exciting.
This is totally, uh, novel technology and, um, it's, it can go very far, uh, beyond just, just this initial use.
So, yeah, I'm excited for it.
And that Yale, uh, developed it'cause that group is really strong.
Yeah.
And we're, we're sort of attacking cancer from all sides.
We have been for years, but it feels like we're getting some momentum now in mm-hmm.
In, uh, in lots of different therapeutics, different ways to approach it.
And then Novo Nordis, uh, cut their prices for the obesity drugs.
We go Ozempic.
And so they, they continue to, you know, try to try to compete in this space.
They're going to be part of the Trump administration's sort of approach to reducing prices in return for getting weight loss to be covered by Medicare.
But, you know, in, in conjunction with that, they're, they're reducing prices overall.
So, yeah, this, I.
This is very positive.
I, I mean, these, these drugs are an unbelievable option for so many patients.
It's, it's more than just the, the elective sort of o obesity piece.
There's obviously a lot more evidence coming out in, in different, you know, ways that these drugs are helping.
So the more that they can become available more broadly.
Um, and outside of, I think what kind of, uh, got me excited here was that it's, they are purposefully seeking to offer these discounts outside of the arrangement with the Trump administration.
So we're removing kind of that political slants.
Yeah.
Uh, I think that could help them, especially, 'cause you know, there is a lot more evidence around the Tirzepatide, right?
That Eli Lilly, so Novo Nortis doing this first.
I think they're, they're trying to like stick out in front.
Right.
Um, I was, this was pretty positive.
I had not heard this.
This is exciting.
Yeah.
Yeah.
And it.
I think there's so many things that are, uh, sort of intertwined with weight gain, obesity, weight loss, that I think a lot of people can benefit from this.
Yeah.
This, well, I mean, it's, it's more than that, right?
Even without the weight loss, it's, it's impacts on chronic pain, addiction, dementia.
Um, I haven't seen, I hadn't heard the dementia piece.
Oh, yeah.
Yeah.
There was a, there was a study, I believe it was a, a VA study, but yeah, there's, there's impacts more broadly than, than the metabolic sort of space, which is, you know, the cardiology kidney.
Yeah.
And I have seen in, uh, alcohol drug addiction.
Mm-hmm.
I mean, all kinds of things.
It really is helpful for that.
Yeah, very much so.
Okay, so then in the health and US, this was a story in the New York Times.
It's, it is an opinion story.
I wanna be clear about that.
And it's from the CEO of Patreon, same's Jack Conte.
And basically it's a, it's a really good video that I recommend people watch.
It's entertaining, but it has, the message is that social media algorithms, you know, have, have rotted our brain is what he says.
I mean, people call it brain wrought because it's sort of mindless and it's, it's designed to keep you engaged and attentive to your device and not engage in the rest of the world.
And I think there's no question that that has, there's been lots of studies that, that, that's true.
Where we have been stuck is, well then how do, what should we do differently?
And so he's proposing that we kind of, you know, it, it's self, uh, fulfilling.
'cause Patreon's business model is to help creators monetize their work, help artists help other.
Uh, songwriters, bands, anyone who's doing creative work, um, it's more of a tipping or subscription.
I wanna subscribe to this Artex who's doing paintings because I, I love what she's doing and I wanna support that work.
And so he's sort of saying we should use the Patreon model of connecting fans to great artists.
Across the whole internet that's obviously self-serving to Patreon.
But, but I thought it was an interesting point because, uh, we need something better.
So, I don't know, what were your thought about this?
Yeah, I mean, there's, there's other examples of this besides the one I won't mention.
I, I just realized Substack is in this same sort of space, right?
Yes.
And I'm, I'm subscribing to a, a handful of, of, and, you know, paying beyond the free option on Substack and, and trying to like, promote independent journalism from that sort of direction.
I mean, I, I think, uh, I think it's a necessary, uh, conversation that needs to be added to this, this larger algorithmic sort of focus that we have elsewhere.
I think there's a, a larger.
Community population that wants to be more in this sort of space as, as we're seeing with these other websites.
So I'm, I, I like this.
It, it made me, it had like the feel good sort of primary care to it as well too.
We should be caring for each other.
Like, it felt good, but yeah, because he's, because he's creative himself, you know, he made the video entertaining, even though it's not, you know, it wouldn't have been super visually stimulating unless, uh, Jack Ante is really creative, which he is.
So it's a, it gets a good point.
Uh, but he, he promotes it in a way that's fun to watch too, kind of.
So I'd recommend people check it out.
Yeah.
Moving into the AI roundup, we don't have any Web3 stories this week.
We'll get back to that.
Um, next week, but we will run through several AI stories.
So, uh, Sanford Health, you had to help me find where they are.
Uh, embarrassingly, I didn't know where Sanford Health was, but they're in the Dakotas mm-hmm.
Decent sized health system there.
Yeah.
They're embedding AI into their electronic health record to really help physicians.
You know, take all of this data and, and get actual insights, is the, is the tagline.
They talked about a kidney disease example as well as colon cancer screening.
But what were your thoughts about this?
I mean, this, this is the direction we're going.
There's, there's others, uh, other solutions coming up that are embedding in, in some of the, the larger, uh, EHRs as well.
Um, we need to get beyond just, you know.
Data visualization or, and, and need to support, you know, care team members, uh, everyone, health plans, community health workers, and everyone to actually do this sort of care and, and interpreting the data.
So, as it says, making it more actionable, I mean, this is, this is where EHRs need to be leaning.
Um, so it's exciting that they have these two new solutions.
I, the colon cancer screening piece sounds like they're, they're, they're really building something, um, a bit unique there.
I'd love to dig into that more, um, around how they're, they're, uh, visualizing that Yeah.
From a chronic kidney disease standpoint, way underdiagnosed, uh, yeah.
Especially in the primary care space.
So that's exciting.
I, I think they're leaning into two areas that are critical.
Yeah, yeah, that's right.
And both are, um, you can make a pretty big impact on.
People's health and yes.
Quality of life in chronic kidney disease and colon cancer screening by, you know, I would say following evidence-based medicine, but at scale.
Yes.
That's really hard to do in, in a, in a practice of any size.
So to having tools that sort of bring things to the surface and ask a clinician to like, look at this potentially actual insight mm-hmm.
Uh, could be really helpful.
Mm-hmm.
That's exactly it.
Okay.
And then Nvidia had their earnings, uh, last night.
You'll be hearing this on Saturday, so it's a few days ago, but they, they beat earnings dramatically and they continue to sort of grow, you know, to the sky 57 billion in the last quarter.
Mm-hmm.
And that was a huge uptick from the.
47,000,000,001 quarter ago, so that they continue to grow incredibly fast.
There is this systematic issue of sort of all of the intertwining of, you know, Nvidia is investing in companies and then those same companies buy their chips.
That will have a story about that in a minute.
But people were very concerned about, you know, is the AI in a bubble?
And this made people feel, um, happy.
At least for today.
It's the next day after it.
But I think positive overall for, for the stock market and for kind of the ai, uh, boom or whatever.
Yeah.
What are your thoughts about this's.
That's the sum of it.
It was, it's uh, it's a little bit more reassuring, but we'll see.
We'll see how long that lasts.
Yeah.
Yeah.
And then sort of on that line, there's lots of stories we could point to.
We've covered, uh, them from time to time.
Nvidia and Microsoft are investing 15 billion into anthropic.
They have, of course have Claw, which is probably the best, uh, for enterprise and best for software engineering.
We were talking before the show about this capital flows diagram, that if you're watching, uh, you can see it's very intertwined where Nvidia is sort of at the center of this ecosystem.
They're investing in lots of companies.
The current story is anthropic, but then Anthropic turns around and, and, you know, buys from Nvidia and Microsoft's invested in Anthropic.
That's where they use the cloud for a lot of their work.
So it's all intertwined.
My thought processes.
I don't know.
That it's necessarily a problem, but anytime this, uh, super complicated capital flow has occurred, it typically doesn't end smoothly.
I don't know where there'll be a problem, but, but it, it makes things more fragile in general.
Yeah.
I love I risky circular financing.
Yeah.
I, this makes me nervous.
I, I have no background in this, but just seeing this, this makes me nervous.
You, you used incestuous before.
Yeah, yeah, that's right.
Like that, that just, I I feel like this could be problematic in the future.
Yeah, that's right.
I mean, I mean, the music will stop every new technology, um, like ai.
I mean, there's incredible capabilities and, and it is gonna be, uh, very impactful in how we.
We live our lives.
And at the same time, human nature is to sort of overemphasize kind of the impact in the near term and under emphasize in a 10, 20 year view.
So there's a decent chance that the financial markets, the stock market will get like over its skis, get over, you know, overly enthusiastic, and then somewhere AI will not perform.
And maybe it's not this quarter, it might be next quarter, it could be a year from now when the music stops.
I mean, some of these companies will do well, but, but there'll be, there might be ones that don't do that well too.
Yeah.
Okay.
And then open AI and Intuit, uh, you know, the maker of TurboTax and QuickBooks struck a partnership.
And you and I were talking before, of course, uh, Intuit, like all these software companies, is using large language models, including open AI internally to sort of.
Help them run their software business.
But the partnership is really not about that.
Mm-hmm.
The partnership is about OpenAI putting into its technology, their solutions, right into the OpenAI interface.
So you don't have to leave your conversation with CHATT T to be able to file your taxes.
You can just do it right there with the chat bot.
What are, what are your thoughts about this?
I, I mean, you know, to make, uh, the, the text process easier.
Great.
I don't know.
I don't know why this makes me nervous.
Um, yeah.
I don't, I don't know why enough about, well, I'll tell you why.
It makes me nervous.
Um, and so, I mean, I understand why Intuit's doing it.
There are.
500 million monthly users.
Now that's globally, I think, but uh, maybe it's 800 million.
There's a lot of users every month that are in open AI's interface, and all the US citizens need to file taxes, and all of the small businesses need to use QuickBooks or something else to keep up with their financials.
It will sell more products for Intuit, I think.
Yes, there's no question about that.
Why it makes me nervous is that, and I've, I think I've been clear on the show, I'm not very trustful that OpenAI will use my data or anyone else's data for purposes that are, you know, good for me.
I think they'll more likely use it to make money for OpenAI shareholders because that's what they're required to do.
Yep.
And in order to file your taxes, you have to give.
Not only your earnings, but your social security number where your address is, like everything about your financial life, including your personal, you know, highly confidential numbers like social security must be entered in.
And the fact that I would use Chat g PT to, to take care of all that information and then expect that it will be put in, placed in the right TurboTax cells and then deleted, I think it's just not realistic.
I think that it's not gonna have, there'll be lots of information that then OpenAI is ingesting, and it may not be as clear how they monetize it, but they might come back to me and sell me something.
Mm-hmm.
Uh, because they know that, they know I, I need it, or they know I've paid for it in the past for, for taxes.
So anyway, that, that's what makes me nervous about it.
Um, but it isn't.
I feel like the horse has already left the barn with that.
I mean, I'm trying to get, uh, health records encrypted and held by individuals, not held by the large language models.
Mm-hmm.
You know, that's hard enough.
But, um, but financial records also, if I was in finance, I'd be trying to fight for that.
So I don't know that that's what makes me nervous about it, but it's, I can't stop it.
It's not gonna stop everyone.
They have everything.
I'm the type that doesn't even like to use, like, you know how you can sign in with your, your, your Google ID to multiple different websites for purchasing.
I don't, I create new IDs for every, I don't want all my data connected like that.
Right.
For the exact reason.
Uh, so yeah, that's, uh.
I don't, I would, I don't think I'd be entering my, my tax info into the che GPT for exactly everything.
Yeah.
And, and TurboTax has a great interface on its own.
Yeah.
My, I have an 18-year-old son who needed to file his taxes.
We sat down and did it and, you know, it took maybe 15 minutes.
It didn't take long at all.
It's a great product.
It's plenty easy enough through their interface, but, but people are gonna use it through, through chat, I'm sure.
Exactly.
Okay.
The last story, uh, Google released their new version of their model, uh, Gemini yesterday, Wednesday.
So a few days ago when you're listening to this Gemini three Pro, and it immediately is the highest performing model.
It's also the, um, the most expensive model.
Um, and then you pointed out that it has, um, some other aspects that are.
I don't know, concern or need to be accounted for.
So what were your thoughts about Gemini?
For our first, we are gonna continue to see, uh, just.
More advancements on, I mean, the speed with which these, these different tools advance, uh, is just astonishing to me.
So I'm excited that, uh, Google is, is giving open ai, it's, uh, run for its money.
I think the point that I raised that you have highlighted here was just this initial hallucination rate.
And so of course from a clinical standpoint, that, uh, definitely, uh, makes me a little nervous.
Um, yeah.
But I'm, I'm loving how, uh, the, the speed, the, the, the ability for these to just advance here.
It talks about being natively multimodal as well, too, how it processes most multiple different inputs together as opposed to relying on separate models.
Like that's, yeah, that's just exciting.
Um, yeah, I mean, the demos, there's always a ton of demos.
The demo that I was most surprised about maybe is that, uh, they had this demo of like a.
Lecture, like a college lecture.
Yes.
Um, and, you know, it is a video of it, and then Gemini can make flashcards for the student to study.
Yeah.
Based on watching the video.
And I had not seen video as an input before, but, um, but that's pretty useful because, uh, in sports or in education or in healthcare, a lot of stuff is, uh, a combination of, yes, there are words and texts, but there's also physical movements and activities and sort of context matters.
So multimodal I think is, is an interesting, uh, benefit.
I, I, I agree with you.
I think the, I've been playing with it, but it's only been 24 hours.
It seems really strong.
Um, but just the com, the, the competition, um, of all of these models kind of leapfrogging each other or lifts all the, lifts everything up and, um, it delivers a better product in the long run.
So, yeah.
Great.
Well, cam, thanks for doing this.
That's the end of the show.
I really appreciate you filling in.
You're, you're, um, have a very different point of view than Marcus.
Much stronger on the public health and actually science side of things than Marcus or I. No, this is, so have your input.
This is fun.
I love you guys conversation every week.
So, um, adding my little sl I'm using the on a treadmill yelling at one of you while I'm, I'm listening, right?
No, you forgot this point.
What about the public health concerns?
So I'm glad I can actually speak to it this time.
Yeah.
Excellent.
Well, thank you for doing this.
We're excited to hear about your new adventure.
When you're ready to, uh, tell us about, we'll have to have you come back on to talk about your new, new idea.
I would love to actually, yes.
Yeah, yeah.
Okay.
Thanks Cam.
Really appreciate you doing this.
Thank you, Vic.
This is great.