Alex Maiersperger

Walmart closing 51 Health Centers over “Lack of Profitability!” Walmart Health Virtual Care (telemedicine) offerings will also end. Article by Daniella Alessandra Genovese Fox Business Network April 30, 2024 MY TAKE: · What does ‘lack of Profitability” really MEAN? o Is it meant that this service line is losing money – financially upside down? o Or does it mean that the line is not producing the “EXCESS PROFITS” that were envisioned - and that corporate leaders and shareholders demand?   ·    Healthcare delivery is NOT a simple business model, though increasingly we see corporate entities entering this arena, often envisioning large profits or - in the case of private equity - valuable ASSETS whose value can be accelerated over short periods - or at least sold off as value-added components.   ·    It has been said that the LURE of ‘excess profit’ invariably leads to GREED, and that in healthcare - greed invariable leads to worsening conditions within healthcare workplaces and worsening outcomes for patients! American Medical Association American Hospital Association American College of Emergency Physicians U.S. Senate Committee on Health, Education, Labor, & Pensions Tennessee Medical Association Jesse Pines Chadd Kraus Lara Vanyo Rita Manfredi TENNESSEE COLLEGE OF EMERGENCY PHYSICIANS Timothy Wilson Ryan Stanton Gabe Kelen, Deidre McPhillips Mollie Pillman Alison Haddock, MD, FACEP Susan Morse mor Chelsea Torres Amy Feldman Jesse Ehrenfeld MD MPH Mel Cortez Larry Bucshon, M.D. Peter Stavros Fox article link - https://lnkd.in/gynsbScT

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🚀 Telehealth’s Rocky Road: Beyond the Pandemic Boom 🚀 Telehealth companies like Teladoc, Amwell, Hims & Hers, and 1Life have experienced a brutal year, with stock prices plummeting 40-80%. This begs the question: what went wrong? 📉 🏬 The Retail Approach’s Fall 🏬 Telehealth initially mimicked the retail industry, prioritizing convenience over building strong patient-physician relationships. This lack of trust and loyalty proved detrimental. 😔 🔄 Continuity Conundrum 🔄 Telehealth often falls short in providing continuity of care. While some offer virtual primary care, this message hasn’t resonated with patients who perceive telehealth as solely for minor, urgent needs. 🏥 🩹 Beyond Band-Aids 🩹 Telehealth primarily addressed low-hanging fruit, focusing on minor issues that could often be ignored or handled by a regular physician. Traditional telehealth hasn’t equipped itself to handle complex diagnoses or common problems requiring thorough workups. 🌱 📚 Lessons Learned 📚 The failures stem from flawed business models, not a lack of patient interest in telehealth. So, what can we learn? 🤔 🤝 Human-Centric Healthcare 🤝 Building trust and loyalty through a strong physician-patient bond is crucial for long-term success. This translates to convenient access for patients and efficient workflows for physicians, potentially using AI tools for administrative tasks. Seamless data exchange with other healthcare systems through Health Information Exchanges is also vital. 🌐 🌟 Expanding Capabilities 🌟 Moving beyond basic video visits is essential. Integrating capabilities like pulmonary function tests, EKGs, and home-based testing for common illnesses can significantly enhance telehealth’s value proposition. Additionally, offering home visits from qualified nurses for specific cases can further improve patient care. 🌈 By addressing these critical shortcomings and focusing on a human-centric, comprehensive approach, telehealth can still thrive in the long run. 🌿 Feel free to ask if you’d like to explore more! 🙌 #healthcare, #telehealth, #investment, #patientadvocacy

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💯agree with Dr. Mehta and to quote her: Healthcare is broken, and those that are in it understand why. Patients need - and deserve - quality health care. This requires safe staffing practices, skilled clinicians who can feel good about what they do, and insurance companies that pay their bills. We can’t have a system where insurance companies can get away with record profits while finding more and more reasons not to pay for care and eroding away at the heart of healthcare. You cannot scale your way out of America’s healthcare problem. You actually need to fix the incentives, regulate insurance companies, pay clinicians appropriately, prioritize clinician well being and retention, and focus on the patient. The days of paying lip service to physicians leaving medicine and physician burnout are numbered. Supply and demand forces will necessitate real solutions that move the needle.

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🩺💻 The Achilles Heel of Telehealth: Why Walmart and Village MD Stumbled 🩺💻 Walmart’s recent decision to shutter its entire healthcare division, including 51 physical clinics and its virtual care platform, sent shockwaves through the industry. This news, following the closure of Village MD clinics by Walgreens, begs the question: what went wrong with these seemingly promising ventures? 🤔 The Walmart Case: Walmart cited “a challenging reimbursement environment and escalating operating costs” as the reason for its exit. While convenient and affordable, their model struggled to compete with established healthcare providers and navigate the complex insurance landscape. 🏥💰 What Didn’t Work: Lack of Integration: The clinics operated independently, lacking deep integration with existing healthcare systems, which made patient data sharing and continuity of care difficult. 🔄📊 Focus on Price Over Value: While offering low costs, Walmart may have prioritized affordability over building strong patient relationships and personalized care. 💲🤝 Limited Scope of Services: The clinics primarily offered basic primary care, potentially failing to attract patients needing more specialized services. 🏥🔍 Models that Work: While Walmart’s venture faltered, other telehealth models are showing promise: Value-Based Care: Providers focus on preventative care and managing chronic conditions, potentially lowering overall healthcare costs and improving patient outcomes. 🌿🏥 Integrated Telehealth: Seamless integration with existing healthcare systems ensures smooth patient data sharing and a more holistic care experience. 🔄🔗 Specialized Services: Telehealth platforms that connect patients with specialists in specific fields, like mental health or dermatology, are proving successful. 🌟👩‍⚕️👨‍⚕️ Village MD Closure: Walgreens’ closure of 160 Village MD clinics highlights another challenge: ensuring the financial viability of these ventures. While Village MD focused on primary care, the high cost of acquiring and operating clinics might have outweighed the revenue generated. 💼💔 The Takeaway: Telehealth holds immense potential, but its success hinges on overcoming these critical hurdles. Building a sustainable model requires: Strong partnerships with established healthcare providers. 🤝🏥 Focus on value-based care and patient outcomes. 🌟📈 Integration with existing healthcare systems. 🔄🔗 Offering specialized services alongside primary care. 👩‍⚕️🔍 The recent closures serve as a cautionary tale, but they shouldn’t overshadow the potential of telehealth to revolutionize healthcare access and delivery. By learning from these missteps and focusing on sustainable, patient-centered models, the future of telehealth remains bright. 🌐🏥🌟 What are your thoughts? #telehealth #healthcare #technology #medicine #futureofhealthcare

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The recent downsizing of VBC operations by giants like Walmart, Walgreens, and CVS marks a pivotal moment in the healthcare sector. This shift from a previous era of aggressive expansion to a more measured approach in scaling value-based care (VBC) reflects a maturing market that prioritizes sustainable growth over size. However, the contraction of these clinics doesn't signal a decrease in the viability of VBC models. In fact, top-performing Accountable Care Organizations (ACOs) continue to prove the profitability of focusing on primary care. These ACOs excel by strategically targeting practices that manage sick yet stable patients—those who are most manageable within a VBC framework and are crucial for consistent shared savings. The success formula is clear: select practices with the right patient demographics and ensure alignment with local specialists and hospitals ready to embrace collaborative, value-driven care. Maximizing risk scores and focusing on preventing care cost escalations in these targeted patient populations are essential tactics. As we move forward, let's consider these shifts as strategic realignments rather than setbacks. For those of us dedicated to transforming healthcare, it's a reminder to remain adaptable, data-driven, and patient-centered in our approaches.

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How do you know if your latest healthcare innovation is ready to scale? 🤔 In my latest post, I dive into a powerful approach for testing new ideas before committing to full-scale development: the "fake back end", also known as a Wizard of Oz experiment. By simulating technology behind the scenes, healthcare teams can uncover valuable insights and refine their solutions without heavy upfront investment. Here's what you'll learn: 📌 What a "fake back end" is and why it’s called the Wizard of Oz experiment 📌 Steps to identify assumptions and validate them with minimal risk 📌 Practical healthcare examples, from AI symptom checkers to appointment scheduling assistants 📌 How to measure success, decide when to pivot, and know when it's time to scale Read the full post to learn how the journey behind the curtain can reveal some of the most valuable lessons in healthcare innovation. 🏥✨ #HealthcareInnovation #DigitalHealth https://lnkd.in/eJ_5aaju

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Why It’s Time to Redefine the Patient Bill of Rights for #Dialysis Care The Centers for Medicare & Medicaid Services Patient Bill of Rights, while foundational, no longer reflects the realities and evolving needs of today’s dialysis communities. Patients, care partners, and providers face challenges that go beyond what current #CMS standards address. It's time for an upgrade. Dialysis is not just a medical procedure—it’s a way of life for millions. From financial transparency to access to cutting-edge technology, patients deserve more than what the CMS framework offers. That's why I’ve developed a reimagined Dialysis Patients Bill of Rights, a forward-thinking framework tailored for the modern world. 🛠️ What’s Outdated About CMS’s Current Standards? The CMS framework prioritizes basic compliance, but it neglects: 🌐 Technological advancements like telemedicine 💼 Financial equity for underserved patients 💔 Mental health and emotional support ⚡ Emergency readiness for home patients 🤝 Inclusive roles for care partners These gaps leave patients and care teams vulnerable in areas that matter most. 🎯 Why My Proposed Version is the Future of Dialysis Care Let’s embrace a more patient-centered, inclusive, and innovative vision for dialysis care. Here’s how my proposed Bill of Rights surpasses CMS’s outdated approach: ✨ Core Innovations 📊 Financial clarity & equity 🚀 Advanced treatment access 📱 Seamless virtual consultations 🧘 Holistic Care 🫂 Mental health focus ❤️‍🔥 Support for care partners 🌍 Cultural & linguistic inclusion ⚖️ Patient Empowerment 📝 Timely transplant referrals 👩‍⚕️ Shared decision-making 🔑 Personalized care plans 🏠 Home Dialysis Revolution 📦 Timely supply deliveries 🛠️ 24/7 technical support 🌐 Emergency preparation resources 🛡️ Proactive Measures ⚡ Emergency planning 🏥 Palliative care options 📡 Community advocacy This is not just about improving healthcare delivery—it’s about empowering dialysis patients to live with dignity, equity, and hope. 🌟 💬 Now, It’s Your Turn What do you think? Is it time for CMS to modernize the Patient Bill of Rights for dialysis care? How would you improve patient experiences in today’s complex healthcare landscape? Let’s spark a conversation. Share your thoughts below or message me to collaborate on shaping a future where every dialysis patient thrives. 💭 My email to CMS is attached (do not steal) #DialysisCare #HealthcareInnovation #PatientRights #Advocacy Chiquita Brooks-LaSure Jean Moody-Williams Meena Seshamani, MD, PhD John McClellan, MD Cheri Rice

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🌶 Hot Take Time. Let's get spicy! Measurement-Based Care -- as we think we know it in behavioral health -- is on life support. 🚦 Signal #1: A number of digital health solutions have pivoted their value proposition from MBC to AI-Powered Notetaking and Treatment Plan Creation for Therapists. The workhorse providers that make up most of the field (i.e., mom and pop SMB's) do not have a strong enough data-driven culture to fully and successfully implement MBC software and workflows. Software is not getting used and there is too much churn and investors are getting impatient. And payors have not seen the consistency and proof necessary to "award" providers with value-based contracts (beyond managed care or capitated rate contracts). 🚦 Signal #2: Domain name changes from .com to .ai and the use of AI in every marketing message everywhere. Yes, #artificialintelligence is the new cool kid on the block. And because many of the digital health solutions are investor-backed, AI seems to be the pivot to build the customer base. The core competency of MBC, which most of these solutions were built for, will re-appear through the backdoor. The biggest challenge those of us on the technology side and those of you on the provider side face is really one of skill and culture. Building a data-driven culture takes time and dedication from leaders, managers, and front-line champions. But when your day-to-day is disrupted because of the nature of the members to be served, building a data-driven culture falls to the backburner. All of this is about improving the quality of care. There is an art and a science to delivering high quality care. The providers that lean into and invest in performance-based skills, simple technology solutions, and longer-term commitments will find themselves delivering measurement-based care. But there are a few steps we cannot skip over to get there. And unfortunately, many of the leveraged digital health solutions do not have the time and must pivot. See above .... AI. #behavioralhealth #digitalhealth #hottake #AI

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I’m excited to share what we've been obsessing over for the last six months! Introducing Threshold Health, a unique patient engagement platform that puts healthcare operators in the driver's seat of modern care gap closure campaigns. Shockingly, only 1 in 20 US adults is up to date on their recommended preventive care, such as cancer screenings or blood pressure testing. This statistic is paradoxically low, especially given the increasingly direct financial incentives tied to increasing population-level care quality. When my longtime friend and now cofounder, Dr. Doug Murad, and I started exploring why patient engagement is so low, we quickly discovered a recurring pattern. Time and again, we heard from passionate operators across diverse healthcare organizations who struggled to mount effective patient engagement campaigns, often waiting until the last few months of the contract year to close important care gaps in their patient populations. In almost every case, these operators seemed to be building campaigns from scratch, deploying blunt tools like bulk SMS, physical gift cards, and manual call centers, and relying on lagging indicators of success. Unsurprisingly, these efforts were operationally expensive and often fell short of their targets. Dr. Doug and I aim to empower healthcare operators level up their patient engagement with campaigns that are cheaper, better, and faster than building something themselves. To do this, we’re building a self-serve platform that makes it easy for operators to rapidly launch and iterate on modern campaigns that integrate well with their existing care coordination workflows. If we’re successful in this first step, we will have a vehicle to deliver an increasingly sophisticated library of campaign templates and next-generation patient engagement technology. So far, we’ve developed a prototype that allows operators to go from zero integration to a modern deployed campaign in fewer than 10 clicks. We’re excited to run our first pilot in mid-July and continue developing the product with 2-3 launch partners through the rest of this year. There's a lot left to learn -- I plan to post regular updates and lessons here. Reaching this level of conviction took a lot of time—not just from me and Dr. Doug, but from numerous experts across various fields who have been extremely generous in sharing their expertise and feedback. I especially want to thank our network of advisors: Daniel Croymans, MD, MBA, Benjamin (Benny) Axt, Indira Gowda, Ivo Vlaev, Suruchi Kothari, MD, Melissa G., Christian Spier and many others; our investors Jane Wang and Saumitra Thakur at MedMountain Ventures; and our first full-time employee Joe Bonneau. Also, shout-out to Shirley Mao and rvnway for designing and building our new website: https://threshold.health With all that said, we’re open for business! Let’s chat :)

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#Startups - Take note! The blog post from Michael A. Greeley of Flare Capital Partners does an excellent job of highlighting key practices in #scaling a #healthcare startup effectively. Check it out and take what Michael says to heart - or in this case - to stomach. #startupsuccess #innovation #healthcareonLinkedin https://lnkd.in/e7wr2Gry

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This is very interesting! I am seeing these "divergent" systems emerging of "Have's and the Have nots" The large AI enablement systems are targeting the large Epic and Cerner Corporation to some extent MEDITECH, providing value for the megahealth systems. Independent primary care is becoming dependent on ACO enablement companies like Aledade, Inc. and Privia Health to some extent agilon health to help them contract and decrease total cost of care. I absolutely agree with the notion that: "Upfront payments at the start of model participation would help practices with limited financial reserves invest in resources to improve care delivery and participate in the models." Will the emerging ACO PC FLEX model be compelling enough? Why or why not? https://lnkd.in/eC-ht_xD

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Need - check Fit - check Proven Solution - check

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Robin Goldsmith thanks so much for having Sameer Berry, MD, MBA on your show to talk about Oshi Health and our innovative care for #digestivehealth conditions. Such a great conversation around the challenges in #gastroenterology and how new care models like ours address them in ways that are a win for all stakeholders. #valuebasedcare #accountablecare #wholepersoncare

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Dr. Daniel C. Baumgart and I each comment on an important work about Health Data Integrity piece by Joe Lennerz, Nick Schneider, and Karl Lauterbach in Issues in Science and Technology (https://lnkd.in/gk5a6TBV) . Read the original! https://lnkd.in/gy_hxcyt

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Question for my network: how do you evaluate your digital health and health tech initiatives? Do you use any frameworks or services, etc? I am not one of those "tech can solve everything" people, but I do think it is a primary enabler for the future of health, equity, and "doing more with less" since we can't seem to magically triple our workforce or funding for it. Digital Health initiatives have been a little willy nilly and certainly aren't a silver bullet. But—for that reason, more and more attention is now being given to both evaluating digital health/health tech initiatives (finally!), AND bringing the health equity lens into their development/implementation (heck yes!) For the latter, I was interested to read the development of this Digital Health Equity-Focused Implementation Research (DH-EquIR) model! This framework outlines how you might start to integrate considerations of health equity into the implementation of your digital health technologies. Key takeaways: 👏 Inclusive Design: Technologies must be accessible and culturally sensitive, designed with input from diverse communities. 👏 Equity-Focused Planning: Integrate health equity considerations at every stage to reduce disparities. 👏 Continuous Evaluation: Monitor and adapt interventions to meet the needs of underserved populations. 👏 Sustainability: Ensure financial sustainability and interoperability for long-term success. 👏 Collaboration: Engage stakeholders from all sectors to drive impactful health solutions. It is promising to see health equity being promoted through thoughtful and inclusive digital health solutions designed to meet people where their real challenge is at, and I recognize that tech, people, and workflows go ✋in ✋ Frameworks like this are helpful as directional guidance to start with. I am also seeing a lot of "Digital Determinants of Health" crop up, though still meaning different things by different groups. Source: Construction of the Digital Health Equity Focused Implementation Research Conceptual Model - Bridging the Divide Between Equity-focused Digital Health and Implementation Research (https://buff.ly/3RbWmDQ) ----------------------------- (AI was used to generate this strange and misshapen/spelled image, but I actually kind of liked it!!)

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In the latest episode of the "In Network's Designing for Health" podcast, I dive into an insightful conversation with Joshua Liu, MD, co-founder of SeamlessMD. We discuss Dr. Liu's journey from medical school to the tech world, his insights on the importance of clinician buy-in, and the simplicity of effective solutions in healthcare. We also discuss strategies for engaging content on social media. Key takeaways include the significance of designing healthcare technology with a patient-centered approach and the impact of SeamlessMD in reducing hospital readmissions by guiding patients through their healthcare journeys. Josh emphasizes the need for healthcare solutions that clinicians are willing to use and endorse, highlighting the pitfalls of bypassing clinician engagement during technology implementation. For more episodes, subscribe to "In Network" on major podcast platforms and consider grabbing a copy of the book I co-authored, "Designing for Health: The Human-Centered Approach," for deeper insights into human-centered design in healthcare. #HealthcareInnovation #PatientCare #DigitalHealth #HealthTech #ClinicalDesign #PodcastHighlight

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A whirlwind of activity last week at the America's Physician Groups conference. Lots of solid insights shared by health system leaders. Some notable thoughts: +++ Artificial intelligence is intelligent in different ways: By now, we all know ai has a diverse set of use cases, incorporated in different applications and tools. But there are fundamental differences in how the intelligence itself is brought to life. Examples include: - Predictive AI, used to forecast future outcomes by leveraging historical data. Shout out to UCLA’s CKD/ESRD early intervention protocol (Joycee Berin) and Diagnostic Robotics’ intelligence care post-dicharge journeys (Kira Radinsky) - Protocolized AI, used to automating a user’s administrative load by using a set of detailed, pre-defined rule sets. Thanks to ARC for sharing their experience using Elaborate 's automated outpatient lab summaries (Manish Naik) - Generative AI, used to create new content. Great overview of ambient documentation at MGB as well as Cedars’ Sinai talking through its medical ontology model powering acute triage (Caroline Goldzweig) Across system leaders and experts, there was clear agreement that the first step to implementing intelligence intelligently is defining the ‘jobs to be done’. That way, internal and external stakeholders are clear on what they're solving for when they architect the solution.  +++ Scaling AI takes time and rigorous observation: Market leaders describe a phased pilot approach that allows clinicians to build confidence and system leaders to measure ROI before deploying systemwide. Loved hearing Rebecca Mishuris outline MGB’s novel approach of piloting two solutions against one another, to pressure test implementation, workflow, and value creation. +++ Proving ROI continues to be challenging: Lots of vendors using lots of different metrics to prove value, but the majority of leaders agreed that estimating the ROI of these new tools today is part science, part art. Demonstrating the ROI of the “soft” metrics around provider burnout and retention seemed to be a big opportunity, especially for investment in more efficient primary care and PCP wellbeing. After all, PCPs drive referrals to specialty-level care (and higher reimbursements) for health systems. Appreciated Anurang Revri's overview of how working team setup can also impact ROI estimates. +++ Value-based care = tools + humanity: VBC will require not only implementing tools to support clinical documentation, risk capture, upcoding, etc, but also humanizing interactions to engage patients. Countless examples, but one that made me smile was a depression focused chat bot responding in the following interaction: - Context: post-discharge check in Bot: Hi Freida, how are you feeling today after your surgery?  Patient: I’m having a tough time, am in a lot of pain.  Bot: Well, it can’t be that bad, I’m sure it will get better with a positive mindset!    🤣 🤣 🤣 Can't wait for next go-around!

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The numbers are linked - value add: here are my humble thoughts on headwinds and tailwinds reading between the lines: Headwinds and Tailwinds for NeueHealth within the Value-Based Care (VBC) Industry: Tailwinds: Consumer Growth and Market Expansion: Strong quarterly growth across Medicaid, Medicare, and ACA markets indicates demand for value-based models. Additionally, partnerships with federally qualified health centers provide a competitive edge in expanding accessible care. Provider and Payer Relationships: The expansion in Central Florida showcases NeueHealth’s ability to grow via payer partnerships and reflects the industry’s shift towards coordinated, quality-driven care. Capital-Efficient Growth: The company aims to leverage existing relationships and a scalable model to drive growth without extensive capital outlays, which is well-aligned with VBC trends. Headwinds: Financial Losses and EPS Decline: Despite positive EBITDA, the EPS miss and revenue decline underscore challenges in achieving profitability and scaling revenue growth sustainably in the VBC industry. Costs in Provider Enablement: The NeueSolutions segment reported a $5.8 million loss in Q3 due to internal payments related to ACO Reach. Managing these costs while expanding partnerships may affect near-term profitability. Regulatory and Market Risks: Shifts in CMS policies or state-level Medicaid funding could impact future growth potential, especially as NeueHealth grows its Medicaid service footprint. In summary, while NeueHealth faces near-term financial challenges, its solid consumer growth, payer partnerships, and alignment with VBC demand trends position it for potential long-term gains in the value-driven healthcare market.

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If you are an executive from a healthcare system or payor or a clinician from a large group practice I would love your participation in this survey. This survey is to help us understand how key decision makers in healthcare find, evaluate and decide which digital health innovations to adopt. https://lnkd.in/g9DjehDv

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