Category Archives: Healthcare Reform

96 Ways To Say “Bite Me”

Posted on September 17, 2011 by
The forgotten codes...

Once upon a time we marveled at the fact that Baskin Robbins had come up with 31 flavors—what a smorgasbord of opportunity.  Then they branched out into seasonal flavors, regional flavors, even frozen yogurt, which vaulted them upwards into having more than 50 flavors.  What a joy to behold:  more is definitely better when it comes to ice cream.

Same story for television.  Some of you, those that are resting comfortably next to me in a nursing home, will remember the old days when we had ABC, CBS, NBC and Channel 13 as the primary TV channel choices.  Then there were 13 channels, then around 20, and now my mercenary cable providers shows me more than 700.  This example is a little sketchier.  More than 4 channels is definitely better.  As many as 700?  Well, I guess it works if you figure that they are trying to capture everyone in the world’s tastes, even those that want to watch Jersey Shore and Deadliest Catch.

So what do we make, then, of the Center for Medicare and Medicaid’s (CMS) recent announcement of the updating of the diagnosis codes that … (read the rest)

Posted in Diagnostics and Screening, Healthcare, Healthcare Information Technology, Healthcare Policy, Healthcare Reform, Random Thoughts of the Day | Tagged , , , , , , , , , | 6 Comments

CHCF: Proud Sponsor of Our Friday Medical Comedy

Posted on July 29, 2011 by
vet

I was fortunate enough to be invited to spend a morning last week with the management and investment team of the California HealthCare Foundation (CHCF).  For those of you unfamiliar with CHCF, it is a non-profit grantmaking philanthropic enterprise based in Oakland, California. Founded in 1996 as a result of the transformation from the old Blue Cross of California to the for-profit Wellpoint Networks, the staff of about 50 people issues around $40 million in grants each year from an endowment of approximately $700 million. CHCF focuses its energies around these four healthcare initiatives:

  • Improving clinical outcomes and quality of life for Californians with chronic disease
  • Reducing barriers to efficient, affordable health care for the underserved
  • Promoting greater transparency and accountability in California’s health care system
  • Supporting the implementation of health reform and advancing the effectiveness of California’s public coverage programs

It is a really wonderful organization full of smart people who are dedicated to improving the delivery, quality and financing of healthcare within the State of California, and particularly to improving access to and delivery of care within underserved communities.

The primary reason for my visit there was to … (read the rest)

Posted in Healthcare, Healthcare Policy, Healthcare Reform, Healthcare Venture Capital, Uncategorized | Tagged , , , , , , | Leave a comment

General Hospital

Posted on July 13, 2011 by
General Hospital's Luke and Laura

 

General Hospital is credited by the Guinness Book of World Records as the longest-running American soap opera currently in production (according to Wikipedia).  What a perfect metaphor this is for the real hospital industry, which is facing more drama than ever.

This week I visited two hospitals, one a very large and well-known academic medical center, the other a very small community hospital.  Fortunately, neither visit was as a patient. In both cases I was there to talk about healthcare information technology and the hospitals’ respective strategies for innovation in that general area.

It is always really interesting to talk with hospitals about how they want to use technology to enhance their operations. There is an inherent tension between the desire to, on the one hand, do the right thing for patients by continuously improving quality of care and, on the other hand, to respond to the fiscal challenge that sometimes doing the “right thing” might just cost more or at least take a while to pay off.  Often times the decision to provide better care can result in hospitals actually losing money, because it means that patients need … (read the rest)

Posted in Healthcare, Healthcare Information Technology, Healthcare Reform, Patient Safety, Uncategorized | Tagged , , , , , , , , | Leave a comment

Go Bryce!

Posted on July 2, 2011 by
Who doesn't love a rainbow-colored unicorn?

You know how they always say that in venture capital and private equity investing, great management is even more important than a great idea?  Well, when you get both together, it’s like finding a rainbow-colored unicorn.

So please meet our unicorn du jour, Bryce Williams, CEO of ExtendHealth.  Bryce is the poster child for dedicated, performance-oriented CEOs and has the unusual attribute of also being a pretty great guy.  And for all that, Bryce has just quite deservedly been named the Ernst & Young Entrepreneur Of The Year® 2011 Northern California award winner in the category of business services. Williams and other category winners (a parade of stars that includes the Chairman of Linked In, and the CEOs of PayPal and Cepheid, among a few others) were honored at a gala event on Saturday, June 25 in San Jose.  I know that “gala in San Jose” seems like an oxymoron, but hey, you eat your rubber chicken where it’s served.

 

 

Extend Health, which operates the largest private Medicare health insurance exchange in the country, is a Psilos portfolio company, natch, and is knocking it out of … (read the rest)

Posted in Healthcare, Healthcare Policy, Healthcare private equity, Healthcare Reform, Healthcare Venture Capital | Tagged , , , , , , , , | Leave a comment

There’s Gold in Them There Healthcare Hills

Posted on June 21, 2011 by
The second coming of the gold rush?

Once upon a time in 1955, Fortune Magazine published its first Fortune 500 list, an annual list that ranks the top 500 U.S. public and private companies based on their gross revenue.   The original Fortune 500 was restricted to companies whose revenues were derived from manufacturing, mining, or energy exploration, although Fortune published some ancillary lists of the 50 largest commercial banks, utilities, life insurance companies, retailers and transportation companies.  Look closely at those early lists; the closest thing to a healthcare company that appears in the original Fortune 50, the top of the list, is Procter & Gamble.  I am not really sure what P&G’s primary brands were in 1955, but their claim to fame in healthcare currently includes toothpaste and tampons, not the “big stuff” such as pharmaceuticals, health insurance, medical devices or healthcare services/IT.

Procter & Gamble remained the only healthcare-ish company in the Fortune 50 until 33 years later in 1988, when Johnson & Johnson joined it on the list.  While there were a few companies that may have dabbled around the fringe of healthcare before 1988, such as Hewlett-Packard, healthcare has had a real … (read the rest)

Posted in Health and Wellness, Healthcare, Healthcare Information Technology, Healthcare private equity, Healthcare Reform, Healthcare Venture Capital | Tagged , , , , , , , , , , , | Leave a comment

We’re From the Government; We’re Here to Help

Posted on June 16, 2011 by
door

Unlike many of my colleagues who got MDs or MBAs, my graduate school education was focused on political science–the study of political behavior to be exact.   I was a good portion of the way through a PhD program in this field when I started working in industry (high tech marketing at the time, not yet healthcare).  I was managing to balance the study of politics and the high tech marketing roles pretty decently, or so I thought until my graduate school advisor gave me an ultimatum:  quit the job and spend full time in the political science department researching and teaching or quit the program.

I remember thinking at the time that my odds of working in government were pretty low (too blunt) and that I wasn’t cut out for a life of public policy-making (too impatient), so I decided to leave the study of government and political behavior behind and dive full-time into the life of the private sector.  That was it, I figured:  political life over, business life here I come.

What a difference a couple of decades makes.

This week I attended two separate healthcare conferences.  The … (read the rest)

Posted in Health and Wellness, Healthcare, Healthcare Policy, Healthcare private equity, Healthcare Reform, Healthcare Venture Capital, Medical Devices, Women in Venture Capital & Private Equity | Tagged , , , , , , , | Leave a comment

Follow the Money

Posted on May 31, 2011 by
Where have all the primary care docs gone?

This weekend’s NY Times had an Op-Ed by doctors Peter Bach and Robert Kocher about why medical school should be free for people willing to pursue a career in primary care.  Drs. Bach and Kocher note that primary care is critical to the successful improvement of quality and cost in the healthcare system and yet the American Academy of Family Physicians has estimated a shortfall of 40,000 primary care doctors by 2020.  Their point is that despite these statistics, the system is somewhat rigged against primary care physicians (“PCPs”)….it costs them just as much as specialists to go to medical school but they come out making 58% of the money ($190K vs. the $325K of the average specialist).  Thus, since we need PCPs far more than we need more specialists, let’s pay for PCP candidates to go to medical school but effectively cause those going into specialty care to cover the costs of those who remain as PCPs.  In other words, let those who will financially benefit from their career choice (specialists) subsidize those that, for all intents and purposes, go into a life of “medical public service” (my term, … (read the rest)

Posted in Health and Wellness, Healthcare, Healthcare Policy, Healthcare Reform | Tagged , , , , , , , , , , , , , | Leave a comment

It’s the End of the World As We Know It

Posted on May 22, 2011 by
duh

Well, we’re alive. Despite the possibility that the world would pass its “use by” date on Saturday, everyone I have checked with is still here. At 6:00 pm on May 21st, 2011, the official time scheduled for the Rapture, I was using my last few moments to crack open peanuts at the Giants v. A’s baseball game (Tim Lincecum pitched a full game shut out—maybe it should have been called the Freakkkture?).  Years from now, when we think back on this day, will people be asking each other, “where were you when nothing happened?”

To be honest, I assumed the whole Rapture thing was the Republican’s insidious plot to kill off Obamacare once and for all. And yet, since it didn’t work out as planned, maybe it was actually a Democrat plot.

One thing’s for sure: our current healthcare system is definitely reaching the so-called end of days.  There is no way our economy can sustain the ongoing inflation it has been experiencing.  Healthcare cost the country $2.5 trillion in 2009 but is expected to hit $4.5 trillion by 2019, according to the Altarum Institute. The healthcare … (read the rest)

Posted in Healthcare, Healthcare Information Technology, Healthcare Policy, Healthcare private equity, Healthcare Reform, Healthcare Venture Capital, Uncategorized | Tagged , , , , , , , , , , , , | 1 Comment

Healthcare: When Innovation is Not Enough

Posted on May 17, 2011 by
Meet the new Chief Innovation Officer

Earlier this week I had the pleasure of attending an event put together by the Agency for Healthcare Research and Quality, a branch of the US Department Of Health and Human Services whose mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.  AHRQ has established an Innovations Exchange designed to speed the implementation of new and better ways of delivering health care.  This particular event was called Scale Up and Spread and was designed to let several of the innovations brought to light through the Innovation Exchange be reviewed by a panel of industry people, Shark Tank style.

If you have seen the show Shark Tank, which I wrote about recently, you can appreciate that they called this a Fish Tank event, as the goal was for the panel to provide pointed feedback to the “innovators” but in a constructive and less confrontational manner than you might find in the TV show.  Not a shark fin in sight, unless you count the one I had to hide with my cardigan since I was the only private equity person in the … (read the rest)

Posted in Health and Wellness, Healthcare, Healthcare Information Technology, Healthcare Policy, Healthcare Reform, Healthcare Venture Capital, Private Equity, Uncategorized, Venture Capital | Tagged , , , , , , , , , , , | 2 Comments

How Health Insurers Can Avoid Being Blockbuster in a Netflix World

Posted on May 4, 2011 by
bird

Talking about health insurance is a good way to clear a room. It is a rare person who is excited to interact with their insurance company or who can understand the explanation of benefits they receive in the mail detailing all of the things that the insurance carrier has decided not to pay on their behalf. According to JD Power and Associates, only four out of ten people fully understand their health benefit plan. No doubt those four are also able to read the Dead Sea Scrolls in their original text.

JD Power also found that consumers rank health insurers at 710 on a 1000-point scale, a number heading downhill faster than Lindsey Vonn. In contrast, consumers rank homeowners insurance carriers at 750 on a 1000-point scale and auto insurers at 837. Nothing like being last place in the league: just ask the Minnesota Twins.

“So what am I supposed to do about it?” you might say. “My employer gives me whatever insurance they want to give me and I have little say in it.” We as consumers have become accustomed to paying (through paycheck deductions and lower wages) … (read the rest)

Posted in Healthcare, Healthcare Information Technology, Healthcare Policy, Healthcare Reform, Healthcare Venture Capital, Patient Safety, Private Equity, Uncategorized, Venture Capital | Tagged , , , , , , , , , , , , , , , , | 2 Comments