Tracea R. Saraliev

Some VC investors believe that brick and mortar - referring to a physical presence of some kind - should be avoided at all costs. Yet, the track record of clinic and hybrid care businesses in health care indicates otherwise. ==> One Medical (sold for $3.9 billion to Amazon), Oak Street (bought by CVS for $10.6 billion), Lifestance (IPO at $7.5 billion market cap), and PE-backed Premise Health (acquired by OMERS Private Equity for $1.1 billion) If a clinic is indicated as the optimal way to deliver care for that patient population, there are creative ways to build and operate them. Full article below with advice and strategies on how to build and operate hybrid clinics from my teammate Anarghya Vardhana from Maveron, Amir Dan Rubin from OneMedical Group, Steven Eidelman from Modern Animal and more!

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Had a blast diving into Amir Dan Rubin's extensive healthcare career on Vital Signs. Amir previously served as the CEO of One Medical and Stanford Health Care, was an EVP at United/Optum and is now the Founding Managing Partner at Healthier Capital. Our conversation spanned payer-provider integrations, lessons learned from leading One Medical, applications of generative AI, and more. Some highlights: ⚡Combining care models We talked a lot about the One Medical/Iora combination. Amir argues that just because two care delivery approaches may occupy the same physical location (e.g., a clinic), that doesn’t mean they necessarily need to conform to the same economic model. For instance, One Medical and Iora were able to combine effectively despite the former being a membership model and the latter being global capitation. Amir emphasizes that much of the overhead resources (e.g., front desk staff, phlebotomy) can be shared across models. ⚡How One Medical uses generative AI to improve efficiency One Medical allows members to message the care team, and then uses NLP to read the message, figure out its content, and triage it to the appropriate team member. Amir is excited about leveraging internal knowledge graphs to get around hallucinations. This approach can point to relevant internal data in helping compose responses, creating more trust and accuracy in the outputs. ⚡Behind the Amazon acquisition One Medical was interested in expanding its direct to consumer offering. However, they recognized that customer acquisition was costly, which is why partnering with Amazon Prime’s existing membership base made sense for them. Amir explains how at their core, both Amazon and One Medical are all about using technology and logistics to create an excellent customer experience. An awesome conversation ranging from health system innovation to startup strategy to health tech investing! Listen to our full episode below: Spotify: https://spoti.fi/3Wrbnol Apple: https://apple.co/3XWOomb

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One conversation we should be having more, especially in healthcare: is this an AI problem or a policy problem? A big challenge in American healthcare stems from the reality that our healthcare strategy changes with every administration. Throwing AI at problems that are well-addressed by policy innovation (e.g., AI for payer-provider RCM war) feels like a gross misallocation of resources. Solution sets are rarely zero sum – in truth, most problems will require policy, tech, and human interventions, but it's worth asking ourselves whether AI is the best solve when we have a multitude of options.

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As I said right at the start of this week's The Heart of Healthcare Podcast, Shivdev Rao is one of the most exceptional founders I have ever worked with. He is also a great human being. In this week's episode he shares what is it like leading the 🚀 that is Abridge and some awesome life lessons. IMHO this is a great listen for founders building in both the AI and healthcare fields!

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The obesity crisis in the U.S. has become unsustainable. We are broken, and we have to change... The prevalence of obesity in adults has grown from 14.5% in 1975 to 41.9% in 2020, and childhood obesity has more than TRIPPLED since the 1970s. The total annual cost of obesity is at a staggering $1.4 trillion. Treatment options range but the emergence of GLP-1's has taken on a national debate. It is our view at 7wireVentures that the growing obesity crisis requires innovative and personalized solutions and digital health companies are rising to meet this challenge. Our team took a deep dive into the market landscape and came up with key predictions on how the market will evolve. ✨ PREDICTION 1: The emergence of high-cost anti-obesity medications and their growing consumer demand will push employers and payers to seek increasingly creative plan design structures that tackle weight management as a discrete disease category.​ 💉 PREDICTION 2: Greater emphasis will be placed on proactive identification and management of patients with an obesity diagnosis 🔬 PREDICTION 3: Key differentiators of successful solutions will include long-term engagement and the ability to address multiple chronic conditions. 🤝 Innovative companies such as 9amHealth, Parsley Health, Transcarent, Everly Health, Foodsmart, Livongo, Season Health, Iron Health, Cylinder, and more. See our full analysis and perspectives on enabling positive change in weight management. 👇 #digitalhealth #obesity #GLP1 #disease #healthcare https://lnkd.in/gUCttSZj

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Should you sell your practice to a VC-Backed MSO Startup? tldr: - new VC-backed startups are forming MSOs to roll up independent practices - The pitch is physicians receive early liquidity from the roll up and are granted ESOP shares that can be used for retirement - Problem is the use of ESOPs with independent practices is not a new concept and has been used with large group practices since the 70's - ESOPs do not grant full ownership and in order for the shares to be valuable for retirement, the practice needs to run the same if not better post roll up - With VC-backed startups being primarily operated by non-physicians with zero clinical or medical practice experience, the likelihood of this happening is extremely low making the entire concept high risk However, there is a viable path for continued ownership + liquidity for independent practices. Check out the article to learn more. ⤵ https://lnkd.in/gmGvTYwP

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I’m optimistic about the potential of generative AI to reduce provider burnout and improve provider-patient interactions. However, that optimism is tempered by the data that indicates the technology is not quite ready yet. Bright Ventures is interested in digital health founders who understand the realities of provider-patient interactions, and the role technology can play in strengthening clinical outcomes. Which founders and teams are getting this right? Tag them in the comments below.

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M13 is thrilled to lead the Series A in RadiantGraph which is focused on personalization in healthcare. As we continue to invest in early stage companies it is abundantly clear that the biggest indicator of success is the founder and his or her ability to execute on their vision of the future. In this case, I don't think I have seen much better founder-market fit than we have with founder and CEO Anmol Madan. We believe in his vision: in order to have the best patient outcomes in healthcare we need increased personalization and AI is the breakthrough to get us there. Anmol started one of the pioneering digital health companies Ginger and then was Chief Data Scientist at Livongo and Teledoc. He has done it all: early stage, late stage, public company. And he deeply understands the nuances of the healthcare market from all angles which is critical for success. While there are many players building healthcare-specific AI capabilities, RadiantGraph is focused on outcomes: The platform is already processing personalization models for more than 3.5 million people, despite launching just last year. Excited to partner with my friend Adam D'Augelli and the great True Ventures again and Morgan Blumberg who has been deep in the healthcare market with me for many years. More on our thesis in the blog below. https://lnkd.in/evDDmC3W

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The Rising Cardiovascular Spend for Seniors and Medicare: The Case for a Value-Based Cardiac Model with AZ Cardiology. As the population ages, the prevalence of cardiovascular diseases among seniors is increasing, leading to a significant rise in healthcare expenditures. This trend presents a pressing challenge for Medicare and the broader healthcare system. To address these growing costs while ensuring high-quality care, a shift towards a value-based cardiac model is essential. The Burden of Cardiovascular Diseases on Seniors and Medicare Cardiovascular diseases (CVDs) are the leading cause of death and a major contributor to disability among older adults. Conditions such as heart disease, stroke, and hypertension are particularly prevalent among seniors, driving up the need for frequent medical interventions, hospitalizations, and long-term care. Key Statistics: Prevalence: Approximately 70% of adults aged 65 and older have some form of cardiovascular disease. Costs: In 2020, the United States spent an estimated $555 billion on cardiovascular diseases, with projections suggesting this could rise to $1.1 trillion by 2035. Medicare: Cardiovascular diseases account for a significant portion of Medicare spending, with nearly 25% of Medicare beneficiaries being treated for these conditions annually. The Need for a Value-Based Cardiac Model The traditional fee-for-service (FFS) model, which reimburses providers based on the quantity of care delivered rather than the quality, often leads to inefficiencies and higher costs without necessarily improving patient outcomes. In contrast, a value-based cardiac model focuses on patient outcomes, quality of care, and cost-effectiveness. Benefits of a Value-Based Cardiac Model: Improved Patient Outcomes: By emphasizing preventive care and chronic disease management, this model can reduce the incidence and severity of cardiovascular events. Cost Savings: Value-based care incentivizes providers to eliminate unnecessary tests and procedures, thus reducing overall healthcare costs. Strategies for Implementing a Value-Based Cardiac Model 1. Preventive Care and Early Intervention: Screenings and Risk Assessments: Regular screenings for risk factors such as high blood pressure and cholesterol can help in early identification and management of cardiovascular diseases. 2. Chronic Disease Management: Comprehensive Care Plans: Tailored care plans that include medication management, lifestyle advice, and regular monitoring can help manage chronic conditions effectively. 3. Care Coordination and Integration: Multidisciplinary Teams: Utilizing teams of healthcare providers, including cardiologists, primary care physicians, nurses, and dietitians, can ensure holistic patient care. 4. Outcome-Based Reimbursements: Incentive Programs: Medicare and other payers can implement incentive programs that reward providers for achieving specific health outcomes and cost savings.

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Some great advice in this interview — featuring Jeffry Weinhuff of Visionary Ventures — relevant to all sub-sectors of #medtech. My favorite line is “investment capital is not tuition.” 😂 But the best advice stems from the insight that good exits via IPO or M&A processes with multiple buyers competing for your company require that most medtech companies must prove their value via strong commercial metrics. And doing that takes a lot of time, expertise and money. Plan, hire and raise capital accordingly. At Vensana Capital, our investment process centers on a deep analysis of every aspect of getting a breakthrough medtech innovation to market, no matter what stage of development a company is at today. We like entrepreneurs who believe their innovation can be highly impactful to patients. We love the ones who want to leave no doubt. https://lnkd.in/eDsUqgn6

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I recently sat down with Michael Batko, CEO at Startmate and Founder of Puddle Pod for Episode 11 of Insane Ambition. Startmate has invested in 230+ startups, much of it under Michael's leadership, and now has $3.5b in value across its portfolio companies. In this episode, we discussed: - Michael's journey from consulting, then living in the Amazon rainforest, to leading Australia's biggest startup accelerator - The future of Australia's startup ecosystem - The labour government's very stupid plan to make it harder for people to qualify as sophisticated investors (now thankfully shelved) - Startmate City! Startmate's plan to build Australia's first startup city. Probably the most ambitious idea I've ever heard from a startup accelerator. - The balance between visionary thinking and traditional startup advice (think Elon Musk's plan to colonise Mars, vs Y Combinator's problem/customer obsession) - "The Courage to Be Disliked", and its influence on Michael's approach to life and business. Links in the description below 👇

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I used to spend 2-3 hours daily on clinic notes, skeptical of AI scribe technology. However, I've been impressed with RevMaxx, a generative AI company transforming clinical note creation by listening to physician-patient conversations and automatically generating comprehensive notes. This platform accurately captures crucial ICD-10 codes, saving valuable time ⏰. 👉 Why This Matters: - **Reducing Physician Burnout:** Administrative tasks are a significant contributor to physician burnout. Innovations like RevMaxx alleviate this burden effectively. #HealthcareInnovation #AI #PhysicianBurnout #MedicalDocumentation #HealthTech #RevMaxx

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On the latest Vital Signs, Nikhil Krishnan and I sat down with Parth Mehrotra, CEO of Privia Health. Privia is a physician enablement platform and >$2B public company partnering with 4500+ providers on practice improvement and value-based care. We talk about the most important ways to manage risk, building effective physician enablement solutions, the future of value-based care programs & contracts, and more. Some highlights: 🏥 Capabilities practices need to participate in risk-based contracts Parth highlights 3 sets of capabilities:  1. Diversification of risk. This can range from pooling the risk with other providers to hedging risk across multiple programs.  2. Audit, compliance, controls and documentation 3. A tech stack and data that allows the provider to understand their patient population and care for them throughout the entire care workflow (e.g., identifying the patient’s relevant conditions, closing care gaps, caring for the patient after the visit). 🏥 The types of providers partnering with Privia Parth explains that physicians have 4 general settings in which to practice medicine: 1. Being employed by a hospital or a clinic. 2. Starting their own practice or joining another independent practice. 3. An independent practice that partners with another entity to help with business operations. 4. Selling the practice and having the new owner transform it. He notes that practices that join Privia are self-selecting: these physicians want to stay independent but need another player to help throughout the entirety of the practice. 🏥 How physician enablement companies influence practices Parth is a strong believer that physician enablement companies don’t need to buy practices in order to influence outcomes. Rather, companies can achieve better outcomes by giving physicians more autonomy. Improved performance is driven by the combination of 1) giving physicians the tools to manage everything outside of direct patient care and 2) maintaining incentives for physicians to want the practice to succeed. A must-listen for anyone looking to understand the physician enablement landscape and how providers can take on risk. Check out the full episode below: Spotify: https://spoti.fi/3Ulb7FL Apple: https://apple.co/4dQwS7i

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The most talked about AI x Medical startup Abridge is working to rescue doctors from the never-ending admin grind (which causes burnout and less patient face-time). Abridge's AI listens to patient visits and generates precise medical notes, slashing the clerical workload. Now, doctors can focus on what truly matters: patient care. Major health systems like Yale and Emory are already on board and raving, calling it "life-changing" and "magical." 🔷 A big reason --> Payback of the scribe tool is easy to measure. It supports 14 languages including Haitian Creole, Brazilian Portuguese, and Punjabi. An ongoing criticism of generative AI is that it still has few substantive business applications. This seems to quash that. Question: is a dedicated medical LLM needed to be successful in the space? Or will the huge foundational models (GPT-4o, Google, and Meta) ingest a plethora of medical notes and kill the competition with performance? We're dealing with a fast and furious pace, and today's edge may not be relevant tomorrow. Competitors include Microsoft-owned Nuance Healthcare , Ambience Healthcare, Nabla and Suki. I'm excited to continue to see this field revolutionized. 🌟 #AI #MedTech #Abridge #HealthTech

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On the latest Vital Signs, Nikhil Krishnan and I had a ton of fun chatting with Dr. Atul Butte. Dr. Butte is a professor at UCSF, Chief Data Scientist of the UC Health System, and a co-founder of numerous healthcare startups. In our conversation, Dr. Butte shared his takes on healthcare AI opportunities, challenges, hype, and more. A few highlights: ⚡LLM use cases, data, and growth LLMs are already helping to solve the “drudgery” aspects of medicine, such as automatically drafting SOAP notes and patient messages. Dr. Butte is excited about future applications of LLMs that can help with the “cognitive” aspects: with difficult medical problems an LLM might be able to stitch together disparate pieces of information to generate a potentially novel solution. He also highlights that prompt engineering will become the next “coding language” as so much of leveraging LLMs is knowing how to ask them the right questions. Additionally, Dr. Butte discusses how since 2016, UCSF has been working to deidentify its patient notes so that it can query them to answer clinical questions and ultimately enhance patient care. ⚡The need for patient-facing AI As patients are increasingly able to access their own personal health data in nicely structured formats (e.g., EHRs, wearables), they desperately need more tools to help them interpret and make decisions using that data. Dr. Butte understands that these patient-facing solutions are challenging to get funded but he emphasizes that patients need to receive the benefits of AI sooner. ⚡Evaluating healthcare AI solutions In order to evaluate AI solutions, we often put human specialists – such as medical professionals – on the same tasks. Understanding that specialists often disagree with each other, a significant challenge arises in figuring out how we can evaluate AI considering we can’t just “average” all the specialist opinions. Dr. Butte points out that there still remains a massive gap in AI evaluation tools. Additionally, there are so many organizations that want to have a say in how healthcare AI is regulated that the landscape is uncertain. An awesome conversation with an expert on all things AI meets healthcare. Listen to the full episode below: Spotify: https://spoti.fi/3Wr3643 Apple: https://apple.co/4acwgan

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Still feeling energized from last week's roundtable on building successful relationships with hospitals. We invited 7 portfolio companies and health system leaders from Mayo Clinic, Cedars-Sinai and UCLA Health. The founders shared their questions ranging from the strategic to the nuts and bolts of closing partnerships. For example, how do you determine what measures of effectiveness help drive alignment? And how do you get all the stakeholders together to actually drive a decision. Answer: put them all in a room for half a day! “I think we're in a pivotal moment regarding how we assess AI. There are numerous risks currently dominating AI discussions, particularly those concerning bias and other associated risks. However, there's a notable absence of focus on evaluating the proactive value of AI. We need to consider what AI actually offers and what we want it to offer. It's not solely about determining whether it will cause harm; people are apprehensive about how this technology will be implemented. One perspective gaining traction involves ensuring the product's validation process is robust enough to prevent risks to various populations.” -Vladimir Manuel, Medical Director at UCLA Health From Vlad's comments above to perspectives others shared, we heard a sense of excitement for the promise of #AI and other new technologies. But we're also in a unique moment where the risks are not well understood. Still much to do here.

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Healthcare innovations always capture my interest, even if it’s not my direct investment focus. Almost every breakthrough mentioned in the article has crossed my radar at events or through social media. I typically forward these to David H. Crean, our resident healthcare expert. It’s inspiring to see companies taking on monumental challenges: GRAIL, Tempus AI, and Freenome are focused on cancer; Altos Labs, Calico Life Sciences, and UNITY Biotechnology are working on aging; and Alzheon, Inc. | Preserving Future Memories, Alector, and Neurotrack are tackling Alzheimer’s. And that’s just the beginning. I’m most excited by companies that leverage technology to address real human needs, as I’m passionate about anything that enhances or simplifies life. One of the first startups I reviewed that embodies this mission is BYON8, which focuses on making healthcare more accessible, affordable, and efficient, especially in underserved markets like Africa. Although we ultimately didn’t invest, I still follow BYON8 closely because I believe in their mission. I had the opportunity to meet their CEO and founder, Josef, in New York, and his dedication truly inspired me. He left his career as an MD in Sweden to fully commit to this mission, which speaks volumes about his passion and commitment. Although BYON8 primarily focuses on Africa, there’s clear potential for this solution in the U.S. as well, where nearly 10% of the population remains uninsured, largely due to cost. Venture capital is undoubtedly about returns, but I admire the dual approach many investors take—pursuing the next Meta or Uber while also striving to make a meaningful, positive impact. These goals aren’t mutually exclusive, and that’s something I deeply respect about this space.

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