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Happy Thursday, Hospitalogists! Today's send is a lookback at some of my favorite sends I've written along with ones that resonated with you guys. Plus you can see how wrong or off I was on my analysis and thoughts! Thanks for supporting me over the past 3+ years and here's to many more! And if there's any send of mine worthy of being on this list that you remember fondly, let me know. |
Was this email forwarded to you? |
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SPONSORED BY PHRMA Let's address the real reasons Americans pay more for medicines. The U.S. is the only country in the world with 340B hospital markups and PBM middlemen fees driving up costs for patients. Americans also foot the bill for the research and development of new treatments and cures, while other countries don't pay their fair share. It's time to lower drug prices by cracking down on middlemen and foreign free riders.
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Hospitalogy's Greatest Hits |
Oscar Health's Pirate Ship |
Original post link here. (Legendary thumbnail, by the way) Last year I wrote a couple articles around insurtech dynamics – first noting a challenging environment for insurtech players post-ZIRP environment, and then diving into the Oscar hero's journey: trying to redefine what health insurance is, the challenges it faced in entering that arena, and ultimately a fall from grace. Despite it all – the cynicism, the noise, the 'I told you so' skeptics – Oscar Health is clawing its way out of the abyss. The firm is reinventing itself with Mark Bertolini at the helm of the ship, so let's dive into why they're set up for success in 2024. |
Done is Done: How Ruthia He turned ADHD Telehealth Platform Done into a pill mill |
Original link post here. I've unexpectedly been in conversation with multiple sources close to Done, and I have the full inside story of what went wrong (spoiler: a lot) and the latest ongoing developments internally. So with that backdrop, today, we're diving into how one founder – Ruthia He – exploited well-meaning people, created a culture of gaslighting and deceit, and built one of the worst-acting pill mill enterprises to date. Done is a terrible example of exploiting patients, providers, and even internal employees – for pure profit. It's as if Cerebral and Theranos had a baby, and out came Ruthia He with Done. Oh, and then she sent your patient data to China. |
CVS, Oak Street Health, and the Great Payor Vertical Integration War |
Original link post here. Payvidors and other strategic players are investing significant capital into primary care. Oak Street Health's main business goals are to lower total cost of care by preventing unnecessary acute events and managing chronic disease, all while providing a better patient experience. As a primary care operator working in with Medicare beneficiaries, Oak Street Health has done an incredible job of pushing the value-based care agenda forward. From an operating and clinical perspective, acquiring Oak Street Health will afford CVS greater integration in its care delivery model, which will result in better care coordination for patients, more patient satisfaction, increased access for Medicare Advantage ("MA") members and dual-eligibles, boosts in quality, and reductions in total cost of care... ...Payors are chasing UnitedHealth Group and the Optum strategy. The shift toward vertical integration means that insurers are moving profits from regulated, capped insurance segments downstream into higher-margin, unregulated, uncapped services entities. |
Hims & Hers, and the Brewing GLP-1 Compounding Controversy |
Original link post here. GLP-1s are on track to be one of the most profitable drug classes of all time – and everyone wants in on the action. With the growing conversation around obesity, there's also a controversy bubbling under the surface ready to overflow. No, I'm not talking about my terrible pasta making skills (how do you keep it from bubbling over?? I leave the starch making to my wife). I'm referring to Hims – and other DTC telehealth offerings – leveraging a loophole to sell GLP-1 medications directly to consumers. Or rather, versions of GLP-1s via compound pharmacies. It's a thriving parallel marketplace. Call it the Underworld of Healthcare. |
Astrana, Awell, and the Emergence of CareOps as a VBC Differentiator |
Original link post here. I wanted to share a recent great conversation I had with two leading organizations in healthcare and value-based care: Astrana and Awell. The two recently announced an innovative partnership which I think is flying under the radar. In general these organizations are underrated, and I wanted to draw some more attention to them. So today kicks off an essay on Awell and Astrana, including how to form a thoughtful partnership and implement a successful pilot. Then I'll dive into how Astrana thinks about scaling as a value-based care player (hint: flexibility is key) and how Astrana thinks about vetting partners for its enterprise. Thanks to both Astrana's Brandon Sim and Awell's Thomas Vande Casteele and Rik Renard for sitting down and having a great conversation with me! |
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- HCA's Grand Plan: Breaking Down their 2023 Investor Day (Link)
- The Ardent Health Breakdown (Link)
- The Rise and Fall of Envision Healthcare (Link)
- The Hospital Strikes Back: Why Kaiser Permanente Formed Risant Health (Link)
- The Hinge Health S-1 Breakdown (Link)
- The Downfall of Babylon Health (Link)
- Forward Health's CarePod: The 'Bird Scooter' of Healthcare? (Link)
- Private Equity in Healthcare: Where do we go from here? An (attempted) balanced look at the good and bad of PE in Healthcare (Link)
- Not Another AI Health Coach: Why Healthcare is Human, and Always will be (Link)
Health System Executive Interview Series: - Pete McCanna – a wide-ranging Hospitalogy Interview with Baylor Scott & White's CEO on Leadership and Health System Transformation (Link)
- The Fairview Turnaround: Talking all things Fairview Health Services in 2025 with President and CEO James Hereford (Link)
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Thanks for the read! Let me know what you thought by replying back to this email. Everyone give a warm shoutout to my wife for her 31st birthday today. 7/11 makes it VERY easy for me to remember luckily! — Blake |
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