Jayne Morgan, M.D.

When the Digital Health Awards categories came out this year, we were thrilled to see one called "Biggest Healthcare Savings Story". Oshi Health continues to demonstrate total cost of care savings: first in a clinical trial, then in 18 months of a value-based contract with a national payer and now with dozens of employers over multiple years. When you provide high-touch care that identifies root causes of #digestivehealth conditions and helps patients gain control of their condition, the cycle of repeated diagnostic testing and emergency room visits stops and total cost goes down. We are honored to be a finalist in this important category! #valuebasedcare #wholepersoncare

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This 👂 podcast episode and insight’s from a16z Bio + Health's Julie Yoo spoke so clearly to the fundamental challenge facing both 🩺 clinicians and 🏥 healthcare systems.  There is a huge disconnect between supply, in the availability of clinicians, and demand, in the increasing volume and complexity of healthcare needs. -     36% of physicians plan to reduce their hours next year according to the AMA -     48% of physicians reported feeling burned out in a 2024 Medscape survey At the same time, the demographic baby boomer bubble and steady increase in the prevalence of major chronic disease, which consumes up to 90% of healthcare expenditures according to some estimates, is driving demand. With this context, Yoo points to a major opportunity for AI adoption in healthcare in 2025. Yeah, a VC hyping a wave of new AI companies that will replace the decades of training and experience of clinicians, the skeptic would say.  But Yoo is thoughtful in pointing to the role AI can play, and is already playing, through solutions such as ambient, autonomous scribe solutions (of which local star Abridge is leading the pack) in not replacing, but freeing up productivity for clinicians. There is so much unstructured context in both the complexity of disease and treatment options and the social/emotional considerations that we shouldn't be looking for AI to *replace* clinicians. But companies are getting better at finding the structured, repetitive and time-consuming places where AI tools can *help* clinicians. Nearly two-thirds of doctors cited bureaucratic tasks as the leading contributor to burnout. Rigorously trained-AI driven solutions can be a force multiplier for clinicians, and I’ve seen several interviews where nurses and doctors go as far as to say some of these solutions are ”restoring their joy in practicing medicine”. Our health is precious; and we rightly want any technology engaging with it to be developed thoughtfully and thoroughly tested. This requires top AI talent and diverse and realistic training data. Pittsburgh’s strengths in both areas is why we are an emerging hub for data-driven healthcare. #AIinhealthcare #clinicianburnout #healthinnovation #digitalhealth

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Here's what caught my eye in the Kidneyverse this month! 🤩 https://lnkd.in/exQUavXr Across the Kidneyverse is my monthly recap of top headlines, research, market insights, funding, and perspectives from the kidney community. This month we’re marking major milestones in xenotransplant, biopharma M&A, frictions from CKCC payment cuts, lessons from RPA, and a number of startup financings you should have on your radars. My goal in writing these monthly updates is leave you feeling more curious, optimistic, and knowledgeable about this space. If you find it helpful, please share it with your networks and let us know what you're following! But enough writing, more exploring... This month's Across the Kidneyverse features insights from: Mass General Brigham American Society of Nephrology Benjamin Hippen, MD, FASN, FAST Dr. George Hart Frank Maddux MD, FACP Paul D. Gordon Centers for Disease Control and Prevention Interwell Health Renal Physicians Association Vertex Pharmaceuticals Alpine Immune Sciences, Inc. Biolinq Reshma Kewalramani, MD FASN Mozarc Medical IKONA Health Lifeliqe World Health Organization International Society of Nephrology PitchBook Carta Silicon Valley Bank Centers for Medicare & Medicaid Services Healio Charlotte Dixon Liz F. The New York Times Uptal Patel Eric Topol, MD DaVita Kidney Care Blake Madden Ian Koons Yubin Park, PhD Signals From [Space] #healthtech #innovation #digitalhealth #valuebasedcare #kidneyverse *** What else should people know about? Let us know! 👇🏻

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👍 In the first half of 2024, U.S. digital health startups secured $5.7 billion across 266 deals, showing a strong rebound after years of slowed investment, according to Rock Health. With early-stage deals driving the momentum, the sector is on track to surpass funding totals from 2019 and 2023. https://bit.ly/4cCRy2W Via Healthcare Dive #digitalhealth #digitalhealthfunding

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For all the talk about value-based care, progress still is very slow. Advisory Board data shows the small amount of progress made from 2017 to 2022, which varies drastically by line of business. Medicare Advantage is the primary segment driving VBC, mainly due to aligned incentives where plans and providers could get paid more through upcoding (or "appropriate coding") of patients to drive more revenue & margin through the entire system. That drove penetration of VBC in MA, and CMS has paid attention, releasing significant headwinds (v28, RADV, Stars) aimed at reducing these perceived overpayments. In other segments, VBC has been very slow to grow. Commercial VBC arrangements were essentially stagnant. Anecdotally, this is starting to change. Plan sponsors (employers) -- especially large, sophisticated ones -- are demanding more from their carriers. They want to see network arrangements that impact quality & cost. Will that be enough to drive VBC activity in the commercial space? We'll see. Employers -- the customers -- will be the ones who will drive VBC forward here. TPAs alone don't have the incentive to make changes. I remain hopeful, but skeptical. #valuebasedcare #healthtech #digitalhealth

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My next Signal takes a closer look at the latest antitrust probe into large dialysis companies and the shifting role of non-competes in kidney care. A recent POLITICO article provides helpful background around topics like NCAs in dialysis and impacts on the adoption of home dialysis technologies. This is an important discussion, so I'd love to hear from you. If you have something you'd like to share, whether it's an anecdote, comment or question for other readers, please leave a comment or send me a message. H/t to Tom Mueller for sharing the article last week. https://lnkd.in/e95a23JF

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Full Medicaid expansion needed to retain Georgia’s physicians Georgia was ranked 5th worst place to practice in a recent Medscape article (“Best and Worst Places to Practice 2024”), using five criteria: physician compensation, cost of living, malpractice premiums, the health of the state’s residents, and physician burnout levels. As current and future physicians and health advocates, this column will add context by detailing our experiences practicing in Georgia. It is no surprise that three of the five worst-ranked states for practicing are among those that have not expanded Medicaid. In Georgia, refusal to expand Medicaid means that nearly 12 percent of residents (well over a million people) are uninsured, significantly limiting their access to healthcare. Only in Texas is coverage worse. Due solely to political concerns, Georgia chose to submit a Medicaid waiver and develop its own Medicaid expansion program, Pathways to Coverage. The governor’s office projected that the program would cover an additional 100,000 Georgians in its first year. But it has been an utter failure, with fewer than 3,500 covered at a cost to taxpayers of $26 million. Full Medicaid expansion would have added over 350,000 Georgians while cutting state spending by $710 million. These three states that refused to expand Medicaid are not surprisingly red. It is also unsurprising that the states with the greatest percentage of unhealthy residents are red. Hopefully, Georgia who thought they had a better way of expanding access to care with their own plan that squandered $26 million to cover 3,500 residents will realize that retaining physicians requires a more sensible approach to expanding access to care. #expandinghealthacess, #accesstocare, #limitingcoveragetoresidents https://lnkd.in/eefqH-9Y

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📣 Oncology 📣 Especially on the Rad Onc Side You may want to start re-evaluating the landscape. This is why Bridge Oncology was created. 📢 The roll ups will continue ----FCS to Mckesson ----TCC to Mckesson ---United Urology to One Oncology ---ION to Cardinal Health 🔔 The consolidation of community oncology practices into large corporate entities is reshaping cancer care delivery, creating significant challenges. Centralized services reduce local care options, standardized protocols may overlook regional needs, and resource allocation often favors profitable services, neglecting radiation oncology. These changes hinder accessibility, increase wait times, and raise out-of-pocket costs, particularly in underserved areas. Amidst this shift, Bridge Oncology emerges as a key expert, uniquely positioned to assist large healthcare entities. We integrate and optimize ALL radiation oncology services, ensuring patients receive accessible, high-quality care. Bridge Oncology’s customized strategies, coverage & peer review models, operational excellence, and advanced technology implementation streamline workflows, enhance treatment precision, and improve patient outcomes. We provide staff training, regulatory compliance, and financial optimization to maintain viable service lines. With a patient-focused approach, they expand access through satellite clinics, telehealth, flexible scheduling, and patient education, ensuring comprehensive care in a consolidating landscape. -------------- Thyme Care OneOncology Siemens Healthineers American Oncology Network Sutter HealthMcKesson Blake Madden Cardinal Health Douglas Flora, MD, LSSBB, FACCC OncoDaily OncoHealth UT Southwestern Radiation Oncology Deirdre Saulet Chevon Rariy, MD Jonathan Bluth ------------------

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🤔 How do (US) hospitals spend money 101? Salaries, Wages, Benefits: 45-55% Professional Services: 12-22% Supplies: 12-18% Depreciation/Amortization: 3-6% Other Expenses: 5-20% 8 key insights: n°1. Hospitals consume 31% of US healthcare spending: Despite being the largest spending category, many hospitals struggle with low operating margins, often below 2%. n°2. Labor costs dominate hospital expenses: Salaries, wages, and benefits account for 45-55% of a hospital’s expenditures, with front-line staff making up 75-82% of the workforce. n°3. Contract labor adds significant costs: Hospitals often resort to staffing agencies due to labor shortages, paying 2-3 times more for contract workers compared to employed staff. n°4. Supplies account for 12-18% of expenses: This includes medical equipment, drugs, and personal protective equipment. n°5. For-profit vs. non-profit hospitals: For-profit hospitals tend to manage costs more efficiently, keeping salaries and expenses lower, but often at the expense of services like Medicaid or charity care. n°6. Economies of scale in larger health systems: Larger systems benefit from negotiating better prices for supplies and services. n°7. Rural hospitals face unique challenges: Limited access to talent and capital means rural hospitals must rely more heavily on expensive outsourced labor and struggle to offer high-margin services. n°8. Staffing shortages remain a key issue: Despite financial recovery post-COVID for many hospitals, staffing shortages continue, driving hospitals to explore different revenue models and operational changes to sustain profitability.​ Great post by the Out-Of-Pocket team Nikhil Krishnan & Ben Chao #healthcare

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📌 Strong cross-team collaboration with shared purpose inspires greater collective contribution. ❓ Have you ever been to a working meeting with a diverse group of teammates in the room where you felt effortless team connection and flow? That was the feeling at our American Medical Group Association (AMGA) Colorectal Cancer (CRC) Screening Best Practices Learning Collaborative this week in Indianapolis. We came #together with shared purpose in learning the best practices across 20 health systems nationally to improve our screening and prevention of colon and rectal cancer in our communities. 📌 We were there to help each other. 🔷 It was easy to listen to other teammates share their ideas, their lessons learned, their missteps and mistakes, their successes to bring back new approaches to help our patients, communities, and care teams at home. 🔷 It was easy to share our Intermountain Health team’s ideas, lessons learned, missteps and mistakes, and successes to help the other health system teams in the room, their patients and communities, and their care teams at home. It was easy to learn. It felt effortless. I think we need more of this in #healthcare. #CrossTeamCollaboration #TeamFlow #WePreventCRCTogether

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Today marks an important milestone with Emory Healthcare’s announcement of their statewide PHC and collaboration with Guidehealth. We began our commercial relationship with Emory Healthcare Network earlier this year on an interim basis and quickly progressed by fully integrating our technology and capabilities. In a short time, our joint efforts have created “speed to value”, demonstrating considerable traction and early wins on quality, patient care and overall performance. There are many people to thank - - and I'll start by acknowledging the network and service line leadership of Patrick Hammond, Tina-Ann Kerr Thompson, MD, MBA and their teams including Dan Salinas, MD and Susan Helton, Adam Tribbett and many others. Unless they saw the merits of us working together, we wouldn’t be here. We as a company have grown through inspiring engagement with Emory’s digital health leadership led by Alistair Erskine MD MBA and his team including Nitu Kashyap. The data science architecture, our use of AI and integration into Emory’s digital health strategy has transformed our business in many ways including accuracy and risk prediction, clinical prioritization, outreach and access, and scalable interventions. A shout out to Guidehealth's technology partners who have led us to unprecedented success and first mover advantage of our platform. I want to personally acknowledge Joon S Lee MD, Emory Healthcare CEO for his vision and personal attention to our collaboration. As also Chris Augostini, EVP and Emory University CFO. Their teams have been working closely with us to make today’s announcement a reality. Finally, to our leadership, at every level beginning with MARK SELNA, McKay Crowley, MD, MBA, FACP, CHCQM, Robert Alterman, Michael Gleeson, Roger Ou, Jeanne Wisniewski, ACC and their teams who’ve been working tirelessly to integrate technology and people into partner workflows, I want you to know that none of this would have been possible without your creativity, dedication and higher purpose that you bring to bear for patients and physicians every day. With today’s announcement, we now support six health systems in four states across a variety of contracts. With Emory, our collaboration extends across all patients and payers and is by far the most comprehensive and clinically integrated expansion of our model. And with it, we are honored to firmly plant our flag in the Peach State! https://lnkd.in/eARfUMnG

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Here’s your recap of last week’s health IT news 🗞️ 👇 🖊️ AI Ambient Scribes • CHRISTUS Health + Abridge: The 15,000 provider Texas health system adopted the ambient scribe enterprise-wide.    • Tampa General Hospital + Nuance Communications DAX Copilot: Over 500 providers at the health system will begin utilizing the AI ambient scribe.    • Texas Oncology + DeepScribe: The statewide oncology practice adopted the AI ambient medical scribe. (ed. note: scribes continue to be hot!) ☎️ AI Contact Center • Clearstep: The AI conversational chat vendor launched a new feature allowing patients to self-schedule specialist visits. 📊 Data & Analytics • InterSystems + CLEAR: The cloud-based patient data service is integrating the identity technology to expedite access to patient records.    • WakeMed + Bamboo Health: The health system is adopting the data interoperability and encounter notification service. 🥼 Clinical Decision Support • University Hospitals + Aidoc: The Cleveland-based health system is implementing the AI clinical decision support platform across 13 of its hospitals and additional outpatient locations. 🧑‍💻 Virtual and At-Home Care • University of South Carolina School of Medicine + Rimidi: The hospital group and an affiliated multispecialty clinic are adopting the remote patient monitoring platform to reduce complications from postpartum hypertension.    • Mount Sinai Health System + HealthSnap: The medical center announced a new remote patient monitoring and chronic care management program in partnership with the virtual care management platform.    • Wheel: The telehealth company released a new AI-driven virtual care platform designed to enhance the patient experience and offer resources to help partners scale their virtual care services. 💬 Patient Engagement • CipherHealth: The patient engagement solution focused on patient rounding released a new AI summary tool.    • DexCare: The care orchestration platform completed a $75M series C funding round 🩼 Durable Medical Equipment • Better Health: The medical device and peer support network completed a $14M funding round. 🧠 Food for Thought: • Silicon Valley Bank released an interesting report on the state of investment in AI in healthcare, including stats on AI usage at healthcare organizations and the impact of leveraging AI on startup valuation. https://lnkd.in/em7AfivT    • The journal Critical Care Medicine published an editorial on an “in clinico” evaluation of a machine learning-based early warning system to predict in-hospital deterioration. We found it to be an interesting look at the actual impact of a model’s deployment on care processes and patient outcomes in a critical care setting. https://lnkd.in/eQhZbVKu

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Let's keep hospice focused first and foremost on the PATIENT. After all, we only get one chance to do it right... "There are six primary trends that are influencing consolidation and professional practices: regulatory complexity. technology and integration, private equity ownership. demographics, economies of scale and consumer expectations,” Henderson said. “So many of these things that we see that are influencing health care consolidation need to be pointing toward the patient." #patientsfirst #hospicecare #youonlygetoneshot https://lnkd.in/gbbgV-YF

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OpenAI enters healthcare 😷 They’re partnering with Color to produce computer-generated personalized care plans for cancer patients. Here’s what they’re doing: 📄 Using GPT-4o for a copilot they’ve built 📄 Identifying missing diagnostic tests 📄 Creating tailored plans for patients 📄 Having a clinician analyze every recommendation made 📄 Relying on APIs to integrate patient data with evidence-based healthcare guidelines and HIPAA-compliance 📄 Building an #AI model that includes family history and individual risk factors 📄 Generating documentation for diagnostic workups like insurance pre-authorization 📄 Extracting information buried in unstructured data So far, providers are able to identify 4x as many missing labs, imaging, biopsy, and pathology results compared to not using this copilot. On average, it takes about 5 minutes to use this tool. This year’s goal is to use this for 200,000 patients. Color has other partners, such as American Cancer Society and University of California, San Francisco, to measure the impact of this tool. It’s great to see more #healthcareinnovation for complex conditions and partnerships across industries! #startupjourney #startup #healthtech

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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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Patient Better, a 501(c)(3) public health educational program, offers patients and families a solution to learn how to navigate healthcare from the comfort of home. Our program is designed to help people manage their healthcare journey, participate in medical appointments, and become better decision-makers for their health. #publichealtheducation #patientbetter #patienteducation #patientandfamilyhealth https://patientbetter.com/

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Health insurance companies Medicare Advantage plans subsidy and premium based EBITDA and Profits can only be guaranteed and expanded by taking from the physicians who manufacture preventive, medical, surgical and palliative outcomes with their patients and also taking from the hospitals in which clinical outcomes are manufactured and produced. #quadrupleaim, #medicare #medicareadvantage #healthcarecosts

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