Marla Ranieri, DPT, OCS

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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“So... Apple is entering the hearing space!” For the past two weeks, I've been flooded with messages asking how Apple's latest announcement will impact Concha Labs. Another consumer tech giant is stepping into the hearing space, but what does this really mean? With over 1.5 billion people affected by hearing loss globally, this is a massive market. Yet, like mental health, hearing loss is something people don’t talk about much. If you ask anyone who’s tried hearing aids, you’ll likely hear stories of frustration—they’re often disliked because of impersonal sound quality. For me, they were always too loud or too quiet, and I could never find the “right” fit. This isn’t new. Apple, like Bose before them, will likely face similar challenges in replicating the status quo. Despite their audio expertise, Bose entered the hearing aid space but exited due to the same hurdles. Bluetooth earpieces, with their short battery life and social awkwardness, also highlight how hard it is to create a practical, long-term solution. But here’s the good news: more attention on hearing health, thanks to Apple’s announcement and the OTC Hearing Aid Act, is a win for everyone. It’s sparking conversations about hearing loss—something I kept hidden for decades. Concha Labs' hearing aids are nearly invisible, like contact lenses. When I tell people I’m wearing our product, they’re always shocked because they don’t notice them, even with my hair up! (And this goes for the guys who wear them, too!) What’s clear to me is that while awareness is growing, real innovation comes from solving actual user pain points. That’s where Concha Labs comes in: we offer a fully personalized hearing experience, much like how Spotify revolutionized music personalization beyond iTunes. Our solution is designed for real-world usability—comfortable, discreet, personalized, and customizable in multiple sizes and colors. Created by people who were tired of the status quo (like me!), our Concha Sol hearing aids are made for those who want something better. So, if you’re tired of the same old hearing aids, let Concha Labs empower you to hear clearly. We promise, you’ll notice the difference. 😉 Amy www.conchalabs.com #hearing #hearingaids #apple #conchalabs #invisible #otchearingaids #startup

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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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Between this and those beautiful 200+ page grant applications for the National Institute on Aging (NIA), I feel like I have also been #backtoschool lately... This report is FULL of great info on the continued evolution of VR in senior housing and related care settings. Take a few minutes and give it a read - there's some great insights from folks like Clint Fowler Michelle Smith Ricky Peña and data from all of our own deployments, overseen by the great David Stoller. DM me if you want the PDF directly! #seniorliving #vr

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Redesign Health has launched its largest fund to date, securing $175M to support over 20 new healthcare startups. Founded in 2018, the venture builder has previously incubated more than 60 companies, including Scriptology and Vivid Health. The new fund aims to address challenges such as healthy aging, interoperability, and expanding sites of care. This funding underscores investor confidence in tackling the $4T healthcare market's persistent challenges.

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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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Noom CEO Geoff Cook joined the Fitt Insider Podcast to discuss the company's evolution from psychology-based weight loss to a comprehensive health platform. We cover: 💊 GLP-1 Integration Noom expanded into medically-assisted weight loss, pairing GLP-1s with psychology-based behavior change. 💪 Program Innovation The company launched specialized features for GLP-1 users including protein tracking, Muscle Defense resistance training program, and body composition monitoring. 📱 Platform Evolution Geoff restructured the platform around the four C's: Content, Coaching, Community, and Clinical, with AI integration across features like food logging and body scanning. 📊 Business Model Geoff is also exploring freemium capabilities while maintaining Noom’s subscription offering, leveraging his experience leading The Meet Group's 40M monthly active users. 🌟 Future Vision  Positioning as a preventative health platform beyond weight loss, Noom is exploring expansion into broader health conditions and medical interventions. 🎧 Check the full interview on Apple, Spotify, Youtube, and more → https://lnkd.in/eThQzE7t 💪 Presented by EGYM

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Bigger isn't always better in healthcare. Just look at the graphic below. Some of the largest health systems in the country are underperforming. They've entered (or operate in) bad markets, hold bloated cost structures, and struggle to hold leverage against payors. As it turns out, and as I'm often reminded, market performance matters. It doesn't matter that you're just big and can absorb a vast swath of overhead. As a health system, the way you throw your weight around in markets is more important than ever. This is the key concept of density and having the right assets in the right markets. CVS, HCA, Tenet, and others all have mentioned the importance of market density in 2024. Density - and being dense in attractive markets - is primarily what separates -3.9% from 10%+ operating margins. I should have paid attention in physics!! PS: if you like graphics and analysis like this, subscribe to my newsletter Hospitalogy here with 34k+ others: https://lnkd.in/gniNmHvz

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Here’s your recap of last week’s healthcare technology news 🗞️ 👇 🤖 AI Clinician Assistant • Carle Health is beginning a full-scale adoption of Nabla through their Epic integration.    • UVM Health Network signed an enterprise-wide agreement with Abridge.    • Regard closed a $61M Series B with an investment from Cedars-Sinai Health Ventures among others.    • Mass General Brigham published a Q&A discussing the results of its initial AI ambient scribe pilot and plans to roll out a wider implementation.    🔁 RCM • Greenway Health released a patient payment solution that integrates cost estimates, patient payments, and payment plans.    💼 Provider and Practice Administration • Kontakt.io released a new wearable tag that aims to enable understanding of patient journey, estimated wait times, room availability, physician time with patient, and more.    📋 Patient Administration • Cone Health is partnering with Lirio on an AI-driven intervention for patients with diabetes.    • SAIGroup acquired Get Well, giving it access to the firm’s AI platform. 🍎 VBC • P3 Health Partners is partnering with Innovaccer to leverage its physician engagement solution as well as its AI-driven analytics.    • HSBlox, Inc released an update to its CureAlign platform that includes tooling for improved care coordination and patient outreach.    • GrayHawk Health is implementing Innovaccer to optimize operations and improve efficiency. 🧠 Food for Thought • We’ve covered numerous studies in our newsletter highlighting the impact of tech on reducing physician burnout. It appears we’re finally seeing signs of widespread impact from these workflow and workload interventions: physician burnout dropped below 50% for the first time since 2020, according to the AMA. https://lnkd.in/eWhj94NB    • ONC released the new, proposed rule HTI-2 to advance interoperability and patient information access and sharing. We're looking forward to more expert takes in the coming days—feel free to send any good ones our way! https://lnkd.in/eyM7eDyq --- Reminder: you can sign up for the Elion Briefing to get the latest healthcare tech news delivered to your inbox each week 📬 👉 https://lnkd.in/e2UJ3ckP

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In a recent op-ed, Jeff Bezos highlighted that "Reality is an undefeated champion." In healthcare, reality shows that many organizations still face challenges with retention. There's a clear link between trust (or the lack thereof) and declining retention rates. Excited to share news of a 5-part podcast series on Emotional Onboarding. Stay tuned as I share discussions with healthcare leaders who have successfully implemented emotional onboarding strategies to not just hire but retain staff. #Healthcare #Retention #EmotionalOnboarding

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There is a blueprint for success and MDisrupt has the experts to deliver it!

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Alot of bad actors and a few good actors. $2.5T HC capital raised & $1T invested by PE in last decade. $31B in 2013 vs. $217B in 2021. We know the story. Misaligned incentives - unrealistic multiples, short-term profit focus, aggressive cost-cutting, unrealistic scaling, misunderstood market dynamics, just to name a few. However, our industry needs money. But our industry is more infrastructure asset class than tech start-up (James Nicholls gave me that epiphany). Mic drop on the lyrical genius of Alex Fair of MedStartr Ventures as he literally gives the whole story poetic justice as he reads HIS POEM on this "On The Road at VIVE" episode of The Reverse Mullet Healthcare Podcast w/BP2 Health. This is the perfect episode for a Friday afternoon! He and Paulo J Machado donned the actual reverse mullets and joined us back in February at #VIVE2024 to talk about the need for REAL change in healthcare, startup focus and investor expectations. It was one to remember and one that is in desperate need of a full-length follow-up episode. Give us a like and a watch or a listen https://lnkd.in/e4w4mjkv https://lnkd.in/egmK3kMB

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The birth of the MedSLP Collective was an unexpected journey that began during my time running a mobile FEES business in New York. Despite support from medical professionals, we faced a challenge: SLPs weren’t making many FEES referrals. This revealed a crucial insight - many SLPs weren’t fully aware of the benefits for their patients. Our field needed more education. To address this, I started a blog and newsletter for the SLPs I worked with. What began as a modest effort unexpectedly sparked a movement, as the content spread rapidly, revealing a deep hunger for specialized knowledge among SLPs. As the blog gained traction, I found myself at a crossroads. The demands of a growing online presence competed with the mobile FEES business. Inspired by podcasts I listened to during long drives, I decided to transform the blog into The Swallow Your Pride Podcast, which debuted at #11 on the iTunes Science and Medicine chart. The podcast’s success clarified my mission: provide accessible, high-quality education to SLPs everywhere. This led to a membership platform offering bite-sized education, designed to fit into the busy lives of practicing SLPs. When I floated this idea, the response was astounding - 300 people signed up overnight. This journey has been transformative. It’s a testament to the power of listening to our colleagues, adapting to their needs, and continuously innovating how we share knowledge. The Collective and our membership platform are the fruits of this journey. They represent not just my vision, but our profession’s collective desire to grow, learn, and provide the best possible care for our patients. As we continue to evolve and expand our educational offerings, I’m reminded daily of the passion and dedication that defines our field. To everyone who has been part of this journey - thank you. Your enthusiasm, curiosity, and commitment to excellence continue to inspire and shape the future of our profession. The Collective was born from a simple desire to educate, but it has grown into a movement that empowers SLPs to provide better care and achieve their full potential. #medslp #medslpcollective #slpeducation

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In this week's episode of What in the Hot Hell is Happening in Healthcare: Northwell is now an entertainment studio Ummmm, say what now? Let's check the financials: FY 2023 $16.9B revenue $198M op income $1.3B cash from ops Hope none of the $156M in CARES and FEMA funding are going to the studio Maybe just some of this? $11.8B total assets exl. PPE and op leases $6.2B unrestricted cash $7.5B current assets $7.2B net assets I don't know, could be some of this... $140M grants and contracts $35M rental income $31M GPO revenue Could be the $7.9M parking income New York parking is expensive after all Probably just using it's $422M endowment Definitely not using its $774M invested in hedge funds and private equity And definitely not taking away from the 19% increase in General and Admin salary (while health care services salary increased 7%) Glad to see tax dollars going to good use Northwell is tax-exempt after all And generates about 50% of it's revenue from Medicare and Medicaid Can't wait to see the movies they make It's going to be awesome P.S. If you liked this little breakdown, you'll love The Healthcare Breakdown, where we look at numbers and stuff so you can get an idea for what makes healthcare so bananas Check it out here: https://lnkd.in/gVRtQGZN See you out there!

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“I think it’s important that the person running the organization understands the core thing that the company does.” - Ben Horowitz, GP at a16z. Totally agree, but we actually see the opposite in healthcare. As care delivery businesses are mostly run by people who have no prior knowledge of how to deliver care. The ACA actually prohibits doctors from even owning hospitals. Which completely enables MBAs and other non-clinical administrators to influence how patients receive care. Call me old fashioned but shouldn’t the people trained and licensed to provide care delivery services be the ones running businesses where care services are delivered? 🤷🏽‍♂️ —— Hi, I'm Dr. Mario Amaro, Founder and CEO Ease and I talk about all things starting, running, and growing a private practice with AI. Follow me, if you are planning to start one or are currently figuring out creative ways to grow one. #PrivatePractice #SelfEmployment #HealthcareOnLinkedin #HeyEase #IndependentTogether

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Peter Birch from Talking HealthTech and I get down to the nitty-gritty of why 2025 might be the year of healthcare #interoperability.

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🥊 A Tough Quarter for CVS – What's Next? 🚨 💊 CVS was the final "Big Six Payor" to reports earnings last Wednesday and I was able to dive into CVS's latest earnings report, and it's clear that the healthcare giant is facing some significant challenges. From Medicare Advantage headwinds to Medicaid acuity issues, CVS is navigating a complex landscape that’s testing Karen Lynch as she has moved to actively manage Aetna. 🗞 In this article, I break down: - The driving forces behind CVS’s Q2 performance and loss of free cash flow along with expanding expenses - Insights into their Medicare Advantage and Medicaid strategies headed into 2025 - The impact of the retail pharmacy contraction and biosimilar partnerships for Cordavis as they look to control the potentially 100 billion dollar market against Cigna and UNH If you’re following the healthcare industry, especially the dynamics among the “Big Six Payors,” subscribe below. CVS Reports Q2 Earnings jeffdelverne.substack.com I'd love to hear your thoughts on CVS’s current trajectory. Do you think they can successfully integrate Aetna, Signify, Oak Street, and Cordavis to turn things around? #healthcare #pharmacy

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Great breakdown from McKinsey & Company here on current Medicare Advantage dynamics. TL;DR they have some levers but margins are as thin as they've been in recent memory in 2024. McKinsey called out the following as challenges for MA players moving forward: -Little to no rate increases from CMS -Broker commissions changes -V28 changes -Star ratings (the biggest near-term lever) -Utilization trends -Part D and other regulatory changes Source: https://lnkd.in/g9U4h2Gp

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