James Powers

Mandatory bundles in surgery are a bi-partisan objective, and (in)ability to optimize cost/quality will dramatically impact hospital P&L. Regular insights from granular data , and AI-based decision support are the only way to systemically reduce unwanted variability and be both profitable and high quality.

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I’ve realized the power of words in transforming perception and driving results in patient finance. Positioning in-house patient lending as patient financing may not always resonate with providers. Instead, reframing it as managing monthly patient bills and receivables can spark interest. Executing in-house payment loans effectively as receivable management with regulatory compliance can lead to legal interest collection and increased receivable value. #HealthcareFinance #PatientBilling #ReceivableManagement #HealthcareIndustry #Patientfinancing

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Over the past several months, Naomi Goez and I did a deep dive into opportunities for innovation within health systems. Throughout that time, we had conversations with innovation executives across four of the top healthcare systems in the U.S. including Mayo Clinic Ventures, Hackensack Meridian Health, Cone Health Ventures, and University Hospitals Ventures to understand current strategies and priorities in order to hone in on our investment thesis. Our goal was to arm health tech founders with the inside perspective on the critical investment areas for US hospitals to help navigate towards product-market fit and solve the industry's most pressing challenges. Health tech is a core thesis area for us at Forum Ventures, as we think technology will play a major factor in improving patient outcomes, providing more accessible care and driving better financial results for health systems. We've already made quite a few health tech investments over the last 10 years and plan to make many more over the coming years. Links to download the report, check out the market map, and submit your company are all in the comments. Thank you to our contributing experts Shai Ran Sapir, Technology Development Manager at Mayo Clinic Ventures, Sandra Powell-Elliott, Chief Innovation and Commercialization Officer at Hackensack Meridian Health, David Heenan, Managing Director at Cone Health Ventures, and Matthew Zenker, Director of Deal Flow and Investments at University Hospitals Ventures. #healthcare #innovation #healthtech #earlystage #healthtechfounders #healthcarestartups

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$1.6 billion. That's what UnitedHealth Group projects as the total earnings impact in 2024 of the February Change Healthcare #ransomware attack. This includes both direct response costs (e.g. platform restoration and increased medical care expenditures) and business disruption impacts (e.g. lost revenue). The figure is now so large that it shows up in the net earnings calculation as part of the first-quarter 2024 financial results announced on Tuesday. And remember that UnitedHealth hasn't yet disclosed the amount of personal #data breached in the hack - it needs to do this within 60 days of learning about the breach, and that time expires next week. The damage could get even worse. More needs to be done to detect and prevent ransomware. 10-figure costs should not become the norm. If you're a #founder working on a new idea, please reach out! Reuters Article: https://lnkd.in/gXBQ5pwb P.S. In case you're wondering, I have lots of thoughts on Lacework/Wiz but waiting for a little more information before sharing a post. Rumors are just rumors.

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There are plenty of ways we rely on interoperability in our daily lives – and we never think twice about it. Like sending a text message that is received by your daughter – that shows up exactly the way you sent it. We only think about interoperability when it doesn’t work and creates frustration for users – like the green bubble versus blue bubble text message debate. It’s no big deal when the photo of your dog is pixelated when it makes it to your friend. But when it comes to the exchange of your health information between your doctor, pharmacist and insurance provider – the consequence of incomplete information risks the safety and quality of your care. We’ve come a long way in healthcare interoperability – but we’re not there yet. Hope you’ll check out my recent article for Forbes Business Council on what we must continue doing as an industry so we can forget about interoperability in healthcare and restore the focus back on patient care. https://lnkd.in/ehi6YRTE   #healthcareonLinkedIn #interoperability Surescripts

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"More than $12.5 billion has been bet on digital behavioral health in the last five years, according to Rock Health. Funding peaked in 2021, with $5.7 billion spent that year alone." As investors and innovators, I believe we need to broaden our focus in the behavioral health space from just expanding access to care, to effectively measuring the quality of that care. As we continue to encourage individuals, employers and plans to increase their spending and focus on behavioral health, we need reliable tools for measuring the long-term efficacy and impact of behavioral health services.

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I'm thrilled that today, we announced a significant milestone for Clover Health: the launch of Counterpart Health. Our innovative Clover Assistant (CA) platform is now available to all Medicare Advantage payors and providers under the new brand name Counterpart Assistant. Why am I so excited about this? This move is a strategic leap forward in our mission to improve healthcare for everyone. With Counterpart Assistant, we're not just expanding our reach—we're leveraging cutting-edge AI and machine learning capabilities that have already proven to make a real difference in patient care. The healthcare landscape is evolving rapidly, and the need for advanced, data-driven tools has never been greater. Medicare Advantage plans, in particular, are under pressure to improve patient outcomes while managing costs. That’s where Counterpart Assistant comes in. By bringing our technology to more providers, we're empowering clinicians with the tools they need to deliver high-quality, personalized care. What makes Counterpart Assistant special? First, we’re broadening our impact by allowing providers outside of Clover Health's Medicare Advantage plan to benefit from our technology. Our hybrid SaaS and shared-savings model aligns financial incentives with health outcomes, ensuring flexibility and scalability. CA’s AI-driven insights enhance clinical decision-making, and are associated with earlier diagnosis and better management of chronic diseases. Plus, we've built a robust support system to ensure seamless integration and ongoing assistance for all users. Clinicians using CA have seen significant improvements in Medical Cost Ratios and patient outcomes. The timing couldn't be better. The healthcare industry is ripe for transformation, and our technology is poised to lead the way. By expanding the use of Counterpart Assistant, we’re not just keeping up with the changes—we’re driving them. Join us on this exciting journey. Visit our website for more details. Thank you for your continued support as we strive to bring high-quality healthcare to everyone on Medicare. #HealthcareInnovation #AI #MedicareAdvantage #ValueBasedCare #CloverHealth

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As part of our #M3P solution in JUDI®, the report dashboard gives Medicare Part D #plansponsors insights into payment activity. With all this data at your fingertips, available to slice and dice as you see fit, you can easily visualize and keep track of payment trends. Want to see Ryan Kelly (Chief Technology Officer) run through a live demo of our M3P solution? Check out the replay of our webinar here: https://okt.to/9ZTsSW

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Personally, I am skeptical about how big of an opportunity there is for standalone virtual behavioral health in the Medicare space. I think the much more effective solution is integrating behavioral health for seniors with their primary care providers. Curious what folks think are the best examples of successful integration of virtual behavioral health into primary care, specifically for seniors. https://lnkd.in/exCEBFpu

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Interoperability in healthcare refers to timely and secure access, integration and use of electronic health data so that it can be used to optimize health outcomes. Hear from our own Bobby Sherwood on the challenges and best practices around #interoperability.

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🤔 What do you know about healthcare administration? 🤔 #claimsadjudication #thirdpartyadministration #specialtyinsurance... :) Andrew Munroe, Senior Vice President of Operations, Pharma, and Payor Partners at NexgenRx Inc. joined us on the latest episode of the Health Tech Horizons Podcast to share industry insights, and the latest trends shaping the future of healthcare administration. Join us as we explore the intersection of insurance related technology, innovation, and healthcare with NexgenRx Inc. and Andrew Munroe. ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ 📲 CHECK OUT the VIDEO 📺 ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡

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The "suburban rut" of saturated markets plagues both broadband providers and healthcare systems (IDNs). My recent blog post explores how this shared challenge presents a golden opportunity. Leveraging telehealth and innovative solutions can make reaching rural populations profitable for both sectors. This shift not only benefits patients with increased access to care but also unlocks new revenue streams. Over the last 4-5 years I have been drawn into projects that involve and impact rural communities. For those of you who know me, I have spent decades developing broadband access markets working for global network equipment manufacturers, and more recently as part of Harbor Pilots. In my Connected Hospital experience working with Integrated Delivery Networks (IDNs) the notion of "access" had a slightly different meaning for healthcare providers but the challenge with access in broadband and healthcare revolves around population density and the cost to reach people. Working with Duke Tech Solutions we provided State and Local Governments with tools to optimize the $42 Bn Broadband Equity Access Deployment (BEAD) funding from the NTIA. Here's a blog post about the opportunity for Telecom providers and IDNs to look at rural communities as an attractive market where they can retreat from the intense competition in saturated suburban markets. I'd love to hear your comments. https://lnkd.in/erJAtJUa

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Don’t miss tomorrow’s Episode with our CEO of Onyx Elite LLC Business Consulting. Are you looking to level up your business? How do you do that? Where do you start? How do you scale? How do you get funding to grow? We are here to help! Contact us for a Complimentary Consultation! #businessdevelopment #consulting #businessgrowth #capital #capitalraise #csuite #operations #branding #marketing #brandbrilliance #entreprenuer #scale #podcast Onyx Elite Business Consulting Doru M. Angelo

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✅Our healthcare report and market map are finally live✅ Over the past several months, I have shared with anyone who would listen that Michael Cardamone and I were in conversation with innovation executives across four of the top healthcare systems in the U.S. including Mayo Clinic Ventures, Hackensack Meridian Health, Cone Health Ventures, and University Hospitals Ventures to understand current strategies and priorities in order to hone in on our investment thesis. The goal was to arm healthtech founders with the inside perspective on the critical investment areas for US hospitals to help establish product-market fit and solve the industry's most pressing challenges. Links to download the report, check out the market map, and submit your company are all in the comments. Thank you to our contributing experts Shai Ran Sapir, Technology Development Manager at Mayo Clinic Ventures, Sandra Powell-Elliott, Chief Innovation and Commercialization Officer at Hackensack Meridian Health, David Heenan, Managing Director at Cone Health Ventures, and Matthew Zenker, Director of Deal Flow and Investments at University Hospitals Ventures. #healthcare #innovation #healthtech #earlystage #healthtechfounders #healthcarestartups

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Investing in preventative health tech platforms requires a strategic approach that balances potential returns to improve public health outcomes. One key consideration is the platform's scalability, as scalable technology can serve large populations, achieve widespread impact, and maximize financial returns. This also makes scalable platforms more attractive to healthcare providers and payers seeking cost-effective preventative measures on a broad scale. To learn more about investing in scalable health tech platforms, read the full article. https://buff.ly/3wswQ67 #healthtech #investing #AIwellness #digitalhealth #ecommerce #investmentstrategies #wellnessindustry #AItechnology Subscribe to the Evolving HealthTech newsletter here: https://buff.ly/44pGPE0

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The article below is a very disappointing perspective by Evan Ramstad's take from Minneanalytics, and the coverage that the field does NOT need post Watson. Firstly, taking one speaker, Chris Mandrodt's opinion over a number of highly influential data scientists that were at MinneAnalytics such as Bonnie Holub, Ph.D. and Trish Lugtu from Teradata and the important work from home town giant, UnitedHealth Group is further discouraging. What Ramstad possibly failed to research or discuss are the huge advances that are being made in a number of smaller companies having a disproportional effect directly on patient health. From our experience at DeLorean Artificial Intelligence 's #Medical #AI product we have seen the following: 1. First AI to be biologically validated with 99% confidence level in healthcare. 2. First AI to be applied at scale to patient health, over 52M patients processed. 3. 26% decrease in hospitalizations within 3 months of implementation. 4. Over 50% increase in detection of chronic diseases in patients that were currently unknown to the payer or provider. These are just a few. Further - we as a field need to move from saying advances in #wearables and their data collection and computer vision associated with radiology are truly advances in AI. This has been around from 2019. The failure in the industry to implement the promise of AI I feel is rather the inability to get the work done, specifically in the payer space. The future is bright in hashtag #healthcare and associated applications of hashtag #AI outside of wearables & data collection. https://lnkd.in/eefXWidJ

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As we continue to navigate the evolving landscape of healthcare, the significance of value-based care (VBC) in improving patient outcomes and reducing costs has never been clearer. The recent playbook on #VBC best practices released by AMA, NAACOS, and AHIP provides a roadmap for success in this area. At PointClickCare, our focus aligns perfectly with these initiatives and our commitment to innovation and collaboration to drive forward the future of healthcare has never been more important. #ValueBasedCare #Innovation #HealthcareFuture

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