Healthcare Beans

Lindsey Kratzer of Spark Health Advisors shares valuable insights on the self-insured employer market.

In episode #16, I speak with Luká Yancopoulos, CEO and co-founder of Grapevine Technologies. Luka is an entrepreneur with a track record of innovation and consistent delivery in the healthcare industry. As CEO and one of the faces of the company, Luká is involved at every level of Grapevine's operations: securing funding, innovating on the platform, and looking for ways to take the company's offering to an even wider market. In this episode, we talk about: Crazy inefficiencies in the current healthcare supplies market Grapevine's marketplace solution and cost savings Price transparency for healthcare supplies Grapevine's growing popularity among specialist providers How Grapevine enables cost savings for struggling rural hospitals The importance of efficient supply chains for value-based care Experiences from early adopters of Grapevine's services Sign up for free at Grapevine today and save on your medical supplies. We hope you enjoy the show! Godspeed ~ James

In episode 15, I speak with Leon Wisniewski about his company Health Cost Labs and their new product Billy - a consumer app that shows hospital prices by service and geographic area, and lets users shop around for the best price. Leo is passionate about bringing fair and transparent prices to healthcare. We talk about... Billy: a healthcare price app Recent healthcare price transparency laws The no surprises act The importance of a "good faith" estimate Hospital compliance with price transparency The Managed care "beast" Payment "no" integrity A superior cash-first system for healthcare payments Prospect of Medicare-4-all Leo's Home Brew recipe -> How to buy low cost healthcare We hope you enjoy the show! Godspeed ~ James

In this episode, I speak with Dr. Yazan Abdullah, an internist who specializes in hormone replacement therapy and founder of Newport Health & Vitality. One interesting quote from Yazan: "Fee-for-service is the most ethical way to pay for healthcare". Our conversation spans: Testosterone therapy and stigma Pursuing vitality in addition to longevity should be the goal for health-conscious Americans.  Obesity and its connection to observed, low testosterone levels in American men Pros and cons of managed care (mostly cons!) The rise of psychedelics as a treatment for mental health disorders The potential for Bitcoin payments for healthcare services We hope you enjoy the show. Godspeed! ~ James

In this episode, I speak to Claudia Armani, a health coach and founder of Claudia Armani Wellness and The Healthy Gourmet blog dedicated to simple and healthy Mediterranean recipes and lifestyle tips. She works with clients both in UK and around the world to help them let go of yo-yo dieting and improve their metabolic health. Our conversation spans: Claudia's background and entry into health and wellness The fundamentals of health coaching and how to empower patients Functional and holistic medicine The use and limitations of willpower for behavior change Intermittent fasting The state of health coaching in the UK The rise of subscription-based payments in health coaching Risks and benefits of new weight loss medications Emotional eating and maladaptive coping mechanisms The pursuit of the dopamine kick The value of social prescriptions in healthcare And the Claudia Armani Wellness brand and services We hope you enjoy the show.. Godspeed! ~ James

In this episode, I speak with Bryan Guadagno - CEO and cofounder of It's Skinny. We discuss the 9-calorie noodle, the health benefits of Konjac, the future of food technology, and the founder's story. Our chat dives into consumer behavior modification and how that relates to healthcare spending in the United States. Godspeed! ~ James

In this episode, I talk with Michael Boerner (CEO of Engage Technologies) about his company's transformative mobile intelligence and patient education technology - connecting patients to a digital health platform with no app or user logins (e.g., NO FRICTION). We discuss the value and power of video storytelling, the importance of behavior change for disease prevention, new opportunities in gamified learning, and how this company is optimizing the patient journey while reducing practice burden on providers. "Engage Technologies believes that timely knowledge from a trusted relationship empowers. It empowers patients, providers and their staff, and all healthcare stakeholders. Engage transforms lives with breakthrough mobile intelligent storytelling at patient height of interest and time of need. The right message at the right moment motivates behavioral change for optimal patient outcomes and improves practice performance with proven six-figure and above return on investment" - Steve Inch, Chief Marketing Officer, Engage Technologies Here's a list of Engage demos & links that showcase different products: Engage Aesthetics Demo (featuring breast augmentation, mastopexy, breast revision, and neuromodulators & dermal fillers, and patient pre-consultation journeys): In the United States, anyone with a mobile smartphone can text to 418418 and enter the typed message: TVPS CONSULT Engage Aesthetics Demo (featuring pre-operative and post-operative breast surgery patient journey): In the United States, anyone with a mobile smartphone can text to 418418 and enter the typed message: TVPS JOURNEY Engage Ocular Demo (featuring multiple ocular patient journeys): In the United States, anyone with a mobile smartphone can text to 214214 and enter the typed message: BRIGHT EYES M Engage Ocular (ROI results) video (6:30 min): Hero Video for Engage Website Engage Aesthetics (behind the scenes) video (5:20 minutes): https://engagetg.wistia.com/medias/8ubwbabbry Godspeed! ~ James

In this episode, I talk with Jonas Goldstein (Vice President of Strategy at VIM) about value-based healthcare, risk-sharing arrangements, Medicare Advantage, direct-to-consumer healthcare, and point-of-care digital solutions. Here is a great article by Jonas in Physicians Practice that lays out the imperative to "lower the risk" in value-based healthcare in order to quickly expand accountable care delivery across the US. Godspeed! ~ James

Episode 9 of the Healthcare Beans podcast Without realizing it, I played an important role in my wife's health journey. But first, a bit of context.. I often find that healthcare professionals pay little regard to individuals' capacity for willpower or grit. The prevailing viewpoint is that poor health outcomes are caused by systemic problems like waste, greed, and failed policy. Period. There is no doubt that healthcare delivery in the United States is poorly designed, and must be corrected through policy changes. But without holding patients accountable for their own health outcomes, we cannot help people live the best version of themselves. And until we do that, I fear a great deal of time and money will be spent on healthcare solutions that barely work. Episode takeaways: (1) I share a story about my wife's health journey, as an example of how family and friends can be excellent constructive critics who propel us toward better living. (2) There are countless success stories about people who dropped unhealthy habits and started living a better life. These stories should form the foundation of how health systems engage patients. (3) Resilience research can serve as a framework for healthcare professionals to better support patient accountability and help people live the best version of themselves through a combination of (1) grit and (2) a practical method of self-improvement. Godspeed! ~ James

Episode 8 of the Healthcare Beans podcast Mental health took a nosedive during the pandemic. We need to expand access to mental healthcare in our communities, ASAP. To meet this need, telehealth companies that provide virtual psychotherapy are growing very fast. In particular, I'm rooting for Talkspace therapy. Episode Takeaways: (1) Have you ever seen a strong, confident, clear-headed person break down in front of you? No one is guaranteed good mental health across time. One thing I learned from the pandemic is to never assume your friends and family are OK based on past appearances. (2) A mental telehealth app called Talkspace recently signed a deal with the city of Reno Nevada to provide psychotherapy for its residents. Here's a good, comprehensive review of Talkspace. (3) The Reno Talkspace therapy deal can set the stage for other cities to make similar deals with telehealth providers. I'm betting it will! ~ James Transcript Hello and thanks for catching episode #8 of Healthcare Beans, I’m your host James Haven. I want to share a strange experience I had during the pandemic, that really hit me in terms of the poor state of mental health in our communities. Now, we’re all hyper aware of how bad depression and anxiety has gotten during the pandemic – it’s common knowledge and supported by public health data (no surprises here). But what did surprise me is that it’s not only people with existing mental conditions who are suffering – people who (in the past) typically enjoyed good mental health are also struggling. And that means we really can’t make assumptions around people who look fine or appear to be happy, thinking to ourselves, “oh that person’s okay”. So, a friend of mine (she’s a psychotherapist) lives in a nice home, in a nice upscale neighborhood with her husband (great guy by the way), her 2 small children and a family dog. And like pretty much everyone in the first half of 2020, they were self-isolating in their home, and my wife and I were isolating in our home, and we didn’t see them for about 5 months. And we come to find out that she and the husband are having a major disagreement about how to stay safe during the pandemic. Essentially, she felt an absolute need to get outside, get some fresh air, mingle with a small group of close friends & family, and provide some sense of normalcy to her kids. On the other hand, her husband took COVID very very seriously. He felt that any contact with other people should be avoided, and that even taking walks outside, by yourself & breathing in the air, was a bad idea. So for about 5 months, they did it his way, living totally isolated from other people, and in that time his wife’s mental state was deteriorating. By the time I finally saw her, she was sitting on the floor of her home, with her head buried in her skirt, just crying uncontrollably. I could not believe my eyes. Up until that point, I’ve always seen her as calm and in control. But the thing I’ll never forget was what she said to us – she said we abandoned her, that we never checked to see how she was doing. And she was right, we did not check on her, we just assumed she’s okay because she lives in a nice home, in a nice neighborhood, with her beautiful family. We were totally wrong – mental illness can strike anyone, at any time, and especially during the pandemic. And from a data standpoint, I know this, but it’s something else to see it happen (up close) to someone you know. So one of the big takeaways from 2020 is access to mental health services – this has got to be a priority going forward - fundamentally improving access to mental health services throughout our communities. So, for the past few months, I’ve been keeping a close eye on mental health apps – in particular, there’s two companies I’ve been reading up on – one is Talkspace and the other is BetterHelp (I found a really good user review of these services, there’s a link in the show notes if anyone is inte...

Episode 7 of the Healthcare Beans podcast Virtual reality (VR) therapy can be very effective for treating pain. The key issues are the types of pain that can be treated with VR, and how we can pay for it. In early 2020, Medicare approved payments for acupuncture to help treat pain without prescribing opioids, which clearly signals the demand for different ways to treat pain. Episode takeaways: (1) Due to the opioid crisis, it's very difficult to (legally) get your hands on prescription pain medication. Clinicians are reluctant to prescribe opioids for anything except severe pain. For people with substance use disorder, this is a good thing. But that also means we need other, non-addictive ways to treat or eliminate pain. (2) Virtual reality companies like AppliedVR and XR Health are providing VR therapy to better manage acute pain, chronic pain and anxiety. VR therapy can be self-administered in your home, after receiving minimal instruction. (3) The next step for VR therapy is getting health insurance companies to pay for it. Certain Medicare Advantage plans and commercial insurers have started covering VR therapy, but it still has a long way to go. The benefits of virtual reality for patients are becoming clear, but what's not clear is whether the technology will be widely adopted, or will it actually help lower the rates of opioid addiction in the United States. I'm betting it will do both. ~ James Transcript Hello and thanks for tuning into episode #7 of Healthcare Beans, I’m your host James Haven. This episode is inspired by a recent experience I had with my dentist (and please bear with me – this will certainly connect with the broader theme of healthcare in the United States).. So I showed up for an emergency visit on a Saturday; and I was in a lot of pain and it turned out that I needed my wisdom tooth pulled… I’m one of those types that wait till the last minute for dental care because I just hate going to the dentist. Now, I’ve had this sort of dental work before, where after a tooth extraction, I start to experience a lot of pain, maybe around 4 hours after the surgery, when the pain medication wears off. As a matter of fact, I once ended up in the ER after dental surgery, the pain was so bad. So I describe my past experience with the dentist and I ask her for prescription pain medication (real pain medication); not high dose tylenol/ibuproferin. And she said to me (these are her exact words) – it’s not in my philosophy to prescribe opioids for a tooth extraction. I got to say, I wasn’t expecting that, and I was a little upset. Nobody wants to hear about someone’s clinical philosophy when you’re having pain. So I left the dentist office with a useless prescription of high-dose Tylenol and crossed my fingers for good luck. About 6 hours later, I was in serious pain. The Tylenol didn’t work, the dental office was closed, and I was pacing back-n-forth in my living room because that’s what I do when I’m not feeling well. And then it hit me – the last time this happened (and I ended up in the ER), the emergency room physician gave me a prescription codeine; and I filled that prescription. So the codeine was somewhere in my home, I just had to find it. And that’s what I did; I frantically searched for the codeine, found it, and popped one pill. And about 20 min later, the pain was much reduced and after another 10 min, the pain was pretty much gone. Presto! Now, the moral of the story is not that codeine is the best thing since sliced bread; I mean, it worked well, but that’s not the point. The point is that pain management is a very real problem in healthcare. Dentists and doctors are very reluctant to prescribe opioids, and there’s a very good reason for that; the opioid epidemic is killing thousands every year, and the best way to save lives, at least in the near term, is to stop prescribing opioids for anything less than 3rd degree burns (unfortunately).

Episode 6 of Healthcare Beans podcast Cityblock Health is a unicorn startup serving high quality healthcare to low-income communities. Episode takeaways: (1) There are several high profile companies supporting the nation's transition to value-based healthcare. Cityblock Health is at the forefront. Here's a short list: Oak Street Health, Iora Health, Lumeris, and UniteUs. (2) Managing healthcare spending for complex, low-income patients is not an easy task - many smart, dedicated people have tried and failed. (3) Addressing the social determinants of health may be the determining factor for long-term success - not just for Cityblock Health, but for the entire sector. ~ James Transcript Hello and welcome to Healthcare Beans, I’m your host James Haven. In this episode, I’m going to focus on a rather interesting startup in value-based healthcare. On Healthcare Beans, I often talk and write about the many federal and state programs which address some really big challenges in healthcare (mostly around lowering healthcare spending or expanding access to good healthcare) and to be fair, the results of these government programs are kind of mixed. Many of these programs fall under some sort of accountable care model and these models try to connect physician (or hospital) payment to patient health outcomes; to put it simply, this means good doctors are rewarded for delivering good care, and bad doctors are financially penalized. But again, the results of these programs are mixed; many of them have not actually reduced the cost of healthcare (at least not in any significant way), and only a few programs show some promise in doing that in the near future. Outside of government programs, there are many interesting and valuable developments in the private sector, and in the end, it wouldn’t be surprising if healthcare companies make some real lasting changes in terms of lowering the cost of healthcare and improving our health outcomes. And the companies I’m currently thinking about use different types of data along with specialized care teams in order to manage (or drive down) healthcare spending. These companies (that I think are worth keeping an eye on) are Oak Street Health, Iora Health, Lumeris, Unite Us, and Cityblock Health. And I include these company names with links in the show notes, if you’re interested in learning more about them. So with that, I’d like to dive more deeply into Cityblock Health. Cityblock is headquartered in Brooklyn NY, and operates across NYC, Connecticut, Chicago and Washington DC. The company specializes in delivering quality healthcare to low-income patients. Now, when you hear “low-income” a few key points come to mind. Low-income patients often have more health problems than people with average incomes, and this is a well-known pattern coming out of numerous studies in Medicare and Medicaid. And because low-income patients have more health problems, they’re much more expensive to care for; they’re more likely to end up in the emergency room, and more likely to be hospitalized. And perhaps most importantly, low-income patients have social service needs that are often unmet. And that could be a lack of transportation, or unstable housing, not having enough nutritious food, being socially isolated... so not having nearby friends or family – and studies have shown these types of social problems play a huge role in poor health outcomes. Going back to Cityblock Health, the company just completed Series C fundraising and is currently valued at over $1 billion, so perhaps there’s an IPO in the near future. And early reporting suggests the company’s healthcare delivery model can reduce unnecessary health spending among complex patients. All in all, I’d love to invest in Cityblock Health if given the chance (it’s a very exciting company), but at the same time, it’s really important to understand just how difficult it is to truly reduce healthcare spending (emergenc...

Episode #5 of the Healthcare Beans podcast In the United States, caregiver burden is a really big problem. Episode takeaways: (1) Care-giving is very stressful work and roughly 48 million people in the US are spending about 28 hours per week caring for loved ones. (2) Patient health outcomes depend on your home environment. When you get sick, your future will depend on a caregiver. (3) A startup called Carallel (www.carallel.com) has demonstrated success in helping caregivers do their jobs well, and with less stress. Listen to the episode to learn more. ~ James

Episode #4 of the Healthcare Beans podcast In the United States, privacy protections for health data are not as restrictive as most people think. Your doctor is not the only person who can access your data. In this episode I talk about: (1) how health data is used, (2) who has access to our health data, and (3) who benefits from sharing health data. Check out these links for background content on health data privacy laws and value-based healthcare. ~ James

Episode #3 of the Healthcare Beans podcast In this episode, I argue against putting too much faith in good doctors. I know that sounds strange but a well organized care team is what really counts, and this is what people should expect from their local health system. I stress the importance of organized care delivery by sharing a story about my 73 year-old uncle who suffers from multiple chronic diseases. He recovered from a COVID-19 infection back in September 2020, after being treated with Dexamethasone. He had a great doctor but his care team dropped the ball. And when it comes to finding a new doctor, I think healthgrades is a good site to explore. But make sure you read the full profile - the bad stuff is often tucked away at the bottom of a profile. Subscribe to my podcast or check out my site's episode list if you’d like to learn more about US health systems and value-based healthcare. ~ James

Episode #2 of the Healthcare Beans podcast Keeping your annual wellness visit is a great way to safeguard your future health! In this episode, I talk about the importance of the annual wellness visit, and how health systems use data to prioritize patient outreach. Check out my earlier post on this topic (if you prefer to read instead of listening to a podcast). ~ James

Welcome to the first episode of the Healthcare Beans podcast! Many health systems and doctors get paid regardless of your health outcomes, and that needs to change. In this episode, I touch on the basics of how our healthcare is delivered, and how that's changing into something better (we hope!). See these links for accountable care organizations and bundled payment models, which are two primary ways value based healthcare is being implemented in the United States. ~ James