Podcasts about iora health

Dr. Ali Khan has spent his career at the intersection of medicine, public policy, and value-based care. He's also been at the forefront of some of the country's most innovative care delivery models—from Iora Health and CareMore to Oak Street Health and now Aetna, where he serves as Chief Medical Officer of Medicare at Aetna, a CVS Health company. In this episode, Keith Figlioli sits down with Dr. Khan for a conversation about Medicare's future—and what it will take to make the promise of better, more affordable healthcare a reality. A general internist by training, Dr. Khan's path into healthcare began with a deep curiosity about the broader systems shaping people's health. That curiosity took him from Harvard Kennedy School to the exam room to health plans and startups focused on reimagining the primary care experience for complex, underserved populations. Throughout his career, he's gravitated toward organizations trying to solve public-sector problems with private-sector solutions—building care models that prioritize trust, access, and long-term outcomes. Now at the helm of a Medicare Advantage program serving 4.2 million members, Dr. Khan brings a unique vantage point. In this conversation, he shares hard-earned lessons on care model design, what payers and providers need from each other, and why Medicare is at an inflection point. He makes a compelling case for a renewed focus on the fundamentals—not just risk adjustment or benefit design, but operational follow-through, last-mile care coordination, and culturally grounded team-based models that scale. Dr. Khan and Keith discuss: Building care models that hold up under pressure. From Iora to Oak Street, Dr. Khan has seen firsthand that delivering better outcomes at scale requires more than mission—it takes structural rigor. He unpacks four key dimensions—cultural, clinical, operational, and technological—and explains why lasting impact depends on aligning all of them. Whether it's equipping care teams to deliver in complex communities or building systems that can flex and scale, success hinges on getting the foundation right. Why affordability isn't enough—and where Medicare Advantage must go next. With over half of Medicare beneficiaries now enrolled in MA plans, Dr. Khan argues it's time to move beyond the value prop of supplemental benefits and zero-dollar premiums. The next chapter is about proving clinical excellence at scale. That means prioritizing follow-through over features—removing last-mile barriers, improving care coordination, and designing experiences people actually trust.  From transactional to transformative: the evolving role of health plans. Plans have long relied on contractual structures to drive change, but Dr. Khan believes that era is fading. To deliver on the promise of value-based care, plans must shift from passive administrators to proactive partners—investing in infrastructure, surfacing actionable insights, and enabling providers to succeed across Medicare, Medicaid, and commercial populations alike. Where AI meets care delivery. Dr. Khan reflects on the potential of AI to reduce clinical variation, improve medication management, and drive better follow-up for patients—especially those with chronic conditions. But he cautions that technology alone won't move the needle. To truly unlock AI's value in Medicare, plans and providers must embed it within human-centered systems, coordinate care in real time, and ensure new tools support—not replace—the relationships that matter most. As Dr. Khan notes, we're entering a “put up or shut up” era for Medicare Advantage, where scrutiny is high and proof points matter. Yet within that pressure lies opportunity—particularly for those willing to do the unglamorous work of identifying barriers, building connective tissue, and supporting clinical teams in the trenches.

Rushika Fernandopulle founded Iora Health, which was acquired by One Medical and subsequently by Amazon. Could Amazon ever achieve Iora's health equity goals? In this episode we discuss what a "successful" exit looks like for health equity under our current capitalistic structures, and what happens after you exit. In Rushika's latest start up, Liza Health, he is exploring new structures to protect the purpose of his product. Liza Health leverages AI to build power for patients. Building new products is only a start, Rushika shares. We need a movement behind us — we need a revolution from consumers.

Jacob and Nikhil sit down with Dr. Rushika Fernandopulle. Rushika is the former CEO and Co-Founder of Iora Health, a primary care provider centered around value-based care and Medicare that One Medical acquired for $2.1 billion. They discuss why we're still in the second inning of value-based care, intersections of tech and healthcare, what it takes for VBC to succeed, and more. [0:00] Intro[0:29] Early Days of Value-Based Care[2:34] Challenges in Commercial Value-Based Care[5:20] Adapting Care Models for Different Populations[13:08] Medicaid and Long-Term Care Issues[16:30] Big Tech's Foray into Healthcare[20:37] Amazon's Healthcare Strategy[21:09] Challenges in Serving Low-Income Seniors[21:43] Innovative Solutions for Patient Transportation[22:16] The Economics of Healthcare Visits[23:22] Building a Custom EHR System[27:34] The Role of AI in Modern Healthcare[33:17] Future of Primary Care and Policy Implications Out-Of-Pocket: https://www.outofpocket.health/

Today, we're excited to get to know Dr. Ali Khan, Chief Medical Officer of Aetna Medicare, overseeing healthcare services for over 4 million members. His career spans across some of the most impactful value-based care organizations, including Oak Street Health, CareMore, and Iora Health. He is also an adjunct lecturer at Northwestern University's Kellogg School of Management and serves on the clinical faculty of the Yale School of Medicine. Additionally, Dr. Khan is a director on the American Board of Internal Medicine. Also a trusted advisor on Pear's Health Industry Council.Before Aetna, Dr. Khan played a key role in Oak Street Health's rapid expansion, scaling it from 21 to 200+ clinics, culminating in its acquisition by CVS Health. Prior to that, he was instrumental in CareMore Health's growth and innovation in care delivery for vulnerable populations.He holds an MD-MPP from Virginia Commonwealth University and Harvard Kennedy School, completed his residency at Yale, and has taught at institutions like Northwestern Kellogg and Yale School of Medicine.As a leader in value-based care, he has firsthand experience in building, scaling, and optimizing healthcare startups—making his insights invaluable for founders, investors, and industry leaders navigating the complex world of healthcare innovation.

In this Relentless Health Value episode, Dr. Rushika Fernandopulle discusses with Stacey Richter his four-prong theory of change for transforming the American healthcare system. Key topics include the necessity of new payment models, process innovation, employing a relational technology infrastructure, shifting the cultural mindset towards team-based care, and emphasizing the importance of long-term partnerships. The conversation underscores the urgent need to move away from the current status quo to ensure better health outcomes and affordable care for all Americans. This is one of those episodes where we consider top-line strategic imperatives and key drivers. There was no better person to do this with than Rushika Fernandopulle, MD, who, in case you were unaware, was the founder of Iora Health, an advanced primary care group that was sold to One Medical and then to Amazon.  They discusses his four-prong theory and as Stacey says, "I can't leave well enough alone, so I plucked one more prong from our conversation and stuck it on the end." For a summary of this 5 prong approach, visit the show notes page where we also list all of the links mentioned in the episode. === LINKS ===

Twenty years before value-based care became a healthcare buzzword, Rushika Fernandopulle was told he had to choose: be a doctor or join "the dark side" of business. Instead, he chose both – building Iora Health from a bootstrapped startup into a billion-dollar healthcare company. In this candid conversation, Fernandopulle reveals the unconventional journey that helped transform American healthcare, from midnight meetings in Las Vegas speakeasies to breaking every rule in the traditional medical playbook.We cover:

Peter Hagan is the Digital Health Director at Commonwealth Care Alliance, and former team member at Iora Health. Iora was a start up that created a new model for value-based care, to improve health outcomes and lower costs. Ten years after launching, it was acquired by One Medical, a primary care provider, which was later acquired by Amazon. Peter initially started out as a patient at one of Iora's first pilot sites, and later became a health coach, playing a critical role in Iora's team-based care model. His third role before leaving Iora to pursue his MPH was to work on the backend of Iora's digital health products, which included a patient-friendly electronic health record system that allowed each patient and their care team to seamlessly coordinate care. In this episode, Pete and I discuss the challenge of shifting from the dominant fee-for-service care model in the U.S., to the value-based care model which focuses on improving people's health rather than profiting from their care needs. Rather than waiting and hoping for existing players to make these changes, could it be the new entrants into the field that disrupt and transform it?

According to a study, the future of primary care in the United States could undergo a major overhaul by 2030, with nontraditional providers like advanced primary care (APC) providers, retailers, and payers expected to capture around 30% of the market. Amid a growing movement towards a more patient-centered approach to primary care, Dr. Rushika Fernandopulle is leading the charge with a model that focuses on relationships rather than transactions. But what does this new model look like, and how can it transform the current healthcare landscape?This question is at the heart of the latest episode of Tuesdays With Morrisey, where host Adam Morrisey sits down with Dr. Fernandopulle to explore the future of primary care. The conversation delves into the limitations of the current system, the principles of a relationship-based model, and the challenges and opportunities in implementing such a change.Key points of discussion include:The need for a shift from a transactional to a relational approach in primary care.The role of team-based care and technology in enhancing patient outcomes.Strategies for patients to advocate for better care and support the evolution of primary care.Dr. Rushika Fernandopulle is a respected figure in the healthcare industry, with a background as an attending physician at the Massachusetts General Hospital, a faculty member at Harvard Medical School, and co-founder of Iora Health. His work has been instrumental in challenging the status quo and pushing for a more humane and effective healthcare system.

Follow me @samirkaji for my thoughts on the venture market, with a focus on the continued evolution of the VC landscape.We have a conversation with Samir Kaul from Khosla Ventures. Founded in 2004, Khosla is one of the largest and most well-known venture capital firms in the world and led by legendary investor and entrepreneur Vinod Khosla. The firm is known for investing in companies that are solving very large and complex problems. The firm currently has over $15B in AUM investing in companies such as Square, Doordash, Stripe, OpenAI, and Impossible Foods.During the episode, we covered investing across cycles, the market insanity we saw pre-2022, and how they approach both building a firm and investing. Note: We recorded this prior to the news that Keith Rabois was rejoining the firm, hence no mention of it during the discussion.About Samir Kaul:Samir Kaul is a Founding Partner and Managing Director at Khosla Ventures, and he specializes in investments across health, sustainability, food, and advanced technology sectors. His notable investments leading to successful exits through IPOs or acquisitions include companies like Vicarious Surgical, View, Guardant Health, Nutanix, Oscar, Quantumscape, Granular, SLD, NanoH2O, Iora Health, and Raxium. Additionally, he has played a pivotal role in investments in transformative startups such as Impossible Foods, Mojo Vision, Primer, and many others, demonstrating a keen eye for identifying and nurturing groundbreaking technologies and business models.Before joining Khosla Ventures, Samir's career was marked by significant achievements in biotechnology and venture capital at Flagship Ventures and the Institute for Genomic Research, where he contributed to pioneering efforts in genomics and biotech startups like Helicos BioSciences and Codon Devices. His work in sequencing the Arabidopsis genome set new standards for efficiency and impact in the field of genomics. Beyond his professional endeavors, Samir is deeply committed to philanthropy, serving on the boards of the Tipping Point Community, UCSF Benioff Children's Hospital, and the US Ski and Snowboard Association, showcasing his dedication to societal betterment and healthcare.In this episode, we discuss:(01:45) Samir's career path to venture(05:15) Traits of Successful Entrepreneurs(06:04) Building Long-term Companies(08:49) Venture Capital's Role Beyond Funding(12:13) Evolution of Venture Capital(16:15) AI and Tech Super Cycles(22:24) Learning from Past Mistakes(28:03) Investing in High Conviction Trends(32:33) Firm Culture and Decision Making(37:17) Hiring and Building a VC Team(39:12) Advice to Younger SelfI'd love to know what you took away from this conversation with Samir. Follow me @SamirKaji and give me your insights and questions with the hashtag #ventureunlocked. If you'd like to be considered as a guest or have someone you'd like to hear from (GP or LP), drop me a direct message on Twitter.Podcast Production support provided by Agent Bee  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit ventureunlocked.substack.com

For a full transcript of this episode, click here. This inbetweenisode is me geeking out, so if that's not your thing, you've been warned. There's a term I'd like to encourage anyone interested to look up. It's the narcissism of small differences. It explains a lot. The narcissism of small differences is the idea that those who, maybe in theory, should be friends/BFFs working side by side toward the same major goal are not. We divide ourselves into these micro-camps. Why? It's a thing to get really narcissistic about small differences. Consider vegans and vegetarians who are so often all up in each other's business in really nasty ways. Who knew whether or not someone decides to eat cheese could create such enmity? Or there's subreddits on Reddit dedicated to people fighting about fantasy football. You would think that everyone who plays fantasy football would be friends, except … not. There are apparently major schisms in the fantasy football world. Or consider branches of the same religion who are at war with one another. Consider people in the same political party fracturing over who is the very most whatever … pick something. So, now let's talk about the narcissism of small differences and how it's relevant when we're thinking about helping patients in the United States get better healthcare for an affordable price. We have these gigantic corporate entities right now very industriously vertically integrating to control supply chains and cornering markets buying up physician practices and using every trick in the book to extract maximum profitability from patients and taxpayers and employers. Achieving some kind of tipping point where these incredibly well-orchestrated and well-funded profit machines are driven back will only happen when enough people, individuals, amass behind that tipping point. It will take more than a village. And my ardent request here is to—I don't know—we quit it with the narcissism of small differences. Do not succumb. “When you cling to ‘my way' you preclude your ability to synthesize, cooperate, support, or even—in [some] extreme cases—peacefully co-exist with other members of your tribe. You destroy a fundamental reason for belonging in the first place: community.” That last bit was a quote from a blog post by Frances Cole Jones. I love the community who I interact with most on LinkedIn, and there's also some Listservs and some Slack groups that I love. Even X and Threads, for the most part, are lovely nests of great people trying to understand one another and further a common cause. I guess when you get into the kind of wonky stuff that you and I get into, there's a finite group of us who are even reading these Tweets or posts or whatever they are. It's a “small junior high school,” as one of my clients used to call it a long time ago. But there's also often enough that somebody who swoops down and in the name of ... something … slams a 95% aligned cause. It's like two people agreeing on the restaurant to go to lunch, but one wants to go there and get a rice dish or because it's closer to their house and the other wants to go there because the restaurant serves a great tortilla—and the two of them fight over what's the right reason to go to that restaurant or what the best item is on the menu. This is literally a metaphor that describes some of the sniping that I have seen, that you have seen amongst mostly aligned folks trying to figure out how to put patients over profits. I mean, guys, go to the restaurant. Once you're there, you can place separate orders. Work together to just get to the restaurant. It's certainly easier to say than do, but if we're aware of this and we focus on the points of agreement and maybe just think a little bit about whether the points of difference really even matter—in real life, not theoretical philosophy life—because a lot of times, they don't. And then divided we fall. I think a lot about small difference narcissism-ing when someone comments derisively that a post or an article puts too much emphasis on … I don't know, transparency or employers or mental health or … pick something. But here's the thing: In the village, everybody is gonna have different number one priorities. That's why it takes a village. Maybe I'm wrong, but I'm thinking it's not a zero-sum game. Just because someone is angling hard for patient empowerment or consumerism or whatever doesn't make it harder for anybody else to promote patient health literacy or better quality measures or integrated behavioral health. Probably it will make it easier, since both are trying to figure out how to put patients over profits. Both are pushing in the same direction, albeit one is headed northwest and the other one might be angled really far northeast. Point is, everybody will get momentum as long as we're all roughly headed northbound. Now, caveat and sidebar: There are people emphasizing things because they're actually working on them, and then there are people promoting things because it's good marketing. Jeff Hogan wrote about this at the beginning of January, and I agree with him here. Here's what he had to say, and then I'm gonna connect it back to what I think is a really important point about the narcissism of small differences. Jeff wrote: Over the course of the last month [I have] been asked no fewer than 20 times about exactly which conferences [I am attending] … this year. … All of my conference intentions are focused on one question: What will this conference do to promote a complete change in our healthcare paradigm … focused on superior [patient] access and outcomes as well as payment reform and care transformation? Said a different way, is this conference literally a honey pot for those who have screwed up the existing system and who are merely virtue signalling …? Who is speaking at this conference? Is it representatives of the same health systems and the same payors [and perpetuating] legacy moats and monopolies or is it a conference promoting change makers, risk takers and provider models and systems embracing risk and [healthcare] transformation? … What kind of change and innovation ever came out of an echo chamber? Challenging my friends and healthcare influencers to think carefully about their choices. Conferences create the opportunity to leverage great ideas and movements. We're finally seeing first followers having expanded influence. Are you one of them? So, talking about that conference that happens at the beginning of January, I heard that a CEO of a major PBM (pharmacy benefit manager) stood up in front of that room and used the word transparency or a synonym six times in five minutes. Check out this LinkedIn post/video and this article as to why my eyebrows are sky-high on what transparency actually means for the CEO when you look at what this PBM is actually doing. If you look at quarterly reports again of some of these big entities, the cover of that annual report has lots of wonderful patient-centric words on it—while if you look at how those entities are actually making money, it is in direct conflict with those words. Now, there's always going to be nuances here … always. And that's what makes this very subjective and very personal. Everyone doing well by doing good is going to have a marketing statement, and it wouldn't be a marketing statement if it didn't sound amazing, right? The nuance or the question is: To what degree are they actually achieving that marketing statement? What's the line that separates pure spin from an acceptable level of achievement of the marketing statement? Because we want to support the organizations that are trying here while, at the same time, make sure that we're kind of quarantining those who are just all talk in ways that confuse the marketplace and don't help patients get affordable quality healthcare, just like Jeff just said. I gotta say, sometimes I struggle here myself. This is why I wrote a manifesto (EP399 and EP400). And you might struggle, too. It's probably no coincidence that sometimes the loudest individuals advocating for patients over profits are retired. And, throwing no shade here, I love the whistleblowing and the truth telling. But I think we have to be a little careful because who is actually gonna do the changing and the tipping point reaching are those who are still working for a living on or about the healthcare industry. And when I say “working for a living,” I mean we're taking money and putting it in our pockets. We need to pay the rent and go on vacation every now and then. And we need money to pay for our family's healthcare. If we didn't take money, if we just volunteered, that cash might have funded more patient care or maybe made that care or premiums more affordable. Every one of us is a cost center if we think about it from the standpoint of the patient or plan member. Every one of us. If you did it for free, the money could accrue to patients, right? I also keep in my mind that there are, for sure, individuals within any of these profit-seeking, financially motivated, maybe not patient-motivated organizations; and these individuals have a job to do the good that that organization is doing. These are the ones who are actually working on pilots that actually work or doing work with social determinants of health or behavioral health that are actually (again) working. While I dislike the overall impact potentially of the one who is paying their paycheck, I gotta keep in mind that the more successful this individual is within that corporate entity, the more good that that entity is gonna wind up doing. I think about this because, again, my main concern is doing better by patients, helping the sort of insurgents within some of these entities. These entities should be held accountable, no doubt; but the people who work within them should—I don't know—I still want to encourage them to do better. The goal is to help patients, not catch up some good people in a quest to punish their boss. So, it's always a matter of degrees. It's always nuances. It's always how much value got delivered back for the dollars that we took in compensation for the work that we did. What did the work we do add up to? In my personal case—and I covered this in the manifesto (again, EP399 or EP400)—I worked really hard, by the way. I was sweating bullets when I was creating that manifesto. I was not sure whether I was gonna get skewered. It really was hard, and it took some major soul searching to create (again, EP399 and EP400). What I try to do, I usually shoot for trying to get patients better outcomes in a way that is cost neutral. The work that I do most of the time (ie, my day job) is probably not gonna lower costs. It's not gonna lower costs. It's just not within the parameters of what I do, and it's not within the parameters of my expertise. Others who I count on to do their thing here, they might be working the opposite angle—the care might be the same, but costs are reduced. Again, a fine way to go. Maybe some of you have figured out how to get patients better care at lower costs. That's the holy grail … and big kudos. But not everybody can do it. It's just not possible a lot of times on any number of levels that we don't have time to get into today. Again, all of this is why I wrote my manifesto for how I reconcile my own self and determine what “having personal integrity” means to me and for me and also for my company. And maybe over the years I've made some choices that I wouldn't make again—but those choices ultimately have wound up funding this podcast, so maybe that's my redemption potentially. I don't know. We all live and learn, and we can't start to hate ourselves because we haven't been perfect. A lot of times, you don't realize the ultimate impact of something until after you've done it. And at that point, you just gotta regroup and try again and do better this time. We all just have to contemplate patient impact. On the other hand, there are often conversations with very motivated entrepreneurs that I've had where the words affordability, impact on patient premiums, access, or better actual measurable health … these words don't come up. At all. Or you talk to somebody else who works at one of these behemoth payers or hospital systems or whoever, and those words do not come up. At all. Again, tracking back to the narcissism of small differences here, are we fighting with someone who is basically 95% aligned with what we're trying to do? Or is this somebody on the other side who's really not in the village because they do not have the same overall intent? The point I'm making here in this inbetweenisode is simply that if we're thinking about this from the standpoint of the patient, then every one of us who isn't retired or independently wealthy or volunteering, we all have a great opportunity to do some amazing work. But we're also all living in glass houses, and if somebody really wants to get all small difference narcissistic about it, they probably could very self-righteously take out most of us. This isn't some kind of cartoon where all the good guys all look the same and everything is black-and-white and there's no nuances. I'm belaboring these points because if we want to build a village, we cannot do so without contemplating who we choose to let in it and who we're gonna beat up on LinkedIn or wherever. But we can be a motley bunch and still work together, as long as we accept each other for the imperfect souls that we are and what we can in the aggregate add to the common cause. There's no “one size fits all” for what we want for ourselves and what we want our legacy to be. I wanna just track back for one sec to that earlier comment I made about people who work for a company that's actively working to take as much money out of the system as possible and give it to their shareholders at the corporate level … because here's an actual case study example of that, and maybe it will be helpful. The other day, I was talking to an actuary who worked for a large (again) payer. And this actuary was trying to figure out ways to create win-wins for plan members within the constraints of his job. This actuary, if he can figure out the math, given the scale of members that he'll reach, he could have a really large positive impact even if he only changes the trajectory of his math by a fraction of a percentage point. I want this guy on my team and in my tribe. He is trying to help, and he has the power to incrementally fix some stuff that is gonna matter to potentially millions of people. I'm not gonna kick him out of my village anyway because of who pays his paycheck. Conversely, I'm gonna try to encourage him to spread his way of thinking to the other actuaries that he works with. Or I get emails all the time (all the time) from people, especially at the beginning of their careers; and they're looking to find a job where they can make an impact. These are smart, ambitious young job searchers, and I hear from them so often I actually have a very long template response that I've been poking away at for years. And I always tell them some variation of many of the things that I have said on this podcast. Often enough, though, I'll get a response back that's something like, “Wow! Thanks so much. This was all so helpful. After much thought, I've decided I'll go work in private equity (PE). I'm gonna go work for a private equity firm so I can fund start-ups who are gonna make a difference for patients.” They may go on, and they mention how they were reading the Slack channel of one of these many groups where they don't talk about the stuff that we talk about on Relentless Health Value. They talk about the thrilling world of start-ups and health information technology and scaling and AI and repeatable whatever. Hold your judgment. I am managing to keep mine in check. I consider that Iora Health (now One Medical) and ChenMed really help a lot of patients. There are some great new companies out there. People also have made lots of money at some of them. Nuances. Choices. Also, who's their leadership? Now, it's inarguable that anyone that's working for a profit-seeking missile of a publicly traded company or a PE-funded company is going to have to contend with a moral framework that is more of a money framework than a moral framework. Same thing goes for anyone working at a huge, consolidated hospital system like the ones that get written up in the New York Times for all kinds of egregious stuff. This money focus may be irrevocably misaligned with the values of someone who works there, and the person may ultimately quit because it becomes too much cognitive dissonance. And if and when they quit, great. They're at a different place in their journey. Maybe they listened to Relentless Health Value long enough and began to realize some of their employer's Kool-Aid might not taste quite right. For them to get to the next stage of their journey and have the impact that they may ultimately want to have, they kinda had to start out in the belly of the beast—and I won't hold that against them, especially if they were able to alter the trajectory of the organization or help patients along the way while they were there. Here's another example to think about as we think about the narcissism of small differences and who gets to be in the village and who we're gonna tell to talk to the hand. I was talking to a friend of my dad's who literally was going to die from a neuroendocrine cancer. He had weeks to live, maybe not even plural. He was given a new immunologic cancer drug. And it's now two years later, and he's still here and in remission. According to the package insert of this drug, he'll probably have 47 months, almost four years, of extra life. Yeah, that drug was expensive. I opened my mouth to say something, and my dad's friend … he kinda shushed me. He said, “Do not say anything bad about the pharma company or my doctors at the big, consolidated health system where I got my care. I am alive, and I should be dead.” This is why I started Relentless Health Value and why I continue to do this thing. It's because almost everything in the healthcare industry along the good-for-patients curve is a matter of degrees. Tip too far in one direction, and we start to cost more than the value we put out in exchange. Tip too far in the other direction, we go out of business. Everything I talk about on Relentless Health Value is in the service of helping myself and you and anybody else I can reach. It's in the service of us figuring out how all of these nuances work in the real world—to help figure out who gets what when and how that might impact patients caught in the crossfire. It's to help figure out my own path forward that I can be proud of, and maybe I can help others trying to do the same. But at the end of the day, we're all gonna make slightly different choices and evaluations. Please don't let the narcissism of small differences prevent us from creating a village large enough to fix healthcare for patients. Also, it's just a nicer way to exist. Also mentioned in this episode are Frances Cole Jones; Jeffrey Hogan; Eric Bricker, MD; Iora Health; and ChenMed. For more information, go to aventriahealth.com.   Each week on Relentless Health Value, Stacey uses her voice and thought leadership to provide insights for healthcare industry decision makers trying to do the right thing. Each show features expert guests who break down the twists and tricks in the medical field to help improve outcomes and lower costs across the care continuum. Relentless Health Value is a top 100 podcast on iTunes in the medicine category and reaches tens of thousands of engaged listeners across the healthcare industry. In addition to hosting Relentless Health Value, Stacey is co-president of QC-Health, a benefit corporation finding cost-effective ways to improve the health of Americans. She is also co-president of Aventria Health Group, a consultancy working with clients who endeavor to form collaborations with payers, providers, Pharma, employer organizations, or patient advocacy groups.   00:42 What “the narcissism of small differences” means. 02:18 How does this narcissism of small differences show up in the effort to fix the healthcare industry? 05:26 Quote from Jeff Hogan. 10:12 “What did the work we do add up to?” 16:31 Why we shouldn't judge someone for working within the “belly of the beast.”   For more information, go to aventriahealth.com.   Stacey Richter discusses small differences and #healthcaresystem fixes on our #healthcarepodcast. #healthcare #podcast #pharma #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Peter Hayes, Joey Dizenhouse, Benjamin Jolley, Emily Kagan Trenchard (Encore! EP392), Cora Opsahl (Encore! EP372), Jodilyn Owen, Ge Bai, Andreas Mang, Karen Root (Encore! EP381), Mark Cuban and Ferrin Williams  

The healthcare space has long been a transactional one, seeing patients as numbers instead of human relationships. In 2004, Dr. Rushika Fernandopulle began to challenge the status quo and create an entirely new model of care delivery that finally put patients at the center of healthcare. Rushika Fernandopulle is the co-founder and former CEO of Iora Health, a value-based primary care group based in Boston that was acquired by One Medical in 2021, where he served as Chief Innovation Officer. One Medical was acquired by Amazon earlier this year for close to $4 billion. Rushika currently serves on the staff at the Massachusetts General Hospital, on the faculty of Harvard Medical School, and on the boards of Families USA and the Schwartz Center for Compassionate Care.In this episode, Hercules Capital's Katie Segien is joined by Rushika Fernandopulle to discuss how he created a new delivery model for medicine, Iora Health's business model evolution, going from bootstrapping to six rounds of funding, and other topics.Topics Include:Rushika's mission and experience in transforming healthcareHow he created a new delivery model for medicineIora Health's business model evolutionGoing from bootstrapping to six rounds of fundingRushika's process for building an optimal teamAdvice for entrepreneurs who are struggling to raise capitalAnd other topics…Dr. Rushika Fernandopulle is a practicing physician who has spent decades improving the quality of healthcare delivered to patients. He was co-founder and CEO of Iora Health, a value-based primary care group based in Boston that delivers better quality, lower costs, and improved satisfaction for both patients and providers. Iora was acquired by One Medical in 2021 for over $2 billion, which went on to be acquired by Amazon earlier this year for close to $4 billion.Rushika was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement and Managing Director of the Clinical Initiatives Center at the Advisory Board Company. He serves on the staff at the Massachusetts General Hospital, on the faculty of Harvard Medical School, and on the boards of Families USA and the Schwartz Center for Compassionate Care.

Walgreens and startup health insurer Alignment Health partner on Medicare Advantage plans for 2024. Amazon's One Medical quietly rebrands its Iora Health senior care clinics. And, new analysis finds that family premiums rose an average of 7% for employer-sponsored health coverage this year. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

While value-based care has been at the forefront of industry conversations in the last decade, there are still a lot of questions about how to successfully create and thrive as a value-based enterprise. At the end of June, around 300 healthcare leaders gathered at Advisory Board's Value-Based Care Summit with one shared goal: make the next 10 years of VBC more impactful from the last. As part of the event, the Radio Advisory team orchestrated a live podcast recording with three renowned leaders at the helm of very different organizations – all trying to build value-based enterprises. In this special live episode of Radio Advisory, host Rachel (Rae) Woods invites Rob Mayer, senior vice president and GM of Optum Insight Clinical Solutions; Laurie Sicaeros, Chief Strategy Officer at Memorial Care Health System; and Rushika Fernandopulle, Co-Founder and Former CEO of Iora Health, to discuss building a value-based enterprise, what defines success, and what capabilities and assets are needed to succeed. Links: The climb to value-based care Introduction to the series: Envisioning paths to nationwide VBC Ep. 166: Employer series: The role of employers in value-based care Ep. 113: What it will take to get to meaningful risk Learn more and register for the 2023 Advisory Board Clinical Innovation Summit [August 22-23, 2023]

Dr. Pankaj Jethwani is the Executive Vice President at W Health Ventures, a Boston-based venture capital firm focused on helping entrepreneurs build the future of healthcare delivery in the US and India. Over the last ten years, Dr. Jethwani has been involved in improving care delivery in several care settings in the US and India as a physician leader, operator, management consultant, and investor.Dr. Jethwani started his career as a Primary Care Physician in Mumbai, India. Through this experience, he witnessed first-hand the gaps in health care delivery in both the public and private sectors. Motivated to bring about reform in this system, he joined The Boston Consulting Group in India where he helped shape BCG's work with Government agencies to improve delivery of healthcare at scale. He later co-founded The Breakfast Revolution (TBR), a social enterprise fighting the malnutrition epidemic in India. TBR has served 220,000+ children over 20 million fortified meals.More recently, Pankaj worked at Iora Health, a Boston-based innovative primary care company that serves seniors on Medicare. This experience helped shape his perspective on building and scaling a technology-enabled value-based care organization, taking global risk, and creating a delightful model of care for patients and providers. At W Health Ventures, Dr. Jethwani leads investments in disruptive technology-enabled healthcare services companies in the US and India. Pankaj holds an MBBS (MD-equivalent) degree from MUHS (India) and received an MBA from The Wharton School of the University of Pennsylvania. Episode Notes: Introduction (2:30) How did Pankaj venture into the world of VC following his career as a doctor? (3:05) Which is more challenging: transitioning into VC or practicing medicine? (6:12) Insights gained from Pankaj's experience as an operator (8:44) The healthcare industry in India: an in-depth analysis (17:48) The transformative impact of VC in healthcare: an exploration (31:11) Valuable lessons derived from high-performing portfolios (36:47) W Health Ventures' investment strategy and approach (44:53) The pivotal role of capital in shaping India's healthcare landscape (51:20) Unlocking growth and fortifying the Indian healthcare industry (55:40) Words of wisdom Pankaj would impart to his younger self (58:25)

Today, we're excited to get to know Dr. Rushika Fernandopulle, previous Chief Innovation Officer of One Medical, an organization dedicated to providing human-centered, technology-powered primary care to people across every stage of life.  In an acquisition that shook the healthcare industry in September 2021, One Medical completed the purchase of Iora Health - a primary care organization that prioritizes human-centered, value-based care. The deal, which amounted to a staggering $1.4 billion, was a testament to Iora Health's success in delivering high-quality care at lower costs, while improving patient satisfaction. The visionary behind Iora is none other than Dr. Rushika Fernandopulle, who spent decades improving the quality of healthcare delivered to patients. He was the Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and Managing Director of the Clinical Initiatives Center at the Advisory Board Company. He also serves on the staff at the Massachusetts General Hospital and on the faculty of Harvard Medical School.  In this episode, Dr. Fernandopulle talks about his path to medicine, describes how he started and grew Iora Health, the acquisition by One Medical, and the future of primary care.

Today, we're excited to get to know Dr. Neil Patel, Chief Health Officer of Patina Health, a new model of primary care for adults 65 and over that reimagines the journey of aging through virtual and home-based care. Dr. Patel is a trailblazing healthcare leader who has been involved in innovation in the primary care space. Prior to joining Patina, Neil served on the executive leadership team of the Boston based startup, Iora Health, leading special projects across different regions in the US. He also served as the medical director at Grameen VidaSana, Harken Health, Freelancers Union, and the Atlantic City Special Care Center described in Atul Gawande's influential 2010 “Hotspotters” article. Neil went to college at the College of New Jersey, and went to Rutgers New Jersey Medical School for his MD. He trained in family medicine at Boston University. Patina raised 50 million of Series A venture funding in a deal led by Andreessen Horowitz and Google Ventures, along with F-Prime capital, Rock Springs Capital, and Viking Global Investors. In this episode, Neil shares his journey in medicine, his work in healthcare leadership as one of the founding team members of Iora Health and Patina Health, and advice he has for founders who are trying to improve healthcare delivery.

This week, we're super excited to get to know Sonia Millsom, CEO of Oxeon, a trusted healthcare firm, powering change through talent, entrepreneurship and investment. She is a veteran healthcare leader who has been at the forefront of value-based healthcare, with extensive experience growing mission-driven innovative companies, as well as serving as an adviser, board member and investor. Prior to joining Oxeon, Sonia served as the Chief Commercial Officer at Maven Clinic, which achieved the first unicorn valuation in women and family health. Before joining Maven, she was Chief Growth Officer at Boston-based startup Iora Health, where she helped strengthen the organization's revenue and oversaw an expansion that led to its $2.1 billion acquisition by One Medical. Sonia also held leadership roles at Best Doctors, Health Dialog and UnitedHealthcare. She is also a board member for Clever Care Plan, Quilted Health and Suvida Health. She is an advisor to a number of early stage startups including, Stellar Health, QHLTH and Flourish Fund. Sonia has a MPH from Columbia University and a BA from Boston College. In this episode, Sonia shares her experiences across the ecosystem from the payer to provider sides, and from large public companies to small startups, all the while empowering diverse leaders in the healthcare space.

Marcus Osborne started his professional life as a White House intern and never intended to pursue a career in healthcare. In fact, he says he has a phobia of needles and doesn't find much pleasure in daily work dealing with issues like insurance and disease. But he says healthcare kept finding him, and he admits that no other sector has more need for good, talented people trying their best to make progress.After a couple jobs in business consulting and time as Chief Financial Officer for the Clinton Foundation's Health Access Initiative, Marcus landed at Walmart, where he ultimately became Senior Vice President of Healthcare Transformation. In January 2022, he stepped down from that role after spending 15 years at the world's largest retailer driving key initiatives to increase healthcare access and affordability, including helping to launch Walmart Health and leading Walmart Health clinics.In this episode of Healthcare is Hard, Keith Figlioli taps into the knowledge and experience Marcus has gained through his career to explore issues including: Viewing healthcare through the consumer's eyes. Looking back on his time at Walmart, Marcus says it was the best place to work on transforming healthcare since it is fundamentally a consumer company. But he also says it was sometimes the worst place given all the other competing priorities outside of healthcare at such a large organization. Marcus credits some of his biggest successes to one simple idea – that consumers are very clear about what they want, and what their challenges are. You just have to listen, and deliver.Retailer acquisitions. In addition to shedding light on the inner workings of Walmart and its ambitions to grow in the healthcare market, Marcus talks about the moves other retailers, including Amazon and CVS, are making through acquisitions. He views Amazon's acquisition of One Medical as a Brilliant move that gives the company excellent operating talent around primary care, a physical presence to continue building the omnichannel healthcare experience, and strong value-based care components through One Medical's earlier acquisition of Iora Health. He says the strategy is a home run, and talks about how it now comes down to integrating and execution.The future for health systems. Marcus and Keith talk about the idea of a health system as a community integrator. Instead of owning assets, they ponder the benefits for health systems that get better at partnering with outside organizations in deeper, more collaborative ways. For example, as the industry moves towards value-based care beyond Medicare, Marcus sees a big opportunity for health systems to create more efficiencies by being the community integrator around specialty practices in areas such as cardiology, maternity or musculosketal health.The opportunities for entrepreneurs: The great news for entrepreneurs, according to Marcus, is that the big players are far from figuring everything out. He compares the current state of healthcare innovation to the Internet in the 1990s where there was a tremendous amount of innovation and companies were focused on developing the best point solutions. For example, there were dozens of search engines, from Yahoo, to Google, Excite, Alta Vista, Ask Jeeves and many more. But Google ultimately emerged to unify the back end of search for everyone. Today in healthcare, Marcus points out how it's becoming harder for consumers to learn how to deal with all the individual solutions in the market, and says they're starting to look for someone to integrate everything for them.To hear Keith and Marcus talk about these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Dr. Elle Markman is the National Co-Director of Integrated Behavioral Health at One Medical. She focuses on integrated behavioral health impact and psychosocial drivers of population health for patients across the country. Prior to this, Dr. Markman served as the Regional Director of Behavioral Health for Iora Health. She has trained and worked in a variety of integrated primary and specialty care clinics across academic and VA medical centers. In addition, she serves as a Clinical Assistant Professor for the University of Houston College of Medicine. Dr. Markman earned her Doctor of Psychology degree from La Salle University and her Masters of Public Health from The University of Texas Health Science Center at Houston. Learn more about Elle at https://atchainternational.com/healthcare-and-higher-podcast-ep49-elle-markman/ Are you a healthcare professional or healthcare executive looking to advance your career, build a better brand, or create a leadership legacy? Visit us at https://atchainternational.com to learn how we can help. Connect with Iqbal on: - Linked at https://www.linkedin.com/in/iqbalatcha/ - Instagram at https://www.instagram.com/iqbalatcha1 - Twitter at https://twitter.com/IqbalAtcha1 Join us next week for another exciting episode of the "Healthcare and Higher" podcast! #HealthcareAndHigher #IqbalsInterviews Song Credits: "Life Is A Dream" by Michael Ramir C. "Stay With Me" by Michael Ramir C. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/iqbal-atcha/support

Dr. Mona Siddiqui says she loves solving problems at the intersection of health policy, strategy, data and operations. After earning a medical degree from Johns Hopkins, a master's in public health with a focus on quantitative methods and data analysis from Harvard, and a master's in engineering from Stanford, Mona has dedicated her career towards using this unique skillset to improve healthcare.She served as a resident at George Washington University Hospital, Innovator-in-Residence at CMMI, and a member of the White House National Science and Technology Council, among other prominent roles. She also became the first ever Chief Data Officer at the Department of Health and Human Services where she led the effort to connect the nation's health care data through a new technology infrastructure, organizational management of data as an asset, and an enterprise training program for data science and AI. In her current role as SVP of enterprise clinical strategy and quality at Humana, she's applying the vast knowledge and experience she's gained towards one main objective: creating a better consumer experience in healthcare.During her conversation with Keith Figlioli on this episode of Healthcare is Hard, Mona shared her thoughts on several timely topics including:The critical, yet unglamorous work of organizing data. Mona recounts how she experienced the pain of not having access to the right information at the right time throughout her career and in her initial role at HHS where she was tasked with thinking about new solutions in the opioid epidemic. She and her team realized the enormous amount of disconnected data at other government organizations such as the Department of Justice and the Department of Labor, and began integrating it to develop a new and unique lens into the challenges they faced. She talks about how infrastructure issues like this are not glamorous, but create incredible opportunities to make a meaningful and lasting impact.Humana's evolution into a healthcare company. Over the past few years, Humana has forged partnerships with providers like Oak Street and Iora Health, acquired organizations including Kindred, the nation's largest provider of at-home healthcare services, and grown many other new initiatives organically. As its track record demonstrates, Humana is considering all options in its transition to a “payvider” and remaining focused on the key objective of creating better consumer experiences and improving healthcare outcomes. Mona discusses how this long-term evolution is still in progress, while notably referring to Humana now as a “healthcare company.”Connecting in-person and digital experiences. With the digital transformation of healthcare, and especially advancements made over the past two years, technology is now an inherent part of consumer experiences in healthcare. Mona remembers her time as a clinician and how she often didn't have the right infrastructure to give patients the support they needed. She talks about how Humana is in a unique position to think about a holistic set of experiences – not just for patients, put for providers too – and how to create them.Partnering with early-stage companies. For startups looking to make a difference in healthcare, Mona discusses what Humana is looking for in its partnerships and how to best work together. In clinical areas, she advises that Humana's largest focus is addressing the needs of the sickest people. She also points to the need for solutions that bring caregivers and families into the conversation, and those that create integrated experiences in home and community-based settings. Overall, the goal is to become more efficient at providing the right care at the right time.To hear Mona and Keith talk about these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Dr. Syed Sumair Akhtar is the Chief Clinical Officer at Livio Health. He is responsible for the oversight and delivery of all clinical services which are done through the company's modern house-call approach which includes primary, palliative and urgent care. He also serves as the Vice President of Stella Health, the parent company of Blue Cross Blue Shield of Minnesota. Dr. Akhtar joined Livio Health in March of 2021. Prior to this, he was the Chief Medical Officer for Caremore Health, where he oversaw mobile and health network markets that served Medicare Advantage, Medicaid, and home-based care across 14 states. He has held various leadership roles throughout his career including as a Staff VP at Anthem and medical director for Iora Health. Dr. Akhtar is a board-certified physician in internal medicine and received his medical degree from the University of Maryland School of Medicine. He also holds a Master's degree in health care delivery science from the Tuck School of Business at Dartmouth College. Learn more about Dr. Akhtar at https://atchainternational.com/healthcare-and-higher-podcast-ep34-syed-sumair-akhtar/ Are you a healthcare professional or healthcare executive looking to advance your career, build a better brand, or create a leadership legacy? Iqbal can help! Schedule your FREE CONSULTATION today at https://atchainternational.com Connect with Iqbal on: - Linked at https://www.linkedin.com/in/iqbalatcha/ - Instagram at https://www.instagram.com/iqbalatcha1 - Twitter at https://twitter.com/IqbalAtcha1 Join us next week for another exciting episode of the "Healthcare and Higher" podcast! #HealthcareAndHigher #IqbalsInterviews Song Credits: "Life Is A Dream" by Michael Ramir C. "Stay With Me" by Michael Ramir C. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/iqbal-atcha/support

TakeawaysGetting a feel for HLTH 2021Revive's Gale Pryor and Brennan Mason joined our team on The No Normal Show to share their takeaways from this year's HLTH conference in Boston, Massachusetts.The purpose of the event is to bring everyone in the health ecosystem to reimagine healthcare delivery. Brennan and Gale found that the ecosystem has more players than ever.A good mix of organizations attended, including Amazon, AARP, Fidelity, AHA, IBM Watson, Maven, Philips, ResMed, Teladoc, Verizon, Vertex, CVS, Walmart, Zoom, Optum, Oak, Cigna, Aetna, Humana, and the Blues+.HLTH orchestrated an indoor event of 6000+ attendees while ensuring that everyone in attendance was vaccinated or had tested negative within the last 72 hours of the conference. They made COVID-19 testing accessible in the lobby. The reinvention of primary care Primary care is attracting heated discussions because many of the core themes in healthcare transformation are coming together in primary care.Amazon Care is expanding its virtual and hybrid primary care service beyond its employees, offering other employers a covered benefit in selected cities.UnitedHealth is rolling out a virtual-first primary care product, NavigateNow, to select employers with self-funded plans in nine markets, expanding to 25 markets by the end of 2022.Primary care is a strangely heated space. This year, Rushika Fernadopulle of Iora Health clashed with serial entrepreneur Adrian Aoun of Forward about tech-based primary care. Adrian equated the entrance of pharmacy retailers to "wanting an iPhone and being sold a Motorola."Our hosts found that Adrian came across as disconnected from the reality of primary care and that retailers like Walgreens, CVS, and Walmart have advantages like a massive physical presence, logistical network, longitudinal understanding of consumers, and high net promoter scores. Digital health, of course Digital health has always been the focus of HLTH, but this year was less about an incoming digital revolution and more about the ways different players collaborate and integrate solutions.Walmart Health put it well: It's not just about going digital; it's about having different mechanisms for different consumer preferences.Hybrid care was widely recognized as a critical element in appealing to consumer preferences and building trust.Much of the conversation was focused on chronic care management and wellness, with Noom, Thirty Madison, Big Health, and Everly Health all present. The goal of digital tools in this space is to become a reimbursed benefit.If healthcare delivery wants to transform healthcare delivery, organizations need to take the lead. To lead healthcare delivery, organizations need to change their business model from a pipeline to a platform where all players can connect to your health system.Plans + employers + digital health As employers take a more proactive role in workforce health, plans seem to be reinventing care delivery using digital health and the workplace to do it. As Divya Paliwal, Chief Clinical Transformation Officer of Horizon BCBS said, "How can we use these dollars better than shelling out to a hospital ED or ICU?"The drivers of the growth in digital health are plans and employers. And employers are moving away from PPO, and high deductible plans to incent healthy behaviors – the key focus of digital health tools.In a world of remote work, benefit offerings become even more important. When features of physical workspace become irrelevant, benefits are essential in recruiting and retention.Employers are certainly stepping up to improve access to health solutions through employee benefits, but this only intensifies the division between the "haves" and "have nots" by excluding small businesses and the unemployed.

General counsel have played a much greater leadership role than ever before in response to the pandemic. Nancy Reiner, Partner, Major, Lindsey & Africa, speaks with Blaire Bernard, Senior Vice President and General Counsel, Iora Health, about her experiences as a health-tech general counsel during the pandemic. They discuss how risk was managed, how governance structures were organized to navigate decision making challenges, and how businesses can prepare themselves for future crises. They also discuss how general counsel can operate in a resilient and human-focused way while encouraging positive and smarter change, and Blaire talks about some of the next big health-tech trends facing general counsel. Sponsored by Major, Lindsey & Africa.

As the heath-tech startup ecosystem sees increasing interest, funding, and valuations in India, We delved deep into a conversation with a Doctor turned VC investor for a refreshing perspective on the space! Our guest Pankaj Jethwani, Executive Vice President of W Health Ventures, sheds light on the following: What motivated Pankaj to become a doctor? What was his trigger to change from being a doctor to becoming part of Management? What is the value of an MBA from Wharton? Pankaj's experience in the non-profit, social & healthcare space. How did Pankaj get into Iora Health? What were the key differences between the healthcare space between India & the US? What was his experience like working in a high-flying US startup? Pankaj's background and role with W Health Ventures? What is W Health's investment focus? What areas is Pankaj looking at personally? Did Pankaj's on-the-ground experience in healthcare and management consulting experience help him pick founding teams? How does Pankaj choose the founders he wants to invest in? How does W Health Ventures help businesses, over and above the capital? What does he look for in a company before investing? What is The Breakfast Revolution, and what does the program include? Over the years, Pankaj has served 2,20,000 children over 20 million fortified meals; how does he continue making such an impact? How does Pankaj get the best mentors for himself? Pankaj's advice to budding entrepreneurs. Where does Pankaj see W Health ventures in the next 5 years? Pankaj's book recommendations: Venture Deals by Brad Feld The New Business Road Test by John Mullins Super Founders by Ali Tamaseb The Great CEO Within by Matt Mochary --- Send in a voice message: https://anchor.fm/damanitalks/message Support this podcast: https://anchor.fm/damanitalks/support

Not so fast, folks. Before we decree the demise of Google Health, Dr. Steve Ambrose is in the house to share some provocative thinking about how business models impact the delivery of consumer-first care, including what he sees as Google Health's opportunity to become a game-changer in price transparency. Then join Steve and Jared on a tour of unique models including Transcarent, Green Imaging, ChenMed, Oak Street, Iora Health, DiRx Health, and more, to learn how to design around the financial needs of consumers. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Not so fast, folks. Before we decree the demise of Google Health, Dr. Steve Ambrose is in the house to share some provocative thinking about how business models impact the delivery of consumer-first care, including what he sees as Google Health's opportunity to become a game-changer in price transparency. Then Join Steve and Jared on a tour of unique models including Transcarent, Green Imaging, ChenMed, Oak Street, Iora Health, DiRx Health, and more, to learn how to design around the financial needs of consumers. Shout-out to the Shift.Health Content Network for spreading the awesome, yo! Next steps: Subscribe to Season 2 of Now What?? on the Shift.Health YouTube channel Check out some of our favorite related podcasts: DGTL Voices with Ed Marx, Healthcare 360 with Scott Burgess, and Healthcare IT Today with John Lynn and Colin Hung See acast.com/privacy for privacy and opt-out information.

Dr. Andrew Schutzbank is a Clinical Instructor of Medicine at Harvard, Chief Product Officer at Cricket Health, and was formerly the SVP of Product at Iora Health. We discuss technology adoption and creation in primary care, payment models, business models, and what can be learned in the specialty space, with particular focus in the diabetes world in his work at Cricket.

Today on Health in 2 Point 00, Jess pokes fun at Matthew because my primary care provider has acquired a Medicare provider – One Medical buys Iora Health for $2.1 billion in stock. This deal is curious because these are two very different organizations. Next, HumanFirst (formerly Elektra Labs) raises $12 million in a Series A, bringing their total to $15 million, working on distributed clinical trials. Medallion raises $20 million in a Series A to address barriers for digital health providers around state licensing rules, and Aunt Bertha raises $27 million working on the social determinants of health and getting social care resources to patients. Finally, Grand Rounds and Doctor on Demand acquire Included Health, an LGBTQ+ focused care navigation platform.

One Medical is acquiring senior-focused primary care company Iora Health. The FDA approves the first Alzheimers drug in 18 years. And Colorado Children's Hospital is so overwhelmed with pediatric mental health patients, last month it declared a state of emergency. 

Cramming in patients, barely having time to eat lunch, spending hours at the end of the day writing notes from visits, and so many billing codes. This is not why Rushika Fernandopulle became a doctor. Rushika became a doctor because he wanted to help people and he realized he couldn’t do that given the current healthcare system. In this special episode, WD Partners’ Dan Stanek takes over as host of WDCast and sits down with the founder and CEO of Iora Health – Dr. Rushika Fernandopulle. They discuss what’s broken in the US healthcare system, how Iora Health is attempting to fix it, and what it means to be a human-centered healthcare organization. 1:14 – Rushika’s background & journey3:31 – I’m gonna change the system6:05 – The Iora Health difference10:25 – Human-centered principles12:13 – Value-based payment14:01 – The primary care lever18:20 – Changing the delivery system21:27 – The impact of the pandemic23:20 – The role of technology26:54 – CEO + MD

We're on the cusp of big changes in our healthcare delivery system. What does it look like? Dr. Rushika Fernandopulle, a physician and co-founder and CEO of Iora Health sits down with Health2049 podcast co-host Jason Helgerson to discuss a detailed approach on how to deliver a highly personalized and accountable ‘health' experience with a shared care plan.Dr. Rushika Fernandopulle:Twitter: @rushika1Connect with Health2049:Website: https://www.health2049.comTimestamps:A completely different model of healthcare delivery. [02:10]Five aspects that need to change in the next 30 years. [03:26]A shared care plan. [06:55]Doctor visit in 2049. [09:48]The outdated medical education model. [11:57]Choosing prospective medical students. [14:06]An equitable healthcare system. [15:52]Hospitals in the future. [18:22]Will hospitals become abandoned towers? [20:34]Health insurance evolution. [22:32]Attracting talented primary care doctors. [25:00]

In our latest episode, Dr. Rushika Fernandopulle, co-founder & CEO of Iora Health, and Ryan Stewart discuss the transformation of the healthcare delivery model. As a result of payment reform and a world where face-to-face medical encounters have not been possible, Healthcare is rapidly shifting towards an omnichannel communications environment, where patients are engaging where they want to be met - virtually - over voice, video and text modalities as well as in-office, as appropriate.With an increasing shift towards value-based risk models, primarily in Medicare, Dr. Fernandopulle talks about the transformation of his business through collaboration with the nation’s leading Medicare Advantage plans and, most recently, through direct contracting with the federal government’s Center for Medicare and Medicaid (CMS) which launched its Global and Professional Direct Contracting model on April 1st.  

In this episode we discuss episodes of care.  An episode of care is looking across a condition or treatment and pulling all the related transactions together to get a holistic view of what has taken place.  Health Plans like to look at episodes to identify total costs of care.  Providers like to look at episodes of care to better anticipate the patient’s needs.  This sounds like a good way to look at health care.   Unfortunately, the actual member experience doesn’t happen this way.  Each provider seems to operate in a different silo and even the health plan doesn’t pull it all together for the consumer.  With us is Duncan Reece, COO and Co-founder of Cohere Health a company whose mission is to enable the Care Journey that is right for the patient and do whatever it takes to arrive at that outcome quickly.  You’ll learn how Cohere Health is breaking down barriers and also learn about the other areas within HealthCare where the company is applying its expertise.  Duncan’s background is steeped in healthcare.  He has worked at outstanding organizations such as Health Dialog, Iora Health, and Behavioral Health company Mindstrong.   Show Notes: Duncan is reading The Trials of Apollo by Rick Riordan and several Roald Dahl books with his two children.  He listens to “How I Built This with Guy Raz.

CPR’s Program Director, Andréa Caballero, chats with Stephen Furia, Senior Vice President, Population Health at Mount Sinai Health System, one of the largest health systems in New York with 3,000 physicians, 400 locations, and a world renown medical school. The Population Health division is the business unit within Mount Sinai that works directly with employers and other health care purchasers, providing an array of services including primary care focused near-site health centers, Centers of Excellence arrangements for specialty care, executive health programs, and, more recently, assisting employers in responding to the COVID-19 pandemic. Reflecting on the Mount Sinai's five years of partnering with those who pay for health care, Stephen offers a set of principles that illustrate how the health system has successfully achieved maximum value in its direct to purchaser partnerships. Those principles are: • Investing more in primary care; • Referring to high-value providers for specialty care, when necessary; • Aligning incentives to promote value; • Encouraging healthy competition among providers in a given market. Listen in to hear Stephen’s explanation of what these principles look like in action for Mount Sinai as it delivers a transformed health care experience to its more than 40 purchaser clients. For starters, the health system’s primary care offering incorporates navigation and care management services to accompany patients from symptom onset to end of treatment and takes a holistic approach to disease prevention. Sound familiar to the models of others like Iora Health and OneMedical? That’s not a coincidence, according to Stephen- these best practices have been adopted throughout the country, marking a move away from away from the disaggregated model of multiple niche vendors filling in the gaps and moving to a broader definition of what high-value primary care entails. Stephen emphasizes how benefit managers play an important role in the success of care delivery transformation. A provider like Mount Sinai may be more willing to take on financial risk in an arrangement where the employer has specific tools in place, such as communications to make employees aware of the offerings and benefit design that makes primary care an easier and cheaper options for patients to access. Finally, Stephen reiterates a resounding truth about transforming care delivery: no one can do it alone. For Mount Sinai, that means collaborating with not only the purchaser itself, to understand the purchaser’s specific needs and pain points, but with the purchaser’s advisors and health plan administrators as well.

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...

Dr. Rushika Fernandopulle, co-founder and CEO of the value-based primary care organization Iora Health discusses how COVID led practices to reorganize around the patient, instead of the physical office. This episode is a rerun and was initially published in September.   

Join us in this episode as we speak with Dr. Mark McClellan, former CMS Administrator and former FDA Commissioner during SARS – his understanding of the COVID-19 pandemic and options for our national response is nearly unmatched. His unique insights into our health care system provide clarity around the new administration's position on value-based care as well as offer understanding regarding what the presidential transition will mean for COVID-19 response efforts, including vaccine distribution. Further, we highlight Dr. McClellans's recent work on the Resiliency Framework with HCP LAN which presents a vision to create a health care system that is responsive and resilient to events like the current public health emergency and achieves better patient experience, outcomes, equity, quality, appropriateness, affordability and accessibility at a reduced total cost of care. We have learned through the pandemic that we must upgrade our health care system – this is not the time to go back to health care the way it was before. Dr. McClellan's work and insights are paramount for professionals in this race to value. Episode Bookmarks 02:37 Dr. McClellan shares his thoughts about the ACLC and the role it plays to advance VBC in our country 03:35 Will the next two years will either be a period of gridlock or a time of historic legislative productivity? 04:14 Economic response and COVID-19 Recovery Plan are the two big legislative issues for the upcoming year 04:24 Evenly-divided Presidential election and the “reverse coattail” effect 04:36 Best case for the Democrats is a 50/50 Senate with moderate Democrats being “thoughtful” about big progressive agenda items 04:55 Bipartisan legislation is most likely outcome (most big legislation items - other than COVID recovery - are not going to happen) 05:14 Other key priorities: climate change, racial issues 05:25 Longshots: Lowering the eligibility age of Medicare or a big coverage expansion (unless Supreme Court ruling somehow takes action on ACA) 06:00 ACA guaranteed issue and community rating provisions 06:23 Potential bipartisan interest: transparency and surprise billing, drug pricing, and value-based care 06:45 “Value-Based Care approaches are a bipartisan issue, but it may not continue quite in the same way.” 07:11 How the Biden Administration approach to VBC may be different 08:15 Health Care Payment Learning & Action Network trying to align public and private efforts on reform 09:15 “We can now see the light at the end of the tunnel.  Vaccines are moving into more advanced development and availability” 09:26 “What we learned throughout the pandemic is that we really need to upgrade our health care system. This is why the work of the ACLC is particularly relevant now.” 10:00 Disruptions in our health care system due to massive reductions in revenue associated with shelter-in-place provisions. 11:30 “The farther away you were from fee-for-service, the more robust and resilient your care response was to the pandemic.” 11:56 Provider success stories in COVID: Advanced Integrated Care Systems (Intermountain, Geisinger) and Primary Care groups centered around capitation (Iora Health, Oak Street) 12:51 Hospital utilization returning back to pre-COVID levels 14:26 Advanced multidisciplinary primary care teams now including more virtual care and behavioral health integration 15:11 Shift to home dialysis for kidney disease and home drug infusion for cancer care 15:53 Social determinants of health enabled by capitation 16:26 Integrated approach to patient management for patients dealing with social isolation and depression consequences 16:45 Elimination of low-value care (the 30% of services that offer limited to no value in health outcomes) 17:05 NEJM Catalyst Article - Building a Better Health Care System Post-COVID-19: Steps for Reducing Low-Value and Wasteful Care

Iora Health co-founder and CEO Dr. Rushika Fernandapulle discusses his journey launching a disruptive venture-backed primary care organization helping push US healthcare away from fee-for-service and toward value-based care. --- Send in a voice message: https://anchor.fm/tdio/message

There might not be a specific moment when we can hit the reset button and start to tackle systemic healthcare challenges with a clean slate, but smaller resets are already underway. Join us as we examine what a COVID-19 Reset looks like for doctors, nurses, and other healthcare professionals. In this episode, we spoke with Dr. Rushika Fernandopulle, founder and CEO of Iora Health, about how physicians have addressed the pandemic in their own practices and the changing perceptions around value based care. We also spoke to Dr. Dan Knecht and Angie Meoli, for insight into how CVS is changing its own systems. One of the most eye-opening impacts of COVID-19 has been the dramatic disparities highlighted in our healthcare system. Dr. Dela Taghipour and Dr. Nadia Abuelezam will discuss how we can collectively reimagine community healthcare to address those disparities.

The importance of Humana's consumer focus, care in the home, technology, and other strategic imperatives related to value-based care have been amplified by the novel coronavirus (COVID-19) pandemic. As COVID-19 presses onward, this week Race to Value presents an industry perspective from Mike Funk, Vice President for the Office of Health Affairs and Advocacy.  Mike Funk believes that the transition to value-based care is inevitable. In his role with Humana, he leads the organization's commitment to ensure that Humana providers are well equipped for the transition to value, especially during these unprecedented times. From stabilizing physician practices, increasing access to care, creating a high-touch primary care model, improving interoperability, and more, Humana has been a leader in the race to value. In this episode Mike reveals Humana's efforts in value, including outlining impressive partnerships with the DaVinci project, OATS, Epic, Oak Street Health, Iora Health, Kindred Health, and the University of Houston, to name a few. Mike Funk is responsible for thought leadership at Humana in transforming the industry to value-based care, as well as serving as the voice of the provider, infusing clinical thinking and leadership across the enterprise. His prior experience includes; executive positions in hospital administration, physician practice management, managed care, insurance products, and health and wellness services. Mike most recently spent the last several years in the Provider Development Center of Excellence, where he focused on developing value-based programs, and assisting physicians with the tools, capabilities, and best practices for transitioning from fee for service to value. Mike is a fellow of the American College of Healthcare Executives and a Certified Medical Practice Executive. References for more information: https://www.humana.com/provider/news/value-based-care http://valuebasedcare.humana.com/ Bookmarks: 5:45 “Unprecedented times call for unprecedented actions” 6:24 Primary focus of Humana during the pandemic has been to improve access to healthcare services 6:45 Pandemic was the catalyst for jumpstarting and mainstreaming telehealth 8:01 5-10 years of technology adoption progress happening in 2-3 months 8:30 The “genie is out of the bottle” when it comes to telehealth 9:10 Limitations with technology and telehealth access in rural areas 9:30 Older Adults Technology Services (OATS) investment by Humana Foundation to launch national digital engagement consortium for older adults 10:11 Recognition by CMS of increased need for telehealth 10:20 Mike shares a story of a practice leveraging telehealth visits in an innovative way 12:40 Lack of interoperability held back the healthcare system in navigating the pandemic crisis 13:20 Need for interoperability COVID-19 test results 13:50 Humana's participation in the HL7 Da Vinci Project to support increased data sharing by leveraging the FHIR Standard 14:20 Humana's work with EMR companies to advance interoperability (Epic, eCW, AthenaHealth) 17:00 Humana's goal to ensure stabilization of physician practices 18:00 Risk-based payment models providing stability in cash flow 21:00 Humana has evolved its value-based product portfolio to include specialty bundles (e.g. joint replacement, spine, maternity care) 21:10 Humana's omni-channel approach to create a value-based care ecosystem that is “personalized, proactive, and predictive” 21:40 Increased demand in home care services and Humana's recent investments in Kindred and Heal 22:00 Humana's partnership with high-touch primary care practices (e.g. Iora, Oak Street) and their own practice (Partners in Primary Care) 22:20 Moving from a health insurance company to a health company with elements of insurance 23:45 Humana's Bold Goal initiative and other strategies to address social determinants of health and support whole-person care

Dr. Rushika Fernandopulle, co-founder and CEO of the value-based primary care organization Iora Health discusses how COVID led practices to reorganize around the patient, instead of the physical office.   

On B-Time, we bring guests to the show who refuse to accept the status quo.  Our guest today, Dr. Rushika Fernandopulle is taking on the primary care delivery system.  His mission in life is to transform healthcare by building a new model of care. Rushika is a primary care physician, CEO and co-founder of Iora Health, a primary care delivery organization dedicated primarily to serving older adults.  Iora is unique in that it focuses on helping patients overcome the barriers that get in the way of their health.  Show Notes: Books: Anti-Fragile: Things That Gain From Disorder by Nassim Nicholas Taleb; Manifesto For A Moral Revolution: Practices To Build A Better World by Jacqueline Novogratz; The Second Mountain: The Quest For A Moral Life by David Brooks.  Favorite Podcasts: B-Time (of course!), Revisonist History; How I Built This; This American Life; A Second Opinion, A Healthy Dose; Zeev Neuwirth: Creating A New Healthcare.

Tony Kulesa is a co-founder of Petri, an accelerator in Boston that backs companies developing new biotech applications and technologies in healthcare, food, industrial chemicals, and new materials. Co-founded and funded by Pillar, a venture firm co-founded by the CEOs of Cytyc, Ginkgo Bioworks, Iora Health and 22 Boston companies, Petri draws on the resources of one of the strongest biotech ecosystems in the world to support founders from around the globe. Dr. Kulesa is an inventor and community builder. Previously, he was the founding Director of the MIT BioMakerspace, a community biology laboratory and incubator space, and an Instructor at the MIT Department of Biological Engineering. He holds a PhD from MIT, where his inventions of new platforms for drug discovery and microbial therapeutics were highlighted in Science Editor’s Choice and Nature Reviews Drug Discovery. While at MIT, he co-founded and directed 3 courses on biotech and entrepreneurship, including BiomedStartup, a course that coaches 10+ teams per year on research commercialization projects. He was a member of the founding officer team at MIT Biotech Group, and an ambassador for Breakout Labs, venture philanthropy from the Thiel Foundation to support companies bringing radical scientific discoveries out of the lab and into the market.Topics:- The value of accelerators within the life sciences- Venture creation and innovation within biotech and pharma- Entering the life sciences industry from academia and other industries- The intersection of technology & biology: Silicon meets Boston & the profile of new funds straddling both philosophies- Types of risk within life sciences ventures: technical, biological, market- Impact of Covid-19 on the life sciences industry, both technological and financial- Investing and building in the life sciences revolutionThank you for listening!BIOS (@BIOS_community) is a community of early stage healthcare and life sciences founders and investors. Alix Ventures (@AlixVentures) is a SF-based venture fund that invests in early stage healthcare and life sciences companies.Music attribution: Danger Storm by Kevin MacLeodLink: https://incompetech.filmmusic.io/song/4985-danger-stormLicense: http://creativecommons.org/licenses/by/4.0/

I'm joined by special guest Scott Johnson of Blitzscaling Ventures to review three hot ventures from February 2020. Scott and I walk through three different deals: Roblox, Maven Clinic, and Iora Health.

Hosts Fred Goldstein and Gregg Masters, MPH welcome Rushika Fernandopulle MD, co-founder & CEO Iora Health. Dr. Fernandopulle is a physician who has spent decades improving the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University. He completed his clinical training at the Massachusetts General Hospital. He discusses the value proposition the Iora Health model contrasting with DPCs, ACOs, and global riaks bearing IDNs, as well as the macro market shift to value based healthcare and the implications for provider positioning strategies and continued relevance of our current 3rd party payor model. Want to stream our station live? Visit www.HealthcareNOWRadio.com. Find all of our show episodes on your favorite podcast platforms. https://www.healthcarenowradio.com/listen/

On PopHealth Week our guest is Rushika Fernandopulle MD co-founder & CEO Iora Health. Dr. Rushika Fernandopulle is a physician who has spent decades improving the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University. He completed his clinical training at the Massachusetts General Hospital. Iora Health changes primary care as we know it. Iora's care team, includes a dedicated advocate for each patient, works together to treat the whole person. ==##==      

On PopHealth Week our guest is Rushika Fernandopulle MD co-founder & CEO Iora Health. Dr. Rushika Fernandopulle is a physician who has spent decades improving the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University. He completed his clinical training at the Massachusetts General Hospital. Iora Health changes primary care as we know it. Iora's care team, includes a dedicated advocate for each patient, works together to treat the whole person. ==##==      

Health care in America is broken. We spend the most out of many countries on health care, and yet among developed countries our quality is among the worst. Why? Because the system doesn't allow us to develop true relationships with our patients. In our inaugural episode, we are joined by Dr. Rushika Fernandopulle, CEO and Co-Founder at Iora Health to discuss new and innovative ways of getting health care, particularly in a model known as Direct Primary Care. Learn how you can find out how to expect more from the health care system, and how entities like Iora Health are transforming the experience of the patient. Find out if Direct Primary Care is a fit for you as over 250,000 patients across the country have partnered with over 1,000 doctors to receive high quality care at low cost and a fantastic experience, where primary care care once again becomes local and personalized.

I'm excited to be joined by Dr. Rushika Fernandopulle, Co-Founder and CEO of Iora Health.  If you haven't heard of Rushika or Iora Health yet, you will.  He has designed a new model of primary care delivery that challenges the core assumptions of U.S. healthcare and produces better health outcomes at lower cost.  He is a Harvard-trained physician who serves on the staff at the Massachusetts General Hospital and on the faculty of Harvard Medical School.  His company Iora Health solves for some of the most pressing problems in our healthcare system today, including physician burnout and addressing social determinants of health.  Our conversation touches on these issues and the future of our nation's primary care. Learn More: https://asecondopinionpodcast.com/

This week we are joined by Andrew Schutzbank, the Vice President of Product and Technology at Iora Health. His passion for revolutionizing health care began as a medical student at Tulane in pre- and post-Katrina New Orleans and continued during his Internal Medicine & Primary Care residency at the Beth Israel Deaconess Medical Center. He writes at schutzblog.com and joins us today to talk his work at Iora Health. We discuss how the idea of completely starting over brought him to Iora Health after his residency, how Iora Health’s model works and how they navigate risk, the central role of Health Coaches in the care team, what challenges Iora is still grappling with, about Iora Health’s novel EHR, Chirp, and finish up with his reflections on how software development and patient care are similar. Please rate and review us on itunes or stitcher, and share us on social media. We tweet at @rospodcast and are on facebook at www.facebook.com/reviewofsystems. Please drop us a line at contact@rospod.org. We’d love to hear from you.

Steve and Trevor kickoff the 25th Annual Wharton Healthcare Business Conference by moderating a CEO Roundtable with guests Rushika Fernandopulle (CEO of Iora Health), Jaewon Ryu (CEO of Geisinger), and Shoshanah Brown (CEO of AIRnyc).

I have known Rushika Fernandopulle, MD for nearly seven years and I worked for Iora Health for almost six years. He's a man of integrity, humility and seeks to provide support for humanity and he's a lot of fun. When I lived in Las Vegas, NV I always looked forward to his visits to the Las Vegas practices because his insight was unique, practical and humane. Rushika Fernandopulle, MD is a physician who has spent more than ten years involved in efforts to improve the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University. He completed his clinical training at the Massachusetts General Hospital.    To connect with Iora Health: * Website: www.iorahealth.com

Rushika Fernandopulle, M.D., Co-Founder & CEO of Iora Health, joins David Johnson in Episode 6 of Market Corner Conversations. Rushika shares how he decided that the incremental change model wasn’t working ... The post Market Corner Conversations: Dr. Rushika Fernandopulle, Co-Founder & CEO, Iora Health appeared first on 4sight Health.

There’s no quick fix for chronic disease, but finding the right words to help a patient through this challenging (and seemingly endless) journey can help make the road smoother and outcome better. We’ll hear from Dr. Rushika Fernandopulle, MD, co-founder and CEO of Iora Health, who will share how patients’ relationship with care teams, along with attitudes and beliefs, can affect the way patients cope with their chronic disease. We’ll also hear a patient’s unique insight and perspective.

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Rushika Fernandopulle MD, co-founder and CEO of Iora Health.  Rushika and his colleagues have spent the past 15 ...

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Rushika Fernandopulle MD, co-founder and CEO of Iora Health.  Rushika and his colleagues have spent the past 15 years building a model of healthcare that is primarily dedicated to optimizing people’s lives through better living - using Primary Care as the foundation.  His courageous approach has really set the vision for what Primary Care can and should look like; and numerous other innovative Primary Care redesigns have been built off of the groundbreaking Iora Health model. In this interview, Rushika will unabashedly discuss the critical success factors upon which he will not compromise.  He also shares stories which illustrate the simple elegance and amazing potential value of Primary Care.  Dr. Fernandopulle ends the conversation with one take-home ‘nugget’: do a team huddle each morning, and talk about your patients, even if it’s only for 5 minutes.  Are you up for his challenge?

This week’s episode is the last episode in our series on new models of Primary Care! Our guest today, Michael Greeley, is a General Partner at Flare Capital Partners. Prior to co-founding Flare Capital Partners, Michael was the founding General Partner of Flybridge Capital Partners where he led the firm’s healthcare investments. Michael’s current and prior board seats include HealthVerity, Iora Health, Predilytics, TARIS Biomedical, and Welltok. Michael also serves on the Industry Advisory Board of the Cleveland Clinic and Boston Children’s Hospital, as well as serving on several other boards including the New England Investors’ Committee of Capital Innovation. Michael is most excited about the convergence of healthcare and information technologies and the profound opportunities to transform healthcare and writes about this and other topics on his blog www.ontheflyingbridge.com In this episode we cover: Michael’s background, work at Flare Capital, and his specific areas of investment interest How Flare Capital’s  investment in Iora Health came together and what led him to say yes Michael’s general thoughts on entrepreneurs trying to build standalone primary care models and if he thinks this helps or could create more fragmentation in the system Where Michael sees the future of these New Models of Primary Care heading Michael’s thoughts around a blog post he wrote in that “if V1 of the Healthcare technology sector was triggered but the HITECH Act of 2009, the sector is now entering V2.0 where the commentary is focused on Artificial Intelligence and Virtual Reality solutions to make the healthcare system “capital light” to drive meaningful operating efficiencies from the significant investment of the past three years." What opportunities Michael believes will develop over the next few years If Michael sees a growth in early stage investment over the next few years or if he thinks we’ll see the percentage grow in Series B and later investments Why Michael thinks "Brands will become even more important” Links mentioned in the show: Steve Kraus at Bessemer Ventures https://www.bvp.com/team/stephen-kraus https://ontheflyingbridge.wordpress.com/2017/02/21/potential-next-steps-where-to-invest/ Connect with Michael: Twitter LinkedIn Blog Connect with Flare Capital Partners: Website Connect with Healthbox Follow us on Twitter and @ChuckFeerick Subscribe and leave a review in iTunes Have guest suggestions or topic ideas for the podcast? Send them to us at ideas@healthbox.com Listen to this episode on iTunes, SoundCloud, or Libsyn

Today’s episode is the second episode in our series on new models of Primary Care! Our guest today, Rushika Fernandopulle, MD, is  Co-Founder and CEO of Iora Health. Rushika is a physician who has spent more than ten years involved in efforts to improve the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his MD and Masters in Health Policy from Harvard University and completed his clinical training at the Massachusetts General Hospital. In 2011, Rushika Co-founded Iora Health; Iora Health is building a different kind of health system to deliver high-impact, relationship-based care, helping patients manage their health and navigate the healthcare system.   In this episode we cover: Rushika’s background and where his interest in improving healthcare delivery came from How the Iora Health model works What early iterations of the business model look like and what did Rushika try before arriving at what Iora is today As the company grows, how Iora Health continue to embrace innovation Iora Health has  raised over $123M in funding to date; Rushika discusses the crucial inflection points in knowing when it was time to bring on new capital How Rushika responds to the criticism that these standalone primary care models could create more fragmentation in the system As Iora Health continues to expand and to raise money, besides capital, what Rushika looked for in his initial investors and what he looks for now in the later rounds Iora Health launched an Accountable Care agreement with Humana in Arizona and Washington for their Medicare Advantage population beginning in 2014. Rushika explains how Iora works with Humana and other insurers and where he sees possible opportunities moving forward What Rushika thinks about partnerships with health systems  Where Rushika sees the future of these New Models of Primary Care heading  Connect with Rushika: LinkedIn Twitter Connect with Iora Health: Website Twitter  Connect with Healthbox Follow us on Twitter and @ChuckFeerick Subscribe and leave a review in iTunes Have guest suggestions or topic ideas for the podcast? Send them to us at ideas@healthbox.com Listen to this episode on iTunes, SoundCloud, or Libsyn

Everyone can agree that our current healthcare model is broken. But the question is, can we fix it from the inside? or do we need to start from scratch? My next guest, Dr. Rushika Fernandopulle believes in order to best address the looming crisis, we need to reimagine health care from the ground up, and build new primary care models from scratch. He is the founder of Iora Health, a next generation primary care practice designed to restore the humanity in healthcare. In recent weeks, we have seen similar primary care models like Qliance and Turntable Health fold under unsustainable business models. By what makes Iora Health different and successful to date? On this episode, Dr. Fernandopulle will share his secret sauce to success, what he believes is broken in primary care, what the future holds for quality medical care, and the inspirational backstory that led him to start Iora Health.  All this and more on today’s episode. Now, That’s Unusual. About Dr. Rushika Fernandopulle Dr. Rushika Fernandopulle is a practicing physician and co-founder and CEO of Iora Health, a healthcare services firm based in Cambridge MA whose mission is to build a radically new model of primary care to improve quality and service and reduce overall expenditures. In 2012 he was named an Ashoka Global Fellow, and is also a member of the Albert Schweitzer and Salzburg Global Fellowships. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and Managing Director of the Clinical Initiatives Center at the Advisory Board Company. He is co-author or editor of several publications including Health Care Policy, a textbook for physicians and medical students, and Uninsured in America: Life and Death in the Land of Opportunity. He serves on the staff at the Massachusetts General Hospital, on the faculty of Harvard Medical School, and on the boards of Families USA and the Schwartz Center for Compassionate Care. He earned his A.B., M.D., and M.P.P. (Masters in Public Policy) from Harvard University, and completed his clinical training at the University of Pennsylvania and the Massachusetts General Hospital. Key Interview Takeaways Although innovations in technology continue to evolve the healthcare space, the way we deliver care has remained stagnant. Healthcare is a series of fragmented transactions, and outcomes are not the focus. Dr. Fernandopulle’s motivation to tackle this issue came from a colleague’s plea, “Every day, I lose a little piece of my soul.” Most enter the medical profession with the intention of helping people, but the system gets in the way. “Half-ass, incremental change doesn’t work.” Dr. Fernandopulle had the simple insight that starting over was the only approach, and Iora seeks to rebuild healthcare from the ground up, starting with primary care. Dr. Fernandopulle set out to replicate the Southwest Airlines paradigm: Show up in the market, break the rules, and compel others to change in order to keep up. His mission is to transform healthcare by building a different model and demonstrating this new approach for others to follow. Iora operates on the idea that the doctor’s job is to radically empower her patients, giving them the tools to improve and maintain health in a system that keeps learning and adapts quickly. The most difficult part of developing the Iora model was designing the payment system. Dr. Fernandopulle rejects the fee-for-service model, and he sought payers (employers, union trusts, etc.) who were willing to pay for the relationship rather than individual transactions. The Iora system has been cost-effective in terms of patient/team experience, clinical outcomes, cost of care, and economic sustainability. Iora practices have 96-98% retention rates, and they have experienced 40-50% drops in hospitalizations. Behavior change is a slow process. The Iora model invests more money in patients early on, but typically sees big savings in healthcare costs by year three.

Rushika Fernandopulle, CEO of Iora Health, discusses how his desire to fix the "stupid system" that is healthcare led to the creation of Iora health and lets us in on what he believes is the secret to better patient care: empathy. He shares the lessons he has learned as a trailblazing entrepreneur and explains how he sought to turn traditional patient care on its head by transforming a transactional system into one based on relationships. Trevor, Steve, Rushika, and Iora's CFO Dave Fielding work through what it takes to survive in the evolving primary care space, how CMS will shift under the new administration, and where we are today in the value-based care movement that Iora helped pioneer.

IORA’s co-founder and CEO Rushika Fernandopulle, MD, has spent the past decade trying to improve primary care. Hear how IORA Health is delivering on that long-time pursuit.

Listen NowMuch of the health care industry's effort to improve health care payment and delivery centers around improving primary care. This is largely because Americans suffer more disease/disease burden throughout their life spans compared to individuals in other industrialized countries.   This therefore makes obvious sense since primary care is the foundation upon which an effective and efficient health care/medical care program is built.  When done well primary care promotes wellness, prevents disease onset, progression, exacerbation and prevents premature death.  Primary care also moderates the need for higher cost specialty care and improves population health.  For numerous reasons, not least of which is inadequate reimbursement, primary care delivery has been sub-optimal.   New models of primary care are emerging, one termed direct primary care (noted in the ACA under Section 1301 (A) (3) and now recognized in 13 states) is showing promise in improving quality, improving patient satisfaction and lowering cost growth.      During this 21 minute conversation Dr. Judge discusses moreover the impetus for the creation of Iora Healh, how Iora's primary care delivery model works or how it is different from traditional primary care delivery, how Iora's model is staffed, IT supported and reimbursed, with whom and how it contracts and what Iora's performance data demonstrates to date. Dr. David Judge serves as Iora Health's Chief Medical Officer.  Dr. Judge joined Iora in 2014 to continue his work in improving and redesigning of primary care.  Priorto , he helped found and was the Medical Director of the Ambulatory Practice of the Future at Mass. General Hospital.  David received his undergraduate degree in biomedical engineering and public health studies at Brown University and attended University of  Mass. Medical School.  He completed his residency training in internal medicine at Columbia Presbyterian Medical Center in New York City. For more on Iora Health go to: http://www.iorahealth.com/ This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Rushika is co-founder and CEO of Iora Health. We interviewed him at the Oliver Wyman Health Innovation Summit held in October, 2015.

Ben talks with John Norman about his process and modified approach to the delivery, payment, and tech of modern managed health care. They also touch on age bias in the programming world, living a purpose-driven life, and dealing with startup growth. Iora Health "The Hot Spotters"- Atul Gawande The Healing of America- T.R. Reid WellnessFX Agile Manifesto HIPAA Being Mortal- Atul Gawande "How to Scale a Development Team"- Adam Wiggins "The Double Diamond Model of Product Definition and Design"- Peter Merholz John on Twitter

Dr. Benjamin Berk shares his entrepreneurial journey and passion for improving healthcare systems and patient outcomes. The ModernMD: Dr. Benjamin Berk Dr. Benjamin Berk, MD, MS&E provides strategic and operational consulting services to innovative payers, providers, health services organizations, and investors.  Benjamin is a Senior Advisor and Content Consultant for Advanced Practice Strategies (APS) and Faculty member for The Dartmouth Institute for Health Policy & Clinical Practice. Previously, Dr. Berk was the Vice President of Population Health for Iora Health and Principle at Boston Consulting Group. Success Quote: “Population health is created one patient at a time.” - Benjamin White Coat to Business Suit: Benjamin started as a software engineer building clinical information systems and clinical decision support software.  As he did not want to spend his career behind a computer screen, he decided to go to Stanford Medical school.  During medical school, he realized he was more interested in the ‘big picture' and made the decision to purse his ‘business residency' at BCG. Listen as Dr. Berk shares his journey, reasons for going into consulting, and his start-up adventures. Idea to Venture: The Idea: How can you transform primary care and improve patient outcomes? Listen as Dr. Berk shares his journey at Iora Health and his passion for transforming primary care. Failures: Benjamin shares his thoughts on the value of failure as a learning opportunity that drives innovation. He also shares insights into fear of failure and success motivators in the US vs. UK healthcare marketplace. Lessons Learned: The buy vs. build technology decision - Learn when buy software and when to build and promote rapid innovation.  Business Rounds: Best Advice: “Opportunity is everywhere.” -  Benjamin's parents Daily Success Habit: Takes personal time daily to relax away from work without distractions.  Healthcare Trends: Value Based Healthcare: Healthcare is moving to larger systems with value based care and accountable care. Healthcare Technology: Clinical dashboards are being brought to the point of care with actionable data. Links: http://tdi.dartmouth.edu/ http://www.aps-web.com/

On the Wednesday July 8th 2015 broadcast of PopHealth Week at 9AM Pacific/12Noon Eastern, in our continuing focus on primary care and population health we are pleased to welcome Rushika Fernandopulle, MD, the Co-Founder and CEO of iora health a growing and disruptive force in the direct practice (including membership and retainer practice medicine) market. Dr. Fernandopulle has spent more than ten years involved in efforts to improve the quality of healthcare delivered to patients.  He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University and completed his clinical training at the Massachusetts General Hospital.iora health value prop iora health believes that better health care starts with primary care. The practice is built upon three principles: Payment Focused on OutcomesPatient at the Center; andTechnologies that Enable Care One of iora Health‘s goals is to empower the individual and they utilize care teams and health coaches as the connection.  Iora health also places a focus on integrating behavioral health.  Join Dr. Rushika Fernandopulle as our guest on PopHealth Week and learn more about this growing and innovative primary care model. For complete blog post, click here.  

At the 15th Annual Population Health Colloquium 2015, my colleague Douglas Goldstein @efuturist and I caught up with the amazing Rushika Fernandopulle MD who's twitter profile @rushika1 notes he's 'a physician trying to radically redesign how we deliver health care' and the Founder and CEO of @IoraHealth an innovative network of direct practices.  This is the audio portion of the interview only, the complete video interview will be available c/o Health Innovation Media and uploaded here.  Enjoy!    

Today's guest is Rushika Fernandopule, Co-Founder and CEO of Iora Health. Iora Health is restoring humanity to healthcare by providing a radically different model of primary care built from the ground up.  Iora Health's care model provides extraordinary service to patients to ensure improved health outcomes while also lowering overall plan costs. Our patients enjoy the benefits of better access to care, office and non-office based encounters (e.g. phone, text messages, and email), an accessible and transparent medical record, and robust educational offerings. Our practices, across the U.S., enjoy the benefits of smaller sizes, closer relationships with patients, and the opportunity to lead systemic change in healthcare delivery while working with a true team. For more information, please visit www.iorahealth.com. We will be covering the topic of Iora Health and the new Las Vegas Clinic Rushika is forming in collaboration with Tony Hsieh (Zappos) and ZDoggMD. Rushika is a physician who has spent much of the last ten years involved in efforts to improve the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University. He completed his clinical training at the Massachusetts General Hospital. www.linkedin.com/pub/rushika-fernandopulle/5/898/807