#38- General Panic 

Highlights and insights from this week in healthcare tech and business

Things That Happened

General Panic. General Electric fired their CEO this week. This may have ramifications in the world of healthcare as departed CEO John Flannery had set in motion the separation of GE Healthcare into its own public company. Given healthcare represents 43% of the overall company’s operating profit, this plan may be scuttled under new CEO Lawrence Culp as he becomes the latest chief to attempt to stem the two-decade $500B loss in GE market value. 

Hi-respiratory Camera. A camera-based sensor was just approved in Europe to detect a patient’s pulse and breathing rate from across the room. I’d expect this tech to see faster uptake in non-clinical settings - e.g. security, gambling, retail. 

Five Star Meds. A study published this week in JAMA shows that telemedicine patients were more likely to give a five-star satisfaction rating for their respiratory ailment visit if they were prescribed antibiotics. 66% of patients presenting with respiratory infections in the study received antibiotics, a rate that one researcher calls “far too high.” Patient satisfaction scores are largely pointless when it comes to finding quality physicians, and as this study points out, they might even be driving bad physician behavior. 

Surprise! You’re broke. Envision, the physician staffing company that relies upon out-of-network “surprise billing” as a key revenue stream, has launched a new campaign to blame pretty much everyone else in the system for their hugely unpopular (and decidedly unethical) billing practices. More context from Evan Sweeney in FierceHealthcare. 

Autonomy Rules. Physicians in solo-practices are less likely to report feeling burnt out compared with physicians working in health-system owned practices, according to a new study

Things To Read

Rock Health summarized the venture funding pouring into digital health. Keep in mind as you peruse the report that Rock Health takes a generously wide view of digital health, including entirely non-clinical firms like Peloton (at-home spinning machines) and Collective Health (a nouveau third-party insurance administrator). Still, there’s a lot of venture money to be had in the wider healthcare space. Whether that’s a good thing depends on who you ask. 

“’I’m 67, so I could give a shit,’ she says. ‘What are they going to do, fire me? I’m packin’ a Medicare card.’” This comes from Marshal Allen’s latest piece in his ProPublica series on health insurance in which he details Marilyn Bartlett’s nothing-to-lose crusade to lower Montana’s state-employee benefit plan healthcare expenditures. Spoiler: she did it, using the payer’s bargaining power to get lower hospital service prices and find a PBM that didn’t fleece them. 

Applied microeconomist Craig Garthwaite summarizes recent work on the changing economics of drug development and how they effect pricing and innovation. It’s not too dense, I promise. 

Amazon’s strategy is to understand the customer’s needs and work backward,” according to Alex Kacik in his piece describing Amazon’s growing healthcare supply business. While Amazon mostly targets healthcare providers’ “tail-spend” - the 20% of products they can’t get through their one or two major suppliers - Kacik shows how the company is using its other consumer-friendly strengths to not just match how providers want to purchase, but actually improve the process. Interested in more Amazon supply chain talk? Here’s an interview with the man in charge, Chris Holt. 

Next year only 30% of large employers will offer high-deductible health plans as the only plan choice for their employees, down from 39% this year. Employers are finding that HDHPs and their ‘skin in the game’ approach to healthcare don’t actually work to contain costs, and instead just increase employee dissatisfaction. Go figure. 

Atul Gawande sat down for an extended interview with Shane Parrish on his The Knowledge Project podcast. You can listen to this interview for clues to Gawande’s priorities at the helm of the Amazon-JP Morgan-Berkshire Hathaway healthcare joint venture (it was recorded before he was announced as CEO), or you can listen because Gawande is an impressive person and physician who has a deep understanding our system, how it fails, and what to do about it. It’s also generally a fantastic podcast full of thought-provoking material. 

Katherine Schwab got a physical at Mount Sinai’s Lab100, which they’re calling the ‘wellness lab of the future.’ While it’s certainly glitzy and futuristic, I think we’ll be patronizing “wellness labs” about as much in the future as we are now. While a focus on wellness rather than sick-care is likely where we’re headed, the idea that care will continue to be delivered in-person and via annual checkups seems antiquated. What’s wrong with annual checkups isn’t the data visualizations or breadth of diagnostics, but instead the fact that they’re only once a year. Virtual primary care, a la Sherpaa, has a much better shot at supplanting our current primary care system than Mount Sinai’s concept car. 

“Eight out of 10 [doctors] said they rarely, if ever, talked to patients about the probability of test results being accurate.” Daniel Morgan wrote in the Washington Post this week about the problematic lack of statistical understanding among physicians, and how that leads to misreading diagnostics and over-treatment. 

Some employee wellness programs put physicians in the position of deciding if employees get reduced insurance premiums for healthy activities. In an article this week in NEJM, Matt Lamkin lays out the realities of wellness programs that reward employees for healthy behaviors: physicians are often the ones determining if their premiums go up, knowing that if premiums and deductibles rise patients will be less likely to seek out care. (Don’t have an NEJM subscription? Read it here)

Thanks for reading The Healthcare Handout, a weekly update on tech and business in healthcare from Isaac Krasny. Criticize, praise, hire, or otherwise get in touch with Isaac via isaac@healthcarehandout.com, or on twitter @isaackrasny

And remember, this machine runs on sharing. If you found this newsletter informative or thought-provoking, give it a boost by sharing with a friend or colleague. Or share a testimonial.