Joe Spector

Health tech startups are scrambling to adapt as labor shortages and pricing pressures loom large. With EHR giants like Epic calling the shots, how are founders supposed to keep their heads above water while navigating this chaotic landscape? #HealthInnovation #DigitalHealth https://lnkd.in/gYbCjspE

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Consumer-led care is shocking the system. Forced to compete, traditional healthcare is feeling pressure from cash-pay platforms, grey market prescriptions, medical tourism, and concierge longevity clinics. Meanwhile, DTC providers are skirting the rules to get ahead. 💉 Hims vs. FDA hims & hers announced a $49/mo. compounded—and unproven—GLP-1 pill last week.The FDA stepped in and Novo filed suit. Hims retracted the product but called the response an assault on consumer access. 🚨 FDA vs. Novo Nordisk The drugmaker received an FDA warning letter for ads falsely insinuating its pill’s benefits extend to emotional and psychological relief. ⚖️ Function vs. Superpower Function Health filed a false advertising suit against competitor Superpower, alleging its lab testing capabilities are embellished. 💊 TrumpRx vs. PBMs The government’s new cost comparison site blames Big Pharma for drug price-gouging while aggregating purchase options for cash-pay customers. 📺 OpenAI vs. Anthropic Both tech companies recently debuted healthcare products. Battling for brand trust, Anthropic’s Super Bowl spot trolled OpenAI for integrating ads. Looking ahead: DIY care has to prove it’s as credible as convenient. AI, telehealth, and consumer platforms are accelerating access, personalization, and price transparency — but without shared accountability, the new system risks repeating old patterns. 🔗 Read the latest from Fitt Insider: https://lnkd.in/eJXTfEZi

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Obesity and cardiometabolic risk factors are among the leading modifiable drivers of premature death and disability globally and account for a disproportionate share of healthcare spending. We have the tools to dramatically reduce the burden of obesity and cardiometabolic disease — screening, clinical guidelines, GLP-1s and other medications, lifestyle interventions. Yet the system isn't converting these tools into results. The failure is structural: payors can't get confidence in ROI at current GLP-1 costs. Patients can't sustain engagement through the churn that plagues US healthcare. Providers can't deliver continuity at scale. And risk management remains too blunt — same intensity for every patient regardless of profile. This is what we're building Onsera Health — a Population Health Partners company – to solve. Our approach starts with precision. Risk stratification that matches each person with the right care journey from day one — clinical teams, behavioral support, and medication management calibrated to individual risk and needs. The aim: sustained outcomes over years, not months. Lowest unit cost per outcome. Best ROI for employer and payor. And most importantly, a healthier human being. We embark on this with a combination of humility and determination. Every component idea we have probably exists already. But bringing these together to deliver sustained value at scale is the execution challenge we're determined to crack. We're launching our first clients this spring. If you're rethinking your approach to managing obesity, want to practice differently, or are building in this space — we’d welcome the conversation. #OnseraHealth #PopulationHealth #GLP1 #Obesity

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Three incredible days at #JPM2026. Same conversation with 10+ health system execs: "We're building our AI strategy. Evaluating vendors. Need to pick the right partners." This sounds familiar. 2009-2012: The EHR decision. After the HITECH Act, health systems spent 18-24 months evaluating Epic vs. Cerner. Consultants. Committees. RFPs. Multi-year implementations. The logic made sense: EHRs were monolithic platforms with huge switching costs. You had to get it right. 2025: The AI decision. I'm watching health systems do the same thing. "AI steering committees." "Strategic AI partner" RFPs. Trying to pick winners. But there's a critical difference: EHRs were a single, massive platform decision. AI in healthcare is dozens of different problems that need dozens of different solutions. Here's what health systems are missing: They're looking for "the AI vendor" when they should be building "an AI portfolio." There's no single AI platform that solves:   → Documentation burden (ambient notes) → Radiology throughput (workflow optimization) → Clinical trials matching → Revenue cycle optimization (across specialties) → Clinical decision support These are different problems. Different technologies. Different vendors. Different timelines. Some need FDA clearance and 24-month validations. Some can pilot in 90 days. Some integrate with Epic. Some replace parts of Epic. You can't solve all of these with one "strategic AI partnership”....no matter that Anthropic is saying right now. <ducks> The AI landscape is evolving too fast for monogamous vendor relationships. 6 months ago: GPT-4 for clinical documentation. Today: Ambient listening, agentic workflows, multimodal imaging analysis. 6 months from now: Something else entirely. That's why you need exposure across the whole landscape—not a bet on one vendor. The mistake I see health systems making: Approach 1: "Strategic Partner" Strategy Pick one AI vendor → Enterprise deal → 3-year commitment → Hope they solve everything Result: You're locked in. Technology moves on. You're stuck in vendor negotiations while competitors move faster. Approach 2: "Portfolio Strategy" Deploy capital across multiple companies → Take equity → Co-develop solutions → Maintain optionality Result: You capture upside. You shape products. You're first to new capabilities. You have relationships across the ecosystem. After 20 years building innovation platforms at JPMorgan, Mousse Partners, Blueprint Health, Junto Health, Atlantic Health: In fast-moving markets, portfolio strategies beat single-vendor bets. Healthcare AI is moving fast. The question isn't "Which AI vendor should we pick?" The question is: "How do we build an AI portfolio that gives us the most optionality" If you're thinking about this, let's talk. 📩 douglas.m.hayes@gmail.com ☎️ 215-620-2032 #healthcareAI #digitalhealth #venturecapital #innovation

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Identical care, unequal pay. A new Trilliant Health report shows how opaque pricing still drives inequity in the U.S. system. Academic medical centers often secure far higher commercial rates than safety net hospitals for the same services. For CPT 99283 emergency visits, AMC rates were about 6.4 times higher in Houston, 4.8 times higher in Los Angeles, and 1.8 times higher in New York City. Some payer affiliated clinics also receive higher reimbursements than peers. In Houston, UnitedHealthcare reimbursed Kelsey Seybold Clinic at roughly 5 to 70 percent higher rates than other local clinics for comparable outpatient visits Why this matters. Price opacity distorts competition, rewards negotiating power over value, and shifts costs to employers and patients. Trilliant’s Allison Oakes notes AMCs argue higher costs from training, research, and specialized services. Safety net hospitals carry more uncompensated care and a heavier government payer mix. Price transparency rules could rebalance leverage, but only if sponsors act on the data The incentives are uncomfortable. With minimum medical loss ratio rules, it can be rational for an insurer to pay more to its own affiliated providers. Employers still have a fiduciary duty to demand value for money. If identical CPT codes pay radically different rates across town, who benefits and who pays My stance is simple. Evidence over opacity, equity over arbitrage, accountability over anecdotes. Use transparent contracts, audited comparators for identical codes, limits on affiliated self dealing without clear quality gains, and employer side governance that ties reimbursement to measurable outcomes. If the prices are justified, prove it with data Employers, will you use transparency files to renegotiate in 2025. Health systems, will you publish CPT level justifications tied to quality and access. Payers, will you disclose affiliated differentials and the performance delta that earns them #HealthcarePricing #PriceTransparency #HealthEquity #Hospitals #SafetyNet #AcademicMedicalCenters #CPT99283 #Payers #UnitedHealthcare #KelseySeybold #EmployerBenefits #ValueBasedCare #FraudWasteAbuse #HealthcarePolicy #DataTransparency

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Your HealthTech product is solid, but you aren’t getting traction. Pilot stalls Failed to scale Uninterested clinicians Ghosted by administrators Founders, why why oh why is this happening to you? If you are building in HealthTech, You have to build something you know will either - fit seamlessly into the current workflow OR - disrupts a current broken workflow and builds it back with true effectiveness And you can only do this if you talk to clinicians Boots on the ground Taking care of patients Doing the admin tasks In the trenches Not their bosses Not their C-suite Not the crusty old RN or MD MBA who hasn’t done a set of vitals in 23 years (sorry) Not your college roommate or golfing buddy. It doesn’t have to be hard. It doesn’t have to break your budget. But you desperately need to validate your implementation to communicate value and drive adoption.

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It took SeamlessMD 10+ years to reach scale as a Health Tech company. Here were the 3 HARDEST things we had to learn along the way: 𝟭/ 𝗬𝗼𝘂 𝗰𝗮𝗻 𝗴𝗮𝗶𝗻 𝗮𝗻𝗱 𝗹𝗼𝘀𝗲 𝗽𝗿𝗼𝗱𝘂𝗰𝘁-𝗺𝗮𝗿𝗸𝗲𝘁 𝗳𝗶𝘁. 𝗬𝗼𝘂 𝗵𝗮𝘃𝗲 𝘁𝗼 𝗰𝗼𝗻𝘀𝘁𝗮𝗻𝘁𝗹𝘆 𝗿𝗲𝗶𝗻𝘃𝗲𝗻𝘁 𝘁𝗵𝗲 𝗰𝗼𝗺𝗽𝗮𝗻𝘆’𝘀 𝗽𝗿𝗼𝗱𝘂𝗰𝘁, 𝗴𝗼-𝘁𝗼-𝗺𝗮𝗿𝗸𝗲𝘁 𝗮𝗻𝗱 𝗺𝗼𝗿𝗲. Pre-COVID it was all about having the strongest clinical evidence and getting bottom up, physician champion buy-in -no one else in the org really cared to own our product. Post-COVID, it was all about aligning with CMIOs/CIOs/Digital/Operational Execs. On the one hand, that gave us a path to system-wide scale. On the other hand, it led to increased competition, making the product stand out more beyond industry-best clinical evidence and more complex sales cycles. I remember telling our investors back in 2021 it “felt” like this transition from bottom-up to top-down adoption was happening, but navigating it was a whole other experience. 𝟮/ 𝗛𝗲𝗮𝗹𝘁𝗵 𝗧𝗲𝗰𝗵 𝗶𝘀 𝗮 𝗹𝗼𝗻𝗴-𝘁𝗲𝗿𝗺 𝗴𝗮𝗺𝗲 𝗯𝗮𝘀𝗲𝗱 𝗼𝗻 𝗹𝗼𝗻𝗴-𝘁𝗲𝗿𝗺 𝗿𝗲𝗹𝗮𝘁𝗶𝗼𝗻𝘀𝗵𝗶𝗽𝘀. 𝗡𝗼 𝘀𝗵𝗼𝗿𝘁𝗰𝘂𝘁𝘀. 𝗝𝘂𝘀𝘁 𝘀𝗵𝗼𝘄𝗶𝗻𝗴 𝘂𝗽 𝗲𝘃𝗲𝗿𝘆 𝗱𝗮𝘆 𝗮𝗻𝗱 𝗹𝗲𝘁𝘁𝗶𝗻𝗴 𝘀𝗺𝗮𝗹𝗹 𝘄𝗶𝗻𝘀 𝗰𝗼𝗺𝗽𝗼𝘂𝗻𝗱. Innovators get frustrated early on in the startup journey - many folks will take meetings with you because they are truly excited by your vision - but the complexity and low-margin environment of healthcare mean that most of those meetings won’t go anywhere… yet. Yet many times we’ve secured new health system partnerships based on individual relationships started many, many years before. If we had given up earlier, those partnerships would never have happened. 𝟯/ 𝗡𝗼 𝗼𝗻𝗲 𝗯𝗲𝗹𝗶𝗲𝘃𝗲𝘀 𝘄𝗵𝗮𝘁 𝘁𝗵𝗲 𝗰𝗼𝗺𝗽𝗮𝗻𝘆 𝘀𝗮𝘆𝘀. 𝗧𝗵𝗲 𝗼𝗻𝗹𝘆 𝘄𝗼𝗿𝗱 𝘁𝗵𝗮𝘁’𝘀 𝘁𝗿𝘂𝗹𝘆 𝘁𝗿𝘂𝘀𝘁𝗲𝗱 𝗶𝘀 𝘁𝗵𝗮𝘁 𝗼𝗳 𝗼𝘁𝗵𝗲𝗿 𝗵𝗲𝗮𝗹𝘁𝗵 𝘀𝘆𝘀𝘁𝗲𝗺𝘀 - 𝘀𝗼 𝗳𝗼𝗰𝘂𝘀 𝗼𝗻 𝗺𝗮𝗸𝗶𝗻𝗴 𝗵𝗲𝗮𝗹𝘁𝗵 𝘀𝘆𝘀𝘁𝗲𝗺𝘀 𝘀𝘂𝗰𝗰𝗲𝘀𝘀𝗳𝘂𝗹. Early on I thought my job was to be the biggest mouthpiece for the company - get on every stage possible to preach the vision and success of the company - I mean, isn’t that what happened in every other tech industry? In Healthcare, it’s the complete opposite - vendors on stage are distrusted. Evidence they share is picked apart, even if it’s evidence developed independently by reputable healthcare organizations. The most powerful marketing occurs when your health system customers, on their own, present, publish and share their success with you. And the best way to make that happen is to focus on making them successful. The challenge? This takes TIME - often a year or two or more - if ever. *** Reflecting on these, the common themes are Resilience and Patience. There’s no secret formula. No magic framework. It’s simply caring about solving the problem more than anyone else, and having the fortune of finding brilliant teammates who care just as much.

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FORCING CHANGE IN SITE OF CARE McKinsey & Company's recent paper on the forces pressuring healthcare, including the possibility of margin compression of up to 13 percentage points for health systems, does a good job of putting numbers around what most operators already feel. Two of the biggest drivers they mention are policy shifts in reimbursement and rising utilization driven by an aging population. The cohort of 70+ year old Americans will grow the fastest over the next 5 years, and it is well established that older patients have more complex needs, more chronic disease, and more touchpoints within the healthcare system. Layer that on top of continued clinical workforce shortages, and the supply-demand gap widens further. From my perspective, optimizing for site of care is the most important lever we have to address this challenge. We can’t quickly reduce how much care older patients need, but we can change where and how services are delivered. Supporting aging patients in lower-cost settings like the home, ambulatory sites, and virtual environments is no longer just a preference or convenience, it’s a necessity. This is where the conversation around site-neutral payments becomes so relevant. CMS is moving quickly in this direction, and hospital outpatient departments (HOPDs) are squarely in the crosshairs. The shift will undoubtedly clamp down further on hospital margins, but it shouldn’t be surprising. We’ve been talking about the demise of HOPD reimbursement for years, and the health systems that will fare best are the ones who are working towards aligning their approach with where patients can be treated safely, efficiently, and at lower cost, rather than relying on legacy reimbursement structures to fill the gap. And just like it doesn’t make sense to try to replicate a hospital or nursing home environment in a patient’s home, we also shouldn’t try to carry the same clinical staffing model into every care setting. Yes, there are non-negotiables when it comes to patient safety and clinical expertise, but there’s also a meaningful opportunity to rethink how teams are built. That means clinicians at every level working at the top of their licenses, thoughtfully involving family members and community resources, and using technology to surround these sites of care with non-clinical operational support. From my health system days, I understand why rising costs, margin pressure, and site-neutral payments feel like threats. While painful, I’m hopeful they can also serve as a positive forcing function, pushing us toward care models that are better aligned with our aging population and the realities of today’s workforce.

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