Why did you decide to expand your medical and academic career into the private sector?
Being at the forefront of change in health care in the U.S. means engaging with venture capital and the startups that are driving that change.
Academic research and public policy development have a tremendous impact, but we are now at a moment when the private sector is responding quickly and leading significant health care changes. The sector is at an inflection point, driven by recognition of the importance of chronic illness and the inefficiency and low value of much of health care, combined with important changes in payment.
The private sector is leading that response, and to be engaged and help shape change requires working in the private sector—specifically in venture funds. That’s what attracted me to Oak HC/FT, which has been at the forefront of innovation in health care for over 15 years and has a peerless team under the leadership of Annie Lamont and Andrew Adams.
What areas of healthcare are generating the brightest opportunities currently?
Fully 84% of all health care spending in the U.S. goes toward chronic illnesses. Within that, some of the most important areas of spending include behavioral health and end-of-life care.
For instance, behavioral health—care for patients with depression, anxiety, and serious mental health problems such as schizophrenia or bipolar disorder—is the fourth largest area of health care spending. Chronic care, behavioral health, and end-of-life care have traditionally been ignored by medicine, but they are among the most important areas of opportunity. So, the areas with the best opportunities happen to be the same areas that have been at the margins for the last 70 years, yet command some of the most health care resources.
What are some of the companies you are working with?
I work closely with Annie, Andrew, and the Oak HC/FT team across several areas, especially advising existing portfolio companies as well as opining on prospective investment opportunities.
Chronic care, behavioral health, and end-of-life care are the areas where I am particularly active, so I tend to spend the most time with Oak HC/FT portfolio companies within these areas.
Village MD, which provides primary care solutions, is a company I have profiled in my book, “Prescription for the Future,” and I serve on its Board. It has some important innovative practices other physician groups can learn from, such as its programs on rooming patients and home care.
Similarly, I am working with Quartet, a mental health company that is trying to develop what I think of as a virtual collaborative care model to link physicians and their patients with behavioral health specialists. Interestingly, it is also trying to bring performance evaluation to mental health, which has not happened previously.
I am also working with Aspire, a palliative-care company that is trying to put into place all the recommendations on improved end-of-life care that the medical establishment has never been able to implement. I started my career working on end-of-life care when it was not fashionable; not even a recognized area of research. Over the years, the field has developed important ideas on how to improve care for patient likely to die. For instance, focusing care on patients not just in the last days of life but beginning palliative care earlier to elicit preferences for end-of-life care and handling symptoms months, if not a year, before they die. This makes the transitions to the dying process much less abrupt and gives time for the patient to adjust and acclimate to dying at home. But such recommendations have rarely been widely implemented. Aspire is dedicated to bringing these optimal end-of-life care practices to patients. We are working with them to analyze and publish their data on quality and on cost savings.
These are a few of the interesting companies I am involved with through Oak HC/FT.
What is “Prescription for the Future” about?
The subtitle for the book gives a clear picture of the book’s subject: The 12 transformational practices of highly effective medical organizations.
The premise of the book is that the U.S. health care system is going to have to change to deliver higher-quality and lower-cost care consistently. So, I went about examining outstanding medical organizations—from smaller physician practices to larger multi-specialty groups to Medicare Advantage plans to whole-health systems—to elucidate what they did to deliver high quality and reduce cost.
We identified 12 different practices ranging from changing scheduling to chronic care coordinators to community health workers, which are key to transforming care delivery to consistently higher quality and lower cost. In the book, I delineate the specific steps medical organizations can take to implement these practices successfully. For instance, I found all groups that achieved successful chronic care management followed the same five basic steps. This leads me to be optimistic that over the next decade the U.S. can achieve much better care, especially for patients with chronic illnesses.
Importantly, we found that no single medical organization did all 12 transformational practices. So, even among the very best practices in the U.S. there is still room for significant improvement.
If you were to triage the industry, what would you prescribe as the most urgent and critical care priorities?
The single most important pre-requisite for transformation is payment change. Physicians, hospitals, health systems, and all the other providers need to be incentivized to change how they deliver care–to focus on higher quality and lower cost. This requires moving away from fee-for-service payment toward what are called alternative payment models, such as bundled payments for an episode of care or capitation. Fortunately, this is happening—especially through MACRA, the new health care bill that changes how physicians are paid, and through payment changes being implemented by private insurers.
A second important prerequisite is data on where physicians are using resources and the outcomes of their patients. One of the biggest changes since the managed care efforts of the 1990s is that the U.S. system has a lot more data on the performance of the system and physicians to guide transformation.
I lay out several other important pre-requisites in the book, such as leadership and governance. I note that no medical organization can implement 12 transformational practices all at once. So, I indicate a few tiers of practices.
The top priorities and most urgent transformational practices to implement are: 1) open-access scheduling; 2) chronic care management and co-locating chronic care coordinators with physicians; 3) performance measurement and improvement, so physicians and other providers can see how they are performing relative to national benchmarks and their local peers from whom they can learn; and 4) site of service to create referral relationships with other higher value specialists and hospitals.
Can transformation occur despite the current political impasse and efforts to repeal the ACA?
As I note in the book, almost everyone in the health care system thinks transformation is inevitable. For one thing, private payors and the public are demanding more affordable care regardless of the status of the ACA. This will drive transformation.
Much of the drive or pre-requisites also go beyond the ACA in terms of changes in government payment to physicians through MACRA, the Medical Advancement, and CHIP Reauthorization Act. MACRA abolished the failed Sustainable Growth Rate (SGR) formula for adjusting Medicare payments to physicians. It was replaced with payment that incentivizes physicians to shift off fee-for-service payment to more alternative models. Regardless of what happens to the ACA, MACRA will stay and push the transformation I described.
What is high value care and how do we achieve it?
High value care is composed of two parts: higher quality of care and lower costs. We achieve it by improving the health care delivered to patients and lowering the costs of delivery.
As I mentioned, 84% of all health care spending is devoted to chronic illness. In addition, 10% of patients with chronic illness account for nearly two-thirds of all spending. So, if we want to improve quality and lower the cost of care we need to improve the care of patients with chronic illnesses. That means we must prevent the exacerbations of chronic illness: prevent patients with congestive heart disease from gaining too much fluid and developing extreme shortness of breath; patients with chronic obstructive pulmonary disease—emphysema—from becoming short of breath; patients with diabetes from developing infections and gangrene; mitigating the side effects cancer patients develop from chemotherapy.
This is the key, and the key to achieving this is identifying the high risk 10% of patients, having chronic care coordinators co-located with physicians actively reaching out, and managing these patients by ensuring they are taking their medicines and following other recommended interventions. It also requires standardizing care so patients are receiving the best care as defined by the best physician experts on these diseases.
Medical organizations that follow these and other care practices can achieve high value care, typically by lowering visits to the emergency room and hospitalization rates by up to 40%.
What are some of the most notable advances you are seeing around care delivery and patient experience?
What makes me optimistic is that there are so many advances being tried and constantly improved by different medical organizations.
One critical improvement is open-access scheduling. This means physicians start every day with between 20% and 50% of their appointment slots open—i.e. unscheduled. So, if a patient develops a problem they can be seen in the office that same day and treated by someone who knows them and their entire medical condition, instead of being sent to an emergency room where they are treated by someone who does not know them or their medical problems. This also enhances patient satisfaction.
Another important advance is for patients with high social needs and few social supports–poorer patients often on Medicaid. Having effective community health care workers is a huge advance. These health care workers find out what these patients need and want, and then help them obtain services and social connections. They help patients get housing, food, job training and jobs, or just find activities, like bowling and sports, that connect them and bring them some joy and happiness. These community health workers become social supports for the patients. And this frequently reduces use of the health care system for what are otherwise social support problems—lowering hospitalization rates and other uses of the system.
Similarly, adding behavioral health to regular medical care is a fundamental advance we will see more of in the next few years. Patients with chronic illness who have co-morbid depression or anxiety are so much more expensive to care for. Important advances are efforts to provide these patients mental health services that are integrated with their regular care. When done well, this helps patients overcome their depression or anxiety and thereby lowers their use of health care services and costs. It is a classic win-win situation.
I could go on and on because the book is filled with scores of these advances being implemented by different medical organizations.
How do you escape work and clear your mind?
I don’t know about escaping work and clearing my mind. I find that when I am relaxing I am often thinking about work on another level.
I love to run, bike, and kayak. Recently, I spent three days navigating 50 kilometers by kayak in the Norwegian fjords around Alesund. The area has some of the most magnificent scenery in the world. Two weeks later, I biked 65 miles from Harper’s Ferry to Washington D.C. I learned a lot about the John Brown raid of 1859 on that trip.
I am about to embark on another fun project: making a world-class chocolate bar. I am partnering with a chocolatier and we are traveling to Madagascar to procure beans, and then will go into the lab and make a fantastic chocolate bar. That will be super fun.
I also love to cook. A few years ago, I was a chef at a pop-up brunch restaurant. That is hard work but fun. I love to throw dinner parties and make new dishes.
I am also an avid reader. My brother, Rahm, and I trade titles we have read. We both love history books as well as great novels. I just finished “The Good Lord Bird” by James McBride about the John Brown raid. I am reading John Steinbeck’s “East of Eden”, and just started the book about Winston Churchill, “Hero of the Empire”.
One day I want to write a history book of a great, but forgotten American physician and revolutionary war hero, Joseph Warren.
We are a software company that helps scientists generate insights that improve human health and our quality of life. Scientific research and clinical testing generate huge amounts of data that need to be collected, organized, and analyzed. We give scientists a cloud-based platform that helps them gather and analyze that data more efficiently to identify everything from new therapeutics to treat or cure disease, to new sources of renewable energy and improve food supply.
Laboratories are traditionally a place for instruments and research. How is technology now playing a role in the way labs and research are managed?
Today, scientific organizations are dealing with several significant changes, which we call the biopharma nexus of forces. For example, the growing use of next-generation sequencing technology to drive precision medicine and targeted therapeutics, or the increasing practice by large companies to use third-parties for their research and development.
Historically, many challenges were addressed with point products, but those products are not designed for the new research modalities and business models we see today. Fortunately platforms can be leveraged to provide a much more efficient and scalable approach. That’s what we’re doing in the scientific domain: leveraging lessons learned from other enterprise software verticals and companies – for example, pioneers like Salesforce.com – and bringing a platform-based model to the scientific community to help them navigate the changes they’re experiencing.
Core’s products apply to a diverse range of industries – from pharma to food to manufacturing. What challenges do these industries all have in common that you can address?
All those different industries rely on the same scientific principles, grounded in chemistry and biology. That is critically important. At an abstracted level, they all conduct research and development in similar ways: conducting experiments; generating samples; moving those samples through a workflow; and analyzing the results to inform decision-making.
Our platform is designed with that abstraction in mind, which gives us the flexibility to serve multiple markets.
You were recently acquired by Thermo Fisher Scientific. What drove the decision to sell?
Thermo Fisher Scientific is the world-leader in serving science, and they have relationships with just about every scientific organization in the world. The acquisition immediately expanded the ability for us to bring our platform to the market. More strategically, Thermo Fisher seized the opportunity to leverage our platform to help drive its strategy to become the leading digital science company in the world, and to dramatically increase automation, efficiency, and productivity for their clients. We’re incredibly excited to be helping craft and execute such an ambitious and important long-term strategy.
It’s also important that being part of such a large company increases our access to talent as we continue to grow our team, and provide greatly expanded career paths for our current team, which we’re very excited about.
You come from a corporate background, having previously worked at IBM in various roles spanning technology, finance, and strategy. How did you make the leap from a major multinational to a smaller, startup company?
In many ways, the change from a large multinational to a startup is less than one might expect. The principles about how to build a team, how to drive solid execution, and how to deliver financial results are very similar.
One big difference is not having all the big-company resources and infrastructure at your disposal. Similarly, it is important to embrace the challenges of wearing many hats, including constantly needing to learn new things, and coping with the extra stress of running a small business.
You ran for public office right out of undergraduate school. Are you still interested in public service? What do you think public office has in common with leading a company?
My interest in public service lies in my continuing belief that there’s a real need to reinvent how government operates and the role it can play in driving economic development and providing a safety net for people who are displaced by the rapid pace of change in our economy.
There are many more stakeholders and constraints to deal with in public service, but I think there are similarities, including the importance of being bold in setting your goals and strategy, challenging the status quo of how things are operating today, and inspiring people to help drive necessary changes.
If I weren’t a CEO I would be…
Involved in public service; likely not running for office again, but trying to help solve critical challenges we are facing, specifically in Connecticut. I love this state. I think it’s a fantastic place. But clearly, we have some challenges at the state level that would be fun to try to help solve.
What’s on your desk right now?
Very little. I believe less is more, so I keep a very clean desk. I have a MacBook, a cup of coffee, and my phone. That’s it.
What is your favorite source for news?
Recently, Twitter has become my favorite source for news. I think if you curate a good cross-section of people and publications, you can follow the twitter feed and stay abreast of what’s going on in the world, as well as other interesting reports and topics.
What’s a great piece of professional advice you’ve received?
Don’t be afraid to take big risks. I think entrepreneurs are the people who drive the bulk of the innovation and forward progress that we enjoy as a society, and it’s been a great experience being part of our Core journey with our cofounders, Anthony Uzzo and Jim Gregory, who quit their jobs started this company in a garage in back of the local Stop and Shop 13 years ago. Risk taking is central to our company’s success, and our success in society broadly.
What one piece of advice would you offer to an entrepreneur?
If I picked just one, it would be to be in touch with customers. If you understand your customers – what’s important to them; what their priorities are; and how you can best help address the pain points – that’s how you learn and improve and help build a successful business.
Here’s our view from the room where Oak HC/FT II happens:
A couple months ago, we began raising our second fund to further our efforts around partnering with promising tech-enabled Healthcare and FinTech companies. Today, we’re announcing the launch of this $600 million fund to continue supporting leading entrepreneurs with their attack on quality issues, inefficiencies, and poor customer experiences that persist across the multi-trillion-dollar Healthcare and Financial Services markets.
Instead of waiting for elected leaders in Washington to advance legislation around these two important sectors, we’re working with the most promising private enterprises to tackle the biggest issues head on –high drug costs, treating patients with complex medical conditions, modernizing payment systems and insurance frameworks, and reducing financial fraud/waste/abuse. Complexity is an understatement in Healthcare and FinTech, but challenge ignites the spark of so many opportunities. We’re confident our approach and the strategies of our companies will prevail regardless of political agenda or regulation.
When we founded Oak HC/FT three years ago, our mission was to build on our 15 years of experience and partner with world-class entrepreneurs using technology and data to tackle complex problems in Healthcare and Financial Services. That’s exactly what we achieved with our first fund, having backed leading companies like Aspire Health, Hometeam, and VillageMD that are improving medical care and reducing spending; Quartet Health, US HealthVest, and Axial that are better managing high-cost populations; Limeade, LDI, and Maestro Health that are improving health and spending for employers; Feedzai that uses machine-learning to reduce financial fraud; Poynt, Urjanet, and FastPay that are streamlining payment data and processing; and Trov and Insureon that are modernizing insurance delivery. With our second fund, we will continue searching across the United States and Europe to identify attractive opportunities that advance our mission in these sectors.
In addition to working with great entrepreneurs, we’ve also been fortunate to partner with talented colleagues. Since closing our first fund in 2014, we’ve assembled an amazing team of professionals to provide unparalleled support to our companies. In Healthcare, we added Dr. Zeke Emanuel, Nancy Brown, and Chris Price who all bring peerless industry expertise. That talent has been matched on our FinTech team with Anil Aggarwal, Jonathan Weiner, and Michael Heller. Add-in our long-time Technology Partner, David Black, and our next generation of professionals in Matt, Vig, Oivind, Jack, and Andy, and it’s tough for any entrepreneur to find a team better equipped to scale Healthcare and FinTech businesses and solve problems.
We are also fortunate to have assembled an exceptional group of investors – many long-time supporters of our strategy and a few new relationships that offer fresh perspectives and strategic insights.
In short, we’re bent on building strong teams and great companies. It is especially rewarding to see the businesses we’ve worked with in the past continue their growth – either as public companies or as innovation engines for larger companies, as evidenced by our recent exit, Core Informatics.
Creating Oak HC/FT and growing the firm has been an absolute blast. There is nothing better than waking up every morning to work with our unmatched team and exceptional entrepreneurs – all passionate about improving Healthcare and Financial Services. Building a portfolio and helping our companies and investors succeed will always be an adventure. We are excited to continue this journey, and we are grateful to our investors for their support with today’s Oak HC/FT II fund launch.
This originally appeared on NVCA’s website on March 8, 2017
MENLO PARK, CA – The National Venture Capital Association (NVCA) today honored leaders of the venture capital industry at the annual NVCA Leadership Gala for their significant contributions to advance innovation, strengthen the industry and promote entrepreneurship. In addition to the Lifetime Achievement in Venture Capital Award, Outstanding Service Award and American Spirit Award, NVCA added three new categories to the lineup this year, including the Rising Star Award, the Excellence in Healthcare Innovation Award and the Venture Firm of the Year Award.
The 2017 award recipients and winners include:
Lifetime Achievement in Venture Capital – Bill Draper, General Partner at Draper Richards
Outstanding Service Award – Ross Jaffe MD, Managing Director at Versant Ventures
American Spirit Award – Ray Leach, CEO at JumpStart Inc.
Rising Star Award – Kristina Shen, Vice President at Bessemer Venture Partners
Excellence in Healthcare Innovation – Annie Lamont, Managing Partner at Oak HC/FT
Venture Firm of the Year – Emergence Capital
About the Awards
Lifetime Achievement in Venture Capital Award
The Lifetime Achievement in Venture Capital Award was created to recognize venture professionals who have dedicated their professional lives to creating and building successful and highly competitive venture firms as well as portfolio companies that have made a significant contribution to the growth and success of the U.S. economy. Recipients of the Lifetime Achievement Award were instrumental in the formation and growth of the venture capital industry and have consistently set high performance standards for the entire industry.
Previous recipients: Chuck Newhall, Mike Moritz, Mark Heesen, Arthur Rock, Sam Colella, Felda Hardymon, James Blair, Brook Byers, Jean Deleage, Anthony Evnin, Grant Heidrich, Jim Swartz, Bill Hambrecht, Sandy Robertson, Thomas Weisel, Edward Glassmeyer, Peter Crisp, Henry McCance, Paul Wythes, Lionel Pincus, Pitch Johnson, Richard Kramlich, Stanley Golder, Burton McMurtry, Reid Dennis, Peter Brooke, Thomas Perkins, Stanley Golder and David Morgenthaler.
Outstanding Service Award
The Outstanding Service Award was created to recognize the exceptional service of an NVCA Director or NVCA member who has committed an extraordinary amount of time, resources and dedication to Association efforts that in turn benefits the entire venture industry. The dedication has raised the visibility of the industry to key legislators and regulators and helped to educate them regarding the pivotal role of venture capital to this economy.
Previous recipients: Diana Frazier, Josh Green, Kate Mitchell, Steve Frederick, Ted Schlein, Warburg Pincus, Jack Lasersohn, Sarah Reed, John Martinson, Robert Pavey, Rodney Goldstein, E. Roe Stamps, M. Kathleen Behrens, Steven Lazarus, Harry T. Rein, Patricia Cloherty, John Doerr and Christopher Brody.
American Spirit Award
The American Spirit Award was created to recognize NVCA members who have shown philanthropic leadership by applying business skills, knowledge, expertise and resources to make an outstanding contribution to society.
Previous recipients: Jeff Fagnan, Robin Richards Donohoe, William Sahlman, Peter Bancroft, Chuck Newhall, Joe Aragona, Ewing Marion Kauffman Foundation, John Doerr, Alan Patricof, William Bowes, Peter Wendell, Floyd Kvamme, William Draper III, Martin Koldyke and Gib Myers.
Rising Star Award
The Rising Star Award was created to recognize the next generation of venture capital professionals who are rising through ranks and establishing themselves as future standard bearers of the industry. Recipients of the award have demonstrated a mastery of venture capital investing gleaned through a relatively short amount of time in the industry and are widely recognized by their peers and others as emerging leaders of the venture capital industry.
Previous Recipients: NA
Excellence in Healthcare Innovation Award
For over three decades, venture capital has been at the forefront of some of the greatest advancements in medicine, pushing the boundaries of medical innovation and spurring the creation of the biotechnology and medical device industries. The Excellence in Healthcare Innovation Award was created to recognize those who have demonstrated a clear commitment to the advancement of healthcare innovation through their investment in and support of groundbreaking medical companies that are working on treatments and cures for the most deadly and costly diseases.
Venture Firm of the Year Award
The Venture Firm of the Year Award was created to recognize venture capital firms for their significant contributions to advance the entrepreneurial ecosystem and generate returns for their investors. Firms receiving the award are recognized for strong fund performance and high exit multiples for recent exits.
WALTHAM, Mass. & BRANFORD, Conn.–(BUSINESS WIRE)–Thermo Fisher Scientific Inc., the world leader in serving science, today announced that it has acquired Core Informatics, which provides a leading cloud-based platform supporting scientific data management. Core’s offerings will significantly enhance Thermo Fisher’s existing informatics solutions and complement its cloud platform, which supports the company’s genetic analysis, qPCR and proteomics systems.
Core’s capabilities include laboratory information management systems (LIMS), electronic laboratory notebook (ELN) technologies and scientific data management solutions (SDMS). The business also offers an Application Marketplace to speed deployment and increase value for customers across a broad range of industries and scientific workflows. Core Informatics’ state-of-the-art laboratory data-management solutions are used by leading biopharma, genomics and other scientific and industrial organizations.
“The scientific community is rapidly adopting cloud-based laboratory and scientific data management capabilities,” said Thomas Loewald, senior vice president and chief commercial officer, Thermo Fisher Scientific. “Integrating the leading technologies of Core Informatics is part of our strategy to set the standard for digital science solutions, from life sciences discovery to applied markets and manufacturing.”
“We are thrilled to join the Thermo Fisher Scientific team to help accelerate the future of the digital lab,” said Josh Geballe, chief executive officer, Core Informatics. “We are excited to become part of the world leader in serving science and look forward to the additional benefits this will bring to our innovative clients and amazing team.”
About Core Informatics
Core Informatics partners with customers in biopharma, genomics, and other industries to deliver lab informatics solutions to derive more value and insight from their scientific data. Core Informatics provides the scalable and extensible Platform for Science that enables customers to quickly and easily build workflows to meet their specific needs and add capabilities as they grow. Based in Branford, Connecticut, Core Informatics has been recognized numerous times as one of the fastest growing private companies in the United States and as one of Connecticut’s best places to work. For more information, please visit http://www.coreinformatics.com
About Thermo Fisher Scientific
Thermo Fisher Scientific Inc. is the world leader in serving science, with revenues of $18 billion and more than 55,000 employees globally. Our mission is to enable our customers to make the world healthier, cleaner and safer. We help our customers accelerate life sciences research, solve complex analytical challenges, improve patient diagnostics and increase laboratory productivity. Through our premier brands – Thermo Scientific, Applied Biosystems, Invitrogen, Fisher Scientific and Unity Lab Services – we offer an unmatched combination of innovative technologies, purchasing convenience and comprehensive support. For more information, please visit www.thermofisher.com.