a16z Bio + Health’s Post

This is such an important message from Julie Yoo. If you are a startup operating in the Medicare, Medicaid, or Marketplace sectors, you cannot afford not to look at the impact that regulations will have on your business. Right now, there are more changes in flight than there have been in years, and almost every change will impact the startup world. Embracing the overarching theme of where regulations are heading and paying meticulous attention to the actual details can be a strategic move for your startup. By aligning with the theme, you are more likely to find opportunities within the details that can benefit your business. Understanding the implications of the regulations coming out from CMS, FTC, and the White House is crucial. By identifying the common threads, you can better prepare your startup for the potential impacts. Here are a couple of areas that I am seeing as important to pay attention to: 1. If you do not measure the efficacy of your product in improving health outcomes for diverse populations, you risk being regulated out of business. 2. If you don't have strong controls and a priority on consent for data sharing of a member/patient, you are likely going to experience pain and/or lack of ability to get contracts. 3. If you were a nice-to-have for a health plan but were not seeing much adoption by members, you are at risk of being dropped as a benefit. You need to show that you understand where your product sits within this shifting landscape and a product sitting on the shelf is going to get dropped. 4. With shrinking budgets, you need to be able to show a clear financial ROI for your customers if you are going to stay in contract. It's essential to understand that health plans and providers are testing numerous AI products. To secure a long-term contract, it's not enough to have a pilot contract. You must clearly describe your model, demonstrate your commitment to addressing bias, and pay attention to the points above. This responsibility lies with you, and it's crucial for the future of your startup. 6. For a while, it felt like a number of startups were helping groups "game the system." We saw startups focused on things like upcoding, using AI for claims denials, or venture-backed brokerages overselling their capabilities. These types of companies are a risk for venture capital and ultimately will be either regulated into compliance or face serious fines. I 100% believe that regulations hint at what is to come, and if you read the tea leaves, you can improve the system and continue to thrive. In our industry, it is critical for all stakeholders to get back to looking at solutions that will provide long-term solutions to healthcare issues and not just be a quick path to making money but ultimately not provide long-term value.

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that? Cheryl Pegus sits down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of the McKinsey Health Institute's #ConversationsOnHealth series, in partnership with the McKinsey Institute for Black Economic Mobility. #HealthEquity #EconomicMobility #GlobalHealth

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that? Cheryl Pegus sits down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of the McKinsey Health Institute's #ConversationsOnHealth series, in partnership with the McKinsey Institute for Black Economic Mobility. #HealthEquity #EconomicMobility #GlobalHealth

The topic of health equity has long been discussed within the healthcare industry, but it’s only recently that we have seen significant changes. These shifts have often been precipitated by macro events that have exposed the inadequacies in our system, such as restricted access to women’s healthcare and the unequal handling of the COVID-19 crisis. While these events have served as a catalyst for reform, they pose an important question: Why must we wait for a crisis to take action? Take, for example, the issue of diversity in clinical trials. This has been a widely recognized need, but it wasn’t until regulatory bodies like the FDA enforced it that we saw substantial compliance. 🔈- Stephanie Jones #healthequity #healthcare #medtech #medicaldevices #medicaldevice

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that? Cheryl Pegus sits down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of the McKinsey Health Institute's #ConversationsOnHealth series, in partnership with the McKinsey Institute for Black Economic Mobility. #HealthEquity #EconomicMobility #GlobalHealth

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that? Cheryl Pegus sits down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of the McKinsey Health Institute's #ConversationsOnHealth series, in partnership with the McKinsey Institute for Black Economic Mobility. #HealthEquity #EconomicMobility #GlobalHealth

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that? Cheryl Pegus sits down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of the McKinsey Health Institute's #ConversationsOnHealth series, in partnership with the McKinsey Institute for Black Economic Mobility. #HealthEquity #EconomicMobility #GlobalHealth

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that? Cheryl Pegus sits down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of the McKinsey Health Institute's #ConversationsOnHealth series, in partnership with the McKinsey Institute for Black Economic Mobility. #HealthEquity #EconomicMobility #GlobalHealth

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that?   Cheryl Pegus recently sat down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of our #ConversationsOnHealth series, in partnership with the  McKinsey Institute for Black Economic Mobility: https://lnkd.in/eWHx_Pad   #HealthEquity #EconomicMobility #GlobalHealth

Zip code can be as big a factor as genetic code when it comes to health. What will it take to change that? Cheryl Pegus sits down with Melvin Mezue to discuss the business case for health equity, the future of healthcare, and the value of diversity at the business table for successful innovation and investment. Learn more in this joint edition of the McKinsey Health Institute's #ConversationsOnHealth series, in partnership with the McKinsey Institute for Black Economic Mobility. #HealthEquity #EconomicMobility #GlobalHealth