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Angel Capital Association keynote - April 2017

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Dave Chase keynote at the Angel Capital Association

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Angel Capital Association keynote - April 2017

  1. 1. HEALTHCARE COLLATERAL DAMAGE $1M LESS SAVED FOR RETIREMENT BY AVG BABY BOOMER FAMILY DUE TO 20+ YEAR WAGE STAGNATION/DECLINE 70% OF AMERICAN HOUSEHOLDS HAVE LESS THAN $1K IN SAVINGS
  2. 2. LARGEST GENERATION IN HISTORY (MILLENNIALS) SLATED TO SPEND > HALF OF LIFETIME EARNINGS ON HEALTHCARE MEDICARE TAXES & PREMIUMS DEDUCTIBLES & OUT-OF-POCKET EXPENSES INSURANCE PREMIUMS EMPLOYER PREMIUMS EMPLOYER MEDICAID TAXES FEDERAL & STATE TAXES VISIBLE PAYMENTS $.6M HIDDEN PAYMENTS $1.3M + $1.9MGRAND TOTAL TOTAL LIFETIME EARNINGS $3.8M
  3. 3. CATASTROPHIC MISALLOCATION OF RESOURCES +37% HEALTHCARE SPENDING -50% LOCAL AID -31% PUBLIC HEALTH -22% MENTAL HEALTH -14% INFRASTRUCTURE, HOUSING & ECON. DEV. -13% LAW & PUBLIC SAFETY -12% EDUCATION -11% HUMAN SERVICES HEALTHCARE SPENDING DEVASTATES SOCIAL DETERMINANTS OF HEALTH (FY01 - FY14 - STATE OF MASSACHUSETTS)
  4. 4. Care Team
  5. 5. Cost
  6. 6. $500B Annual Citizen-driven Economic Stimulus Stopped: Redistribution from kids, families & businesses to “morbidly obese” healthcare
  7. 7. $3,000,000,000,000
  8. 8. 50+ years of optimizing for flawed financial incentives. Healthcare’s root cause of dysfunction Operational waste Clinical waste Paid for volumeCost-plus models Would be world’s 16th largest economy
  9. 9. Who pays for healthcare $2.7T in annual spending (2014) (excluding pharma) Government 48% Employers 52% ($1.4T) Medicare 24.8% Medicaid 19% Fully insured 19.7% Self-insured 32% Least flexibility Most homogenous Most politicized Most flexibility Least homogenous Least politicized Other 4.5%
  10. 10. $191B Operations waste Fraud Excessive admin costs Unnecessarily high prices 28% of $1.4T is systemic “obesity” $204B Clinical waste Unnecessary services Inefficient delivery Missed prevention $395 B annually in employer segment Individual behaviors like obesity = ~$200B
  11. 11. 1 Improve care team experience Enhance patient experience Improve health outcomes Lower health costs 2 34 Healthcare’s Square Deal: Quadruple Aim
  12. 12. Watch where your insight comes from Beware of throwing tech on top of broken models Status quo business models are highly vulnerable hospitals = newspapers
  13. 13. 98% of Digital Health Startups are Zombies Winners possess: 1)Unique biz model & GTM 2)Experienced, yet unshackled teams
  14. 14. Align investments with biggest opportunities Tech Avoid conflating these tech & model transformations - No/low-touch - Many patients - Payment & ops SaaS, data analysis, etc. Services - High-touch - Fewer patients - Care delivery, ancillary services, benefits, etc. 5% patients 80% costs
  15. 15. Operational Next-gen operations mgmt. & supply chain Disintermediation & financial/clinical integration Reduce pricing failure Full-stack services Enablement High-performance benefits Payment integrity & infrastructure Next-gen networks, esp. primary care & major procedures Clinical Evidence-based care in high-cost specialties Identifying and treating outlier patients Team-based care & next-gen facilities Upstream intervention Key categories that address the largest systemic waste
  16. 16. Twitter/LinkedIn: @chasedave Health Rosetta Institute: www.healthrosetta.org Health Rosetta Group: www.healthrosetta.com The Big Heist: www.bigheistmovie.com

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