Doug Klinger

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.

23

1 Comment

Longevity isn’t about living longer at any cost, it’s about living better for longer. Yet, the gap between healthspan and lifespan in the US is the highest in the world and has grown to over 12 years. This gap is 29% higher than the global average and means that, in general, we are living over a decade of life in a diseased state. I spend a lot of time thinking about how this shift from reactive to proactive care is evolving and what emerging strategies from the elite performance world can be applied to accelerate this transition. The focus becomes less about how long can we live, and more on how long can we maintain strength, cognition, metabolic health, and independence? I’m really looking forward to this conversation with three outstanding people operating in this space. Hope you can join us live, but if not, be sure to register to receive a recording of our conversation. Registration link in comments.

24

2 Comments

Transforming healthcare with AI requires industry. Industry requires capital investment. Capital investment requires return. Return requires revenue. Revenue requires reimbursement. Medicare (and transitively private insurance) reimbursement policy for clinical AI will define the incentives for the technologies we build and deploy over the next decade. Our existing fee for service codes are what the military would call cost-plus contracting. We pay for every nail, screw, and hour of labor and don't care if that was a good and efficient way to build the tank or not. Our CMS Innovation Center director, Abe Sutton, believes cost-plus is the wrong path for the future of American healthcare. ACCESS and VBC models pay for outcomes. When we have AI that can manage heart failure can we link payment to making people healthier? Doing so would unleash the might of American techno-capitalism on exactly the thing we care about in society, but there are devils in the details.

135

3 Comments

Over the weekend, alongside Sam Ulin of ClearView Healthcare Partners, I discussed how the rise of integrated direct-to-consumer (DTC) models marks a foundational shift for pharma, streamlining access, empowering patients, and redefining how treatments are promoted, prescribed, and delivered.   What started in obesity care is now expanding across therapeutic areas. The momentum is clear that patient-first models aren't just better for patients, they enable faster access and greater innovation.    Read the piece in BioCentury Inc.: https://lnkd.in/ejqJbhJh   #DTC #Innovation #Obesity #Healthcare #PatientFirst

79

2 Comments

The convergence of market pressures alongside emerging technologies presents unique challenges for health plans. With the right convergence of data and technology, the top five challenges health plans face can be turned into opportunities for growth. Learn how health plans can turn challenges into opportunities and future-proof their business in our latest white paper, Converge without Limits: https://ow.ly/3YBK50W1xhB

52

1 Comment

More data in health care does not always mean better outcomes. Most consumer data only appeals to the worried well, without considering the downstream impact on the health system. Real change requires real ROI - justified reimbursement, workflow changes, and overall cost reduction. Data is only valuable when it changes behavior, not just for patients, but for payers and providers too. The founders who win will connect consumer insight to system economics, where the real leverage lives.

21

1 Comment

𝗣𝗿𝗶𝘃𝗮𝘁𝗲 𝗘𝗾𝘂𝗶𝘁𝘆 𝗗𝗼𝘂𝗯𝗹𝗲𝘀 𝗗𝗼𝘄𝗻 𝗼𝗻 𝗦𝗲𝗹𝗲𝗰𝘁 𝗛𝗲𝗮𝗹𝘁𝗵𝗰𝗮𝗿𝗲 𝗦𝗲𝗰𝘁𝗼𝗿𝘀 Healthcare private equity deal activity grew about 10% in 2025 to roughly 747 deals, with investors expected to accelerate activity as regulatory and policy uncertainty clears. Investment concentrated in specific areas:  • 𝗔𝗺𝗯𝘂𝗹𝗮𝘁𝗼𝗿𝘆 𝘀𝘂𝗿𝗴𝗲𝗿𝘆 𝗰𝗲𝗻𝘁𝗲𝗿𝘀: health systems deploying capital for expansion  • 𝗦𝗸𝗶𝗹𝗹𝗲𝗱 𝗻𝘂𝗿𝘀𝗶𝗻𝗴 𝗮𝗻𝗱 𝘀𝗽𝗲𝗰𝗶𝗮𝗹𝘁𝘆 𝗽𝗵𝗮𝗿𝗺𝗮𝗰𝘆: deal growth up 143% and 138%, tied to aging demographics  • 𝗢𝗻𝗰𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗺𝘂𝘀𝗰𝘂𝗹𝗼𝘀𝗸𝗲𝗹𝗲𝘁𝗮𝗹 𝗰𝗮𝗿𝗲: viewed as strong near-term opportunities  • 𝗚𝗮𝘀𝘁𝗿𝗼𝗲𝗻𝘁𝗲𝗿𝗼𝗹𝗼𝗴𝘆: slowed due to uncertainty around GLP-1 impact on long-term demand Overall, capital is shifting toward services aligned with aging populations, site-of-care migration, and specialty drug economics rather than broad provider rollups.

6

2 Comments

Happy to share HealthStream Ventures’ latest industry analysis: The 2026 Dental Technology Landscape: Cloud, AI, and the Economics of Modern Practice Management. In today’s dental market, technology decisions are no longer IT decisions—they’re enterprise decisions. We’re seeing them surface earlier in diligence, influence post-close execution, and increasingly affect scalability, margin durability, and exit readiness. Legacy systems are becoming a silent tax on growth. This report examines how rising overhead, labor constraints, and ongoing consolidation are colliding with outdated practice management platforms—and why modern systems are now core operating infrastructure for DSOs and doctor-led organizations alike. If you’re an investor, operator, or industry partner thinking about growth, integration, or long-term value creation, this shift deserves attention. #DentalIndustry #PrivateEquity #EmergingDentalGroups

19

Former Drawbridge Health CEO Launches Manifold Health AI at JPM to Build the First Digital Health Index Twin for Chronic Disease. SAN FRANCISCO, Jan. 13, 2026 /PRNewswire/ -- Manifold Health AI today announced its launch at JPM Healthcare Week and the GMT MedTech Symposium, unveiling a first-to-market platform that combines a novel, precision-designed blood test with an AI-driven Digital Health Index Twin to translate biological data into financial risk intelligence for healthcare infrastructure. The announcement was delivered by Manifold's Founder and CEO, Jerome Scelza. This will fundamentally change health risk management, improve health outcomes, and make healthcare affordable again. For the complete press release: https://lnkd.in/e9NsnRiT Message me if you would like to know more!

5

Nice quote from one of our Partners Andrew Brackin in TechCrunch: “This was one of the biggest use cases of ChatGPT,” Andrew Brackin, a partner at Gradient who invests in health tech, told TechCrunch. “So it makes a lot of sense that they would want to build a more kind of private, secure, optimized version of ChatGPT for these healthcare questions.” https://lnkd.in/gY3TV5VD

27

1 Comment

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

79

6 Comments

AI is starting to make its way into advance care planning, as highlighted in Hospice News recently: http://bit.ly/3JjKNK0. Healthcare leaders need to be aware of both its potential and limits. AI can help teams identify patients earlier, ease documentation burdens and personalize outreach. Used wisely, it can give clinicians more time to focus on what matters most: meaningful conversations with patients and families. But technology can’t replace the human touch. We need strong guardrails around privacy, bias and transparency, plus clear clinician oversight. Any AI tool should support, not lead, the conversation. We must put ethics and equity at the center of piloting and adopting AI. The future of advance care planning should use AI to augment the human element rather than replacing it. #hospice #palliativecare #AI #advancecareplanning #healthcareinnovation #leadership

39