Ralph Terkowitz

Distribution is becoming the moat in healthcare AI Anthropic’s recent Claude for Healthcare update was a good example: the main features were not focused on model performance, it was connectivity, making Claude usable inside the healthcare enterprise stack. The main drops were: -> Coverage rules (CMS Coverage Database connector): check whether a treatment is reimbursable and under what conditions -> Coding (ICD-10 connector): translate clinical language into billing/diagnosis codes -> Provider verification (NPI Registry connector): validate provider identity for credentialing and claims -> Prior Authorization Agent: assemble documentation and rationale for approvals/appeals -> Interoperability tooling: make it easier to plug into health IT systems This shift creates real opportunity for founders. Healthcare is fragmented by country, system, and workflow, so teams that can embed applications deeply in specific workflows can build meaningful markets, even from narrow starting points. Source: https://lnkd.in/dFEi8UDP

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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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Check out the first in a series of Town Hall Ventures' perspectives on the potential of AI to improve healthcare in places where it is most needed!

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Intelligent data platforms are the future of the healthcare industry. This compelling acquisition by Ardan Equity portfolio company Datavant positions the company as a continued leader in the sector. Most important are the benefits for life sciences customers and the impact to their pharma portfolios and their patients. Datavant enables more than 60 million healthcare records to move between thousands of organizations, more than 70,000 hospitals and clinics, 75% of the 100 largest health systems, and an ecosystem of 300+ real-world data partners. Always proud to partner with amazing leaders like CEO Kyle Armbrester, Arnaub Chatterjee and the team at New Mountain Capital led by great partner Matt Holt. #healthit #pharmait #lifesciences #digitalhealth #privateequity #mergers #acquisitions #healthcareit #healthcaresoftware #saasgrowth #healthcaredata #data #pharma #pharmadata #dataplatform #privateequity #ai #artificialintelligence #rwe #realworldevidence #rwd #realworlddata

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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.

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AI and Health Tech in Focus   AI Tool Predicts Heart Risks in Routine Chest Scans Researchers at Mass General Brigham working with the US Department of Veteran Affairs have developed a machine learning tool that can detect coronary heart disease from routine chest CT images before symptoms occur. The algorithm was trained on previously collected CT scans (routinely taken primarily to detect lung cancer) to measure coronary artery calcium (CAC) levels at 98 VA medical centers. The CAC scores predicted with 87% accuracy a patient’s risk of future heart attacks. The tool also predictively scored 10-year mortality rates—helping doctors assess cardiovascular risk and recommend early intervention and treatment The researchers note that the data used to train the algorithm was limited to the VA population, but future studies will include the general population as well as an assessment of whether lipid lowering medications proactively lower scores and prevent subsequent long term health risks.    VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark https://mikalventures.com/ for additional insights and information.

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Emerging company profile in BioCentury Inc. on Brandon Capital company ENA Respiratory. Phase 2 Virus-agnostic prophylaxis to prevent respiratory infections.

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For anyone thinking about or building in Health AI, this is a must listen to pod! Eric Larsen is one of the most experienced and thoughtful leaders in our sector. In this week's The Heart of Healthcare Podcast episode, he provides a master class on the opportunities and challenges that this transformative technology poses to innovators and incumbents alike. TowerBrook Capital Partners L.P. Bessemer Venture Partners

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