Who am I? What's #NewHealthcare? And why start this Newsletter?

Thank you for reading #NewHealthcare Insider! In this first newsletter, I would like to tell you a little about myself and why I decided to invest the time creating a newsletter to track and analyze the evolving mobile/retail/home transformation of healthcare. I will also share why I hope you will invest the time reading it.

My name is Sam Basta and I'm an internist. After completing my residency at Eastern Virginia Medical School, I stayed there as an academic internist, completed a graduate degree in medical management at Tulane, and was chief quality officer for a couple of years. I then moved to Sentara Healthcare, an integrated delivery system in Virginia and North Caroline. After a couple of years as a medical director in the health plan division which at the time had 380,000 members, I worked at the system level on Transformation of Care. Some of the projects I helped lead included Patient-Centered Medical Home implementation in 38 primary care practices with 400 providers, Value-Based Care including starting a 2000-provider clinically-integrated network, and integrating chronic care across the system. I then returned to the health plan to lead population health, quality improvement, and value-based reimbursement.

I've always been interested in technological innovation and business transformation which was the reason I started Healthcare Innovation by Design in 2009, a LinkedIn group with almost 19,000 members today. I studied and analyzed closely other industries to learn how technology and new management methodologies improved business performance and the service experience. I've shared some of my learnings and insights on LinkedIn over the years. I have become a strong believer and practitioner of Agile/Scrum in my current work.

The positions I held over the years provided many opportunities to apply innovative technologies, products and services to solving healthcare problems. From starting one of the first anticoagulation clinics with point-of-care testing when the technology first became available as a young academic internist in the late 1990s, to building a Population Care Delivery platform for 1,000,000 members with services spanning home colorectal cancer screening, comprehensive virtual diabetes care, and various population-level interventions that resulted in award-winning clinical outcomes, and tens of millions of dollars in savings. In my current position, I'm building Medicare Special Needs Populations (SNP) plans, and a Population Health Management Service for Medicare Employer Group Waiver Plans (EGWP).

My passion for technology and management innovation led me to invest literally tens of thousands of hours over the years reading and learning. This helped me tremendously in my career. I applied a lot of what I learned to my work. I also evaluated hundreds of technologies, products, and companies from startups to huge multinationals, and from medical devices, to medical services, and software products. I learned that the huge majority of them, despite having great products, had very little knowledge of working in the healthcare industry! So much wasted time, money and talent. I also learned how to find the diamonds in the rough, however. And I helped many of them refine their products and their pitches. I gained some great friends and connections along the way.

After years of working with healthcare innovators and talking to healthcare leaders about innovation, I can confidently says that I've never witnessed anything like the change reshaping healthcare that I see right now! There are three main factors contributing to this state:

• COVID: the pandemic that overtook the globe and shook its economic system to its core has stretched the healthcare system beyond its limit leading to a wave of innovation that transformed the system. One manifestation of that transformation is Telehealth which increased 80 times during the early days of the pandemic and has now stabilized at a 38 fold increase.

• Technology: the rate of technological innovation is accelerating. It used to take decades for significant technological breakthroughs and scientific discoveries. That became years towards the end of the 20th century and early 21st. Today, significant breakthroughs occur in months. The rate of spread of innovation has also been accelerating. There are many reasons for this but cloud computing, wireless networks, mobile devices, DNA sequencing, and most recently artificial intelligence and machine learning are some of the main contributors. I will discuss these technologies in details in future newsletters and outline their impact on healthcare.

• Money: the rate of investment in healthcare innovation is growing exponentially. Venture capital investment in healthcare technology has been doubling annually for the past couple of years. Also large technology companies like Google, Amazon, Apple, and Microsoft have been investing tens of billions of dollars in healthcare. Amazon's recent purchase of OneMedical for $3.9 billion is just one of the latest examples. Why is all this money going into healthcare? What are the different strategies and competencies big tech and other large corporations like CVS, Walgreens, and Walmart bringing to the healthcare space? These are some of the questions that I will try to answer. These investments are creating what I'm labeling #NewHealthcare. Much of this money, however, is not being spent wisely! Many of the healthcare startups receiving those investments, and even some of the large corporations, have little knowledge of the healthcare industry, or experience navigating its arcane rules and regulations. They also have no experience navigating the complex relationships and incentives shaping the actions of #OldHealthcare's many incumbents from providers, to hospitals, to payers, and pharma.

This rate of innovation and change will create a very turbulent period for the healthcare industry. A four trillion dollar industry, representing 20% of the US economy or $1 out of every $5 spent, is not going to be disrupted without a massive fight. I would like to invite you to join me on this journey of observation, reporting, and analysis from the frontlines of change.

Which brings me to my last title question, why start this newsletter? I believe we deserve a hugely better healthcare system than what we have. I am a user of the healthcare system. Many of my loved ones are users of the healthcare system. I am appalled and infuriated by the care that we receive when we need healthcare. The level of waste is shameless. The errors are rampant. I dare say that in most significant healthcare system interaction, I intervened to prevent a consequential medical or system error. I am the quintessential healthcare insider, and even I have a hard time sometimes navigating the system and getting someone I love the care they need! I am committed to doing everything in my power to make things better. I think #NewHealthcare companies can have a positive impact and I am determined to helping them do so by shining a light on their work and helping others understand the transformation underway and how they can contribute and benefit from it.

Now here is something I have to do to keep I promise I made. In a recent post about TikTok's purchase of a large hospital system in China, I asked for funny or insightful comments about the transaction and ask everyone to vote for their favorite comment. I promised to name the winner based on the highest number of likes in this newsletter. So here we go! Drumroll!! The winners tied for the most votes are Hari Nair and Kunal Gurav . All of the comments were really funny and I would recommend you check them out at the link below.

It's time to wrap things up and click the send button! I will end each newsletter with a personal piece of information or a topic of personal interest: an upcoming trip, a recent interesting conversation, a book I'm listening to, or a non-healthcare area of interest (fair warning, I'm obsessed with machine learning and Tesla but you can always skip this part). Today, I'll share a 3-minute Youtube video that I watched over 10 years ago and has made a significant impact on my thinking and actions. It is some of the most profound insight I've ever heard! In a way, it's the reason I'm creating this newsletter.

In this newsletter, I'm a follower. I will shine a light on others who are making significant change in healthcare. But I'm also a leader, sharing what I'm observing in the #NewHealthcare space and connecting the dots. I'm hoping that you will soon relieve me from my Lone Nut status :-) Please subscribe to the newsletter and help spread the word! I would also love to hear your thoughts in the comments or in your own posts tagging me!

Till next time,

Sam