How Can Payers Thrive Amidst Today’s Market Pressures? The US healthcare landscape faces unprecedented volatility, escalating the need for data-driven strategic planning and risk mitigation. Anticipated shifts in Medicaid and ACA funding post-election pose new challenges for health plans navigating financial pressures and evolving member populations. Demographic shifts are fueling Medicare Advantage (MA) and D-SNP growth, but the average MA plan Star rating has continued to decline and some plans are scaling back service areas. In Medicaid, redeterminations have strained margins, shifting risk pools and causing some payers to adjust their Medicaid guidance. Despite these challenges, some plans have thrived. For example, Kaiser and SCAN recently increased their MA Star ratings by an impressive ~0.5 points, and Molina demonstrated resilience in Medicaid performance in its latest earnings results. So, what sets these high-performing plans apart? What can plans do to achieve similar results? At Stellation Care, we’ve launched Competitive Intelligence Insights to help plans answer this question and thrive. We empower plans with deeper visibility into performance drivers, supporting targeted, data-driven strategies to improve member outcomes, network performance, and financial sustainability. Let's connect if you are navigating the current market pressures and are interested in a data-first approach to mitigate risks and thrive. Feel free to reach out directly on LinkedIn or send me a note at [email protected]. Thank you for your invaluable input as we’ve continued to refine our product Chad Pendleton, PhD, MHA, MPhil Genevieve D. Caruncho-Simpson Frank Bird Lara Rosenblum Ryan Goodenough Vik Bakhru, MD/MBA! #MedicareAdvantage #Medicaid #CompetitiveIntelligence #HealthcareAnalytics
Pear Healthcare Playbook
医院和医疗保健
Sharing stories from trailblazing entrepreneurs on how to build a healthcare business from 0 to 1.
关于我们
As pre-seed and seed investors, the Playbook is for founders to learn from other healthcare leaders who've done it before. We’ll be focusing on building at day 0, from selling to payers to landing to pilot to getting your first 100 patients— reach out if you have specific topics you're interested in!
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https://pearhealthcareplaybook.substack.com/
Pear Healthcare Playbook的外部链接
- 所属行业
- 医院和医疗保健
- 规模
- 2-10 人
- 总部
- San Francisco
- 创立
- 2022
- 领域
- Health Tech、Healthcare和Startups
动态
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??Huge Thank You to Our Amazing Judges?? We want to extend our heartfelt gratitude to the amazing judges who joined us for the Generative AI in Health Hackathon. Your insights, expertise, and dedication played a crucial role in making this event a success. A special thank you to Vishal Parikh from Hippocratic AI, Pablo Lleras from StartX, Vivien Ho from Pear VC, Chuka Esiobu from Define Ventures, Karen Matthys from Stanford University, Jun (Alex) Gao from HealthUnity, DeCarlos Love from Thrive AI Health, Wei Wei from Accenture, and Sooah Cho from SignalFire. Your feedback was instrumental in helping teams further enhance their innovative projects. We deeply appreciate your time and support. Thank you for helping us empower the next generation of healthcare innovators! #HealthUnity #GenerativeAI #HealthcareInnovation #Hackathon #ThankYou #Judges
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?? Hello everyone! I'm excited to announce, after a short break, a new episode in Pear VC's Medicaid Series from Pear Healthcare Playbook. Today, I’m featuring Afia Asamoah and Dr. Sanjay Basu, co-founders of Waymark—a company enabling value-based primary care for Medicaid. I'm particularly fond of this episode for two reasons: first, Afia and Sanjay are remarkably personable, authentic, and intelligent; and second, Waymark exemplifies a company that's deeply rooted in evidence-based practices. In this episode, we dive deep into Waymark's innovative approach to community-based care. Learn how they're: ??Bringing their legal and clinical expertise to building an innovative company in this space ???????? Partnering with community health workers to locate and engage Medicaid patients ?? Leveraging data science and research to differentiate their care model ?? Redefining what cost-effectiveness means in the context of care delivery ?????Developing long-term relationships with payers through contracting Don't miss this insightful conversation with Waymark's leadership team as they share their vision for a more equitable and effective healthcare system. ????Episode: https://lnkd.in/ejhhdFqC ???Substack: https://lnkd.in/eH3F88MW What are your thoughts on Waymark? Share in the comments below!
Lessons from Afia Asamoah and Dr. Sanjay Basu, Co-founders of Waymark, on differentiated, effective care models for Medicaid
pearhealthcareplaybook.substack.com
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Excited to feature Counsel Health, our new Pear VC Portfolio company on the Pear Healthcare Playbook with Muthu Alagappan, MD, CEO and Founder of Counsel Health, on defining a new healthcare paradigm in asynchronous care. Hope you enjoy the candid conversation I had with Dr. Muthu on his journey to founder market fit at the intersection of AI and clinical medicine, on the origins of Counsel, and how Counsel brings a novel solution to increase access to care and address the 100,000 clinician shortage that we'll see in 5 years. P.S. They're hiring - this is an incredibly rare opportunity to join a world class team: Rishi Khakhkhar, MD, MBA, Justin Yu, Jessica Fan, Uzair Khan, Jaisal Friedman and growing!
Dr. Muthu Alagappan, CEO and Founder of Counsel, on defining a new healthcare paradigm in asynchronous care - Pear VC
https://pear.vc
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We're so proud to share that ixlayer has announced their Complete Blood Count test with their direct-to-patient biopharma programs through ixEngage. ixLayer is paving the future for at-home testing access for patients. “Remote CBC testing as part of ixEngage accelerates patient-centered healthcare,” explained Pouria Sanae, CEO and co-founder of ixlayer. “At ixlayer, we continually merge medical and technological innovations to shift the healthcare paradigm from reactive to proactive care so patients can get the care they want and need when it’s convenient for their schedules.” Congratulations! #HLTHUSA
Today at #HLTHUSA, ixlayer?announced the availability of a Complete Blood Count (CBC) test with at-home sample collection for direct-to-patient biopharma programs through our DTP solution, ixEngage. ixEngage removes barriers to care by accelerating pre-treatment and routine CBC tests used for hundreds of conditions, including asthma, heart disease and kidney disease. #HLTH #HLTHUSA2024 Read the press release: https://lnkd.in/drrMBjjN
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We at Pear VC are so thrilled to partner up with Counsel Health and fearless leader Dr. Muthu Alagappan, MD to give everyone that "magical" feeling of having instant medical advice from a trusted doctor ???? , similar to have a doctor in the family. Asynchronous care will be the future of how we get access to quality medical advice. Grateful to co-invest with the best healthcare investors Andreessen Horowitz (Julie Yoo, Jay Rughani), Asymmetric (Rob Biederman, Nancy Chou), Floodgate (Ann Miura-Ko) and Founders You Should Know (Jennifer Yip). The Counsel team is an amazing combination of clinical leaders who are leaders in Healthcare AI and high caliber technical builders. Counsel is hiring incredible growth leaders and AI/fullstack engineers to build this future: https://lnkd.in/g5q6yqmH If you're a health plan leader, would love to connect you to the team to serve your members!
???Today, we’re introducing Counsel Health, the world’s first medical service that provides personalized, high-quality medical advice from physicians within minutes. Unlimited access to the world’s best doctors. Welcome to the new age of healthcare — personalized, convenient, and accessible. See the article below for more information. a16z Bio + Health Asymmetric Floodgate Pear VC Founders You Should Know
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EM resident Stanford| MD/MBA Penn Med and Wharton | Pear VC | Podcast Host of Pear Healthcare Playbook
In my clinical career, I often encounter challenging medical questions where high-quality evidence isn’t always available. As clinicians, we frequently rely on consultations with colleagues, but the reality is that not every clinical decision is backed by gold-standard RCTs. This leaves a gap where many medical decisions lack the robust evidence we strive for. However, there is an opportunity to bridge this gap through real-world data. With vast amounts of real-world evidence, we can make more informed decisions when traditional evidence falls short. That's where companies like Atropos Health step in. Atropos is transforming healthcare decision-making by generating high-quality, personalized real-world evidence in minutes. By leveraging advanced observational research techniques, such as high-dimensional propensity score matching, their platform empowers physicians, researchers, and even pharmaceutical companies to make better, data-driven decisions faster. In the latest episode of the Pear Healthcare Playbook with Pear VC, I had the pleasure of speaking with Neil Sanghavi, President of Atropos Health. We dove deep into his journey into health tech, the role of data in healthcare, and Atropos’ innovative growth strategy. We also explored their go-to-market approach, the creation of ChatRWD, and the critical importance of data quality. Neil shared his vision for the future and some valuable advice for aspiring founders. If this sounds interesting, I’d highly recommend giving the episode a listen and checking out the article. Neil shares some incredible insights! Article: https://lnkd.in/eU7RSfcV Podcast: https://lnkd.in/eekQpdgm
Lessons from Neil Sanghavi, President and Head of Product and Solutions at Atropos on developing publication-grade evidence for healthcare and life sciences
pearhealthcareplaybook.substack.com
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Tandem is a generational opportunity to rethink how we bring new therapies to market with AI. Looking at you, my consulting and strategy friends, let me know if you have someone who is excited to be a part of a extremely fast paced and game-changing company in healthcare. Happy to share a warm referral if it's a fit! ?? https://lnkd.in/gUznVCpm Pear VC
Strategy & Operations
jobs.ashbyhq.com
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Loved gathering an incredible group of Healthcare AI technical researchers, builders and founders with the Pear VC and Define Ventures! Thank you to our Lighting Talk speakers! ? Professor James Zou,?Healthcare AI Professor at?Stanford University ? Cyril Zakka, MD, ML Research Health Lead at?Hugging Face ? George Spurling, CEO & Founder of?Budgie Health ? Randy Womack, CEO & Co-Founder of?Solara Health Shoutout to my co-host Chuka Esiobu and my partner Eddie Eltoukhy, Tracy Do and Maile Paulmeier!
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