AJ Loiacono’s experience in supply chain consulting for pharmaceutical manufacturing afforded him a world-class education in supply chain logistics, drug pricing, and software implementation. However, it wasn’t until he worked with healthcare payers that he realized the glaring problems in the U.S. drug pricing system and that pharmacy benefit managers retained much of the control and profit. He says, “The reason why our drug pricing is the way it is today… is because no one has either had the resource, bravery, or perseverance to stand up and say, ‘This is what’s wrong, and we’re going to fix it instead of profiting off of the system.’” Looking to disrupt the status quo, Loiacono founded Capital Rx. As one of the fastest growing healthtech companies in America, Capital Rx reconstructs prescription pricing and puts savings back in the patient’s hands. Loiacono speaks with host Steve Krupa about his desire to simplify drug pricing and increase transparency, how Capital Rx’s novel cloud-native enterprise pharmacy platform, JUDI, reduces labor costs by up to 80%, how they maintain a 99.5% retention rate with their clients, and why their books have demonstrated a negative drug trend for the past three years. Links from this episode:  HealthEdge  Capital Rx JUDI Enterprise Pharmacy Platform Capital Rx Facebook 

Dr. Schneider’s interest in medicine began when she was diagnosed with type 1 diabetes as a preteen living in a small rural Minnesota town. After becoming a physician, her journey to CEO started with a return to her roots and a desire to help decrease the exorbitantly high mortality rates observed in rural communities across the nation.  In this episode, host Steve Krupa speaks with Dr. Jenny Schneider, CEO of Homeward Health, about the company’s recent launch, how it leverages technology to scale healthcare for underserved patients, and the mobile clinic that builds trust with rural communities and increases access to care. Schneider says, “The good and bad news about healthcare is that it’s so highly inefficient that there’s a lot that can be improved… Our ability to engage and allow people to interact with the healthcare system allows them to improve their health and ultimately costs less money.”  Links from this episode:  HealthEdge  Homeward Health 

From working nights in the Prudential mailroom during college to securing leadership roles at big names like IBM Watson Health, Allscripts, and Pfizer, Steve Tolle, now general partner at HLM Venture Partners, has seen it all. With a multi-faceted skill set and a wealth of knowledge in technology and healthcare, he eventually transitioned from an operator to an investor at one of the nation’s oldest and most established healthcare venture capital firms. Given his background, it is no surprise that Tolle knows a thing or two about the growing needs of the healthcare industry and how to spot a winning investment. In this episode, Tolle speaks with Breaking Health host Steve Krupa about HLM’s focus on behavioral health, member engagement, access to care, value-based care enablement, and tech-enabled services. He also talks about the six-point test every company must pass before he considers investing and what each founder should know to win over investors in under five minutes. Links from this episode:  HLM Venture Partners HealthEdge Software 

Healthcare’s most vulnerable patients meet a fragmented system when they seek to simultaneously address chronic comorbidities, behavioral health challenges, and social needs (i.e., navigating access to food, transportation, and housing). In response, ConcertoCare employs a multidisciplinary team and offers an integrated approach to clinical care, behavioral health, and social services. The organization takes its name from a musical composition involving a soloist and an orchestra. With ConcertoCare, the patient (soloist) and interdisciplinary team (orchestra) work in tandem to meet the patient's needs beyond clinical care. Chairman and CEO Julian Harris, MD, MBA, talks with Breaking Health host Steve Krupa about the company’s clinical model, delivering exceptional care backed by technology and data, developing a brick-and-mortar health center, and its role in helping senior patients receive in-home care for as long as possible. Links from this episode:  ConcertoCare 

Payers and providers spend unnecessary time and energy approving medical and diagnostic procedures. CEO and Co-Founder Siva Namasivayam, believing that the digital health market has yet to leverage the full power of technology, launched Cohere Health in 2019 to transform utilization management into proper care management. Cohere Health employs individual and cohort medical data, records, and proprietary algorithms to generate approvals for nearly 90% of authorization requests. Evidence suggests that Siva and his team will soon realize their goal of a 96% approval rate. With more automatic approvals, providers can focus on what matters most while patients receive timely and appropriate care. Additionally, payers experience up to 15% savings when Cohere Health suggests cost-effective yet high-quality alternative treatment options. Siva and his team serve over 5.5 million members and approximately 100,000 physician offices today. 

 When Bill Taranto pitched the Global Health Innovation (GHI) Fund, he envisioned an independent venture that mimicked a private firm but maintained the backing and power of a big health company. The Fund's partnership with Merck allows them to make groundbreaking investments in the digital health space. Following what is often known as "ecosystem investing," the GHI Fund matches two or more companies, each solving a portion of a healthcare problem, to solve the issue effectively and thoroughly. In addition, GHI maintains a strong focus on the future of healthcare, including patient identification and aggregation as well as data security, integration, analytics, and informatics. Boasting a success rate of over 95%, Bill talks about GHI's mission to scale companies using an integrated approach, data science, and revolutionary technology. Links from this episode: GHI Fund 

Dan Brillman, CEO of Unite Us and former US Air Force pilot, shares his journey in bridging the gap between Americans and essential social and health services. He discusses the fragmented nature of support systems faced by veterans and the need for a unified approach to care. The conversation highlights how digital health innovations are connecting communities and improving access to services, while also addressing regional disparities. Brillman underlines the importance of collaboration among organizations to achieve better health outcomes and equity across diverse populations.

While the pandemic may have dramatically advanced our virtual care ambitions, even pre-pandemic many people noted that care outside of the hospital resulted in improved outcomes for some groups of patients. In a recent conversation at the Digital Healthcare Innovation Summit, leaders in care delivery for a variety of patient needs—as well as payer representatives—explored how innovative care models can better address complex diseases like eating disorders, can engage and empower home caregivers and community pharmacies and physicians, and better employ a limited healthcare workforce. In many ways, the panelists explained, it’s a logistics problem. But smarter approaches to predictive modeling, assessment triage, and needs-matching are helping solve some of our biggest healthcare disparities.  PANEL MODERATOR: Billy Deitch, Partner, Oak HC/FT PANELISTS: Mark Prather, MD, Co-Founder & CEO, DispatchHealth Kristina Saffran, Co-Founder & CEO, Equip Brandon Kerns, President & CFO, Russell Street Ventures Katherine Knutson, MD, MPH, Senior Vice President, United Health Group; CEO, Optum Behavioral Care LINKS:Cambridge Healthtech Institute   Breaking Health   HealthEdge  https://dhis.net/  

Sid Viswanathan doesn’t believe that a pre-existing passion is essential to entrepreneurial success, instead he recommends choosing an area with plenty to learn. “Find something you can spend a lot of time obsessing over,” he told the Breaking Health podcast. When he co-founded Truepill, Viswanathan didn’t know much about healthcare, but now it is a passion. “It’s such a meaty industry; there’s so much stuff to do,” he said. Truepill launched as a virtual pharmacy in 2016, offering everything from the digital consumer-facing front end to pill packing and shipping on the back end. But the vision, Viswanathan said, is virtual healthcare, which now includes telemedicine and diagnostics as well. Truepill serves as a collaborative partner, he said, for payers, life sciences, healthcare, and providers.  Breaking Health boiler: Conversations between VCs and entrepreneurs typically occur in boardrooms or coffee shops. In the Breaking Health Podcast, you get a seat at the table. Healthcare Chief Executive Officer Stephen Krupa, HealthEdge Software, Inc., brings his more than 20 years’ investor experience insight to revealing conversations with the most disruptive CEOs in healthcare. Listen to understand how these leaders are building the companies—and fostering the cultures—that will change everything.  Breaking Health Links:  Cambridge Healthtech Institute Breaking Health HealthEdge  Truepill  

Enam Noor has been an entrepreneur since he graduated from college with a degree in computer programming. After honing his skills in digital analytics and digital workflow, he’s taking what he learned and applying it to the healthcare field. His company, Insightin Health, brings vast healthcare data to bear on care decision-making, empowering health plans to use data as an asset—not just an operational byproduct. By tearing down silos and combining data from physician practices, pharmacies, customer service interactions, and much more, Insightin is using machine learning and natural language processing to drive the next best action for customer health.