Vital Signs with Jacob Effron and Nikhil Krishnan

Elliot Cohen—PillPack co-founder and now co-founder of General Medicine—joins Jacob Effron and Nikhil (Out-of-Pocket) to unpack what “best care” really means in 2025. He explains why General Medicine is building a broad front door to care. Elliot also revisits the PillPack vs. PBMs saga, what Amazon Pharmacy got right (and what was unexpectedly hard), and how AI is already raising the bar in intake, clinical prep, and follow-up. (0:00) Intro(0:58) Simplifying Healthcare with General Medicine(1:53) The Importance of Triage in Healthcare(3:22) Consumer Empowerment in Healthcare(5:10) Patient Experience and Structured Forms(6:27) Challenges in Healthcare Pricing Transparency(8:28) Diverse Patient Needs and Quality of Care(10:00) The Philosophy Behind General Medicine(16:43) Consumer Directed Care: Pros and Cons(18:57) PillPack(35:53) Debating Insulin Search Results(38:16) AI in Healthcare: A New Era(39:15) Integrating AI with Clinical Teams(41:39) Challenges and Opportunities in Digital Therapeutics(58:21) Building a Healthcare Company: Lessons from Amazon(1:01:25) Quickfire Out-Of-Pocket: https://www.outofpocket.health/

Flashback episode in honor of Hinge Health's IPO this week. In the episode, Jacob and Nikhil sit down with Daniel Perez, the Co-Founder and CEO of Hinge Health, a digital clinic for patients with joint and muscle pain. They discuss Hinge Health’s strategy for selling to employers, how digital health solutions can reach and retain users, the role of software x hardware in disrupting healthcare, and more. (0:00) Intro(2:34) The Evolution of Employer Health Solutions(4:03) Challenges and Strategies in Digital Health(7:07) Focus on Musculoskeletal Care(9:51) Engaging and Retaining Patients(16:17) Marketing and Awareness Strategies(19:31) The Role of Independent Validators(22:27) Clinical Validation and R&D Excellence(23:04) Healthy Competition and Market Differentiation(23:59) Product Superiority and Customer Validation(26:05) Team Dynamics and Tough Decisions(29:49) Future of Hinge Health and Healthcare Automation(31:44) AI and Technology Integration(36:18) Hardware Innovations and Market Impact(39:19) Value-Based Care and Outcome Guarantees(41:14) Regulatory Challenges and Innovation Constraints(43:38) Closing Thoughts and Entrepreneurial Advice Out-Of-Pocket: https://www.outofpocket.health/

Otto Sipe, CEO and Co-Founder of Photon Health, revolutionizes pharmacy experiences by promoting transparency in pharmacy selection. He dives into the challenges of traditional pharmacy models and the transformative role of e-prescribing. The conversation highlights the future of pharmacy benefit managers (PBMs) and the impact of AI on drug pricing. Otto shares innovative approaches to patient care with outcomes-based pricing for GLP-1s, alongside insights into fostering resilience within company culture through creative office decor.

Jacob and Nikhil sit down with Dr. Rushika Fernandopulle. Rushika is the former CEO and Co-Founder of Iora Health, a primary care provider centered around value-based care and Medicare that One Medical acquired for $2.1 billion. They discuss why we’re still in the second inning of value-based care, intersections of tech and healthcare, what it takes for VBC to succeed, and more. [0:00] Intro[0:29] Early Days of Value-Based Care[2:34] Challenges in Commercial Value-Based Care[5:20] Adapting Care Models for Different Populations[13:08] Medicaid and Long-Term Care Issues[16:30] Big Tech's Foray into Healthcare[20:37] Amazon's Healthcare Strategy[21:09] Challenges in Serving Low-Income Seniors[21:43] Innovative Solutions for Patient Transportation[22:16] The Economics of Healthcare Visits[23:22] Building a Custom EHR System[27:34] The Role of AI in Modern Healthcare[33:17] Future of Primary Care and Policy Implications Out-Of-Pocket: https://www.outofpocket.health/

Frank Wu, Co-founder and CEO of Taro Health, shares insights on revolutionizing health insurance with innovative, patient-centered models. He delves into the Direct Primary Care approach that enhances patient-doctor relationships and simplifies payments. The challenges of enrollment and market strategies are discussed, along with the shifting dynamics in InsurTech. Wu also explores the potential of generative AI in transforming healthcare processes while balancing automation with the need for human interaction.

Jacob sits down with Erik Wexler, the President and CEO of Providence. Providence is a non-profit, faith-based health system with 51 hospitals and 1,000 clinics across seven states. They discuss how to think about new AI opportunities with discipline, the value of health system partnerships, programs to support health equity, and more.[0:00] Intro[2:07] Challenges and Opportunities with AI[3:38] Leadership and Organizational Focus[5:30] Whole Person Care and Health Equity[7:23] Financial Challenges in Healthcare[9:25] Collaborations and Partnerships[13:38] Innovations in Healthcare Delivery[15:12] Tech Integration in Healthcare[16:55] Choosing the Right Innovations[17:48] Policy Landscape and Concerns[19:33] Handling Wildfires and Crisis Management[21:59] Commitment to Climate Change and Sustainability[24:14] Health Equity and Community Investment[27:14] Challenges and Successes in Healthcare Innovation[29:18] Future of Healthcare and Final ThoughtsOut-Of-Pocket: https://www.outofpocket.health/

In this conversation, Daniel Perez, Co-founder and CEO of Hinge Health, shares insights from leading a digital clinic focused on joint and muscle pain, with over $800 million raised. He discusses the evolving landscape of employer health solutions and the importance of integrating digital and in-person care for patient engagement. Daniel emphasizes the significance of both software and hardware innovations, AI's role in automating healthcare, and the necessity for guaranteed outcomes amid regulatory challenges. His entrepreneurial advice offers valuable lessons for aspiring founders.

Hemant Taneja, CEO of General Catalyst and a leader in healthcare venture capital, shares insights on the future of health tech. He discusses the potential of creating a $100B healthcare company and the transformative role of AI in the industry. Hemant emphasizes the importance of strategic partnerships, particularly through health system acquisitions, to foster innovation. He also explores how venture capital is evolving, the globalization of healthcare solutions, and the necessity for a collaborative ecosystem to tackle complex challenges.

Stef van Grieken, Co-founder and CEO of Cradle, spearheads AI innovations in protein engineering for drug development. They delve into the rapid growth of Cradle, fueled by a $100M funding round, and discuss the complexities of AI's integration into drug discovery. Stef highlights the challenges of selling SaaS to pharma and the critical need for effective lab automation. With insights into future trends, he explores what the next 25 years hold for biotechnology and the evolving landscape of AI-driven drug development.

Dr. Angela Fitch, Founder and CMO of knownwell, shares her expertise on obesity medicine, emphasizing the need for innovative care. She discusses the transformative potential of GLP-1 medications, highlighting their impact beyond obesity treatment to conditions like Alzheimer’s. The conversation also addresses challenges in insurance coverage and the importance of continuous and integrated care. Dr. Fitch advocates for recognizing obesity as a serious medical condition and stresses the necessity of creating a supportive environment for effective treatment.