70 – Surgeon General’s Bold Move: Gun Violence and Social Media Under Fire!

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Vic: Okay, Bo Bartholomew. Thanks for doing health further. Appreciate you coming in downtown and doing this with me. Absolutely. So for the listeners, Marcus Whitney is off with the Aspen Institute. Uh, he has a week long retreat with them. And so I have a guest host, Bo Bartholomew, who is the CEO of Evidence Care.

Vic: And then also a partner, general partner, at a VC firm called Rockmont. Bill, thanks for doing this. Uh, maybe give a little bit of your background. How did you get involved in healthcare? I think you started at a little firm called HCA at first, maybe?

Bo Bartholomew: Yeah. Um, first of all, I should say thank you for being here.

Bo Bartholomew: Yeah. And, uh, I have a, uh, [00:01:00] infatuation with Marcus’ Hair . Yes. And so the fact that I could even sit in his chair, I, I’m honored and, uh, yeah. Yeah.

Vic: This week the hair, uh, component has gone down dramatically. . I’m bald. You’re bald. And, uh,

Bo Bartholomew: Marcus’ dreads are not here. Absolutely. And, uh, immense respect for, for Marcus.

Bo Bartholomew: So, I’m, uh, truly honored to be a part of this. Um. So, high level background, I spent four years active duty in the Army Corps of Engineers. Um, you’d be surprised how much jumping out of helicopters and navigating landmines, uh, equips you for healthcare.

Vic: And investing.

Bo Bartholomew: Um. And, uh, I got hired to help build the hospital at HCA.

Vic: Yeah, from the, from like dirt. From dirt,

Bo Bartholomew: yeah. Ground up, project manager, um, and, uh, we opened a hundred bed, a hundred million dollar, at the time, the newest hospital in the country. And, uh, they asked me to [00:02:00] stay on and help run the facility, so. Yeah. Next thing I know, I’m a hospital administrator. Right, right.

Bo Bartholomew: Um, uh, was there a little over half a decade at HCA. Yeah. And their executive development program had a great, uh, great time, learned a lot, uh, loved every minute of it. Uh, uh, when they asked us to more, uh, to move to four very undesirable locations.

Vic: Yeah. That’s part of the HCA, uh, process. They make you, you built a hospital nearby to, So net Nashville skyline, I think.

Vic: Is that right?

Marcus: Yes.

Vic: Yeah. That’s right. Uh, but then if you want to move up in the org chart, you got to go to some far flung place. There’s a lot of truth to that.

Bo Bartholomew: And I was truly excited about it, but my wife and my two month old timing being what it was, I became an entrepreneur, uh, co founded, uh, uh, medication software business called, uh, farm MD with Clayton [00:03:00] McWherter.

Bo Bartholomew: Uh, learned a lot. Uh, he became a phenomenal mentor, uh, both on how to invest and mentor companies, but also how to build and grow startups. Uh, so took that from scratch. We grew it to 30 million, uh, was there 12 years, sold it to private equity, uh, joined another private equity backed, uh, company called Shearwater.

Bo Bartholomew: When I joined as chief revenue officer, we were 60 million in revenue, 10 million EBITDA. Two years later, 120 million and 22 million EBITDA. Had a great quick exit. Um, 2020, uh, came around, um, was able to kind of step back and, uh, obviously COVID hit, uh, which caused us all to reflect on, on the things that are more meaningful.

Bo Bartholomew: And I began to, uh, invest with one of my best friends growing up. Guy named Brian Fox who had sold his fintech business. Yeah,

Vic: also an [00:04:00] entrepreneur successful entrepreneur. Absolutely

Bo Bartholomew: So we formed Rockmont partners Uh named after the the boys camp we went to when we okay nice.

Vic: I didn’t know where the name came from

Bo Bartholomew: in north carolina and Our third investment was evidence care 15 investments Uh, we’re right now closing a 50 million dollar fund Uh this fall Uh, we’ve got five portfolio companies and a sixth, uh, that we should have definitive docs on in the

Vic: next two weeks.

Vic: Okay. And then what was the process like to go from investor then to CEO? Yeah. So Evidence Care Reserve. And just for transparency, that’s, it’s in my portfolio too. That’s correct. And so, uh, Jumpstart Capital is an investor.

Bo Bartholomew: Yeah. You all were engaged before I was. Yeah. That’s

Vic: right.

Bo Bartholomew: Uh, we participated in the A round after Jumpstart Capital.

Bo Bartholomew: Um, [00:05:00] and, uh, more or less in parallel with that A round, the board and the founder, Dr. Fangler, uh, agreed Dr. Fangler would be, uh, much more in his swim lane and have a lot more fun if he was, Full time chief medical officer. So he’s still with us. Um, Haven’t met a more brilliant minded physician, but also someone humbling enough to really know Um what he was good at and what he wanted to do.

Vic: Yeah, and uh, so what’s what’s good for him in his career? What’s good for the company and the customers and shareholders everyone?

Bo Bartholomew: Yeah, so great great transition. Um, So I stepped in I got asked by the board and the management team to be ceo You And, uh, we’ve grown, uh, over 100, 120 percent three years in a row now.

Bo Bartholomew: Uh, knock on wood, I don’t try to get that much this year, um, but we continue to grow. We’ve been very honored, uh, you and I were talking and we’ve, we’ve [00:06:00] just this past quarter won, uh, Nashville Business Journal’s Best Places to Work, Tennessee and, and Modern Healthcare.

Vic: Yeah. And so for the listeners, maybe give a little summary of, of what evidence care does for health systems.

Vic: You’re integrated with the EHR. We are. I really love the CareGage product, but I know you have several products. That’s correct. So how, how should the listener think about where evidence care fits in?

Bo Bartholomew: Yeah, so we’re a true SaaS, all software based business. All of our products are embedded inside the electronic health records.

Bo Bartholomew: Uh, they are our best friends in the industry. Um, and we insert the right information and the right workflow for the clinicians so that they can make the best possible decision. We, we really envision a day when every decision is the right decision at the right time. Right time. Uh, and we’re giving the right information.

Bo Bartholomew: [00:07:00] Today, you gotta go digging, you gotta go, uh, Yeah, all the data’s

Vic: in the EHR, but it’s not easy to find it. It’s not at my fingertips. So,

Bo Bartholomew: 20 years ago, part of my role in the brand new, newest HCA hospital in the world was to go convince doctors that this thing called the electronic health record was gonna make their life better.

Bo Bartholomew: Uh, some of those same doctors look at me and say, when, uh, I think companies like evidence care, we’re now bringing that electronic health record 2. 0 where we’re inserting the value to the doctors. And one of the things we spend a lot of time on evidence care is we. What helps the doctors the most while simultaneously benefiting the hospital?

Bo Bartholomew: Because when you align those two, you’ve got something that’s really kind of a secret sauce for the providers that they need. And, uh, [00:08:00] that’s what we’ve done really well. Um, the CareGage product you, you asked about was we actually acquired another company in 2021. Uh, that product care gauge is like a gas gauge in your car.

Bo Bartholomew: Did you use that today on the way to work?

Vic: Um, I did last night, uh, but because I filled up last night, I didn’t use it on the way to work. But yes, it was like, it’s a, that’s a perfect analogy. So talk through that. I’m surprised you’re

Bo Bartholomew: not driving an electric vehicle.

Vic: Yeah. Uh, although

Bo Bartholomew: probably the same concept if you’re running out of batteries.

Bo Bartholomew: But, uh, It turned red or showed an E and you changed your behavior. Yeah,

Vic: I realized gosh I need to fill up.

Bo Bartholomew: That’s right. Yeah. So the gauge inside the electronic health record compares any given patient DRG physician care utilization to all their peers at that facility and gives them a real time indicator.

Bo Bartholomew: They don’t have to click anything. They don’t have to drill [00:09:00] in green, yellow, red. We’ve got three patents on it and it shows exactly where they compare to their peers now they can drill down And we give them the price of anything and everything which most doctors have never seen What it costs to order an x ray versus a ct um, and what we’re finding is when someone’s in the red they Go, oh, wait a minute.

Bo Bartholomew: I don’t want to be an outlier right or i’m going to be out of gas What’s going on? So they change their behavior.

Vic: What I really like about is it’s it’s um, You It’s always available for the doc. Yes. And it’s right there in the EHR. He or she can see it every time they come in, but it’s not obtrusive. It doesn’t prevent them.

Vic: It doesn’t pop up and block their field. That’s right. And so if they’re running around and really busy, they may not have time to dig in and learn more, but then when they have a down moment, If they’re yellow, or if they’re red, they might choose to go in and learn. Okay, where [00:10:00] can I get closer to the, the clinical validated evidence?

Vic: Where, what are my peers doing? Uh,

Bo Bartholomew: you know, when I was running hospitals, we dreamt of being able to have real time information.

Vic: Hmm.

Bo Bartholomew: Uh, we used to use these products that would compare doctors. 180 days in arrears. Yeah, and

Vic: you give them like a report.

Bo Bartholomew: And they would say, all right, I’m an outlier, but I’m not really going to change anything.

Vic: Yeah.

Bo Bartholomew: And you try to say, well, if I take you to play another round of golf, will you change? Right. It was a very difficult conversation. Um, most doctors wanted to improve quality, but the Dr. Deming approach was kind of, uh, a distant where when you improve, uh, Efficiency and quality, you can decrease costs all in one.

Bo Bartholomew: And uh, this product was designed by a doctor. Quite frankly, he was on the board of a little hospital and they said, our [00:11:00] doctors are screwing our budget. They’re ordering all these tests and we’re losing money. And he took offense and he said, well, give me a tool and I’ll make it better, but you don’t have a tool for me.

Vic: Yeah.

Bo Bartholomew: So he dreamt one up, filed a patent, built the product and we’re all the beneficiaries of it today. And hundreds of hospitals around the country are as well. Yeah.

Vic: And then, so that might be the, um, often that’s the way I think about entering into evidence care. But then you have a couple other products too, that would help with different use cases.

Vic: Right?

Bo Bartholomew: Absolutely. Yeah. We, we have about five products. Uh, our goal is to find that, that intersection where the doctor needs something in their workflow that today they either have to go elsewhere. Or someone’s bothering them or what’s called shoulder tapping to distract them. Uh, the other kind of fastest selling product, [00:12:00] if you will, is a tool at the point of admission.

Bo Bartholomew: And, uh, for those of you who understand healthcare, um, doctors know when you’re sick and when you’re not, when you need to be in the hospital. But they have no clue that there’s a test every hospital has to pass in order to get paid for your admissions. Thanks.

Vic: Yeah, and the medical necessity is not exactly lined up with the admissions requirements.

Bo Bartholomew: There’s criteria, there’s whole companies built around that. And, um, many doctors don’t even know their names or the criteria. So we found a way to automate that. So it literally is in the doctor’s workflow. They can select the right criteria and we auto populate, uh, what the doctor’s trying to communicate in a way that the payers Uh, actually use it and consume it.

Vic: Excellent. Well, thanks for doing this. I think you’ll bring, uh, A different and a [00:13:00] pretty interesting perspective to, to the weekly roundup of news. So, so let’s dig into it. I look forward to it. Okay. So in the, in this economy section, we’re going to go through a couple, um, large publicly traded companies. So Apple got hit by the first ever charge from the, from the EU.

Vic: And it’s the fine is up to 10 percent of their rev, the global revenue. And I was really just surprised. It seems like, um, The first maybe a shot over the bow that, um, the EU is claiming that the app store doesn’t allow developers to interact and easily work with consumers, which has been true for a long time, um, and sort of part of.

Vic: Apple’s value in some way to control their walled garden and have it be really easy for the user. What are your thoughts about this? And then, um, the next day they also hit Microsoft with the same thing. So maybe [00:14:00] let’s talk about both these stories at once.

Bo Bartholomew: Yeah, at a high level. Uh, anytime you have companies this large, um, kind of taking on, you know, uh, whole countries and, uh, kind of like the EU, the, the cynic might argue that, uh, the EU is tapping into a new revenue source because either way there could be a settlement, uh, and that type of thing.

Bo Bartholomew: But at the same time, uh, I think it just shows the massive size of companies. That now have influence, not just over elections and populations, but, uh, at a pretty massive way, uh, they control markets.

Vic: Yeah, yeah, and I think the, um, there needs to be fair competition. So the Microsoft case, um, Slack was upset in how they bundled teams into the overall, [00:15:00] uh, office suite, which is pretty similar to 25 years ago when Microsoft bundled Internet Explorer.

Vic: I feel like we’re, you know, it’s Groundhog Day all over again. Um, as a relatively small company. Bringing a solution that’s an add on to the EHR. What’s your feeling about this bundling issue?

Bo Bartholomew: I think it’s, um, So, in full disclosure, we were big Slack users. We were addicted to it, loved it. Uh, we went through the high trust.

Marcus: Yeah

Bo Bartholomew: process right and uh, that was in a weakness that was identified So we had to kind of pull the ripcord and go to teams

Vic: go to teams. Yeah,

Bo Bartholomew: microsoft because

Vic: of the security and um High trust is sort of a data security That’s correct And it certification maybe

Bo Bartholomew: it identifies especially a lot in the in the in the health care world [00:16:00] Uh, it’s a formal way of Uh, doing your cyber security, uh, in a way that it’s kind of been vetted by the largest health plans and health systems.

Bo Bartholomew: Um, and I, I was probably the biggest complainer, uh,

Marcus: because I, I Leo

Bo Bartholomew: is always the last one to want to change over. Yes. I think they’re still joking about that. Um, but I have to say there’s a lot of efficiencies that go with it. And, uh, uh, from a business perspective, I think it’s a brilliant move. Uh, we with our clients, Health Systems, they today are telling us, we had a whole bunch of CIOs do a panel and they said they’d much rather have one or two companies with 50 solutions integrating to the EHR versus 50 vendors.

Bo Bartholomew: Each integrating to the EHR and there’s not enough, uh, uh, IT resources. So in our markets, I [00:17:00] think the idea of bundling makes a lot of sense, uh, especially for SAS based businesses that can keep everything on one platform, uh, like Microsoft and evidence care.

Vic: Yeah. So there definitely is a trend towards health systems and payers wanting to have fewer vendors bringing more holistic solutions.

Bo Bartholomew: And I, and I would say Slack’s got to find. The you know, who’s the the other pay? Yeah, who’s the other competitor to microsoft that they can get bed? Well slack slack

Vic: Uh, I mean, you know the eu takes a long time to prosecute these things They have already sold to salesforce. So I think that that ship say, oh, yeah, they were complaining When they started this whole thing, they, they complained, but that was five years ago or something.

Vic: So now they’re sold to Salesforce.

Marcus: But

Vic: yeah. Um, and it’s something that I’ve, Marcus and I’ve been watching, I’m going to keep bringing it up. I think the, the globalization trend, maybe from like 85, Until [00:18:00] COVID was really a huge tailwind, uh, getting work done and more efficient venues, less costs. And yet the shipping and all the, all the politics and interaction between countries really was a great benefit to, to my companies, to the whole, to the whole global economy.

Vic: And I think we’ve sort of reached the, the maximum globalization and now kind of coming back where the EU is. And the next story, the U. S. is rebuking China for its tactics. They are all sort of, um, related to the same thing, which is, uh, the, you know, the geopolitical environment is getting more tense. We have, we do have a couple of hot wars.

Vic: We are a lot of, a lot of people. Posturing and complaining at each other in a way that’s gonna make trade more expensive. I think

Bo Bartholomew: it does feel [00:19:00] like for two decades or so. There was kind of this extended, um, period of economic global stability. I’ll say it that way. Because there’s a lot of instability and, you know.

Bo Bartholomew: Yeah, one politician might change

Vic: or something, but the economics were pretty, uh, stable.

Bo Bartholomew: And, uh, I think it, it, it feels like, and, uh, I don’t want to give him more credit than he’s due, but it seems like the last president or two have kind of created a lot of instability and, and maybe some of it’s right.

Bo Bartholomew: You know, there’s probably some taxes owed and tariffs due, but at the end of the day, it does feel like the business of doing business around the world is more challenging than it’s ever been.

Vic: Right. Definitely sort of related to that in a different way. Uh, we’ve had a lot of cyber crime this week. [00:20:00] It caught my attention.

Vic: A black hat firm called lock bit claimed yesterday that they had hacked into the federal reserve, which rang all kinds of alarm bells around the U S of course, because it’s a global reserve currency and someone getting in and stealing 33 terabytes of data. Would be not bad. Uh, but today it came out that lock bit had been let’s say, uh, embellishing They did hack into one bank in the federal reserve system, which is still bad, but it wasn’t Quite as bad as it was first publicized by them, but talk you’ve thought a lot about this Um, I mean, cyber is a big issue with everyone, including evidence care.

Vic: How do you think about this ongoing, I mean, in healthcare, we’ve had lots of cyber issues every couple of weeks this one.

Bo Bartholomew: I spent a lot of time in 2017 trying to pull a deal together. Specifically around cyber [00:21:00] security in the healthcare space. So, um, did a lot of diligence and we weren’t able to pull it off at the time.

Bo Bartholomew: But, um, two, two thoughts come to mind. I, you, you and probably all your listeners have probably heard in an Uber or at a bar or somewhere say, well, I don’t have anything really to hide. Everybody’s going to get access to all my information one way or the other. Probably my data personally has probably been hacked multiple times now between healthcare and banks and everybody else.

Bo Bartholomew: So there is this, uh, I would say individual cynicism to say it, it’s out there, nothing’s really safe. At the same time, uh, if anyone does business in the software tech field, we’re now spending more on cyber insurance. More on cybersecurity, more on our IT resources and teams than we ever [00:22:00] have before.

Marcus: So

Bo Bartholomew: it’s a true cost of doing business.

Bo Bartholomew: I do think those, uh, and I’m on a number of healthcare boards and we lean in on all our investments very early that if they haven’t invested towards a cybersecurity certification or other formal governance program, they’ve got to start doing it. It’s becoming table stakes. Yeah. And any of the early stage companies you and I invest in, um, once they figure out that product market fit, the very next thing they’ve got to do is make sure they are locked tight as can be.

Bo Bartholomew: Uh, and even then there’s hackers out there that make a living. So, yeah, you know, you’ve just got to have all those plans in place.

Vic: Yeah. And so we do, uh, with all our portfolio companies, like a secret shopper kind of program where there’ll be attempts made to get an employee to give out sensitive information.

Vic: [00:23:00] I know you run a similar program. Yeah. I think we have to start, um, just talking about it more. Like, we have to prepare ourselves. We have to try to practice more. And I know I get the, I get the phishing, uh, secret. Secret shopper things. Yes. I’m pretty good at spotting it. I also don’t read my email that often so it’s easier for me because I’m a pain in the ass.

Vic: Um, but what have you seen at evidence care? Is it an issue y’all are dealing with?

Bo Bartholomew: It is. Uh, we implemented a program. One of our clients, um, had had a pretty major, uh, breacher attack a year or two ago. And, uh, our, our board is made up of. health system execs and they kept saying, well, what are you doing about it?

Bo Bartholomew: So we leaned in, uh, even before we had full high trust certification, but we, we, We use a self attacking phishing training mechanism [00:24:00] and in fact, we’re, we’re going to ring our bell and celebrate tomorrow. This is the first quarter in two years where we’ve had zero, uh, folks open those.

Vic: Oh yeah. For your own like self testing ones.

Vic: Yeah. Uh, you went the whole quarter, no one, no one felt, uh, got tricked by it.

Bo Bartholomew: And, and it was always, you know, literally every month, like if a C suite member opened it, or a, that guy, it was kind of everybody making fun of everybody else, because it, it’s real. Um, and I will tell you the, the amount of texts.

Bo Bartholomew: That are going up now people are getting fraudulent text answer and click on a link and

Vic: they’re pretty well Uh researched. Oh, it’s fascinating. Like they’ll know my cfo’s Name an email address and maybe the email is one character off, but yes But it’s the right name and the right kind of frame of reference.

Bo Bartholomew: Uh, the one I’m seeing a [00:25:00] lot this year, uh, is a, a version of DocuSign. Uh, as, as CEO, I have to sign all of our agreements and the amount of fake DocuSigns that have come in that look pretty legit either for an investment or for evidence or whatever company. Yeah.

Vic: You might be, uh, in an airport trying to sign it on your phone or whatever, and it’s not that easy to really differentiate.

Vic: Yeah.

Marcus: Yeah.

Vic: Well, I think it’s, uh. Unfortunately, it’s probably part of life going forward now. Okay. So then just rounding out the economy, uh, Amazon had a good day yesterday. They popped about 2 percent and, uh, sorry, 4%. And so they kind of pull it up the rest of the market. So we’ve had, it’s not quite, uh, All time record, but we continue to have this, uh, stock market is, is close to all time records and the overall economy, uh, in middle America [00:26:00] feels like it’s bumping along.

Vic: I don’t know if it’s at, uh, on hitting on all cylinders, but it’s okay. We sort of have this soft landing. I mean, the Fed has, I think, done an okay job getting inflation back under control without. Really causing a huge recession, but what what are you seeing out there in the overall economy?

Bo Bartholomew: Yeah, I I’ll be the first to tell you i’m not a macroeconomist and and there are others opinions who are going to be more Uh astute than my own You know The way I think about it is the the amount of money the government put in the market Uh two or three years ago was just unprecedented in many ways Like it’s hard for us to fathom What trillions and trillions of dollars really is and I think a lot of that is working its way through both private equity and venture funds into businesses, um Individuals who who [00:27:00] either got checks from the government or do really well in the market Are still kind of I would say generally speaking upbeat, I think there’s parts of of our economy the the lower and wage earners who are starting to really struggle more now than ever because of inflation Yeah, obviously this is going to be the The number one topic in, uh, in tonight’s to be out

Vic: with.

Bo Bartholomew: Yeah. Uh, or, or later this fall.

Vic: Yeah. So this will drop, uh, on Friday night or Saturday morning. We are just for the listener. We are talking before the debate. So that, um, that one liner that everyone’s talking about, uh, that we’re not mentioning it’s because we haven’t seen it yet. We’re recording this just before the, I

Bo Bartholomew: should ask you your predictions on the debate tonight.

Vic: So my predictions are that I think Biden’s going to be much better than has been touted around on social media, and I am, I’m [00:28:00] generally optimistic overall. And so I’m optimistic that CNN is able to have a fruitful discussion of topics. I don’t know. That’s my prediction. I’m hopeful that that will happen.

Vic: I think Biden will be okay. And not, you know, old and unable to speak. I think that is, is, um, hyperbole. Um, but I think it’s going to be, um, interesting to see how they, how they battle it out. So hopefully we won’t get into as much personal attacks and people speaking over each other. Um, Yeah, I’m hopeful that

Bo Bartholomew: I’m probably a little more pessimistic on the debate.

Bo Bartholomew: Yeah. Uh, meaning I think there’s more Americans looking forward to pulling up to the TV with bowl of popcorn for the entertainment tonight than any form of substance. Yeah. Uh, it’s kind of like, um, Uh, Rocky, uh, the, the 10th where [00:29:00] there’s just one more round with yet the same rival. And, uh, it, it, it really is going to be fascinating.

Bo Bartholomew: I, I think, uh, I, I think there will be a lot of talking over each other and jabbing. Uh, I’m not sure, uh, they can help themselves, uh, to a degree. So I think the amount of professionalism will be wanting. Uh, but I’m hoping that it’ll give something to the American

Vic: we’re going to get some insight out of it.

Vic: That’s right. Through all the insights and interruptions,

Bo Bartholomew: honestly, we, the people, we, we want answers. We want to know where’s the economy going to go, where’s, where is the next president going to take us? Cause we, we need to begin to define that. And, uh, our country’s been a leader less. In terms of a firm vision as to who we are and who we will be.

Bo Bartholomew: For a long time now, and yeah, so yeah,

Vic: okay, well, uh, [00:30:00] hopefully you’re wrong and we get some, uh, actual debate of ideas. Okay, uh, shifting into the V. C. Report. So function raised 45 million. It’s a, uh, it’s in Austin. It’s kind of a, uh, membership based, functional medicine, kind of, uh, integrated medicine platform.

Vic: Um, have you seen this company? What do you, what do you think about this overall integrated medicine?

Bo Bartholomew: Yeah, I, I had not seen it. Uh, I did have to look it up. The, uh, it, it, it’s an interesting, the, the idea of a digital therapeutic. Um, I think there’s an appetite for it. The fact that there it’s almost a direct to consumer.

Bo Bartholomew: Type of business is the way I understand it. Um, is is unique because everybody right now is looking for the next silver bullet to help with their health issues. And we’ve got, [00:31:00] uh, with the baby boomers getting older, there is a lot of people with a lot of needs that you can throw a thousand things at.

Bo Bartholomew: And I think people are willing to pay for those things.

Vic: Yeah. So, um, I think it’s a good. Sign that we’re starting to get decent number of 40 50 60 million dollar rounds every week. Yeah

Bo Bartholomew: Yeah, I definitely think you’ll start to pick up um Well, this may, uh, I’m not sure if this is the right example of what I was going to say, but I think there’s a lot of, uh, what I’ll call them A rounds, uh, early rounds a year or two ago, where investors are basically trying to Keep the company afloat at a flat round To get to that next yeah valuation.

Bo Bartholomew: They’re kind of having to grow back into the valuations that got a year or two ago

Vic: Yeah, yeah, [00:32:00] definitely.

Bo Bartholomew: Uh, I I do like this one in particular Adonis, this is what I would kind of 30

Vic: 31 million dollar series b

Bo Bartholomew: Yeah, AI in the revenue cycle space, uh, we’ve looked at a number of companies in this sector.

Bo Bartholomew: Uh, we really like it. Uh, I think using AI on things in healthcare that are not life threatening and patient impacting, such as the billing and revenue cycle, is a brilliant place to start. Uh, there’s a lot of manual labor going on that can be automated and leverage AI.

Vic: Yeah, I mean, the, um, the administration of healthcare, Back office, revenue cycle, billing, scheduling, all of those aspects that are really not clinical care.

Vic: You’re not necessarily hands on a patient. It’s something like a trillion dollars a year. It’s a lot of [00:33:00] money. Oh. Yeah. And incredible numbers of people doing manual data entry work. Yeah. And no, none of those people really love those jobs. And so I think this is a good example of a solution that can be really helpful.

Vic: And unlike a lot of parts of AI, the workers are welcoming admit that they don’t, they don’t necessarily want to do all these things. And so adding technology that can help, I think is important. I do too. Okay. So then we go to Jogo Health. They are a chronic pain company raised a five and a half million dollar round.

Vic: Again, another, this is a, this is a smaller round, New York based company, Mayo, as well as several financial investors invested. So,

Bo Bartholomew: uh, for me, one of the big takeaways is the FDA still has a lot of cachet. Uh, there’s a lot of companies out there that are doing good things and kind of have a marquee. Uh, brand name hospital [00:34:00] system behind their product, but to go in and have an FDA, CLIA, some sort of governing bodies.

Bo Bartholomew: Validation that does create value. Yeah, and as an investor we look at those things Uh, because the buyers of those products If you’ve got that that that’s kind of your golden ticket ahead of you. Yeah,

Vic: it’s a credibility stamp It helps with the sales cycle. It accelerates everything. That’s exactly right.

Vic: Have you ever done so this company? They did a five million dollar Uh priced round and now they’re doing a reg cf community funding Add on, which I had never seen the combination of those. I’ve seen the community funding stuff Yes, and the venture rounds, of course mixing them together is complex.

Bo Bartholomew: Yeah, i’m, um, I’ve been um the the I lost More money.

Bo Bartholomew: In fact, I don’t think i’ve ever made money In these kind of crowdsource. Yeah, like I [00:35:00] probably like

Vic: you I played around But, uh, I don’t know, 40, 50, 000 in one of these crowd things in maybe 15 to 20 different assets. Yes. And I lost money in it. It was not. And I learned a lot, but it was not good

Bo Bartholomew: challenge.

Bo Bartholomew: So what I worry when I read that is. Those are the most uninformed investors, and typically they don’t have any board representation. I don’t know whether this firm does or doesn’t. Um, but as I would encourage, uh, angel investors and hobby investors to steer clear.

Vic: Yeah,

Bo Bartholomew: you, there’s no protections. You’ve got no one representing typically, uh, you in the boardroom where things happen and, and

Vic: often it’s not the same security, which is, so I would be, I think I would be really in favor if you did a venture backed round and then made available an, an extra 20 percent for the community of the [00:36:00] exact same security.

Vic: That’s exactly right. Cause then the VC who is probably on the board. Is looking out for their own interests and they’ll inherently take care of the other people Yeah, but that’s not what happens. No

Bo Bartholomew: and and generally speaking So we we generally lead a rounds in health tech and fintech early stage businesses uh More often than not we don’t take the whole round and we want other syndicated investors, but we’re going to be predisposed to another strategic or fund that can go ahead and continue to participate alongside us.

Bo Bartholomew: The idea of bringing a crowdfunded type of investor pool, it’s, it’s minimal value. It’s not quite as strategic. And oftentimes you have a harder, uh, time dealing with the follow on financing. The one we lost a lot of money on, uh, was an overseas London based headquarter company. [00:37:00] Fantastic company. I still love the business.

Bo Bartholomew: I think we need it here in the U. S. Um, but they just ran it in a way and, and I literally think he had 2, 000. Investors he had to get signatures from

Vic: yeah

Bo Bartholomew: in order

Vic: to do anything. Yeah, I think the sec is trying to slowly open up the opportunity to folks that are Not accredited and not in the vc Lp space, which I think in general is is something that is really valuable for the overall Economy and for people’s opportunity, but it needs to be structured In a way that kind of aligns interests and well, I I love the way you all done jumpstart

Bo Bartholomew: And

Vic: everything.

Vic: Yeah. Yeah, so if

Bo Bartholomew: you’re an angel investor out there Uh, go through a structured program where there’s vetting, there’s discipline, there’s some governance, uh, go through a fund, right? Uh, you and I, yeah, but for jumpstart,

Vic: I mean, so [00:38:00] we have a low minimum 15k minimum and uh, I don’t know what’s rock months minimum.

Bo Bartholomew: Yeah, we we’re a little bigger. We’re about half a little bit again, but

Vic: For jumpstart, even at 15 K, you have to be accredited. Yeah. And so that is a million dollar net worth, or there’s an income test. Maybe it’s 300 K, but, but it limits, uh, certain people, if you’re not at that threshold, you can’t be in.

Vic: And we have chosen to not go to the community reg CF stuff, because I don’t know that the, all the regulations are that. solidified it still feels kind of moving but So I agree it’s complex, but I mean it was interesting to see it occur And be happy to watch joe go and learn from them

Bo Bartholomew: I do think you’re going to see a little bit of pace pick up this Back half of 2024 on in deal making and deal making there’s a number of ipos that are kind of in the queue

Marcus: Yeah,

Bo Bartholomew: so to speak, uh for the last 12 months i’ve been [00:39:00] hearing the bankers say that You Spring of 24, you’re going to see the IPO market open up and I think it’s actually happening.

Vic: Yeah. Yeah. There’s been a couple, one, two, three a month kind of, but hopefully it’s going to pick up a little bit more. Yeah. Um, I was talking to one banker, I guess two weeks ago, I was at a conference and he was saying it’s a 5 billion. You need to be 5 billion or more to go public, which seems way too much.

Vic: Way higher than would be healthy. I think

Bo Bartholomew: well, I also think you’re we I’ve watched a couple companies Go overseas.

Vic: Yeah

Bo Bartholomew: to go public.

Vic: Yeah, London is the

Bo Bartholomew: Even several years ago was on the board of a company. We try to go public in Australia Yeah, and so it’s it’s gonna be really fascinating. Yeah how that plays out in the midst of the, the world economic discussion we said earlier.

Bo Bartholomew: All

Vic: the, all the fraction, like a fracturing of the [00:40:00] globalization. That’s right. Okay, Sharecare has been, um, around Nashville and Atlanta for, gosh, for a long time. They are going private. What are your thoughts about Sharecare? 500 million dollars, so they’re going private for 518. Atlanta based PE firm.

Vic: Although that sounds like a lot of money. I think it is, uh, kind of a okay graceful ending to this Sharecare as a public company. What are your thoughts about Sharecare?

Bo Bartholomew: Yeah, uh, I’m, I’m, so first of all, I’m, I’ve been a big fan of Sharecare for a couple of reasons. The product

Vic: is, is, it’s great.

Bo Bartholomew: It is, uh, I think if you scroll down in the article, I want to say they were valued at, what was it?

Bo Bartholomew: 3 billion. Uh two years ago, yeah 3. 9. So we go from 3. 9 to 518 You know not ideal like the great story and they’re still burning Uh, so I think this is a story of good company good product [00:41:00] um got out over their skis very ambitious and Now they got to have someone else help bail them out Um, one of the reasons I love share care and they they featured in this article, but their product care link.

Bo Bartholomew: Yeah You Is a company, uh,

Vic: that’s one of their best products, really, I think. Yeah. It, it,

Bo Bartholomew: it continues to grow. It spins off a lot of cash and it fits the theme that, and, and of, of workforce needs.

Marcus: Mm-Hmm.

Bo Bartholomew: that everybody in healthcare is facing right now. Um, yeah. And I, we may talk about it a little later, but you’ve got, um, 70,000 physician shortages, openings coming up, primary care.

Bo Bartholomew: Uh, in the next 10 years, uh, you’ve got 140, 000 physician shortage in rural areas. Yeah. And then you’ve got 330, 000 shortage of registered nurses in the next 10 years. Uh, CareLink specifically solved some of that by being The dating app [00:42:00] or the uber for In home caregivers. Yeah,

Vic: it’s like a matching dating matching app for um, what you need for your mom At home care.

Bo Bartholomew: Yeah.

Vic: Yeah

Bo Bartholomew: brilliant. And uh, I I think they were looking for a home They found a good home and share care got a good price. Uh, but share care needed their cash flow

Vic: Yeah,

Bo Bartholomew: so I think a lot of that cash has been going to offset other losses Is So I think there’s a few assets I wouldn’t be surprised if, uh, the new owners try to carve out some of it, um, but there’s some really good products inside that company.

Vic: Um, okay, and then the last one, Grail is spinning out of Illumina, so Illumina is the genetic testing sequencing company that they tried to acquire Grail, and this is one of those that got blocked by the, really by the EU, although I think the FTC also was looking at it. Yeah. [00:43:00] Um, And it’s a failed deal.

Vic: It’s they can’t get it together. So, so they are now parting ways and grail will be, uh, independently traded again. And sort of three years of sorry, uh, this is not going to work. I,

Bo Bartholomew: I think, um, anybody in healthcare. It seems to go in waves, and maybe this is just the old guy in me talking, but every five to ten years, governments get certain things on their agenda, and they get, they become experts at that.

Bo Bartholomew: And I think the EU, this is an area that they’ve been targeting now for three or four years, and it’s going to be very difficult to get things done. Obviously, And we’ll talk about this in your next section, but we, we’ve got the FTC right now really locking down on, on health systems. Yeah, yeah. And it’s going to make it not, you can’t, you know, You’ll be able to navigate it.

Bo Bartholomew: It’s just going to [00:44:00] be harder, more expensive, and take longer. Well, and the amount of

Vic: time that, um, it takes to get through the court process is crazy. I mean, it’s been four years since they’ve tried to do this. And the amount of time and waste and legal fees, um, I think I’m okay with the, uh, regulatory bodies saying, here’s the set of rules.

Vic: And if you are trying to do something that’s not competitive, we are not going to allow that to help our consumers, but we got to get through the process faster, I think.

Bo Bartholomew: I don’t know if they’ll ever give us the, uh, the rules of the road ahead of time. I think they wait until they see deals happen and then lean in.

Bo Bartholomew: Uh, so yeah,

Vic: unfortunately. Yeah. Okay. So now shifting over to, uh, policy. So the surgeon general came out this week with a declaration that gun violence is a public health [00:45:00] crisis. Yeah. And I kind of have two questions. Two conflicted feelings about this. I completely agree with them. It is a public health crisis and he has been silent for years.

Vic: And then all of a sudden, back to back last week, he’s talking about social media. And this week he’s talking about gun violence. All he really has is the bully pulpit and the ability to like. Symbolically say this is what the yeah most senior doctor in the US government thinks I don’t know that it makes sense to do it back to back like that, but I don’t what were your thoughts about it

Bo Bartholomew: I I applaud it.

Bo Bartholomew: Um Um former military. I have pretty strong feelings on the use of of guns. Yeah I’m, i’m a big proponent for anybody to have a gun if they know how to do use it Yeah, and they’re using it responsibly, but there’s no need to [00:46:00] Yeah. You’re not hunting with,

Vic: with an automatic. No.

Bo Bartholomew: Um, and honestly, if you’re going to have one, most of the time.

Bo Bartholomew: Responsible gun owners would be the first to say, let’s go through appropriate training. Yeah Let’s get a former military folks to train us how to use this the right way And and you get to know the people and if they can pass those tests They’re going to have some amount of stability and health, right?

Bo Bartholomew: Um I think it’s no coincidence that social media and gun violence are coming out at the same time.

Vic: Oh, really? So you, you think they are related together?

Bo Bartholomew: I think the implications of both is what we’ve felt now for a decade. And we’re suffering for those, uh, in the Nashville community. around the Covenant shooting.

Bo Bartholomew: I mean, it is unfathomable what colleagues and friends and some of our dear friends and their kids to lose a daughter or a [00:47:00] child to that. Like, that’s unacceptable. We should not accept that as a country. And, uh, not only uh, Yes, the Surgeon General, as I know it, was the one who saved millions of folks because we put that label on cigarettes.

Bo Bartholomew: Yeah, right. So, how do we get that out there in a way that’s truly meaningful again? I don’t know the right answer. Yeah. So, I don’t know what you do with it, as you said, but I do think he’s pointing the spotlight in areas that I think he should.

Vic: Yeah, so I, I agree that, uh, weak gun laws or lack of gun laws cause Cause us citizens to die.

Vic: There’s no, I think there’s no question about that. Yeah. Um, but I, I was, I’m, I guess the reason I’m frustrated with this is I think there’s a lot of [00:48:00] work to do in the social media story and by him coming out. In the next week, it just sort of like closes that social media story and we’re on to guns.

Marcus: Yeah.

Vic: And

Bo Bartholomew: it could be that. And there may be some kind of agenda behind the scenes. My hope actually for both topics would be that the surgeon general allows there to be Bipartisan point of commonality that allows people to come together and work together, because right now no one wants to work with anybody.

Bo Bartholomew: They just want to be the most extreme they can be and and then, therefore, nothing gets done.

Marcus: Yeah,

Bo Bartholomew: so,

Vic: yeah, I mean, I guess the, uh, framing gun laws and gun policy as a health care issue. I don’t know that that goes anywhere. useful [00:49:00] because it’s a political issue and a legal issue and a cultural issue. I really like the idea that warning parents that social media is highly addictive and is perfectly fine for adults that know how to to manage vices.

Marcus: Yeah.

Vic: But for children that are not Their brains are fully developed to be able to navigate that the parents should Be involved and it’s very similar to the smoking warning and making it

Bo Bartholomew: I think if if Let’s speak to parents our generation with our kids. I mean, I hate to say it, but they’re kind of screwed like Our kids we we didn’t know any better Uh, I have a dear friend whose daughter was really struggling This was five ten years ago and the doctor said you need to let her be in a room on her phone You As part of a therapy that’s good for [00:50:00] her and only now in hindsight with struggle with depression and other mental health issues Did he realize it only made things worse?

Marcus: Yeah,

Bo Bartholomew: and so if nothing else I was with a an LP down in Birmingham this past week young kids and he’s like I can now tell my daughter to say the Surgeon General says it’s bad for you, so we’re not going to do it. And if some other parent wants to go against the surgeon, like, yeah, there’s parents that

Vic: buy their kids cigarettes or whatever, but doesn’t mean I, yeah, you’re equipped, you have like a backup, you have something to point to.

Bo Bartholomew: Yeah. And, and, and maybe it’s a way that, that if nothing else, by naming it, calling it what it is, it creates those communal discussions. Yeah. That allows there to be a point of reference and, and uh, [00:51:00] commitment to doing the right and most healthy and, and safest thing for our kids.

Vic: Yeah, I agree with that, definitely.

Vic: Okay. Um, okay. So moving on to the ending of a story, outcome health was a fraudulent advertising company in health care. Yes. And the CEO got sentenced to seven and a half years in jail, uh, yesterday or the day before. Did you know outcome health when it was a high flyer? What do you think about this guy going to jail?

Vic: What’s your thought about it?

Bo Bartholomew: Uh, we crossed paths, um, a little bit, 10, 12 years ago. They’ve been around for a while. Yeah.

Vic: I remembered thinking like I was competing with them, like, gosh, how, how are they killing us like that? And it turns out that they were manufacturers making it up.

Bo Bartholomew: So, yeah, uh, I, I never got, uh, cross paths from that perspective.

Bo Bartholomew: I just heard about them in the market, but it was even, um, and I would say 10 years ago, there were people who kind of, [00:52:00] once the word got out that like either they’re don’t trust them. Or that I felt like there was a lot of negative in the industry around it before ever anything became public

Vic: Yeah, so the rumor kind of comes out before the the police come in maybe yeah,

Bo Bartholomew: yeah, and I I think the takeaway is like Everything’s gonna come to light.

Bo Bartholomew: And you gotta run things the, the right way. Um, uh, five or six years ago I was with a small group, um, and one of the, the, the former engaged executives at Theranos Mm, yeah. put a small group in Nashville together and said, Look, here’s the twelve reasons Theranos would never happen in Nashville. And I remember it going, this is the most fascinating conversation I’ve ever heard.

Bo Bartholomew: And, uh, a lot of it was just the way you do business, [00:53:00] by having accountability, talking to your peers, having appropriate governance. And the idea that, uh, a Theranos or an Outcome Health could happen, it’s kind of hard to fathom if you just do business the right way, and you’ve got the right transparency.

Bo Bartholomew: Yeah. Yeah.

Vic: Yeah, I think I think that’s right. And it’s it’s good to see that bad actors get punished.

Bo Bartholomew: Bad guys belong in jail.

Vic: Yeah. Okay. So, uh, United Health came out with a report about their diabetes program. Last week we had Humana with a, uh, kidney disease, uh, program that had real good success. And this, so we have a new payer this week talking about managing a one C levels pretty successful.

Vic: Um, What are your thoughts about this program?

Bo Bartholomew: Yeah, I’ve, uh, I’ve been on the board of a couple different diabetes [00:54:00] management companies over the years. And, uh, you know, we used to have a publicly traded company that had a building shaped like an H, um, around this very topic. So, a couple things. One, I, I do hope.

Bo Bartholomew: These programs, uh, are meaningful to, to the patients. I’m skeptical with payers. I mean, their business models are designed and no offense to the payer executives on your, your listening pool. Cause there’s great payer executives, individuals who are doing this for the right reasons, the right way. But in general, uh, a payers business model, Is to get as much money in per member per month and to spend as little money as possible per member per month.

Bo Bartholomew: And so if you can put a, a low cost program like this in place and see some [00:55:00] outcomes and keep money in your car, like there’s just some of that, that That I always struggle reading some of these results to figure out what’s really real behind these numbers.

Vic: Yeah. Yeah. I mean, I think, well, I think that the payvider or the integration of health systems and doctors with an insurance underwriting component is the way that we have to start moving the system.

Vic: And there are health systems. We’ll talk about Kaiser in a couple of minutes that are building on that model. And I think United Health Group is coming at it from the other direction. They’re, they’re sort of adding optimum and a lot of the care first data, but then more recently care, I think they employ the most doctors of anyone there.

Vic: So it’s sort of, um, my view is that them adding in. Um, disease management, uh, patient support [00:56:00] type tools, like a type 2 diabetic managing the A1C. Um, Is a positive thing, just like I think it would be good for a health system to add in underwriting and, and more payer things. So I think it’s good that the payers are starting to move into that space.

Vic: And I think it’s good that they, that they publicize their results. Now, obviously they are waiting until they have good results to publish, but that’s not unique to United.

Bo Bartholomew: No, it’s not and and there’s a lot of diabetics in our country.

Vic: Yeah, and and and they don’t manage the a1c levels Very well, that’s exactly

Bo Bartholomew: right.

Bo Bartholomew: And I know we’ll talk about some of that in your last section. Yeah.

Vic: Yeah the pharma folks Kaiser announced their new brand resent when they bought geisinger, maybe six eight months ago. That’s correct It really got my attention and got everyone’s attention because Kaiser is one of the best and biggest integrated healthcare delivery systems [00:57:00] in California, largely, and they do a really good job and then they bought Geisinger, probably one of the best platforms on the East Coast.

Vic: And that’s pretty interesting. And at the time when they branded it, Ryzen, they were talking about other systems and yesterday they announced the acquisition of cone health in North Carolina. Maybe they’re in South Carolina too. I think of them in North Carolina. Um, what are your thoughts about this? It seems like Kaiser resort is, uh, going to grow in geographically diverse Areas, which is much safer from a regulatory approval process.

Bo Bartholomew: Exactly.

Vic: And it’s going to expand the quality and the integrated system.

Bo Bartholomew: It makes all the sense in the world. Um, part of this system is where is our client. And so we,

Vic: Oh, you have, you have, you, uh, work with, we do.

Bo Bartholomew: Yeah. And, uh, they, they, we. We’ve heard rumors [00:58:00] already that there’s another five hospital system kind of, uh, probably announced in the next quarter or two,

Vic: if I’m guessing, um, I think the, and they’ll fill in different geographies, there’ll be Southwest, there’ll be Midwest.

Bo Bartholomew: That’s exactly right. And, and, and for years, there’s been kind of this, uh, And I can’t remember the name of it, but there was literally an association of regional payviders that didn’t compete with each other, that all kind of came together, strategized together, worked together. Almost like

Vic: the Blues Association, except for regional payviders.

Bo Bartholomew: Yeah. Very, very similar. And, and, and so it’s not surprising. I do think the payvider integrated system. Model has enormous advantage, competitive advantage, and if they can overlay, uh, their insurance arm on top of a Cone Health that doesn’t have one today. Right. [00:59:00] Overnight, you can begin to make better financial, uh, margin and sense of these.

Bo Bartholomew: Yeah, you can

Vic: immediately improve your finances. What’s going to be And you also can negotiate more effectively with United or whoever the payers are there across North Carolina.

Bo Bartholomew: And what’s going to be fascinating, because there’s also this, uh, narrative that, uh, hospital systems are beating their head against right now, that for profit or, or, or acquisitions hurt care and drive up costs.

Bo Bartholomew: And so, uh, I think it’s kind of, hospitals have got to be able to do these things to drive efficiencies. Uh, they’re the largest employers in all these communities. And they’ve got to find ways to get more efficient because that’s Mostly how their business model works today Payviders have the [01:00:00] advantage Because they can begin to lean into The value based care or other arrangements of the future and not let the lever of money being on one side of the ledger or the other interfere with best patient care.

Bo Bartholomew: Right. And I think that’s what Kaiser’s gotten right.

Vic: And instead of the narrative, which is not always true, but instead of the narrative that, This, uh, regional health system is acquired by a big national player and they cut a lot of the leadership jobs and funnel money to wherever corporate is. I don’t, I’m not sure, I don’t think that is in actuality true that often, but, but that’s the narrative versus, uh, Kaiser Resident acquiring Cone and now bringing in the payer side.

Vic: And maybe there’ll be some leadership roles that, that aren’t [01:01:00] there, but they’re adding a whole another set of capabilities.

Bo Bartholomew: Well, you could argue that it’s going to be higher quality care. Yeah. In, in reality, um, I know people in the common health market that have gotten care there, and, uh, they, they’ve had to, Fight with their payer or try to get self pay and all those kind of things everybody’s dealing with.

Bo Bartholomew: But if it’s integrated, it’s gonna drive the cost down while also improving quality, which, which everybody wants.

Vic: Yeah, yeah. So good to see them expand. And then, um, UAB also is expanding. Now, this is, Within their their footprint. I think the ascension st. Vincent system is right there right there, too Yeah,

Marcus: yeah,

Vic: so this one is pretty different.

Vic: This is more of a consolidation in the same geography Yeah, market share. Yeah, and I think although it’s small is [01:02:00] more likely subject to questioning from regulators

Bo Bartholomew: I think it is, uh, but at the same time, like, They needed to survive. They have

Vic: to consolidate to keep going.

Bo Bartholomew: It’s, it’s fascinating to me because we see a similar story in college education right now.

Bo Bartholomew: Where the bigger campuses that buy up smaller ones and put their programs in diverse locations. Meanwhile, you’ve got, there’s a school in Birmingham, Birmingham Southern, going out of business. It’s Going bankrupt. Um, there’s a bigger story there, but I, I think we’ve gotta let hospitals work together to drive efficiencies.

Bo Bartholomew: HCA, Uh, the mothership here in Nashville, they, they’ve proven the model, like when you have markets that can work together to drive efficiencies, obviously get better rates with the payers who have had a heyday for the last decade, [01:03:00] um, the hospital systems have got to find ways to get that margin shifted back over delivering true value add patient care.

Vic: And Alabama is certainly. Blue cross alabama has a lot of negotiating power because they have plus percent

Marcus: market share and

Vic: so Even though it’s consolidation. It may be necessary to sort of keep going

Bo Bartholomew: So that’s an interesting comment, by the way, you you allow for Market dominance on the payer side, but you prevent it for all the hospitals in the same market Well

Vic: the way that sure that’s really the way the blue cross thing grew up, you know, over the last hundred years, uh, they were limited to only one state by, by statute, I think.

Vic: And then now it has been broadened, but, um, yeah, the government’s ability to navigate this is maybe not ideal.

Marcus: Yeah. [01:04:00]

Vic: Um, okay. So then there’s a story in the journal, um, that I wanted to talk to you about. It sort of goes directly to this question of, okay. So the title is when hospital prices go up local economies take a hit and it’s a pretty It attracted my attention the headline But how I know you looked into this in detail.

Vic: Yeah You know rising health care prices We all are concerned with and for those of you that are listening and not watching on youtube. First of all, you should Subscribe to youtube and watch the the you can see how handsome bow is Um, but we also have some graphics on marcus

Bo Bartholomew: is

Vic: much better looking.

Vic: Trust me. So, um, We have a graphic up here where the average impact of hospital price increases. So when the prices go up, [01:05:00] um showing that there’s five percent in job losses and Uh reduction in wages And less taxes, uh, but you you dug into some of the details of this. So talk through uh, what your takeaway was

Bo Bartholomew: Yeah, I think I think this was um I don’t know who the author is, but the it was a little bit of a stretch if you go down to the map Uh, they pulled out here, right?

Bo Bartholomew: uh, what’s what’s really fascinating is The the light blue which is most of what all these are it’s it’s

Vic: Yeah, so for people that are listening, it’s the map of the U. S., there are 20 cities where, um, there has been a merger of health systems. All in major markets, by the way. Yeah, so Dallas, Austin, Nashville, Atlanta, Tampa, New York, Boston, Cleveland, Chicago.

Vic: These are all the big cities and where deals are occurring. And then there’s a color [01:06:00] coding thing. Showing about the, um, employment declines, sort of around that market. Yeah. And so with that framing, uh, what was your takeaway?

Bo Bartholomew: Yeah, my, well, first of all, almost all of it is 10 to 150 people. Right. And, and for So in the

Vic: city of Dallas, 150 people or less lost their job.

Bo Bartholomew: That’s

Vic: correct.

Bo Bartholomew: And, and they were trying to correlate with mergers. With unemployment insurance applications, um, and maybe they did it from those same institutions, but if you’ve got two 6, 000 personnel Organizations merging I would expect there to be 10 to 50 people you don’t need to as cfo’s you don’t need.

Bo Bartholomew: Yeah,

Vic: I mean if you have 6, 000 in each company You don’t need 12, 000. I think you might cut more than a hundred jobs. I mean, 10 percent

Bo Bartholomew: I think you still got a shortage of nurses. You still have a shortage of [01:07:00] doctors. They are not cutting, uh, clinical care jobs. Um, in many cases, and, and I’m, uh, I’m around the revenue cycle industry a lot.

Bo Bartholomew: We’re an investor in some, uh, there’s an enormous amount of outsourcing back offices occurring around the market, typically around mergers. Yeah. So if you’ve got one group that outsources all their, you are their revenue cycle denials management. And they merge, they’re going to do the same thing. A lot of that occurs with rebadging.

Vic: Those employees, um, Yeah, so they end up going to work for the company that is now managing the revenue cycle.

Bo Bartholomew: Very well possible, and quite honestly, there’s a lot of remote workers. Um, I think the industry statistic is most remote workers have two plus jobs. In the software industry I work in, if you’re a developer, Uh, I read, uh, and I’ll have to find this and get the, you all need to [01:08:00] talk about this.

Bo Bartholomew: The average software developer has five plus full time jobs.

Vic: Like I can’t even fathom. I want to look into that. Like that. Um, how do they, I want to look into that. We need to do a whole show on that. How would they, how would they keep up with five full time jobs? They’re obviously not working. 40 hours a week on all of them.

Bo Bartholomew: Well, there’s folks getting their keyboards working. And encoding is a very hard thing. It’s a hard thing to quantify. And you can do it at 2 in the morning. You can do it 2 in the afternoon. So there’s some nuances there, but I just say all of that is with the economy tightening up over the next year or two, with folks becoming more efficient, you Employers know who’s delivering.

Bo Bartholomew: Yeah. And they know who’s not. And any of us who have a job, we need to show up, put the company first, deliver value, or we don’t [01:09:00] deserve the job we’ve got. Yeah. And, uh, you know, there, I hate to say it, but there’s probably folks who were taking advantage of whatever organization. And when a merger occurs, the spotlight shows who’s performing, who’s not.

Bo Bartholomew: Yeah. Everything

Vic: becomes very visible. Everything is examined. Yes. And, um, if there are a few hundred jobs. That are lost. I don’t know that’s that’s that big of a story

Bo Bartholomew: No, and and I think that was just my criticism of the article is they’re trying to make this a broader right?

Vic: thematic well, there’s a thing in the zeitgeist around private equity buying up health systems consolidating and, um, cutting jobs and making the services worse for patients.

Vic: That has occurred. It’s not like that never occurred, but I think, you know, we’re here in Nashville for profit. You and I both know several private equity [01:10:00] guys and girls in that space, and certainly they’re bad actors, but there’s also a lot of good firms that do it.

Bo Bartholomew: Well, and, and if you look at, uh, there’s, there’s countless articles about, uh, hospital margins.

Bo Bartholomew: They even rank hospitals by how much margins. Yeah, right. And the majority of the hospitals in our country operate on a negative margin. There’s a, everybody loves to say hospitals have a 4 percent operating margin. Well, those are the best performing ones. And so the idea that you’ve got underperforming businesses.

Bo Bartholomew: And you’re not going to allow them to have access to capital. They’re going to get it different ways. Not for profits use a lot of leverage in the banks. For profits, they’re going to use private equity. So at the end of the day, we don’t want to hinder any business from doing what they need to do to be successful.

Bo Bartholomew: But if you’re going to regulate things, I mean, the [01:11:00] amount of regulations on a hospital, Like, who in the world would want to get in that business if they didn’t care about patients and doing the right thing? And it’s like walking into the, the, the deepest swamp of regulations you can walk into in healthcare.

Vic: Yeah. Yeah, so I think we both agree this story was, uh, maybe, More bluster than than real so moving on to the um, Pharma and sort of new therapies right aid has now sort of shown their bankruptcy plan Which involves closing a bunch of stores in ohio and michigan um, they’ve already closed several but then also Using the bankruptcy to get out of the opioid settlements and about uh, is it 2 billion in debt?

Vic: Two billion in debt will be, will be, will be, um, washed away. [01:12:00] So, uh, what, what do you think about this story? And then also the next story, which is Walgreens. Came out today with their earnings report, not a good earnings report. And they’re, they’re closing a lot of stores. They didn’t say, but a significant portion of their 8, 700 stores, uh, and cutting back their village MD relationship.

Vic: So it’s, you were in pharmacy managed, uh, farm day was a sort of medication management. So not exactly dispensing, but adjacent to that, the business of running a pharmacy is hard today. Everyone’s losing money, I think and yet we need them.

Bo Bartholomew: Yeah, it’s uh, it’s been a fascinating industry to watch over the last few decades because pharmacies Well by virtue of their name bring value because of the pharmacist who’s there to assist patients with their medications Yeah, and what most people don’t [01:13:00] realize is Medications are hurting as much as helping and Yeah.

Bo Bartholomew: Patients. Uh, the average Medicare member is on 13 plus medications. Um, my co founder, Clayton McWhorter, his brother Fred, who was also a pharmacist. Always said if you’re on five or more medications, you’re beginning to harm your body more than help it Yeah, and a pharmacist all the inner

Vic: reactions and and yeah,

Bo Bartholomew: and for ever in a day The pharmacist was there in the community got to know the patient.

Bo Bartholomew: I know my pharmacist by name at our drug store and Uh,

Vic: and he or she You might have I mean a medicare pharmacist Recipient has how many docs five or six seven?

Bo Bartholomew: Oh easily my grandfather part of the reason I got in the business is my grandfather Was on 12 medications when he passed away Arguably his bad habits [01:14:00] led to his early untimely death But the tragedy of it all was no single doctor Knew about all the different medications everybody

Vic: else was prescribing, but it used to be that You all went to the, you went to the same pharmacy for all your medications.

Vic: So the pharmacist could be that central point and see it all.

Bo Bartholomew: And, and our company back then, um, and many of the, the software out there is trying to attempt to do that. Uh, the, there is no reliable, good data on what you put in your mouth. Um, so the. Most of the industry operates on what did you purchase?

Vic: Yeah

Bo Bartholomew: and if you picked it up as a proxy for as a proxy and and so And I think one of your other articles around PBMs the they are the best business models in the world at moving volumes and volumes of medications and so that [01:15:00] has Taken a lot of the core business margins away from pharmacies so they’ve Uh, diversified and taking advantage of their retail locations, um, with both real estate, most of them are in good locations.

Bo Bartholomew: So can they add a lot more groceries, photography, uh, and, and then it was a big push, Rite Aid did a little bit of this and definitely Walgreens with putting clinics and doctors and urgent care. And I think people are finding like, that’s just a really difficult.

Vic: Yeah, so, um, Walgreens and CVS both own a PBM and Rite Aid does not, and all the independent pharmacies and the kind of grocery connected like Kroger or Publix pharmacies don’t have a PBM.

Vic: And it seems to me like [01:16:00] the, over the last 10 to 15 years, The big PBMs have sort of focused at making their margin on the network pricing PBM and sort of scaled back the dispensing fee or the part of the revenue that goes to the actual in store pharmacist dispensing the drugs. That’s right. And unfortunately, it’s no, they lose money on every script they fill.

Vic: They don’t get paid enough for the cost of it. And so where we go from here, I don’t know, but, but right now, as of today, Rite Aid is trying to emerge from bankruptcy, um, by not paying the opioid settlement and closing a bunch of stores and Walgreens is closing stores and cutting back on Village MD, which is their clinic partner.

Bo Bartholomew: Well, and there was, uh, and I don’t know the exact dates of all of this, but there was kind of [01:17:00] an arms race in the pharmacy. And, and it was. Who could have the most? stores It’s what they reported to the analysts. Yeah, and It was all about acquisition roll ups growth growth growth um And i’ll never forget one of my early days at hca Tommy frist was talking to a group of us about how he had pared the company down From the proverbial rick scott days and he said, you know, sometimes bigger is not always better and You I think in the pharmacy world, how can you deliver the right true care?

Bo Bartholomew: Because if you’re going to be in the healthcare industry, there’s a care component that I think consumers will notice, will be loyal to, and show up to if they’re getting That type of thing and so that’s a tough model. It’s frustrating to me because the [01:18:00] uh, Even walmart is uh getting out of the health clinics

Vic: the um, The importance of the role of the pharmacist or the community health care worker where like You could you could go into a pharmacy and it’s great if they have a clinic there and you can quickly get Evaluated.

Vic: Yeah. Um, that’s very valuable to people’s health and wellness and living their life And yet we don’t reimburse it in a way that really enables that or fosters that

Bo Bartholomew: In 2005 Clayton McWherter asked me to map out the pharmacy industry Okay, and he said I want to know how every business in the world of pharmacy makes money We could not find one You Business anywhere that made money by getting [01:19:00] someone off of a medication that maybe they shouldn’t be on.

Bo Bartholomew: Right,

Vic: right.

Bo Bartholomew: And that was some of the vision and the impetus of, of our design. And we were lucky because CMS passed some regulations about getting people on the right meds and, uh, using something called medication therapy management to screen and optimize, uh, A therapeutic regimen, because there are drugs that contraindicate, contraindicate with each other.

Bo Bartholomew: And they cause side effects

Vic: that present like perhaps another issue. So the doc then gives you a medication for that side effect. And next thing you know, you’re taking 13 different things.

Bo Bartholomew: I’m a huge fan of Dr. Mark Watkins, uh, here locally, the chief medical officer of Kroger. Uh, 10 years ago, he started preaching food is medicine.

Bo Bartholomew: Yeah. And I think if we can get doctors and pharmacists, uh, to kind of have the courage to say, Hey, Vic, [01:20:00] I can give you this medication, but what I really need you to do. Is go home and eat these types of foods for two to three weeks and see if it solves the problem Yeah, because that’s the single best thing you can do and oh by the way put some exercise on top of that Which I know you do a lot already Um, and then if it doesn’t work, we’ll go the medication route, but like we’ve gotten into a therapeutic culture It’s the american way To hit the easy button, get a script and to solve something.

Vic: I think that’s right too. Um, we’ll see, I mean, this week, both Walgreens and Rite Aid are cutting back. So yeah, the GLP ones. Have taken the kind of the world by storm. Everyone can benefit. It’s going to, we’re going to put GLP ones in the water, I think. Um, but there’s a shortage of them and they’re very expensive, 1, 200 a month.

Vic: And so Teva came out yesterday with a generic GLP [01:21:00] one that is authorized in the U S. And so they don’t have a price in here, but it’s going to be much less expensive. Uh, what are your thoughts about GOP ones in general and then this generic?

Bo Bartholomew: First of all, I think Teva’s got a history of being kind of the generic provider for a lot of Um, and there’s a there’s a business place Um that helps overall care by driving down costs Um, with this.

Bo Bartholomew: So,

Vic: yeah, generics are good to have in the market, whether they’re always the right choice or not. It’s up to you and your doctor. Absolutely,

Bo Bartholomew: absolutely. So I think in general, this is a good news thing. Um, I’ve even heard rumors. There’s a company with an oral. Yeah. Um, that, uh, is comparable with their results, assuming they get FDA approval.

Bo Bartholomew: So. Those types of things I think are definitely coming. Um, [01:22:00] you know, um, Jane Fonda and Richard Simmons were all the rage when you and I were in college or whatever. So I think there’s always going to be something trying to solve the age old issue of our weight in this country. Um, I think, generally speaking, I would say, generationally, people are more healthy than they ever were.

Bo Bartholomew: We think about it. We talk about it. My parents never did. Um, and, but I think from a pharmacy industry perspective, uh, the cat’s out of the bag. The results are there. I do worry that people have forgotten, uh, about the Fin Fin. Right. Um, which, which was only two decades ago.

Vic: Right, which was an amazing wonder drug until it started giving people heart attacks.

Vic: Yeah, and

Bo Bartholomew: it, it took The [01:23:00] Market by Storm. It was on commercials. It did all the same thing. This is

Vic: very similar to GLP 1.

Bo Bartholomew: Extremely similar. And there’s even a documentary on FemFem. So you can go out and watch it. But I, I, you know, I’m sure there’s a lot of families and loved ones who’ve asked you in healthcare, what do you think?

Bo Bartholomew: Are you going to do it? I tell everybody, you’ve gotta wait and see. And I love our scientist community, but the amount of people on this drug, we’re gonna learn a lot in the next five years to see what the downstream implications

Vic: are. Yeah, I think that’s right. It is, um, there’s a lot of attraction to this drug.

Vic: Take this shot and then all your weight problems are solved. Yeah. But there’s no free lunch, right? There’s something that is happening there. Yeah. I’ve seen studies where the, um, the GLP 1 that is commonly occurring in the stomach and in the body has a very short, uh, [01:24:00] uh, half life. So it, so it is, um, it’s localized to whatever organ is producing it.

Vic: And it has several uses. The brain uses it differently than the gut. And in order to make this more, uh, stable and commercially viable, the, the pharmaceutical companies extended the half life so that it would, it would last a week or something that lasts a day. And we don’t know what Negative effects, if any, that has on the body, but you have free floating GLP 1 hormones that are really supposed to have a half life of like five minutes, and now they have a, you know, 72 hour half life.

Vic: Yeah. And so that, that’s one example of, of how we need to maybe watch some of this live experiment in the wild before we jump in fully.

Bo Bartholomew: And, and. I think there are people who will benefit this that medically [01:25:00] speaking and probably tried everything under the sun Do have some some kind of morbid obesity issues That need this yeah, and it’s probably worth A payer paying for that, um, probably prevents a lot of downstream, uh, hospitalizations and all sorts of things.

Bo Bartholomew: But I think to have it as a mass marketed direct to consumer, uh, I know what is it his and hers is starting to offer their version of, yeah,

Vic: his and hers is doing compounding, which I think, um, it works fine when there’s a

Marcus: Yeah,

Vic: right. But, but no, we’re not. So the next story, no, we’re notice is, uh, building a 4 billion manufacturing plant in North Carolina, probably in the cone area.

Vic: Yeah. Um, and so we have a generic coming out and we have a bun. Now it’ll take a while from the build the plant, but I [01:26:00] think those compounding solutions and I’ve looked at, I don’t know if you have, I’ve looked at maybe 15 to 20 years. Yeah. Startups that are basically doing compounding glp1 with a wraparound Dread consumer website and i’ve avoided it just because i think it’s um, the timing thing you need to get in Quickly make money and get the heck out.

Vic: Yes, and I get nervous about those because i’m not good at timing the market

Marcus: Yeah.

Vic: So, um, but Nova Nordis is on the shortage right now for Wegovy, um, and Ozempic. And so they’re gonna build a huge plant to start making a lot more. Here it comes. Okay, we’re switching to our AI tracker. Um, okay, so Correlation for health, AI or Chai.

Vic: Is a group of, uh, industry health doctors, administrators, healthcare folks that are, they just released a proposal for testing the quality of an a healthcare [01:27:00] AI tool. I know you have done a lot of work in this space and you’re running a software.

Marcus: Yeah.

Vic: Uh, healthcare company. What are your thoughts about ai, uh, the responsibility of AI in healthcare, and what do you think of the chai.

Vic: Platform.

Bo Bartholomew: Yeah, I, uh, so first of all, uh, AI is, uh, is here. It’s alive and well. Um, we, uh, tend to avoid, uh, companies that are AI companies and nothing else. Uh, as investors, we like to see products that solve problems, but use ai. Mm-Hmm, . Yeah. And, and I’m using those words very intentionally.

Vic: So they use artificial intelligence to.

Vic: Take some action or bring some solution

Marcus: Yes

Vic: In health care where they’ve defined the problem and they’re now as opposed to like ai for fun Or ai to [01:28:00] do something that’s sort of more open ended. That’s right

Bo Bartholomew: and and I think you’re gonna have a handful of the navidias of the world that Uh are so large they can kind of give you their ai Platform, but I think you you’re gonna be very hard pressed to be a startup You And say you’re an AI company.

Bo Bartholomew: Yeah,

Vic: yeah, with my size fund or your size fund. I mean, you gotta be pretty big to, to, uh, go do that.

Bo Bartholomew: And, uh, one of our mentors and investors who teaches at MIT and Harvard, he said, Hey, look, when the internet came out, there were thousands of internet companies valuations. And then they realized, well, every food truck uses the internet.

Bo Bartholomew: Everybody’s an internet company. Yeah. And that A. I. Is a tool and all of us need to use it. Learn how to use it. We’ve got a evidence care university coming up where one of our programmers is teaching us all, which I know I need to learn. How we use [01:29:00] AI in our day to day lives to make ourselves more productive.

Bo Bartholomew: Um, the reason I think these types of organizations like CHI are important is any time an industry is facing a lot of unknowns, it’s important to get people around the table to say, how do we appropriately create, uh, the playing field, so to speak. Right. We like it. Uh, Rockmont. We invested in a company that we like to say was playing checkers when everybody else was playing chess with a, uh, some A.

Bo Bartholomew: I. Experts who were being brought into court cases where lawsuits were happening because A. I. Became biased and yeah, caused harm. Uh, they developed software that audits. And it’s learnings and it’s capabilities because the most auditors will go in and say, Vic, you gave me a mortgage two years ago using [01:30:00] these parameters in this decision.

Bo Bartholomew: And it holds true today. And that’s fine. The problem with AI is it learns. We don’t know. And it changes and it gets biased information. And so, uh, we invested in a company called monitor. And, uh, they are an AI governance or auditing company. So, any company anywhere using AI, you’ve got an outside third party.

Bo Bartholomew: How do you know your CFO is managing the financials correctly? You bring in an outside, unbiased third party. Same thing I think we’re going to see with AI.

Vic: Yeah, so like a financial audit, you’ll start doing a tech audit or an AI audit.

Bo Bartholomew: Yeah. How do you know your AI or your CTO is using it correctly? Right.

Bo Bartholomew: You just really know. Let’s bring an outside third party, unbiased, to make sure it’s doing the right thing. Otherwise, there will be bad actors, bad algorithms, because there’s a handful of bad apples. I don’t think the vast majority of AI is anything we need to be afraid of, [01:31:00] but we do need to have the right components, and I applaud organizations like CHI, uh, or companies like Monitor to try to provide.

Bo Bartholomew: The framework the guidance and uh the ability to hold companies accountable.

Vic: Yeah, so chai came out Uh, I think two days ago with their guide And there’s a 60 day comment period so we’ll put the the link to chai itself in the in the show notes I think it would be great for our listeners to go on and and give comments and I mean we have 60 days to read the chai Plan and provide feedback.

Vic: I think the more Perspectives that we get into groups like chai The better

Bo Bartholomew: one of those health care organizations listed. Yeah is trying to find ways to optimize their organizations We work with a lot of these health

Vic: systems. Yeah, so for people that are listening advent [01:32:00] boston children’s duke johns hopkins kaiser Partners, Mayo Clinic, MedStar, I mean, it’s a, it’s a list of, there’s a lot of really good firms on there.

Vic: Yeah,

Bo Bartholomew: and, and they need to be able to go in and deploy these things, but do it in a way that’s responsible. Yeah. And so I applaud these organizations for getting in there and doing this.

Vic: And there’s um, There’s value, I think, in collecting information from all across the country, all different size groups, and then also our listeners, and, you know, tell your friends that you should go in and maybe ask questions, or this is the moment, the next 60 days to sort of make comments, and then hopefully we’ll find best practices and, and, you know, And we can sort of help manage this whole crazy AI world together.

Bo Bartholomew: Yeah. You’ll, you’ll notice Amazon, Google, and Microsoft. To make sure that, uh, anything that’s regulated and guided, uh, supports

Vic: their AI business models. Yeah. Um, [01:33:00] okay. So Teladoc came out and we should have talked about this. When we were talking about the diabetes solution from United Health Group, um, but they came out with their AI diabetes management tool that gives in quotes nudges to diabetic patients through the Teladoc like phone app and they’ve had good results helping people manage their diabetes.

Vic: A1C levels. Um, what is your experience with the behavior change nudge? I mean that, at some level, you have a different user base, but, but evidence care is sort of trying to nudge physicians into the right place. Um, what are your thoughts about Teladoc and this behavior change?

Bo Bartholomew: Well, first of all, I think this is a perfect use of AI in health care.

Bo Bartholomew: You’ve got a company they’ve been struggling ever since kovat, but they were predicated on being a [01:34:00] Person based engagement company Uh, over the telephone, teledoc, and to be able to take the discreet, repeatable information database nudges or guidance and use AI to do that. That’s a perfect, you’re going to drive more efficiencies as a business.

Bo Bartholomew: The

Vic: perfect example of, of a business need that AI can address.

Bo Bartholomew: That’s exactly right. So I, I, I applaud, uh, I’m not surprised. Have better engagement the AI algorithms probably do learn and work especially if you have turnover of your health coaches and And uh your clinicians behind the screen. So, um I think this is a great use and I applaud Teladoc.

Bo Bartholomew: They’re a great company and I’m hopefully things like this will begin to Pull them back up. Yeah.

Vic: Okay. And then the last AI story, meta shut down a bunch of its, [01:35:00] uh, biology research, AI team, and out of those, um, that was in 2023 because, you know, new biotech inventions didn’t seem core to meta, um, And so, um, a new round led by Lux Capital, who I think is a great, uh, VC firm in New York City.

Vic: Really kind of a deep tech. They do a lot of healthcare too. Yep. They put a significant amount of money in. I think it’s, uh, 140 million? Is that right? Yeah, 142 million. 142. Yeah. Into a company called Evolutionary Scale. And I’m trying to process this. I’m going to summarize it. I want your comment. I think they are, so a large language model.

Vic: Like we normally think of, ChatGPT or others, they have, um, ingested or taken in and absorbed all [01:36:00] the text on the internet. Yep. And then through some process that is hard for me to understand, they understand all the patterns and can somehow predict the next letter or the next word in a way that seems to replicate what’s going on.

Vic: Our communication language. And evolutionary scale is Doing the same kind of thing, but instead of ingesting text, they’re ingesting DNA and RNA and ribosomes and everything they could find in nature. Um, not human. I mean, there is human DNA, but all kinds of DNA from all over the globe. And we’ll put the link in the show notes is a pretty interesting 90 second video about it.

Vic: Um, the concept is that you can then take something like Could we make up a new, [01:37:00] uh, a new bacteria that will eat up plastic in the oceans?

Marcus: Yeah.

Vic: Um, I get a little worried about unintended consequences, but it’s a pretty interesting thing to observe. It just got funded with 142 million dollars and whole new world.

Vic: Evolutionary scale is a pretty bold name.

Bo Bartholomew: You know, I, uh, so a couple things, uh, thematically, uh, alongside Lux, uh, the other two big name investors were Amazon and NVIDIA. Yeah. So you’ve got a big play here with folks with lots of money who are betting on a pedigree of those leading it, um, and a thesis that kind of makes a lot of sense because you’ve got.

Bo Bartholomew: Uh, the world of biology in and of itself is, is complicated and fascinating. Yeah, it’s a whole new language. I mean,

Vic: just like we use English [01:38:00] as a language, biology uses DNA and, and um, It’s hard for us to understand the language, but a large language model maybe could.

Bo Bartholomew: And so this has got the makings of a big success.

Bo Bartholomew: I think what we don’t know is what is the value that comes of it? Does it make your biology experiences 10 times more? Efficient and does that really have value or is there something new and novel that ai is going to be able to introduce? And I think that’s the bet That they’re making um that quite honestly most of us would hope they could make yeah We’d love to find the the cure to alzheimer’s or the the cure to plastics in the ocean Um, so I I like the bat.

Bo Bartholomew: I like the the the pedigree in the company Um But this is a high risk, high reward. Yeah. Um, and if you’re [01:39:00] gonna capitalize on what true artificial intelligence at scale on masses amount, uh, massive amounts of data can do this, this might be it.

Vic: Yeah. Yeah. So I, what I’m, they didn’t announce very much. I mean, it’s a, um, it’s a showy announcement to grab attention, which, you know, It’s probably what I would do, what either of us would do too if we did a new deal.

Vic: What I’m hopeful about that wasn’t totally clear is, we have a lot of, uh, biology and chemistry research labs in this country and other countries. And I think it would be really interesting to have a simulation, Model that researchers could use to sort of test a bunch of creative, novel, new ideas, look for similar, um, maybe pathways in other in [01:40:00] other forms of life.

Vic: Maybe it’s in in some. Some sea creature or in some, uh, they were talking about the warm vents at the bottom of the ocean and things. Yeah. And, um, run it in simulation so you don’t have to actually do the hard work of in the wet lab, on the bench, one at a time, pipetting things. And we have tools to do that at bigger scale, but not like simulation.

Vic: Right. To then make us much more efficient and the humans that are doing research, they can be much more targeted or they can use their time more effectively. So that’s my hope. That’s why I wanted to cover this. I agree. It’s a big, big swing and I think it’s great to see it.

Bo Bartholomew: I, I, I think Nvidia is making their way into healthcare a lot these days.

Bo Bartholomew: There’s been a few other announcements, but. If I were them to take a small bet, because for them this is small, and to put it in a company that’s going to go all in on healthcare [01:41:00] is a really good move.

Vic: Yeah, yeah, so we should, I’d like everyone to go on to Chai and help us think about how to, Validate these things, how to vet them, how to integrate it into our system.

Vic: But then there’s more and bigger things coming. So we need to prepare ourselves. Evolutionary scale is going to be one of several things that are really big swings. So that’s what we have. Thanks for doing this, Bill. I really enjoyed going through it with you. Any other closing comments or things you want to leave the audience with?

Vic: Well, I,

Bo Bartholomew: um, during COVID, when I was, uh, sitting around, uh, looking for things to do, um, I used to, to do exactly what your, your podcast does, and I would geek out on the healthcare news. Yeah. So I applaud what you and Marcus are doing. Yeah. Would encourage anybody to listen to it. Yeah. And, um, This is fantastic.

Bo Bartholomew: I, I love the scope of what you cover [01:42:00] and for those of us in and out of the industry all the time, this is, these are meaningful. Updates we all need to pay attention to so thank you.

Vic: Yeah, and whatever domain We spend our career in like you and I are in venture and growth scale companies We know those sections pretty well but I I find it really beneficial to force myself to read up about the health system mergers and the payers and the macroeconomic stuff Because it’s all sort of intertwined together And we get so siloed that we don’t necessarily pick our head up.

Vic: So hopefully this podcast sort of gives people a little touch to all the different areas.

Bo Bartholomew: Yeah. So this was great. Thank you to, uh, to both you and Marcus for, for having me on the show.

Vic: Yeah. Thanks for joining. And we’ll have you back to talk, uh, give an update on evidence care as you keep growing.

Vic: Absolutely. So thanks pal. All [01:43:00] right.