Roja Garimella, MD
@RojaGarimella
Followers
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Following
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Media
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Statuses
79
building in health tech | past stops @HarvardHBS , @BrownUniversity , @McKinsey , @Humana , @CCAUncommonCare
NYC
Joined May 2022
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@healthcareandy
If you remove DTC and replace with care delivery (minus those with truly revolutionary care model innovation), think that almost all of this also applies
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@BrooketheOstomy
must have learned from all the nurses on the prior seasons- social media influencing pays way more than $5 an hr
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@erinbrodwin
PE is simply an efficient profit extraction model & their impact in healthcare is a proxy for incentive structures
Stopping deals isn’t going to solve problems unless we also solve underlying payment/comp models, anti-trust issues, COIs in vertical/horizontal integrations, etc
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@morgancheatham
chart review prior to admitting a patient w/ a complex PMH always took 1hr+ to do well, with much skimming for relevant info.
augmented chart reviews and discharge summaries-> time saved and every patient gets a comprehensive review (not just how busy is the Dr today)
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@benln
@nextplayso
Any healthcare folks? I’d love to meet them. Hiring for a couple technical founding team roles!
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@CoffeeBlackMD
@AjKavanaugh
I think he’s saying that training spots are artificially constrained (the system is keeping supply lower than demand intentionally to keep $ up)
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@BrownJHM
Dupuytren's 2/2 hepatic encephalopathy
it causes not just tremor but in severe cases can lead to to contractures
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@halletecco
hot take: because most are care delivery and very little care delivery should be venture backed (get PE / search fund money instead!). There's a reason we don't see mom & pop's obgyn practice who is offering tele med tryna raise VC money
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@GZuckerman
I'll be re-reading the man who solved the market (one of my favorites) this mo -- what a legacy he's left; thanks for sharing it with the rest of us
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@mariots
@vijaypande
it’d be interesting to see some vbc dollars go to payors who can reduce time to payment on hospital/emergency/high cost specialist or drug spend to <7 days - and should study the impact of this on patient outcomes (and costs)
should be doable at the state Medicaid -> MCO level
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@chrissyfarr
I think non-clinical folks would be surprised just how much human ETL is involved in clinical planning -- there are lot of use cases in “front office” clinical work that are just as time-saving without blurring into clinical decision-making too!
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@morgancheatham
Even better - “add to study” / “create study” button that helps auto-identify related cases. The # of hours spent scouring charts is such a limiter of the research we do… hopefully by research assistants but way too often by MDs too lol
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@KimiChernoby
imagine if residents were compensated based on their billables, law associated salaries would look like pocket change
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@VivHo
@veryyyyvera
@helenissocial
@eddie_eltoukhy
what a flattering photo (but truly great events!)
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@RIDICULO_pathy
at this point, I trust having AI do it way more... at least it's trained on actual med school textbooks
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@cturitzin
@dp_oneill
@CarbonHealth
@UHC
Health systems have been a far worse culprit- but virtual care (& esp virtual MSOs) have indubitably pushed up baseline rates (or charged crazy 30% take rates, acting as middlemen/further reducing provider margin), in the name of improved quality of care (I’m not convinced)
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@TroyShen3
Both low & high margin services! bottom line is we can expect same productivity with 1/2 the cost, relative to whatever current margin ; “tech-enabled” revenue cycle in healthcare is relatively “high margin” for HCIT, w/ AI-enabled roll up can easily 2x EBITDA / enterprise value
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@aiyappa__
@TroyShen3
Hmm, I’d love to agree as a start up founder. But I don’t think this is true in enterprise focused sales/ industries. Simple CAC and time to close those clients is worth the 2-3x ebitda acquisition multiple. The fastest start ups are going to have roll up strategies embedded
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@msuster
Agreed. Normally am anti imaging > labs w/o high predictive value because of the extra risks ("incidental findings" -> stress/invasive tests/risks)... BUT this one of those tests that simply makes sense and can prevent cardiac arrest with limited risks. Insurance should cover!
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@jareddashevsky
Is there really a debate on this? Even the most capitalist people I know who do roll ups probably wouldn't try to argue that it's actually good for patients / care quality. It's good for arbitraging rates and consolidating overhead - e.g. taking advantage of economics of scale
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@phlegmfighter
honestly I largely agree, but maybe we need a change to med ed financing instead — pay less, go be a primary care doctor
but also the world needs more ppl with clinical backgrounds in policy/public health/ running hospitals/insurance cos than we need cosmetic dermatologists
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@dvasishtha
"affordability is our
#1
,
#2
, and
#3
prio right now" - multiple payor execs in customer interviews this past yr
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@aiyappa__
@TroyShen3
You nailed it btw^^
Expecting to see smart growth investors looking for and wanting to fund this strategy in the coming years.
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@venturetwins
>50% of people I know who lived in sf have moved to nyc in the last 2 years. NYC tech is on the up and up, and the city is thriving!
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@morgancheatham
don’t think this makes sense when pediatricians make 180K and many cosmetic dermatologists, plastic surgeons, rad oncs, etc make $1M+. the latter group more likely to go schools like JHU and NYU in the first place.
debt isn’t the only reason people pursue high paying careers
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@DusetzinaS
I can’t tell you how many times I would just call a friend at the other hospital to get information on a patient’s history because it was necessary for inpatient treatment but the medical records dept/fax machines weren’t cutting it
This process and the fax machines kill ppl
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@dvasishtha
@chrissyfarr
Until payors buy/consolidate them like they are doing primary care
Only thing stoppin them are antitrust limitations
But I’d expect health system / regional payor mergers in 2025-2030
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@chrissyfarr
agree, churn in non Medicare market is
#1
misalignment for prevention (+ inc's barrier for high cost/high ROI drugs or procedures)
ideas for alignment // amortization of costs: a) pooled/securitized ICHRA contracts, b) supplmntl plan on top of HDHPs for high cost commercial pops
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@AlyssaJoyJaffee
plenty of people are building with a $100-200K pre seed; they’re just bootstrapping or not taking institutional funding. And you answered your own q imo - the need for so much $ is your competitors have it, esp in health tech when no one is building in totally net new markets
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@rtnarch
Have you ever been in a teaching hospital? M&M (morbidity/mortality meetings are weekly; daily rounds for teaching/revamping plans). Not saying AI won’t help make errors that might go unnoticed or swept under the rug more obvious but this feels like an unfair mis categorization
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