Podcast
Vital Signs with Jacob Effron and Nikhil Krishnan
Hosted by by Redpoint Ventures · EN
On Vital Signs, Jacob Effron and Nikhil Krishnan dig into cutting-edge trends in healthtech and the people shaping them. Every two weeks they’ll explore a new sub-sector and trend with policy leaders, startup founders and industry executives.
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32episodes
Episodes
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Ep 68: Garner Health Founder on Measuring Doctor Quality, The AI Landscape & What Improves Healthcare
1w ago01:00:56Tap to summarizeNick Reber, CEO and founder of Garner Health, joins Jacob and Nikhil to walk through what is arguably one of the most structurally underrated problems in American healthcare: that the single biggest driver of cost and quality variation isn't which hospital system you use or whether your plan is value-based — it's which individual doctor you see. Nick traces the intellectual journey from his time at Oscar Health, where he first encountered 4x variation in complication rates across physicians at the same brand-name institutions, to building Garner's core infrastructure: a dataset of 320 million patients used to score every doctor in the country on quality-adjusted outcomes, layered on top of existing employer health plans with financial incentives to steer patients toward top performers. The episode drops alongside the announcement of Garner's Series E with Index Ventures, valuing the company at approximately $2.7 billion. The conversation covers the technical depth required to actually measure physician quality fairly (and why existing methodologies are fundamentally flawed), why value-based care has largely failed and what actually moves patient behavior, how AI will reshape the front door of healthcare, what it will take for AI health companies to build durable businesses beyond 2030, and why the solution to the US healthcare cost crisis may be as simple — and as politically hard — as treating it like a corporate expense policy. (0:00) Intro (0:30) Garner's Origin Story (2:05) Doctor Choice Is the Biggest Lever (3:45) How Garner Works (5:43) Why Old Scoring Methods Failed (7:39) The Knee Pain Problem (11:58) Consumer UX, Incentives, and AI (33:44) How Much Spend Can AI Actually Touch? (36:00) Why Doctor Choice Needs Plan Integration (39:18) Build vs. Buy: Garner's AI Philosophy (41:38) The Unified Data Flywheel (43:01) What Actually Predicts Doctor Quality? (46:28) Enabling Independent Providers (51:37) Quickfire Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Ep 67: Abridge Leaders on AI-Native Healthcare, Doctors Who Code, and the Future of Clinical AI
Apr 3000:44:36Tap to summarizeA couple weeks ago, Michał Nedoszytko placed third globally at Anthropic's hackathon out of 13,000 participants. He was the head of cardiology at a hospital in Brussels at the time. Now he is Clinical Scientist at Abridge. On this episode of Vital Signs, Nikhil and I sat down with Abridge's CEO Shiv Rao and Michal to chat about how the hire came together, what changed with Opus 4.6 that let a cardiologist ship a working MVP in 40 minutes, and where they both think clinical AI goes next. (0:00) Intro (0:19) Hackathon Fame (3:52) Shiv Recruits Mahal (6:30) Doctors Who Code (9:07) Prototypes vs Production (10:26) Regulation and Partnerships (13:00) Customization vs Reliability (15:59) AI Native Company Ops (19:29) Healthcare in 10 Years (21:08) Admin vs Clinical AI (24:47) Payers and Prior Auth (29:48) Training Doctors for AI (35:19) Context, Autonomy, and Demand (40:40) Pre-visit Workflows and Triage Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Ep 66: Pete Shalek On The Future of Front Office Automation
Jan 700:35:19Tap to summarizePete Shalek, founder of Valerie Health, is a multi-time healthcare entrepreneur who previously founded Joyable in 2013 (one of the earliest digital mental health platforms) and served as Chief Product Officer at AbleTo and Stellar Health. Pete discusses why AI in healthcare needs to move beyond selling software tools to actually doing the work for providers. He shares hard-won lessons from a decade in digital health, including why the shift to quality-based care in behavioral health has been surprisingly slow and why Joyable's therapist-free model was ahead of its time relative to payment models. The conversation covers Valerie's approach of building an AI front office that handles referrals, scheduling, and intake for independent medical practices without requiring them to learn new software, achieving 3-4 week implementations and 5-7% conversion lifts. Pete explains the technical challenges of structuring unstructured healthcare data with 100% accuracy, the strategic choice to own operations end-to-end rather than just provide tools, why referrals are the perfect wedge product as the most upstream data point, and his evolving views on how quickly AI will impact the gray area between administrative and clinical work. Throughout, he emphasizes the importance of meeting healthcare where it is (turning faxes into structured data rather than trying to force system-wide transformation) and building for today's payment models while working toward a bigger vision. (0:00) Intro(0:52) Pete's Journey in Digital Health(1:45) Challenges in Behavioral Health(3:38) Valerie Health: An AI Front Office(4:47) Valerie's Unique Approach to Software(6:16) Customer-Centric Solutions(8:38) Data and AI in Healthcare(10:19) Building a Successful Health Tech Company(13:19) Future of AI in Healthcare(16:16) Operational Challenges and Solutions(28:57) Pricing and Value Delivery(30:12) Quickfire Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Ep 65: CMMI Leaders on ACCESS Model Launch, Drug Pricing Strategy, and the Future of Technology Enabled Care
Dec 800:56:54Tap to summarizeThis episode announces the launch of CMS's ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) model - a groundbreaking payment innovation that enables technology-enabled care organizations to treat Medicare fee-for-service patients with chronic conditions through outcome-aligned payments rather than traditional fee-for-service. Abe Sutton (Director of CMMI) and Jacob Shiff (Chief AI & Technology Officer at CMMI) explain how the model addresses a fundamental gap in healthcare: while commercial and Medicare Advantage patients have access to digital therapeutics and technology-enabled chronic disease management, original Medicare beneficiaries have been left behind. ACCESS changes this by paying providers monthly fees for managing conditions like diabetes, hypertension, obesity, behavioral health issues, and musculoskeletal pain - but only when patients achieve measurable clinical improvements. The model is designed to be deflationary rather than inflationary, encourages innovation by simplifying go-to-market for digital health startups, integrates with existing risk-bearing models like ACOs, and represents a broader CMMI strategy to shift from activity-based to outcome-based payments while leveraging new AI capabilities to democratize high-quality care. (0:00) Intro(0:57) The ACCESS Model: Advancing Chronic Care(4:35) Outcome-Aligned Payments and Technology(7:40) Encouraging Innovation and Investment(09:23) Practical Implementation and Examples(24:28) Evaluating Success and Future Goals(26:18) Connecting the Dots: Broader CMMI Initiatives(28:40) Generous and Its Impact on Drug Pricing(30:11) Challenges and Benefits of Prior Authorization(35:19) The Role of Technology in Healthcare(37:59) AI and Technology-Enabled Care(40:26) Reflections on Value-Based Care Models(43:51) Encouraging Competition in the Healthcare Market(48:24) Quickfire Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Ep 64: Sutter Health CEO & President Warner Thomas on Digital Transformation and the Future of Health Systems
Nov 700:44:35Tap to summarizeThe episode explores how Warner Thomas is transforming Sutter Health into a digitally-enabled, ambulatory-focused health system that can navigate major industry headwinds through growth rather than contraction. Thomas discusses Sutter's aggressive expansion of its physician network and ambulatory footprint, the system's push to dramatically improve consumer experience through technologies like online booking and ambient AI documentation, and their strategic pivot toward value-based care models as Medicare payment pressures intensify. Throughout the conversation, he emphasizes that successful health systems must embrace AI and digital tools not as futuristic concepts but as immediate operational necessities, while maintaining focus on integrated care delivery that keeps patients at the center—a philosophy shaped by his experience building integrated systems at Ochsner and now applied to reimagining Sutter's historically hospital-centric culture into one that blends physical and digital care delivery across the full continuum. (0:00) Intro(1:01) Overview of Sutter Health(1:56) Comparing Sutter Health and Ochsner(4:08) Key Focus Areas for Sutter Health(6:49) Consumer Experience and Technology Integration(10:56) The Role of AI in Healthcare(18:03) Advice for Startups in Health Tech(21:19) Navigating Financial Challenges in Healthcare(24:23) Healthcare Policy and Advocacy(25:59) Competition and Differentiation in Healthcare(29:58) Value-Based Care and Medicare(34:03) Quickfire Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Ep 63: Narayana Health Vice Chairman on Scaling Quality Care in India and Tech’s Role
Oct 100:46:29Tap to summarizeThis episode features Viren Shetty, Vice Chairman of Narayana Health, discussing how his father founded a cardiac surgery hospital in India 25 years ago that revolutionized healthcare delivery by applying manufacturing efficiency principles to drastically reduce costs while maintaining quality. The conversation explores how Narayana Health scaled from one cardiac center to 19 multi-specialty hospitals across India and one in the Cayman Islands by implementing supply chain optimization, standardization of care, physician specialization, and high-volume operations—enabling them to perform cardiac surgeries at a fraction of Western costs. Shetty discusses the challenges and opportunities of operating in India's largely out-of-pocket healthcare market, the hospital's expansion into insurance and primary care to become a fully integrated provider, their measured approach to AI adoption, and why their high-volume, efficiency-driven model wouldn't directly translate to the US healthcare system despite offering valuable lessons in operational excellence and cost reduction. (0:00) Intro(1:20) Founding and Growth of Narayana Health(2:48) Cost Reduction Strategies in Indian Healthcare(6:04) Challenges and Cultural Shifts in Standardization(8:16) Scaling and Expansion Bottlenecks(14:10) Impact of COVID-19 on Narayana Health(19:15) Medical Tourism and the Cayman Islands(23:03) High Patient Volume in Indian Hospitals(24:29) Exploring Healthcare Ecosystems(25:25) Automating Healthcare Administration(26:39) Challenges in US Healthcare(28:18) Innovative Healthcare Models(30:28) AI in Medicine(33:22) Driving Efficiency in Hospitals(37:48) Opportunities in Indian Healthcare(40:34) Quickfire With your co-hosts: @jacobeffron - Partner at Redpoint, Former PM Flatiron Health @patrickachase - Partner at Redpoint, Former ML Engineer LinkedIn @ericabrescia - Former COO Github, Founder Bitnami (acq’d by VMWare) @jordan_segall - Partner at Redpoint
Transcribe →Ep 62: Merck KGaA Chief Data and AI Officer on Scaling AI in Pharma and The Future of Enterprise Software
Sep 2900:32:45Tap to summarizeThis episode captures Walid Mehanna's perspective on how Merck KGaA has approached enterprise AI adoption through a federated strategy that prioritizes people over technology. The core message is that successful AI implementation requires building organizational capability across three dimensions - people, processes, and technology - rather than seeking a single transformative solution. Walid argues that companies must establish a broad foundation of AI literacy (exemplified by their internal MyGPT tool reaching 25,000 users) before pursuing specialized applications, while maintaining human accountability to prevent complacency. He emphasizes that AI works best when it's treated as an experimental, iterative capability distributed across the organization rather than controlled centrally, with success depending on persistence through the inevitable J-curve of initial productivity drops. The conversation reveals how a large multinational navigates the practical realities of AI deployment - from managing regulatory complexity across different geographies to making pragmatic build-versus-buy decisions - while maintaining focus on the fundamental principle that AI should augment human expertise rather than replace human judgment and responsibility. (0:00) Intro(0:29) How AI is Used at Merck(2:18) AI Applications Across the Value Chain(4:31) Challenges and Risks of AI Implementation(5:35) Federated Approach to AI Prioritization(6:44) Future AI Use Cases and Data Challenges(10:38) Building and Partnering for AI Solutions(15:11) AI in Drug Discovery and R&D(26:47) Quickfire Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Ep 61: Co-Founder of Chai Discovery Joshua Meier on 99% Faster Drug Discovery, BioTech’s AlphaGo Moment, Building Photoshop for Molecules
Sep 2200:56:45Tap to summarizeIn this episode, Jacob sits down with Joshua Meier, co-founder of Chai Discovery and former Chief AI Officer at Absci, to explore the breakthrough moment happening in AI drug discovery. They discuss how the field has evolved through three distinct waves, with the current generation of companies finally achieving success rates that seemed impossible just years ago. The conversation covers everything from moving drug discovery out of the lab and into computers, to why AI models think differently than human chemists, to the strategic decisions around open sourcing foundational models while keeping design capabilities proprietary. It's an in-depth look at how AI is fundamentally changing pharmaceutical innovation and what it means for the future of medicine. Check out the full Chai-2 Zero-Shot Antibody report linked here: https://www.biorxiv.org/content/10.1101/2025.07.05.663018v1.full.pdf (0:00) Intro(1:25) The Evolution of AI in Drug Discovery(5:14) Current State and Future of AI in Biotech(10:08) Challenges and Modalities in Therapeutics(14:44) Data Generation and Model Training(22:52) Open Source and Model Development at Chai(29:52) Open Source Models and Their Impact(34:36) How Should Chai-2 Be Used?(38:53) The Future of AI in Pharma and Biotech(42:46) Key Milestones and Metrics in AI-Driven Drug Discovery(47:20) Critiques and Hesitation(54:01) Quickfire Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Ep 60: General Medicine's Elliot Cohen on Lessons from PillPack and Amazon and The Future of AI x Healthcare
Jul 3101:07:33Tap to summarizeElliot Cohen—PillPack co-founder and now co-founder of General Medicine—joins Jacob Effron and Nikhil (Out-of-Pocket) to unpack what “best care” really means in 2025. He explains why General Medicine is building a broad front door to care. Elliot also revisits the PillPack vs. PBMs saga, what Amazon Pharmacy got right (and what was unexpectedly hard), and how AI is already raising the bar in intake, clinical prep, and follow-up. (0:00) Intro(0:58) Simplifying Healthcare with General Medicine(1:53) The Importance of Triage in Healthcare(3:22) Consumer Empowerment in Healthcare(5:10) Patient Experience and Structured Forms(6:27) Challenges in Healthcare Pricing Transparency(8:28) Diverse Patient Needs and Quality of Care(10:00) The Philosophy Behind General Medicine(16:43) Consumer Directed Care: Pros and Cons(18:57) PillPack(35:53) Debating Insulin Search Results(38:16) AI in Healthcare: A New Era(39:15) Integrating AI with Clinical Teams(41:39) Challenges and Opportunities in Digital Therapeutics(58:21) Building a Healthcare Company: Lessons from Amazon(1:01:25) Quickfire Out-Of-Pocket: https://www.outofpocket.health/
Transcribe →Flashback: Hinge Health CEO Daniel Perez on Effective Employer Sales, Patient Engagement and His Top Advice to Founders
May 23, 202500:45:21Tap to summarizeFlashback episode in honor of Hinge Health's IPO this week. In the episode, Jacob and Nikhil sit down with Daniel Perez, the Co-Founder and CEO of Hinge Health, a digital clinic for patients with joint and muscle pain. They discuss Hinge Health’s strategy for selling to employers, how digital health solutions can reach and retain users, the role of software x hardware in disrupting healthcare, and more. (0:00) Intro(2:34) The Evolution of Employer Health Solutions(4:03) Challenges and Strategies in Digital Health(7:07) Focus on Musculoskeletal Care(9:51) Engaging and Retaining Patients(16:17) Marketing and Awareness Strategies(19:31) The Role of Independent Validators(22:27) Clinical Validation and R&D Excellence(23:04) Healthy Competition and Market Differentiation(23:59) Product Superiority and Customer Validation(26:05) Team Dynamics and Tough Decisions(29:49) Future of Hinge Health and Healthcare Automation(31:44) AI and Technology Integration(36:18) Hardware Innovations and Market Impact(39:19) Value-Based Care and Outcome Guarantees(41:14) Regulatory Challenges and Innovation Constraints(43:38) Closing Thoughts and Entrepreneurial Advice Out-Of-Pocket: https://www.outofpocket.health/
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