Dave Chase keynote at the Angel Capital Association

2. HEALTHCARE COLLATERAL
DAMAGE
$1M LESS SAVED FOR RETIREMENT
BY AVG BABY BOOMER FAMILY DUE
TO 20+ YEAR WAGE
STAGNATION/DECLINE
70% OF AMERICAN HOUSEHOLDS
HAVE LESS THAN $1K IN SAVINGS

3. LARGEST GENERATION IN HISTORY (MILLENNIALS)
SLATED TO SPEND > HALF OF LIFETIME EARNINGS ON
HEALTHCARE
MEDICARE TAXES & PREMIUMS
DEDUCTIBLES & OUT-OF-POCKET EXPENSES
INSURANCE PREMIUMS
EMPLOYER PREMIUMS
EMPLOYER MEDICAID TAXES
FEDERAL & STATE TAXES
VISIBLE
PAYMENTS
$.6M
HIDDEN
PAYMENTS
$1.3M
+
$1.9MGRAND TOTAL
TOTAL LIFETIME EARNINGS $3.8M

4. CATASTROPHIC MISALLOCATION OF
RESOURCES
+37%
HEALTHCARE
SPENDING
-50% LOCAL AID
-31% PUBLIC HEALTH
-22% MENTAL HEALTH
-14% INFRASTRUCTURE, HOUSING & ECON.
DEV.
-13% LAW & PUBLIC SAFETY
-12% EDUCATION
-11% HUMAN SERVICES
HEALTHCARE SPENDING DEVASTATES SOCIAL DETERMINANTS OF HEALTH
(FY01 - FY14 - STATE OF MASSACHUSETTS)

6. Care Team

7. Cost

8. $500B Annual Citizen-driven Economic
Stimulus
Stopped: Redistribution from kids, families &
businesses to “morbidly obese” healthcare

9. $3,000,000,000,000

10. 50+ years of optimizing for
flawed financial incentives.
Healthcare’s root cause of dysfunction
Operational waste
Clinical waste
Paid for volumeCost-plus models
Would be world’s
16th largest
economy

11. Who pays for healthcare
$2.7T in annual spending (2014)
(excluding pharma)
Government 48%
Employers 52%
($1.4T)
Medicare
24.8%
Medicaid
19%
Fully
insured
19.7%
Self-insured
32%
Least flexibility
Most homogenous
Most politicized
Most flexibility
Least homogenous
Least politicized
Other
4.5%

12. $191B
Operations waste
Fraud
Excessive admin costs
Unnecessarily high prices
28% of $1.4T is systemic “obesity”
$204B
Clinical waste
Unnecessary services
Inefficient delivery
Missed prevention
$395
B
annually in
employer
segment
Individual behaviors like obesity = ~$200B

13. 1
Improve care
team experience
Enhance patient
experience
Improve health
outcomes
Lower
health costs
2
34
Healthcare’s Square Deal: Quadruple Aim

14. Watch where your insight comes from
Beware of throwing tech on top of broken models
Status quo business models are highly vulnerable
hospitals = newspapers

15. 98% of Digital Health Startups are Zombies
Winners possess:
1)Unique biz model & GTM
2)Experienced, yet
unshackled teams

16. Align investments with biggest opportunities
Tech
Avoid conflating these tech & model transformations
- No/low-touch
- Many patients
- Payment & ops SaaS,
data analysis, etc.
Services
- High-touch
- Fewer patients
- Care delivery, ancillary
services, benefits, etc.
5% patients
80% costs

17. Operational
Next-gen operations
mgmt. & supply chain
Disintermediation &
financial/clinical
integration
Reduce pricing failure
Full-stack services
Enablement
High-performance
benefits
Payment integrity
& infrastructure
Next-gen networks,
esp. primary care &
major procedures
Clinical
Evidence-based care in
high-cost specialties
Identifying and treating
outlier patients
Team-based care &
next-gen facilities
Upstream intervention
Key categories that address
the largest systemic waste

18. Twitter/LinkedIn:
@chasedave
Health Rosetta Institute:
www.healthrosetta.org
Health Rosetta Group:
www.healthrosetta.com
The Big Heist:
www.bigheistmovie.com