YouSaid · the spoken record

Bob Kocher

lines on the record
21
first
2015-09-23
most recent
2015-09-23
sittings or episodes
1
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podcast

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  1. “Our most recent investment is a company called LURA Health, and LURA Health is seeking to reimagine how behavioral health care works. Behavioral healthcare today, so things like depression, anxiety, and mental illness is a totally separate healthcare ecosystem for the medical system. And it so happens that most patients who have many chronic diseases have a bunch of needs to have their stress and anxiety and depression managed. And so we're trying to connect those two and use data to identify the better practitioners there and use technology to share information across those and treat patients' anxiety so they can therefore take their medical conditions and give better care. The CEO has a company named David Ebersman, who's a longtime friend and amazing guy. And so that's why we did it.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  2. “Oh man. I think when I was an undergraduate, I began to fall in love with protein trafficking and microtubules, and that led me to do several years of research at the NIH studying actimized in motor proteins, working with a brilliant scientist named John Hammer, who taught me how to problem solve.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  3. “My favorite book, I think, is a book called The System by David Broder. He wrote the classic on the Hillary Clinton Healthcare Reforms from 1993 and how they unraveled. It's a book that we all read before marking up on the Obama Care Reforms so we would not repeat all the mistakes and the lessons and then we repeated all the mistakes.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  4. “I think today it's in the private sector, places like Venrock or the companies that we and others fund, showing people the way forward and showing people you can build new businesses that have better margins and better growth by embracing new incentives. And that will lead to big companies and will lead to lots of emulation and copying by incumbents, which makes the whole healthcare system better for people. And so I think today the game is being played in the private sector and that we're the ones leading the way and that over time there'll be future regulatory changes too that probably cement some of these changes and push us further forward. But I bet for the next decade the disruption comes from the private sector. And so I feel happy to be here.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  5. “Costas of a procedure that they're about to pay and something about the quality. And that wasn't true before they were attacked by Castlight. And so I'm grateful for the fact that we can pull people forward.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  6. “I love making healthcare a little bit better each day. I wake up and say, can we make healthcare suck a little less today? I'm not trying to make it perfect. I'm trying to make it better. And making it better means that patients get to the doctors that take better care of them, that do the right treatment, and avoids patient suffering and unnecessary costs, making it better is getting rid of stupid processes that require faxing, making it better is getting rid of the waiting time to go get a simple problem solved, making it better is helping an insurance company design a benefit design that actually is understandable. And so to me, that's what makes life rewarding. I also love it because I can show people the way. I mean, there's no question that cast flight health, a company that I joined the board of when I left the White House that helps give out price and quality information has had an amazing effect on everybody in the healthcare system. Every insurance company in the country in America today will tell patients what the”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  7. “I think the first thing is find joy in what you do each day. People that do a job in the hopes of getting another job later that makes them happy, I think are missing out. Because stress is diminished when you love what you do and when you're doing something that makes you happy and when you're learning. And so that will be the first thing I'd say is don't, you know, it's not about meditation before work and then having a sad day. It's about finding joy in your work and other people you work with.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  8. “Imagination about scoping your products and solutions to be big. Healthcare has a lot of incremental things, and the U.S. healthcare system has 30% waste, highly erratic outcomes, and unnecessary complexity. And so I prefer ideas that go after bigger parts of the pie and aren't sort of working on just one type of patient with one type of disease for one type of thing. And so I prefer more horizontal thinking than narrow nichey things.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  9. “No. Most investors and entrepreneurs at first think that regulatory risk is a big problem and really complicated. Regulators, since I was one of them, are seeking to make the healthcare system be more productive and lower cost. And so technologies and approaches that do that, I think, have a good shot and aren't going to be encumbered by regulations that make it hard.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  10. “Well, one of them is administrative cost. So one of the amazing statistics about U.S. healthcare is that for every doctor, there are 16 FTEs walking around behind that doctor doing stuff. And of that 16, nine of them are administrators. That ratio has gone from 1 to 10 to 1 to 16 in the last 20 years. So we've gotten actually less productive. Every other sector of the economy has figured out how to squeeze administrative labor down to as close to zero as you can because that's not productive and then have all your labor be the productive stuff that's making the product work. Healthcare has to get rid of hopefully seven of those nine people on admin as fast as it can if it ever wants to have lower prices and higher margins. And so I think that there's a lot of opportunity to create software that digitizes a lot of what those people do. That includes things like bill encoding and collections. It takes half the FT per bed to build and collect for patients in a hospital. It's crazy. Things like compliance reporting.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  11. “And so I think that we'll use technology first to help match patients to the right doctors because there's no question that matching a patient to a person that's very expert at their exact problem and their exact procedure leads to better outcomes and lower costs because there's fewer complications. So software can help us do that. The second thing software can do is no matter how expert a doctor is, you cannot read and remember everything. And software will help us actually curate the literature and give us the right information to tailor care so we know that we're giving you exactly the right medication, we have exactly the right clinical goal, we know exactly how fast you should achieve it and we can exactly know if you're actually meeting that goal and then we can intervene sooner instead of having you come back in three months and have me ask you how are you doing?”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  12. “Well, I think first, the way in which care is delivered is going to improve substantially. One of the biggest challenges is getting the right patient to the right doctor and the right treatment. Prior to going into policy, I was a physician and I did internal medicine healthcare and brought it to care of adults with all kinds of problems. And I was very good at some and less experienced at others. And for the ones I was less experienced at, I'd go or read between patients connection and doing it right. But those patients probably weren't getting the world's best care for me since they were one of three people I took care of with that condition.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  13. “Well, sure. So one of our profile companies is called Doctor on Demand. And what Dr. On Demand does is it allows you to use your phone or tablet to do a video meeting with a doctor within about a minute for $40. And it so happens that about a third of all healthcare business can be handled over video from your home with a woman at waiting time for 40 bucks, which is about 30% of what it costs to go to a doctor's office and about three hours faster. And so there's a lot of productivity you can unleash by shifting visits from brick and mortar places to video and a lot of satisfaction that you can create. The net promoter scores from patients when they use videotal medicine or in the 70s and 80s, when they go to a doctor's office, it's like 17. And so it's a much better way and it's much cheaper. And for most Americans who are increasingly having one in $2,000, maybe $5,000 deductibles, saving $150 when they see a doctor is a really great thing for the patient too.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  14. “For the last couple years, quite frankly, the incumbents have done pretty well. And so with the expansion of coverage, there's been a nice uptick in volume of paying customers and the bad debt that used to play hospitals and doctors has gone down. And so margins have actually gotten better for hospitals and insurance companies, which allows them to change less quickly. The other issue is we've had a lot of consolidation on the provider side, which allows those systems to raise prices and therefore feel less pressure on productivity. And so that's modulating the rate at which we're having full scale adoption of new payment models and then the tools that they need.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  15. “I think so. I mean, we've seen. Amazing amount of talent in the form of entrepreneurs coming into healthcare over the last five years and a commensurate amount of increases in venture capital funding and a broadening of those people that invest in this space to include many technology investors to support the creation of new companies. I think we've also seen enough successes that people will say, healthcare is not Siberia anymore. I could come here and build a high growth interesting company, whether that's Athena Health, who was one of the early examples of a healthcare technology company that was SaaS that did really well or were recently CASTHEL or Fitbid or some of our newer ones, benefits in Lua Health, but you're seeing people build high growth companies that are very interesting and that strong retaliation to the sector. The other great thing is that it used to be eco-siberia like to sell products to hospitals and insurance companies, and they've been jolted enough by the changes in the U.S. healthcare economy that they're willing to take risks of trying products.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  16. “But as importantly, it allows us to have new payment models. And so most of the payment models that we're putting forward as a result of the Affordable Care Act rely on data to make sure that doctors aren't stinting on care and data to help doctors do the accounting and coordination necessary to make money in payment structures where they have to actually be more efficient. And so those to me are the sentinel changes. And they're being rolled out over this next decade. And so Medicare announced recently that their goal is to have 80% of payments and risk models by 2018 and that they're moving forward with new types of payment models like bundled payments. And employers now are beginning to take advantage of that too by saying to their workers that we want to use reference prices and have you pick networks of care that are more productive. And so that tremendous externality, which is changes in information and changes in incentive, create a tremendous need for software and tools and technologies.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  17. “On information, healthcare has been classically the textbook example of information asymmetry leading to inefficient markets. And for the first time, beginning with really the high tech act, which was a byproduct of the recession, we decided that it was time to wire American healthcare. And so we gave roughly $30 billion to doctors to buy meaningful used computers into hospitals. And today we have about 90% of hospitals and 80% of doctors using computers. And those computers create data. And that data allows patients now to begin to ascertain quality and value. It allows doctors to begin to understand the quality of the referrals they make, the quality of the devices that they're using.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  18. “So I think that there's been two enormous changes, which are byproducts of the Affordable Care Act, the High Tech Act, and the recession point, frankly, which engaged a lot of companies who pay for a lot of health care on how they should manage their costs. The first one is an amazing liberation of information. The second one is changes to incentives. They go together.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  19. “It's all about incentives. So, you know, the way the U.S. healthcare ecosystem works in the entire 20% of that economy of our economy, which is healthcare, is driven by how we pay for it and how we measure performance. And honest to God, in a little company, the way you make a product work is how you measure it and how you incentivize people to use it. And so it's much more micro, but it's the same idea, which is aligning incentives and then putting great people around something to make it happen.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  20. “Great question. I think they're both actually great chances to do problem solving. When you're at the White House, you're trying to think through how can I get 60 senators to agree on something? And what are the things you have to give and take and to make that happen, as well as to make the rest of America accept an idea with a little company, you have to imagine, you know, how can I invent a product or a service that somebody wants to use that will make sense, that will have ROI to them today that I can make, and that over time can grow into an interesting business that has things like network effects and economics around it that make it interesting. And, you know, it's the same type of creative problem solving. I think that you have to use to imagine how a policy can become a law and change America.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source

  21. “Sure. So, my path in the venture capital is serendipitous. So prior to being at Venrock, I was at the White House where I worked on healthcare and economic policy. And I were closely with a guy named Todd Park, who was chief technology officer at HHS and went on to fix healthcare.gov. But before the White House, he founded a company called Cassette Health and Athena Health. And his first investor was a colleague of mine now here named Brian Roberts. When I was leaving the White House, Todd had the great idea that I should go do investing because my passion to making healthcare change more quickly and my theory of the case was that the way to make healthcare change in America more was to make more companies that show people the way. And so Todd's suggestion was to give ventraelists and he introduced feet of Brian Roberts who ran Venrock, who runs Venrock. And Brian and I clicked and you hired me.”

    2015-09-23 · The Twenty Minute VC · 20 VC 074: The Future of Healthcare with Bob Kocher, Partner @ Venrock · IDENTIFIED FROM THE TRANSCRIPT · source