Nathan Heerdt

Value-Based Care (VBC) is simple to describe and hard to run. If your team is “moving into VBC,” here’s the operator test: What single metric are you moving this quarter? Readmissions. ED visits. A1c/BP control. Medication adherence. Total cost of care. My framework: Metric → Program → Operating System Programs like RPM, CCM, RTM, TCM, MTM, immunizations, and APCM only work when you install cadence, ownership, escalation triggers, and proof that matches what you bill and report. I put the VBC Foundation Guide in the first comment. It’s built for operators. What metric are you accountable to right now? #VBC #ValueBasedCare

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Previous iterations of search have all been about what the algorithms perceive with their signals about your brand. However, AI is where we are starting to see the realization of what business leaders like Scott Cook and Jeff Bezos have been saying for years, your brand is what people say about you when you are not in the room. Brands are not going to be able to outspend or outmuscle their way to visibility, customer experience and community impact will be the larger “ranking” factors.

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A stale list is a slow problem. A DELETE request you did not process is a fast and costly one. Without a clear framework for intake, suppression, and proof of deletion, you aren’t just losing reach. You’re taking on real regulatory risk. The CPPA is already fining data suppliers and other stakeholders, and DROP gives it a much easier way to see who is keeping up. Check out our observations & learnings as DROP rolled out #hcpmarketing

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You know what a hospital buying team told me this week? Healthcare point solutions are thinking about Epic integration backwards. They've bought a lot of healthcare software over their careers. And they said something that made me stop: "I actively don't want vendors integrating directly with Epic." Wait, what? Here's their reasoning: They already have a robust Epic integration, but also their own data platform. When a vendor builds its own Epic integration, it forces the hospital to go back through Epic's processes. The hospital loses control and flexibility. Their goal? "Demote the EHR." They want the health system to own the integration layer and the UI. Epic should sit underneath as a data and transaction system, not the thing everything plugs into. So when startups lead with "we integrate with Epic" as a selling point, they're actually creating a problem for experienced buyers like this team. What works better: plug into the hospital's existing data platform. Snowflake, Azure, whatever integration layer they've already built. Design your product to fit their architecture, not to be a standalone thing bolted onto Epic. This matters if you're in the $1-5M range right now. A lot of companies are making product decisions based on the idea that "we need Epic integration to be credible." But the more sophisticated buyers? They're moving in the opposite direction. Epic becomes infrastructure. The hospital owns the orchestration.

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One of the biggest issues in healthcare is that your CRM doesn’t talk to your PMS. So you build manual workarounds with lists, downloads and multi-step actions in different systems. One system of record for the clinical journey. One system of record for the customer journey. And a prayer that the two tie up. This is especially painful for healthcare providers who work with PMS platforms that have previously been inaccessible - either from a usability, API, or data management perspective. Which is why we’re excited to launch our TM3 integration. Clinics that use TM3  can now enjoy seamless data transfer across their customer facing platforms… all hands-free, without compromising on human touch or experience.  Generic players like HubSpot, Zoho, and Pipedrive might think TM3 is cocktail. You no longer need to pay for their oversight.

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CMS published the reimbursement rates for ACCESS last night and they are SIGNIFICANTLY LESS than what many folks expected, but I'd argue that's NOT necessarily a bad thing: e.g., $180/y for MSK and BH, which after waiving the 20% beneficiary coinsurance => $12 PMPM, with only 50% being paid monthly and the rest subject to outcome and substitute spend adjustments, so really $6 PMPM (!!) to work with. WOW. So, if you reverse engineer the math it leads you to a very clear conclusion. You want to cap your expenses at $5 PMPM to make sure you have a minimal guaranteed margin and minimize operating capital needed. How can you meet the requirements of the program (data to CMS and coordination w/ PCP) AND achieve the target outcomes with only $5 PMPM? The ONLY way is *end-to-end* automation + AI with essentially almost no human-in-the-loop. "Middle-to-middle" (human clinicians using AI) will not be profitable ... must be end-to-end from onboarding to patient engagement to data capture to care coordination. The entire thing. How can you pull this off? This is essentially CMS creating a constraint that is a forcing function on the industry -- which I love. Constraints drive creativity and innovation. Also, this creates deflationary pressure: not only is it that we *should* be able to drive certain outcome improvements for *some* patients in a highly automated way and low cost way, but we *must* if we are to keep our healthcare expenses from spiraling out of control. What can you do w/ $5? Here's what you can do w/ just $2:! Pull a medical record via HIE ~ $1.25 Send 30 SMS ~ < 30 cents Use AI (1 M input tokens + 100k output tokens w gpt-5-mini) ~ 45 cents Will this work for all patients and all conditions? Of course not. But it can move the needle for some, so let's find those folks and move the needle for them in the most efficient way possible. Brainstorming w/ some really creative and innovative folks on this topic. Samantha Wu Dr. Marc Gruner Christian Pean M.D., M.S.. If you need an automation orchestration platform, check out Revel AI. The payment info has been added to the ACCESS resource center: https://lnkd.in/e7vWgqHX Check out the official publication from CMS here: https://lnkd.in/e9YqtJAg

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Haider Warraich is showing the industry some magic. Specifically, how government (!) can actually help navigate (!!) the GTM (!!!) in healthcare. It's not that we want to have more regulations, it's we want to have transparency and clear roadmap how hospitals can work with AI companies. If you're building a patient focused cardiology AI product, check the link in the comments.

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The Metric Nobody Tracks (But Should) Most clinic owners track revenue per patient, patient acquisition cost, treatment revenue, margins. But there's a number almost nobody tracks that's actually more important than all of those. It's: how many patients are you losing between the first consultation call and the actual appointment? Call it the "consultation-to-appointment conversion rate." At most clinics, it's somewhere between 60-75%. Which means 25-40% of people who inquire and get a consultation booked... never show up. Why? Sometimes it's genuine change of mind. But most of the time? You didn't follow up. Or you followed up late. Or the reminder didn't land. Or they forgot. Let's do the math: 100 consultation calls a month 75 convert to bookings 55 actually show up That's 20 consultations you lost. At $500-$2000 per consultation, that's $10k-$40k in lost revenue monthly. For a clinic doing $200k-$500k monthly revenue, that's 2-8% of your top line evaporating because of poor follow-up. Now multiply that by 12 months. That's $120k-$480k annually just disappearing. Most clinic owners have no idea this is happening because they're not tracking it. They see "bookings made" and assume "conversion complete." The gap between booking and show-up is where your real leak is. Fix that one metric and you've solved a revenue problem worth hundreds of thousands annually, without acquiring a single new patient.

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