It’s no secret that the United States health care system remains a dysfunctional mess. Despite some improvement since passage of Affordable Care Act, the US spends still spends far more per person than any other wealthy nation in the world and often gets poorer results.
About 13 percent of Americans are still uninsured. Meanwhile, the United States has the lowest average life-expectancy of any wealthy industrialized nation and ranks higher than most on infant mortality, heart disease, diabetes, and a host of other of troubling health indicators.
Is there hope? Lisa Suennen, a veteran health care venture capitalist and author, as well as a lecturer at Berkeley-Haas’s Graduate Program in Health Management, is optimistic.Embed from Getty Images
For all the problems, she argues, health care in the United States offers enormous opportunities at the intersection of business and social impact. For those who want to do well by doing good, she says, health care is at an ideal juncture for improving both efficiency and health care outcomes.
“It won’t be easy, and it won’t be fast,” Suennen cautions. “This requires blowing up a lot of old business models, and nobody is going out quietly. But we have a confluence of trends that we haven’t had before. It’s almost a perfect storm to make some major strides forward.”
The elements of that perfect storm include inexpensive new technologies for monitoring health and delivering care; brutal economic and financial pressures to become more efficient; new knowledge about behavioral economics that can spur people to take better care of their own health; and a set of regulatory changes that encourage better alignment of incentives among the players in the system.
Suennen knows her subject. Since January, she has been managing partner at Venture Valkyrie Consulting, which advises corporations and institutional investors in areas such as digital health care strategy, health technology innovation and new business models for delivering healthcare.
From 1998 through the end of 2013, she was a co-founder and general partner of Psilos Group Managers, a health-care venture capital firm with $600 million under management. Earlier in her career, Suennen spent almost a decade as a top executive at Merit Behavioral Healthcare, a firm that specialized in behavioral healthcare insurance, and helped it grow from a start-up to a firm with 35 million beneficiaries and $800 million in revenue.
Suennen is a prolific and often acerbic author and commentator on the challenges facing health care. She is the co-author, with Dr. David Shaywitz, of Tech Tonics: Can Passionate Entrepreneurs Health Health Care with Technology? She also writes a blog called Venture Valkyrie. Among her recent posts: Digital Health: What the Hell?, The eHarmonizing of Healthcare, and one about the similarities between venture capital and Las Vegas.
In August, a health care website named Suennen one of 15 “disruptive women in health care” to watch over the next year.
Suennen sees several areas of opportunity. The first is in new outpatient technology, such as biosensors, that make it possible to remotely monitor a patient’s health, analyze the effectiveness of medications, and even improve the delivery of medications. The new technologies can reduce costs, improve understanding of what works for individuals, and produce better outcomes.
Another big arena is finance and payments: tying payments more closely to health care outcomes, increasing transparency in prices, and creating a marketplace for services that is simpler, easier to navigate, and more financially rational.
“Shopping for health care should be much more like shopping on Amazon,” Suennen suggests. “Can you imagine if you went online to Amazon for a book, but didn’t know where to look for what you wanted, couldn’t figure out the price, didn’t know what the return policy was – and it was expensive on top of all that? You probably wouldn’t come back. But people face that at hospitals and with insurers, and yet come back again and again.”
Better models are on their way. Suennen is on the board of PokitDok, a venture-backed healthcare information technology firm that not only helps people search for specific health care services but allows them to get firm price quotes. It can even sort out insurance benefits and arrange payments. Walgreen’s, the retail chain, offers clinics in stores that feature a wealth of basic services and easy-to-read price lists.
Another form of innovation comes from Big White Wall, a company based in the United Kingdom that provides a new way for people to seek out mental health care, peer support, and reliable information, without stigma and with far less confusion than most people experience today.
“People seeking healthcare services deserve a good consumer experience,’’ says Suennen. “They want to find options easily. They want to know if a doctor is practicing the current state of the art. They want reasonable and reliable measures of quality and price. They want to be treated with respect and like valued customers.”
Suennen has mixed emotions about the Affordable Care Act (ACA), noting that it falls far short of its intended goal of providing universal health care – the norm in almost every other wealthy industrialized nation. “It’s well-intentioned and the goals are right, but the execution has been rough at best.”
Despite the flaws, however, she says the ACA has created an accelerant to enable for-profit businesses and entrepreneurs to produce big improvements and make money at the same time.
“The opportunities are there and many are trying hard to capitalize on them,” Suennen says. “It is a time of prolific and much-needed healthcare innovation.”