The Ledger
Every statement that passed quotation and attribution checks. Mix any filter with any other: certainty 1/5, debate potential 5/5, or both at once.
why aren't all 90 resolved? a statement only gets an assessment when the public record can support or contradict it. opinions and what-ifs never can, and 1 checkable ones are still open, waiting for their date. predictions held up or didn't; assertions are supported or contradicted. on every card: ▮▮▮▮▮ certainty · ▮▮▮▮▮ debate potential. speakers are clickable
Yoo: AI task unbundling could nearly double clinical workforce capacity
“So, you know, imagine like almost doubling the capacity of a given clinical labor pool simply by applying some of these unbundling tactics.”
Yoo: Healthcare's lack of SaaS legacy enables faster AI adoption
“One of the dynamics that we believe is driving this rapid adoption cycle of these new AI tools is what we call this kind of leapfrog dynamic, where, you know, healthcare historically has been a laggard with respect to software-based technology. And we've alway…”
Yoo: Healthcare AI will increasingly be sold as digital labor
“We're at a breaking point where the industry needs these solutions, and therefore we're going to see a much higher adoption than we've ever seen before. I think it will come in the form of these super staff. I think we will increasingly see adoption of these A…”
Yoo: AI insurance lawsuits stem from denial speed, not denial rates
“The rate of denials is not going up, it's the speed with which the denials are happening that's going up.”
Yoo: Pandemic accelerates 10-year healthcare modernization trends into 2-3 years
“Now, all of those things were tailwinds that we thought would take 10 years or even longer to play out. But with the current dynamics at play during this pandemic it's more likely that those things will play out in two or three years.”
Yoo: Consumers will sever longstanding provider relationships for affordability and access
“Affordability will become even more prominent of a focus. And as a result, I believe that consumers will be willing to sever longstanding provider relationships in the name of affordability and access.”
Yoo: Health tech should automate admin tasks, not replace doctors
“We think that you know, the right conversation to have there is, you know, what if robots were actually able to automate a way The, you know, 80 to 90% of things that doctors have to do or frontline staff have to do that really take away from the human experie…”
Yoo: Boston has highest U.S. doctor density but severe access issues
“Boston is actually the highest density of physicians in the entire country, but they have the worst access issues because the vast majority of doctors there are working in academic environments.”
Yoo: Most hospitals have 10% to 20% open headcount constantly
“Most hospitals have About 10 to 20% of their head count open at any given time, and they simply just can't find enough people to fill those roles.”
Yoo: Healthcare is uniquely positioned with an existing AI approval framework
“We are the only industry that actually has an existing regulatory framework for approving products, especially in the clinical setting.”
Yoo: Insurers are creating dedicated billing codes for AI-assisted visits
“There are some early signs that insurance companies are creating actual billing codes for AI, where they now say that, you know, an AI enabled, you know, visit or an AI enabled diagnostic can now be reimbursed Differentially, and you can get, you know, sort of…”
Yoo: Electronic health records fail to capture real patient journeys
“EHRs are at best a highly abstract, you know, representation of patient journeys, at worst, you know, just sporadic encounter-related data that really does not capture the essence of what's happening with that individual.”
Yoo: Population-level healthcare inherently fails the majority of patients
“And arguably everything that's wrong with healthcare is because it is done at the population health level, because it's inherently then designed for, like, least common denominator, and therefore, like, the majority of people aren't actually being accommodated…”
Yoo: Automating healthcare claims could eliminate 30% of system waste
“You could eliminate 30% of the waste in our system if you were able to do that.”
Yoo: 100% of healthcare incumbents at JPM claimed active AI deployment
“At this last JP Morgan conference, like, a hundred percent of the incumbent, you know, payers and providers got up on stage and talked about not just what they want to do with AI, but how they're actually deploying AI in practice”
Yoo: Specialized AI models are required to accurately interpret medical information
“This is where I think one of the prime examples where we certainly believe that a specialist, you know, model is necessary to understand the specific nuances of how to interpret medical information versus general internet information.”
Yoo: Healthcare is ahead of tech regarding AI regulatory frameworks
“These are like some of the rare cases where healthcare is actually ahead of the curve as far as technology goes.”
Yoo: US healthcare system cannot bear costs of breakthrough therapies
“Our current healthcare insurance system is just not set up to bear the cost of these therapies, or to accurately gauge their value, given that some are curative, nor are our healthcare providers prepared to manage the complex logistics, data collection, and cl…”
Yoo: Administrative collection tasks consume one-third of US hospital revenue
“Roughly about a third of every dollar of revenue collected by a hospital is spent on Administrative tasks required to collect it, you know, meaning really you're only seeing roughly about a 70% yield on, on every dollar that you're actually supposed to get pai…”
Yoo: Tech-native health insurance neo-carriers represent a huge market opportunity
“We think there's a huge opportunity for sort of neo carriers, so to speak, right? So upstart health insurance products to be built in a tech native fashion. That number one does focus on user experience. Number two does use data in novel ways, whether it be on…”
Yoo: Large health system CFOs often lack financial visibility to cover payroll
“Turns out it's a relatively universal problem. This notion of kind of a system of record, a source of truth for the finances of healthcare providers. And, you know, that, and that has such, you know, significant implications on like broad swaths of workforce, …”
Yoo: The next digital health tech stack will enable risk-bearing care
“If the first generation of the digital health tech stack, which we wrote about in 2020, was about enabling administrative and operational efficiency for virtual first providers, the next generation will be about helping providers bear risk. And enabling payers…”
Yoo: The 2020 recession reversed healthcare labor growth for the first time
“This is the first recession in which the healthcare labor growth has actually been reversed. It's typically been the case that in past recessions, healthcare was the only industry that grew its labor force during those times, but this has been the reverse.”
Yoo: Novel care provider data will soon surpass traditional EHR data value
“The data that are being generated by these novel care providers, you know, outside of the traditional EHRs and the traditional providers is far more high resolution, far more granular. And very soon, I think we're going to be at a tipping point where it's far …”
Yoo: Government regulation catalyzes major platform creation in healthcare
“I think we should be looking at it the other way that regulation can actually be a catalyst for some of the major platforms that have been created in the past several decades.”
Yoo: Building insurance products on national virtual care networks is highly lucrative
“I think perhaps what is more exciting and more lucrative is the opportunity to really build new insurance products on top of that infrastructure where you have fundamentally new network design, again, not constrained to local geographies, but really able to ta…”
Yoo: Digital health in 2019 is like the 1999 internet market
“We liken where digital health is to where the internet market was back in 1999, where core infrastructure is only just being laid down.”
Yoo: U.S. faces active shortage of up to 100K doctors
“When you look at, for instance, the number of doctors that we have estimated a shortage in it's anywhere between, let's call it, 60 to a hundred K doctors today, as of today, in terms of the relative demand that we have in our system, and roughly about 75 K to…”
Yoo: 45% of U.S. physicians are currently over age 60
“There's a ridiculous stat that in the last couple of years, the percentage of doctors that are over the age of 60 has reached, like, 45%, which is crazy.”
Yoo: Over 300,000 U.S. clinicians left the healthcare workforce in 2021
“Upwards of 300,000 clinicians left the workforce in the year twenty-twenty-one.”
Yoo: Up to 50% of a clinician's job is administrative work
“It could be upward of 50%. Like, half of their job is mired in these, you know, clerical tasks that, again, take their time away from actual care delivery.”
Yoo: Past healthcare software increased complexity; generative AI reduces it
“The last waves of technology products that have been given to them have just increased the amount of complexity of their jobs, whereas these are doing exactly the opposite.”
Yoo: Healthcare Downstream Costs Are Driven by Clinical Mistakes
“And to me, the cost of mistakes piece is the thing that's, I think relatively unique in healthcare where, again, the cost of a misdiagnosis or a cost of a incorrect triage, you know, that's really, really what, you know, is ballooning so many of the downstream…”
Yoo: Soft factors will drive near-term clinician AI adoption over money
“I personally think that that it's probably gonna be more the, these soft things in the near term. That drive adoption, at least for clinicians and then, you know, perhaps if you're able to layer on a financial element to it could just be icing on the cake.”
Julie Yoo: Exception handling in healthcare will always require human clinicians
“So I think, at least for the foreseeable future, you know, exception handling, I think, will always require the human input.”
Yoo: Healthcare labor crisis driven by technological administrative burdens
“One of the number one crises that our healthcare industry is facing right now is a labor crisis. And that we have both, both have a shortage of labor to do these kind of highly specialized jobs that we have, whether it be clinical or whether it be administrati…”
Yoo: Monolithic contracts and claims systems prevent real-time healthcare spot pricing
“Today it's probably deemed illegal, honestly, by many of the contracts, because you're sort of bound by these, again, these monolithic agreements that highly specify, and the fact that you have this claim system there's no, really no notion of a real-time adju…”
Yoo: Long appointment wait times mask widespread wasted healthcare capacity
“You as a patient are told to wait weeks for a doctor's appointment, and you assume that that's because every doctor is booked out solid. But it actually turns out that a lot of the capacity in our system goes completely wasted.”
Yoo: Doctors design schedules defensively to protect against bad software
“You would see the way that doctors designed their schedule and very much to your point, they would design the templates of their schedules specifically in a very protective, like almost a defensive way. Because they felt wronged by the way that the system sent…”
Yoo: Fewer than 70% of doctors used EHRs five years ago
“Even five years ago, like, less than, you know, 70% of doctors had an electronic health record.”
Yoo: Startups are integrating LLMs into inpatient nurse walkie-talkie streams
“That actually reminds me of a company that we saw that It sort of reminded me of, like, what if every nurse in the inpatient ward, because the inpatient setting is very chaotic, very active, things are, like, surprises happen all the time, and a lot of nursing…”
Yoo: LLMs can unbundle care by automating triage, even without physical treatment
“Unbundling the role of a clinician. You know, there's one part which is actually the treatment part, so that's the part where maybe we can't necessarily today build an LLM that will stitch your finger. But the notion of triage, right and kind of getting you to…”
Yoo: A 1% cost optimization in health plans unlocks hundreds of millions
“Where a one percent impact on the cost structure of a health plan or the way that you underwrite risk in a certain health plan could literally mean hundreds of millions of dollars of either cost savings or better economics to the providers who are part of thos…”
Yoo: Only 25% of employer health plans cover GLP-1 drugs
“It's probably only about a fourth, 25% of employer sponsored insurance plans that today cover these drugs in terms of the benefit.”
Yoo: Dozens of cell and gene therapies will reach market soon
“There are dozens of drugs of this ilk that are projected to be approved and brought onto the market in the next several years”
Yoo: Drug makers lack post-market data feedback loops for prescriptions
“That is unfortunately like the state of affairs for many drugs that we have on the market today is that once the drug is prescribed and it's out there, there's not really great ways for the biomanufacturing companies to get feedback back.”
Yoo: CMS will launch payment guidance for breakthrough therapies despite election delays
“And then CMS, which administers Medicare and Medicaid the government sponsored insurance programs in our country. They generally tend to be at the tip of the spear of any payment innovation for new classes of drugs and new classes of services. And so the expec…”
Yoo: Separating care from payment causes healthcare's core incentive misalignment
“And so the point there being that the people delivering the service And receiving the service are not the people paying or, you know, sort of privy to the payments flow of those services. And that very bifurcation is what causes so much of the incentive misali…”