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Speaker 1: Bloomberg Audio Studios, podcasts, radio news. This is Master's in

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Speaker 1: Business with Barry Ridholds on Bloomberg Radio.

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Speaker 2: What can I say about this week's rock star guest?

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Speaker 2: Annie Lamont incredible track record as a venture capitalist. She's

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Speaker 2: co founder and managing partner of Oak HCFT. I can't

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Speaker 2: list all her accolades because they're just one hundred most

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Speaker 2: influential people in healthcare Forbes Midas List five times, Top

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Speaker 2: one hundred venture capitalists according to CBE Insights, Top vcs

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Speaker 2: on the New York Times List, Top twenty Private equity

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Speaker 2: power Players, Fintech Finance forty. She has had seventy exits

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Speaker 2: seven zero over the past twenty five years. Fifth ten IPOs.

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Speaker 2: Just an incredible track record of investing, primarily in the

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Speaker 2: healthcare but also the financial technology space. There as surprising

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Speaker 2: amounts of overlap in terms of access, outcomes, cost speed, friction,

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Speaker 2: especially those last three cost, speed, and friction between the two.

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Speaker 2: She's also First Lady of Connecticut and married to Governor

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Speaker 2: Ned Lamont. She's been doing VC work for thirty five

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Speaker 2: forty years and just as as insightful as anyone in

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Speaker 2: the world about those areas, especially healthcare. I found this

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Speaker 2: conversation to be absolutely fascinating. I think you will also

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Speaker 2: with no further ado, my discussion with Oak Hcfts.

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Speaker 3: Annie Lamont, thanks very great to be here.

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Speaker 2: I've been really excited for this conversation. You do so

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Speaker 2: many interesting things. But let's start with OAKEN Investment Partners.

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Speaker 2: You were a GP there starting in eighty six and

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Speaker 2: eight c ventures. What led you to that part of

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Speaker 2: your career.

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Speaker 4: Well, very early on, I got out of Stanford when

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Speaker 4: Silicon Valley was really at the very beginning of Silicon

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Speaker 4: Valley and joined somebody called hambrickton Quist, which was a

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Speaker 4: boutique investment bank venture firms or of legendary at that time.

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Speaker 4: I think I was the fiftieth employee and really fell

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Speaker 4: in love with venture from day one and working with entrepreneurs.

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Speaker 4: I Carrie Steve jobs Bags on the Apple IPO road

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Speaker 4: show in my first three months there. Wow, the first

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Speaker 4: three months we also took Genentech public, so I worked

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Speaker 4: with two of the greatest entrepreneurs ever.

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Speaker 1: I didn't know that at that time.

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Speaker 2: That was my next question is did you have any

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Speaker 2: sense of who you were upping shouldiers with or was

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Speaker 2: just like fast moving blur.

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Speaker 4: I certainly those two seemed like extraordinary people, and I

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Speaker 4: extrapolated that to most entrepreneurs. I quickly learned they were

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Speaker 4: two extraordinary individuals. But that was it just got me hooked.

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Speaker 4: I thought, if I could just learn and be with

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Speaker 4: people like this and not be the entrepreneur, but be

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Speaker 4: the person that supported, helped, edited, therapist, whatever was required.

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Speaker 4: I just wanted to spend the rest of my life

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Speaker 4: with people who envisioned the world as it should be.

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Speaker 2: And H and Q is known for a lot of

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Speaker 2: their software, internet hardware technology. What led you over to

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Speaker 2: the healthcare sector.

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Speaker 4: So when I joined Oak, which was really just a

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Speaker 4: couple of years out of out of Stanford. We were

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Speaker 4: founding Genzyme the year that I joined, one of the

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Speaker 4: also very first biotech companies, and there was only one

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Speaker 4: public software company at that point. And I wasn't really

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Speaker 4: interested in one of the three hundred disktrive companies that

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Speaker 4: were being created.

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Speaker 2: Not an Iomega fan, I remember that one.

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Speaker 4: Just yeah, they had done seagates for the original Seagate

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Speaker 4: shuegart And so I said, I want to create my

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Speaker 4: own space, you know, I want to create my own

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Speaker 4: expertise in an area that I could fundamentally be interested in,

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Speaker 4: and that ended up being biotech and so focused on

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Speaker 4: life science is the first fifteen years of my career,

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Speaker 4: and that companies like Alexian, Cephalon, Alkermes, all host of companies.

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Speaker 2: Were you anything healthcare or medical or biotech related at Stanford?

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Speaker 3: Well would you do?

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Speaker 2: Now?

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Speaker 4: I should have been a hum bio major, but I wasn't.

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Speaker 4: I had no idea how interested I was in the topic.

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Speaker 4: But I became fascinated by it and educated myself and

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Speaker 4: I wish it would have been nice to have had

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Speaker 4: the Internet back then.

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Speaker 2: But what what'd you study at Stanford?

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Speaker 4: I was a political science major, so of course that

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Speaker 4: prepared me for my life with my husband ultimately. But

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Speaker 4: I did have an interest in politics, but.

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Speaker 2: No technology, no engineering.

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Speaker 4: I mean, everybody takes a computer science course at Stanford.

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Speaker 2: But huh really interesting. So Oak Investment Partners very sophisticated

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Speaker 2: VC platform going back to like the late seventies, I

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Speaker 2: think is when they launched. Yeah, so when you joined

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Speaker 2: them in the eighties, what did you what did you

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Speaker 2: focus on? What? What was was it healthcare right out

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Speaker 2: of the gate or how did that transition take place

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Speaker 2: from carrying Steve jobs bags on the road show to

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Speaker 2: focusing on healthcare.

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Speaker 4: I think my interest, I said, and we found a

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Speaker 4: genzyme it just intellectually interested in the area, but worked

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Speaker 4: on you know, some software companies back then, and then

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Speaker 4: decided I really needed my own hook. Like the reality

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Speaker 4: is in every career, you know you should, you need

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Speaker 4: to create your own expertise and your own special lane.

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Speaker 1: And that was going to be my lane.

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Speaker 4: I wanted to differentiate myself from all the other engineers

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Speaker 4: at at OAK and do my own thing.

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Speaker 2: Was was that kind of a white sheet at that point?

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Speaker 2: There wasn't a lot of there. Yeah.

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Speaker 4: Yeah, that was the other thing. It wasn't any real

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Speaker 4: competition at OAK. And in terms of the market, it

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Speaker 4: was a burgeoning area and you didn't have to be

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Speaker 4: a PhD. You could hire PhDs to help you analyze

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Speaker 4: these things.

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Speaker 2: What was Oak's core focus when you joined them was

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Speaker 2: was healthcare something that had they had previously played in?

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Speaker 2: Or you essentially did you stand up that sector? Yes, Oak? Yes,

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Speaker 2: huh So what else were they investing in at the

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Speaker 2: same time?

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Speaker 4: Well, a lot of hardware is, I said, a number

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Speaker 4: of disk drive companies PC. I mean we did actually

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Speaker 4: invest in compac during that period, and so it was

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Speaker 4: more PC hardware telecom related.

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Speaker 2: So clients, the LPs who come to Oak, were they

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Speaker 2: just giving them cash to be allocated across all these

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Speaker 2: different sectors or did people say all right, I'll try

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Speaker 2: a little bit of healthcare and a little now.

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Speaker 4: We always had and we do have an OKHCFT one

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Speaker 4: fund at everything, and we would choose the allocation.

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Speaker 3: Huh.

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Speaker 2: So that investors are getting bosure to whatever you guys

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Speaker 2: think has the most potential. Right, So you're listed as

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Speaker 2: a managing partner at Oak as well as a managing

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Speaker 2: partner and co founder at Oak HCFT. What's the relationship

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Speaker 2: between the two companies?

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Speaker 4: There is there is no relationship. Ok Investment Partners is

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Speaker 4: Wine is wound down effectively, I'm still there until the

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Speaker 4: last company is.

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Speaker 2: Just waiting for a right.

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Speaker 3: Yes, for the last.

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Speaker 4: Exactly have an obligation to those LPs in that firm,

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Speaker 4: But the reality is there is no relationship. We started

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Speaker 4: ok HCFT because we had had two practices obviously in

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Speaker 4: healthcare and fintech. Andrew Adams and myself launched the firm

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Speaker 4: and ten years ago and really wanted to focus on

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Speaker 4: the new model of investing that wasn't just Jedi Knights

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Speaker 4: from you know, twenty five years ago, where it was

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Speaker 4: just you're a good advisor and you don't have a

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Speaker 4: talent function and you're not The really changed to become

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Speaker 4: a service entity to entrepreneurs, to support entrepreneurs. And it

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Speaker 4: was always partnering with entrepreneurs in the past, but the

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Speaker 4: reality is that became a far more competitive world. You

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Speaker 4: really needed to be deep in a specialty to differentiate yourself,

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Speaker 4: and you needed to have things like tech support. Talent

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Speaker 4: support is enormous because it is all about people. We

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Speaker 4: have five individuals that are just singlely focused on talent

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Speaker 4: and attracting talent for our companies and also introducing us

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Speaker 4: to repeat entrepreneurs we haven't invested in before.

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Speaker 2: So you've used the phrase Jedi Knights in the past.

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Speaker 2: Tell us a little bit what you mean by that.

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Speaker 2: I get the sense the world of venture today is

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Speaker 2: very different than the eighties and.

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Speaker 1: Nineties, very different.

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Speaker 4: I think the Jedi Knights means that it's just a

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Speaker 4: group of individuals, maybe a firm, but it's a group

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Speaker 4: of individuals that are sort of all out for themselves

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Speaker 4: just investing directly with entrepreneurs, with no real overlap between

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Speaker 4: anyone else in the firm and that entrepreneur, whereas now

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Speaker 4: I would say, like, okay, safety is very much a

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Speaker 4: team based approach where we support the entrepreneur in a

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Speaker 4: myriadive ways. Whatever they need, you know, will we will

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Speaker 4: supply as a firm.

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Speaker 2: So some of the VC books and autobiographies and the

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Speaker 2: like that I've read kind of imply the early eighties

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Speaker 2: and earlier days of venture was first they would write

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Speaker 2: a check, and after they had been writing checks for

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Speaker 2: a few years, they ended up having a bit of

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Speaker 2: a network of other engineers and other venture funds and

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Speaker 2: other entrepreneurs, and so people would plug into that network.

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Speaker 2: It sounds like you're describing something much more comprehensive and

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Speaker 2: holistic than the venture of old. Servicing the entrepreneur put

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Speaker 2: some flesh on those bones. How much service does oak

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Speaker 2: provide to the companies you work work with besides funding?

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Speaker 4: I think that first of all, that we should just

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Speaker 4: talk about that the difference between a world where everything

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Speaker 4: there was more, There was less capital and more entrepreneurs

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Speaker 4: in the early days, so the supply demand balance was

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Speaker 4: such that there was a lot more power I would

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Speaker 4: say with the money than with the entrepreneurs and the

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Speaker 4: great entrepreneurs. And I would say that's flipped in this

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Speaker 4: world and that there are obviously many more entrepreneurs, but

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Speaker 4: there's also a lot more money in the industry, and say,

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Speaker 4: you really have to differentiate yourself. And I think that's

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Speaker 4: where this service model came in of support that is how,

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Speaker 4: in part, you differentiate yourself. And yes, it's great relationships

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Speaker 4: and great advice, but it's also the wrap around of

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Speaker 4: talent which is huge, like recruiting and understanding that you're

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Speaker 4: providing someone go to market advice at times exit, really

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Speaker 4: understanding the process in terms of exiting companies introduce you introductions,

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Speaker 4: which is the importance of being deep in these two

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Speaker 4: sectors is you know the customers. We know the customers intimately,

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Speaker 4: we have great relationships with them broadly, and so we

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Speaker 4: can help make the introductions as well as many of

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Speaker 4: those customers end up being buyers of the companies, and

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Speaker 4: so just understanding that life cycle and being completely connected

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Speaker 4: to those communities is really is hugely important.

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Speaker 2: So that flipping of the power dynamics from the capital

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Speaker 2: to the entrepreneur. Does that have anything to do with

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Speaker 2: companies now staying private for so much longer that seems

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Speaker 2: like there's endless amounts of money around and no shortage

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Speaker 2: of people willing to fund startups. How does that dynamic

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Speaker 2: play out with all these companies just postponing IPOs for

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Speaker 2: seemingly much longer than they used to.

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Speaker 4: Less about postponing ipo. So though certainly some of the

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Speaker 4: major you know, some of the very large companies are

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Speaker 4: doing that in order to realize full value, I would

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Speaker 4: say that the IPO market is not as you know.

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Speaker 1: It is so cyclical.

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Speaker 4: It's just not For example, it's not friendly right now,

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Speaker 4: and it's hard to get exits. So I would say

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Speaker 4: in these two sectors, I mean, a stripe can go

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Speaker 4: public anytime it wants. Is when to choose to go

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Speaker 4: public when it feels like the values there and they're

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Speaker 4: in the best position from a profitability standpoint and growth perspective.

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Speaker 4: The reality is most companies cannot go public. What has

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Speaker 4: changed dramatically in the last thirty years is that companies

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Speaker 4: could go public much earlier in their life cycle. Now biotech,

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Speaker 4: which we don't do anymore, we do all technology enabled

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Speaker 4: software and services and healthcare that it started in two

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Speaker 4: thousand with Athena Health.

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Speaker 1: The reality is is.

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Speaker 4: It is not an exit to go public, and with biotech,

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Speaker 4: it's just a funding mechanism, right, there's a it's a

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Speaker 4: public private world in biotech. The rest of the universe,

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Speaker 4: you really have to be a more mature company. You

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Speaker 4: have to be an over billion dollar market cap company

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Speaker 4: to haven't make any sense to go public. You know,

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Speaker 4: there used to be companies that have one hundred and

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Speaker 4: two hundred million dollar market gaps that would go public,

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Speaker 4: but it's been it's been made much more difficult to

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Speaker 4: be a public company. There are far fewer people that

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Speaker 4: play with those companies. If you don't have a large

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Speaker 4: market cap, people don't the liquidity isn't there. The dollars

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Speaker 4: are so much larger going into these public companies that

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Speaker 4: it's just a it's a very different world than it

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Speaker 4: was thirty years ago. But now we've created in the

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Speaker 4: private markets a sort of private public world. And I

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Speaker 4: would say while eighty percent of our exits are through strategics,

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Speaker 4: the financial pe world is our buyers for early stage companies,

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Speaker 4: but we have to get them profitable, you know.

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Speaker 2: It seems odd that markets are at all time highs

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Speaker 2: at the same time. Not a friendly IPO market. I'm

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Speaker 2: trying to remember the last time those two things happened

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Speaker 2: at the same time, right, Like you think back old

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Speaker 2: time highs, late nineties, red hot IPO market, even mid

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Speaker 2: seventies before the financial crisis, pretty robust IPO market. And

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Speaker 2: then again venture and IPO is right up and through

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Speaker 2: the early part of the pandemic, you know, red hot market.

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Speaker 2: This is my first example of all time highs and stocks,

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Speaker 2: but not so much in IPO issuance.

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Speaker 4: But I think if you looked at the market, so

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Speaker 4: much of it has been driven by the top seven

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Speaker 4: tech companies. So it's a bit of a head fake.

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Speaker 4: You're now seeing rotation right in terms of other companies

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Speaker 4: through you know, other companies now benefiting by the markets

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Speaker 4: from being higher. But I think the reality is right now,

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Speaker 4: we just have an overhang from certainly in my world

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Speaker 4: I can speak to healthcare and fintech, a number of

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Speaker 4: companies going public and then disappointing or evaluation just being

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Speaker 4: excessive compared to the maturity of the businesses. So I

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Speaker 4: think there's just a hangover from that, and people are

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Speaker 4: going to invest in known entities that are already public

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Speaker 4: at this point, and we still have a ways to go.

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Speaker 4: I think for some of those companies, many of those

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Speaker 4: smaller to mid sized companies being valued in the marketplace

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Speaker 4: and appropriately really interesting.

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Speaker 2: So let's talk a little bit about some of the

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Speaker 2: companies that you guys have invested in. You were very

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Speaker 2: early in some iconic names. You mentioned Athena, there's also

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Speaker 2: one medical Village MD Devoted Health. Quite a on of

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Speaker 2: really big names. Tell us what led you to these companies?

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Speaker 2: How are you so early so often in companies that

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Speaker 2: turned out to be, you know, big movers in the space.

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Speaker 4: Well, I would say it started with Athena Health, backing

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Speaker 4: Jonathan Bush and the Park brothers there, Todd and Eddie Park,

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Speaker 4: then founded cast Light actually by Todd, and then then

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Speaker 4: devoted So a lot of what we do repeat entrepreneurs.

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Speaker 4: Once you find a great entrepreneur, you develop a deep

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Speaker 4: relationship with them their friends as well as business colleagues,

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Speaker 4: and then you back them over and over again. And

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Speaker 4: so we've done that very successfully over time. But it

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Speaker 4: did start with that. The whole tech enabled services approach

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Speaker 4: and healthcare started with Athena, and it started with our

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Speaker 4: view that we really just wanted to invest in things

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Speaker 4: that lowered cost, improved outcomes, and patient experience in healthcare

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Speaker 4: period the end.

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Speaker 2: Give me, give me those three again, improved outcomes and

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Speaker 2: patient experiences. Yes, well that sounds like, you know, the

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Speaker 2: Holy grail if you can do all three of those.

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Speaker 4: So you don't always do all three, but at least

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Speaker 4: two of them. It really is a mission for us

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Speaker 4: and trying to improve healthcare. And we started Athena was

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Speaker 4: the first cloud based healthcare company, and we invested in them,

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Speaker 4: and really it was just a red cycle management company then,

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Speaker 4: which was part of art thinking also around why we

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Speaker 4: did payments and fintech. A lot of overlap in the

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Speaker 4: whole payments world in healthcare. But so and then and

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Speaker 4: then it became an EHR Electronic health record company seven

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Speaker 4: years later actually, and so now they have one of

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Speaker 4: the most important EHRs in the country and in that space.

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Speaker 4: But really it was just a like paid doctors faster,

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Speaker 4: better using technology. And so if you're looking at some

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Speaker 4: of the newer companies, think Devoted, which is a fascinating

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Speaker 4: company that's focused on medicare advantage and is competing with

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Speaker 4: all legacy companies, United, Humanita, Elevants, Anthem. If you think,

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Speaker 4: if you look at what Devoted is doing, they have

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Speaker 4: redesigned the entire tech stack. They're using gen Ai in

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Speaker 4: their function. They are a combination of a villager, Oak

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Speaker 4: Street and an MA plan, meaning that they're actually they

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Speaker 4: have Devoted Medical Group which started as virtual but as

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Speaker 4: a network managing network of the care because you cannot

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Speaker 4: you cannot as a health plan, directly manage the cost

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Speaker 4: of care is eighty five percent of all healthcare, and

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Speaker 4: so as a health plan, in order to manage care,

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Speaker 4: you actually have to in part own the care. And

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Speaker 4: so Devoted Medical Groups starts with you know, primary care

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Speaker 4: docs virtually wrap around services virtually as well as extending

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Speaker 4: their networks so that they can actually impact the quality

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Speaker 4: and cost of care. So there really is nobody else

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Speaker 4: effectively doing both being the NMA plan as well as

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Speaker 4: being a source of managing the care. And so they've

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Speaker 4: done that amazingly well. The fact that they have a

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Speaker 4: modern tech stack that no one else has. Everybody else

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Speaker 4: is writing off of thirty and forty year old legacy programs.

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Speaker 4: Even I mean, if you look at Epic just from

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Speaker 4: the software side. I mean, there's literally based on mumps,

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Speaker 4: you know, from the nineteen seventies. So what's exciting about

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Speaker 4: Devoted is that you're now seeing the impact of all

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Speaker 4: of that, whereas MA plans all over the country are suffering,

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Speaker 4: and they're actually excelling this environment.

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Speaker 2: So let's talk a little bit about quality and cost.

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Speaker 2: It seems like healthcare, unique in the US business space,

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Speaker 2: has been so resistant to an end to end form

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Speaker 2: of technology that improves quality reduced costs, like technology and

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Speaker 2: computers and software seem to have improved productivity and lowered

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Speaker 2: costs everywhere twenty thirty years ago, and it's still compounding.

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Speaker 2: Why has healthcare been such a challenge to build in

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Speaker 2: basic technologies? Why are they still working on thirty forty

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Speaker 2: year old legacy systems?

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Speaker 4: Well, so a little like banking, as many of those

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Speaker 4: are also working off of cobol systems but are now

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Speaker 4: finally being reinvented. I would say healthcare. If you actually

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Speaker 4: to most people who have worked in healthcare, there's almost

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Speaker 4: like a right brain left brain disconnect and that you're

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Speaker 4: either tech focustory or healthcare focused. And I would say,

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Speaker 4: what's happened in the last decade is that you have

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Speaker 4: a younger generation coming into the industry that are just

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Speaker 4: naturally tech focused, right your tech savvy users. There are

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Speaker 4: a number of technologists that are interested in healthcare and

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Speaker 4: so there's been much more reinvention. I mean, I think

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Speaker 4: not to talk about devoted too much, but the reality

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Speaker 4: is the CEO Eddie Park is a computer science major

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Speaker 4: from Herbert So that is is like a different mentality.

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Speaker 4: And I would say if you look at most healthcare companies,

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Speaker 4: they just have not focused on that and they haven't

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Speaker 4: if you're a hospital system in general, you've not been

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Speaker 4: forced to be truly efficient. HCA different story they have,

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Speaker 4: but in most cases they've implemented epic or in some

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Speaker 4: cases than the ambulatory side, maybe in Athena. But they

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Speaker 4: are not tech. This is not their business. You know,

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Speaker 4: their core business is delivering healthcare and they really haven't

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Speaker 4: understood the power of tech. I do think what's changing

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Speaker 4: and the massive inflection point right now with jen Ai,

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Speaker 4: you now have all this unstructured data that is abundant

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Speaker 4: in healthcare, and you now can take that and have

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Speaker 4: the power of that to change workflow, to change and

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Speaker 4: support the doctors and nurses that are delivering here in

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Speaker 4: a way that doesn't require behavior change but makes their

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Speaker 4: lives easier, and that is going to be a game changer.

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Speaker 2: So I want to put a little It's almost a

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Speaker 2: cliche to say flesh on the bones, no pun intended.

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Speaker 2: So I have my Charts by Epic on my phone

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Speaker 2: and it's the first app I've ever used where I

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Speaker 2: can renew a prescription, I could set up an appointment,

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Speaker 2: I can ask a doctor question. But literally six months ago,

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Speaker 2: if I wanted a record before I put this on

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Speaker 2: this phone, the doctor's office would say, fax your request

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Speaker 2: to us, Like, what's a fact? I mean, really, we're

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Speaker 2: still using fifty year old technologies. But that seems to

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Speaker 2: be in most of the medical profession. I know there's

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Speaker 2: some security concerns and some rules about what can and

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Speaker 2: can't be emailed, but faxes, I mean they're living in

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Speaker 2: the nineteen seventies. Is it that far behind the curve

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Speaker 2: for much of the medical US?

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Speaker 4: Yes, just even in New York City. Just got any

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Speaker 4: doctor and you will find that they're still faxing or

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Speaker 4: handing you a piece of paper, and they're not integrated

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Speaker 4: with their own hospital system that they may be affiliated

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Speaker 4: with or have surgical privileges at is.

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Speaker 1: It's absolutely insane.

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Speaker 4: My images, I'm still carding around on discs right, it's crazy. Now.

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Speaker 4: The amazing thing and the problem with Hippa is you're right,

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Speaker 4: like you can't do zoom.

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Speaker 1: You're not supposed to do zoom.

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Speaker 2: Right because it's not secure.

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Speaker 1: It's not you don't have it's not hippo compliant.

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Speaker 4: You. What makes absolutely no sense is that a fax

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Speaker 4: is considered secure.

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Speaker 2: Right. It sits on the fax machine somewhere for hours.

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Speaker 4: Anybody can see it, right, you know the sanitation worker

402
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Speaker 4: that night, can you know, like see, the whole thing's

403
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Speaker 4: crazy so much somehow you know your private email is

404
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Speaker 4: not private enough?

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Speaker 2: So I mentioned my charts. Epic is still private, very

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Speaker 2: large private company. There's been some litigation because of any

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Speaker 2: trust concerns with them. How big is their penetration if

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Speaker 2: so many offices are still you know faxing records around.

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Speaker 4: Their penetration is enormous and growing and I effectively you

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Speaker 4: know Serner is losing traction and losing clients every day.

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Speaker 4: Really and yes, Epic is is owning that market.

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Speaker 2: Is that because the software is so good? And I

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Speaker 2: will tell you my experience with the app, you know,

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Speaker 2: ten out of ten. But what else is happening behind

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Speaker 2: the scenes that's giving them such an advantage over everybody else.

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Speaker 4: Well, I think Cerner lost its way in manner a

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Speaker 4: decade ago. Oh really a decade ago. So it just

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Speaker 4: create opened up the it just opened up. There wasn't

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Speaker 4: you know. It takes time to create all the different

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Speaker 4: modules and all the different departments. So this is just

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Speaker 4: a time game almost and that you know, Epic had

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Speaker 4: a lot of time to create integrated software across all

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Speaker 4: of these different departments. And and because they got every

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Speaker 4: academic medical institution in the country to effectively adopt them,

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Speaker 4: you know, they they've become a standard and there there

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Speaker 4: is a danger in that in terms of talking about monopoly,

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Speaker 4: they are going to have a growing monopoly in this market.

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Speaker 4: They've also as you say, it's it's a benefit you know,

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Speaker 4: their views like Apple, they're going to be a walled

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Speaker 4: garden and that'll be a benefit to the customer. And

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Speaker 4: that's that's okay. And certainly hospitals you know, like it

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Speaker 4: and there's a real benefit to it. I do think

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Speaker 4: the issue is, I mean, we would never sue epic

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Speaker 4: for any of our small companies that are trying to

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Speaker 4: interface with them. That isn't the way we roll. But

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Speaker 4: do think that there it's a cautionary note about the

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Speaker 4: amount of power.

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Speaker 2: They've become the eight hundred pound gorilla in the space.

439
00:26:08,240 --> 00:26:11,440
Speaker 4: Is that what's happened, no question, And you as an

440
00:26:11,440 --> 00:26:15,480
Speaker 4: innovator has to have privileges to link into that system.

441
00:26:16,000 --> 00:26:20,159
Speaker 2: So they were the disruptor, and now like Apple was

442
00:26:20,200 --> 00:26:25,360
Speaker 2: the disruptor, now they become the dominant player. So that's

443
00:26:25,400 --> 00:26:29,120
Speaker 2: why there's some challenges. I was kind of shocked when

444
00:26:29,160 --> 00:26:33,360
Speaker 2: I saw the chatter about anti trust because literally it's

445
00:26:33,400 --> 00:26:37,240
Speaker 2: the first app that just works as a patient. Wait,

446
00:26:37,359 --> 00:26:40,480
Speaker 2: I could do all these things, prescriptions, appointments, I could

447
00:26:40,520 --> 00:26:43,800
Speaker 2: see X rays or whatever. Wow, nothing else has ever

448
00:26:43,920 --> 00:26:46,840
Speaker 2: worked this well, they always send you to a website,

449
00:26:46,880 --> 00:26:50,640
Speaker 2: which opens up a different site. Like nothing really felt secure.

450
00:26:50,720 --> 00:26:55,120
Speaker 2: This really does feel like a secure app. So does

451
00:26:55,160 --> 00:26:59,000
Speaker 2: that create opportunities for other companies to come in and

452
00:26:59,040 --> 00:27:03,600
Speaker 2: being disrupted disruptors or are they sort of blocking the

453
00:27:04,359 --> 00:27:07,240
Speaker 2: entrance way to new startups that want to compete in

454
00:27:07,240 --> 00:27:08,000
Speaker 2: that same space?

455
00:27:08,920 --> 00:27:11,520
Speaker 4: Well, I think you know, let's define the space right

456
00:27:11,600 --> 00:27:15,600
Speaker 4: that is just for providers and hospital systems specifically, not

457
00:27:15,760 --> 00:27:19,439
Speaker 4: independent providers there. But you think about the way we

458
00:27:19,480 --> 00:27:22,440
Speaker 4: think about healthcare in general. What we do in tech

459
00:27:22,520 --> 00:27:27,760
Speaker 4: enabled software and solutions is we're treating pharma services so

460
00:27:27,880 --> 00:27:31,960
Speaker 4: farmer as a client, employers payer, employer market as a client,

461
00:27:32,040 --> 00:27:35,800
Speaker 4: and payers our clients beyond our customers of our companies,

462
00:27:36,160 --> 00:27:38,800
Speaker 4: beyond hospital systems.

463
00:27:38,960 --> 00:27:40,080
Speaker 1: Actually, this has.

464
00:27:40,000 --> 00:27:43,080
Speaker 4: Been the hardest place to play and where we've made

465
00:27:43,240 --> 00:27:47,600
Speaker 4: the least number of investments, the fewest number of investments

466
00:27:47,840 --> 00:27:52,600
Speaker 4: is in hospital systems because Epic owned it, and so

467
00:27:53,119 --> 00:27:55,480
Speaker 4: you know, it's been a sort of dangerous territory for

468
00:27:55,520 --> 00:27:58,399
Speaker 4: a young innovator to go into. But there's plenty of

469
00:27:58,480 --> 00:28:03,399
Speaker 4: opportunity to have payers, solutions to focus on provide creating

470
00:28:03,440 --> 00:28:06,520
Speaker 4: companies that are value based or focused on out how

471
00:28:06,520 --> 00:28:10,320
Speaker 4: do we create better outcomes in medicare, medicaid and commercial.

472
00:28:10,800 --> 00:28:14,359
Speaker 4: That don't mean that you're competing in the hospital environment. Again,

473
00:28:14,640 --> 00:28:18,680
Speaker 4: but back to Jenai, I think the reality is because

474
00:28:18,720 --> 00:28:22,719
Speaker 4: of the power of our unstructured data, I think that

475
00:28:22,800 --> 00:28:25,960
Speaker 4: there will be many more opportunities to be a disruptor

476
00:28:26,240 --> 00:28:30,080
Speaker 4: in the hospital market. And I don't think it's certainly possible.

477
00:28:30,119 --> 00:28:33,000
Speaker 4: My dream would be in a decade, ten to twenty

478
00:28:33,080 --> 00:28:36,400
Speaker 4: years that you wouldn't you wouldn't need an EPIC because

479
00:28:37,359 --> 00:28:41,120
Speaker 4: you would have the ability to integrate with all these

480
00:28:41,120 --> 00:28:44,640
Speaker 4: solutions using unstructured data across the hospital.

481
00:28:44,680 --> 00:28:48,600
Speaker 2: So you guys aren't necessarily an investor in hospital systems

482
00:28:49,000 --> 00:28:52,800
Speaker 2: or hospitals. But when we look in the hospital space,

483
00:28:53,240 --> 00:28:55,600
Speaker 2: there's been a lot of private equity activity. There's been

484
00:28:55,640 --> 00:28:59,080
Speaker 2: a lot of consolidation. A ton of not for profit

485
00:28:59,160 --> 00:29:02,880
Speaker 2: hospitals still carrying that moniker have been picked up by

486
00:29:03,360 --> 00:29:07,320
Speaker 2: for profit private equity players. How do you look at

487
00:29:07,360 --> 00:29:10,760
Speaker 2: the consolidation taking place in the hospital chain area? How

488
00:29:10,760 --> 00:29:15,400
Speaker 2: does that affect how you think about software technology and integration.

489
00:29:16,200 --> 00:29:19,480
Speaker 4: There will be more consolidation, it will mostly be done

490
00:29:19,640 --> 00:29:23,120
Speaker 4: by not for profits. That is, the vast majority of

491
00:29:23,280 --> 00:29:26,440
Speaker 4: hospital systems now are part of not for profits. Right

492
00:29:28,160 --> 00:29:32,200
Speaker 4: the private equity world, we consider ourselves venture capitalists or

493
00:29:32,280 --> 00:29:36,080
Speaker 4: growth growth investors, not PE but p you know, has

494
00:29:36,720 --> 00:29:40,680
Speaker 4: bought several hospital systems, not all of it's gone well.

495
00:29:42,280 --> 00:29:45,240
Speaker 4: I do feel there's some backlash to that. You know,

496
00:29:45,320 --> 00:29:49,640
Speaker 4: our goal is to reduce costs in healthcare and improve

497
00:29:49,680 --> 00:29:53,520
Speaker 4: the patient experience, and you can't really do that if

498
00:29:53,560 --> 00:29:56,720
Speaker 4: you're focused on owning hospitals. The reality is, everything we

499
00:29:56,800 --> 00:30:00,640
Speaker 4: want to do is keep people out of hospitals. That's

500
00:30:00,680 --> 00:30:03,440
Speaker 4: the goal, right. Nobody wants to be in hospital, Nobody

501
00:30:03,480 --> 00:30:07,800
Speaker 4: wants to die in a hospital. So everything that we

502
00:30:07,840 --> 00:30:10,280
Speaker 4: want to do is a better patient experience in the home,

503
00:30:10,800 --> 00:30:13,920
Speaker 4: right in military surgery or in the home, outside of

504
00:30:13,920 --> 00:30:17,240
Speaker 4: the hospital system. So that that's our goal and focus,

505
00:30:17,400 --> 00:30:20,560
Speaker 4: not being not owning hospital systems. I will say I

506
00:30:20,640 --> 00:30:22,360
Speaker 4: was on the board of HCA for a while, not

507
00:30:22,520 --> 00:30:25,720
Speaker 4: as an investor, but an observer of the best hospital

508
00:30:25,720 --> 00:30:28,600
Speaker 4: system in America. And if you think about that, that

509
00:30:28,680 --> 00:30:30,400
Speaker 4: was a pe deal. It was owned by a family,

510
00:30:30,480 --> 00:30:33,720
Speaker 4: but multiple times right they went public, they went private,

511
00:30:33,720 --> 00:30:36,320
Speaker 4: they went public again, and that is the best run

512
00:30:36,400 --> 00:30:40,080
Speaker 4: hospital system in America as a for profit really, yes,

513
00:30:40,320 --> 00:30:45,760
Speaker 4: the best run, the most efficient, great outcomes. And I

514
00:30:45,800 --> 00:30:47,200
Speaker 4: think the way you've got to look at this not

515
00:30:47,360 --> 00:30:50,880
Speaker 4: for profit hospitalism is that every not for profit hospital

516
00:30:51,400 --> 00:30:55,280
Speaker 4: is a for profit hospital because every decision is made

517
00:30:55,320 --> 00:30:56,920
Speaker 4: by a for profit doctor.

518
00:30:57,240 --> 00:30:59,959
Speaker 2: Right somewhere along the line, someone is making a decision

519
00:31:00,080 --> 00:31:01,920
Speaker 2: and obviously.

520
00:31:01,800 --> 00:31:02,840
Speaker 1: That impacts their income.

521
00:31:03,080 --> 00:31:05,480
Speaker 4: Right, So that there's no such thing as a not

522
00:31:05,520 --> 00:31:08,400
Speaker 4: for private hospital in America.

523
00:31:08,040 --> 00:31:11,960
Speaker 2: So what are the better known hospitals that HCA manages

524
00:31:12,120 --> 00:31:17,360
Speaker 2: If I'm not familiar with eight c A generally, Well.

525
00:31:17,240 --> 00:31:18,160
Speaker 1: They're going to be brands.

526
00:31:18,200 --> 00:31:21,200
Speaker 4: You know, there's Baptists, there's They're gonna be brands all

527
00:31:21,200 --> 00:31:22,960
Speaker 4: over the country and they're gonna be different in every

528
00:31:22,960 --> 00:31:23,840
Speaker 4: market because they.

529
00:31:23,680 --> 00:31:24,440
Speaker 1: Want to be local.

530
00:31:24,720 --> 00:31:28,800
Speaker 4: You feel local, and so you wouldn't necessarily know the brands.

531
00:31:28,840 --> 00:31:31,200
Speaker 4: It's gonna be Florida, and it's going to be city

532
00:31:31,200 --> 00:31:33,200
Speaker 4: by city, and every hospital will have a different name.

533
00:31:33,440 --> 00:31:36,600
Speaker 2: Like I've been fortunate to not spend a whole lot

534
00:31:36,600 --> 00:31:40,320
Speaker 2: of time in hospitals, my experience at NYU Lang Gone

535
00:31:40,440 --> 00:31:44,920
Speaker 2: was kind of eye opening. Well, first, you know, sometimes

536
00:31:44,960 --> 00:31:48,280
Speaker 2: you get advice, Hey, go someplace that specializes what you need.

537
00:31:48,640 --> 00:31:52,640
Speaker 2: So they've seen every variant. And even with that, I

538
00:31:52,760 --> 00:31:57,640
Speaker 2: wasn't prepared for what an amazing factory assembly line. And

539
00:31:57,680 --> 00:32:01,200
Speaker 2: I mean that the most positive sense of it. It's like, yeah,

540
00:32:01,200 --> 00:32:03,800
Speaker 2: we do a million of these a day. Whatever you have,

541
00:32:03,960 --> 00:32:07,520
Speaker 2: it's not a problem. We've seen it. And it was true.

542
00:32:07,560 --> 00:32:10,960
Speaker 2: They had it down to like bing bang bing, you're

543
00:32:11,000 --> 00:32:14,920
Speaker 2: in and out and it was really impressive to see.

544
00:32:15,440 --> 00:32:21,120
Speaker 2: I'm just curious if that degree of competency. I think

545
00:32:21,160 --> 00:32:24,240
Speaker 2: my whole copay for the whole experience was fifty bucks,

546
00:32:24,600 --> 00:32:27,280
Speaker 2: which I guess just means my wife has good health

547
00:32:27,280 --> 00:32:32,640
Speaker 2: insurance as a New York teacher. But it was really impressive.

548
00:32:33,880 --> 00:32:38,480
Speaker 2: Is that specifically a function of one hospital or is

549
00:32:38,480 --> 00:32:42,040
Speaker 2: that a broader management approach to the whole chain?

550
00:32:42,920 --> 00:32:47,360
Speaker 4: New York does not allow for hospitals, so you wouldn't

551
00:32:47,400 --> 00:32:49,240
Speaker 4: experience it in New York state.

552
00:32:49,560 --> 00:32:52,360
Speaker 2: It did not feel like it was a not for profit. Yeah,

553
00:32:52,600 --> 00:32:55,880
Speaker 2: it felt like everything was structured to get them in,

554
00:32:55,920 --> 00:32:57,480
Speaker 2: get them out, move on time.

555
00:32:57,520 --> 00:33:00,720
Speaker 4: We have New Yorker's a lucky and that they've got

556
00:33:01,480 --> 00:33:06,360
Speaker 4: a somewhat competitive hospital environment and for sure excellent care

557
00:33:06,440 --> 00:33:07,040
Speaker 4: here right.

558
00:33:08,000 --> 00:33:09,720
Speaker 1: So No, it's and that's that is.

559
00:33:09,800 --> 00:33:11,960
Speaker 4: I think if you sat in a boardroom of a

560
00:33:12,000 --> 00:33:14,240
Speaker 4: not for profit and a for pro hospital, you'd be

561
00:33:14,280 --> 00:33:16,400
Speaker 4: amazed how similar the conversations are.

562
00:33:17,920 --> 00:33:20,640
Speaker 2: I don't doubt that at all. How do you think

563
00:33:20,680 --> 00:33:24,680
Speaker 2: about having sat on a board how do you think

564
00:33:24,720 --> 00:33:28,840
Speaker 2: about managing problem hospitals? I just got off the phone

565
00:33:28,880 --> 00:33:32,320
Speaker 2: with a friend in Florida who jokingly said, you know,

566
00:33:32,360 --> 00:33:34,320
Speaker 2: if you fall and break your leg in Florida, you

567
00:33:34,360 --> 00:33:36,840
Speaker 2: don't call an ambulance, You call cab. You call an

568
00:33:36,920 --> 00:33:39,000
Speaker 2: uber to take you to the airport to fly up

569
00:33:39,040 --> 00:33:42,320
Speaker 2: to New York. I think he was exaggerating a little bit.

570
00:33:42,400 --> 00:33:44,560
Speaker 2: But that's not the first time I've heard things like.

571
00:33:44,520 --> 00:33:45,760
Speaker 1: That over and over again.

572
00:33:45,840 --> 00:33:49,240
Speaker 4: People come dig you know, from Connecticut, and people come

573
00:33:49,280 --> 00:33:53,280
Speaker 4: back to Connecticut all that they do their healthcare. Connecticut

574
00:33:53,320 --> 00:33:55,960
Speaker 4: may be there, or Northeast could be their second home,

575
00:33:56,040 --> 00:33:59,160
Speaker 4: and maybe theyre domicile now in Florida, but they come

576
00:33:59,200 --> 00:34:00,880
Speaker 4: back for the hospital.

577
00:34:01,640 --> 00:34:04,400
Speaker 2: How does the system that has that sort of reputation,

578
00:34:04,520 --> 00:34:08,120
Speaker 2: how do they address that. It seems like in Florida,

579
00:34:08,280 --> 00:34:10,879
Speaker 2: you would think that they have lots of people who

580
00:34:10,880 --> 00:34:13,320
Speaker 2: were older. They should be really good.

581
00:34:13,120 --> 00:34:15,160
Speaker 1: At that, they should be really good.

582
00:34:16,560 --> 00:34:19,080
Speaker 2: It's a it's just a you know, it's just a

583
00:34:19,320 --> 00:34:23,360
Speaker 2: I'm just musing. But it just seems like I mentioned

584
00:34:23,480 --> 00:34:26,520
Speaker 2: somebody I was speaking to you, and they're like, find

585
00:34:26,520 --> 00:34:29,160
Speaker 2: out why Florida hospitals are not good. I don't think

586
00:34:29,200 --> 00:34:30,800
Speaker 2: she invests in hospitals.

587
00:34:30,400 --> 00:34:32,360
Speaker 4: Well, you know, and I think there's there's just a

588
00:34:32,440 --> 00:34:35,960
Speaker 4: long history, like they have doctors going to to Florida

589
00:34:36,040 --> 00:34:38,719
Speaker 4: to there's been a culture of like making money there,

590
00:34:39,280 --> 00:34:42,160
Speaker 4: you know, and the more specialists you have, the more

591
00:34:42,800 --> 00:34:45,960
Speaker 4: it's it's amazing. The more specialist you have, more surgeries and.

592
00:34:46,000 --> 00:34:47,480
Speaker 1: More things to get done it right.

593
00:34:47,560 --> 00:34:50,200
Speaker 4: And so I just don't think they have the same

594
00:34:50,239 --> 00:34:54,440
Speaker 4: tradition of quality that other states have had, or the

595
00:34:54,600 --> 00:34:55,600
Speaker 4: Northeast has had.

596
00:34:56,440 --> 00:34:57,560
Speaker 1: So I can't.

597
00:34:57,600 --> 00:35:01,960
Speaker 4: Obviously they're good HCA hospitals and Florida, but for some reason,

598
00:35:02,000 --> 00:35:05,520
Speaker 4: the whole ethos there has not been the same in general.

599
00:35:06,160 --> 00:35:10,160
Speaker 2: So I'm kind of intrigued by a couple of things

600
00:35:10,200 --> 00:35:15,399
Speaker 2: you've said about wanting to improve outcomes, reduced costs, and

601
00:35:15,480 --> 00:35:21,400
Speaker 2: enhance experiences, and you talk about five levers of change

602
00:35:21,480 --> 00:35:24,480
Speaker 2: that the fun looks at, and let's go through all

603
00:35:24,520 --> 00:35:32,280
Speaker 2: of these access, outcome, cost, speed, and friction that sounds

604
00:35:32,320 --> 00:35:37,600
Speaker 2: like everybody's combined headache in healthcare. Tell us a little

605
00:35:37,640 --> 00:35:39,240
Speaker 2: bit about those five levers.

606
00:35:40,120 --> 00:35:42,320
Speaker 4: Well access. I think we all learned a lot about

607
00:35:42,320 --> 00:35:47,200
Speaker 4: that during covid R. There is differential access and it's

608
00:35:47,239 --> 00:35:50,719
Speaker 4: not just minority or city based. Obviously rural. The rural

609
00:35:50,840 --> 00:35:52,920
Speaker 4: environment is very challenging a.

610
00:35:52,920 --> 00:35:54,240
Speaker 2: Little bit of a healthcare desert.

611
00:35:54,239 --> 00:35:58,920
Speaker 4: In some healthcare desert, you've got pharmacies closing, you have

612
00:35:59,480 --> 00:36:02,040
Speaker 4: hospital that are a year and an hour and a

613
00:36:02,080 --> 00:36:05,960
Speaker 4: half away from people. You have challenged hospital systems. I

614
00:36:05,960 --> 00:36:11,160
Speaker 4: would say in suburbia and urban environments, hospitals are actually

615
00:36:11,160 --> 00:36:13,480
Speaker 4: doing quite well in making a fair amount of money,

616
00:36:13,800 --> 00:36:17,480
Speaker 4: but in rural far more challenged. So that is something

617
00:36:17,880 --> 00:36:20,000
Speaker 4: that we're actually addressing in whatever our company is called

618
00:36:20,040 --> 00:36:24,320
Speaker 4: main Street, which is focused on it's a oak Street

619
00:36:24,440 --> 00:36:28,920
Speaker 4: maybe Village MD for the rural environment, but with a

620
00:36:28,960 --> 00:36:32,480
Speaker 4: different business model, and the point is for them to

621
00:36:32,480 --> 00:36:36,600
Speaker 4: actually own everything in those environments except for cute care

622
00:36:36,760 --> 00:36:39,680
Speaker 4: hospital and try to keep people as much as possible

623
00:36:39,920 --> 00:36:43,400
Speaker 4: out of the hospital, but provide a broader set of

624
00:36:43,480 --> 00:36:46,319
Speaker 4: care opportunities to those in rural environments.

625
00:36:46,800 --> 00:36:50,200
Speaker 2: So I have a vivid recollection of a television show

626
00:36:50,280 --> 00:36:54,279
Speaker 2: called Northern Exposure. They wanted more doctors in Alaska, so

627
00:36:54,480 --> 00:36:57,040
Speaker 2: the state of Alaska would pay for your medical school,

628
00:36:57,280 --> 00:36:59,560
Speaker 2: but you had agreed to practice there for five years.

629
00:37:00,520 --> 00:37:03,680
Speaker 2: It seems amazing that in the United States in twenty

630
00:37:03,760 --> 00:37:08,920
Speaker 2: twenty four there are healthcare deserts. Why haven't states? And

631
00:37:09,000 --> 00:37:12,360
Speaker 2: I know this is not your expertise, but it seems

632
00:37:12,440 --> 00:37:14,960
Speaker 2: like states should have addressed this a long time ago.

633
00:37:15,200 --> 00:37:17,839
Speaker 2: How is it possible in a modern era you could

634
00:37:17,840 --> 00:37:21,160
Speaker 2: be two hours away from an emergency room. It's unthinkable,

635
00:37:21,520 --> 00:37:23,960
Speaker 2: at least in the Tri state area. It's hard to imagine.

636
00:37:24,040 --> 00:37:24,920
Speaker 1: Yeah, no, I agree.

637
00:37:25,040 --> 00:37:27,200
Speaker 4: I'm the fact that they should be in setting primary care,

638
00:37:27,320 --> 00:37:29,640
Speaker 4: paying for people's medical school that will go into primary

639
00:37:29,640 --> 00:37:31,840
Speaker 4: care and go to rural markets, and there are some

640
00:37:32,000 --> 00:37:34,800
Speaker 4: that are doing that. I think about virtualization though, because

641
00:37:34,800 --> 00:37:37,560
Speaker 4: of one of the aspects of a main street or

642
00:37:37,680 --> 00:37:40,880
Speaker 4: some other models we have care Bridge is that virtual

643
00:37:40,920 --> 00:37:43,760
Speaker 4: care and wrap round care so much of this actually

644
00:37:43,760 --> 00:37:47,000
Speaker 4: can be done virtually. You can have specialists in a

645
00:37:47,040 --> 00:37:51,320
Speaker 4: network that don't you know, your best oncologist from MSK

646
00:37:52,040 --> 00:37:55,360
Speaker 4: in New York City can be advising people in rural environments.

647
00:37:55,440 --> 00:37:57,600
Speaker 3: Right, memorials locattering, Ye, yes.

648
00:37:57,440 --> 00:37:58,960
Speaker 1: Memorials loancuttering exactly.

649
00:38:00,120 --> 00:38:03,600
Speaker 2: Difference between virtual and wrap around how do they differ?

650
00:38:04,040 --> 00:38:06,399
Speaker 4: Well? I think wrap around may mean that you have

651
00:38:06,480 --> 00:38:11,520
Speaker 4: a connectivity locally, plus you have virtual care that extends

652
00:38:11,640 --> 00:38:15,279
Speaker 4: what is available locally. But wrap round could be you

653
00:38:15,360 --> 00:38:19,520
Speaker 4: have in Carebridge's case, you're you're managing what we call

654
00:38:19,600 --> 00:38:23,600
Speaker 4: dual eligibles, which are those who have Medicaid and Medicare.

655
00:38:23,680 --> 00:38:26,359
Speaker 4: They're the sickkest of the sick that are in long

656
00:38:26,480 --> 00:38:28,920
Speaker 4: term services home based services, so they're in the home.

657
00:38:29,360 --> 00:38:31,960
Speaker 4: Generally they're sick enough to have a caregiver and who's

658
00:38:31,960 --> 00:38:36,480
Speaker 4: either a family member or a caregiver who's hired to.

659
00:38:36,160 --> 00:38:36,799
Speaker 1: Help them out.

660
00:38:37,280 --> 00:38:40,920
Speaker 4: And then you're supplying you know, nurses and mad and

661
00:38:41,160 --> 00:38:44,719
Speaker 4: others that will they get to know these patients, but

662
00:38:45,000 --> 00:38:48,400
Speaker 4: all virtually but end up you know, developing a relationship

663
00:38:48,440 --> 00:38:50,920
Speaker 4: with the caregivers that have a you know, we have

664
00:38:50,960 --> 00:38:54,719
Speaker 4: an iPad in the home with a button essentially, you know,

665
00:38:54,760 --> 00:38:57,319
Speaker 4: like the nine one one button where you hit the button,

666
00:38:57,360 --> 00:38:59,960
Speaker 4: as opposed to all of a sudden for every issue,

667
00:39:00,200 --> 00:39:04,000
Speaker 4: sending that patient to the emergency room, which is wildly expensive,

668
00:39:04,120 --> 00:39:07,120
Speaker 4: right and not constructive because often they get admitted and

669
00:39:07,480 --> 00:39:08,560
Speaker 4: you know, and then all of a sudden you have

670
00:39:08,560 --> 00:39:12,360
Speaker 4: a thirty thousand dollars expense. The reality is that button

671
00:39:12,440 --> 00:39:15,160
Speaker 4: is going to a nurse that's on you know, on

672
00:39:15,320 --> 00:39:18,720
Speaker 4: call or in a call center for a care bridge

673
00:39:19,120 --> 00:39:21,560
Speaker 4: and or a main street that's taking care of that

674
00:39:21,760 --> 00:39:26,760
Speaker 4: individual and actually knows knows the medical records, has gotten

675
00:39:26,840 --> 00:39:30,120
Speaker 4: developed a relationship with the caregiver and the patient so

676
00:39:30,160 --> 00:39:32,640
Speaker 4: they can walk through what are the issues to say

677
00:39:33,080 --> 00:39:36,640
Speaker 4: mental health crisis, which is you know often is or

678
00:39:37,800 --> 00:39:40,759
Speaker 4: get ahead of some of the challenges of wound that

679
00:39:40,920 --> 00:39:43,120
Speaker 4: gets taken care of as opposed to in the er,

680
00:39:43,640 --> 00:39:45,359
Speaker 4: you know, by somebody going to the home or getting

681
00:39:45,400 --> 00:39:48,000
Speaker 4: them to another facility. So these are the things that

682
00:39:48,280 --> 00:39:51,960
Speaker 4: it's just like long digital care management of individuals and

683
00:39:52,000 --> 00:39:54,000
Speaker 4: the chronically ill are those that end up in the

684
00:39:54,000 --> 00:39:55,040
Speaker 4: hospital most often.

685
00:39:55,320 --> 00:39:58,040
Speaker 2: And you mentioned Carebridge, that's a company you have an

686
00:39:58,080 --> 00:40:01,480
Speaker 2: investment in. It seems I'm so obvious. How do we

687
00:40:01,520 --> 00:40:06,600
Speaker 2: get better outcomes and less expensive costs by intervening before

688
00:40:06,640 --> 00:40:10,200
Speaker 2: they end up in an emergency room? Again, how has

689
00:40:10,239 --> 00:40:13,400
Speaker 2: this not taken place before? Is that is that what

690
00:40:13,480 --> 00:40:14,960
Speaker 2: care bridges business?

691
00:40:15,160 --> 00:40:19,120
Speaker 4: Yes, and yes they mainish the sickness of this chronically

692
00:40:19,120 --> 00:40:22,200
Speaker 4: ill in the home that are in that are dual eligibles,

693
00:40:22,640 --> 00:40:24,759
Speaker 4: and that is what they do. They develop a relationship,

694
00:40:24,760 --> 00:40:27,279
Speaker 4: they wrap around, but they it's all about part of

695
00:40:27,280 --> 00:40:29,839
Speaker 4: this is financial alignment. They have contracts with the health

696
00:40:29,840 --> 00:40:33,480
Speaker 4: plans to take care of these individuals. They get paid Basically,

697
00:40:33,640 --> 00:40:36,080
Speaker 4: they have full responsibility for the cost of care for

698
00:40:36,120 --> 00:40:38,720
Speaker 4: these individuals, so they're highly incentive to take.

699
00:40:38,600 --> 00:40:42,160
Speaker 3: Good care of them, preempt those emergency.

700
00:40:42,000 --> 00:40:45,640
Speaker 4: Those emergencies rooms. The two most expensive things are in

701
00:40:45,719 --> 00:40:49,760
Speaker 4: healthcare are rising hospital costs, which are up like twenty

702
00:40:49,760 --> 00:40:53,880
Speaker 4: percent this year, and drug costs, So if you can

703
00:40:54,280 --> 00:40:59,440
Speaker 4: manage drug compliance better, and most importantly the easiest but

704
00:40:59,480 --> 00:41:01,480
Speaker 4: not easy thing to do is to keep people out

705
00:41:01,480 --> 00:41:05,640
Speaker 4: of the hospital appropriately. Nobody wants to be at the hospital.

706
00:41:05,640 --> 00:41:07,879
Speaker 4: I mean, this is the thing I always hospitals always

707
00:41:07,880 --> 00:41:11,200
Speaker 4: talk about utilization management. You're keeping people out of the hospital. Well,

708
00:41:11,200 --> 00:41:14,120
Speaker 4: that's actually our job is do preventative care and keep

709
00:41:14,120 --> 00:41:16,760
Speaker 4: people from using the most expensive resource in America.

710
00:41:17,080 --> 00:41:20,919
Speaker 2: And it's always astonishing to when you read I think

711
00:41:21,080 --> 00:41:24,879
Speaker 2: medical errors are the third most common cause of fatalities

712
00:41:24,920 --> 00:41:29,040
Speaker 2: in the United States. That's a stunning number. And I

713
00:41:29,080 --> 00:41:31,640
Speaker 2: guess why none of us really want to be in

714
00:41:31,640 --> 00:41:32,600
Speaker 2: a hospital this weekend.

715
00:41:32,640 --> 00:41:35,920
Speaker 4: It's dangerous to be in a hospital. It is dangerous.

716
00:41:36,040 --> 00:41:41,120
Speaker 4: Think about the infection rate in a hospital staff, and yes,

717
00:41:41,200 --> 00:41:43,640
Speaker 4: it is actually dangerous to be in a hospital. So

718
00:41:43,680 --> 00:41:45,319
Speaker 4: there's better be a good reason to be there.

719
00:41:45,680 --> 00:41:50,400
Speaker 2: So we talk about access outcome. I'm kind of intrigued

720
00:41:50,440 --> 00:41:54,319
Speaker 2: by the focus on cost, speed, and friction because all

721
00:41:54,400 --> 00:41:57,680
Speaker 2: three of those seem to apply to both healthcare and

722
00:41:57,800 --> 00:42:02,400
Speaker 2: financial technology. You mentioned they both live on old legacy systems.

723
00:42:02,400 --> 00:42:05,520
Speaker 2: They're not nearly as cutting edge as they should be.

724
00:42:06,360 --> 00:42:08,880
Speaker 2: Is that how you ended up being both a healthcare

725
00:42:08,920 --> 00:42:10,200
Speaker 2: and a fintech investor?

726
00:42:11,000 --> 00:42:15,520
Speaker 4: Certainly between insurance and payments and rev cycle, we thought

727
00:42:15,520 --> 00:42:18,359
Speaker 4: it was in two thousand and two and obvious place

728
00:42:18,440 --> 00:42:21,319
Speaker 4: to go. And having gone into biotech early and then

729
00:42:21,360 --> 00:42:24,799
Speaker 4: tech enabled you know, software using leveraging the Internet in

730
00:42:24,840 --> 00:42:28,920
Speaker 4: healthcare early, I just felt like payments in fintech I

731
00:42:28,960 --> 00:42:30,799
Speaker 4: wanted to be early, like that was an area you

732
00:42:30,800 --> 00:42:33,680
Speaker 4: could just tell the tailwinds were there. And so we

733
00:42:33,800 --> 00:42:36,160
Speaker 4: came in two thousand and two before anybody knew what

734
00:42:36,200 --> 00:42:39,839
Speaker 4: fintech was, and we were focused initially on the sort

735
00:42:39,880 --> 00:42:42,640
Speaker 4: of prepaid underbanked market.

736
00:42:43,320 --> 00:42:45,680
Speaker 2: And prepaid an under bank.

737
00:42:46,200 --> 00:42:49,480
Speaker 4: Underbanked being sixty at that time, sixty million people in

738
00:42:49,560 --> 00:42:53,640
Speaker 4: America did not have checking accounts or credit or debocards, right,

739
00:42:53,680 --> 00:42:55,440
Speaker 4: and think about what you can't do, okay, and you

740
00:42:55,800 --> 00:42:59,160
Speaker 4: had the advident of the internet, you can buy things online.

741
00:42:59,520 --> 00:43:02,440
Speaker 4: You could and reserve a hotel room, you couldn't rent

742
00:43:02,480 --> 00:43:06,320
Speaker 4: a car, like all these things that change your life.

743
00:43:06,719 --> 00:43:09,239
Speaker 1: So by investing in netspend, which is one of the.

744
00:43:09,160 --> 00:43:13,959
Speaker 4: First prepaid debit cards, people could actually do those things.

745
00:43:13,960 --> 00:43:16,359
Speaker 4: They could buy online, they could reserve a hotel room,

746
00:43:16,400 --> 00:43:18,920
Speaker 4: they could rent a car. I mean, these are game

747
00:43:19,040 --> 00:43:20,680
Speaker 4: changing things to someone.

748
00:43:21,239 --> 00:43:22,080
Speaker 1: So that was.

749
00:43:22,320 --> 00:43:26,719
Speaker 4: Exciting because we were changing people's lives and giving them access,

750
00:43:27,000 --> 00:43:30,239
Speaker 4: you know, democratizing credit effectively.

751
00:43:30,719 --> 00:43:34,000
Speaker 2: So it's interesting you started in fintech in two thousand

752
00:43:34,040 --> 00:43:38,240
Speaker 2: and two, because I recall former fitcham and Paul Volker

753
00:43:38,960 --> 00:43:41,399
Speaker 2: said only half in Jess and I want to say

754
00:43:41,440 --> 00:43:46,400
Speaker 2: it was twenty eleven, twenty twelve. You know, what innovation

755
00:43:46,560 --> 00:43:50,000
Speaker 2: is there in the financial space? Other than the ATM,

756
00:43:50,280 --> 00:43:53,759
Speaker 2: nothing's happened, And it seems like that really isn't true.

757
00:43:53,800 --> 00:43:57,200
Speaker 2: There's been a ton of innovation in the financial space.

758
00:43:57,560 --> 00:44:00,960
Speaker 2: Tell us some of the other fintech investments made.

759
00:44:03,040 --> 00:44:05,680
Speaker 1: More recently. And fraud. Just think about fraud as being

760
00:44:05,719 --> 00:44:06,480
Speaker 1: an area.

761
00:44:06,160 --> 00:44:10,239
Speaker 2: Of constant, constant.

762
00:44:08,719 --> 00:44:09,799
Speaker 1: Battle arms race.

763
00:44:10,040 --> 00:44:12,319
Speaker 4: It is an arms race, and well even more so

764
00:44:12,480 --> 00:44:14,720
Speaker 4: when you think about what happened was in the payments

765
00:44:14,760 --> 00:44:18,680
Speaker 4: world you had card present right, you're swiping at the

766
00:44:18,719 --> 00:44:21,480
Speaker 4: point of sale. And then we had the Internet come

767
00:44:21,480 --> 00:44:26,480
Speaker 4: along and they had virtualization of payments. Then fraud exploded, right.

768
00:44:26,600 --> 00:44:27,680
Speaker 1: And now with.

769
00:44:29,120 --> 00:44:32,520
Speaker 4: You know jen ai and obviously deep fakes, you have

770
00:44:32,560 --> 00:44:35,640
Speaker 4: person at present, So you've got a whole different level

771
00:44:36,239 --> 00:44:40,399
Speaker 4: of fraud that is being experienced right now, right where

772
00:44:40,440 --> 00:44:43,600
Speaker 4: somebody's mimicking your voice for a call right.

773
00:44:45,160 --> 00:44:49,279
Speaker 2: Literally, just had this conversation yesterday with my head of compliance.

774
00:44:50,480 --> 00:44:52,560
Speaker 2: It was a I don't remember it was Gizmoto or

775
00:44:52,600 --> 00:44:56,720
Speaker 2: one of those sites that talks about the fake calls

776
00:44:56,760 --> 00:45:01,120
Speaker 2: you're getting supposedly from Google, who will never really call you.

777
00:45:01,360 --> 00:45:04,240
Speaker 2: Assume any foone call you're getting it is a fake.

778
00:45:04,680 --> 00:45:09,880
Speaker 2: But the AI agent on the other side sounds so realistic.

779
00:45:11,440 --> 00:45:14,120
Speaker 2: Always ask them to sing a song and that was

780
00:45:14,440 --> 00:45:16,840
Speaker 2: that was the solution, and AI app will sing it

781
00:45:17,239 --> 00:45:21,040
Speaker 2: until or whatever silly thing you ask. But it just

782
00:45:21,040 --> 00:45:25,880
Speaker 2: seems like the ability to impersonate people is just getting

783
00:45:25,920 --> 00:45:29,239
Speaker 2: better and better. Who's going to win this arms race?

784
00:45:29,320 --> 00:45:31,840
Speaker 4: Yeah, Well, I think it's just going to be a

785
00:45:31,880 --> 00:45:37,160
Speaker 4: continual battle of they'll create new ways to implement fraud

786
00:45:37,239 --> 00:45:40,040
Speaker 4: and then we'll create solutions against that fraud, and so

787
00:45:40,120 --> 00:45:43,920
Speaker 4: it is I think will be a perpetual and continual battle.

788
00:45:44,600 --> 00:45:47,799
Speaker 4: We have companies like feeds I and Prove that are

789
00:45:48,480 --> 00:45:49,920
Speaker 4: focused on that area, and it.

790
00:45:50,040 --> 00:45:55,440
Speaker 2: Be feeds I focuses on risk management and combating fraud.

791
00:45:55,560 --> 00:46:00,520
Speaker 4: Combating fraud for Yes and Prove is that when you

792
00:46:00,560 --> 00:46:03,480
Speaker 4: get the pin and you're you're putting, you're doing sort

793
00:46:03,480 --> 00:46:06,840
Speaker 4: of double authentication. They're the ones that are integrated in

794
00:46:06,840 --> 00:46:09,920
Speaker 4: the operating system of phones and effectively are giving you

795
00:46:09,960 --> 00:46:13,480
Speaker 4: that number that pen when you're typing in that second

796
00:46:13,560 --> 00:46:18,400
Speaker 4: number to authorize a transaction. So so we have a

797
00:46:18,480 --> 00:46:21,200
Speaker 4: number of companies, probably seven or eight in that space.

798
00:46:22,480 --> 00:46:27,040
Speaker 4: Other companies that do If you think about the America

799
00:46:27,440 --> 00:46:31,520
Speaker 4: and where we are here in terms of credit payments,

800
00:46:31,880 --> 00:46:36,719
Speaker 4: think about La Latam is two decades behind us, and

801
00:46:36,800 --> 00:46:40,160
Speaker 4: so we're seeing a number of opportunities in fintech.

802
00:46:39,960 --> 00:46:41,440
Speaker 2: And two decades behind.

803
00:46:41,520 --> 00:46:44,120
Speaker 4: Yeah, two decades behind, which actually will probably be an

804
00:46:44,160 --> 00:46:47,359
Speaker 4: advantage and they will leap frog us because they don't have.

805
00:46:47,320 --> 00:46:48,920
Speaker 2: These they'll start from scratch.

806
00:46:49,080 --> 00:46:51,160
Speaker 4: Those start from crutch and scratch. And if you look

807
00:46:51,200 --> 00:46:55,600
Speaker 4: at Brazil, they've created something called Picks, which they built

808
00:46:55,640 --> 00:46:59,479
Speaker 4: for two million dollars, which is amazing by their central bank,

809
00:46:59,800 --> 00:47:02,920
Speaker 4: and it's real time payments, and effectively it's a protocol

810
00:47:03,040 --> 00:47:06,319
Speaker 4: and effectively allows bank to bank authentication. So if you

811
00:47:06,320 --> 00:47:10,040
Speaker 4: think about ACCH and your cash account to somebody else's gay,

812
00:47:10,239 --> 00:47:13,719
Speaker 4: it is incredibly complicated in the US to do an

813
00:47:13,800 --> 00:47:16,840
Speaker 4: ACCH transfer your bank account to another bank account.

814
00:47:16,920 --> 00:47:19,320
Speaker 1: Right, there's this takes forever.

815
00:47:20,800 --> 00:47:23,680
Speaker 2: I wanted to address that. I grabbed my phone and

816
00:47:23,719 --> 00:47:27,120
Speaker 2: I'm opening the folder with the fin tech apps on it.

817
00:47:27,560 --> 00:47:30,480
Speaker 2: So Venmo is the easiest thing in the world to

818
00:47:30,600 --> 00:47:34,880
Speaker 2: use just to send money to someone else. But I

819
00:47:34,960 --> 00:47:38,880
Speaker 2: did something in South American Colombia. I had an old

820
00:47:39,000 --> 00:47:44,279
Speaker 2: truck rebuilt in Colombia and I was using remitly and

821
00:47:44,400 --> 00:47:47,359
Speaker 2: World remit to send as long as it was less

822
00:47:47,360 --> 00:47:50,799
Speaker 2: than ten thousand dollars at a time. Internationally, it was

823
00:47:50,880 --> 00:47:55,239
Speaker 2: like click click, click done. That was an unthinkable nightmare.

824
00:47:56,480 --> 00:47:59,480
Speaker 2: I don't know five years ago, ten years ago, I'm

825
00:47:59,520 --> 00:48:02,080
Speaker 2: looking at at the t D and the Schwab app,

826
00:48:02,120 --> 00:48:06,320
Speaker 2: I'm looking at the chase. I mean, just the amount

827
00:48:06,360 --> 00:48:09,799
Speaker 2: of things you could do on your phone. So it

828
00:48:09,880 --> 00:48:11,120
Speaker 2: feels like the innovation.

829
00:48:11,360 --> 00:48:14,879
Speaker 4: Certainly, the innovation from the consumer experience is there. It's

830
00:48:15,320 --> 00:48:17,800
Speaker 4: ironic though, because if you think about Venmo, everything runs

831
00:48:17,840 --> 00:48:21,000
Speaker 4: on on the credit card rails right now, right, I

832
00:48:21,040 --> 00:48:23,000
Speaker 4: mean that's actually what's happening on the visa rails, the

833
00:48:23,040 --> 00:48:26,080
Speaker 4: master card rails or MX and the reality is that

834
00:48:26,120 --> 00:48:29,640
Speaker 4: because it scur it exists.

835
00:48:29,280 --> 00:48:30,000
Speaker 1: Right, and it's easy.

836
00:48:30,360 --> 00:48:32,560
Speaker 4: So I mean think about Apple, right, they run on

837
00:48:32,800 --> 00:48:34,880
Speaker 4: you're putting your credit card in for Apple.

838
00:48:34,640 --> 00:48:38,960
Speaker 2: Pay, right, I just drop the phone on it and

839
00:48:39,000 --> 00:48:41,880
Speaker 2: that's right, that goes right through the credit So that's.

840
00:48:41,719 --> 00:48:45,600
Speaker 4: If you think about Latim, that's an expensive option. And

841
00:48:45,680 --> 00:48:48,680
Speaker 4: so what they've done in Latam has created a pretty

842
00:48:48,719 --> 00:48:54,400
Speaker 4: friction free visa like rails, but the very cheap like

843
00:48:54,520 --> 00:48:58,759
Speaker 4: sense pennies like virtually no cost. So that is then

844
00:48:58,800 --> 00:49:02,839
Speaker 4: that is probably taken like forty percent of credit card

845
00:49:03,000 --> 00:49:04,560
Speaker 4: and debit card transactions.

846
00:49:04,680 --> 00:49:08,719
Speaker 2: Really and wasn't there a couple of things done over

847
00:49:08,800 --> 00:49:12,080
Speaker 2: cell phones in parts of Africa where they didn't have

848
00:49:12,120 --> 00:49:16,080
Speaker 2: a credit card system and just you know, necessity being

849
00:49:16,080 --> 00:49:19,600
Speaker 2: the mother invention came up with some things. So my

850
00:49:19,800 --> 00:49:24,840
Speaker 2: question is are all of these various things secure or

851
00:49:25,239 --> 00:49:28,719
Speaker 2: you know, what is the challenge building the next generation

852
00:49:28,800 --> 00:49:31,520
Speaker 2: what's going to replace I think will anything replace credit cards?

853
00:49:33,080 --> 00:49:35,839
Speaker 4: Well, I think real time payments will replace credit cards.

854
00:49:35,880 --> 00:49:37,759
Speaker 4: But you are going to build costs on top of it,

855
00:49:37,800 --> 00:49:41,319
Speaker 4: because if you're talking about large B to B payments, right,

856
00:49:41,640 --> 00:49:43,520
Speaker 4: you're still going to be talking about something that needs

857
00:49:43,560 --> 00:49:46,399
Speaker 4: and even larger B two C payments. There is more

858
00:49:46,480 --> 00:49:50,480
Speaker 4: fraud capability that needs an identity authentication capabilities that need

859
00:49:50,520 --> 00:49:52,360
Speaker 4: to be built on top of it. There will be

860
00:49:52,400 --> 00:49:55,640
Speaker 4: great opportunities for companies for us to invest in that

861
00:49:55,719 --> 00:49:58,800
Speaker 4: will create B to B opportunities on top of picks

862
00:49:58,840 --> 00:50:02,040
Speaker 4: and on top of other infrastructures that are being built

863
00:50:02,520 --> 00:50:06,440
Speaker 4: in Latam or India or Africa.

864
00:50:06,920 --> 00:50:11,200
Speaker 2: H really kind of fascinating. So, given these two areas

865
00:50:11,239 --> 00:50:15,320
Speaker 2: that you focus on and the track record you guys

866
00:50:15,360 --> 00:50:18,840
Speaker 2: have put up, I just wanted to mention again you

867
00:50:18,920 --> 00:50:22,000
Speaker 2: were named one of the top ten venture farms of

868
00:50:22,320 --> 00:50:28,200
Speaker 2: twenty twenty four and a number of other accolades last year.

869
00:50:28,880 --> 00:50:31,640
Speaker 2: How does this affect the deal flow you see in

870
00:50:31,680 --> 00:50:34,439
Speaker 2: the companies you look at. Do you have your own

871
00:50:34,480 --> 00:50:37,680
Speaker 2: space and that's what you drill into or are you

872
00:50:37,719 --> 00:50:41,080
Speaker 2: guys a little broader thinking about a variety of different

873
00:50:41,120 --> 00:50:42,000
Speaker 2: types of companies.

874
00:50:44,320 --> 00:50:48,080
Speaker 4: For example, we define fintech very broadly. If that is

875
00:50:48,480 --> 00:50:53,120
Speaker 4: e commerce infrastructure, you know, it's fraud and identity, it

876
00:50:53,200 --> 00:50:59,440
Speaker 4: is payments, it is general infrastructure. So it's fairly broad

877
00:50:59,600 --> 00:51:01,799
Speaker 4: and to how we look at it. I think the

878
00:51:03,120 --> 00:51:07,440
Speaker 4: as we think about opportunity in the sector, think of

879
00:51:07,520 --> 00:51:12,359
Speaker 4: us as starting things or backing an entrepreneur who has

880
00:51:12,440 --> 00:51:15,440
Speaker 4: started something, because we have a whole thematic approach to

881
00:51:15,960 --> 00:51:17,960
Speaker 4: an area, and I'll talk about something we just did

882
00:51:18,320 --> 00:51:21,839
Speaker 4: all the way up to a classic ABC round, right,

883
00:51:21,960 --> 00:51:26,160
Speaker 4: And we'll even do an occasional buyout or two where

884
00:51:26,160 --> 00:51:29,880
Speaker 4: we think there's huge growth opportunities if we invest in

885
00:51:29,880 --> 00:51:33,680
Speaker 4: the tech portion of it. So something we did recently

886
00:51:33,880 --> 00:51:38,000
Speaker 4: I think is emblematic of what we're doing more lately

887
00:51:38,040 --> 00:51:40,280
Speaker 4: with a two billion. Our most recent fund was two billion,

888
00:51:40,920 --> 00:51:45,600
Speaker 4: and we backed the individual Dave Clark out of Amazon,

889
00:51:46,120 --> 00:51:49,239
Speaker 4: who built the for twenty two years, built all the

890
00:51:49,280 --> 00:51:53,279
Speaker 4: supply and logistics chained at Amazon, and he brought his

891
00:51:53,360 --> 00:51:56,320
Speaker 4: chief scientific officer and a number of people from Amazon

892
00:51:56,320 --> 00:52:00,480
Speaker 4: and others that he's worked with. And when we announced

893
00:52:00,480 --> 00:52:05,240
Speaker 4: this company, twelve hundred people that day submitted resumes. Wow

894
00:52:05,280 --> 00:52:08,200
Speaker 4: to them it was it was extraordinary and speaks to

895
00:52:08,239 --> 00:52:10,360
Speaker 4: his reputation. And the idea is that we will build

896
00:52:11,080 --> 00:52:17,200
Speaker 4: a Jenai software native AI software platform that will incorporate

897
00:52:17,640 --> 00:52:21,280
Speaker 4: some of the supply chain software boutique best to breed

898
00:52:21,960 --> 00:52:25,279
Speaker 4: software systems that are out there that constitute the supply chain,

899
00:52:25,320 --> 00:52:28,480
Speaker 4: because if you are in Amazon or someone else, you're

900
00:52:29,120 --> 00:52:33,680
Speaker 4: working with twenty different vendors to complete your supply chain,

901
00:52:33,680 --> 00:52:36,480
Speaker 4: and the reality is you really want that integrated in

902
00:52:36,560 --> 00:52:39,800
Speaker 4: one infrastructure. And so their plan is to basically build

903
00:52:39,840 --> 00:52:42,120
Speaker 4: the supply chain infrastructure.

904
00:52:41,600 --> 00:52:44,920
Speaker 2: And to end one company for software from when it

905
00:52:45,040 --> 00:52:47,080
Speaker 2: leaves this place to what ends up that place and

906
00:52:47,480 --> 00:52:51,600
Speaker 2: all the quantitative metrics and tracking and everything that with it.

907
00:52:51,960 --> 00:52:54,719
Speaker 1: Huh really really, So we committed one hundred million to that.

908
00:52:54,880 --> 00:52:58,120
Speaker 2: Oh no kidding. Oh so that's you're pretty that sounds

909
00:52:58,120 --> 00:52:59,160
Speaker 2: like a pretty big bet.

910
00:52:59,360 --> 00:53:00,200
Speaker 1: Yeah, we're all in.

911
00:53:00,400 --> 00:53:03,160
Speaker 4: But yes, we're doing more of the one hundred million

912
00:53:03,160 --> 00:53:07,080
Speaker 4: plus investments seventy million dollar investments because we want concentrated

913
00:53:07,160 --> 00:53:10,520
Speaker 4: bets in the areas that are most exciting to us

914
00:53:10,520 --> 00:53:11,960
Speaker 4: with the best entrepreneurs.

915
00:53:12,120 --> 00:53:15,400
Speaker 2: So I only have you for another ten or fifteen minutes,

916
00:53:15,640 --> 00:53:17,799
Speaker 2: and before I get to my favorite questions I ask

917
00:53:17,880 --> 00:53:21,960
Speaker 2: all of my guests. I gotta throw a curveball at you, Okay,

918
00:53:22,239 --> 00:53:25,960
Speaker 2: which is you know, normally at this point in a

919
00:53:26,000 --> 00:53:30,680
Speaker 2: conversation with a VC, we talk about you've had seventy

920
00:53:30,760 --> 00:53:36,040
Speaker 2: exits and fifteen IPOs, and but you're also the first

921
00:53:36,160 --> 00:53:39,640
Speaker 2: Lady of Connecticut. You're married to Ned Lamont, the governor

922
00:53:40,160 --> 00:53:44,400
Speaker 2: of Connecticut. Kind of an unusual role for first ladies

923
00:53:44,560 --> 00:53:48,920
Speaker 2: being a VC. Tell us how you juggle these two roles.

924
00:53:48,680 --> 00:53:52,560
Speaker 2: It's it's You're the first VC I've spoken to who's

925
00:53:52,640 --> 00:53:54,520
Speaker 2: also in a state house.

926
00:53:54,640 --> 00:53:56,160
Speaker 1: Right, it is unusual.

927
00:53:56,920 --> 00:54:00,799
Speaker 4: The great news is that there is no expectation for

928
00:54:00,880 --> 00:54:04,879
Speaker 4: the first Lady of Connecticut either. There is no established role,

929
00:54:05,880 --> 00:54:09,200
Speaker 4: and so I'm really just a partner to my husband

930
00:54:09,719 --> 00:54:14,600
Speaker 4: as I would be in terms of just their support

931
00:54:14,680 --> 00:54:17,880
Speaker 4: and guidance. But I do campaign with him. I go

932
00:54:17,920 --> 00:54:20,480
Speaker 4: on week you know, on weekends, we do things together.

933
00:54:21,239 --> 00:54:23,920
Speaker 4: But he's very much running the state of Connecticut. Well,

934
00:54:24,000 --> 00:54:26,080
Speaker 4: I am doing my thing, you know, during the week,

935
00:54:26,560 --> 00:54:29,439
Speaker 4: and then we come together in Connecticut and Greenwich during

936
00:54:29,480 --> 00:54:29,880
Speaker 4: the weekend.

937
00:54:30,560 --> 00:54:33,040
Speaker 1: But it's been I mean, it's fascinating. He loves the job.

938
00:54:33,640 --> 00:54:36,799
Speaker 4: It's I you know, I'm biased, but I think he's

939
00:54:36,800 --> 00:54:40,560
Speaker 4: done a great job for Connecticut as a businessman himself,

940
00:54:40,600 --> 00:54:44,000
Speaker 4: but somebody who has a you know, his social conscience.

941
00:54:44,719 --> 00:54:46,839
Speaker 4: So it's been fun to watch because he does love

942
00:54:46,880 --> 00:54:47,319
Speaker 4: the job and.

943
00:54:48,320 --> 00:54:52,240
Speaker 2: Really really interesting. All right, let's jump to our favorite

944
00:54:52,280 --> 00:54:55,920
Speaker 2: questions that we ask all our guests, starting with since

945
00:54:56,000 --> 00:54:59,000
Speaker 2: since you mentioned you like to uh spend the weekends

946
00:54:59,000 --> 00:55:01,880
Speaker 2: with your your husband the governor, what do you guys

947
00:55:01,920 --> 00:55:04,799
Speaker 2: do on the weekends? What are you watching listening? What's

948
00:55:04,880 --> 00:55:05,880
Speaker 2: keeping you entertained?

949
00:55:06,040 --> 00:55:06,200
Speaker 1: Right?

950
00:55:07,520 --> 00:55:10,359
Speaker 4: Yukon basketball? I can't wait to have it back. So

951
00:55:10,760 --> 00:55:13,000
Speaker 4: women and men are going to be amazing this year.

952
00:55:13,200 --> 00:55:15,799
Speaker 4: So and they I have been obviously, the men have

953
00:55:15,840 --> 00:55:17,640
Speaker 4: won two years in a row.

954
00:55:17,760 --> 00:55:21,000
Speaker 2: Huskies have a great team. They've been they've been winning for.

955
00:55:20,920 --> 00:55:22,040
Speaker 1: A long time, amazing.

956
00:55:22,080 --> 00:55:24,720
Speaker 2: And the women's team has done really well. Also the past.

957
00:55:24,640 --> 00:55:25,600
Speaker 1: Gina is incredible.

958
00:55:25,640 --> 00:55:28,320
Speaker 4: I mean, the fact that they had five injured players

959
00:55:28,360 --> 00:55:31,719
Speaker 4: and got into the basically the final four was incredible.

960
00:55:32,120 --> 00:55:36,120
Speaker 4: So between Gino Oriama and Dan Hurley to the best

961
00:55:36,160 --> 00:55:38,880
Speaker 4: coaches in the country. So that's been super fun. We

962
00:55:38,960 --> 00:55:41,279
Speaker 4: go to games and we and we watch on weekends,

963
00:55:41,440 --> 00:55:43,799
Speaker 4: but we're we're I don't know, I don't know if

964
00:55:43,800 --> 00:55:46,360
Speaker 4: I'm an athlete, but I love sports, and we love sports.

965
00:55:46,440 --> 00:55:49,920
Speaker 4: We play golf and tennis and hike and it's being

966
00:55:49,920 --> 00:55:52,640
Speaker 4: out ski and being outside as much as possible.

967
00:55:53,280 --> 00:55:53,560
Speaker 1: Uh.

968
00:55:53,600 --> 00:55:56,439
Speaker 4: And he watches and you know, he's been a long

969
00:55:56,480 --> 00:55:59,200
Speaker 4: suffering Jets fan. We're hoping the Jets are back, and

970
00:55:59,239 --> 00:56:01,920
Speaker 4: I having to be a Pack fan being from Wisconsin.

971
00:56:01,440 --> 00:56:06,239
Speaker 2: So really interesting. Tell us about your early mentors who

972
00:56:06,280 --> 00:56:07,520
Speaker 2: helped shape your career.

973
00:56:08,120 --> 00:56:11,400
Speaker 4: Yeah, there was an individual, Jerry Gallagher. I'm from Wisconsin.

974
00:56:11,560 --> 00:56:17,520
Speaker 4: He was from Minnesota and he ran for a prior firm.

975
00:56:17,640 --> 00:56:22,760
Speaker 4: He ran the retail investing and was a brilliant investor.

976
00:56:22,760 --> 00:56:25,279
Speaker 4: I mean it was somebody at Donaldson, Luff and Jen

977
00:56:25,360 --> 00:56:27,840
Speaker 4: Ratt in the early days. He was the retail analyst

978
00:56:27,920 --> 00:56:32,400
Speaker 4: and he actually invented the same store sales metric.

979
00:56:32,760 --> 00:56:33,440
Speaker 2: Oh no kidding.

980
00:56:33,440 --> 00:56:35,719
Speaker 4: If you can imagine, people were just saying, oh, that

981
00:56:35,760 --> 00:56:37,560
Speaker 4: company's growing one hundred percent a year. They didn't know

982
00:56:37,560 --> 00:56:39,760
Speaker 4: if they'd added one hundred store you know, double number

983
00:56:39,760 --> 00:56:43,359
Speaker 4: of stores. But yeah, so he actually invented that. He

984
00:56:43,480 --> 00:56:46,480
Speaker 4: joined us and invested in well, there was a filing's

985
00:56:46,520 --> 00:56:52,920
Speaker 4: basement Whole Foods Amazon Whole Foods, which we sold Amazon

986
00:56:54,600 --> 00:57:01,480
Speaker 4: Dick's Sporting Goods office depot. It was just a pfang Jambajews,

987
00:57:01,520 --> 00:57:04,920
Speaker 4: I mean, just an unbelievable track record, the best retail

988
00:57:05,000 --> 00:57:08,479
Speaker 4: investor in the country. And he taught me a ton.

989
00:57:08,920 --> 00:57:11,840
Speaker 4: So he was the first person, when I was twenty

990
00:57:11,920 --> 00:57:14,360
Speaker 4: seven years of age who said to me, you're focused

991
00:57:14,360 --> 00:57:16,480
Speaker 4: on the idea. You're not focused on the CEO enough,

992
00:57:16,520 --> 00:57:19,000
Speaker 4: You're not focused on the people like you have got

993
00:57:19,040 --> 00:57:23,040
Speaker 4: to raise your bar on CEOs. And of course it's

994
00:57:23,200 --> 00:57:25,120
Speaker 4: of course it's I mean, it's so obvious it's all

995
00:57:25,120 --> 00:57:27,640
Speaker 4: about the people. But I think people you do get

996
00:57:27,760 --> 00:57:32,919
Speaker 4: enamored with trends, secular trends and ideas, and ultimately it's

997
00:57:33,000 --> 00:57:35,160
Speaker 4: it was the most important advice anybody ever gave me,

998
00:57:35,200 --> 00:57:37,160
Speaker 4: because it's it's all about the CEO at the end

999
00:57:37,200 --> 00:57:39,640
Speaker 4: of the day, and the team they can attract and

1000
00:57:39,640 --> 00:57:41,840
Speaker 4: how they treat people. It's and I think it was

1001
00:57:42,000 --> 00:57:45,360
Speaker 4: very much golden rule, you know, he was. Some might

1002
00:57:45,400 --> 00:57:48,520
Speaker 4: have considered Jerry old fashioned, but the reality is that

1003
00:57:48,520 --> 00:57:51,280
Speaker 4: that old fashioned message just cycles back and every crazy

1004
00:57:51,320 --> 00:57:54,120
Speaker 4: cycle yeah have with entrepreneurs, and that is you know,

1005
00:57:54,440 --> 00:57:58,000
Speaker 4: just obviously do the right thing, you know, and treat

1006
00:57:58,000 --> 00:58:01,240
Speaker 4: people like you'd like to be treated, and be kind

1007
00:58:01,320 --> 00:58:03,680
Speaker 4: and yet you know, be be direct of you tough.

1008
00:58:04,280 --> 00:58:07,480
Speaker 2: I don't remember which VC it was that said the

1009
00:58:07,520 --> 00:58:11,640
Speaker 2: same thing that you just said about backing the team

1010
00:58:11,760 --> 00:58:15,960
Speaker 2: and the entrepreneur, not the idea, but to drive the

1011
00:58:16,080 --> 00:58:19,400
Speaker 2: point home. Hey, each of these companies that have had

1012
00:58:19,440 --> 00:58:23,800
Speaker 2: a successful exit, they've pivoted five times and however it

1013
00:58:23,920 --> 00:58:27,480
Speaker 2: works out. It's never the initial idea, it's always the person.

1014
00:58:28,280 --> 00:58:32,520
Speaker 2: And I never really thought about that until right. It's

1015
00:58:32,840 --> 00:58:36,680
Speaker 2: if you're betting on the idea, your you're three iterations

1016
00:58:36,720 --> 00:58:38,080
Speaker 2: away from where it's going to end up.

1017
00:58:38,800 --> 00:58:41,919
Speaker 4: Yeah, and the general idea and secular trend maybe right,

1018
00:58:42,000 --> 00:58:44,400
Speaker 4: but actually the business model is wrong. So getting the

1019
00:58:44,400 --> 00:58:48,880
Speaker 4: business model is so right is so critical.

1020
00:58:49,760 --> 00:58:52,840
Speaker 2: Really really interesting. Let's talk about books. What are some

1021
00:58:52,920 --> 00:58:53,680
Speaker 2: of your favorites?

1022
00:58:53,720 --> 00:58:55,080
Speaker 3: What are you reading right now?

1023
00:58:56,840 --> 00:59:00,280
Speaker 4: Well, original favorite was To Kill a Mockingbird, and but

1024
00:59:00,360 --> 00:59:05,120
Speaker 4: that like influenced my sense of social justice. And then

1025
00:59:05,160 --> 00:59:07,680
Speaker 4: it's probably the Robert Massey books. And you know, I've

1026
00:59:07,680 --> 00:59:10,680
Speaker 4: never been to Russia, but I've been fascinated by you know,

1027
00:59:10,680 --> 00:59:13,680
Speaker 4: Peter the Great Nicholas and Alexandra Catherine the Great. I

1028
00:59:13,680 --> 00:59:17,080
Speaker 4: mean one, it's so if you look at what's going

1029
00:59:17,080 --> 00:59:20,720
Speaker 4: on in Russia now, same exactly like you understand cultures, right,

1030
00:59:20,760 --> 00:59:22,640
Speaker 4: I mean, it's sort of like understanding history and culture.

1031
00:59:22,720 --> 00:59:25,040
Speaker 4: Don't It doesn't change that much, right, I mean, it's

1032
00:59:25,080 --> 00:59:27,880
Speaker 4: a It is a that is a country that understands

1033
00:59:27,880 --> 00:59:31,560
Speaker 4: suffering and likes autocrats basically, you know.

1034
00:59:31,880 --> 00:59:34,520
Speaker 3: They like Not a coincidence, right.

1035
00:59:34,400 --> 00:59:36,800
Speaker 1: Yeah, yeah, not a coincidence. So yeah.

1036
00:59:36,840 --> 00:59:41,040
Speaker 4: And then recently The Money Trap, written by a friend

1037
00:59:41,040 --> 00:59:44,040
Speaker 4: of mine of Lokes Soma, is a fascinating book. He

1038
00:59:45,320 --> 00:59:47,920
Speaker 4: was the head of soft Bank during the crazy period

1039
00:59:48,200 --> 00:59:51,600
Speaker 4: in North America. Yeah, and he actually had never written

1040
00:59:51,600 --> 00:59:54,160
Speaker 4: a book. He went to the Creative writing program Okay,

1041
00:59:54,320 --> 00:59:57,000
Speaker 4: got his visa, was able to stay in America, went

1042
00:59:57,040 --> 01:00:00,040
Speaker 4: to the Creative writing program in New York City and

1043
01:00:00,040 --> 01:00:02,600
Speaker 4: and wrote this book. And it's absolutely beautifully written and

1044
01:00:02,640 --> 01:00:05,600
Speaker 4: it's fascinating. So I highly recommend it Money Trap.

1045
01:00:05,680 --> 01:00:08,520
Speaker 2: I'm gonna I'm gonna put that on my list. If

1046
01:00:08,560 --> 01:00:12,560
Speaker 2: you're you mentioned books about Russian I know you're talking

1047
01:00:12,600 --> 01:00:16,720
Speaker 2: more historically. If you haven't read read Notice.

1048
01:00:16,360 --> 01:00:18,960
Speaker 3: By I know Bill and yes, so you did.

1049
01:00:19,160 --> 01:00:23,960
Speaker 2: Yeah, astonished. It's it reads like it's fiction and it's

1050
01:00:24,000 --> 01:00:27,920
Speaker 2: such a page turner. All right, Our final two questions,

1051
01:00:28,400 --> 01:00:30,960
Speaker 2: What sort of advice would you give a recent college

1052
01:00:31,000 --> 01:00:36,840
Speaker 2: grad interest in a career in either venture investing, healthcare, fintech?

1053
01:00:37,320 --> 01:00:41,040
Speaker 2: What would you would you how would you advise them?

1054
01:00:41,160 --> 01:00:44,560
Speaker 4: They have to go work inside companies, and they should

1055
01:00:44,560 --> 01:00:48,120
Speaker 4: go work in a startup, in an early stage company,

1056
01:00:48,600 --> 01:00:53,120
Speaker 4: and maybe mid stage, and definitely a larger legacy company,

1057
01:00:53,440 --> 01:00:56,400
Speaker 4: because they need to understand business. I mean when I

1058
01:00:56,480 --> 01:00:59,800
Speaker 4: read the New York Times Business section, now, I think

1059
01:00:59,840 --> 01:01:04,280
Speaker 4: these people have never been in business. And obviously Bloomberg

1060
01:01:04,400 --> 01:01:06,080
Speaker 4: specializes in it, and so it has a lot of

1061
01:01:06,080 --> 01:01:08,920
Speaker 4: reporters that deeply understand it and respect it. But I

1062
01:01:08,960 --> 01:01:11,959
Speaker 4: think that you can't write about something you don't haven't

1063
01:01:12,000 --> 01:01:16,120
Speaker 4: actually lived at all and truly understand what is. They're

1064
01:01:16,120 --> 01:01:19,520
Speaker 4: obviously things that are very flawed in business, and it's often,

1065
01:01:19,600 --> 01:01:23,440
Speaker 4: particularly in the early stage, extremely chaotic, but it is

1066
01:01:24,000 --> 01:01:28,320
Speaker 4: what drives our economy, which provides jobs for people and

1067
01:01:28,400 --> 01:01:32,360
Speaker 4: employees people and allows them to pay their bills and

1068
01:01:32,400 --> 01:01:34,160
Speaker 4: support all our great social programs.

1069
01:01:34,160 --> 01:01:36,480
Speaker 1: So it's important to understand and.

1070
01:01:36,480 --> 01:01:39,040
Speaker 2: Our final question, what do you know about the world

1071
01:01:39,080 --> 01:01:42,320
Speaker 2: of investing today you wish you knew back in the

1072
01:01:42,400 --> 01:01:44,520
Speaker 2: nineteen eighties when you were first getting started.

1073
01:01:44,840 --> 01:01:48,000
Speaker 4: It's an interesting question because I, you know, and maybe

1074
01:01:48,120 --> 01:01:50,200
Speaker 4: because I have a tough, long memory, but I feel

1075
01:01:50,200 --> 01:01:54,720
Speaker 4: like I only remember the good things. I think, you know,

1076
01:01:54,720 --> 01:01:58,280
Speaker 4: knowing that large secular changes are the most important thing

1077
01:01:58,320 --> 01:02:02,800
Speaker 4: that drive investment waves and right and and ultimately build

1078
01:02:02,840 --> 01:02:06,800
Speaker 4: great companies, just focusing on those. But I feel like

1079
01:02:06,880 --> 01:02:12,040
Speaker 4: I ended up actually doing that well, you know, picking

1080
01:02:12,200 --> 01:02:14,720
Speaker 4: the secular wave that made sense and getting ahead of it,

1081
01:02:15,040 --> 01:02:16,120
Speaker 4: but not too far ahead of it.

1082
01:02:16,200 --> 01:02:17,840
Speaker 2: I was going to say you did that well, but

1083
01:02:18,000 --> 01:02:20,280
Speaker 2: you were You were also early in a lot of

1084
01:02:20,360 --> 01:02:21,480
Speaker 2: big secular trends.

1085
01:02:21,600 --> 01:02:25,439
Speaker 4: Yes, So I would say that ended up working out well.

1086
01:02:25,520 --> 01:02:28,200
Speaker 4: You can't be Being too early is a killer, right

1087
01:02:28,280 --> 01:02:31,440
Speaker 4: right in investing, So that worked out well. But I

1088
01:02:31,760 --> 01:02:36,160
Speaker 4: would say, you know, in general, I don't sweat the

1089
01:02:36,200 --> 01:02:39,400
Speaker 4: small stuff. You know, get the large things right and

1090
01:02:39,440 --> 01:02:41,480
Speaker 4: the rest of it will take care of itself. So

1091
01:02:42,280 --> 01:02:45,720
Speaker 4: I would only caution those that are starting out now

1092
01:02:45,720 --> 01:02:48,080
Speaker 4: in the investing world, or frankly in any career, to

1093
01:02:48,280 --> 01:02:51,800
Speaker 4: just all those things that seems so important that are

1094
01:02:51,800 --> 01:02:55,480
Speaker 4: so small during the day, Like just remember that, you know,

1095
01:02:55,560 --> 01:02:58,440
Speaker 4: think about yourself forty years from now, what's going to matter,

1096
01:02:58,600 --> 01:03:00,520
Speaker 4: what will have mattered to you, what will matter to

1097
01:03:00,560 --> 01:03:04,280
Speaker 4: your success, and just focus on those things and don't

1098
01:03:04,320 --> 01:03:08,240
Speaker 4: focus on all of the petty small things that it

1099
01:03:08,400 --> 01:03:12,560
Speaker 4: may go on wrong or the people around you, you know.

1100
01:03:12,600 --> 01:03:15,400
Speaker 4: And then otherwise, just stay away from toxic people and

1101
01:03:15,440 --> 01:03:19,360
Speaker 4: make sure you carefully work with people you love and respect.

1102
01:03:20,080 --> 01:03:21,840
Speaker 4: And I think in general I've done that, but I

1103
01:03:21,880 --> 01:03:23,720
Speaker 4: think there are times where I would have walked away.

1104
01:03:23,720 --> 01:03:26,960
Speaker 4: I would have started OKHCFT so much sooner, and that

1105
01:03:26,960 --> 01:03:28,920
Speaker 4: would be like the one change in my career that

1106
01:03:28,960 --> 01:03:29,600
Speaker 4: I would have made.

1107
01:03:29,800 --> 01:03:33,280
Speaker 2: Huh really interesting. Thank you Annie for being so generous

1108
01:03:33,320 --> 01:03:36,200
Speaker 2: with your time. We have been speaking with Annie Lamont,

1109
01:03:36,720 --> 01:03:40,920
Speaker 2: co founder and managing partner at okhc FT. If you

1110
01:03:41,200 --> 01:03:44,320
Speaker 2: enjoy this conversation, well, be sure and look up any

1111
01:03:44,360 --> 01:03:47,960
Speaker 2: of the previous five hundred discussions we've had over the

1112
01:03:48,000 --> 01:03:55,360
Speaker 2: past ten plus years. You can find those at Bloomberg, iTunes, Spotify, YouTube,

1113
01:03:55,760 --> 01:03:59,040
Speaker 2: wherever you find your favorite podcasts. And be sure and

1114
01:03:59,120 --> 01:04:02,960
Speaker 2: check out my new short form podcast at The Money

1115
01:04:03,440 --> 01:04:07,960
Speaker 2: conversations with experts about your money, earning it, spending it,

1116
01:04:08,040 --> 01:04:11,760
Speaker 2: and most importantly investing it. At the Money in the

1117
01:04:11,920 --> 01:04:16,160
Speaker 2: Master's in Business feed or wherever you find your favorite podcasts.

1118
01:04:16,720 --> 01:04:18,480
Speaker 2: I would be remiss if I did not thank the

1119
01:04:18,480 --> 01:04:22,520
Speaker 2: Crack team that helps me put these conversations together each week.

1120
01:04:22,880 --> 01:04:26,560
Speaker 2: Anna Luke is my producer, Sean Russo is my head

1121
01:04:26,560 --> 01:04:31,400
Speaker 2: of research. Steve Gonzalez is my audio engineer. Sage Bauman

1122
01:04:31,520 --> 01:04:35,160
Speaker 2: is the head of all podcasts at Bloomberg. I'm Barry Ritoltz.

1123
01:04:35,640 --> 01:04:40,160
Speaker 2: You've been listening to Masters in Business on Bloomberg Radio.