141–150 of 160 posts
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This mindset (that it will be a goldrush) is why we can't have nice things. Can't trust capitalism to do this kind of stuff in a non-exploitative way
We don’t have nice things because congress sucks. Keep Blaming capitalism, that wall has lots of screams to bear yet.
Kudos to their founders and team for trying to disrupt this space. https://www.ycombinator.com/companies/brave-care https://www.bizjournals.com/portland/news/2021/10/07/brave-c... | https://archive.today/Qd8fQ https://techcrunch.com/2019/09/09/yc-backed-brave-care-raise...
Most people outside of healthcare will have a hard time disrupting anything until they realize the goverment has tilted the rules in favor of status-quo. Healthcare insurance in the US is heavily subsidized, and no number of revolutionary care delivery models will put you on level terms with the behemoth of US govt insurance subsidies. Your only hope as a non-provider is to come in with your own a-la-carte insurance…
It's not an easy market to jump into; you spend a huge amount upfront on site construction (particularly if you're building standalone clinics outside of existing medical buildings, which is not unusual for urgent care), labor cost and complexity is high, and reimbursement cycles are long and painful. Healthcare chains scale like retail, not like software, with all the attendant cash management problems.
It feels like they did offer a superior service with lots of effort put into getting into the community, but I question both their decision to try and build a custom EHR -- yes, EHRs suck, but once you start building your own, you're no longer a medical services company, you're now an EHR company -- and not to pursue a regional-centric expansion strategy aligned with local health systems via contract or JV, instead choosing to build a small number of clinics across the country, which goes against proven successful buildout strategies in healthcare.
It's a shame they've gone under -- again, superior service, obviously a lot of care for their patients -- but "we went under because of cash management problems and inappropriate growth strategy" is a pretty standard story in the healthcare world.
Sad to see a care organization like this shut down. But curious to understand what exactly they were disrupting? From the outset, looks like a pediatric clinic that accepts insurance (and has a cash pay option) - but this is how most pediatric clinics/urgent care that are not venture backed operate. There doesn’t seem to be a disruption in their revenue model (like a one medical style subscription service), and vbc d…
OP here. I visited their clinics for my daughter several times when she was a toddler for ear aches and other ailments— I found the experience refreshing: instant online booking, no BS registration and online communication with staff was seamless. Very sad to see them go so abruptly. Up until this morning when I was told they were gone, I had no idea they were YC or otherwise VC funded. Just came here to pour one out…
Given the highly escalating price of medical care, it's astounding that a provider that isn't required by federal law to provide no-cost indigent care can go bankrupt. [1] makes it sound like they were assuming a never-ending stream of venture funding and didn't make a sustainable business. It'd be interesting to see where the money went. [1] https://www.oregonlive.com/business/2022/09/portland-pediatr...
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How come it's cheaper in places where everyone has insurance?
> How come it's cheaper in places where everyone has insurance? Those places don't have a hellish Frankenstein's monster combination of public and private and a load of regulations at the federal and state levels all adding up to high costs that have to be passed on to the consumer, but also weird niches of market inefficiencies that can be exploited by anyone who's managed to luck or judge their way into an advantag…
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Dump $1 trillion into Kaiser and push it out to all 50 states. I have it in Bay Area and it’s mostly been great for me. It’s not the best but it also gets 90% of things right.
Asking doctors about Kaiser will be an eye opening experience for you.
Doctors: It's like working for any other hospital; it's not bad.
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Most people outside of healthcare will have a hard time disrupting anything until they realize the goverment has tilted the rules in favor of status-quo. Healthcare insurance in the US is heavily subsidized, and no number of revolutionary care delivery models will put you on level terms with the behemoth of US govt insurance subsidies. Your only hope as a non-provider is to come in with your own a-la-carte insurance…
> .. they realize the goverment has tilted the rules in favor of status-quo Or is it that the Healthcare industry has tilted the government into making rules that favor the status-quo?
I have heard conflicting accounts of inefficiencies in the US healthcare system. One account is that the US has too many medical facilities in urban areas. In other words, there might be five hospitals each with its own radiology equipment. That equipment is idle some of the time, so you could close some of the imaging departments and leave just one or two for the metro area. That would obviously inconvenience some p…
I'm curious what the truth is regarding the number and character of brick-and-mortar healthcare facilities in the US: too many? too few? Because it looks like this company was opening physical clinics. Services are unevenly distributed and I wouldn't say there's too many providers in urban areas. Rural areas are underserved though (off the top of my head I can think of a movie and a TV series whose premise is rooted…
Crucially, among those who leave are not just patients. There are also doctors leaving.
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How come it's cheaper in places where everyone has insurance?
The problem is private insurance companies + private hospitals. They shouldn't exist. Healthcare is an inelastic service: people will pay everything to get it. So private hospitals in a free market are pushed to bill their services as higher as possible. Actually, their prices would go to infinity, if not limited by people total savings and earnings. So, here the insurance companies make the problem worse: they give…