Medicaid Matters with Mark Smith

Join healthcare expert Dan Rosenthal and a16z Bio + Health general partner Julie Yoo in a deep dive into the evolution of provider networks and their strategic importance in the health insurance ecosystem. Dan discusses how networks are built, managed, and optimized for both cost and quality—including the complexities of payor-provider contracts, the future impact of transparency laws, and opportunities for digital health startups to break into the network space. Dan also explores the possibility of AI-driven, personalized networks, challenging traditional models and paving the way for innovation. Whether you're building a health tech startup or seeking to modernize provider networks, this conversation offers a roadmap for navigating and disrupting healthcare's foundational structures.This episode was originally released in August 2023.

Chris Ellis, CEO and Adam Stevenson, president, both cofounders of Thatch, join Julie Yoo and Jay Rughani of a16z Bio + Health.In early 2020, a new policy called ICHRA altered the insurance market, which had remained largely unchanged for decades. As you’ll hear in the episode, it’s been slow to catch on — but the cofounders of Thatch think it’s a game changer. Together, they discuss these key takeaways:Consumers as a growing class of payor:Traditionally employers shouldered healthcare costs, but now consumers are paying more out of pocket and making purchasing decisions directly for their health coverage.ICHRA represents a major shift, allowing companies to give employees tax-free dollars to shop for personalized health plans.Distributed teams and geographic diversity are creating friction in providing effective healthcare via traditional group plans. Employees may find that certain doctors aren’t covered and plans aren’t tailored to their needs, making ICHRA an increasingly attractive option for employers.The fintech intersectionHow do you make spending healthcare dollars easy, secure, and efficient? By leveraging fintech solutions that ensure employees use healthcare dollars on what matters  most for them.This alignment between fintech and healthcare could enable more flexible, localized plans, with individuals choosing the add-ons that work best for them at that moment in their lives.

Jonathan Lim is the CEO of Erasca, but his career path took him on a fascinating journey from practicing as a surgeon to leading life science companies. In a recent conversation, Lim shared valuable insights about his transition to the biotech world, his leadership experiences, and the lessons he's learned while founding and guiding organizations through high-stakes decision making. Reflecting on a personal trip to the Galapagos Islands, Lim also drew parallels between Darwinian evolution and business. In today’s challenging biotech environment, entrepreneurs need to adapt or die, consistently evolving by reprioritizing, raising funds smartly, and staying agile to survive and thrive. 

In this episode, Vijay Pande and Daisy Wolf of a16z Bio + Health join a16z Podcast host Steph Smith to make a provocative case for why technologists—not just medical professionals—are key to reinventing healthcare. They argue that to transform a sector representing 20% of U.S. GDP, innovation must move beyond curing diseases toward tackling healthcare’s broken systems. By likening the healthcare industry to a logistics challenge, Vijay and Daisy outline how technologists can leverage their expertise in consumer engagement, operational efficiency, and AI to drive the next frontier of health innovation. They also explore high-impact opportunities like improving patient experiences and deploying AI for behavioral change at scale. If you’re ready to explore new paths in healthcare, this episode is essential listening for understanding the powerful role technologists can play in shaping its future.

Marta Bralic Kerns, founder and CEO of Pomelo Care, joins Will Shrank, MD, a16z Bio + Health venture partner.Together, they talk about the innovator’s dilemma with building in the Medicaid space, how Pomelo partners with managed care plans, and the opportunity to potentially lower costs through providing additional support to pregnant women.This is the third episode in our Medicaid Matters series. Listen to previous guests Mark Smith, MD, and Nikita Singareddy in the Raising Health feed.

Nikita Singareddy, cofounder and CEO of Fortuna Health, joins Will Shrank, MD, a16z Bio + Health venture partner.Together, they discuss building a useful and convenient platform for Medicaid enrollees, listening to patient feedback to improve, and the complexities of different states’ Medicaid processes. This is the second episode in our Medicaid Matters series. Listen to previous guest Mark Smith, MD, to hear about Medicaid from a provider's perspective.

Over the next three episodes, we’re going to talk about why Medicaid matters, and the potential for technology to make it easier for enrollees to access and utilize the program. Our first guest is Mark Smith, MD, Clinical Professor of Medicine at UCSF. He was the founding President and former CEO of the California HealthCare Foundation from 1996-2013, which is where he began his work to improve Medicaid. He experienced Medicaid from a provider perspective when he began his residency during the early days of the AIDS epidemic in San Francisco in the 1980s. In this interview, he is joined by a16z Bio + Health venture partner Will Shrank, MD. Together, they discuss Mark's time at CHCF, how Medicaid works, and how founders can potentially partner with the Medicaid program. In future episodes, we’ll also hear from Marta Bralic Kerns, founder and CEO of Pomelo Care, and Nikita Singareddy, cofounder and CEO of Fortuna Health. Both companies are directly working with Medicaid patients to make their lives easier.

Vijay Pande, PhD, founding partner of a16z Bio + Health, joins Derrick Harris, host of the AI + a16z podcast. Together, they discuss how computer science has subsumed biotech.

Casey Means, MD, a Stanford-trained physician, cofounder of Levels, and author of the new book Good Energy, joins Vijay Pande,  PhD, founding partner of a16z Bio + Health.Together, they discuss the downsides of physician specialization, the rising tide of chronic illness in the U.S., and how tracking biomarkers might allow people to determine the best nutrition options for their unique physiology. Casey's book is available here.

Greg Meyers, EVP and Chief Digital and Technology Officer at Bristol Myers Squibb, or BMS, joins Jorge Conde, general partner at a16z.This is a follow-up to their 2023 episode, where they discussed how biopharma can adapt to AI. Now, they revisit the conversation to see what’s changed and what hasn’t.Together, they chat through tech as a competitive differentiator for large companies, generative AI for drug development, and what Greg and BMS look for in potential partners. They also highlight the importance of being agile and adaptable while navigating the changing landscape of biotech, providing valuable insights for founders.