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AJ Loiacono & Holly Maloney (Part 2): Outlook for 2023 – What to Watch For

February 9, 2023

Capital Rx

In Part 2 of Capital Rx CEO AJ Loiacono’s discussion with General Catalyst’s Holly Maloney, the 2023 “crystal ball” revealed 5 predictions:

1.    Technologies that help address the workforce transformation crisis will come into focus - it's a problem that must be solved

2.    Greater attention will be paid to the behavioral/mental health of the aging population

3.    Investment dollars will flow into infrastructure that drives transparency

4.    The public sector will close the gap and catch up with the private sector – i.e., expect to see more thoughtful, purposeful legislation and stronger patient advocacy

5.    The workforce will remain distributed, and we'll migrate toward a healthy middle ground of work-life balance


Lightly edited for length and clarity.

AJ Loiacono - Capital Rx  

I think, inevitably, there comes a portion in any discussion when we say, “What's happening next?” What's going to happen in health technology, be it the next 12 or, if you can, even 24 months? What do you think are one or two of the trends that you think are really going to be important or happening during this timeframe going forward?

Holly Maloney - General Catalyst

Yeah, it's always the hot topic this time of year heading into the holidays: how are we going to think about next year?

And there really are a few themes that I think a lot about, and we're still in the very early innings of figuring out how to solve them. One is the workforce transformation crisis.

As you think about the state of health systems and the caregiver ecosystem, where it is a crisis, you know, in terms of the workforce shortage, misalignment of incentives, and a fundamentally broken economic model for many, many health systems. And so, figuring out what are the technologies to drive better experiences, more scalability of the human labor of the people that are dedicating their lives to treating patients. It's something that we have to solve, and it is a key strategic priority for every one of our health system partners, of which we have 15. So that's something I think a lot about.

I think a lot about the aging population. And there are a few different takes on that. One is finally having a dedicated focus on the behavioral health of the aging population, especially as we think about Alzheimer's and dementia and the number of potential patients we may have in that demographic not too long of a time from now and figuring out how we identify this early, how do we treat [them] with empathy and dignity and really focus on reducing that total cost of care. There are so many downstream effects of an Alzheimer's or dementia patient, not only for that person but for the community of caregivers that are working with them.

And we now have a life sciences partner internally, so trying to figure out how we bridge that gap from the drug development side to the care delivery side but that's going to take many, many years, but it's something we're really focused on.

And thinking about that family caregiver workforce, it is a naturally occurring organic workforce that we have that is massively under-optimized and sort of forgotten about in some respects. How do you enable that person to be compensated for the work that they're doing? Because it is a full-time job. How do you get that person the tools and the resources and the economics deserved that align with how they're spending their day, every day?

And then lastly, I think a lot about pricing transparency – we talked about it as it relates to drugs, but with things like the No Surprises Act, I’m thinking a lot about pricing, transparency on the care side, and how we empower patients to make the most informed decisions as it relates to their healthcare?

And we need an entirely new data infrastructure to be able to do that. So, what are the tools that we can be investing in to support that transition, which will be a long transition, but there's a lot of innovation that needs to happen to support that…

Holly Maloney - General Catalyst

Once again, I'd love to get your take on it. I mean, I know you're so “heads down” in the day-to-day of your business, but I would love to hear what you think are the biggest trends for next year.  

AJ Loiacono - Capital Rx

I was smiling and nodding through so many of your comments because I couldn't agree more with so many things that you were saying. I was like, “I was just talking about that this morning.”

But I think some of the things that are trends that I'm looking at going into 2023 and beyond … this is one of the first times in my adult life where I'm really getting a sense of – and I hate to use the word – hope. Not just transformational and evolutionary innovation, but I think, in addition, I see regulatory bodies and legislative arms coming together and really being thoughtful and purposeful in their desire to help the end patient both have better care and reduced costs.  

And so, I think one of the trends that we're going to continue to see in the current administration and in many states is that you're going to see and feel this kind of stronger advocacy, you know, from the federal government and the States, on behalf of patients across the United States. Trying to make sense of this $4 trillion market and how do they improve it. And I think that's one of the areas where I genuinely get a sense of hope, dare I say, because I think it is important. I think all too often, the reason why health care was overlooked for a period of time is that people just felt as if substandard care was their lot in life. That's all they should ever aspire or hope for. And I think people just sort of had somewhat given up.  

And I'm glad that, in many ways, the private sector has stepped up to create innovation; but I think it needs to be a bridge and a complement. And I do believe that members of the Legislative arms, regulatory bodies, and even the press are getting involved in asking the right questions because you're bringing questions to the forefront that maybe people were too scared to ask or didn't want to invest the time in. To be fair, healthcare is so complex. Like, “Gosh, why do I want to understand the pharmaceutical supply chain and all the economic drivers there?” So, I think that's the first one, that real trend of the public sector catching up with the private sector on some level.  

I think my other prediction for the future kind of goes back to what I was saying earlier, and I think the workforce has changed forever. I think there are positive aspects of the change in the workforce being hybrid work from home, being able to draw upon more talent from more regions versus only being able to pull from the region your headquarters or satellite offices are located in. So, I do believe that the entire talent pool has gone national, at least in healthcare and for us.

And I think, in addition to it, how we engage with our colleagues, how we train, how we promote, how we think of next-gen leadership, is all going to have to be redefined on some level. But I think this is staying with us. I don't think it's going away.

I don't think the genie is going to go back in the bottle to five days a week at a static location. I think the word “must” is being removed from a lot of conversations with employees, and I think there's a healthy middle ground of balance that ensures highly efficient workforces coming together, but more importantly, people can enjoy a little bit more time to themselves. So, I think that's the other area that I continue to look at. I think this is a path, and it's going to continue to evolve, but that’s what our colleagues are, what they're becoming, and where they’re headed.  

Holly Maloney - General Catalyst

I couldn't agree more.

If you'd like to watch any of the other videos in this series:

Part 1: Navigating 2022 - A Recap of Top Challenges Faced

Part 3: Capital Rx’s Expansion into Medicare

Part 4: Regulatory Progress – The CAA & IRA

Part 5: The Decision to Back Capital Rx

Part 6: Suggestions for Entrepreneurs & Startup Leadership

Click here to get in touch and learn more about what Capital Rx's full-service PBM or PBA solution can do for you.

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