Episode 1: Disrupting healthcare - Funding the next generation of innovation with Michael Greeley

Justin Steinman: 
Definitively Speaking is a Definitive Healthcare podcast series, recorded and produced in Framingham, Massachusetts. To learn more about healthcare commercial intelligence, please visit us at definitivehc.com. 
 
Justin Steinman: 
Hello. Welcome to the inaugural episode of Definitively Speaking, a podcast about finding your way in the complex healthcare marketplace. I'm Justin Steinman, chief marketing officer of Definitive Healthcare, and your host for this series of data driven conversations with thought leaders and experts, from across the healthcare industry. 
 
Justin Steinman: 
On today's episode, I had a chance to chat with Michael Greeley, co-founder and general partner at Flare Capital Partners, one of the leading healthcare and healthcare IT venture capital firms in the world. 
 
Justin Steinman: 
Michael and I had a wide ranging conversation, covering everything from hot places to invest to the retailization of healthcare and everything in between. Let's dive right into my conversation with Michael. I hope you enjoy. 
 
Michael Greeley: 
So Michael. Welcome. Great to see you, Justin. You look younger every day. 
 
Justin Steinman: 
I wish. I wish, I wish, I wish. So, Michael, you and I have known each other a long time, almost two decades at this point. I think we met way back when you were at Flybridge Capital Partners. You held a networking session at MIT. 
 
Justin Steinman: 
Way back when, you had a more broad based approach. You invested across multiple industries. But in 2014, you left Flybridge to start Flare Capital, where you focused exclusively on healthcare and healthcare IT. What opportunity did you see, that drove such a dramatic shift in your investing? 
 
Michael Greeley: 
Yeah. It's probably a lot of the same things you've seen. You and I have compared notes, as you've said, on and off for a couple decades. 
 
Michael Greeley: 
I think coming out of, over the last decade or so, what I was observing was that, the healthcare tech entrepreneur was relatively underserved. 
 
Michael Greeley: 
I'm actually quite in active in the venture capital industry and think a lot about the forces at work in our industry. 
 
Michael Greeley: 
It's kind of a funny industry. There're probably 1,300 venture firms in the United States. Relatively few of them focus on what is an enormous category, healthcare, obviously. It's $4 trillion of spend, but I felt like as somebody who's with entrepreneurs all day long, there was an opportunity to build a new firm. 
 
Michael Greeley: 
So, seven or eight years ago, set out. Didn't actually leave my office, but was co-located with my old firm. We raised a dedicated healthcare tech fund. 
 
Michael Greeley: 
There are also forces at work in the venture industry. I think over time, investors and venture funds recognize that returns tend to be superior for firms that are more focused on specific markets versus more generalists. 
 
Michael Greeley: 
Obviously, there are firms that disprove what I've just said. They're world class firms, that are very much generalists in nature, but this is a very complicated industry. 
 
Michael Greeley: 
It's hard to dabble in the healthcare industry. So, I thought there was an opportunity to build a dedicated firm of size, to service great entrepreneurs, like you, frankly. 
 
Justin Steinman: 
What makes your approach special? I mean, obviously, you got a little bit of a secret sauce over there. What do you do, that's so different? 
 
Michael Greeley: 
I think one thing we did, that in hindsight, has played out remarkably well, by design, about half the capital come from strategics. 
 
Michael Greeley: 
There's two kind of schools of thought in my industry, on how one should engage with strategics. Do you keep them kind at arm's length and out from under the tent? Or do you engage with them? 
 
Michael Greeley: 
It struck me, that a potential competitive advantage in the markets, certainly in the minds of entrepreneurs, is to be able to introduce them to executives who have enormous budgets, that are trying to solve important problems that those entrepreneurs are building solutions for. 
 
Michael Greeley: 
So, about half the capital, we manage a half a billion dollars today, come from 20 strategics. They represent the entire healthcare industry, providers, payers, retailers, pharma devices, lab companies. That's proven to be, I think, quite differentiated. Frankly, the healthcare tech category is a little chaotic right now. 
 
Michael Greeley: 
Several hundred companies are being created every year. We're going to hit an all time record high, in terms of funding activity this year. 
 
Michael Greeley: 
It gets, just increasingly harder for companies to break out and get recognized. So, I think that was one thing we did well. 
 
Michael Greeley: 
I think, the magic of venture firms that succeed, is they collect investors. Kind of a core team, that have very different and at times, opposing opinions. You allow them to debate them. 
 
Michael Greeley: 
Over time, over many decisions, I think you'll be more often right than wrong. So, I'm super proud of the team we've built. 
 
Michael Greeley: 
COVID has been a massive accelerant for technology adoption. As tragic as it is for literally billions and billions of people, for those of us fortunate enough to fund people who are building companies, it's a pretty exciting time, because the industry is in such urgent need of novel solutions. 
 
Justin Steinman: 
Yeah. I want to pick up on a couple of things that you said. You used the word chaotic, to describe healthcare tech investing right now. I actually would use the word chaotic, to describe the healthcare industry right now, in the midst of COVID. 
 
Justin Steinman: 
I agree with what you're saying, around COVID really changing healthcare. You always look for disruptive forces. COVID has been a disruptor on so many different scales, whether it is disrupted people's individual lives, their family lives, their working lives, their personal lives. COVID has disrupted business and industry. 
 
Justin Steinman: 
So, I find myself thinking a lot, around what healthcare's going to look like in the next 12, 24, 36 months. What are you seeing around healthcare? How's it going to look different over that timeframe? 
 
Michael Greeley: 
I fully agree with what you're saying. The system obviously has been forced to be virtual, on demand, real time, intelligent, predictive. We all knew that was inevitable, over probably a couple of decades. It's had to do it in a couple of years. 
 
Michael Greeley: 
The obvious implication is, the executives who run the system, payers, providers, don't have the tools to navigate. They're already confronting fee to value, that transformation. Now they're being forced to do cartwheels, to get through this. 
 
Michael Greeley: 
Yet what's been successful in just the last couple of years, will be what will be focused on over in the next couple of years, because the journey has just begun. 
 
Michael Greeley: 
The companies in our portfolio that tend to be scaling faster than expectations, both on an absolute and a relative basis, are able to claim a cost reduction story with data and therefore, attribution, in the near term ,sort of one or two budget cycles. 
 
Michael Greeley: 
They can tell an outcome story. That tends to take three, four, five years. And again, data and attribution are the key dimension. 
 
Michael Greeley: 
We're in an environment where those cycles have been collapsed, where you've got to be able to show outcomes and impact very, very quickly. 
 
Michael Greeley: 
My sense is, in talking some of the senior executives amongst our strategic LPs or just frankly, across the industry, like you're doing, there's a level of urgency that I've never experienced before. I've been investing in this space for a couple decades. 
 
Michael Greeley: 
I think the next two years define the next five years, the strategic agenda. And the next five years likely defines the next 20 years. 
 
Michael Greeley: 
So, on top of everything else, there's this competitive urgency. It's remarkable how palpable that is. 
 
Michael Greeley: 
You look at other industries that have gone through these radical transformations. If you look at the advertising industry, it's 260, 270 billion of spend in the United States. And for 20 years, we've rearchitected that industry. 
 
Michael Greeley: 
Today we have, I think arguably, 10 to 12 trillion of venture capital backed public equities, google, Facebook, Twitter, that whole laundry list of companies. The healthcare industry is 17 times larger in spend. 
 
Michael Greeley: 
You couldn't today, credibly start another search engine company or another social media company. I mean, you could around the edges, but you couldn't create such a dominant franchise as what we have today. Those were started 20 years ago. 
 
Michael Greeley: 
So, I think there's some parallels to healthcare, that it does feel like we're going to be more predictably, more repeatably starting companies in this environment, under these extraordinary pressures, that will be very enduring, big businesses. 
 
Michael Greeley: 
Today, they're small businesses. But in two to five years, they'll start to break out. In 10 to 20 years, they'll be household names. I think that's exactly kind of where we are, at this knee of the curve, of this sector. 
 
Justin Steinman: 
That's a really interesting perspective. As I hear you talk about that, the one thing that I'd poke a hole in that theory, is the fragmentation of healthcare and the combination of the fact that there are some pretty, big established players, today in healthcare. 
 
Justin Steinman: 
You got CVS. You've got HCA. You've got Tenet. You've got, here in Massachusetts, the Mass General system. Those players aren't going away. 
 
Justin Steinman: 
Do you think there's room for new companies to get started and grow and become a Google? Or do you think it's more of, they get started, they get incubated and then, Oracle... I mean, Oracle just bought Cerner. Do we start seeing one of these established tech players or a provider, become the institutional amalgamator? 
 
Michael Greeley: 
Yeah. Very fair critique of the analogy . I freely admit it's got shortcomings. But as big as those companies are, relative to the market opportunity, they're still relatively small. 
 
Michael Greeley: 
We have several thousand provider hospital systems. As dominant as we feel Mass General and Brigham, is because we live in the shadow of that institution. On a national scale, it's a relatively small player. 
 
Michael Greeley: 
I think what might be a distinction from the ad tech analogy, is you may see over the next couple of years, pretty interesting M&A activity. Where a healthcare tech company will scale to be a few billion, 10 billion in value, be acquired by one of these larger incumbents. That's a way that they begin to recharacterize who they are. They buy technology and they become technology companies. 
 
Michael Greeley: 
I think a lot of the payers are struggling with, what does their future look like? They have these incredibly important positions in the industry, but when you distill it, they are transaction processing companies. 
 
Michael Greeley: 
How do they become more accountable for care and outcomes? I think you'll start to see them acquire some interesting, novel solutions. And then they sort of recharacterize what their purpose is, over the next decade or so. 
 
Michael Greeley: 
Your critique is fair. My pushback is that, venture investors get excited about industries that are measured in billion or 10 billion. 
 
Michael Greeley: 
So, I think it gives you a lot of degrees of freedom, to build substantial businesses. They may not be hundred billion dollar businesses or three trillion, like an Apple, but I think you could see a clear path of scaling to a several billion dollar outcome, in a handful years. Not two years, but not 20 years. 
 
Justin Steinman: 
I think you've already started to see the payers transform themselves. You've got CVS, Aetna merging. They're really trying to create that vertical. 
 
Justin Steinman: 
CVS wants to be that front door of healthcare. They can make the backend money by saving the money, paying for all their Aetna subscribers. 
 
Justin Steinman: 
You've got United transforming itself, I feel like daily, through all these different optimize. 
 
Justin Steinman: 
I think it would be a little bit more challenging for the Blues to transform themselves, just simply due to their affiliations and the massive spread of that. But I really do think you're seeing the payers start to transform themselves. 
 
Michael Greeley: 
Yeah. You've obviously been in the front line of that. I fully agree. I think what's interesting and maybe provocative, is to see where they draw the line around clinical services. 
 
Michael Greeley: 
Obviously, we've seen CVS start to be very ambitious around primary care offerings and virtual care offerings. 
 
Michael Greeley: 
Look at what they were 10, 20 years ago. To my point, you would never have thought that, that's where they would be heading. They were a retailer. 
 
Michael Greeley: 
Now, through these interesting, strategic investments and acquisitions, they're recharacterizing their business, to be a more complete clinical provider, potentially. I think it's fascinating. 
 
Justin Steinman: 
That's actually one of the things I wanted to talk to you about, a little bit. 10 years ago, I went to CVS to get razor blades and shampoo. Now, I'm going to go there for my annual physical? Potentially. It's interesting. 
 
Justin Steinman: 
Here's a really interesting stat that we unearthed, when we were preparing some of the research here. According to Accenture, only 45% of Gen Z has a primary care physician today. Just astronomical. I mean, I have a PCP. I can't fathom not having one. 
 
Justin Steinman: 
We all know that primary care is the best way to lower costs, because you're regularly seeing your, PCP to keep you healthier. Cheaper to keep you healthier than treat you when you're sick. That's kind of healthcare 101. 
 
Justin Steinman: 
But the question, you have to think about this, is does CVS or Walmart... Walgreens are also trying to get into this retailization of healthcare with PCPs. Do you think they can really step in and deliver true longitudinal care? Or do you think they're going to provide more episodic primary care? Oh, I sprained my ankle, kind of MinuteClinic plus. 
 
Michael Greeley: 
I think for the general PCP opportunity, it's more the latter. I think you're right, for a whole host of reasons. I don't know if their footprint, the store footprints allow themselves to be really, full service PCP providers. 
 
Michael Greeley: 
Every time I go into my CVS, it's a different pharmacist. So, I think there's a labor retention churn issue, that you as a... Any individual, any of us that really want longitudinal care, you don't want to see a different PCP every time you walk in. So, I think that's a real issue. 
 
Michael Greeley: 
But there are an awful number of non-acute cases that are episodic, and that's a perfectly acceptable format. So, I think the retailers will get where you'll see them more active in clinical service, around some specialty services. 
 
Michael Greeley: 
I think CVS has made some really interesting acquisitions, to be in the home, infusion services. 
 
Michael Greeley: 
I think you'll see some of these more acute specialty services. There may be a branding issue, that wouldn't even identify them with CVS. 
 
Michael Greeley: 
It's shocking, that data stat you just cited, 45%. That's like a time bomb, waiting for that generation as they age. They're going to be unaffiliated with the healthcare system. They'll have these conditions, that'll surprise them and just be super expensive. 
 
Michael Greeley: 
So, I'm really excited about what the retailers are doing in primary care. Because I think, frankly, it's good for all of us, that people have better access to quality care. 
 
Michael Greeley: 
One of the things that get me really excited about our strategy is, ultimately technology is, not to sound sort of grandiose, a democratizing force for quality and access. 
 
Michael Greeley: 
So, we're actually spending a lot of time thinking about Medicaid. Are we now at a point where we can bring MGB-like care to populations that have been disenfranchised? 
 
Michael Greeley: 
I think CVS, they have that front door. They have the ability to really engage and activate a lot of different populations in the country. 
 
Justin Steinman: 
I spend a lot of time thinking about who's going to consume these services. Is it my 17 year old daughter? Is it me and my generation? Is it my parents, who are in their late seventies? 
 
Justin Steinman: 
I have a hard time seeing my parents decide to go to CVS. On the flip side, I can see my daughter, a year from now, when she's 18 and my wife can no longer take to the pediatrician, she's like, "Yeah, I'm going to get my healthcare at CVS. I'm too busy. I've got other things going on with my life." 
 
Michael Greeley: 
Fully agree. Those are the most tech savvy parts of the population. So, there's a notion of digital front door, they're going intuit it. They're going to get it. They're going to engage. 
 
Michael Greeley: 
There's a risk here though, as we start to empower each of us more and more. Take ownership and make decisions, I'm not sure that generation is ready to... they'll need a real trusted advisor to navigate anything that's more than a cold. 
 
Michael Greeley: 
I don't know where you got your COVID shots, but I went to a CVS. So, we're also seeing that role in a different light. That generation, I think, is going to grow up, engaging with those kind of offerings, very different than your parents or my parents certainly would. 
 
Justin Steinman: 
It's interesting. I got my shot at CVS, too. One of the most interesting things about the shot and where I almost say my shot is "value add", is the digital record that came with it. Because suddenly, I was able to link up my ClearPass with my CVS record. I don't walk around with my little yellow card or white card, saying I got vaccinated. I go, "Hey, here's a QR code. Scan me in. I've been vaccinated." 
 
Michael Greeley: 
Super powerful. 
 
Justin Steinman: 
Yeah. 
 
Michael Greeley: 
As you and I have talked about over the years, the arm wrestling in the industry is, who's going to manage the arc of our healthcare journey? Not quite cradle to grave, but certainly from your mid to late teens, until you have your own family. Who's going to manage that? 
 
Michael Greeley: 
Wow, that is very sticky, when you start to see all your data on your device, in your pocket. 
 
Justin Steinman: 
Yeah, it really is. A kind of tangential theme to what we're talking about here, is the shifting of procedure volumes as well. 
 
Justin Steinman: 
I mean, the hospitals are really changing. So, some of our data shows that, between 2016 and 2019, the number of patients that had a procedure done in ASC, increased by 16%. Whereas, hospitals really only increased by just under 6%. 
 
Justin Steinman: 
Now, granted, hospitals have more procedures to grow with, but you can't deny the fact that there's more than double digit growth going on in the ASCs. Does that impact some of your investment philosophies? Are you thinking more about that distribution of care? 
 
Michael Greeley: 
Yeah. I think it hits us in sort of indirect and direct ways, as we move to a more distributed system. You're absolutely right. The forces are pushing a lot of these procedures into other settings. 
 
Michael Greeley: 
One area that we've gotten very excited around is just, how do you provide the security infrastructure around this distributed delivery system, much more distributed? 
 
Michael Greeley: 
We have a number of really exciting investments that are trying to address, not only all these new vulnerabilities that you've been introduced, but all the enabling infrastructure around that, is something that we're very excited about. 
 
Michael Greeley: 
The big providers have a similar dilemma, that I think the retailers. You have a lot of the stranded assets in real estate. How do you repurpose that? 
 
Michael Greeley: 
So, it may be slow to move, but I think it inevitably moves. And as I said, we have nine world class provider systems, you'd recognize all of them, as investment partners. 
 
Michael Greeley: 
All of them have chief strategy officers now, who are thinking deeply about, how do we extend our brand into these non-traditional settings? What are the boundaries of our offerings, as some of this gets disintermediated? Ultimately, technology will be the enabling infrastructure for that. 
 
Justin Steinman: 
You keep talking a lot about technology as infrastructure. Let's pivot and talk a little bit about virtual care and telemedicine. Do those words mean the same thing to you, virtual care and telemedicine? 
 
Michael Greeley: 
I think, ultimately, they are different. Telemedicine for us, at least in our shop, feels more like a reactive modality. Virtual care, for us, implies a much richer set of offerings and more of a anticipatory or proactive approach, to providing care to certain populations. 
 
Michael Greeley: 
Obviously, the analytics that we've developed over the last five or 10 years in the industry, has allowed us to much more exquisitely identify at risk populations and engage them in very novel ways. 
 
Michael Greeley: 
As we think about virtual care, and I think we've made four or five virtual care investments this year, that feels profoundly different for us, than just a telemedicine console. 
 
Michael Greeley: 
We have a handful of investments recently, that I would call virtual care and not call telemedicine. 
 
Justin Steinman: 
I think a lot about that as well, in terms of remote patient monitoring and chronic condition management. 
 
Justin Steinman: 
You never want to call pregnancy a chronic condition. But you think about that nine-month continued engagement, where you want to continue to monitor the pregnancy. You don't have to see your doctor every day, but collecting all of data is really important. You can identify trends over time. 
 
Michael Greeley: 
Yeah. 
 
Justin Steinman: 
It's those kinds of virtual care, that I think the technology really enables us to be able to do. 
 
Michael Greeley: 
Yes. Yes. Fully agree. If I'm holding my breath at all, it'll be over the next three to five years, to see the impact on outcomes, because ultimately, that's what we need to see. 
 
Michael Greeley: 
I read something out of CMS, recently. This is not directly related to that. But of the 50 test models that they ran over the last number of years, only like half a dozen of them actually had a material cost savings. 
 
Michael Greeley: 
It will be interesting to see if these models... We all expect and intuit that they'll have real profound impacts, but we need to see the data, ultimately. 
 
Justin Steinman: 
The data is really interesting. I got some interesting stats here, around usage of telemedicine in the pandemic. We'd love some of your reaction. 
 
Justin Steinman: 
When we hit the pandemic start, in April 2020, telemedicine spiked nearly 24 million visits per month. It's now kind of normalized. Over the past six months, it's been about nine to 11 million per month. That's pretty consistent, from June to December. 
 
Justin Steinman: 
What does that tell you about the role of telemedicine, in terms of that massive spiking coming down? 
 
Michael Greeley: 
Yeah. Obviously, we saw it in our portfolio in early 2020. It went from nominal, single digit percent telemedicine, to virtually a hundred percent, clearly. 
 
Michael Greeley: 
It feels like, in the companies that are relevant, it's normalizing in around 40 or 50% of all visits. So, our feeling is, it's kind of table stakes. All of our service companies have to have that capability. 
 
Michael Greeley: 
My suspicion is that, you or I as patients, will ultimately want to see a provider face to face. So, I think it probably normalizes something closer to 20 or 25%. 
 
Michael Greeley: 
I've seen data, where if you aggregate all visits, it's something like mid single digit percent. 
 
Michael Greeley: 
Ultimately, great healthcare is a human-to-human interaction, that's not over a screen. There's something around empathy. Maybe it's just a placebo effect, but you always feel better once you've seen your doctor and they've really consulted with you. You feel at ease. 
 
Justin Steinman: 
Yeah. 
 
Michael Greeley: 
That's hard to get, virtually. 
 
Justin Steinman: 
It's the old proverbial laying of the hands. They put their hand to your neck. They feel your lymph nodes. They bang your knee. How are your reflexes? 
 
Michael Greeley: 
Yeah. My reflexes are good, I'm happy. You feel better for it. 
 
Justin Steinman: 
Yeah. 
 
Michael Greeley: 
But it's not going to go to zero, clearly. I think the interesting thing, as an investor, is we now have kind of two vectors. 
 
Michael Greeley: 
We have a number of general platform companies, Amwell's terrific and Teladoc, et cetera. And then we have a number of specialized offerings. 
 
Michael Greeley: 
Given comorbidities and the condition of many of people in our country, they need multiple specialists. So, how does that consolidate and aggregate? 
 
Michael Greeley: 
Do the platform companies start to acquire those other virtual care companies, to move into higher value cases, or do the virtual care companies aggregate themselves? Obviously, Livongo and Teladoc is an example of the former. 
 
Michael Greeley: 
I think there's kind of a second wave of M&A activity that, frankly, you or I would welcome. We don't want to have to call up five different platforms. We want to have one point of contact, that'll help us navigate. I actually think that's quite an interesting... kind of over the next couple of years. 
 
Michael Greeley: 
My earlier comment, around how the next two years define the next five years, I think that's going to be part of what we're going to see unfold. 
 
Justin Steinman: 
I do, too. Selfishly, I really want to control my healthcare from the palm of my hand, my Apple or Google device. I want to have it all synchronized there. I want to interact with all of my doctors. 
 
Justin Steinman: 
I think whoever controls my interaction on my device, is going to ultimately be the arbiter of my healthcare. That's what's going to drive me. And even so, the generations behind us, are even more attached to that type of stuff. 
 
Michael Greeley: 
Although, I'll say something a little provocative. I'm undoubtedly wrong. Maybe this starts to get into the RPM space. There's now some infrastructure in a lot of our homes, think of the Alexa platform, that can uniquely activate and incent and engage us in ways that are subtle, but quite profound. 
 
Michael Greeley: 
If you think about, who could take risk on us longitudinally, it introduces yet another sort of platform company, that could profile us in very interesting and unique ways. 
 
Michael Greeley: 
In this whole morass, you've got a lot of companies out there, a lot of technologies, that I think have the ability over time, to augment what their co-offerings are, to be actually quite comprehensive providers. 
 
Michael Greeley: 
I don't think we're going to get our care from Alexa, anytime soon. But the ability for them to inform and send, activate, change behavior, it's just provocative to think where these things all start to converge. 
 
Justin Steinman: 
It is. But it starts to almost create a problem. You start to get a signal from the noise problem. 
 
Justin Steinman: 
My Alexa can collect how many data points on me every day, in all the different rooms in my house, of what I'm eating. Is Justin exercising? Is he drinking three beers in front of the couch and eating a bag of popcorn? 
 
Justin Steinman: 
At some point, my primary care provider doesn't really care. But if you take all this data and then how many patients are in his practice, you send it all in, how does he identify the signal from the noise? 
 
Justin Steinman: 
You're going to need some pretty smart people writing algorithms, to say, "Okay. No exercise, plus three beers a night, plus six bags of popcorn, okay, you got to call Justin. He's not being so healthy." 
 
Michael Greeley: 
Yeah. Well, this is where you guys play a role. Definitive, there are going to be data aggregators and data curators that will deliver to the PCP, just the answer that they got, that the PCP wants. They're going to suck in and multiplex all these different, really informative data. 
 
Michael Greeley: 
We saw at Iora, when we went virtual, we started to see into people's homes, that we had never seen before. 
 
Michael Greeley: 
We couldn't digitize that insight, but our providers were seeing our people at risk. It's a small leap to look at your purchasing behavior and then, does that begin to create a feedback loop? 
 
Michael Greeley: 
Obviously, Definitive is hopefully going to play an important role in helping us think through this, over time. How do you aggregate disparate datasets, to draw interesting conclusions? 
 
Michael Greeley: 
It may not be a critical set of insights. But if you have a one to a hundred scale, it starts to inform that kind of nuance. 
 
Michael Greeley: 
The point is, with technology and the pervasiveness of it, we can be passively and intelligently monitored. That has clinical implications, hopefully for the good. 
 
Justin Steinman: 
Yeah, hopefully, hopefully. Big Brother's watching, though. You never know. 
 
Justin Steinman: 
When we were prepping for this podcast, you mentioned the concept to me, of data to liquidity in healthcare. What is that? 
 
Michael Greeley: 
Yeah. I think for us, and it's akin to what we were just talking about, we all know this, it's incredibly siloed. It's disparate, different formats, different standards. 
 
Michael Greeley: 
We have a couple of companies that we are super excited about, that can begin to normalize and de-identify that type of data, those datasets and enable... Some are directly going after drug development. 
 
Michael Greeley: 
It's super powerful, in thinking about clinical trial design or post-market approval processes. So for us, this notion of data liquidity... which I take your point, it's a little bit fuzzy around the edges, but it's deriving greater value from any one dataset. Because you can mung it with other datasets, that may not have been obvious to mung together, but some really interesting insights can come from that. 
 
Michael Greeley: 
You shared with me some of the data that you're looking at, that I thought was fascinating, that I would never have thought that you could multiplex different data. I thought it was fascinating, some of the work that you're doing. So that, for us, is what data liquidity is. Ultimately, it's those platforms that enable that. 
 
Justin Steinman: 
I always say, we are awash in data, but we're lacking in intelligence. I think the job of all technology companies right now, is really to try to extract that intelligence out of it and make it useful. What can you do, that's really useful, with it? 
 
Michael Greeley: 
Yep. Fully agree. 
 
Justin Steinman: 
As we start to get toward the end of our time here together, I kind of got one last wrap-up question for you. 
 
Justin Steinman: 
If you were an entrepreneur right now... I know you are an entrepreneur, but if you're an entrepreneur in a healthcare IT, what kind of company would you start right now? Who would you try to sell to, providers, IDNs, consumers, tech companies? 
 
Justin Steinman: 
We've got a lot of people who are listening here, say, "I want to get Michael to invest in my company." What's interesting to you right now? 
 
Michael Greeley: 
I think the customer that we find most compelling, are the ones that bear the risk and the cost. So, I think in this world, the employers are interesting. The payers are interesting. 
 
Michael Greeley: 
I think version 1.0 of our sector over the last decade, was really focused on the consumer as the customer. 
 
Michael Greeley: 
Obviously, there are wildly successful examples that disprove that. But I think the complexity of the data they're being provided, just the consumer is disadvantaged in owning this journey. 
 
Michael Greeley: 
So then, who owns the risk and the reward from managing this journey? We think the employers have a very big voice here. So, we like solutions that sell into the employers. We like actually, solutions that sell into the payer. Different set of reasons. 
 
Michael Greeley: 
If you went through the CIO's budget of a provider, for the next three years, stack ranked their urgent priorities, and we've made a handful of investments that try and address their urgent priorities, like around credentialing. 
 
Michael Greeley: 
So, we think they're is interesting opportunities in the provider space. But the urgency, I think, is around those that are having to take risk and develop solutions that help them take risk. 
 
Michael Greeley: 
Iora was a terrific investment for us. We were the first investor in Bright Health. Notwithstanding where it's currently traded, it's an amazing company. So, we think there are interesting, novel risk bearing entities... for us, those may be more in the virtual care space, that we find really exciting. 
 
Michael Greeley: 
And then the meta themes you and I have been talking about, around data, liquidity and infrastructure. Probably third of our companies sell into the pharmaceutical industry. So, they have enormous budgets and under significant pressure to buy novel solutions. Those tend to be the things that we're excited about. 
 
Justin Steinman: 
Michael, thank you very much for your time there. I really enjoyed talking with you. 
 
Michael Greeley: 
Justin, all the best. I've watched your career, your meteoric career. This is a great effort to engage our community. I really welcome you doing this. 
 
Justin Steinman: 
Thanks for listening to Definitively Speaking, a Definitive Healthcare podcast. Please join me next time, when Brittany, Todd and I will break down the most salient points from today's podcast, and explore how they could impact the many players across the healthcare ecosystem. 
 
Justin Steinman: 
If you like what you've heard today, please remember to rate, review and subscribe to the show on iTunes or wherever you get your podcasts. 
 
Justin Steinman: 
To learn more about how healthcare commercial intelligence can support your business, follow us on Twitter @DefinitiveHC, or visit us at DefinitiveHC.com. Till next time, take care and please stay healthy.