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AU Feature: Everyday Low Healthcare Prices
Private Equity Central.net
By Natalia Radziejewska
Monday, June 11, 2007
The venture industry and America's largest state pension system
came together this week when it was announced that CalPERS would
allocate $700 million to invest in an area of healthcare that will
increasingly become a topic of concern, but has thus far been ignored
by venture capital. The new fund, created by former Bush administration
health official Dr. David Brailer, will look at ways to reduce the
cost of healthcare.
Brailer was the administration's national coordinator of health
information technology. Brailer and CalPERS turned out to be a good
match. The $240 billion pension system is the third largest health
purchaser in the nation.
"Our staff struggle like all health benefit purchasers to keep
cost increases at bay while trying to secure better health care
for our 1.2 million members," CalPERS board President Rob Feckner
said during the press conference announcing the new initiative.
In looking at their own health insurance needs, Feckner and CalPERS
Chief Executive Officer Fred Buenrostro discovered that there may
be a way for them to increase the pension system's bottom line,
while lowering the cost of healthcare.
Among the fields Health Evolution Partners would look to invest
in are remote monitoring of patients, management of chronic diseases,
telemedicine, predictive genomics to tailor drug doses and an Internet
marketplace for non-emergency medical procedures.
Health Evolution Partners will also seek to invest in healthcare
services, an area in which venture capital investment has been scarce.
The lion's share of investment in the healthcare area goes to biotechnology
and medical devices.
"Services have always made up a very small portion of the venture
capital pie," says John Taylor, research and financial affairs executive
at the National Venture Capital Association. "Typically, it is about
1% to 2%." Biotechnology and medical devices make up 40% of venture
capital investment in the life sciences area.
The decision was welcomed by venture capitalists in the healthcare
space, who have long considered the sector to be an inefficient
one.
"David is right on. If you look at where he wants to put capital,
those are the best leverage points we have today," says Kevin Kemmerer,
senior vice president in the technology group at private equity
firm Safeguard Scientific. Kemmerer believes the best way to reduce
healthcare costs is with enterprises that treat chronic diseases.
"[The company] is going to make sure that you are taking your medicine
and regulate your condition, so you never have to go the hospital,"
he says.
Kemmerer also sees remote monitoring, an area Brailer named as
a potential area of investment, as a cost saver.
"What if you could have more remote monitoring of patients, so
they don't have to come into the hospital, but you can check the
vitals remotely?" Kemmerer asks. Take away hospital visits and costs
will be reduced, he believes.
Mark Brooks, a managing director at Scale Venture Partners broke
down the U.S. healthcare system to show the parts of it where costs
could be lowered.
"The healthcare system costs $2 trillion a year and $1.5 trillion
of that is in the service sector," Brooks says. Venture firms could
invest in companies seeking to reduce the amount of paperwork doctors
have to file, Brooks says.
"With more claims filed electronically, you could reduce the number
of back office personnel you have to employ," Brooks says.
One thing Taylor, Brooks and Kemmerer all agree on is that one
major government agency must be reformed before any real reduction
in healthcare costs could be realized.
"The biggest obstacle in the healthcare space is that the majority
of payments are done through CMS [Center of Medicare and Medicaid
Services] and until they change, the market can't change," says
Kemmerer. He went on to explain that CMS is such a force in America's
healthcare system because the rates it charges for hospital stays
and doctor visits are the ones insurance companies use to set their
own prices.
The federal government is also the largest purchaser of healthcare.
"A procedure or drug can be approved by the CMS, but if they won't
pay for it, doctors can't provide it as an option to their patients,"
says Taylor. Non-approved procedures can still be used on patients,
but more than half of the user base is wiped out when Medicare and
Medicaid is eliminated as a source of revenue.
There is no panacea that will solve all the problems of the healthcare
system. "People are going to get sick," Kemmerer says.
The healthcare system is not going away. "All you are trying to
do is lower the cost of healthcare by eliminating the waste, the
fat in the system," Kemmerer says.

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