Exits & Outcomes Is Good

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So my sponsored posts are basically always going to be talking about different healthcare companies. However, this time I’m making an exception because I think what Brian Dolan is doing is really important for the ecosystem and is so good that it deserves more attention. 

He writes Exits & Outcomes, a paid newsletter where he dives really deep into digital therapeutics, health benefits, and what’s happening with digital health companies. 

I’ll go into specifics on why it’s good and give some examples from his paywalled reports:

  • He looks at weird esoteric sources

  • He follows up on “what ever happened to that announcement”

  • He’s building a pretty interesting database

  • He looks at the benefits stacks of employers

  • The long form reports look at the operational components of a business

This is a sponsored post - you can read more about my rules/thoughts on sponsored posts here. If you’re interested in having a sponsored post done, email nikhil@outofpocket.health.


Brian is, for real, a digital health OG. He started MobiHealthNews in 2008 to cover digital health. Beepers were considered digital health. Integration wasn’t yet prefaced with loud sobbing. I think I was mastering Mario Sunshine (great game btw). 

Deciding that starting one publication during a recession was too easy, he started his new one, Exits & Outcomes, in 2019 — right before a global pandemic. Since then, he’s published 120 newsletters and 13 reports. I have learned an immense amount from reading his newsletter, and Brian told me I have a >90% open rate (because I am on the internet literally 24/7).

Here are the specific reasons I think his newsletter is great:

He looks at weird esoteric sources

Guess who has two thumbs and no time to scour the internet for random company presentations and flyers despite being interested in the content.

Guess who presumably also has two thumbs and actually synthesizes all those random sources in a way that’s interesting and easy to read.

Brian looks up the clinical trials of digital therapeutic companies and writes about their trial design, finds weird pamphlets and posters like this one about Amazon workplace wellness and safety, job descriptions and the projects they’re attached to, and will even write the transcripts of interesting interviews and podcasts to highlight key points.

He surfaces lots of info I probably wouldn’t have seen otherwise because he’s looking in interesting places. Like, just look at the amount of stuff here lol. 

He follows up on “what ever happened to that announcement”

You know when you hear about that one massive partnership like 3 years ago, Twitter just goes bananas (or LinkedIn if you’re sad), and then you just...kind of never hear about it ever again? One of the benefits of Brian having covered this space for so long is he actually goes back to check-in on those projects.

One thing that sucks about healthcare is that the feedback loops are stupid long. You don’t know if something is working or not for 1-3 years. It’s helpful to see if companies launching big initiatives actually ended up doubling down on them or if they faded into the background. It gives you a sense of what’s real and what’s a PR move.

For example, Brian followed up on Pear and Novartis joint schizophrenia study announced in 2018 and found the 2021 trial results in some weird corner of Novartis’ site. Again, I have 0 idea how he sniffs this out. 

He’s building a pretty interesting database

Exits & Outcomes is building a couple of pretty interesting databases, starting with digital therapeutic reimbursement amounts in Germany and the pipelines for prescription digital therapeutic companies. If you’ve ever had to build prospecting lists for digital therapeutic companies or need benchmark reimbursement pricing, you’ll understand how much time is saved having this in one place. Or if you’ve ever caught yourself in the shower being like “huh I wonder what the German government chose to reimburse a digital therapeutic for agoraphobia”, this will also be helpful.

He looks at the benefits stacks of employers

As someone without a job my only health benefit is free access to peer-to-peer therapy. And my roommates keep telling me to stop bothering them. 

But real companies have actual health benefits packages. Considering how big of a role employers play in healthcare, it’s cool to see which services large companies offer. Specifically it’s interesting to see how they position certain benefits to their employees.

Here’s an example from his breakdown of BorgWarner’s benefits packages. He’s looked at Chevron, Blizzard, 3M, and more. 

MDLive: BorgWarner suggests its employees use MDLive if they would like to talk to a doctor, therapist, psychiatrist, or specialist. The out-of-pocket cost is one of the highest I’ve ever seen for something that is supposedly a benefit to employees: “At under $55/visit, this option provides a cost-effective solution when it comes to care that qualifies for telemedicine.” (That’s obviously a maximum fee — maybe it is that high for certain specialists — so hopefully it’s typically closer to half that.) The company also notes that “Your visit will tie into your deductible and out-of-pocket max for the plan year.” Site

Livongo for Diabetes Management: BorgWarner employees with diabetes have access to Livongo’s diabetes management program at no additional cost. The pitch is Livongo’s standard one: “A $75/month benefit, paid for by your employer or health plan. Unlimited supplies, smart meter and coaching at no cost to you.” Interesting that BorgWarner has no mental health programs on offer outside of virtual visits with providers via MDLive. It also has no hypertension management programs in its benefits — even though Livongo offers both of these in addition to its diabetes management program. Site

The long form reports look at the operational components of a business and how it’s evolved

The Exits & Outcomes reports are long but detailed. Sometimes it’s hard to remember all the different initiatives a company is involved in. These reports show the evolution of businesses over time, startup and shutdowns of different product lines, and in many cases, key metrics surrounding the business. He has a new one coming about Crossover Health soon if you’re interested in direct primary care/onsite health clinics, etc.

I particularly like the Enrollment Report which I’ve quoted frequently in this newsletter. Brian reads all these interviews, pamphlets, etc. to actually show how digital health companies would engage members after signing a contract with a payer or employer. I learned that companies are using napkins as the start of some very intricate drip campaign. That’s information I had no idea I wanted to know, and now constantly stare at napkin dispensers thinking about the unused ad space.

This is the kind of interesting operational detail I’d love to learn about more broadly. How do these healthcare companies actually work on the inside?

Conclusion

Thus concludes my unabashed love letter to Exits & Outcomes. It’s really good healthcare journalism and I think more people should know about it. You should check it out.

Also if his newsletter is funnier than mine, don’t tell me. My confidence will shatter into a million tiny pieces.

Thinkboi out,

Nikhil aka. “healthcare newsletter writers ASSEMMMMBBBBLLLEEEE”

Twitter: @nikillinit

IG: @outofpockethealth


If you’re enjoying the newsletter, do me a solid and shoot this over to a friend or healthcare slack channel and tell them to sign up. The line between unemployment and founder of a startup is traction and whether your parents believe you have a job.

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