Krupa's Back Pages

October 29, 2015

The Breaking Health Podcast

I am hosting a weekly podcast called Breaking Health where I interview the cutting edge CEOs of todays Digital Healthcare companies.  I’ve been fortunate to have a series of excellent guests including Robert Mittendorff of Norwest Ventrues, Dan Burton CEO of Health Catalyst and Steve Wiggins CEO of Remedy Partners.

The podcast is part of Healthegy’s Digital Health Innovation Summit and Breaking Health newsletter, and is produced by Healthegy’s Content Director Tom Salemi.

New interviews will be coming out weekly and I will be posting updates here, on my twitter account (@Steve_Krupa) and on LinkedIn.

Here’s a direct link to the Breaking Health podcast website, and you can also subscribe to the podcast though iTunes.

I hope you get the chance to listen.



October 1, 2014

Psilos Healthcare Outlook Fall 2014

Filed under: Healthcare,Venture Capital — Steve Krupa @ 4:26 pm
Tags: ,

At Psilos we have been predicting the oncoming wave of consumerism in the health insurance market for sometime, and for that matter we have invested behind our beliefs.  But over the last couple of years it occurred to us that it may not be exactly clear what this reality means for insurance companies. This is the subject of this year’s Outlook, titled: A Race to Embrace the Consumer Business Model: Insurance companies must change or face obsolescence.

In our 2011 Outlook we wrote the following:  “Psilos believes that the PPACA [a/k/a Obamacare] will accelerate sweeping changes to consumer-oriented business models and distribution channels, as well as increase the competition among insurance companies… These changes are already beginning to occur, but they will accelerate rapidly post- 2014 [emphasis added], when the number of Americans shopping for their own health insurance will increase exponentially at the expense of the current model, in which most people either have their health insurance provided to them by their employers or simply remain uninsured.”

Post-2014 is now upon us, and it would seem that we are in the midst of much of what we predicted three years ago.

To us the most interesting question for investors in the HCIT and services space is exactly how will insurers adapt to the new reality.  And so this is the focus of our 2014 Outlook.

The fact is that insurers are not set up as a business to service individual consumers, especially the version of the individual consumer that is born from our current information age, where almost any transaction and piece of relevant information is available to us at will, through the internet and on our mobile devices: except of course our health insurance and our healthcare information.  Why?  Because the infrastructure of the industry is not set up to service individual consumers, in large part because those consumers have not historically been a primary customer; however, they are now.

Our report takes a broad Michael Porter-esque view of the insurance company value-chain, which today is set up to service their employer customers, and argues it must be completely re-thought and re-engineered to service individual consumers.  Within these changes lie ripe opportunities for investors, and those insurance companies that successfully establish a value-chain built for the consumer business have the opportunity for material gains in market share and profitability.

You can read through the entirely of our report here.

If you find it interesting, which I think (hope) you will, I would love some feedback.


March 6, 2014

Another Opinion on Digital Health, Mine…

Filed under: Uncategorized — Steve Krupa @ 8:15 pm

A few days ago I was pleased to do an interview with Brian Dolan of mobihealthnews, which served as a basis for his recent article, “Investor Weighs in on Digital Health Startups’ Relevancy.”

Brian gave me the opportunity to talk about some of my favorite digital health companies, including SeeChange, Patient Safe Solutions, Mequilibrium and Glow, in the context of “being immediately relevant.”  What I mean by this is that digital health entrepreneurs cannot count on the same set of forces that propel users toward media-oriented digital applications.  Healthcare has yet to become part of the average consumer’s lifestyle, and until it does there will only be a small number of special applications for modern digital technology and networks.  In the long-term this may change, but the big moment we are facing today is the establishment of a meaningful and hopefully highly competitive individual healthcare insurance market.  As this evolves, digital health will begin to find more applications and more users, because consumers will become engaged in healthcare as their personal responsibility.

Please check out the article, if you get a chance.

February 28, 2014

Companies (Ideas) for the Times: Glow

Filed under: Uncategorized — Steve Krupa @ 5:45 pm
Tags: , ,

One of the promises of big data is better event predictions.  A prediction has a percentage confidence interval, but the outcome is binary, the event either happens or not, as anyone who has gone “all-in” with pocket aces and lost knows.  The win was, however, highly probable.  So what.

Talk to any fertility expert and they will eventually get around to talking about probabilities too.  There is a data model for getting pregnant and Glow is distributing just that to want-to-be parents. Glow is also demonstrating a very practical application for two other modern trends: crowd-funding and the “quantifiable self” (more on this in the future).  Couples pay $50/month to use the Glow application and monitoring system, which provides ongoing predictive information for the ideal times for a couple to attempt to reproduce, among other things (if you click on the website the FAQ section will take you through the necessary data inputs, but body temperature is one of the inputs, for example).  

The $50/month contribution is held in a funding pool.  If a successful pregnancy doesn’t occur within 10 months that couple gets pro-rata funding from the pool to go against the cost of fertility treatment.  How much money is in the funding pool?  All of the money paid in by couples that did succeed in getting pregnant within 10 months.

The bet is that, over time, with more data and experience, the Glow application will give couples better advice and enable a greater percentage of natural pregnancies, leaving more money in the pool to help finance those couples that absolutely need fertility treatments.

Here’s the link.  Please check it out.  I think it’s a very important idea.

February 27, 2014

Mt Gox – Bitcoin / How Bitcoin is Supposed to Work

Filed under: Uncategorized — Steve Krupa @ 2:56 pm
Tags: ,

I have to admit, I am hoping Bitcoin survives its current onslaught of controversy. It’s hard to trust governments, and I find the idea of a borderless currency very intriguing. I am also very curious about the prospect of a technology that allows for services to be built around the concept of programmable money.

I am going to post more on these issues in the future. For right now I thought the attached video would be interesting for those of us looking for insight into the failure of the Mt Gox exchange. After all, as you will see, the intent of the Bitcoin protocols are to make stealing money extremely difficult.

Another take away from this video might be to note how deeply computer science and complex mathematics have penetrated the essential day-to-day activities of our lives.

The prospect of Bitcoin is one of a supply of money and a corresponding anonymous payment system that is controlled by computers and their operators/programmers. Bitcoin’s first value proposition is that it has the potential to be a more reliable store of value than a fiat currency and banking system regulated by a sovereign government.

As you will see, the inter-workings of Bitcoin are very interesting, complex and hard to understand. We are aggressively building modern society around computer technology (including complex mathematical encryption), and to me, this video gives some sense of what that actually might mean.

February 26, 2014

Copying VC’s

Filed under: Uncategorized — Steve Krupa @ 12:17 pm
Tags: , , ,

Here’s an interesting article by Joel Dreyfuss at titled “How to Invest Like a VC in the Hottest Technology”.  I got a little play here for our healthcare investment strategy, and I think it caught Joel’s attention because it definitely is the case that some of the more disruptive technology ideas like SaaS computing and mobile are earning a way into the healthcare industry, where business model and immediate ROI tend to dominate technology purchases.  More to come on this throughout the year as healthcare technology starts to gain mindshare in the press and public market investment community.  

June 21, 2011

The Best of the Big Man

Filed under: Music — Steve Krupa @ 5:04 pm
When the change was made uptown
And the big man joined the band
From the coastline to the city
All the little pretties raise their hands
I’m gonna sit back right easy and laugh
When scooter and the big man bust this city in half…” 

There is little doubt that Clarence Clemons made Bruce Sprinsteen’s music better.  Clemons’ sax funneled Springsteen’s exuberance, creating a unique rock and roll big band sound that was often imitated, particularly by bar bands up and down the Jersey shore, but never replicated.   

Clarence stands equal with the other of my favorite rock and roll saxophonists, the Texan, Bobby Keys, who defined himself on the great Rolling Stones albums of the late 60’s and early 70’s (recall the sax solo in Brown Sugar – that’s Bobby).  Clarence and Bobby growled through their instruments, preferring minimalist melodies focused on tone and emotion to the wild flourishes favored by their jazz counterparts.  For rock and roll and the blues, this sound worked.  It made the songs memorable, rhythmic and big.
My wife and I listened to Bruce Springsteen’s Live Box set on the way back to the city on Father’s Day Sunday night after we learned Clarence had passed.  I really don’t know how the E Street Band can continue without him.  His place on stage next to Bruce will seem so empty.  Clarence was both a player and a showman, akin to his Boss.
In remembrance I offer you my 5 favorite Clarence Clemons tracks, all defining moments in the Springsteen catalog.  You can probably dig them up for a listen on or download them from iTunes, if you don’t have them already.  They are well worth the $0.99.  Enjoy.
5.  Born to Run (on the album Born to Run)
4.  Rosalita (on the album The Wild, The Innocent and the E Street Shuffle)    
3.  Spirit in the Night (on the album Greetings from Asbury Park New Jersey)
2.  Jungleland (on the album Born to Run)
1.  Drive All Night (on the album The River – Disc 2)

June 16, 2011

VC as Stock Picker

Filed under: Finance,Healthcare — Steve Krupa @ 4:17 pm

Many members of my family, and probably some of my close friends, think I am something akin to a stock broker (not that there is anything wrong with that).  In truth, I am on the private investment side of things, often selling investments to public companies, but not actively investing in publicly traded healthcare stocks.

Recently David Whelan, a reporter for Forbes magazine, took an interest in Psilos’ healthcare investment strategy and he asked me to apply that strategy to public company stock selection.

Here is a link to David’s Forbes article that discusses five stock picks, companies that, as David points out, compare nicely to some of Psilos’ private investments.  Invest at your own risk!

May 5, 2011

Psilos Group’s 2011 Outlook on Healthcare Economics & Innovation

Filed under: Finance,Healthcare,Venture Capital — Steve Krupa @ 2:01 pm

It’s been a while since I’ve written, and my excuse is typical, I’ve found any number of work projects overwhelming my time to sit, and write, and blog.  One such project was the composition of Psilos Group’s 2011 Outlook on Healthcare Economics & Innovation, which I put this together with one of my business partners (and awesome blogger) Lisa Suennen (you can check out Lisa’s blog, Venture Valkyrie, here, where she proves to be a much more consistent correspondent than yours truly).

For those of you that come to these pages for the pop-culture commentary (more to come on that too, I promise), you may note that I manage to get a few words in on healthcare and investing, and after all, this is what I spend the majority of my time on.  With that, the Psilos Group report outlines what we see as some of the most significant impacts on healthcare investing of the implementation of the new health reform law.

Chief among these are:

  • The reality that we should expect a doubling, and potentially a tripling of the individual health insurance policy market, which will result in a dramatic shift in the relationship between insurers, employers and consumers.  In many cases, employers will simply stop buying group health insurance, leaving the consumer to directly purchase coverage (partially or fully funded by the employer) on their own through a newly established public or private health insurance exchange.
  • Health insurance plans will have to become superior consumer marketing and service organizations to thrive and survive, acting more like Starbucks or Apple if they are going to expand consumers’ trust in their brands and grow while their sales process evolves from a primarily business-to-business market towards a much larger business-to-consumer market.
  • Health plans will have to proactively manage clinical and financial risk through active care coordination for those with chronic illnesses.  This dovetails with the need for such organizations to make a quantum leap forward in their commitment to utilize modern information technology to change their business dynamics.
  • Provider organizations who seek to become Accountable Care Organizations will have to learn to think and act like next generation insurance companies (financially, clinically, technologically) to avoid becoming a repeat of yesteryear’s physician practice management debacle.

If these subjects are of interest to you, the entire Psilos 2011 Outlook on Healthcare Economics & Innovation can be found by clicking HERE.  Let me know what you think.

February 17, 2011

A Business Chart for Music Fans

With the Grammy’s behind us, I thought music fans might enjoy mulling over this chart, which came to my attention courtesy of Bob Lefsetz, a music industry blogger.  It falls into the “a picture is worth a thousand words” category.  

Revenue from digital music is growing, but not enough to make up for the decline in CD sales, which have fallen precipitously since the advent of digital music.  It looks like the music business should be in a state of emergency, yet new music is everywhere, from what I can tell.

 chart of the day, music industry 1973-2009, feb 2011

Lefsetz’ quote: 

“… the CD was the greatest invention in the history of recorded music”

And he is right, at least in the context of generating profits for the music industry.  Yet, while the gross margins on CD’s were massive, the margins on digital music should be even better.  Afterall the production and distribution costs on digital music are minimal.  Sure, the revenue of the music business is declining, but I wonder where the profits are headed.  Oddly, much of what I have read indicates that profits are headed down, under the theory that piracy of digital music continues to damage profitability.  While I am sure piracy has eaten away at music industry profits over the years, it is also true that modern technology has significantly reduced the production costs for making professionally recorded music.  To me it feels like there is more music, i.e., more artists and albums in a greater variety, than ever before.  If it is in fact the case that record labels cannot turn an outstanding profit under these conditions, the problem is more than likely poor management rather than piracy.

It also feels like music has transformed from a Superstar culture to a more journeyman profession.  We have a lot more music and many more acts, but fewer mega-acts and fewer stars.  And I think that’s okay.  It’s now inexpensive to make and distribute music, allowing anyone with creative impulse and ability to try to build an audience.  The barriers to entry are low, and it seems that a creative revolution should follow.  I definitely look forward to that.

I have posted on some interesting D-I-Y artists in the past, including Bon Iver, Animal Collective and the Brian Jonestown Massacre, and as I find more new acts that make great music outside the power base of the music establishment, I will definitely bring them your way.

In the meantime, as an example of where music might be heading, keep an eye on the new Radiohead album, King of Limbs.  It is coming out on Saturday, in all sorts of formats, released by the band itself.

The King of Limbs

Next Page »

Create a free website or blog at