Neil Machhar

CEO @greenbrookmedical | @stanfordGSB dropout, former @patientping, @mckinsey, @berkshirepartners

[Neil Machhar @MachharNeil]

Excited to introduce Greenbrook Medical and our joint venture with @TGHCares to build a high-touch, personalized primary care experience for seniors across Tampa Bay. @RajMachharMD

https://t.co/NZq7sLblGK

[Neil Machhar @MachharNeil]

@GrantHesser @jdesai01 sounds a bit like what you described to me a few years back, no?

[Neil Machhar @MachharNeil]

@GrantHesser Yeah agreed. Even if they’re right on the long term play, won’t come without its scars… have to be feeling pretty good about your decisions if you’re HUM right now

[Neil Machhar @MachharNeil]

@GrantHesser Is this short term pain for long term gain? They took a bunch of share. Those members were the ones that others gave up b/c they were unprofitable markets - under coded, under managed. But UNH should be able to manage better. Surprised this isn’t a more strategic story from mgmt

[Neil Machhar @MachharNeil]

@GrantHesser Is 2025 United just 2024 Aetna? Bought the market and are getting punished for it now? Seems like this is all a predictable side effect of all their share gains this year. I was shocked they didn’t seem to cut benefits as hard as HUM

[Neil Machhar @MachharNeil]

@GrantHesser @dvasishtha Yeah I think we’re saying the same thing. Before HCC-based risk adjustment, the methods used weren’t really that good. I didn’t know about PIPDCG though

[Neil Machhar @MachharNeil]

@GrantHesser @dvasishtha Well not always. But before HCC-based risk adjustment you had tons of adverse selection in MA. So it serves a purpose, and one that we can all likely agree is good. But most likely ran too hot for a while. I’d still argue a net good, as it drove lots of attention and investment

[Neil Machhar @MachharNeil]

@dvasishtha Was there an announcement? Or just seeing people you know?

[Neil Machhar @MachharNeil]

@chrissyfarr @khakrish

[Neil Machhar @MachharNeil]

@dvasishtha Homecare Homebase spun out of Encompass Home Health

[Neil Machhar @MachharNeil]

@nikillinit Prob applies to most journalism

[Neil Machhar @MachharNeil]

@dp_oneill @cwhogg @HillPhysicians @SCANHealthPlan Yeah there’s plenty of this in Florida too

[Neil Machhar @MachharNeil]

@khakrish 🫡

[Jay Rughani @JayRughani]

We @a16z are excited to announce our investment into @CounselHealth, as they offer consumers 24/7 access to personalized medical advice from expert physicians within minutes.

In a world where we can call a (driverless!) car, order a meal, and pay a friend -- all with a tap and a swipe on our phone -- we expect to find reliable medical answers about our health just as easily. It is no surprise that, today, the fastest-growing care setting isn’t the hospital or the home, it’s the mobile phone.

However, our healthcare system is under tremendous strain. Wait times to see a doctor in many cities can exceed 40 days, while patient messages for medical advice have increased sixfold in the past decade. Doctors deal with increasing information overload at the point of care, leading to worsening burnout, growing labor shortages, and greater barriers to accessing care.

Counsel Health is building a national medical practice that provides everyone unlimited, 24/7 access to personalized medical advice from expert physicians. Their solution is to go upstream of the problem: by providing the appropriate clinical expertise to patients right away, before they are bounced around the healthcare system, Counsel can prevent unnecessary medical expenses and avoidable stress. Under the hood, Counsel does this sustainably by empowering their clinicians with “Ironman suits for doctors” -- specialized medical co-pilots through which they leverage the collective knowledge of the best of their peers and multiply their patient reach well beyond traditional medical practices.

@malagappan, along with @justinyu__, @khakrish, and the rest of the Counsel team together bring a rare combination of experiences building AI systems, scaling healthcare operations, and delivering patient care with which to design a new care model for a post-large-language-model world.

We are thrilled to lead Counsel’s seed financing, alongside our friends at Asymmetric, Floodgate, PearVC, FYSK, and many more.

Thanks to Counsel, we’re closer to a future in which everyone can feel like they have “a doctor in the family”.

@a16zBioHealth, @julesyoo, @sk_leung, @rajko_rad, @liubowen16

[Neil Machhar @MachharNeil]

With v28, lower benchmark rate increases, and stars headwinds, CMS is pulling lots of money out of MA. Benefits are already on their way down - wouldn’t be surprised if we see a material slowdown in enrollment. Especially if they expand trad Medicare benefits alongside this

[Neil Machhar @MachharNeil]

@JayRughani @VivHo @khakrish 🫡

[Neil Machhar @MachharNeil]

@dp_oneill @dreece11 @HBSMemphis Will wait for data on national picture, but in South Florida we’re seeing huge reductions in benefits. Premiums stable but supplemental benefits down big in 2025. But that’s also one of the most mature and benefit-rich markets in the country, so maybe an outlier

[Neil Machhar @MachharNeil]

@B_Madden4 Ah makes sense. Forgot about the JV with WCAS

[Neil Machhar @MachharNeil]

Would say this is the end of the retail health experiment, but CVS presses on and Humana trying their hand at Walmart locations now too 🤔

https://t.co/ACro73Nwwj via @healthcaredive

[Neil Machhar @MachharNeil]

@dp_oneill @sacjai Yeah that’s what MA was before MRA. Risk adjustment + a focus on more direct metrics that actually measure success feels like the right balance