The Takeaways: Week 11 of 2022

Among other topics, insights about product careers, big questions about care coordination and telemedicine, and (finally) federal guidance on web accessibility.


Ezra Klein (host), The Ezra Klein Show. Timothy Snyder interview (March 15, 2022)

TIM SNYDER: I think time is a really essential component of politics. But it has the feature, like many important ideas, that it seems self-evident or natural to the point of invisibility. So time is a kind of parameter for everything else. The way we think about time just becomes as natural as breathing. But actually the way we think about time is an idea.

Melissa Perri (host), Product Thinking. Episode 57: Carving Out Your Product Career Path With Jocelyn Miller (March 2, 2022)

Jeff Veen (host), Presentable. Episode 118: Emily Tate, The Path to Product Management (October 14, 2021)

Tate outlines three broad categories of product manager:

  • strategic product managers
  • creative product managers
  • execution-oriented product managers

Very, very few managers excel in all three of those. You probably lean toward one. You might have pretty good skill set in this weekend and then you might be weaker on the third.

Within that we need to start to acknowledge that that’s an OK thing. Rather than feeling like -- and typically what ends up happening is whichever you're weaker in, is what you decide is the thing product manager should be good at, and use it as a reason to say "I’m not very good because I can’t do what that person does."


Vicki Boykis, Normcore Tech. With the Feed as my Witness (March 20, 2022)

Putting aside my personal stake in all of this and putting on my professional recsys hat for a minute, what is most remarkable is that Telegram has almost no recommendation or discovery features. Everything is organized how you want it, and every channel is found either through word of mouth, or reading about it on some news site or on Twitter, or in the shares from another Telegram channel, and it is entirely up to you to curate your Telegram experience. This ends up being both a blessing and a curse.

Nikhil Krishnan, Out-of-Pocket. What's The Deal With Telemedicine? (March 14, 2022)

In general, I see telemedicine as a feature of new care delivery companies and necessary for new workflows, but not necessarily a standalone business. We’re already shifting away from the telemedicine businesses that aims to virtualize the inefficient in-person experience. I think our fixation on the number of billable telemedicine visits that have occurred is the wrong way to look at this. Telemedicine used correctly helps enable a better longitudinal patient relationship and better product/user experience that encounter-based billing will never be able to capture.

Olivia Webb, Acute Condition. No one is in charge of care coordination (March 18, 2022)

Given the health system example, what I’m thinking of as open systems is obvious—it’s everything else. Outside of a unified, vertically integrated health system, care coordination is far more complicated. Individual providers, LabCorp/Quest, infusion centers, and smaller hospitals might all have different electronic health record providers, different communications systems, and different interpretations of HIPAA... To share patient information and even begin to coordinate care, all of these entities have to be on the same page, which they’re not. For open systems, care coordination depends far more on partnerships up front, before healthcare leaders can even begin to start working on processes.


Joseph Benitez, PhD, Tradeoffs Research Corner. How Safety Net Programs Work Together To Improve Health (March 15, 2022)

In a recent research summary in the NBER Reporter, researchers Lucie Schmidt, Lara Shore-Sheppard and Tara Watson pull together key findings from multiple studies they’ve done on the interactions among the Supplemental Nutritional Assistance Program (SNAP, formerly known as food stamps), Temporary Assistance for Needy Families (TANF, a cash assistance program), Supplemental Security Income and Social Security Disability Insurance (SSI and SSDI, income support for people with disabilities), the Earned Income Tax Credit and Additional Child Tax Credit (EITC and AITC) and Medicaid.

One really cool way the authors assessed these overlapping programs was by creating a multi-program benefits calculator. This allowed them to estimate the total value of the benefits associated with the combined programs and investigate how they jointly affected the welfare of low-income households. Using this calculator across several studies, they found that households with more benefits have less financial insecurity and psychological distress.

Amy Goldstein, The Washington Post. Millions of vulnerable Americans likely to fall off Medicaid once the federal public health emergency ends (March 14, 2022)

The first coronavirus relief law, in March 2020, offered states a bargain to help them cope with the sudden spurt of Americans losing jobs and health benefits that accompanied the worst public health crisis in a century: The federal government would give states extra money to help pay for Medicaid if they promised not to move anyone off the program as long as the emergency lasted.

Every state accepted the bargain at a moment when few imagined that, two years later, the pandemic — and the public health emergency the Department of Health and Human Services has been renewing every 90 days since the coronavirus’s first winter — would still be present. In that time, Medicaid caseloads have jumped about 22 percent nationally as new people have joined and no one has cycled on and off the rolls. The nearly 78 million Americans on Medicaid as of September, the latest figure available because federal tallies run months behind, are the most since the program began as a shared federal-state responsibility in the 1960s as a pillar of President Lyndon B. Johnson’s War on Poverty.

Dan Michaelson, Fortune. Commentary: The greatest comeback in the history of health care (January 22, 2022)

40th Annual JP Morgan Healthcare Conference themes:

  • Diversifying revenue streams
  • Mergers and acquisitions
  • Investing in innovation
  • Value and risk-based contracts
  • Creating destination centers
  • Deploying virtual care platforms

Katie Palmer, STAT. Doctors often turn to Google Translate to talk to patients. They want a better option (March 16, 2022)

“For a lot of patients who have non-English language preference, what actually happens is either the clinical team doesn’t talk to them, or they use sign language, or they try to mime,” said [Elaine] Khoong [an internist and assistant professor of medicine at the University of California, San Francisco]. Interpretation can be especially scarce in safety net facilities, which often end up paying higher rates for call-in services. And physicians can be reticent to call in an interpreter for anything but the most mission-critical moments in a patient’s stay, like surgical consent, because it can take away precious minutes from their interaction with a patient.

That leaves out many of the small moments that make up a patient’s care. “If you want to ask the patient, ‘Are you cold?’ ‘Open your eyes, take a deep breath,’ the time it can take to prepare for those two sentences can be untenable,” said Won Lee, an anesthesiologist at UCSF who is investigating Google Translate’s accuracy in those interstitial moments of care. Research consistently shows that patients who do not share a language with their provider fare more poorly.

United States Department of Justice, Office of Public Affairs. Justice Department Issues Web Accessibility Guidance Under the Americans with Disabilities Act (March 18, 2022)

The Department of Justice published guidance today on web accessibility and the Americans with Disabilities Act (ADA). It explains how state and local governments (entities covered by ADA Title II) and businesses open to the public (entities covered by ADA Title III) can make sure their websites are accessible to people with disabilities in line with the ADA’s requirements.

The guidance discusses a range of topics, including the importance of web accessibility, barriers that inaccessible websites create for some people with disabilities, when the ADA requires web content to be accessible, tips on making web content accessible and other information and resources. The guidance offers plain language and user-friendly explanations to ensure that it can be followed by people without a legal or technical background.

Dan Weissman, KHN. How to Avoid Surprise Bills — And the Pitfalls in the New Law (March 16, 2022)

Beware the “Surprise Billing Protection Form.” Out-of-network providers may present patients with a form addressing their protections from unexpected bills, labeled “Surprise Billing Protection Form." Signing it waives those protections and instead consents to treatment at out-of-network rates.