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Anthony Wood, founder and chief executive officer of Roku Inc.
David Paul Morris | Bloomberg | Getty Images

Roku co-founder and CEO Anthony Wood worked at Netflix in 2007, but he says his company’s cultural similarities to the streaming giant are mostly coincidental.

“The culture at Roku was the same before I worked at Netflix,” Wood said in an interview. “Just similar philosophies.”

Netflix and Roku have culture documents in which theyliken themselves to sports teams.

“Working at Roku is like being part of a professional sports team,” Wood wrote in a 2015 document that every employee receives. “We put extreme care into recruiting the best people; we pay well in a competitive market; encourage excellent teamwork, and expect everyone to perform at a high level.”

One former executive said every job at Roku is like being a “field goal kicker,” where employees are expected to accomplish specific, detailed goals. Some employees thrive under the pressure. If they can’t, they won’t be there long.

“We expect you to do a good job,” Wood said. “If you don’t do a good job, you’re going to get fired eventually.”

Wood and Netflix CEO Reed Hastings point to their cultures as a reason for their companies’ success. But both cultures can also lead to an environment of fear and confusion — though for different reasons.

At Netflix, as The Wall Street Journal explained in a 2018 story, employees formally review each other, giving blunt feedback to bosses and underlings alike. Workers “sunshine” errors, offering up public apologies and acknowledgments of failures.

“We expect you to do a good job. If you don’t do a good job, you’re going to get fired eventually.”
Anthony Wood
CEO, Roku

In contrast, Roku doesn’t give any performance reviews at all. Wood has also made the unusual decision of paying employees based on a market rate rather than giving raises tied to internal performance. That’s irritated some younger employees who have expected a perfunctory raise every year at performance review time, said Wood.

“We have a lot of younger employees now, and they are very focused on getting raises,” Wood said. “You know, I’ve been here a year, I should get a raise. And, you might not get a raise. Or you might. It just depends on what we think the rate is for you. Sometimes they understand and adapt, sometimes they don’t understand, and they quit and then they post on Glassdoor. So, it’s a bit of a cultural mismatch.”

Anthony Wood
David Orrell | CNBC

It can be difficult to figure out market rate, Wood acknowledged, especially because California and New York state laws prohibit asking employees how much they’re getting paid. But Roku can glean competitive salaries because it knows what it needs to pay to poach employees from other companies, Wood said.

Excelling in ambiguity

Annual reviews aren’t necessary because employees should be getting real-time feedback, Wood said.

“The work is hard, but it is also rewarding, and I am given a lot of autonomy,” said Taylor Yanez, a Roku engineer. “We don’t do annual reviews, which are a huge time suck.”

But while Yanez said he was given instant feedback by peers, seven former Roku employees who left in the last 18 months said they felt confused by Roku’s culture. They spoke with CNBC on condition of anonymity, either because they feared potential backlash or because contractual language in their severance packages forbids speaking about their firings.

“I literally don’t know why I was fired,” said one recently departed manager. “It’s the strangest place I’ve ever worked.”

Former employees said while they were assigned specific tasks, bosses evaluated them on different metrics because goals frequently changed as Roku grew. In addition to no performance reviews, Roku has very little hierarchy— almost all Roku engineers are called “senior software engineers,” regardless of tenure or role. Mix in a recent surge of new employees — Roku has increased headcount almost threefold, to more than 1,900 employees, since its 2017 IPO — and the result can be confusing.

Several ex-Roku employees said their bosses told them that working in ambiguous settings was part of the job. That runs counter to the Roku culture document, which claims, “Roku teams communicate clearly, in real time with each other and with other teams across the company. Plans, milestones, and strategic context are broadly known.”

“There’s no formal training,” said one mid-level executive, “At Roku, finding information is on you.”

Roku is trying to improve some of its organizational infrastructure as it grows, including formalizing an internship orientation for the first time this year, two of the people said.

“We compete to attract and retain the best talent anywhere and treat people like adults,” a Roku spokesperson said. “We provide onboarding and training for new and existing employees and seek those who are particularly resourceful, innovative, and self-sufficient. And we have a culture of real-time feedback, which has been remarkably successful.”

Netflix with a twist

Netflix and Roku offer unlimited vacation time, giving employees the right to dictate their own schedules as long as they can get their work done. Both have purposefully flat organizational structures, deemphasizing titles and hierarchy.

But unlike Netflix and other large technology companies, Roku offers few external employee perks, such as on-site day care, daily free catered lunches, inexpensive health plans or extensive personal wellness benefits. Roku doesn’t even match 401(k) contributions.

Instead, Wood has chosen to funnel that money into workers’ salaries, believing employees should be in charge of how they spend their money. Every past and present Roku employee who spoke with CNBC said the company compensated at or beyond their expectations. It pays a base salary and grants restricted stock units, though it doesn’t give bonuses.

Given the stock’s performance, it’s easy to see why employees have been eager to stick with the company. Roku shares have gained about 2,000% since the company’s IPO.

Roku’s senior leadership website page also illustrates a lack of diversity — including no women. That will change soon. Wood said Roku just announced a new head of human resources, Kamilah Mitchell-Thomas, previously Dow Jones’ chief people officer, who will replace current HR leader Troy Fenner. Roku’s board does have three women of nine members.

But Wood said diversity for diversity’s sake won’t dictate whom he hires.

“My focus is hiring the best people I can find,” Wood said.

Wood said he meets weekly with an executive coach, Dave Krall, who was Roku’s president and chief operating officer in 2010 and, before that, CEO of Avid Technology. He defines his leadership as hiring the right people and allowing them the freedom to do their job.

“The leadership a company needs changes as it grows,” Wood said. “When you’re 15 or 20 people, I’m the product leader at that point. As it gets bigger and you hire more senior people, you don’t have to do that anymore and they don’t want you to do that, because that’s their job. I used to do our product road map. I don’t do that anymore. These days, we have new initiatives. Pushing us into new business areas and expanding our businesses are where I’m hands-on today.”

WATCH: There’s a lot of room to keep growing in the streaming business: Roku CEO

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Telcos are barely done rolling out 5G networks — and they’re already talking about ‘5.5G’




Telcos are barely done rolling out 5G networks — and they're already talking about '5.5G'

You probably remember mobile operators raving about the promise of 5G several years ago. Now, they’re getting excited about a new upgrade: 5G Advanced.

Angel Garcia | Bloomberg | Getty Images

BARCELONA, Spain — Telecom operators haven’t yet finished rolling out 5G wireless mobile networks. And yet bosses of major carriers are already talking about building something called “5.5G,” or “5G Advanced.”

There was a lot of chatter about 5.5G at the Mobile World Congress tech trade show in Barcelona, Spain.

MWC brought together thousands of people in the mobile industry, including from leading telecom companies like Deutsche Telekom, Orange, Telefonica, BT, and Vodafone.

At the show, executives from some of these companies that they were working toward rolling out a new generation of mobile internet.

That would enable even more advanced applications than the data-intensive apps we’ve all come to use today, such as Facebook, Instagram, YouTube, Netflix, and TikTok.

These apps are already well served by the current mobile internet, but in the future 5.5G is expected to power more advanced applications.

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That includes mixed reality headsets, which are getting more and more powerful with tech giants like Apple launching its Apple Vision Pro and Meta upgrading with its Meta Quest Pro headset last year.

But it also means some of the things that 5G promised us years ago, such as self-driving cars, unpiloted air taxis, and smart manufacturing enabled via the so-called internet of things (IoT), will start to become a reality, too.

What is 5G?

5G is the next generation of mobile internet after 4G, which promises superfast data speeds and better coverage.

You probably remember mobile network operators raving about the promise of 5G several years ago. Carriers in China, South Korea, the United States, and Europe, properly got underway with launches of 5G networks in 2019.

Now, nearly five years on, penetration of 5G among consumers remains low.

The number of consumers with a 5G connection is increasing. But it’s still well below “mainstream” levels.

5G has been the fastest mobile generation rollout to date, surpassing 1 billion connections by the end of 2022, rising to 1.6 billion connections at the end of 2023 and 5.5 billion by 2030.

5G connections are expected to represent more than half (51%) of mobile connections by 2029, though, and that is forecast to then rise 56% by 2030. Those numbers are up to date as of January 2024, GSMAi said.

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5G has been positioned by the telecoms industry not just as a consumer product for faster download speeds, but as a network that could underpin new technologies like driverless cars or unpiloted air taxis.

That’s because it has lower latency than 4G. That means the time it takes for devices to talk to each other is significantly reduced, a feature important in scenarios where data needs to be delivered quickly.

However, after hundreds of billions of dollars of investment into 5G networks, carriers have struggled to see the return. Analysts say that the real potential to monetize 5G might be on the horizon.

What’s ‘5.5G,’ and why are telcos talking about it?

5G Advanced, or the name for the next stage of 5G, is the next evolution of mobile networks.

Telecommunications networks require standards. These are globally accepted technical rules that define how a technology works and its interoperability around the world — interoperability is the ability for two or more systems to work together.

These standards take several years to come up with and finalize and involve several players from companies to academics and industry bodies.

The standards-setting body 3GPP, which contributed to 5G, uses a system of parallel “releases” to provide developers with a platform to implement new features at a given point and then allow more functionality to come in further releases.

In the 3GPP releases system, 5G is considered release 17. That means 5.5G is dubbed “release 18” by the industry.

Release 19 is what will effectively be 6G, another major network upgrade. Work is also underway on 6G standards, but it’s still in the early stages.

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“Main priorities for developing 5G Advanced standards are to increase commercial relevance of 5G by expanding vertical markets, resolve deployment issues, and continue technology evolution to build a bridge towards 6G,” Milind Kulkarni, vice president and head of InterDigital’s wireless labs, told CNBC.

“Research in standards have introduced, improved, and finalized several new enterprise-specific features for 5G Advanced, including network slicing, the integration of private and public networks, enhanced positioning, and even applications specific to each enterprise vertical.”

Howard Watson, the chief technology officer of British telco giant BT, said that 5.5G will promise faster uplink speeds, meaning you’ll be able to stream video, post things online, and play multiplayer games, much faster than before.

“My children’s generation, or even dare I say it, my grandchild’s generation … that generation, they share a lot. And clearly, sharing requires quite a lot of upstream,” Watson told CNBC on the sidelines of MWC. “There will probably be a doubling of upstream capacities coming in release 18.”

Further benefits to 5G Advanced over current 5G, telco execs say, is that it will make the networks themselves more “intelligent” through the application of AI and machine learning, while also boosting performance and reducing overall power consumption.

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Mats Granryd, director general of the GSMA, told CNBC he hopes the industry can continue focusing on staying in a 5G environment for years to come, as there’s still plenty of work to be done on monetization.

“I hope that we can stay in 5G territory for long, because normally in the 4G environment, you and I were the consumers. And it’s quite quick for us to just say, change a SIM card,” Granryd told CNBC’s Karen Tso. “In 5G, 5G is a technology standard that is predominantly towards business to business. And it takes a longer time for businesses to convert and use new technology.”

“This normal of 10 years between standards, I wonder if that’s going to be enough,” Granryd added. “We hope that we can stay in a 5G environment. 5G advanced — 5G standalone, that’s absolutely fine. But push out the time and make sure that we have enough mileage to capitalize and monetize and show the world that 5G is a fantastic technology.”

With 5G Advanced, telecoms firms could start to make more money from their 5G rollouts by charging higher prices. And, with a key focus of 5G being enterprise applications, that could be a much more significant money maker for network operators than consumers.

Telcos haven’t yet revealed how much more a 5G Advanced data plan will cost compared with 5G. But analysts expect they’ll look to make money from 5G Advanced by getting clever about subscriptions and using AI and other technologies to operate their networks more efficiently.

With a key focus of 5G being enterprise applications, that could be a much more significant money maker for network operators than consumers.

The telco industry has been awash with talk about so-called “private 5G” networks, nonpublic mobile networks that are installed on-premise at companies’ work sites for example, in a smart factory, or remote surgery operation.

When will 5G Advanced be here?

Chinese telecommunications equipment supplier Huawei expects 2024 to be the year that commercial deployments of 5G Advanced officially begin. For Huawei, 5.5G is a network that will be capable of 10 Gbps downlink speeds — and in case you’re wondering, yes, that is very fast.

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Huawei revealed eight 5.5G “innovation practices” last week which it says will help operators build 5.5G networks across all frequency bands. The company is working with carriers in the Middle East, Europe, Asia Pacific, and Latin America to deploy 5.5G.

It’s going to take some convincing for consumers to go from 5G to 5G Advanced, given the little noticeable improvement they’ve seen from their phones upgrading to 5G in the past five years. But Philip Song, Huawei’s chief marketing officer of the carrier business group, said that it’s important telcos convey the use cases of 5G Advanced to consumers well.

“The most important thing for us is how can we support the customers,” he said at a press briefing last Tuesday, in response to a CNBC question. The “biggest success” for 5.5G will only arrive if carriers “acknowledge solutions” and bring that across to customers sufficiently.

In some markets, operators are still working on deploying 4G, Song said — but he doesn’t think that matters because different parts of the world “are at different stages.”

Watson told CNBC that he thinks 5G Advanced will arrive on the EE network later this year. That’s because the 3GPP standard release 18, or 5.5G, is already open for experimentation and telcos have been working on trials. It is expected to conclude by June 2024, by which time the protocols that enable 5.5G should be stable.

“Release 18 we will start to roll out this year,” Watson told CNBC. “We also plan to launch 5G standalone this year as well.”

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5G standalone is different from 5G Advanced. Sometimes referred to as “true” 5G, it refers to the development of a 5G network that uses technology independent of 4G and comes with the promise of realizing 5G’s full potential.

5G Advanced, on the other hand, is a complete evolution of the network.

There’s no definitive date for when 5G Advanced will start to be rolled out, though. And telcos are on the clock to get it up and running.

“I hope that we will be at the bandwidth, the latency, the capability needs to be sufficient,” Mats Granryd, director general of the GSMA, told CNBC’s Karen Tso at MWC last week.

“That’s what we’re struggling with to see in Europe. In five years, we’re going to have a quadrupling of data usage. And I am really concerned about what’s going to happen at that stage.”

“Will we have cut-offs? Will we have congestions?” he added. “Will we have a much much worse situation, a much worse landscape? By having that worse landscape, the competitiveness of Europe will go down.”

— CNBC’s Arjun Kharpal contributed to this report

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College AI degree programs are booming. Are they worth the cost?




College AI degree programs are booming. Are they worth the cost?

Ute Grabowsky | Photothek | Getty Images

Computer science is not a new major at top schools, but with AI jobs in high-demand, there’s a growing list of colleges and universities offering a four-year “AI” degree specifically.

These programs generally move beyond the foundations of computer science to home in on topics such as machine learning, computing algorithms, data analytics and advanced robotics. The University of Pennsylvania recently announced that its B.S.E. in Artificial Intelligence program will begin in fall 2024. Carnegie Mellon introduced a program well before gen AI was a buzzword, in fall 2018, and MIT’s program began in fall 2022. Purdue University offers an AI undergraduate major, while many colleges and universities offer AI classes within their computer science department, even if there’s not a dedicated major.

The rise of AI-specific degree programs comes as companies are short on talent for this fast-developing field. Half of the highest-paid skills in technology are AI-specific, according to the employment website Even so, there’s some degree of skepticism about the applicability of an AI-specific four-year degree given how quickly the technology is changing. But proponents say that as long as a program is steeped in computer science and other fundamentals, a focus on AI could provide a resume-building boon.

Here’s what students and their parents, as well as anyone thinking about going back to school for a new career, needs to know about a four-year AI degree:

STEM fundamentals remain critical

Students that want to pursue a degree in AI should look for a program that teaches fundamental information such as computer science concepts, statistics, mathematics and engineering, which lay the foundation for a career in an AI-related field, said Kerem Koca, chief executive of BlueCloud, a cloud service provider. The technology itself is changing, but these core underpinnings do not, and they can prepare students to be successful, even as underlying technology changes, he said.

“It’s important that AI degrees and other education training programs not only focus on specific skill development, but that the focus is on helping students learn how to learn, which includes developing an intellectual curiosity, and skills like leadership, communication and critical thinking,” said Maria Flynn, president and chief executive of Jobs for the Future, an organization that focuses on worker opportunity and education, in an email.

AI degree spike since 2011

There are a number of different programs that focus on AI at the undergraduate and graduate level, and there has been an increase in offerings and degrees being awarded for over a decade now.

According to the Georgetown University Center for Security and Emerging Technology, AI degrees have bucked the general trend in education since 2011, with positive degree conferral growth versus negative growth across all degree areas. AI-related degree awards, in particular, grew even faster than STEM degrees as a general category at bachelor’s master’s and PhD levels. Its review of government data and other sources on the higher education market described the growth of AI degree conferrals as “dramatic,” increasing 120% since 2011 at both bachelor’s and master’s levels.

Some students might also be interested in pursuing AI as an associate’s degree, which several schools, including Miami Dade College, offer.

Education relevance in fast-changing tech market

Some students may wonder if they even need a degree at all, given how fast the market is changing and the fact that more employers have expressed a willingness to hire workers without degrees if they have the appropriate, job-required skills.

It’s important to note that recent research suggests the practice of hiring people without degrees has fallen short, however, and research from the Ladders career site shows that a degree is still required for the highest paying jobs, a list that includes software engineers.

A four-year degree is still a big step up for most entering the job market for the first time, said Celeste Grupman, chief executive of Dataquest, which supplies AI-related educational materials and labs to universities. “It’s still one of the first things an employer is going to look at. It’s not going to get you disqualified, whereas not having one might.” 

Even so, several providers including Dataquest and Coursera, offer certificate programs for learners to build skills quickly. These programs may be appropriate for students who lack the time and resources to complete a four-year program, or already have a degree and are looking to upskill, Grupman said. An online platform allows students to quickly start building projects and understanding how to implement these tools successfully for employment purposes.

AI vs. computer science

It’s important for students to think critically about the curriculum for the program they are considering, how it’s different from a standard computer science curriculum, the likely career trajectory for graduates of the program and economic outcomes for graduates. “As we see in product marketing, anyone can slap ‘AI’ onto an existing product. Students should ask what aspects of AI they will be learning,” Flynn said.

It’s also important for students to carefully consider what they want. Are they looking for a program that provides exposure to AI or practice using AI, or do they want a technical program that provides foundational content and courses on AI technology? They should also consider whether they ultimately want relevant skills and knowledge that will get them into the labor market right now or whether they want a broader degree that will be a foundation for longer-term advancement, Flynn said.

“If you’re an architect, you don’t want a degree in hammers. You want to understand hammers, you want to understand zoning and you want to understand how to build a house that helps a family come alive. The same is true in AI,” said Nichol Bradford, artificial intelligence and human intelligence executive-in-residence with SHRM, an organization for human resources professionals.

How to gain an edge with employers

Some employers may look more favorably upon an AI-specific degree versus a plain-vanilla computer science degree, said David Leighton, chief executive at WITI, an organization for technology-minded professionals. “I think it sets them apart.” 

On the other hand, no one really knows right now what the value of such a degree will be in a few years. “In the year 2000, if you had an internet degree, if there was such a thing, it would have looked great,” Koca said. “Now, it wouldn’t be as applicable. But if you had it in 2002, you could have gotten a job anywhere. The same could be true for a degree in AI.” 

Given the uncertainty, some professionals said students can’t go wrong with a traditional computer science degree or an AI-specific one, provided the fundamentals are covered. Those who take the former route, however, should consider taking classes related to AI and data science, which can be important for future employment. Otherwise, students might need to “close the practical application gap themselves post-graduation,” said Bryan Ackermann, head of AI strategy and transformation at the management consultancy Korn Ferry, in an email.

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Venture capital firm’s plan to buy nonprofit hospital system has Ohio community on edge




Venture capital firm's plan to buy nonprofit hospital system has Ohio community on edge

Dr. Marc Harrison, who’s now CEO of HATCo, speaking at the Healthy Returns conference in New York City on May 21, 2019.

Astrid Stawiarz | CNBC

Dr. Marc Harrison is a different kind of venture capitalist.

He’s not looking for the next Mark Zuckerberg or Elon Musk. He’s not hanging out at startup demo days. He’s definitely not posting life advice screeds to founders on X. (He hardly posts at all.)

Far removed from the internet hub of Silicon Valley, Harrison went to medical school in the late 1980s and has spent the bulk of the past two decades at the upper ranks of medical systems, most recently as CEO of Intermountain Healthcare, a Utah-based nonprofit with 33 hospitals and over 63,000 employees.

In late 2022, Harrison joined venture firm General Catalyst, which has backed tech highfliers like Stripe, Snap and Airbnb. But the move to VC from health care hardly represented a career change.

In January, General Catalyst announced it was buying Summa Health, a nonprofit integrated health system that supports more than 1,000 inpatient beds across its network of hospitals, community-based health centers and its multi-specialty group practice. Summa operates across five counties in northeast Ohio and also runs a health insurance entity. 

Under its new structure, Summa will become a for-profit organization, and General Catalyst says it will introduce new tech-enabled solutions that aim to make care more accessible and affordable.

General Catalyst set the stage for the deal when it brought in Harrison and, a year later, introduced a new company called the Health Assurance Transformation Corporation, or HATCo, that would operate on a “decades-long time horizon.” Harrison was named HATCo CEO, and is now in charge of overseeing its work with Summa.

“This is the first time that anybody has done anything quite like this,” Harrison, 60, told CNBC in an interview. “There are many digital health solutions that are out there as point solutions. This is the first holistic transformation of a health system to a thoughtful combination of digital and in-person care.”

The deal isn’t done.

Over the next several months, HATCo and Summa will engage in a due diligence period, work to craft a definitive agreement and begin to map out the specific challenges they hope to tackle. In the latter half of the year, the transaction will go through the regulatory approval process. 

The parties declined to share specific financial details about the acquisition with CNBC, but HATCo wants to make clear that this isn’t just “another ‘private equity’ deal,” Harrison wrote in a statement. By that, he means the objective isn’t to overhaul Summa by cutting costs. 

Summa Health Medina Medical Center

Courtesy: Summa Health

History in health care

While buying a hospital is an unprecedented move in the venture industry, where firms rake in big piles of money from institutional investors and seek to outperform the market, General Catalyst has a rich history in the broader health-care sector.

The 24-year-old firm has closed the most deals in digital health since 2020, according to data from PitchBook. Its portfolio companies in the space include insurer Oscar and digital health company Livongo, which was acquired by Teladoc almost four years ago.

Hospitals are different though, and many are nonprofits for a reason. Providing health care is expensive, and reimbursement rates can vary dramatically. With patients shouldering so much of the load, a study last year by the Urban Institute found that 73% of adults with medical debt owe hospitals at least some of that money. 

An October report from Fitch Ratings said labor costs “remain stubbornly high,” and that controlling these expenses will be crucial if nonprofit hospitals want to reduce credit pressure and deliver stronger margins. 

Conditions are not likely to change overnight.

“We expect weak margins to persist through 2023 and into 2024 due to an inelastic revenue model and higher labor costs due to still very tight labor conditions,” Fitch said. 

General Catalyst says it wants Summa to serve as a “blueprint” that shows other health systems how delivering better care for patients can also be “good for business.”

Experts like Ceci Connolly have concerns. Connolly, CEO of the Alliance of Community Health Plans, which represents nonprofit provider-aligned regional health plans, said she’s excited to see if the deal presents a new approach that can address some of the problems in health care. She’s just not sure how it will work.

“I would be lying if I didn’t say it gives me a little bit of pause that you are going to take a nonprofit, community-based health-care entity, and now have it answering to investors and needing to generate profits,” Connolly said. 

Connolly’s viewpoint makes sense. Limited partners — the endowments, sovereign wealth funds and pensions systems that put money into venture capital — look to the asset class as a bet on innovation in tech. It’s where billions can get minted on a single lucky bet.

“A lot of people feel like a PE or venture capital company owning a hospital is kind of like asking Freddy Krueger to come babysit your kids,” said John Bass, CEO of the health-care venture studio Hashed Health. “It just makes people a little nervous, and it doesn’t feel quite aligned with this concept of health care being a human right.”

Still, Bass said he’s “thrilled” to see General Catalyst take big swings in health-care innovation, given all the challenges the industry faces.

The venture capital model has broken down over the last two years, says advisor

HATCo is capitalized outside of General Catalyst’s funds structure. It operates as a holding company within General Catalyst and is completely independent from its venture business, the firm says, though it will collaborate with the investment team. 

General Catalyst said HATCo is not designed to realize returns through increases in volume-based revenue or cost cutting. Instead, it will work to generate new revenue streams by introducing new solutions and models of care.

Chris Bischoff has been leading General Catalyst’s health investments since 2021. The firm has been in the space for more than a decade, and Bischoff said it’s come to view the health-care business as having two distinct but interrelated parts. 

The first is the “innovation side,” or the more traditional venture business, where General Catalyst works with entrepreneurs to create and scale new solutions. The second is the “transformation side,” which now includes HATCo. The goal there is to partner with health systems to try and speed up delivery and roll out new tools. 

“We see a really powerful flywheel between the two,” Bischoff told CNBC in an interview. 

Chris Bischoff speaks at Slush 2023.

Courtesy of General Catalyst

General Catalyst has teamed up with more than 20 health systems across the U.S., Canada, the U.K. and Israel as part of its transformation business. The partnerships are designed to share best practices and encourage collaboration. Bischoff said they help reduce friction when it comes to tech deployment, eliminating the need for a bunch of third parties to get involved. 

Some partners include HCA Healthcare, University of California Davis Health and Intermountain Healthcare, Harrison’s former employer. In a book published last year about his work at Intermountain, Harrison wrote that General Catalyst was helping the hospital build a new marketplace, much like the App Store, for health care.

“Think of it this way: Major airlines don’t build their own air-planes,” he wrote. “They work with a range of partners to help them deliver their offerings. To revolutionize how we care for patients, we in health care are doing the same.”

The matter is personal for Harrison.

In 2009, he was diagnosed with bladder cancer, which was remedied thanks to “aggressive surgical treatment,” Harrison wrote in his book.

But almost a decade later, he was diagnosed with multiple myeloma, a form of blood cancer, and things looked dire. After a failed bone marrow transplant, Harrison said he “scrambled” and tried a novel immunotherapy that eventually helped him get his condition under control.

“I don’t know how long this treatment and others I might try will contain my disease, so I’m not wasting a minute,” Harrison wrote.

If his athletic accomplishments are any indication, Harrison isn’t one to back down from a grueling fight. He’s a nine-time Ironman participant who represented the U.S. in 2014 at the world triathlon championship.

‘There’s a lot of unused capacity’

Michael Greeley, co-founder and general partner at the health tech VC firm Flare Capital Partners, said the health-care provider world is in “acute distress” as many organizations are trying to operate on “razor thin profit margins.”

“There’s a lot of unused capacity, like beds that are empty, because they literally don’t have the labor to clean the rooms,” Greeley told CNBC in an interview. “It’s a high fixed-costs business that, if you can’t drive the volume through it, you’re gonna lose money.”

On its FAQ page about the acquisition, Summa said it’s in “sound financial standing” and on track to meet its targets. The organization reported $1.79 billion in revenue in 2022, up from $1.67 billion in 2021, according to Summa’s annual reports. 

However, the organization said it would have a limited capacity to invest in growth or other improvements within its existing structure since challenges like supply costs will continue to hurt its bottom line.

Summa had been on the market for a partner since 2018. The next year it announced plans to merge with the Michigan-based system Beaumont Health. The organizations reached a definitive agreement that December, but Beaumont, now Corewell Health, suddenly pulled out months later without offering a public explanation. 

Summa Health System – Akron Campus

Courtesy: Summa Health

Dr. Cliff Deveny, Summa’s CEO, said that in the years that followed, the organization hadn’t been able to find a health system with adequate digital health resources and technological ambitions, especially since many large providers are contending with similar financial constraints. 

“We had been on about a 10-year journey of growing, but not really making the transformational changes in and how we run our business,” Deveny told CNBC in an interview. “We saw this as a way to really pivot and change how we provide care.”

HATCo set its sights on Summa after scanning the broader health-care environment. Harrison said he was fortunate to meet Deveny early in the search.

Summa’s executive leadership team will remain intact, and the organization says it will continue to provide the same services to patients and the greater community. 

Harrison said the executives will have to remain careful and rigorous about managing traditional operations, but that they will now have additional “money, time, people, technology.”

“This is not like a turnaround, this is not a distressed system,” Harrison said. “This is an excellent system that has weathered maybe the most difficult time in health care that anybody’s ever experienced, and they’ve done it well. And now they’re ready to go to the next level.”

HATCo said its primary objective is to bring sustainable and agile innovation to Summa, particularly through the introduction of new platforms and tech solutions. The organization will also transition to what’s known as a value-based care model, which incentivizes preventative care and keeping patients healthy as opposed to charging fees for services like appointments and procedures. 

It’s an expensive undertaking, and aligning insurance payers, clinicians and patients behind a value-based care model is often easier said than done.

Harrison said HATCo will likely use tech solutions from some of General Catalyst’s portfolio companies, as well as from others. The tech companies HATCo taps will be on the mature side, not early-stage startups, he added.

Ben Sutton, Summa’s operating chief, said the two organizations are also still evaluating what introducing new technologies will look like in practice. 

“We want to build it from the ground up,” Sutton told CNBC. “We really want to make sure that we’re tailoring those solutions to the challenges that we’re having here in Akron and in the region that we serve, and make sure that we’re implementing things that are most impactful immediately.”

Additionally, Summa will no longer operate as a nonprofit system. Summa said on its website it will start a new community foundation in order to maintain its commitment to charity care, but the Summa Health Foundation will no longer be operational. 

We’re not ‘guinea pigs’

Summa supports a workforce of around 8,500 people, making it the largest employer in Summit County, home to the city of Akron. There’s some fear among the locals about what happens next. 

At a luncheon in late January, Akron Mayor Shammas Malik said residents and employees have expressed some confusion and concern about the deal, according to a report by Ideastream Public Media. More than 450 people have signed a petition urging Summa to remain a nonprofit and to halt negotiations with HATCo.

James Hardy, a member of Akron’s city council, said during a meeting on Jan. 22, that he opposed the sale, citing a “moral objection to the use of Summa, its staff and its patients as ‘guinea pigs’ for venture capitalists.” 

During his more than six-minute speech, which was met at the end with scattered applause, Hardy went on to ask that Summa pause the process and consider alternatives like converting the hospital to a “county-owned system.”

“The community has not been consulted at all and we stand to gain or lose the most at the outcome of this proposal,” Hardy said. “At the very least, Summa owes greater Akron a transparent process where concerns and questions of the general public are asked and answered.”

Mayor Malik met with Harrison and Summa executives early in February, following the city council meeting, and had a “positive and thoughtful conversation” about their ambitions to create a “new model” for health care instead of making cuts, the mayor said in a statement to CNBC. 

“When looking at the proposed Summa acquisition, there are plenty of fair and understandable concerns,” Malik said in a statement. “There is also the potential for this to be a very positive and transformative step for Summa, stabilizing a pillar of our community.” 

Harrison has dealt with competing concerns in the past. In his book, he wrote about steering Intermountain during the Covid pandemic, when health-care workers, government officials and Utah residents openly disagreed about the right path forward.

“Rather than avoiding conflict or seeking to ram through it, we’ve accepted it as a fact of life and attempted to manage it adroitly and compassionately on behalf of progress,” Harrison wrote.

HATCo has a complex, decades-long road ahead, and Harrison is now at the center of an effort to show that community-based health-care providers can be profitable without cutting costs or abandoning patients.

Flare Capital’s Greeley said other VCs are unlikely to follow General Catalyst’s lead because of all the costs and complexities involved in owning a hospital system. But he said he’s cheering the firm on from the sidelines.

“Hats off,” he said. “If anybody can pull it off, I think they’ll have a reasonably good shot.” 

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