Disney, WarnerMedia and NBCUniversal wrestle with balancing the value of cable networks and streaming services
If last year’s biggest corporate media challenge was launching subscription streaming services, this year’s unifying dilemma is figuring out what to put on them.
The tension between how to balance streaming video, theatrical release and linear TV is leading to some peculiar choices bound to confuse consumers in what’s becoming an increasingly jumbled landscape.
“The challenge all of these companies are battling — the central question — is what content goes where, who decides, and why?” said Rich Greenfield, a media analyst at LightShed Partners.
The programming decisions may alter how the public views streaming video. So far, most media companies have marketed streaming video as a complement to traditional pay television. This is why so many of the products are named with the suffix “plus” — Disney+, ViacomCBS‘s Paramount+, Discovery+, etc.
In the long run, it’s possible each streaming platform will become the home for all of a media company’s programming. The “plusses” will essentially be lopped off. ESPN+ may just be ESPN, with everything ESPN has to offer.
But the world isn’t there yet. And the results are increasingly confusing for consumers as new programming is made specifically for streaming services, and the best of linear TV still doesn’t show up on streaming.
The streaming labyrinth
For scripted television series, media executives have largely made the decision that streaming services will be the home for the highest quality original programming. Disney, AT&T‘s WarnerMedia, Comcast‘s NBCUniversal and ViacomCBS are all attempting to convince Wall Street they can grow beyond traditional cable television. They’re using new hit shows, including “The Mandalorian,” “Mare of Easttown,” and “Yellowstone,” as bait to entice subscribers. The results have varied from service to service, but all of the major new streaming services are growing by millions of customers each quarter.
For movies, there’s disagreement at a film-by-film level across the different services. Disney put Pixar movies “Soul” and “Luca” directly on its Disney+ service for no additional charge upon release. For “Jungle Cruise,” “Black Widow” and “Raya and the Last Dragon,” the company decided to make users spend an additional $30 to stream the movies before eventually making them free with a subscription. NBCUniversal placed “The Boss Baby: Family Business” on its paid tier of “Peacock” but only released “F9” in theaters. WarnerMedia decided to place its entire slate of 2021 films directly on HBO Max but won’t do that for blockbuster movies in 2022.
For news and sports, most media companies have kept their most valuable programming exclusively on traditional cable TV. The most-watched primetime programming on CNN, MSNBC and ESPN is still locked inside the cable bundle. This has allowed executives to push against the steady but not yet overwhelming surge of pay-TV cancellations, keeping alive a highly profitable business that brings in billions of dollars each year.
NBCUniversal is navigating the challenge of distributing valuable programming as it broadcasts the Olympic Games. Executives can choose to air live and pre-recorded events on NBC’s broadcast channel, NBC’s cable networks, NBC’s authenticated apps for cable subscribers, NBC’s free apps, Peacock’s free tier and Peacock’s paid tier.
The variety of choices has led to a complicated ecosystem because NBCUniversal is attempting to achieve several goals at once. The company wants to push Peacock subscriptions, appease pay-TV distributors who have agreed to many years of fee increases because they were receiving unique content, and maintain expensive TV advertising rates by attaching commercials to exclusive live programming.
“It’s the innovator’s dilemma in action,” said one veteran broadcast television executive. “You know the linear TV world is collapsing, but you’re trying to stay on the Titanic for as long as possible. At the same time, you’re setting up the lifeboats, which are digital and streaming.”
Making the numbers work
Disney is staring down a major streaming dilemma as soon as next year with “Monday Night Football.” The company secured rights to stream the perennially most-watched cable series on ESPN+ in its new TV rights deal with the National Football League in March. But Disney and ESPN haven’t said anything about when it will actually include “Monday Night Football” on ESPN+.
ESPN is by far the most expensive network on cable TV. It gained that distinction by being the only way Americans can watch “Monday Night Football” and other popular sporting events. If Disney starts moving previously exclusive programming from ESPN to ESPN+, pay-TV distributors will push back on future rate increases and millions of consumers will be given another reason to cancel cable TV.
The math makes this calculus tricky. Beginning Aug. 13, Disney will charge $6.99 per month for ESPN+ after a recent price increase. But Disney makes more than $9 per month per cable subscriber for ESPN, according to Kagan, the media research division at S&P Global, in pay-TV distribution fees. When bundled with the other ESPN networks, Disney Channel and ABC, Disney makes more than $16 per month.
In other words, for every customer canceling cable, Disney loses more than $16 per month. It will need to start charging more for its streaming products to break even and that’s not even counting the loss in advertising associated with its linear programming, which dwarfs streaming video advertising revenue.
“Nobody is ready to unplug the linear ecosystem, because it brings in so much cash,” Greenfield said. “So they’re all balancing how to manage legacy assets with future investments that are free cash flow negative to show Wall Street that they’re trying. They’re all walking the tight rope.”
News programming decisions
NBCUniversal and WarnerMedia announced this month they’ll hire hundreds of new employees to beef up their streaming news services.
Instead of simply duplicating MSNBC, CNBC and CNN programming on “Peacock” and “HBO Max,” the media companies are taking a different strategy. CNN is building a subscription news service, CNN+. CNN chief digital officer Andrew Morse said he plans to hire 450 people to develop and market new series and newscasts. NBCUniversal News Group Chairman Cesar Conde announced plans to hire nearly 200 new employees across its news brands, the majority of which will support NBC News Now, the company’s flagship streaming network.
The decision to create separate programming for streaming — some of which may duplicate the content of what’s already being broadcast on linear TV — can be viewed in several different ways.
Skeptically, it could be seen as a waste of resources, filled with redundancies, as a “moment in time” decision to keep exclusivity in the cable bundle that may no longer exist in two or three years.
But NBC News executives say the investment acknowledges streaming audiences aren’t the same as linear viewers. That should lead to programming decisions that acknowledge digital viewers tend to be younger and more diverse.
“We’re always thinking about ways to optimize our journalism for each distribution platform,” said Noah Oppenheim, president of NBC News. ”How do we engage these new audiences? Sometimes the answers lead to different faces on screen, different approaches to storytelling, a different lens on the world.”
It’s unclear if there’s actually an audience for an all-streaming news network — especially one that demands consumers pay a monthly subscription fee, such as CNN+, which debuts in 2022. The notion of programming to a younger audience is suspect, as a video news broadcast, whether streaming or on traditional TV, may simply not appeal to those under 25. The decision to invest more in streaming news could lead to a gradual decline in investing in broadcast or cable productions if total revenue is shrinking.
NBC News Chief Digital Officer Chris Berend said he’s confident further investment in NBC News Now will pay off because he can already see the growth in time spent on the existing product, which launched in 2019. NBC News Now is free for consumers, backed by advertising.
“We are incredibly excited about the millions of hours audiences spend with NBC News NOW and how that continues to grow as we continue to invest,” said Berend. “That time spent, which includes more than an hour per visit on some platforms [like YouTube], is a clear indicator we are satisfying our audience across many platforms, each with their own demographic nuances.”
Disclosure: NBCUniversal is the parent company of CNBC.
WATCH: Comcast CEO Brian Roberts on earnings and streaming business
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.
At the show, executives from some of these companies that they were working toward rolling out a new generation of mobile internet.
These apps are already well served by the current mobile internet, but in the future 5.5G is expected to power more advanced applications.
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.
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.
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.
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.
“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.
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.
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.
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.”
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
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 Indeed.com. 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.
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.
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 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
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.
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.
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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