Why the biggest opportunities in kidney and cardiometabolic health lie in the connections the system was never designed to complete, and in the bridges being built to close them
This is a really interesting framing of the opportunity. I’m convinced some of these gaps, or “bridges”, will define where the next wave of value is created.
The challenge is that the existing systems are deeply entrenched. Designing the bridge is one thing; changing the behaviours, incentives and habits around it is often the harder work.
The four bridges framing is the clearest articulation of CKM value capture I've read. Thanks for writing this
One question: as payment architecture shifts toward accountability, does the value capture at Bridge One get stronger or weaker? On one read, upstream signal becomes more valuable because it determines downstream outcomes. On another, signal gets commoditized as infrastructure and value concentrates at the coordination and accountability layers
Curious how you're thinking about this - especially with CKCC expiring in 2027
Also, I am building at bridge one for the past 3 months, spent a lot of time in discovery and problem identification, raised initial capital and now working towards building solution. Would love to compare notes and share what I'm seeing from the clinician side. Happy to DM
Thanks for the comment and glad it was useful, azeem. We didn't get too in the weeds on exactly "who" captures value at each of the stages, but as you might imagine it really depends who's involved. For that first area, a handful of players (pharma, health systems, provider groups, health plans) have models that make it sustainable. Glad to chat and hear more about what you're learning and seeing out there. Feel free to DM.
![Signals From [Space]](https://substackcdn.com/image/fetch/$s_!IXc-!,w_40,h_40,c_fill,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9f7142a0-6602-495d-ab65-0e4c98cc67d4_450x450.png)
![Signals From [Space]](https://substackcdn.com/image/fetch/$s_!IXc-!,w_120,h_120,c_fill,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9f7142a0-6602-495d-ab65-0e4c98cc67d4_450x450.png)
![Signals From [Space]](https://substackcdn.com/image/fetch/$s_!lBsj!,e_trim:10:white/e_trim:10:transparent/h_48,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F0e0f61bc-e3f5-4f03-9c6e-5ca5da1fa095_1848x352.png)
This is a really interesting framing of the opportunity. I’m convinced some of these gaps, or “bridges”, will define where the next wave of value is created.
The challenge is that the existing systems are deeply entrenched. Designing the bridge is one thing; changing the behaviours, incentives and habits around it is often the harder work.
The four bridges framing is the clearest articulation of CKM value capture I've read. Thanks for writing this
One question: as payment architecture shifts toward accountability, does the value capture at Bridge One get stronger or weaker? On one read, upstream signal becomes more valuable because it determines downstream outcomes. On another, signal gets commoditized as infrastructure and value concentrates at the coordination and accountability layers
Curious how you're thinking about this - especially with CKCC expiring in 2027
Also, I am building at bridge one for the past 3 months, spent a lot of time in discovery and problem identification, raised initial capital and now working towards building solution. Would love to compare notes and share what I'm seeing from the clinician side. Happy to DM
Looking forward to Part 3!
Thanks for the comment and glad it was useful, azeem. We didn't get too in the weeds on exactly "who" captures value at each of the stages, but as you might imagine it really depends who's involved. For that first area, a handful of players (pharma, health systems, provider groups, health plans) have models that make it sustainable. Glad to chat and hear more about what you're learning and seeing out there. Feel free to DM.