From e1c84b77f10d5efb767d92c01b1b38ace34c76c3 Mon Sep 17 00:00:00 2001 From: m3taversal Date: Fri, 6 Mar 2026 11:21:36 +0000 Subject: [PATCH] vida: update _map.md with Devoted claim and demand signals - Add Devoted growth claim to Value-Based Care section - Document demand signal gaps (Devoted-specific, structural health claims) - Document known thin areas (GLP-1 durability, behavioral health, provider consolidation) Co-Authored-By: Claude Opus 4.6 --- domains/health/_map.md | 20 ++++++++++++++++++++ 1 file changed, 20 insertions(+) diff --git a/domains/health/_map.md b/domains/health/_map.md index d14dfc7..4ba0403 100644 --- a/domains/health/_map.md +++ b/domains/health/_map.md @@ -25,6 +25,9 @@ Vida's domain spans the structural transformation of healthcare from reactive si - [[human-in-the-loop clinical AI degrades to worse-than-AI-alone because physicians both de-skill from reliance and introduce errors when overriding correct outputs]] — physician overrides degrade AI from 90% to 68% - [[healthcare AI regulation needs blank-sheet redesign because the FDA drug-and-device model built for static products cannot govern continuously learning software]] — Wachter's physician-licensing model for AI regulation +## Value-Based Care & Devoted Health +- [[Devoted is the fastest-growing MA plan at 121 percent growth because purpose-built technology outperforms acquisition-based vertical integration during CMS tightening]] — proof of concept for purpose-built payvidor model during CMS tightening + ## Value-Based Care & Social Determinants - [[value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk]] — the gap between VBC participation and actual risk-bearing - [[healthcare is a complex adaptive system requiring simple enabling rules not complicated management because standardized processes erode the clinical autonomy needed for value creation]] — Porter/Larsson framework connecting VBC to complexity science @@ -58,3 +61,20 @@ Vida's domain spans the structural transformation of healthcare from reactive si - [[Big Food companies engineer addictive products by hacking evolutionary reward pathways creating a noncommunicable disease epidemic more deadly than the famines specialization eliminated]] — food industry creating disease - [[modernization dismantles family and community structures replacing them with market and state relationships that increase individual freedom but erode psychosocial foundations of wellbeing]] — dissolved social structures - [[famine disease and war are products of the agricultural revolution not immutable features of human existence and specialization has converted all three from unforeseeable catastrophes into preventable problems]] — historical context for health transition + +## Demand Signals (claims referenced but not yet written) + +**Devoted Health-specific** (highest priority — Cory works at TSB which led Devoted's Series F and F-Prime): +- `[[Devoteds atoms-plus-bits moat combines physical care delivery with AI software creating defensibility that pure technology or pure healthcare companies cannot replicate]]` +- `[[Devoteds Orinoco platform eliminates healthcare data silos by building a unified AI-native operating system from scratch rather than assembling from legacy components]]` +- `[[Devoted Health proves that optimizing for member health outcomes is more profitable than extracting from them]]` +- `[[UnitedHealth and Humana exhibit textbook proxy inertia where coding arbitrage profits rationally prevent pursuit of purpose-built care delivery]]` + +**Structural health claims** (needed to complete reasoning chains): +- `[[US healthcare incentives are fundamentally misaligned because every participant profits from sickness not health]]` +- `[[healthcare costs threaten to crowd out investment in humanitys future if the system is not restructured]]` + +**Known thin areas**: +- GLP-1 economics beyond launch — durability/adherence problem, second-generation oral formulations +- Behavioral health infrastructure — what DOES work for scalable mental health delivery +- Provider consolidation dynamics — hospital/health system M&A effects on VBC transition