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Charger outage rates varied broadly by operator, Gruber said. One had almost no charger downtime – just 3 percent. Drivers failed to charge at nearly 2 in 5 visits, or 39 percent, at the most problematic last year.

J.D. Power declined to make public which networks had the best and worst reliability records. Its study included more than 26,500 charging attempts at Level 2 and Level 3 chargers in all 50 states.
The reasons for failed charging sessions range from software glitches to payment processing errors to vandalism.

Nearly three-quarters of respondents who were unable to charge their vehicle last year said they couldn't charge because the charger was out of service.
Companies are failing to act quickly, said Ben Shapiro, a manager at RMI, a clean energy nonprofit.

"It might be a pretty minor issue, but they need somebody to come out and fix it… and they don't do that for 24, 48 hours," he said.

Tesla's Supercharger network tends to have better charger uptime than peers. Fewer Tesla drivers face charger outages and, if a charger is down, the driver typically finds a working charger at the same location, Gruber said.
EV charging company EVgo launched EVgo Renew this year to better handle its charger issues. The company plans to replace, upgrade or retire hundreds of chargers this year. It upgraded, replaced or removed 125 chargers during the first nine months of last year.

Many EVgo charging stations are a decade old, said Jonathan Levy, EVgo's chief commercial officer. Most issues are reported by drivers who are using EVgo's charger for the first time, he said.

EVgo realized it must Excellerate education and reliability. Today, it has 17 error codes. Just two years ago, EVgo used only one error code for a failed charging situation.

"If the customer didn't plug it in all the way or the charger was broken or the car was communicating poorly, it would just say connection error," Levy said. "That's not particularly useful to the driver and it's actually not that useful to us in terms of fixing a problem."

Level 2 charging satisfaction improved in the fourth quarter from the third quarter, largely because charger conditions had improved and the cost of charging had decreased, according to J.D. Power.

"Many network operators are starting to upgrade existing Level 2 chargers, so those efforts are starting to show, at least from a physical condition standpoint," Gruber said.

Rakuten Symphony, announced general availability of its Symworld™ RAN Commander solution for automated 5G mobile network planning and optimization. 

RAN Commander has proven to boost Radio Access Network (RAN) productivity planning by 4x[1] to overcome limitations of conventional planning and optimization methods.

The ever-increasing number of connected devices demands real-time, data-driven planning to ensure high performance and accuracy of premium coverage. In the 5G era, operators recognize an urgent need to scale processes through automation, Excellerate and speed decision-making with a far richer set of network and subscriber data, and minimize timelines and budgets for expensive, complex integration projects.

Symworld™ RAN Commander is a one-stop solution for all aspects of network planning and optimization, consolidating legacy PC-based tools, licenses, and data into one managed cloud native platform operation. This eliminates all problems with license management, single user tool installation and scattered confidential data. All calculations and simulations are performed in the cloud, eliminating local processing delays, while offering a customizable approach to network expansion, 5G profitability and business transformation.

Symworld™ RAN Commander empowers telecom operators with complete visibility and awareness of the live network, subscriber intelligence and traffic distribution, enabling targeted investments and actions for maximum returns at every phase of an operator’s network rollout journey. Rakuten Symphony’s vendor-agnostic solution uses real-time network data, which drives the planning process and facilitates optimization algorithms for accurate and reliable network planning, allowing operators to make effective and informed business decisions.

The Symworld™ RAN Commander suite comprises:

 - RAN Designer to dynamically plan a large-scale greenfield network or optimize expansion and configuration of existing networks for maximum performance via a user-friendly interface.

 - RAN Optimizer for network monitoring and optimization via a powerful geospatial interface with single-click visualization of network health, fault, configuration and performance, aggregated from highest to lowest granularity of geography and node. It also offers optimization capabilities with algorithms to identify and mitigate network coverage, capacity and interference issues.

Rakuten Symphony recently briefed customers on the Symworld™ RAN Commander, providing an overview of key features, capabilities and deployment considerations. A replay of the interactive webinar, which includes a product demonstration and Q&A, is available here.

Like all Rakuten Symphony Intelligent Operations solutions, the Symworld™ RAN Commander suite leverages the scalable, cloud native Symworld™ Platform to streamline the complex mesh of support systems and custom integrations that all operators have accumulated. This helps telecom operators scale faster as cloud sets the pace for speed, innovation and network expectations. Symworld™ Platform allows for seamless integration between products within the RAN Commander suite and other Symworld™ applications to leverage the power of data for improved planning and optimization.

The Indian Army’s latest request-for-proposal (RFP) seeking emergency procurement of 12,730 ballistic helmets in two sizes — 8, 911 in large and 3,819 in extra-large size — has become mired in an avoidable controversy.

Veer customised headgear, designed by MKU, will include a central bulge to accommodate “jura” (hair bun) with the head wrapped in the form of a dastar (turban)-like patka or parna/kesaki. These wrappings, worn by the UN forces, are referred to as a semi-turban. Sikh troops have been donning functional head covering during PT, sports and maintenance parades.
This is the first time that customised headgear, which seeks to combine protective and smart, battle function attributes, is being procured.

Sikh troops deployed in counter-insurgency (CI) areas and on the Line of Control (LoC) have been using bulletproof patka (BPP). The improvised, unpopular contraption has its share of problems with weight and rigid configuration due to dated technology. The current generation of headgear based on Kevlar and ceramic materials seeks to redress these problems and provide value-added attributes.

The procurement has been criticised by Sikh religious bodies, who have called the helmet a ‘loh top’ (iron hat). They have termed it as interfering with Sikh rehat maryada (tenets and traditions) and expressed apprehension at the replacement of pugri (turban) with a helmet. They also assert that the turban is not merely a 5-7m piece of cloth, but a “crown” gifted by Gurus.

The issue needs to be logically analysed.

The first requirement is to look at the historical perspective. There are illustrations that show Sikh warriors of Maharaja Ranjit Singh’s forces wearing metallic helmets with chain mail for providingprotection. Few pieces are displayed in British museums and were reportedly used in Anglo-Sikh wars.

The evidence is backed up by engravings on the Sutlej Medal awarded in colonial times. This fits into Maharaja Ranjit Singh being far ahead of his time and readily adapting various technologies. The defining trend of pragmatic improvisation, or jugaad, and resilience continue to define Sikh soldiers.

Sikh soldiers used steel rings, called chakris, over turbans to ward off attacks by swords and spears. These are still displayed on ceremonial turbans by Sikh regiments. Nihang dastar-bunga turbans, in pyramidal, tier shape, include multiple rings and steel contraptions. It is a fact that Sikh regiments refused the offer of wearing helmets in the two world wars and even fought post-Independence wars in turbans. Precision and lethality of weapons have, however, altered the basic paradigm of survivability.

Sniper rifles with singleshot kill capability are emerging realities. The most vulnerable target is the head of a soldier. A study of ballistic injuries with disabilities is required to objectively analyse the issue.

Soldiers in contemporary armed forces in the US, Canada and Australia wear combat helmets. Sikh soldiers in our forces, who have been serving as part of the crew of tanks and armoured fighting vehicles, have been using padded headgear with builtin headphones. Pilots, paratroopers, divers and submarine crews have also been donning specialised headgear. Sikh sportsmen in cricket, hockey and boxing have opted for functional head wraps like patka, with protective helmets, to optimise their performance. How can we forget Milkha Singh, the Flying Sikh, with just a rumal (kerchief) covering his hair bun?

Sikhs have five basic mandated tenants, referred to as kakkars — kesh, kada, kanga, kaccha and kirpan. All five have become modified and compromised to a considerable extent.

Dastar, or turban, is an adjunct to maintain kesh, but the original version of rounded dastar and dumalas have gone through multiple variations, with only a few persisting with the near-original form.

The four dominant types of turbans currently are vattan wali, Amritsari shahi, Barnala shahi and taksali dumala. The present turban of our Sikh soldiers is an inverted, V-shaped variant with symmetrical seven folds. Intransition, starched turbans have given way to unstarched ones. In civilian society, they have been affected by fashion trends and have been used as regional and even caste/identity markers.

Religious bodies are seeking to discard functional dastars like kesaki, patka and parnas. They project it in zero-sum format, whereas both forms can co-exist. Sikh soldiers can continue to wear turbans for ceremonial occasions and switch to much preferred functional head wrap for operations, sports and maintenance. These can be combined with the new proposed headgear.

Socio-religious bodies need to focus on critical societal issues like drug menace, deras and a large number of Sikh youth, especially role models, opting to cut their hair.

In network-centric warfare, soldiers would be like plugged entities in battlefield surveillance and management system. Each link would have to be given the requisite processed and synthesized awareness as also protection, as the chain snaps at the weakest link. It would be axiomatic to equip Sikh soldiers with multi-functional gear, which is light, protective and comfortable, and provides hands-free operations. To deny it to the mainstay of our forces (Sikhs make up 8%) is both retrograde and illogical. Bravado and tradition alone cannot compensate for combat realities.

Most importantly, socioreligious bodies should allow forces to devise their own norms as these are generally evolved after due consultation and feedback. However, the proposed customised gear could be renamed as kesaki-veer headgear. The government, on its part, needs to put at rest apprehensions, especially with regard to proliferation in the civilian domain.

END OF ARTICLE

[UPDATED at 3:45 p.m. ET]

Brenna Kearney was seven months pregnant in December 2019 when she experienced what she thought were bad flu symptoms.

Her husband, Casey Trumble, drove her from their Chicago home to her OB-GYN’s office at Northwestern Medicine Prentice Women’s Hospital downtown. With suddenly elevated blood pressure and protein in her urine, she was diagnosed with preeclampsia, a potentially fatal but treatable pregnancy complication. Doctors admitted her to the hospital, saying she could expect to stay up to six weeks and have an induced delivery.

Then Kearney developed a bad headache and her blood platelet count plummeted, signs she was experiencing a rare, dangerous type of preeclampsia and requiring an immediate delivery by cesarean section.

Kearney’s daughter, Joey, born at 31 weeks, was placed on a ventilator and moved to the hospital’s neonatal intensive care unit. Small but healthy, she slowly began breathing on her own and eating normally. She was discharged in late January 2020, after 36 days in the NICU.

Then the bill came.

The Patient: Josephine “Joey” Trumble, now 3, was covered by her mother’s health plan through her employer, an advertising agency. For 2019, it was an Aetna plan, and for 2020, it was a plan from Blue Cross and Blue Shield of Illinois. Both policies were fully insured plans governed by Illinois laws.

Medical Service: Neonatology physician services provided in January 2020. Joey needed tube feeding and ventilator care to provide oxygen.

Service Provider: Ann & Robert H. Lurie Children’s Hospital of Chicago, whose staff physicians treated Joey at Northwestern Medicine Prentice Women’s Hospital. Ownership-wise, Lurie is independent of Northwestern Medicine, but it is physically connected to Prentice Women’s by an enclosed walkway. Lurie has a collaboration agreement with Northwestern Medicine to provide neonatology and pediatric physician services to Prentice Women’s patients.

Total Bill: Aetna paid for nearly all of Joey and her mother’s hospital and physician charges in December, while Blue Cross picked up nearly all of Joey’s hospital charges in January. Physician charges from Lurie in January totaled $14,624.55, of which the family was asked to pay $12,531.58 after payments from Blue Cross.

What Gives: It took Kearney months of calls to Blue Cross and the two hospitals to find out why Lurie billed more than $14,000 for physician services: The physicians treating her daughter at Prentice Women’s — an in-network hospital under her health plan — actually worked for a separate, out-of-network hospital.

Illinois law bars insurers from charging patients out-of-network rates for neonatal care at in-network hospitals.

Kearney said no one had told her or her husband that Lurie doctors were treating their daughter. She said the family never signed an agreement consenting to receive care from out-of-network doctors.

Though it did not happen here, many patients unknowingly sign broad financial agreements — saying they’ll pay for almost anything their insurance doesn’t cover — in the piles of paperwork they receive upon admission to a hospital. In many cases, they are simply asked to sign on a screen, without seeing the document.

Blue Cross agreed to pay Lurie the in-network rate for the doctors’ services, reducing the bill to about $12,500 — which Lurie expected the family to pay.

In November 2020, Kearney started receiving letters from ICS Collection Service, a collection agency.

“Talking to Blue Cross was impossible, and Lurie said it’s not their problem and just wanted to put us on a payment plan,” Kearney said.

Joey’s 36-day stay in the NICU happened before the federal government implemented the No Surprises Act barring surprise out-of-network billing. A state law prohibiting it, though, was in effect.

Since 2011, Illinois law has prohibited insurers from charging out-of-network rates for neonatologists, anesthesiologists, and certain other physicians when patients are treated at in-network hospitals.

Kearney said she repeatedly mentioned the law to Lurie and Blue Cross representatives, who denied knowledge of the provision.

“It definitely appears that under the 2011 law, Brenna can only be billed for in-network cost sharing,” said Kathy Mikos, a registered nurse and patient advocate with the Navocate Group in Woodridge, Illinois, who is not involved with Kearney’s case.

In December 2020, an insurance broker working for Kearney’s employer persuaded Blue Cross to pay the full out-of-network charges for the Lurie doctors, leaving the family owing $289.63 for coinsurance, which they promptly paid.

Having spent nearly the first year of her daughter’s life fighting medical bills from her birth, Kearney thought the ordeal was over.

Then, last month, she got a call from the collection agency, which again demanded payment at the full out-of-network rate for Lurie physician services provided to her daughter three years ago — the bill she believed Blue Cross had paid.

It took five hours on the phone for Kearney to piece together what had happened. Blue Cross had indeed paid the out-of-network charges in December 2020 — but, two days later, had taken back the money, ultimately paying Lurie’s doctors only the in-network rate.

A Lurie representative said Kearney and her husband still owed thousands of dollars. A Blue Cross representative suggested she set up a payment plan.

“I was at wits’ end, and I didn’t know how to fight this anymore,” Kearney said.

Lurie, Blue Cross, and Northwestern Medicine repeatedly declined to comment on the case. Lurie cited patient privacy, despite receiving a release from Kearney regarding the federal Health Insurance Portability and Accountability Act, or HIPAA, which authorized the hospital to discuss Joey’s case with KHN.

The Resolution: After KHN contacted Lurie and Blue Cross, a Lurie representative called Kearney offering to accept payment at the in-network rates after all.

Kearney said Tracy A. Spicer, manager of consolidated services at Lurie, told her Lurie has a “long-standing policy” of accepting in-network rates for Lurie physician services provided at Prentice Women’s. Spicer subsequently described it as a “long-standing courtesy,” then explained that acceptance of in-network rates was subject to “case-by-case consideration,” Kearney said.

Spicer said the family owed about $3,000 for their coinsurance share and offered to set up a payment plan.

A day later — following additional requests by KHN for comment — Spicer called Kearney and said she would remove all physician charges for her daughter’s care. Spicer did not return KHN’s call seeking comment.

“I’m certain I’m not the only person still dealing with this” kind of predicament, Kearney said.

Kearney has filed complaints with the Illinois Department of Insurance and the Illinois Attorney General’s Office. The attorney general’s office told KHN it had never enforced the 2011 law barring certain out-of-network billing.

Presented with the facts of Kearney’s case, state Sen. Ann Gillespie, who sponsored a 2022 state law expanding consumer protections against out-of-network bills, told KHN she plans to contact Lurie, Blue Cross, and Northwestern Medicine to ask about their billing arrangement and whether they are in compliance with state law.

“We’ll see if it was a pattern and whether they need to look back and see if refunds are warranted,” Gillespie said.

The attorney general’s office told KHN it will investigate Kearney’s complaint, including whether Lurie violated the state Consumer Fraud and Deceptive Business Practices Act by telling her it was extending a “courtesy” by charging her only in-network rates, when that is what the 2011 law required. The insurance department also said it would investigate the complaint.

The Takeaway: Even resourceful consumers who appear to have the law on their side, like Kearney, may find themselves in a losing, time-consuming battle with medical billing bureaucracies and facing collection actions.

Gillespie, the state senator, said Lurie, Northwestern Medicine, and Blue Cross should have known about the state law. She said patients who believe they have been improperly charged should file complaints with their state’s insurance department, which can trigger a broader investigation.

The federal No Surprises Act, which took effect last year, prohibits medical providers or insurers from billing patients for out-of-network physician charges at an in-network hospital, unless the patient formally consents to an out-of-network doctor. To be safe, patients should ask treating doctors whether they are in or out of network, even at an in-network hospital.

While the federal law offers patients new protections from out-of-network bills, many Americans still face problems from before the law took effect, said Loren Adler, associate director at the USC-Brookings Schaeffer Initiative for Health Policy. Illinois is one of relatively few states that had prior laws to protect consumers.

Also, some out-of-network physicians continue to bill patients, despite the new federal protections. So know your rights. Cite the new law. And don’t write the check.

For the first time in more than four years, Orioles CEO and Chairman John Angelos met in person with a group of Baltimore media and openly discussed the operations of the team he oversees.

Between the November 2018 introduction of executive vice president and general manager Mike Elias and Sunday, Angelos had taken questions from a collection of local reporters just three times. At a January news conference to discuss a charitable donation from the organization, he declined to answer a question about his family’s future owning the team, using Martin Luther King Jr. Day as his reason.

Standing beside the bullpen on the Ed Smith Stadium backfields on Sunday, Angelos fielded and answered questions for more than 37 minutes, covering the Orioles’ expiring lease, a major league payroll that’s the second lowest in the majors and more.

Here are five takeaways from Angelos’ session with reporters.

New lease could be ‘All-Star break gift’

Earlier this month, the Orioles declined to exercise an option in their lease with the Maryland Stadium Authority that would extend the agreement by five years, leaving it to expire Dec. 31. As he has been in latest years, Angelos was adamant the team will remain in Baltimore, expressing hopes a new long-term lease will be in place by July.

“I’d love to have that as an All-Star break gift for everybody, really, in the community,” Angelos said.

Potentially affecting negotiations is Maryland Gov. Wes Moore’s replacement of Tom Kelso as the chairman of the MSA with Craig Thompson, his campaign chair and a former employee of the law office founded by Angelos’ father, Orioles principal owner Peter Angeles. Angelos said he and Thompson have spoken once thus far and that they are “looking forward to working together.” Kelso, who was appointed by former Gov. Larry Hogan, had served in the role for the past eight years.

“I didn’t think it would be right to rush something through in the final days of the Hogan administration,” Angelos said.

With a long-term lease, the Orioles would gain access to $600 million in public funds to upgrade their 31-year-old ballpark. Angelos said much of that will be devoted to needed repairs and replacements of the stadium’s infrastructure, with amenities such as “improved seating areas” and upgrades to Oriole Park’s scoreboard and audiovisual system. It could also factor into Angelos’ hopes to upgrade the Camden Yards facility for what he repeatedly referred to Sunday as “live, work, play, 365,” the idea of giving people a reason to go to the downtown area throughout the year and not only for Orioles or Ravens games.

“The real facility use agreement, renewing a 30-year-old document, that’s really a minor sidebar,” Angelos said. “… We can really make a statement for why Baltimore is back and why it’s going to be a big part of the future of the country and thought of in a ‘can do’ way instead of in some of the ways it’s been thought of in the past.”

Orioles ‘lucky’ pandemic hit during rebuild, aiming to be ‘next Tampa’

Like Elias and manager Brandon Hyde, Angelos acknowledged the Orioles’ rebuild is over, with Baltimore pursuing a playoff spot in 2023. He also said the team was relatively “lucky” it was in that mode when the coronavirus pandemic started in 2020 and prevented fans from attending games.

“We were fortunate that as the world hit a pandemic, we were stripped down to that [level],” Angelos said. “That was just good luck, really, in that sense, to not have a lot of payroll out there. Teams that had a lot of payroll and that were relying on live attendance to pay for that were in a much worse situation. We were much better situated. Just lucky, really.”

The Orioles are projected to have the second-lowest payroll in the majors this season at nearly $65 million, according to Cot’s Baseball Contracts. Angelos noted that throughout the rebuild, the club has made investments elsewhere, notably scouting, development and technology.

But after the team unexpectedly broke out of that rebuild with an 83-79 record in 2022, there were expectations the Orioles would be far more aggressive in seeking major league upgrades. Their payroll is more than $20 million above last season’s opening figure but more than $100 million below three of the other four teams in their division.

The fourth, the Tampa Bay Rays, is one of three teams Angelos has repeatedly pointed to as models for Baltimore, saying Sunday that Tampa Bay, the Cleveland Guardians and Milwaukee Brewers are models in “sustainability” for the Orioles. Asked what it says about his aspirations for the franchise that none of those teams have won a World Series since 1948 and have consistently ranked in the bottom half of the league in payroll, Angelos responded, “Well, we’re aiming for sustained success, and I think what you see in a place like Tampa, they have had sustained success. … I would be disappointed if we’re not the next Tampa, which means being sustainably competitive and relevant.”

He said the Orioles’ payroll will not match those of the New York Mets, Los Angeles Dodgers, New York Yankees and Boston Red Sox, saying, “That’s not an Oriole thing. That’s a small, middle market team [thing].” Baltimore is the No. 28 media market in the country. The San Diego Padres, who play in the 27th largest market, have a payroll approaching $250 million that ranks third in the league. He also claimed that setting the team’s payroll is not his responsibility.

“Could payroll be double or triple what it is?” Angelos said. “Or could it be over 100 million? Yeah. We’re not there yet. We have a very young team that’s overachieved and overperformed because of the great work of our baseball folks.

“It’s not my job to predict payroll. My job is to make sure that the community partnerships are sustained, and I think all of that comes after that.”

‘You don’t need litigation to solve problems’

With one of Angelos’ legal battles recently resolved, another is getting ready for its next step.

Earlier this month, the lawsuits pitting Angelos and his mother, Georgia, against his brother, Louis, over Peter Angelos’ estate were settled, ending eight months of escalating claims.

“Those things are distractions, and it’s unfortunate whenever they arise, but all good things going forward now,” Angelos said.

Next month, the New York Court of Appeals will hear arguments in the ongoing legal dispute between the Orioles and Washington Nationals regarding the Nationals’ claim to about $100 million in rights fees from the Mid-Atlantic Sports Network, which broadcasts both teams’ games and of which Angelos is also the CEO. The situation, which Angelos called “eminently solvable,” stems from an agreement put in place when Major League Baseball moved the Nationals, then the Montreal Expos, to Washington in 2005.

“I think it’s resolvable today, tomorrow — I’m oversimplifying — separate and apart from that appellate track,” Angelos said. “That’s litigation. My goal, as you might be totally surprised to hear, is to never be around any litigation again. You don’t need litigation to solve problems. You just need good partners.”

Angelos also addressed what he called the “business decision” to have MASN show only four spring training games each for the Orioles and Nationals. That’s believed to be the lowest number of spring television broadcasts for any club.

Noting the network shows more than 300 regular-season games and 600 pregame and postgame shows between the two baseball teams, Angelos said, “Should that come at the expense of spring training? I don’t know. I think it’s certainly a valid question and criticism.”

Elias, Hyde ‘under contract long term’

Like Elias, Angelos declined to get into specifics about his GM’s and manager’s contract status but stated he and they will be with the Orioles “for the long haul.”

“We are all fully vested,” Angelos said. “We’re not going anywhere. And nobody’s a short-timer. Nobody is expiring in a year or two years or anything like that.

“We’re all here under contract long term.”

Although one suit Georgia Angelos filed claimed Peter Angelos wanted her to sell the team upon his death, John Angelos said Sunday, “There is absolutely no plan to change the partnership group or to change the managing partnership structure that we have.” Angelos, who said last month his family owns 70% of the Orioles, said he would be open to making additions to the ownership group.

“It’s been a tremendous amount of continuity,” he said. “But you want to have a next generation of people coming in, too, and you want them to be excited, and it’d be nice if we could attract strategic people who care about Baltimore, care about we’re doing this now, who care about the example Camden Yards set, and want to be part of it. That’s not necessary or requisite, but we’re open to it, but there is no plan to change or to transition out of what we have today.”

Financials meeting to take place during spring training

During his five-minute lecture at last month’s Martin Luther King Jr. Day news conference, Angelos said he would welcome reporters back to Camden Yards the “next week” and “show you the financials … [and] governance of the Orioles.” It’s been more than a month since he made that offer, and asked Sunday whether he expected that meeting to take place, Angelos said he would follow through before spring training ends in late March.

“I’m not gonna be able to pull out the payrolls and show you everything financially,” Angelos said. “But I will supply you a full picture for the business. I can supply you certainly a picture for what our objectives are on the field.

“When I say something, like I’m gonna sit down with you guys explain the business from my perspective, I’m gonna do it. I’m not gonna say it and walk away from it.”

()

Women make more than 80% of healthcare decisions in this country on behalf of not only themselves but also the men and children in their families. I believe that the lived experience positions many women especially well to drive innovation in healthcare.

A great lesson I have learned working as both a surgeon and an entrepreneur is that medical expertise alone is not enough to connect patients with best care in the most effective ways possible. Technology matters at least as much, and the application of that technology in context is critical.

One of the reasons that I love writing this column is that I get to interview l individuals with stories like mine who have achieved amazing things. Dr. Jennifer Schneider is the co-founder and chief executive officer of Homeward, a company focused on rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. She previously served as the Chief Medical Officer of Castlight, the President of Livongo, and is a trained internist.

Dr. Schneider is a great role model for men and women looking to recombine their skill sets, prioritize the right thing at the right time, and develop the foresight to seize opportunities. Dr. Schneider zoomed in with me one morning from her beautiful cabin-esque home from Napa Valley. Her relatable insights about motherhood, healthcare and entrepreneurship resonate with me, and I am thrilled to share them here.

What inspired you to go into the field of healthcare?

I come from a family in the midwest where my dad runs the local auto parts store. It is the lifeblood for my family, who is still very involved in the local community of my hometown of Winona, Minnesota.

I was diagnosed with type 1 diabetes when I was 12, and that ignited my interest in healthcare. The ability to manage my condition was very empowering. From that day on, I told people I wanted to be an endocrinologist, and most people didn’t know what that was.

After entering the field of medicine, what made you pivot into the business of healthcare?

After completing my medical degree at The Johns Hopkins University School of Medicine and my master's in Health Services Research at Stanford University, I worked as an internist. I later became the chief medical officer of Castlight Health and eventually became the chief medical officer and president of Livongo, leading the company through a successful Initial Public Offering and the industry's largest merger with Teladoc Health.

I stopped clinical practice when we decided to take Castlight public. I had just had my third baby and realized it was challenging to be breastfeeding one child, birthing another, taking Castlight public, and moonlighting as a hospitalist. I am most happy when I am busy.

I strongly believe that the combination of both sets of training, as both a medical doctor and a business leader, have been very important to my career development. One of my favorite stories is that one day, we had a very bad meeting at Castlight and everyone was super upset. Later that evening, I went into my shift into the hospital and I literally coded someone seconds after parking my car at the hospital. And I thought: the care I deliver actually matters in the context of this person’s life. It really does put things into perspective.

I like hard problems, and I like solving them. When we launched Castlight, the question was, how do we make a free market in healthcare? There are people spending $200 on a hairdresser, but having difficulty paying a $20 co-pay for their doctor’s appointment. Building on that concept, Livongo was all about: how do we make it easier for people with chronic conditions to manage their health. We combined data science with a deep empathy for people living with chronic conditions to Excellerate that experience.

Homeward Health is a very different business from Castlight and Livongo, but I’ve built upon many learnings from my previous businesses to thoughtfully use technology to scale access to clinical services. At Homeward, we are focused on expanding access to healthcare in a system that is tragically broken for people who live in rural communities. It’s not a little broken, it’s a lot broken. In fact, there is a 23% higher rate of mortality if the last 3 digits of your zipcode are designated as rural.

Since launching Homeward, I have heard people say, great, you are going into a niche area. And I respond: 60 million people live in rural communities. Homeward’s total addressable market is actually twice the size of Livongo. This is a very big problem.

What is Homeward, and what made you decide to tackle rural healthcare as your latest venture?

Homeward is a company focused on rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. We enter the market as an in-network provider and partner with health plans to care for Medicare eligible beneficiaries. We are a value-based care provider, meaning we take full-risk on the total cost of care for our members. We believe this approach effectively aligns incentives for all parties involved by incentivising health outcomes rather than being paid for the total number of visits.

By taking full-risk on the total care, we can also more flexibly deploy technology-enabled services in rural markets, which are often not reimbursed in a fee-for-service model. Finally, care models and technology are implemented in a way that ensures practitioners operate at the top of their licensure, meaning they can do what they were ultimately trained for.

How does Homeward fit into the current healthcare market and what sets it apart from other companies?

We differentiate ourselves by, first, being an in-network provider, and, second, building a technology platform that helps scale access to providers. Our technology is able to connect to our members via cellular technology rather than relying on the Wifi or broadband access, which is often inaccessible in the communities we serve. This has been hugely helpful in connecting with individuals in rural areas where internet access may be limited. Furthermore, in rural markets, building trust with our members is key, and that is why we often begin our care journey with an in-home visit. Our providers will physically enter their phone number into the person’s phone, which helps to establish a connection and build trust. Many people in rural markets have family members who have moved to urban areas for work, so the support of younger generations may not always be physically present.

How has Homeward been received by health plans?

It is widely acknowledged that healthcare in rural markets is subpar in terms of outcomes, cost, and experience. Homeward had success in partnering with health plans to provide care to Medicare and MA plan beneficiaries in these areas, as there is a clear need for improvement. They love how Homeward can help manage challenging populations on their behalf, Excellerate key health plan metrics such as HEDIS and CAHPS measures by improving the member experience, and help Excellerate penetration in Medicare Advantage.

You have been an advocate for women in leadership positions throughout your career. Why is this so important to you?

Women are the dominant healthcare purchasers, so it is important to have representation and understanding of women’s perspectives in leadership positions. As a woman and the mother of two daughters, I strongly believe in the value of diverse leadership styles and empowering women to take on leadership roles. Women have different approaches and leadership styles, which tend to be more inquisitive. In order to bend the curve, you have to understand who the decision makers are. I am on the boards of multiple companies with women founders, including Toyin Ajayi of Cityblock Health and Kate Ryder of Maven, and believe it is crucial to support and mentor the next generation of female leaders.

What advice would you supply to the next generation of women leaders?

I think it is simple: Bet on yourself. And I say this to my children too: You never say “I can’t,” you say “I can.” Part of growing and learning is about making mistakes. Enjoy the process, and double down on your strengths.

What challenges did you face and how did you overcome them in your transition from practicing physician to entrepreneur?

One challenge I faced was the shift in mindset from a hierarchical medical training environment to a more team-oriented and collaborative business setting. In a healthtech company, we are creating something new and novel, and there are elements from each person’s unique skill set which are critical for the success of the company, from tech, to sales, to clinical expertise.

I also felt at times: “If you don’t see me, then I am not important.” But I have learned that sometimes it is important to try things differently for a bit. After Livongo, I joined General Catalyst as an executive-in-residence, and I wasn’t in the limelight for a period of time. That experience gave me time to think about what I cared most about and what I really wanted out of my next business. It led me to found Homeward, which has been an amazing experience.

Likewise, leaning in and leaning out as my kids have been different ages has been very important to me. I worked more when they were younger, because I believe the kind of influence I have on them is different throughout the years. Lately, I lean in more, as my kids are becoming more independent throughout their teenage years.

To learn more about Homeward Health, click here.