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AposHealth Solutions — Dr. Cliff Bleustein

AposHealth Solutions — Dr. Cliff Bleustein

Real Talk: The Charles Mizrahi Show podcast

AposHealth Solutions — Dr. Cliff Bleustein

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AposHealth is changing the way people walk. Its groundbreaking device eliminates knee, lower back and hip pain by changing the way your feet interact with the ground. The company’s CEO, Dr. Cliff Bleustein, joins host Charles Mizrahi to discuss how this innovative technology is revolutionizing the treatment of musculoskeletal conditions — and why the healthcare industry is ripe for disruption.

Topics Discussed:

  • An Introduction to Dr. Cliff Bleustein (00:00:00)
  • Osteoarthritis Journey (00:03:13)
  • AposHealth Solutions (00:9:07)
  • Market Disruption (00:16:59)
  • Reforming Healthcare (00:25:27)
  • Pushing Transparency (00:32:12)

Guest Bio:

Dr. Cliff Bleustein, MBA, is the Global President and CEO of AposHealth. He practiced urology for several years before going on to earn his MBA from New York University’s Stern School of Business. He now teaches there as an adjunct professor of healthcare economics.

Previously, Dr. Bleustein served as President and CEO of Computer Task Group. He was also the Executive Director, Chief Medical Officer, and Global Provider Solutions Leader at Dell.

Resources Mentioned:

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Read Transcript

CLIFF BLEUSTEIN: I want the system to be purely patient-centric. I think our health care system has been designed not around how an individual experiences it but around legacy providers.


CHARLES MIZRAHI: My guest today is Dr. Clifford Bleustein. Cliff is the global president and CEO of AposHealth. 


CHARLES MIZRAHI: Today, over 32 million Americans suffer from osteoarthritis — the most common form of arthritis. Osteoarthritis is a degenerative joint disease — or wear-and-tear arthritis — that occurs most frequently in the hands, hips and knees. Cliff’s company, AposHealth, has an innovative treatment that helps people with knee, hip and lower back pain live well by improving their gait — all without surgery.


CHARLES MIZRAHI: I recently sat down with Cliff. We talked about AposHealth’s approach to arthritis, the state of health care in the U.S. and how it can be improved.


CHARLES MIZRAHI: Cliff, thanks so much for coming on the show. I greatly appreciate it.


CLIFF BLEUSTEIN: Thank you very much. Good morning. Glad to be here.


CHARLES MIZRAHI: Before we start, I’m curious … Most doctors knew at 10 years old that they wanted to be doctors. Was that your journey?


CLIFF BLEUSTEIN: When I was in high school, I worked for a health club. And when I was there, I was fascinated by the bodybuilders who were able to lift hundreds of pounds on their shoulders, chests and legs. I found how the body works — the mechanics of it — to be absolutely fascinating.


CLIFF BLEUSTEIN: I was interested in learning more about how the body worked and how a human could do things that were not even human. How do you lift 800 and 900 pounds? It was just amazingly fascinating to me. And I wanted to learn more.


CHARLES MIZRAHI: What age were you?


CLIFF BLEUSTEIN: I was in my teens then. My parents said that when I was growing up, I always wanted to be a doctor. Most people who go into medicine want to help others. They are fascinated by the science and the ability to blend their curiosity with the ability to help others. And I think that’s been my journey all along.


CHARLES MIZRAHI: Wow, nice. In high school, I didn’t know what I wanted to do. But the kids who wanted to go into medicine knew since they were four years old. And I envied them because they knew what they wanted to do with their lives. I had no idea. The kids who wanted to be in medicine had everything planned out. It was absolutely amazing.


CLIFF BLEUSTEIN: The career of a physician is pretty prescribed. And I think you know, early on, what you have to do to be successful — between medical school, residency and then ultimately in practice.


CHARLES MIZRAHI: All right. So, you are the CEO of AposHealth. You’ve been at AposHealth for how long now?


CLIFF BLEUSTEIN: Almost five years.


CHARLES MIZRAHI: OK. So, folks, I want to talk to you about AposHealth and how I found Cliff. I work out with a friend of mine. And I was having tremendous knee problems. This friend, Dr. David Mandel, looked at my knee. And I said: “Dave, what is it?” He said: “Go get an MRI. I’m not going to diagnose you here.” I got an MRI, and it was osteoarthritis. Define that for us, Doctor.


CLIFF BLEUSTEIN: Arthritis is a deterioration that people have in their joint spaces and bones. And for some individuals, it progresses over time.


CHARLES MIZRAHI: For over two years, it was painful. It was bone on bone. And I loved walking. I was able to walk 8 to 10 miles a day without a problem. I’d walk with my dog or walk just to think. In fact, before I do any type of investment, I usually wait a day and walk around the block several times to think. And here I was, unable to do any of this.


CHARLES MIZRAHI: So, I got the MRI and went to an orthopedist. I wanted knee surgery to replace it. I said: “I can’t keep living like this.” And he talked me out of it. Now, how common is osteoarthritis? I think you told me millions of Americans have it.


CLIFF BLEUSTEIN: Roughly 14 million Americans every year visit a health care professional for knee osteoarthritis. And the actual number of people who have it — beyond those visiting — makes up around 6% of the total population. So, it’s a tremendous number of people who are impacted by this. And the cost to the health care system is extraordinary. For knee osteoarthritis alone — just associated with surgery — it’s roughly $32 billion in expenditures.


CHARLES MIZRAHI: Wow. About how much is surgery for one knee?


CLIFF BLEUSTEIN: For a commercial insurance product, it’s about $32,000.


CHARLES MIZRAHI: In New York, I think it’s going to be much more.


CLIFF BLEUSTEIN: In New York, it’s probably around $65,000 to $70,000.


CHARLES MIZRAHI: Yeah. Someone recommended this one doctor. I called up the doctor, and he said: “I don’t take insurance.” You’ve got to be crazy. I’m spending a fortune on health care and you don’t take insurance?


CHARLES MIZRAHI: I went to this other doctor. He looked at the MRI and everything. And he’s talking me out of surgery. Why is that? A surgeon wants to operate. Is knee surgery with osteoarthritis such a complicated thing, or is it just the process? Because he told me it’d be six months of rehab, and a bunch of complications could come about.


CLIFF BLEUSTEIN: The actual surgery itself is well-tested and proven. They have 10-year outcome data associated with it. But surgery is surgery. At the end of the day, there are associated complications. If you look at both U.S. and U.K. data, anywhere from three to four people out of 1,000 could potentially die from surgery. And roughly 30% of individuals can have a complication that’s non-life-threatening.


CLIFF BLEUSTEIN: Some studies demonstrate that at least 20% to 30% of the people who had knee surgery are not happy with the outcome afterwards. And there are a certain number of revisions that are required. It’s estimated that every year, 5% to 6% of all surgeries on the knee are actually revisions. Some people who have had a prior knee surgery need to have it done again. So, surgery is rough. It’s a major surgery and requires rehab afterwards for people to regain their function.


CHARLES MIZRAHI: When I first developed this two years ago, I couldn’t believe how many people 50 years old and up had knee or meniscus problems. I thought these were people in their 80s. But I was fascinated by how many people it affected.


CLIFF BLEUSTEIN: Yeah, up to 45% of individuals can have a lifetime risk of getting osteoarthritis at some point. Musculoskeletal complaints impact people’s daily lives and activities. It impacts roughly 66 million people in the U.S. alone.


CHARLES MIZRAHI: That’s absolutely astounding. So, anyway, I went to this orthopedist, and he basically convinced me not to do surgery. He said: “You could still walk about 1 to 1.5 miles a day.” I said: “I’m in tremendous pain every day. On a scale of 1 to 10, I’m a seven. It hurts.” I couldn’t live like this. I couldn’t row anymore. I have a Concept2, and rowing was a big part of my workout. 


CHARLES MIZRAHI: I wasn’t interested in getting drugs, going to therapy or wearing a brace. He said: “When it gets worse, come back to me.” So, Dr. Mendel said: “Try AposHealth.” And that’s how I found you. Now, you folks have been doing procedures for 18 years?


CLIFF BLEUSTEIN: We’ve been in business for more than 17 years.


CHARLES MIZRAHI: It was so interesting that I had to try it. And I speak here as a patient. I just started the process two months ago. And I want to tell you, I was shocked. I was really skeptical, but the pain went down, and I’m feeling a lot better.


CHARLES MIZRAHI: But before we get into that, I want you to share what AposHealth is. Why is it so innovative and disruptive for the osteoarthritis industry? And why aren’t the health insurance companies covering this? So, let’s start with the first thing. Tell me what this is.


CLIFF BLEUSTEIN: When people have osteoarthritis, they often get a breakdown of two different parts of the body. The first is the normal biomechanics of how they walk. And the other aspect is their neuromuscular apparatus. To put it in English: Changing the way somebody walks can change everything.


CLIFF BLEUSTEIN: When a person has pain from osteoarthritis, it hurts every time they walk. The body overcompensates for that pain by creating a tension in the muscles around the joint to prevent it from moving further. And that exacerbates the pain. So, it creates this vicious cycle in which you’re walking, you have pain, your protective response is an overcompensation and it makes it all worse.


CLIFF BLEUSTEIN: Then, people slowly start doing less. So, as you said, you’re not doing the same activities that you used to do. Instead of running five miles, you start walking. Then, you walk less. And within a couple of years, people who used to be incredibly active have stopped doing most of their activities. They’ve stopped doing life. And that’s what drives them to go to a doctor for some form of intervention.


CLIFF BLEUSTEIN: In simple terms, what AposHealth does is we’re able to change your biomechanics to help you walk better. And by changing how your body interacts with the ground, we alleviate your pain. Then, we’re able to retrain your body’s muscles and brain so that when you take the device off, your body remembers how to walk again.


CHARLES MIZRAHI: Got it. This device is a sneaker with plates underneath that you adjust. So, I went into your office and walked about 20 feet. You had sensors on my feet to see how I walked, my gait and the length of my stride.


CHARLES MIZRAHI: And I was in sad shape. 70% of my time was spent on my right leg because I was favoring my left leg. And you’re right, my back started hurting. My body started wilting. I started getting pain in other areas. And the mental side is that it becomes very depressing.


CLIFF BLEUSTEIN: Yes, many people who have difficulty with their locomotion or walking and have pain like you do, develop depression. Many withdraw from the activities they used to do and like. On top of that, many individuals also have other medical conditions. And all of those start getting worse, too. So, if you have high blood pressure or diabetes, those are improved with more levels of activity. And ultimately, people develop weight gain, depression and worsening of other chronic conditions.


CLIFF BLEUSTEIN: That’s one of the reasons why AposHealth is so effective. We’re helping people to walk again. We’re helping alleviate their pain complaints and improve their function. And I think that’s what has driven the success of the company over the last several years.


CHARLES MIZRAHI: So, it’s a sneaker that you modify on the bottom with certain plates that change the way I walk. Why did I feel better almost immediately when walking with this improvement to the sneaker? What was going on?


CLIFF BLEUSTEIN: We are changing how your body interacts with the ground by changing the biomechanics. If you start where your belly button is — which is roughly your center of mass — and draw a line to where your foot interacts with the ground, that creates forces that impact your knee. By moving where the pods are on the ground, we’re changing where those force factors are.


CLIFF BLEUSTEIN: As a result, we are redistributing your weight at your knee level. And by redistributing your weight where your knee is, we’re able to off-load the point of contact that’s creating your pain. It’s like flipping a switch on. By changing the biomechanics so that you’ve off-loaded the pain, you’re now able to walk without pain and your body’s normal gait cycle returns.


CLIFF BLEUSTEIN: And we are able to then remember that new gait cycle by having pods that are convex. They have a small amount of imperceptible wobble on the bottom. So, when you take them off, that wobbling retrains your muscles in this new gait pattern and you’re able to remember it. Just wearing the device for up to an hour a day while you’re doing your normal activities really helps to retrain your muscles. It’s getting all of the activity without the work.


CHARLES MIZRAHI: Yeah, I’ve been finding that. I started wearing it 10 minutes a day. After a week or so, I did 15 minutes and then increased to 25 to 30 minutes a day. And I find that the pain went down. But more importantly, I’m able to walk further distances without an exaggerated gait. Just going down stairs became a confidence-builder for me because I was always scared my knee was going to buckle.


CHARLES MIZRAHI: And I’ve been hearing from a lot of people who have knee problems. All of a sudden, you start attracting these people because everyone has a story about knees — especially athletic people. And one guy said: “I walk down the stairs holding two banisters or I go down on my butt.” That’s how concerning it is. I didn’t realize what a big risk falling was until it happened to me.


CLIFF BLEUSTEIN: AposHealth is FDA-cleared for knee osteoarthritis and temporary improvement in pain and function — which means we’ve done the clinical trials to demonstrate the improvement in function.


CLIFF BLEUSTEIN: Function can be measured in many ways. One is going up and down stairs, and another is walking more quickly. So, we clinically measure velocity — which is how fast a person walks. And we’ve been able to demonstrate an improvement in people’s walking speed.


CLIFF BLEUSTEIN: But equally important are patient-reported outcome measures such as pain, stiffness and function. For example, you’re reporting an improvement in doing not only your daily activities, but the things that were important to you — like working out. That’s a quality of life issue above and beyond the improvement in health that we’re talking about.


CHARLES MIZRAHI: OK, perfect. So, AposHealth was developed in Israel. They’ve been using it for years. It’s in Europe and the United States as well. Is it covered by insurance in the United States?


CLIFF BLEUSTEIN: Yes. We have several insurance carriers that are covering AposHealth as we continue to grow and expand on a regional basis. Our business model grows into each state as we secure additional commercial carriers to cover us.


CHARLES MIZRAHI: For some reason, my insurance doesn’t cover it. Now, I want you to take off your medical hat. For the folks who don’t know you, you are also a professor at New York University.


CLIFF BLEUSTEIN: Yes, at the Stern School of Business.


CHARLES MIZRAHI: So, you have an MD and MBA. I want you to walk me through something I don’t understand. Every year, my health care ratchets up 15% or 20%. I really hit the crossroads when your noninvasive product is $4,000 or $5,000, but I got approved for knee surgery without any problem. It would have included medications, hospital stays, $60,000-plus, longer rehabilitation and physical therapy. It would have cost them a hell of a lot more.


CHARLES MIZRAHI: So, my question to you is: Are the therapies and companies like yours, that delay surgery and big-ticket problems, finding more daylight in health care?


CLIFF BLEUSTEIN: The answer is yes. More companies like us are approaching insurance carriers for coverage or benefits determination. And we get more insurance coverage day by day. I think the challenge insurance carriers have is there are thousands of innovations that they need to review and evaluate. They want clinical trials that have evidence-based research to demonstrate effectiveness of the product. Then, you also have to be able to demonstrate that there’s a need [for your product] and the potential cost savings for the insurance carrier.


CLIFF BLEUSTEIN: Companies like us spend a tremendous amount of time, energy and effort doing research to demonstrate [the product’s] effectiveness in terms of the outcomes. And we are also doing health economics research to demonstrate that we can save insurance carriers and employers money.


CHARLES MIZRAHI: So, for people who are not candidates for surgery, shouldn’t this be something that most insurance companies would be more than happy to do? You’re saving $60,000-plus and a whole bunch of other issues. And here you have something that’s pretty low-impact — $4,000 to $5,000. Shouldn’t that be front and center for them? If I was an insurance carrier and could get the research, I’m saving a fortune on this.


CLIFF BLEUSTEIN: Well, we certainly believe so. We’ve been able to demonstrate time and time again that we can save insurance carriers money. We decrease the utilization of typical health care resources like medication use and visits to physical therapists, orthopedic surgeons and the emergency room. Apart from that, they get savings from either delaying or avoiding surgery. Ultimately, that’s part of the economic value that you have to present to an insurance carrier.


CLIFF BLEUSTEIN: So, we’ve been able to demonstrate to several of the insurance carriers that we can save them money — both by decreasing the total cost of care and avoiding procedures. We see it as a win-win-win. It fulfills the quadruple aim: improve patient outcomes, save insurance carriers money, save patients money and impact our population by helping thousands of patients have better outcomes in an area that often struggles to find solutions.


CHARLES MIZRAHI: Yeah. In the health care industry, do you see a lot of companies like yours that are innovators in healing patients for a fraction of the cost and with low impact? Is this a new trend that I should be looking at as an investor?


CLIFF BLEUSTEIN: Absolutely. A lot of companies out there can bend the cost curve and save money. And AposHealth is certainly one of those that people should look at to see how they can invest in solutions.


CLIFF BLEUSTEIN: One of the top three expenditures for employers is musculoskeletal pain complaints. There are a lot of new entries into the market trying to tackle that issue for employers and payers. And we’re one of them. I think this market innovation is going to continue into the future.


CLIFF BLEUSTEIN: The number of total knee replacement surgeries right now is more than 1 billion a year. That’s expected to grow 6% to 7% every year into the foreseeable future due to an aging population in the U.S. and increased obesity and other risk factors for osteoarthritis. And because of that, it’s a growing market. It’s a growing problem, and there aren’t a lot of great solutions out there.


CHARLES MIZRAHI: This trend is like a tsunami because you have 118 million 50-year-olds and older in this country. So, close to a third of the population is over 50 years old. And the younger cohort of millennials is not growing much in terms of population.


CHARLES MIZRAHI: But over the next five years, the cohort of older Americans will become bigger and bigger. We’re living longer. So, as time goes on, it seems like a tremendous trend in terms of medicine and profit opportunity.


CLIFF BLEUSTEIN: Yeah, you always want to invest in markets that are growing. And the treatment of musculoskeletal conditions is going to grow. The population is getting older, becoming less active and is heavier than we’ve ever been before.


CLIFF BLEUSTEIN: And we know that osteoarthritis of the knee and other conditions are going to continue to grow into the future. We also know that much of the treatment for knee osteoarthritis — in terms of what is approved by the guidelines — includes relatively poor options. The recent indications around knee injections is conditionally approved…


CHARLES MIZRAHI: I had the injections. They did absolutely nothing for me. Then, I had cortisone shots and couldn’t walk for two or three days because my leg swelled up with the volume of liquid in there. And it did nothing. The gel worked for my wife. But for me, it did nothing. And I didn’t want the cortisone anymore. So, those options sucked. They were just terrible.


CLIFF BLEUSTEIN: Yeah. And we clearly have an opioid epidemic in the U.S. You certainly don’t want to be giving opioids to patients who have knee pain. So, you’re left with two ends of the spectrum: physical therapy, education and dieting to reduce your weight or surgery. And that’s where the opportunity for AposHealth comes in as a nonsurgical, safe option to help people walk again and get back to their lives.


CHARLES MIZRAHI: When we were speaking in your office, you told me that back pain has an enormous impact on the economy. You told me some numbers, but I forgot what they were.


CLIFF BLEUSTEIN: Yeah. Roughly 47 million individuals visit their health care providers for complaints of low back pain. An additional 300,000-plus people have back surgery for chronic back pain. And the cost for chronic back pain alone is at least another $66 billion.


CHARLES MIZRAHI: Wow, amazing. So, I want you to take a 10,000-foot view for me because you’re knowledgeable on both ends. You’re knowledgeable from the perspective of running a company as a CEO, as well as seeing the numbers behind it. If you could change one thing in the health care system — the way it’s set up in the United States today — what would it be?


CLIFF BLEUSTEIN: I want the system to be purely patient-centric. I think our health care system has been designed not around how an individual experiences it, but around legacy providers and how they’ve historically delivered the care. If you look at almost every other industry … For example, in banking, all you have to do is pick up your phone. You can do anything under the sun — deposit checks, transfer money, do wire transfers and everything else — on the phone in an extremely seamless way.


CLIFF BLEUSTEIN: I think when people are experiencing health care today, it is not designed around how they would want to experience it. It’s hard to get doctor’s appointments. It’s hard to go to the office. You have to deal with insurance claims, co-pays and deductibles. The customer experience aspect of it has been lacking.


CLIFF BLEUSTEIN: If I could change anything, I would love for all people within the health care environment to focus purely on how we service the needs of an individual the way they want to engage with the health care system.


CLIFF BLEUSTEIN: And that’s certainly what we’re doing in AposHealth. We’re trying to work towards being able to deliver our device where, how and when they want — from the comforts of their own home. Ultimately, our goal is to create a customer experience that’s driven by how patients want to experience it.


CHARLES MIZRAHI: So, why isn’t the medical community being more adaptive to this? You can’t hold back innovation. An example that comes to mind is several years ago, when former Mayor de Blasio wanted to keep out Uber and protect the taxi cabs in New York. He tried and made it difficult, but the public pushed back on not having Uber, Lyft and other ride-sharing services.


CHARLES MIZRAHI: I go to doctors and it’s like nothing has changed since 1975. You have to place a call. Some of them do have apps now. But to get medical information, it’s archaic.


CLIFF BLEUSTEIN: There are a lot of individuals out there trying to change that. All of these new entrants into the market are trying to chip away at what were legacy health care providers. If you look at vaccines today, most people get their vaccines at the pharmacy. You’re not actually getting it at your primary care doctor.


CLIFF BLEUSTEIN: So, as new entrants continue to get into the marketplace and bring different ways of delivering care, they’re going to continue to chip away at the legacy providers and historic ways of doing things. And there are a lot of primary care groups that are trying to do telemedicine and create a different experience for their consumers.


CLIFF BLEUSTEIN: Health care in general is very conservative. And because of that, they’re somewhat risk-averse and nervous about changing the way things have always been done. So, a new way of treating somebody may or may not be better. They’re not sure yet.


CHARLES MIZRAHI: During COVID-19, the telemedicine visits were a gamechanger. I remember going to a dermatologist and spending hours because they booked 47 people for the same half-hour slot. You’d have to take half a day for a 10-minute visit — which can be done on the telemedicine system now. It seems like COVID-19 rapidly pushed this innovation forward. Would you agree with that?


CLIFF BLEUSTEIN: There’s no doubt that telemedicine usage went from less than 1% of all visits to roughly 60% at its peak. It’s probably back down to about 10% now. So, there’s clearly been a shift in how people are thinking about delivering health care — and telemedicine is certainly one option. I think everybody has changed the way they think about interactions.


CLIFF BLEUSTEIN: Having said that, some visits have to be in person. At AposHealth, we do a mix. There are some patients who are amenable to doing treatment with a telemedicine model. And there are other patients who are complex, challenging and better served when seen in a clinic. Then, there are people in between. You may want to see them in person for an initial clinical visit, and then follow up with them by telemedicine.


CLIFF BLEUSTEIN: Health care is learning — or trying to learn — the right patients for each of the different models. That’s going to take time to figure out. But we are always trying to push the envelope in innovation. And we care about patient and customer experience — which is why 98% of all patients who try out AposHealth are willing to refer it to friends and family. That’s ultimately what we strive to do.


CHARLES MIZRAHI: Ten years ago, if you woke up in the middle of the night with a terrible stomach ache and went to the emergency room, you’d sit there for six hours. Now, we have urgent care centers all over the place. And you don’t have to go to a doctor’s office for vaccines. You can go to Walgreens. It is changing — but too slowly for those who want it quicker and too quickly for those who are conservative and want to make sure we don’t screw it up.


CLIFF BLEUSTEIN: It’s all about balance. And as patients continue to demand more, that will speed up the rate of change. Consumers have to be more active in making their health care decisions than they have been historically. And there have been many attempts to try and get better information to consumers — both around pricing transparency and clinical outcomes associated with the choices they’re making.


CLIFF BLEUSTEIN: Health care is clearly more complex than buying a car, but wouldn’t it be cool if we had the same type of information about outcomes and providers that we have for finding out about any car? There are all sorts of reliable data sources that you can go to for information. And I think transparency — which is being implemented now — will help improve that.


CHARLES MIZRAHI: I was reading in The Wall Street Journal that hospitals are supposed to be transparent based on this new law that was passed. And some were putting out web pages that search engines could not find. Many of them didn’t do it at all because they felt there was a competitive disadvantage to let someone know who their surgeon was. But for a patient, it’s absolutely staggering that I can’t compare costs from hospitals A, B and C. Why is that?


CLIFF BLEUSTEIN: It’s hard. At the end of the day, every hospital negotiates their own reimbursement rates for all the procedures they’re doing with the different insurance carriers. And it is a competitive marketplace out there. Health care is still a business. Sometimes, people don’t want to think of it that way. But it is a business.


CHARLES MIZRAHI: But why can’t I compare as a consumer? You’re saying it’s a business, but you’re not disclosing information that can benefit me by making me a more informed consumer. How is that good business?


CLIFF BLEUSTEIN: I think that every consumer would love to have price transparency. What makes health care complex is that, unlike a car — where you’re going to the dealer and paying out of pocket to buy it — we have a third-party payment system. So, typically your insurance carrier is paying on your behalf for whatever services you’re receiving. And you are only paying a fraction of the cost in out-of-pocket expenditures. So, it makes it a little bit more complex to understand and create that type of transparency.


CLIFF BLEUSTEIN: But if you look at Medicare, it’s publishing the rates they’re paying for most procedures across the board. You could see how much surgeons are making for most procedures based on Medicare. And you can get a pretty good guess as to what the pricing is based on those fees.


CHARLES MIZRAHI: Yeah. It’s an industry that’s still such a black hole for the consumer. I really know nothing about what goes on — other than what’s on the surface. You get a bill at the end of a medical procedure that shows what the insurance company paid. I got a brace for my knee and it came out to $900 — for something I could have bought on Amazon for $64. I just don’t get that.


CLIFF BLEUSTEIN: You asked me earlier what I would change about health care. From my perspective, the question is: How do you create a patient experience that is driven by what consumers ultimately want? How do you deliver care where, how and when they want? That’s ultimately what we’re trying to do at AposHealth and what a better-designed health care system is going to deliver.


CHARLES MIZRAHI: Yeah, I just hope they do this quicker. Because we have an aging population and 118 million people over 50 years old. The prices I pay for insurance are absolutely insane. I could have put a down payment on a house for the price we’re paying. And they keep going up quicker than the rate of inflation. Inflation has no bearing on this. In New York, it’s been going up 15% or so for a couple of years. It’s staggering. This is an industry that’s ripe for innovative disruption.


CLIFF BLEUSTEIN: There’s no doubt. And that’s one of the reasons there is so much investment right now in all of these different types of innovations and technologies to disrupt the market. You’re talking about an economy that makes up roughly 18% to 19% of the total GDP of the United States.


CHARLES MIZRAHI: Let’s put that in dollars. That’s $4 trillion or so a year — $12,500 for every man, woman and child in the United States.


CLIFF BLEUSTEIN: I’ll put the number differently. Our health care expenditure is larger than the entire economy of almost every country in the world. We spend more on health care than almost every other country in the world does in terms of their entire economies. So, there’s no doubt we spend a tremendous amount of money on health care.


CLIFF BLEUSTEIN: Companies like us are trying to innovate because we want to disrupt what is traditionally an area in musculoskeletal that costs a lot of money. It needs innovations to drive the cost of care down and improve patient outcomes in a transparent way.


CHARLES MIZRAHI: Wow, outstanding. All the power to you and AposHealth. As I said, I’m a patient. So, we just started the process. You said it’s about a year-long journey on this. But so far, so good. I want to have you on a year from now, and I’m going to tell you how it’s going.


CHARLES MIZRAHI: To me, this is what the semiconductor chip in technology was 50 or 60 years ago — it disrupted a whole industry. The health care industry is $4 trillion. There’s too much money there to not be disrupted in a big way. And there are going to be a few big players that are going to go both feet in. The innovation keeps picking up. And that’s a great thing for everybody. Like you said, it’s a win-win-win.




CHARLES MIZRAHI: Beautiful. Dr. Cliff Bleustein with AposHealth, folks. I’ll put a link in the description so you can check them out. They have some nice videos. Look at the site.


CHARLES MIZRAHI: Like I said, I’m using it and so far, so good. Everything’s working. The hardest part was tying the laces. And it became a lot easier. We have to help companies like yours not only stay in business but thrive. Because you guys are the tip of the spear in attacking a $4 trillion industry.


CLIFF BLEUSTEIN: Thanks, Charles. And remember, you also failed everything else first. So, you’re coming to us after you tried everything else — from injections to physical therapy to pain medication. You’re coming to us as a typical patient — one who has failed with everything else and is coming as a last resort before surgery.


CLIFF BLEUSTEIN: So, we’re happy to hear that you’re doing well so far. It’s expected that you’ll continue to improve since it’s still relatively early on. We’re excited to be able to come on your show and talk about our company.


CHARLES MIZRAHI: Beautiful. Cliff, thanks so much for coming on the show. It was great. We’ll have you on a year from now. And hopefully, I’ll be tap dancing by then.


CLIFF BLEUSTEIN: Sounds great. Looking forward to it.


CHARLES MIZRAHI: All right. Thanks so much, Cliff.



CHARLES MIZRAHI: Thanks for listening to this episode of The Charles Mizrahi Show. If you’re a new listener, welcome! If you’ve been listening for a while, we’re glad to have you back. Either way, we’d love to know what you think of the show. Please leave a review if you listen on Apple Podcasts. Reviews make it easier for others to find the show. You can also see the video of the interview on The Charles Mizrahi Show channel on YouTube.


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