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Illustration: Aïda Amer/Axios

Adam Boehler was one of very few VC-backed founders who joined the Trump administration, leaving Landmark Health in 2018 to become director of the Center for Medicare and Medicaid Innovation. Now he's back in the private sector, with a new startup that wants to disrupt the kidney care market.

Why it matters: The CDC estimates that 15% of U.S. adults suffer from some form of chronic kidney disease, including more than 38% of those over 65 years old.

  • There are plenty of businesses servicing this population, including a pair of publicly traded dialysis center giants. But Boehler argues they're too focused on fees, and too little on helping patients get at-home treatments or kidney transplants.
  • It's a case that's been made by several academic nephrology centers, with which Boehler says he wants to partner. It's also reminiscent of Landmark Health, which focused on at-home medical services and which was bought earlier this year by a UnitedHealth subsidiary for billions of dollars.

The new company is called Evergreen Health, and will be publicly unveiled later Tuesday.

  • It's under the umbrella of a healthcare incubator called Rubicon Founders, which Boehler recently formed with an undisclosed amount of funding from Oak HC/FT and Welsh, Carson, Anderson & Stowe. At least $25 million is being dedicated to Evergreen's launch.

Lessons learned: Boehler says his big takeaway from Landmark Health was that physicians will change their behavior if compensation is linked more to patient outcomes than to their procedures.

  • "We told physicians that we were going to pay them very well, but pay them very well for treating patients the way they wanted to when they went to medical school ... Who gives a shit how many patients you can see in a day at a dialysis center? Instead of seeing 20 patients, see three and get them to a place where they can be treated at home or get a transplant."
  • Boehler, who also served as the first-ever CEO of the U.S. International Development Finance Corp., adds that his big lesson from government was that it has a lot more smart and talented people than he realized while in the private market, and says "there's no platform like it in terms of making an impact if you're willing to lean in."

Look ahead: Expect Rubicon Founders to continue launching new companies focused on health markets that it considers to have at least $1 billion of value opportunity.

Go deeper

Tech founders have left the building

Illustration: Aïda Amer/Axios

Most of today's tech giants are no longer run by their founders, but by a new breed of successor CEOs tasked with holding true to a corporate mission while continuing to pump up growth.

The big picture: Silicon Valley has long embraced a "founders know best" philosophy. But eventually, most successful founders get old and tired and rich — and lose interest in the meetings, the management messes, and the sheer hard work of running a company.

Kate Marino, author of Markets
Sep 8, 2021 - Economy & Business

Businesses grapple with vax mandates and COVID policies

Illustration: Sarah Grillo/Axios

A growing number of U.S. companies have mandated COVID-19 vaccinations for employees. But in the absence of a federal mandate there's a wide variance in what’s happening — mandates for all, some, or none — with employee demands being put front and center thanks to the Great Resignation.

Why it matters: How companies answer questions about vaccines and return-to-work policies has wide ranging impacts — on the health of their employees, on where people live, and on the strategic direction of their businesses.

Biden: There won't be "American forces moving into Ukraine"

President Joe Biden told reporters Tuesday that he does not foresee U.S. troops moving into Ukraine.

Why it matters: Biden's comments come as tensions between Russia and Ukraine persist, and a Russian invasion of Ukraine appears increasingly likely.