BLACKROCK FUTURE FORUM

Healthcare in the age of the coronavirus

Jul 21, 2020

Mark McCombe, BlackRock’s Chief Client Officer, hosted conversations with three senior leaders from the healthcare industry — Gianrico Farrugia, President and CEO of Mayo Clinic; Craig Thompson, President and CEO of Memorial Sloan Kettering Cancer Center; and David Wichmann, CEO of UnitedHealth Group. They discussed how the efforts to combat the coronavirus are progressing, how technology and telemedicine are impacting the industry and what the future of healthcare may look like.

After the conversation, Erin Xie, BlackRock’s Head of Health Sciences Investing for Active Equities, provided perspectives on how the topics discussed are affecting the opportunity set for healthcare investors.

Mark McCombe: Well, thank you for that introduction Zach. Now, I’m delighted to welcome three leaders in healthcare who’ve been in the eye of this pandemic that has swept the globe.

First, I’d like to introduce Dr. Gianrico Farrugia, President and CEO of the Mayo Clinic. Dr. Farrugia has spent over 30 years with the Mayo Clinic, which remains one of the preeminent healthcare institutions in the world, and he took over as CEO in 2019.

Dr. Craig Thompson, President and CEO of Memorial Sloan Kettering also joins us. Dr. Thompson became President and CEO in November 2010 after a long and distinguished career with Memorial Sloan Kettering. Memorial Sloan Kettering is the world’s oldest and largest private institution devoted to cancer prevention, treatment, research and education.

Later on in the session, I will be having a conversation with Dave Wichmann, CEO of United Health Group, the largest health insurer in the US. And then, finally, I’ll discuss investment implications for the healthcare sector with BlackRock Erin Xie, who heads our Health Sciences Investment Group within our Active Equities Business.

Mark McCombe: Well, Dr. Farrugia and Dr. Thompson, you’ve very kindly allowed me to call you by your first names. So, let’s get started. And Craig, Perhaps just could you situate for us a little bit your experience as a long-term healthcare professional of just what you've seen and experienced in New York with regard to this pandemic?

Craig Thompson: Well, certainly, Mark. It was, as everyone knows, just an unprecedented event as New York became the epicenter beginning in March. it really was amazing to be part of the care response here in New York as our death total reached over 20,000 here in the City and our infection rate got to over 230,000 people over the last four months. It really required a coordinated level of effort at the state, the federal, and all of the individual hospitals that make up New York’s extensive healthcare system.

This is the first time in my medical career of over 40 years that we faced an entirely new pathogen that had this level of transmissibility.

Past viruses had either been very different in how severely ill they made people and that limited its infection, or they weren’t very transmissible. Other coronaviruses before us, like SARS-1, had not been particularly transmissible. So, even when it arrived in the United States, contact tracing did extremely well. We did not appreciate the transmissibility.

It got way ahead of our normal mechanisms of controlling an epidemic and it required a full conversion of all the hospitals here in New York to just being capable to care for the surge of COVID patients. At our own hospital at the time it started, we were treating 150,000 patients actively with cancer. We knew from the Chinese and Italian experience that they were more at risk for getting COVID and from dying potentially of COVID. So, That mean establishing massive increases in our PPE supplies to be able to do that, as well as to develop treatment protocols.

So, as we see the surge now in the Southwest part of the United States, there are better treatment protocols. Our PPE supply lines are better and that’s what is changed as from the emergent emergency that we saw March, April, and May to now this resurgence where the healthcare system has better protocols to deal with it.

Mark McCombe: perhaps, Gianrico, I can turn to you, because, you know, the Mayo Clinic has a lot of operations in Florida and Arizona, two of the states that are seeing this resurgence. What have you learned from the experience out of New York and how are you applying that as this resurgence takes place in these different southern states?

Gianrico Farrugia: Thank you. And as you heard from Craig, we’ve learned a lot, learned a lot from what’s going on outside of the United States, from New York, and from our own work.

Therefore, a lot of the models were built around the fact that what did we understand about previous pandemics and that included the pandemic, the Great Influenza pandemic of a huge surge and then a second wave. . We learned from it by physical distancing and later by masking, by testing, by contact tracing. The surge did not appear as much in other parts of the country and, therefore, it left a lot of people exposed. And now, we’re seeing that play out.

It’s relevant that in some countries this resurgence was stopped because there was an ability to clamp down. But, in a country as big as ours with states playing different roles, we’ve seen how it is really important to learn and be able to identify quickly and then intervene. And what we’ve done is we’ve co-op’d resources with our partners to predict what’s going to happen next two or three weeks and then we have to live with this for several more months at least. And, therefore, like Craig, we’re going to have look after patients with COVID and patients with complex and/or serious disease and do them both at the same time. And, therefore, predicting and then being able to juggle the two and modulate who’s coming to our hospital has been a big help.

We’ve also developed our own testing to be able to keep our hospital safe. And importantly, this resurgence, this innovation around telemedicine has allowed us to modulate how many people actually need to come to see us, combining that with a partnership we have with Medically Home developing new models of keeping patients with serious disease safe.

Mark McCombe: there’s obviously a lot of debate about testing and testing protocols. there’s a lot of debate about CDC guidelines around things like wearing masks. Can you just give us a sense how would you inform us of the importance of testing?

Gianrico Farrugia: This virus is different in the sense that it is highly infectious, as you heard, and it’s infectious even when somebody has it and is asymptomatic. Without testing, you simply cannot know who has the infection. You cannot contact trace and, therefore, you cannot limit spread. Therefore, if we want to be able to safely reopen our economy, if we want to be able to control this surge and future waves, and as I’ve said, I believe there’s going to be a frequency of about eight weeks of a wave

We have to be able to test and give results to people as quickly as possible a big push for Mayo Clinic as we developed our own testing capabilities is to make sure we can give results within that 24-36 hour time period, which is crucial.

Mark McCombe: Craig, I'd love to get your perspectives in how you’re seeing people’s behavior change given the uncertainty. are you seeing people beginning to reengage with healthcare in the normal course of business or is there still a great deal of uncertainty and fear

Craig Thompson: Sure. at the start of March, we were treating 150,000 patients. Our hospital was filled, our outpatient clinics.

Our ability to treat patient with radiation oncology was completely full, because that’s pretty much how we run as a referral center. We were down on our cancer care delivery about 80% by the end of April. We have recovered back to nearly 90% of our pre-COVID levels now, because we’ve been able to control the epidemic here in New York.

This week, we had the first day with no one having died of COVID since March in the greater New York area. And, in addition, we are gone now multiple days without any new patients being diagnosed as part of our screening procedures.

We’re able to, as Gianrico said, now do surveyance testing of all of our staff. We test every patient as they come to care

PPE is the biggest issue that makes a difference and the PPE that really matters that he pointed out is the universal masking of everyone involved in healthcare. It is really the first, second, third, fourth, and fifth thing that really controls the spread of this virus.

So, all measures of hygiene, hand washing, changing your clothes, protective gowns, were equal, given equal importance.

But we are getting public health fatigue, And so, we’re trying to focus on the central messages of what they should do, that we still need social distancing wherever possible. And at the same time, we are engaging people in returning to normal activities of healthcare and self-maintenance.

Where we are concerned is that the 20-somethings here in New York have experienced a resurgence in the incidence of surveyance testing and their caseload. All other age groups are declining still in New York. But, we are worried that the social congregation when they initially opened up restaurants and bars led the 20-somethings to thinking this was over and we’re reinforcing that message, starting in the healthcare industry That's what the US needs to understand as we move forward.

Mark McCombe: With so many people on the frontline and dealing with these extraordinarily traumatic situations, how have you been dealing with your colleagues from a mental health point of view and just a resilience in managing through this pandemic?

Gianrico Farrugia: Look. So, this is a real phenomenon. You just heard Craig describe what happens when you have to deal with something for week after week, now month after month. It’s a mixture of pride and exhaustion, both from the healthcare worker standpoint, as well from the hospital itself. They’ve supported each other. They’ve kept each other going and the results show.

At the same time, it is incredibly hard to put on protective equipment several times a day, to go home and also be careful to keep physically distanced so that you don’t bring infections back to the hospital. increasingly, we have to look after the mental health, the physical health of our workers so they can continue to provide help to patients. And that will include finding ways of unexpected joy in the workplace and that’s what we’re working on at the moment

Mark McCombe: As you think about where we are today, the US is on a different path from many other countries. What insights would you bring about the importance of having a national strategy to respond to a pandemic like this, as well as obviously the local nuances that exist within the state structure?

Craig Thompson: So, I want to reinforce something Gianrico said. What really helped the most for us at Memorial Sloan Kettering beyond the masking and the PPE was the ability to test. And we were lucky in that we were able, through our Research division our Laboratory Medicine program the first FDA approved test for New York City.

That testing was critical to limit the spread of infection.

We need a national strategy of testing that duplicates that, that we all can feel confident we’re getting the same test results. And, as Gianrico said, it’s got to be done in real-time. We return results now within 12 hours everywhere in our care mission. We need that on a national level. That has to have national leadership.

The other area that’s critically important on a national level was to reestablish supply chains of PPE those supply chains were broken and there was no way to reestablish them.

The national effort to reestablish that working publicly and private has given a lot more confidence to the healthcare system as we move forward. But we need that to continue on into the future if we’re going to do this effectively.

Mark McCombe: Gianrico, Can you give us a little bit of your kind of perspectives go – looking forward as to what changes in the healthcare system now then also perhaps just a little bit of a view on things like the national strategy?

Gianrico Farrugia: Yes. Let me start off by saying that in times of crisis it is important to speak with one voice. Even when there’s uncertainty, you need to have some sort of clarity with the understanding that things may change over time. as we deal with this pandemic, it becomes crucially important to understand that funding, the National Institute of Health, funding NCI, funding the FDA, funding state healthcare departments is critical. Funding has to remain a priority.

We have to further integrate telehealth with face-to-face visits so that they’re not either/or. (Chyron: Gianrico Farrugia says we have to further integrate telehealth with face-to-face visits.) They become one whole experience for the patient. And fundamentally, we have to as healthcare workers, as a healthcare industry, take the reins and say we are going to transform healthcare from within. We know how to do it, we’ve shown that we can do it, and we have to make sure that we do not let up on some of the change that needs to happen within our system.

Mark McCombe: Craig, We're three years or five years down the line from today. When we look back on this experience, what lessons do you think we should have learned? And secondly, how as a non-healthcare professional, how do you think COVID-19 will be viewed and treated in that point of time?

Craig Thompson: Yeah, I think we’ll have some experimental vaccines even within this year. But one that will be safely given to the entire 300 million Americans probably will take several years. (Chyron: Craig Thompson believes we’ll have experimental vaccines this year. But it will be several years before all Americans can be vaccinated.) And so, we’re going to have to continue to use public health measures to control this and to continue providing healthcare to all the other diseases.

The opportunity to change, which is what Gianrico introduced, is telemedicine’s time is there. The ability to use digital platforms to deliver and enter people into care we have got to expand on in this opportunity. The federal government and the state governments have been very helpful in that in relaxing restrictions. It will be a terrible shame if we revert to the things that restricted our ability to communicate with patients on digital and telemedicine platforms and to do remote access and monitoring of patients as we go forward.

Mark McCombe: Well, Gianrico and Craig, I'd just like to thank you again for both of you for giving up your very valuable time and wish you all the very best to all your colleagues as we move forward through this pandemic. Thank you.

Well, I'm thrilled now to be joined by Dave Wichmann, CEO of the United Health Group.

You have over 300,000 serving 140 million people worldwide, you probably have an incredible seat on and view on what’s been going on with this pandemic. I wonder if we could just tee things off with you giving us a bit of perspective on how you think the healthcare industry has managed through this unprecedented global shock.

Dave Wichmann: Yeah. Well, I appreciate it, the opportunity to do so and give strong recognition to, first of all my team, the 325,000 people globally of which about 120,000 of them are clinical workers and they’re on the front lines of care and they’re on the front lines of care that you read about. .

I think the health system has done a very good job not knowing exactly where to go, there is no known treatment for COVID-19. And so, it was really the individual ingenuity of the people that are in hospital systems and care delivery practices that made a very large difference in managing this pandemic to date.

I'd say one of the things that we focused on very early was we realized that testing was going to be a constraint in healthcare. And so, we had to go from, modest amount of tests per day to, you know, nearly a million.

So, one of the things you don’t see in our company is the scientific capacities..

We also, adapted to working with the healthcare delivery system on creating an infectious disease model and a way to protect the health workforce. we created a mechanism so that when people encountered a COVID-19 infected patient, would actually follow a clinical protocol at the same time make sure that they were safe and not transmitting virus onto other patients. So, that was designed in collaboration with HCA and some others to make that happen.

And then we needed to address health equity issues. There’s a high correlation to the impact of the disease and the living conditions of individuals.

Now overall, I think the industry has adapted nicely

Mark McCombe: I think you’ve reported previously has been the delaying of elective procedures. Could you perhaps give us a bit of perspective on is that a sort of second health crisis as more and more people have decided to stay away from the hospital systems or delay important procedures. And as you look forward, how do you think the health industry will cope with perhaps the catch-up that needs to happen over the coming months and years?

Dave Wichmann: Yeah. That's a very good question. We like to refer internally here that there’s three pathogens. One’s COVID-19, the virus, the second is the economic downturn and the third is the deferred care that’s occurred. There’s been a measured reduction in the number of heart attacks and in strokes and you know that that’s not because of the fact that the prevalence has dropped, but rather people did not seek care for their heart attack or stroke.

you see the same thing with respect to access to primary care and specialists. an almost three-quarter reduction in access to those services in the initial instance and that resulted in a material reduction in what we call first time fills for pharmacies as well.

Dave Wichmann: So, what we showed in our earnings call, was that there was a significant deferral of procedures through the second quarter and our expectation is that procedures will be seasonally up in the third and the fourth quarter of this year and we expect that the acuity levels of those visits will be up as well.

Mark McCombe: Can you tell us a little bit about like what does it actually mean practically and how are you as an organization thinking about kind of the use of technology in the healthcare system going forward?

Dave Wichmann: Yeah. Well, just to give you a perspective, telemedicine was used thirtyfold in the month of April relative to the month of January this year. So, we engaged a full four million telemedicine visits, you know, as just in our own operations. we enabled telemedicine visits directly with their own doc and that’s where telemedicine needs to go.

What we’re doing is we’re building a broader capacity around the home, which we think is essential. It’ll be part of the care, of the clinic of the future. (Chyron: Dave Wichmann says that the home will be part of the clinic of the future.) What that really requires is that you have a really strong digital signaling platform, which gives the biometrics are of the patient.

And I think you’ll see advances in all these fronts. I know you will from us over the course of the next six months and I imagine the industry broadly will advance.

Mark McCombe: Can we talk just for a second about kind of the future of the health industry, both in the US and globally? what do you see in terms of the cost dynamic of healthcare? And does telemedicine, for example, reduce the cost? are there other measures that have to be brought in that will actually increase costs?

Dave Wichmann: Yeah. Well, I think the – you're going to see rising use of information for decision making and greater alignment of incentives to the health system around achieving strong outcomes experiences and lower cost structures broadly.

I think telemedicine in general will continue to be utilized.

So, making sure that the physicians and the patient actually know based upon a unified portable medical record which has AI deployed to determine next best action. That's where telemedicine needs to go. all in an order to achieve the triple aim, which is to reduce healthcare costs, improve experiences, and to improve outcomes for the patient.

Mark McCombe: As you look forward, over the next three years or five years, what do you think will change forever as a result of this pandemic and what things have we learned that you think will actuallyguide medicine and healthcare?

Dave Wichmann: I think the biggest transition you’ll see in the next five years is how ambulatory care becomes –what we’ve learned is there’s a lot of myths about procedures that have to be performed in facilities, either doctor’s offices, hospitals, outpatient centers, that really simply don't need to.

I think you’re going to see the home and the ambulatory markets, meaning the primary care through ambulatory surgery, just explode.

Mark McCombe: thank you again for joining us on a very busy day and taking the time out to speak to our colleagues and partners across the world.

Dave Wichmann: Well, we appreciate it. We’re going to keep working for America, for South America, and the world and aiding new discovery around treatment, around cure

Mark McCombe: All right, well let me bring in Erin here. Erin’s the head of BlackRock’s Health Science’s investing arm, which invests actively across the healthcare sector. Erin’s a PhD and has been with BlackRock for coming up on 20 years, all dedicated to healthcare industry.

Erin, welcome to the session and thanks for spending time with us.

Mark McCombe: in what areas are you seeing some of the more important innovations in healthcare and what are some of the key themes that make up your macro investment thesis today?

Erin Xie: Sure. So, I like to think we actually are really at the inflection point of genomics revolution and digital, digital revolution. (Chyron: Erin Xie says we are at the inflection point of the genomics revolution and the digital revolution.) From the genomics side, I think the industry is really benefiting from decades of genomics research. So, we really have much deeper understanding of human biology and also the causes of diseases.

So, across multiple therapeutic areas we’re seeing some really exciting new medicines emerging. For example, in cancer therapy versus historical chemotherapy, we’re really seeing new ways of medicine targeting specific cancers. there are companies, for example Seattle Genetics was really at the forefront of a so-called antibody drug conjugate, which they very smartly designed antibody that look for specific cancer cells and also drag a toxin linked to the antibody and when the antibody look for the cancer cells, the toxin does the double killing. And it’s this type of technology and many other very exciting cancer drug pipeline that really are pushing a new wave of medicines. And this is not just in cancer. We’re seeing great medicine emerging in autoimmune diseases and as well as genetic diseases.

Elsewhere, we’re also seeing robotic surgery being developed and still we’re very early in either. So, quite bit of room to improve the technology and adoption. Even hospital beds these days have smart function. There’s also many new device and tools for remote monitoring of people’s health conditions, such as, you know, your blood sugar or heart, you know, heart rate. All of this, I think, really the – really make the underlying companies great investment opportunities.

Mark McCombe: Erin, you’ve been an investor in health sciences for nearly two decades now. I'm sure you’ve seen some incredible changes and evolutions during that time. But perhaps you could just give us a few examples of how you – you’re taking advantage of the dispersion in the market as you think about your investment strategies.

Erin Xie: when hospitals really tried to dedicated resources to take care of the COVID patients, a lot of the elective procedures were canceled or delayed. So, there’s some really high-quality medical device companies manufacturing elective procedure products. Their stocks really got hurt badly.

We think from a long-term perspective this actually represents very attractive price point for these securities as we think the elective procedures will come back as the COVID situation normalize at some point. It’s really a matter of when, not if. And this is act – the market actually make such securities, some very high-quality companies, for example, Boston Scientific, Stryker, so forth, very attractive.

Mark McCombe: Erin, thank you for that.

We’ve heard from two of the leading CEOs of some of the most renowned hospital systems in the country and globally, and also from Dave Wichmann from United Healthcare Group, who’s really given us insight into how that healthcare industry is evolving. And Erin, you’ve brought us home with some really fascinating investment insight.

So, I'd just like to say thank you, again, to all the panel members and particularly to all of those colleagues of theirs working on the frontlines to get us through this pandemic. So, with that, Zach, I'd like to hand it back to you. And thank you.

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Mark McCombe: Well, thank you for that introduction Zach. Now, I’m delighted to welcome three leaders in healthcare who’ve been in the eye of this pandemic that has swept the globe.

First, I’d like to introduce Dr. Gianrico Farrugia, President and CEO of the Mayo Clinic. Dr. Farrugia has spent over 30 years with the Mayo Clinic, which remains one of the preeminent healthcare institutions in the world, and he took over as CEO in 2019.

Dr. Craig Thompson, President and CEO of Memorial Sloan Kettering also joins us. Dr. Thompson became President and CEO in November 2010 after a long and distinguished career with Memorial Sloan Kettering. Memorial Sloan Kettering is the world’s oldest and largest private institution devoted to cancer prevention, treatment, research and education.

Later on in the session, I will be having a conversation with Dave Wichmann, CEO of United Health Group, the largest health insurer in the US. And then, finally, I’ll discuss investment implications for the healthcare sector with BlackRock Erin Xie, who heads our Health Sciences Investment Group within our Active Equities Business.

Mark McCombe: Well, Dr. Farrugia and Dr. Thompson, you’ve very kindly allowed me to call you by your first names. So, let’s get started. And Craig, Perhaps just could you situate for us a little bit your experience as a long-term healthcare professional of just what you've seen and experienced in New York with regard to this pandemic?

Craig Thompson: Well, certainly, Mark. It was, as everyone knows, just an unprecedented event as New York became the epicenter beginning in March. it really was amazing to be part of the care response here in New York as our death total reached over 20,000 here in the City and our infection rate got to over 230,000 people over the last four months. It really required a coordinated level of effort at the state, the federal, and all of the individual hospitals that make up New York’s extensive healthcare system.

This is the first time in my medical career of over 40 years that we faced an entirely new pathogen that had this level of transmissibility.

Past viruses had either been very different in how severely ill they made people and that limited its infection, or they weren’t very transmissible. Other coronaviruses before us, like SARS-1, had not been particularly transmissible. So, even when it arrived in the United States, contact tracing did extremely well. We did not appreciate the transmissibility.

It got way ahead of our normal mechanisms of controlling an epidemic and it required a full conversion of all the hospitals here in New York to just being capable to care for the surge of COVID patients. At our own hospital at the time it started, we were treating 150,000 patients actively with cancer. We knew from the Chinese and Italian experience that they were more at risk for getting COVID and from dying potentially of COVID. So, That mean establishing massive increases in our PPE supplies to be able to do that, as well as to develop treatment protocols.

So, as we see the surge now in the Southwest part of the United States, there are better treatment protocols. Our PPE supply lines are better and that’s what is changed as from the emergent emergency that we saw March, April, and May to now this resurgence where the healthcare system has better protocols to deal with it.

Mark McCombe: perhaps, Gianrico, I can turn to you, because, you know, the Mayo Clinic has a lot of operations in Florida and Arizona, two of the states that are seeing this resurgence. What have you learned from the experience out of New York and how are you applying that as this resurgence takes place in these different southern states?

Gianrico Farrugia: Thank you. And as you heard from Craig, we’ve learned a lot, learned a lot from what’s going on outside of the United States, from New York, and from our own work.

Therefore, a lot of the models were built around the fact that what did we understand about previous pandemics and that included the pandemic, the Great Influenza pandemic of a huge surge and then a second wave. . We learned from it by physical distancing and later by masking, by testing, by contact tracing. The surge did not appear as much in other parts of the country and, therefore, it left a lot of people exposed. And now, we’re seeing that play out.

It’s relevant that in some countries this resurgence was stopped because there was an ability to clamp down. But, in a country as big as ours with states playing different roles, we’ve seen how it is really important to learn and be able to identify quickly and then intervene. And what we’ve done is we’ve co-op’d resources with our partners to predict what’s going to happen next two or three weeks and then we have to live with this for several more months at least. And, therefore, like Craig, we’re going to have look after patients with COVID and patients with complex and/or serious disease and do them both at the same time. And, therefore, predicting and then being able to juggle the two and modulate who’s coming to our hospital has been a big help.

We’ve also developed our own testing to be able to keep our hospital safe. And importantly, this resurgence, this innovation around telemedicine has allowed us to modulate how many people actually need to come to see us, combining that with a partnership we have with Medically Home developing new models of keeping patients with serious disease safe.

Mark McCombe: there’s obviously a lot of debate about testing and testing protocols. there’s a lot of debate about CDC guidelines around things like wearing masks. Can you just give us a sense how would you inform us of the importance of testing?

Gianrico Farrugia: This virus is different in the sense that it is highly infectious, as you heard, and it’s infectious even when somebody has it and is asymptomatic. Without testing, you simply cannot know who has the infection. You cannot contact trace and, therefore, you cannot limit spread. Therefore, if we want to be able to safely reopen our economy, if we want to be able to control this surge and future waves, and as I’ve said, I believe there’s going to be a frequency of about eight weeks of a wave

We have to be able to test and give results to people as quickly as possible a big push for Mayo Clinic as we developed our own testing capabilities is to make sure we can give results within that 24-36 hour time period, which is crucial.

Mark McCombe: Craig, I'd love to get your perspectives in how you’re seeing people’s behavior change given the uncertainty. are you seeing people beginning to reengage with healthcare in the normal course of business or is there still a great deal of uncertainty and fear

Craig Thompson: Sure. at the start of March, we were treating 150,000 patients. Our hospital was filled, our outpatient clinics.

Our ability to treat patient with radiation oncology was completely full, because that’s pretty much how we run as a referral center. We were down on our cancer care delivery about 80% by the end of April. We have recovered back to nearly 90% of our pre-COVID levels now, because we’ve been able to control the epidemic here in New York.

This week, we had the first day with no one having died of COVID since March in the greater New York area. And, in addition, we are gone now multiple days without any new patients being diagnosed as part of our screening procedures.

We’re able to, as Gianrico said, now do surveyance testing of all of our staff. We test every patient as they come to care

PPE is the biggest issue that makes a difference and the PPE that really matters that he pointed out is the universal masking of everyone involved in healthcare. It is really the first, second, third, fourth, and fifth thing that really controls the spread of this virus.

So, all measures of hygiene, hand washing, changing your clothes, protective gowns, were equal, given equal importance.

But we are getting public health fatigue, And so, we’re trying to focus on the central messages of what they should do, that we still need social distancing wherever possible. And at the same time, we are engaging people in returning to normal activities of healthcare and self-maintenance.

Where we are concerned is that the 20-somethings here in New York have experienced a resurgence in the incidence of surveyance testing and their caseload. All other age groups are declining still in New York. But, we are worried that the social congregation when they initially opened up restaurants and bars led the 20-somethings to thinking this was over and we’re reinforcing that message, starting in the healthcare industry That's what the US needs to understand as we move forward.

Mark McCombe: With so many people on the frontline and dealing with these extraordinarily traumatic situations, how have you been dealing with your colleagues from a mental health point of view and just a resilience in managing through this pandemic?

Gianrico Farrugia: Look. So, this is a real phenomenon. You just heard Craig describe what happens when you have to deal with something for week after week, now month after month. It’s a mixture of pride and exhaustion, both from the healthcare worker standpoint, as well from the hospital itself. They’ve supported each other. They’ve kept each other going and the results show.

At the same time, it is incredibly hard to put on protective equipment several times a day, to go home and also be careful to keep physically distanced so that you don’t bring infections back to the hospital. increasingly, we have to look after the mental health, the physical health of our workers so they can continue to provide help to patients. And that will include finding ways of unexpected joy in the workplace and that’s what we’re working on at the moment

Mark McCombe: As you think about where we are today, the US is on a different path from many other countries. What insights would you bring about the importance of having a national strategy to respond to a pandemic like this, as well as obviously the local nuances that exist within the state structure?

Craig Thompson: So, I want to reinforce something Gianrico said. What really helped the most for us at Memorial Sloan Kettering beyond the masking and the PPE was the ability to test. And we were lucky in that we were able, through our Research division our Laboratory Medicine program the first FDA approved test for New York City.

That testing was critical to limit the spread of infection.

We need a national strategy of testing that duplicates that, that we all can feel confident we’re getting the same test results. And, as Gianrico said, it’s got to be done in real-time. We return results now within 12 hours everywhere in our care mission. We need that on a national level. That has to have national leadership.

The other area that’s critically important on a national level was to reestablish supply chains of PPE those supply chains were broken and there was no way to reestablish them.

The national effort to reestablish that working publicly and private has given a lot more confidence to the healthcare system as we move forward. But we need that to continue on into the future if we’re going to do this effectively.

Mark McCombe: Gianrico, Can you give us a little bit of your kind of perspectives go – looking forward as to what changes in the healthcare system now then also perhaps just a little bit of a view on things like the national strategy?

Gianrico Farrugia: Yes. Let me start off by saying that in times of crisis it is important to speak with one voice. Even when there’s uncertainty, you need to have some sort of clarity with the understanding that things may change over time. as we deal with this pandemic, it becomes crucially important to understand that funding, the National Institute of Health, funding NCI, funding the FDA, funding state healthcare departments is critical. Funding has to remain a priority.

We have to further integrate telehealth with face-to-face visits so that they’re not either/or. (Chyron: Gianrico Farrugia says we have to further integrate telehealth with face-to-face visits.) They become one whole experience for the patient. And fundamentally, we have to as healthcare workers, as a healthcare industry, take the reins and say we are going to transform healthcare from within. We know how to do it, we’ve shown that we can do it, and we have to make sure that we do not let up on some of the change that needs to happen within our system.

Mark McCombe: Craig, We're three years or five years down the line from today. When we look back on this experience, what lessons do you think we should have learned? And secondly, how as a non-healthcare professional, how do you think COVID-19 will be viewed and treated in that point of time?

Craig Thompson: Yeah, I think we’ll have some experimental vaccines even within this year. But one that will be safely given to the entire 300 million Americans probably will take several years. (Chyron: Craig Thompson believes we’ll have experimental vaccines this year. But it will be several years before all Americans can be vaccinated.) And so, we’re going to have to continue to use public health measures to control this and to continue providing healthcare to all the other diseases.

The opportunity to change, which is what Gianrico introduced, is telemedicine’s time is there. The ability to use digital platforms to deliver and enter people into care we have got to expand on in this opportunity. The federal government and the state governments have been very helpful in that in relaxing restrictions. It will be a terrible shame if we revert to the things that restricted our ability to communicate with patients on digital and telemedicine platforms and to do remote access and monitoring of patients as we go forward.

Mark McCombe: Well, Gianrico and Craig, I'd just like to thank you again for both of you for giving up your very valuable time and wish you all the very best to all your colleagues as we move forward through this pandemic. Thank you.

Well, I'm thrilled now to be joined by Dave Wichmann, CEO of the United Health Group.

You have over 300,000 serving 140 million people worldwide, you probably have an incredible seat on and view on what’s been going on with this pandemic. I wonder if we could just tee things off with you giving us a bit of perspective on how you think the healthcare industry has managed through this unprecedented global shock.

Dave Wichmann: Yeah. Well, I appreciate it, the opportunity to do so and give strong recognition to, first of all my team, the 325,000 people globally of which about 120,000 of them are clinical workers and they’re on the front lines of care and they’re on the front lines of care that you read about. .

I think the health system has done a very good job not knowing exactly where to go, there is no known treatment for COVID-19. And so, it was really the individual ingenuity of the people that are in hospital systems and care delivery practices that made a very large difference in managing this pandemic to date.

I'd say one of the things that we focused on very early was we realized that testing was going to be a constraint in healthcare. And so, we had to go from, modest amount of tests per day to, you know, nearly a million.

So, one of the things you don’t see in our company is the scientific capacities..

We also, adapted to working with the healthcare delivery system on creating an infectious disease model and a way to protect the health workforce. we created a mechanism so that when people encountered a COVID-19 infected patient, would actually follow a clinical protocol at the same time make sure that they were safe and not transmitting virus onto other patients. So, that was designed in collaboration with HCA and some others to make that happen.

And then we needed to address health equity issues. There’s a high correlation to the impact of the disease and the living conditions of individuals.

Now overall, I think the industry has adapted nicely

Mark McCombe: I think you’ve reported previously has been the delaying of elective procedures. Could you perhaps give us a bit of perspective on is that a sort of second health crisis as more and more people have decided to stay away from the hospital systems or delay important procedures. And as you look forward, how do you think the health industry will cope with perhaps the catch-up that needs to happen over the coming months and years?

Dave Wichmann: Yeah. That's a very good question. We like to refer internally here that there’s three pathogens. One’s COVID-19, the virus, the second is the economic downturn and the third is the deferred care that’s occurred. There’s been a measured reduction in the number of heart attacks and in strokes and you know that that’s not because of the fact that the prevalence has dropped, but rather people did not seek care for their heart attack or stroke.

you see the same thing with respect to access to primary care and specialists. an almost three-quarter reduction in access to those services in the initial instance and that resulted in a material reduction in what we call first time fills for pharmacies as well.

Dave Wichmann: So, what we showed in our earnings call, was that there was a significant deferral of procedures through the second quarter and our expectation is that procedures will be seasonally up in the third and the fourth quarter of this year and we expect that the acuity levels of those visits will be up as well.

Mark McCombe: Can you tell us a little bit about like what does it actually mean practically and how are you as an organization thinking about kind of the use of technology in the healthcare system going forward?

Dave Wichmann: Yeah. Well, just to give you a perspective, telemedicine was used thirtyfold in the month of April relative to the month of January this year. So, we engaged a full four million telemedicine visits, you know, as just in our own operations. we enabled telemedicine visits directly with their own doc and that’s where telemedicine needs to go.

What we’re doing is we’re building a broader capacity around the home, which we think is essential. It’ll be part of the care, of the clinic of the future. (Chyron: Dave Wichmann says that the home will be part of the clinic of the future.) What that really requires is that you have a really strong digital signaling platform, which gives the biometrics are of the patient.

And I think you’ll see advances in all these fronts. I know you will from us over the course of the next six months and I imagine the industry broadly will advance.

Mark McCombe: Can we talk just for a second about kind of the future of the health industry, both in the US and globally? what do you see in terms of the cost dynamic of healthcare? And does telemedicine, for example, reduce the cost? are there other measures that have to be brought in that will actually increase costs?

Dave Wichmann: Yeah. Well, I think the – you're going to see rising use of information for decision making and greater alignment of incentives to the health system around achieving strong outcomes experiences and lower cost structures broadly.

I think telemedicine in general will continue to be utilized.

So, making sure that the physicians and the patient actually know based upon a unified portable medical record which has AI deployed to determine next best action. That's where telemedicine needs to go. all in an order to achieve the triple aim, which is to reduce healthcare costs, improve experiences, and to improve outcomes for the patient.

Mark McCombe: As you look forward, over the next three years or five years, what do you think will change forever as a result of this pandemic and what things have we learned that you think will actuallyguide medicine and healthcare?

Dave Wichmann: I think the biggest transition you’ll see in the next five years is how ambulatory care becomes –what we’ve learned is there’s a lot of myths about procedures that have to be performed in facilities, either doctor’s offices, hospitals, outpatient centers, that really simply don't need to.

I think you’re going to see the home and the ambulatory markets, meaning the primary care through ambulatory surgery, just explode.

Mark McCombe: thank you again for joining us on a very busy day and taking the time out to speak to our colleagues and partners across the world.

Dave Wichmann: Well, we appreciate it. We’re going to keep working for America, for South America, and the world and aiding new discovery around treatment, around cure

Mark McCombe: All right, well let me bring in Erin here. Erin’s the head of BlackRock’s Health Science’s investing arm, which invests actively across the healthcare sector. Erin’s a PhD and has been with BlackRock for coming up on 20 years, all dedicated to healthcare industry.

Erin, welcome to the session and thanks for spending time with us.

Mark McCombe: in what areas are you seeing some of the more important innovations in healthcare and what are some of the key themes that make up your macro investment thesis today?

Erin Xie: Sure. So, I like to think we actually are really at the inflection point of genomics revolution and digital, digital revolution. (Chyron: Erin Xie says we are at the inflection point of the genomics revolution and the digital revolution.) From the genomics side, I think the industry is really benefiting from decades of genomics research. So, we really have much deeper understanding of human biology and also the causes of diseases.

So, across multiple therapeutic areas we’re seeing some really exciting new medicines emerging. For example, in cancer therapy versus historical chemotherapy, we’re really seeing new ways of medicine targeting specific cancers. there are companies, for example Seattle Genetics was really at the forefront of a so-called antibody drug conjugate, which they very smartly designed antibody that look for specific cancer cells and also drag a toxin linked to the antibody and when the antibody look for the cancer cells, the toxin does the double killing. And it’s this type of technology and many other very exciting cancer drug pipeline that really are pushing a new wave of medicines. And this is not just in cancer. We’re seeing great medicine emerging in autoimmune diseases and as well as genetic diseases.

Elsewhere, we’re also seeing robotic surgery being developed and still we’re very early in either. So, quite bit of room to improve the technology and adoption. Even hospital beds these days have smart function. There’s also many new device and tools for remote monitoring of people’s health conditions, such as, you know, your blood sugar or heart, you know, heart rate. All of this, I think, really the – really make the underlying companies great investment opportunities.

Mark McCombe: Erin, you’ve been an investor in health sciences for nearly two decades now. I'm sure you’ve seen some incredible changes and evolutions during that time. But perhaps you could just give us a few examples of how you – you’re taking advantage of the dispersion in the market as you think about your investment strategies.

Erin Xie: when hospitals really tried to dedicated resources to take care of the COVID patients, a lot of the elective procedures were canceled or delayed. So, there’s some really high-quality medical device companies manufacturing elective procedure products. Their stocks really got hurt badly.

We think from a long-term perspective this actually represents very attractive price point for these securities as we think the elective procedures will come back as the COVID situation normalize at some point. It’s really a matter of when, not if. And this is act – the market actually make such securities, some very high-quality companies, for example, Boston Scientific, Stryker, so forth, very attractive.

Mark McCombe: Erin, thank you for that.

We’ve heard from two of the leading CEOs of some of the most renowned hospital systems in the country and globally, and also from Dave Wichmann from United Healthcare Group, who’s really given us insight into how that healthcare industry is evolving. And Erin, you’ve brought us home with some really fascinating investment insight.

So, I'd just like to say thank you, again, to all the panel members and particularly to all of those colleagues of theirs working on the frontlines to get us through this pandemic. So, with that, Zach, I'd like to hand it back to you. And thank you.

MKTGH0720U-1248250

We're going to turn now to the topic that has changed the way we live in almost every possible way. COVID-19 is a virus, unlike anything we've seen in our lifetime. The next conversation will focus on the progress being made to combat the virus and what the new future of health care is going to look like. I am pleased now to introduce BlackRock's Chief Client Officer, my mentor, Mark McCombe.

Well, thank you for that introduction, Zach. Now, I'm delighted to welcome leaders in healthcare who've been in the eye of this pandemic that has swept the globe. I can't think of a better group of individuals to have a conversation with about the future of healthcare both in the US and beyond.

First, I'd like to introduce Dr. Gianrico Farrugia, President and CEO of the Mayo Clinic. Dr. Farrugia has spent over 30 years with the Mayo Clinic, which remains one of the preeminent healthcare institutions in the world, and he took over as CEO in 2019.

Dr. Craig Thompson, President and CEO of Memorial Sloan Kettering, also joins us. Dr. Thompson became president and CEO in November 2010 after a long and distinguished career with Memorial Sloan Kettering. Memorial Sloan Kettering is the world's oldest and largest private institution devoted to cancer prevention, treatment, research, and education.

Well, Dr. Farrugia and Dr. Thompson, you very kindly allowed me to call you by your first names. So let's get started. And Craig, perhaps I can come to you first. You've obviously been at the heart of the epicenter of the pandemic in New York, and Memorial Sloan Kettering has clearly played such an important role in managing through this pandemic. Perhaps, just could you situate for us a little bit your experience as a long term healthcare professional of just what you've seen and experienced in New York with regard to this pandemic?

Well, certainly, Mark. It was, as everyone knows, just an unprecedented event as New York became the epicenter beginning in March. It's hard to believe we had our first case in New York on March 1st. And it really was amazing to be part of the care response here in New York as our death total reached over 20,000 here in the City and our infection rate got to over 230,000 people over the last four months. It really required a coordinated level of effort at the state, the federal, and all of the individual hospitals that make up New York's extensive health care system.

So it's important at this point to then answer the question, why did it feel so uncertain to everybody? Why was the news, particularly back in the middle of March, making it look so uncertain? And you saw how the health care workers themselves responded both heroically and of concern for their own health.

This was an unprecedented virus. This is the first time in my medical career of over 40 years that we faced an entirely new pathogen that had this level of transmissibility.

Past viruses had either been very different in how severely ill they made people, and that limited its infection, or they weren't very transmissible. Other coronaviruses before us like SARS-1 had not been particularly transmissible. So, even when it arrived in the United States, contact tracing did extremely well.

And our first case here in New York was actually an individual who came back from giving health care overseas and reported herself to health care. Contact tracing limited that spread entirely in the first two weeks in New York. We did not appreciate the transmissibility.

And so as it emerged how quickly it got into community-acquired infection, it got way ahead of our normal mechanisms of controlling an epidemic and it required a full conversion of all the hospitals here in New

York to just being capable to care for the surge of COVID patients. At our own hospital, at the time it started, we were treating 150,000 patients actively with cancer. We knew from the Chinese and Italian experience that they were more at risk for getting COVID and from dying potentially of COVID. So we had to shelter them in place, and at the same time, expand our capacity to help patients that would need ventilatory support through their COVID infection and to open up our hospital to safely be able to take care of it and protect our health care workers. That mean establishing massive increases in our PPE supplies to be able to do that, as well as to develop treatment protocols. Because at the time it arrived here in New York, there was no established treatment protocol. And so the uncertainty has been the evolving ability to take care of patients.

So as we see the surge now in the Southwest part of the United States, there are better treatment protocols. Our PPE supply lines are better, and that's what has changed this from the emergent emergency that we saw in March, April, and May to now this resurgence where the health care system has better protocols to deal with it.

Well, thank you, that was an incredible insight into being at the epicenter of this pandemic. I think you use the term uncertainty, and perhaps Gianrico, I can turn to you because you know the Mayo Clinic has a lot of operations in Florida and Arizona, two of the states that are seeing this resurgence. Give us your perspective. What have you learned from the experience out of New York and how are you applying that as this resurgence takes place in these different southern states?

Thank you. And as you heard from Craig, we've learned a lot, learned a lot from what's going on outside the United States, from New York, and from our own work.

It's important to realize, as Craig said, that this was a new pandemic. And therefore, a lot of the models were built around the fact that what did we understand about previous pandemics and that included the pandemic, the Great Influenza pandemic of a huge surge, and then a second wave. We got a surge in New York City. We learned from it by physical distancing and later by masking, by testing, by contact tracing. The surge did not appear as much in other parts of the country and, therefore, it left a lot of people exposed. And now we're seeing that play out, especially in the southern part of the United States, Florida, and Arizona, where Mayo has a significant presence.

It's relevant that in some countries this resurgence was stopped because there was an ability to clamp down. But, in a country as big as ours with states playing different roles, we've seen how it is really important to learn and be able to identify quickly and then intervene. And what we've done is we've co-op'd resources together with our partners, Google, Inference, SHS, there is an ability to predict what's going to happen next two or three weeks, and then we have to live with this for several more months at least. And therefore, like Craig, we're going to have to look after patients with COVID and patients with complex and/or serious disease and do them both at the same time. And, therefore, predicting and then being able to juggle the two and modulate who is coming to our hospital has been a big help.

We've also developed our own testing to be able to keep our hospitals safe. And importantly, and I'm sure Craig would say the same thing, this resurgence, this innovation around telemedicine has allowed us to modulate how many people actually need to come to see us, combining that with a partnership that we have with Medically Home we're developing new models of keeping patients with serious disease safe, get them treatment without actually coming to the hospital as often.

Well, Gianrico, thank you. And I'd like to talk a little bit about the second-order impact on things like elective procedures and so forth. But before I get to that, perhaps I'll stay with you for a follow on

question. To those of us not in the health industry, there's obviously a lot of debate about testing and testing protocols. And then there's a lot of debate about CDC guidelines around things like wearing masks. Can you just give us a sense as we're seeing this kind of spiking again in cases, how would you inform us of the importance of testing and what that allows you to do as a healthcare professional in terms of managing through the crisis?

This virus is different in the sense that it is highly infectious, as you heard, and it's infectious even when somebody has it and is asymptomatic. Without testing, you simply cannot know who has the infection. You cannot contact trace, and therefore, you cannot limit spread. Therefore, if we want to be able to safely reopen our economy, if we want to be able to control this surge and future waves, and as I've said, I believe there's going to be a frequency of about eight weeks of a wave in different states as we go through this getting a little more careful and getting more lax.

We have to be able to test and give results to people as quickly as possible. Because if you give results five or six days later, it's not as useful and a big push for Mayo Clinic as we develop our own testing capabilities is to make sure we can give results within that 24 to 36 hour time period, which is crucial.

Masking is a very interesting exercise because, initially, there was a lot of confusion about masking. Does it really help? Does it not help? There's now clear evidence that it helps. It helps others. But it also helps the person wearing the mask. So masking has to be an integral part of what we do to control the virus, as well as something as simple that we have to come back to, handwashing.

Handwashing, wearing a mask, physical distancing gives us the ability to prevent these market surges and give us the ability to keep our health care environment safe for people why they remain safe at home.

Thank you for that. And maybe just coming back to you, Craig. I would love to get your perspectives on how you're seeing people's behavior change, given the uncertainty that we had with the virus itself. But now New York seems to have got things under control. So are you seeing people beginning to re-engage with health care in the normal course of business, or is there still a great deal of uncertainty and fear? As well as I think what I would say personally is not wanting to overload in any way an already stretched health care system? Perhaps you could give us some perspective on that.

Sure. So as I said at the start of March, we were treating 150,000 patients. Our hospital was filled.

Our outpatient clinics, our ability to treat patients with radiation oncology, was completely full, because that's pretty much how we run as a referral center. We were down on our cancer care delivery about 80% by the end of April. We have recovered back to nearly 90% of our pre COVID levels now, because we've been able to control the epidemic here in New York. The number of cases is way down.

This week, we had the first day with no one having died of COVID since March in the greater New York area. And in addition, we have gone now multiple days without any new patients being diagnosed as part of our screening procedures.

We're able to, as Gianrico said, now do surveillance testing of all of our staff. We test every patient as they come to care. And so we've been able to control the infection.

And PPE is the biggest issue that makes a difference. And the PPE that really matters that he pointed out is the universal masking of everyone involved in health care. It is really the first, second, third, fourth, and fifth thing that really controls the spread of this virus. And that was uncertain in the beginning. We took on universal control measures before we knew what the transmissibility of the virus was.

So, all measures of hygiene, handwashing, changing your clothes, protective gowns, were given equal importance. And now we know that the number one thing that controls spread within a closed indoor

environment is, in fact, universal masking. It is what's really controlled the infection here in New York. And I have to say New Yorkers have been terrific about that in adopting masking. We've been led by our governor. We've had very good state and local contributions to that, and that's really helped.

But we are getting public health fatigue, which is what you are asking me about Mark. People are getting tired and restless of all the others. And so we're trying to focus on the central messages of what they should do, that we still need social distancing wherever possible. We're continuing to work here in New York for those who can work at home so that we have the spaces within our existing infrastructure to give the social distancing and the masks a chance to really quell this infection completely.

And at the same time we are engaging people and returning to normal activities of health care and self-maintenance. So all of the hospitals have opened, as Gianrico said. We all now segregate patients who are being cared for with COVID. We're down to only two patients in our hospital currently who are being treated for COVID, and over the weekend, we were down to no patients over this. But we maintain a ward. We maintain the ability, both a surgical suite, as well as an intensive care area, in case there are cases of COVID. They're completely segregated at both the inpatient and outpatient basis.

Where we are concerned is that the 20-somethings here in New York have experienced a resurgence in the incidents of surveyance testing and their caseload. All other age groups are declining still in New York. But we are worried that the social congregation when they initially opened up restaurants and bars led the 20-somethings to thinking this was over, and we're reinforcing that message, starting in the health care industry but everywhere in New York that that's the number one public health measure. That's what the US needs to understand as we move forward.

Well, thank you, and I think you'd give us a sense of optimism that actually, with coordinated strategy, we can beat this virus. But you raise an interesting question. And Gianrico, I'd like to just turn it to you. With so many people on the front line and dealing with these extraordinarily traumatic situations, how have you been dealing with your colleagues from a mental health point of view and just a resilience in managing through this pandemic? Any insights you could give us on that?

Look, so, this is a real phenomenon. You just heard Craig describe what happens when you have to deal with something for week after week, now month after month. It's a mixture of pride and exhaustion, both from the health care worker standpoint, as well as from the hospital itself. There's, of course, a lot of pride. Our health workers across the country, certainly at the Mayo Clinic, are proud of their ability to provide great help to people and be able to provide care for patients when they really need it. They've supported each other. They've kept each other going, and the results show.

At the same time, it is incredibly hard to put on protective equipment several times a day, to go home and also be careful to keep physically distanced so that you don't bring infections back to the hospital. And so increasingly we have to look after the mental health the physical health of our workers, so they can continue to provide help to patients. And that will include finding ways of unexpected joy in the workplace. And that's what we're working on at the moment. Is how to reintroduce joy in the workplace. The same actually applies to hospitals.

Craig mentioned Mayo clinic, that so many hospitals have done so much to help out. The hospitals at the same time are dealing with issues of a very precarious supply chain. Working on other issues, including finances. How do you keep going with a very high capacity time and time day and day in and day out? And therefore, we also have to take advantage of this opportunity and really work on understanding what worked and use that innovation to create a better health care system. So that when this is over, we don't

go back to how health care was. Because health care in 2019 wasn't exactly perfect. But take the opportunity to co-innovate together and transform health care.

Thank you. Very, very insightful comments and I'd like to pick up on a couple of points that you've both raised. One is the sort of dichotomy between a national strategy and states looking after their own strategy on the response to COVID. As you think about where we are today, where clearly the US is on a different path from many other countries, what insights would you bring about the importance of having a national strategy to respond to a pandemic like this, as well as, obviously, the local nuances that exist within the state structure? Craig, maybe I could turn that to you first.

Sure. So I want to reinforce something Gianrico said. What really helped the most for us at Memorial Sloan Kettering beyond the masking and the PPE was the ability to test. And we were lucky in that we were able, through our Research division, the Sloan Kettering Institute, to have developed with our Laboratory Medicine program the first FDA-approved test for New York City. So not only were we able to test all of our staff and our patients early on and at the beginning but help other hospitals out in our local area.

That testing was critical to limit the spread of infection. We have not had a hospital-acquired infection of COVID since mid-April, for eight weeks now. And that's because we have, we are able to do surveillance testing of everyone on a regular basis. Every patient-facing staff member is tested every two to three weeks. Every patient that comes for a patient experience is tested at the time they enter our system. And that really has allowed us to be able to stay ahead. And to, when we've actually seen someone, quarantine them early. Avoid them spreading it to anyone else in their family as well as to making sure we don't enter them into the health care system where they could expose others. Also, not initiate treatments until they're over their COVID infection. And so limit the severity of their illness.

We need a national strategy of testing that duplicates that, that we all can feel confident we're getting the same test results. And as Gianrico said, it's got to be done in real-time. We know that some of our patients who go to outside testing as this disease has progressed are waiting four and five days of uncertainty of what to do while they wait for some of the outside vending tests. We need a system. Right now, we return results now within 12 hours everywhere in our care mission. We need that on a national level. That has to have national leadership.

The other area that's critically important on a national level, which I have to say the federal government as we started to control this was incredibly valuable for here in New York and that was to reestablish supply chains of PPE. We all imagine-- nowhere in New York, because it's such a dense area had warehouses of medical supplies. We were used to ordering that on a supply chain on an as-needed basis. We still don't have warehouses to store that stuff. So we had to have an effective supply chain. And no one realized that the supply chain begins in Malaysia for gloves. Begins in China for some of the masks. And for other masks, it began in Italy. And so those supply chains were broken, and there was no way to reestablish them.

The national effort to reestablish that, working publicly and private, has given a lot more confidence to the health care system as we move forward. But we need that to continue on into the future if we're going to do this effectively. Those would be my number one and number two issues.

And very forcefully said, which I think will resonate incredibly. Gianrico, you mentioned in the previous question a little bit about things that will change forever as a result of this. Can you give us a little bit of your kind of perspective looking forward as to what changes in the health care system now as a result of

this? And then also perhaps just a little bit of a view on things like the national strategy because obviously, you're seeing differences across different states.

Yes. Let me start off by saying that in times of crisis, it is important to speak with one voice. Even when there is uncertainty, you need to have some sort of clarity with the understanding that things may change over time. And even as we deal with this pandemic, it becomes crucially important to understand that funding the National Institute of Health, funding NCI, funding the FDA, funding state health care departments is critical. Because when we then get in a situation where we need them, then it's too late. You cannot ramp up. Sustained funding over a period of time is so important for research, and it's so important then to be able to respond to pandemics like this. Funding has to remain a priority.

We also learned a lot about health care. And one of the things I would say that we should all be proud of is that health care institutions partnered not among themselves, partnered with external companies, partnered with the government, Mayo clinic had a great relationship with the FDA, we went in 14 days to be able stand up an expanded access plasma program for the country. And we've had good partnerships that way, with the state of Minnesota to be able to offer testing as needed.

But what became really apparent is that we have this unique opportunity to truly transform health care, and we cannot lose it. We owe it to our health care workers, we owe it to the country, to make sure that some of the regulations that were loosened as a result of the pandemic don't go back. Because they allowed us to do things that previously we couldn't. That we have to further integrate telehealth with face to face visits so that they're not either-or, they become one whole experience for patients. And fundamentally, we have to as health care workers, as a health care industry, take the reins and say, we are going to transform health care from within. We know how to do it. We've shown that we can do it. And we have to make sure that we do not let up on some of the change that needs to happen within our system.

Yeah. Extremely powerful words. Thank you so much for that. Craig, I use the crystal ball analogy here a little bit as well for you. We're three years or five years down the line from today. When we look back on this experience, what lessons do you think we should have learned? And secondly, how, as a non-healthcare professional, how do you think COVID-19 will be viewed and treated in that point of time? Is it like the flu? Or are we going to find a way to potentially eradicate it? What's your sense of that?

Yeah. I think just in terms of going backwards for your question. How we're going to think about the virus? This is going to be the fourth of the common coronaviruses that causes the common cold by the time it's done. What makes this virus unique is that it is like the other three that have been with the human population for hundreds of years. And so we have accommodated to this. We all have some level of natural immunity, starting with our mother passing us passively antibodies to those other three coronaviruses. We're at risk to getting them at some period over time. And they are not associated with major morbidity and mortality. But just an illness that's inconvenient, the reason we call it the common cold.

This is a newly emerging virus, so it occurred without anyone having any pre-existing immunity to it. We have no vaccine strategies for it compared to things like influenza, which is also similarly transmitted by aerosolization. So everyone in the world was susceptible, and it was transmissible easily across all populations. And so that's why we're seeing this surge of illness that's occurring. The history, if we look back, of viruses like this that have occurred in this way is that they will get milder in their illnesses over time.

What's unique about this that Gianrico mentioned earlier is this is one of the few viruses we've ever seen of all different types where it's transmissible from patient to patient before the first patient has symptoms. Most viruses, you only begin to transmit the virus as you have symptoms. This one clearly has been documented, whether it's truly asymptomatic or symptomless spread that's definitely occurring and that's unusual for us.

And so that means we are going to have to learn some new lessons about how to control the episodic nature of this virus as it will occur as a common cold. Whether it gets milder, we're going to have to wait four or five years. But there's real potential possibility of an effective vaccine in the four to five year time range that you've talked about.

I think we'll have some experimental vaccines even within this year. You're hearing about that every day on the news. I don't have any special information beyond that there are many new attempts to build effective vaccines that will be used. But one that will be safely given to the entire 300 million Americans probably will take several years. And so we're going to have to continue to use public health measures to control this and to continue providing health care to all the other diseases.

It's been terrible how many people have died of COVID-19, but 600,000 Americans are going to die of cancer this year. 1.9 million are going to actually be diagnosed with cancer. We've done extraordinarily well over the last 30 years at giving people better outcomes but not if they delay going to treatment and going into care. The opportunity to change, which is what Gianrico introduced is telemedicine's time, is there. The ability to use digital platforms to deliver and enter people into care we have got to expand on in this opportunity. The federal government and the state governments have been very helpful in that, in relaxing restrictions. It will be a terrible shame if we revert to the things that restricted our ability to communicate with patients on digital and telemedicine platforms and to do remote access and monitoring of patients as we go forward.

We've made tremendous strides. When we started this epidemic in March, Memorial Sloan Kettering did 100 televisits a day. Today we're doing 2000 televisits a day.

Incredible.

We have learned to make them effective. We do telemonitoring. Many of our patients that got COVID-19, we were able to care for them at home because we shipped them pulse oximeters that they wore that we could remote monitor to make sure they were safe while they were recovering in their own home environment. There are many things like that we can learn to take advantage of this health care crisis that we're following. But if we go back to the same old, same old, we have missed a huge opportunity to improve health care going forward.

Well, thank you, Craig, and you sort of teed up my last question for Gianrico, which really is about confidence in the future. You put a timeline on the vaccine that is, I think, much longer, and I think one of the questions I had for you Gianrico, was around your views on distributing a vaccine. Because it seems to me that there's the development phase and the testing phase, but actually, the distribution mechanism becomes something very important in giving people confidence to go back into the workplace.

The Bank of International Settlements talked about the economy having a hard stop. And that's what's been so shocking about this is both a health pandemic but then obviously economic dislocation. So how do we bring confidence back into the healthcare system? Craig talked about telemedicine. We would love to hear how Mayo's thinking about telemedicine. And then giving people that confidence ahead of a

vaccine that they do go back into the health system and deal with some of these other issues that are prevalent in society today.

So two components there, the distribution channel, I'll be brief on that one. Here in the United States, we actually have done relatively well. We have gone ahead and primed the pump by making commitments to buy a vaccine, even before the phase two and phase three trials are done, and that will serve us well.

What's really important, however, is that we have to understand that at the moment, 30% of people in the United States are saying they will not get vaccinated when a vaccine is available. That is a shame. There are people that will not be able to get vaccinated. Not everybody develops an immune response when they get vaccinated. We will very soon have to start a public campaign to educate people about how important it is to get vaccinated, including for the flu.

More and more, we're beginning to understand that there is this build-up of immunity that is important. You just heard Craig speak about it. And making sure that people understand how important it is to get the flu vaccine, especially this year, and be committed to getting the vaccine for COVID when it's available.

In Europe there the supply chain is reasonable. The problem is in other countries. And I think there's been unfair criticism towards organizations like Gavi that really are going to play a crucial role in distributing vaccines globally.

Mayo Clinic is committed to transforming healthcare. We're committed to being the first integrated health care platform. Like Craig and MSK we went from 200-300 visits to 35,000 visits in a week. Importantly, what we have to do, however, is build on that and move from data to knowledge and then from knowledge transfer that knowledge into usable pieces of information that everybody can use within this country and globally.

Again, I finish by saying what I've said before. It would be a shame if we would not take the lessons we've learned from this pandemic and take the opportunity to make health care better and more accessible, and more equitable for all.

Well, Gianrico and Craig, extraordinary leadership both of your organizations have displayed during an incredibly tough time. And I would just like to say on behalf of I'm sure everybody watching this conference to just say an enormous thank you for all of your colleagues and what they've delivered during this very difficult time.

So and at a personal level, I think this has been such an extraordinary conversation. Your insights, the experiences you're having, and actually the optimism you're showing for the future because I think as you both said, if we don't use this as an opportunity to bring real change and have a real debate in the country about health care going forward, then I think it's a missed opportunity. So I'd just like to thank you again, both of you, for giving up your very valuable time, and wish you all the very best to all your colleagues as we move forward through this pandemic. Thank you.

Thank you, Mark, for hosting us.

Extended conversation with Dr. Gianrico Farrugia and Dr. Craig Thompso

Watch the entire interview with Dr. Farrugia, CEO of the Mayo Clinic & Dr. Thompson, CEO of Memorial Sloan Kettering

We're going to turn now to the topic that has changed the way we live in almost every possible way. COVID-19 is a virus unlike anything we've seen in our lifetime. The next conversation will focus on the progress being made to combat the virus and what the new future of health care is going to look like. I am pleased now to introduce BlackRock's Chief Client Officer, my mentor, Mark McCombe.

Well, I'm thrilled now to be joined by Dave Wichmann, CEO of the UnitedHealth Group. Dave, thanks for joining us. How are you today?

I'm very well thank you. Thanks for having me.

Yeah, well, you've obviously had a long and distinguished career at the UnitedHealth Group. And it's very impressive to see your recent earnings results. So congratulations on that. And you've taken over as CEO in 2017. And clearly the last five months have been such an unprecedented shock to the whole health care industry.

As you, I think, have over 300,000 employees serving 140 million people worldwide, you probably have an incredible seat and view on what's been going on with this pandemic. I wonder if we could just tee things off with you giving us a bit of perspective on how you think the health care industry has managed through this unprecedented global shock?

Yeah. Well, I appreciate it-- the opportunity to do so and give strong recognition to, first of all, my team, the 325,000 people globally, of which about 120,000 of them are clinical workers and they're on the frontlines of care. And they're on the frontlines of care in the places that you read about like Chile, Colombia, Peru, Brazil, New York City, Washington State, in Miami.

Most of them are in Florida, Texas, Southern California, Arizona, which are all the hotspots. So not only are we an insurance company, but we have a significant operation in our clinical delivery capacities being the number one employer of primary care and advanced practice clinicians in the country.

So perspectives are I think the health system has done a very good job not knowing exactly where to go, meaning that there is no-- was no known treatment for COVID-19. And so it was really the individual ingenuity of the people that are in hospital systems and in care delivery practices that made a very large difference in managing this pandemic till date.

I'd say one of the things that we focused on very early was we realized that testing was going to be a constraint in health care. And so we had to go from, you know, some modest amount of tests per day to nearly a million. And that means that the test needed to be self-administered, almost an at-home version of that.

So one of the things people don't see in our company is the scientific capacities we have. And these may sound small to you but we changed the place where you collect your sample from somewhere in here, which through your nose you access that, to basically mid nose. We changed the swab to a rolled polyester swab, which is widely available. And we changed the transfer media to saline. The combination of those three things enabled us to get to where we are today, which is significant testing capacities overall.

We also, I think, adapted nicely working with the health care delivery system on creating an infectious disease model and a way to protect the health workforce, which was essential. There was a strong

shortage of PPE in part because there was a significant loss of-- or a significant use of PPE when they engage with the COVID-19 patient.

And so we created a-- not only did the swabbing technique that we described lower the use of PPE but also we created a mechanism so that when people encountered a COVID-19 infected patient, they would actually follow a clinical protocol or protocol to ensure that they can continue to work to the maximum amount possible but at the same time, make sure that they were safe and not transmitting the virus onto other patients. So that was a design in collaboration with ACA and some others to make that happen.

And then the other thing that became very obvious very quickly is that we needed to address health equity issues. Because they're very prominent with this disease. There's a high correlation to the impact of the disease and the living conditions of individuals. And so the underserved populations, those that don't have access to care evenly, have been worst affected. And so again, collectively worked hard with health care delivery systems and others to ensure that those who are most underserved were getting the types of attention that they needed like testing and treatment and things like that.

So overall I think the industry has adapted nicely. And I know our two colleagues here and the CEO of Mayo Clinic is working on convalescent plasma and then Memorial Sloan Kettering, who is right in the middle of it all, you know, have done a really good job managing this during this time.

Dave, can we-- you mentioned testing, which obviously has been very front of mind and a lot of coverage in the media. You know, in financial markets as investors, we like sort of predictability and stability. And clearly, testing has been such a critical component of really understanding where we are in the cycle of this pandemic. So as you look forward having the benefit now of experiences for the last four or five months, how critical do you see testing continuing through the remainder of this year and into 2021 before potentially some sort of vaccine is available?

Well, I think it's critical for the identification of the virus. And then obviously it precedes contact tracing, which is essential too to see whether or not those who have been in contact with the infected were infected themselves. So I think it's a critical part of the management process that's required.

So the PCR tests, which is the do you or do you not have the virus, is the one that's most essential. There's a lot of conversation around serologic testing as well, which, you know-- it has not yet been confirmed that the presence of antibodies can confer immunity yet. And obviously, you know, those kinds of tests will be used for more public health purposes and occupational health purposes.

But you know, the PCR test is essential alongside the contact tracing work that's been done. And we've been involved in a number of the tests. And in fact, in California where I believe you are, we've stood up a number-- probably about 110 rural and underserved population pop-up testing sites to ensure that everybody gets a chance to be tested when they express symptoms or otherwise.

Just changing course a little bit on the impacts of the pandemic on the health care industry. I mean, clearly one of the things we've seen, and I think you've reported previously, has been the delaying of elective procedures and the impact that that's having.

Could you perhaps give us a bit of perspective on-- is that a sort of second health crisis that is emerging as more and more people have decided to stay away from the hospital systems or delay really important procedures that they might have needed? And as you look forward, how do you think the health industry will cope with perhaps the catch up that needs to happen over the coming months and years?

Yeah, that's a very good question. We like to refer internally here that there's three pathogens. One's COVID-19, the virus. The second is the economic downturn. And the third is the deferred care that's occurred. And you can see it very prominently.

There's been a measured reductions in the number of heart attacks and strokes. And you know that that's not because of the fact that the prevalence has dropped but rather people did not seek care for the heart attack or stroke. They just got it about at home.

And you see the same thing with respect to access to primary care and specialists. We can measure that. There was a significant reduction-- almost 3/4 reduction in access to those services in the initial instance. And that resulted in a material reduction in what we call first time fills for pharmacies as well.

So it just gives you a sense too that there's been this reduction in services. And some people say, well, those are elective services. And they're really not. I mean, there's some that are elective. But the vast majority of them are ones that people are going to access going forward. And to the extent that they don't, disease will continue to escalate and to a very challenging spot for individuals.

So we've seen the health system come back. It's probably back at about 95% of its projected levels at this time right now. And we continue to see it move forward, even in the-- even with the South having reduced a lot of its elective procedure availability we have seen health care continue to come back. And it's something that we're very strongly encouraging because we know people need to get access to care.

So what we showed today in our call-- we've just had our earnings call-- was that there was a significant deferral of procedures through this second quarter. And our expectation is that procedures will be seasonally up in the third and the fourth quarter of this year. And we expect that the acuity levels of those visits will be up as well.

Yeah, it's fascinating insight. And I think maybe just to build on that question, I mean, we do a lot of risk modeling and looking at different scenarios and how they play out. Clearly, you know, this has been an unprecedented shock to the health care system and the broader economy. So many risk models really didn't take into consideration the gravity and extremity of that shock to the system.

Now there's a lot of talk about the kind of potential of a second wave and obviously the flu season as well coming in and playing into that. It strikes me that there's a question of confidence in society to sort of go back into the health system and to start to engage with it the way people did before the pandemic. As you look at your risk models and you look forward and project forward how this pandemic might play out, any insights you could share on just how you are thinking about the modeling of how the course of the pandemic may play out over the coming months?

Yeah. Well, most of the modeling that we're focused on is really about people getting back to accessing care on as routine a basis as possible. We recognize that that access is going to be both physically in the doctor's office or in the emergency room or otherwise. But we also see a significant advance and utilization of telemedicine or other digital therapies.

And we believe it's going to be a combination of those two things that will hopefully allow the individuals to continue to see their own doctors and maintain the level of care while COVID-19 continues on, which we have no reason to believe it will not continue well into 2021 at this stage, given what we know about it so far and the timing-- or potential timing of vaccine and relevant treatments that are out there as well. So we see this as a system that operates at near full seasonal capacities and at the same time addresses COVID-19.

Now, the one thing I'd suggest is that there's a material impact of preventative measures on the spread of this disease and it's pretty obvious. There's a study in Australia, for example, that shows that the flu is significantly less this year than it has been in the past and in part because people are exercising personal hygiene, social distancing, masking, and a number of other procedures that, you know, prevent the infection of all infectious diseases, including flu and others.

So if we can get a higher level of compliance, which I think now that everybody has kind of gone through their first wave, maybe we can get there. But, you know, a higher level compliance in America I think we'll see a better management of this condition.

The only other thing I would say is that it's really important that we manage our high risk. Because one of the things that happened early on was a lot of people were infected in nursing homes. And I don't think that the protocols were quite there in order to manage infections and also including discharging COVID-19 patients into nursing homes. That's only going to result in infection spread. So managing high risk is an essential element of managing this disease and making sure that hospitals don't get overrun.

Yeah. It seems that there's had to be a lot of course correction throughout the pandemic to sort of meet some of those imperatives. You've talked about technology and telemedicine. We hear a lot about it, we read a lot about it. Can you tell us a little bit about like what does it actually mean practically? And how are you as an organization thinking about kind of the use of technology in the health care system going forward?

Yeah. Well, just to give you a perspective, telemedicine was used 30-fold in the month of April relative to the month of January this year. So yeah, we engaged a full four million telemedicine visits, you know, just in our own operations. What we heard-- it depends upon who you're with. If you're with a senior, they want to talk to their own doctors. So we enabled telemedicine visits directly with their own doctors.

That's where telemedicine needs to go. Right now it's kind of to any doctor. And what's really important, particularly when you're dealing with a chronically ill patient or one which has multiple comorbidities, is that you need to keep the care team pretty tightly aligned and the information center upon which they're operating complete so that they know what the right next best action is and make sure that they don't induce contraindicated therapies or medications. So that's the central part of it.

What we're doing is we're building a broader capacity around the home, which we think is essential. It will be part of the care-- the clinic of the future. Some of that will come from the home and some of that will be in the physical realm, in the office facilities. What that really requires is that you have a really strong digital signaling platform which gives people a sense as to how-- what the biometrics are of the patient.

You have to have an engagement platform to incent people to engage in managing their health when they're sheltering. You've got to have a clinical capacity to be able to go into the home with skilled resources. And you've got to be able to have a telemedicine capacity that is more direct to their own doctor, which requires good scheduling mechanisms and otherwise. And I think you'll see advances in all these fronts. I know you will from us over the course of the next six months. And I imagine the industry broadly will advance.

Can we talk just for a second about kind of the future of the health industry, both in the US and globally? I mean, here in the US obviously there's been a lot of concern about rising health care costs. When you look at the COVID pandemic and you think about some of the long-term implications going forward, what do you see in terms of the cost dynamic of health care?

Does telemedicine, for example, reduce the cost? But there are other measures that have to be brought in that will actually increase costs? I wonder if you could just give us a bit of perspective on that?

Yeah. Well, I think you're going to see rising use of information for decision-making and greater alignment of incentives to the health system around achieving strong outcomes, experiences, and lower cost structures broadly. So I think you'll see those things advance quite considerably as I think we've learned how valuable those things were through the COVID-19 process. So I think you'll continue to see those types of things move forward.

I think telemedicine in general will continue to be utilized. There are certain situations where it's not effective and we see people accessing their normal primary care doctor within days of having situations seemingly resolved through telemedicine. So those are the kinds of things we need to reduce.

And the other thing we need to make sure we're reducing is the implications of contraindicated therapies and recommendations coming from doctors who really don't have a really strong patient history. So that's what I mean about really making sure that the physicians and the patient actually know, based upon a unified portable medical record which has AI deployed to determine next best action, that's what I mean-- that's where telemedicine needs to go.

It needs to be a much more informed and engaged consumer and physician experience really based upon the best evidence that's available all in order to achieve the triple aim, which is to reduce health care costs, improve experiences, and to improve outcomes for the patient. And we've proven that we can do so by managing these integrated systems of care that are supported by information and technology.

Well, it's clear you've been at the forefront of driving that technology change. And certainly in financial services, we look forward and think there are certain things that will never be the same. And this pandemic has really taken us in a different direction and other things that will potentially mean revert.

As you look forward-- maybe the final question-- over the next-- call it three years or five years, what do you think will change forever as a result of this pandemic? And what things have we learned that you think will actually guide medicine and health care in this country and globally over the coming three to five years?

I think the biggest transition you'll see in the next five years is how ambulatory care becomes. What we've learned is there is a lot of myths about procedures that have to be performed in facilities-- either doctors offices, hospitals, outpatient centers-- that really simply don't need to. So we've seen a significant rise in our ambulatory surgical centers and you know, the acuity levels of the surgeries that they're doing.

We've seen a significant increase in [home patients]. So where-- in particular with the immunocompromised, there's no worse place to go than into the health care delivery system to be able to receive your therapies. So I think you're going to see the home and the ambulatory [INAUDIBLE] markets, meaning the primary care through ambulatory surgery, just explode.

And we've seen that prove out a lot of the myths about the quality of the services that you receive and the scope of practice that can be conducted in these home and/or ambulatory settings. And those myths have been demystified. And that as people sought care in a safe environment, we proved broadly that these other alternate places of care can serve the needs of consumers in a much broader way than they have in the past.

So we'll see that continue to advance. And then along the same lines, ensue the use of information and the advancements in technology are all what I would characterize as the two primary macro movements we'll see going forward.

Well, Dave, I know it's probably been an incredibly challenging few months for you and all your colleagues. So I would like to say on behalf of everyone on this call today an enormous thank you for particularly the work that the frontline colleagues of yours have been doing in delivering such needed support in this pandemic. And so thank you for that.

And thank you for your leadership in helping manage through this very difficult time. And as we look forward, I know there's still a lot of things-- a lot of surprises that we don't know about. But I think we know that with organizations like yours, there's the best minds thinking about this. And so thank you again for joining us on a very busy day and taking the time out to speak to our colleagues and partners across the world.

Well, really appreciate it. We're going to keep working for America, for South America, and the world, and aiding new discovery around treatment, around cure. But you hit the most major point and we owe a great deal of thanks to the frontliners in this pandemic. And those frontliners are-- I'm speaking specifically to the health care workforce that's out there facing off a somewhat dangerous situation.

We are protecting them very, very well. But they are brave and they should be quite proud of the tremendous work that they've done. And I know at least as it relates to our 120,000, I can't thank them enough. But as relates to our other guests here, their teams have done a terrific job and I couldn't be prouder of the way in which the health system has responded and driven ingenuity in the heat of battle to minimize the adverse consequences of COVID-19.

Thank you.

Thank you for having me. Appreciate it.

Thank you.

All right? All right. Take care.

Take care.

Extended conversation with David Wichmann

Watch the entire one-on-one interview with United Health CEO David Wichmann

Key insights from this session

Combatting the virus

Without testing, you simply cannot know who has the infection, you cannot contact trace and, therefore, you cannot limit spread. Therefore, if we want to be able to safely reopen our economy, if we want to be able to control this surge and future waves, we have to be able to test and give results to people as quickly as possible. We need a national strategy of testing that we all can feel confident in, and it’s got to be done in real-time.

Quotation start

“We need a national strategy of testing that we all can feel confident in, and it’s got to be done in real-time.”

Quotation end
Craig Thompson President and CEO of Memorial Sloan Kettering Cancer Center

Rise of telemedicine

The use of telemedicine has exploded during the pandemic, and it will continue to be utilized going forward. But we also need to see further advances in the technology. As telemedicine grows, it’s critical to make sure that physicians and patients have access to unified portable medical records that leverage artificial intelligence to help determine the best course of action. We need a much more informed and engaged consumer and physician experience based upon the best available evidence in order to achieve a triple aim: to reduce healthcare costs, improve experiences and improve outcomes for the patient. And we’ve shown that we can do this by managing integrated systems of care that are supported by information and technology.

Future of healthcare

In the past few months, a lot of myths have been shattered about the quality of services that patients can receive and the scope of practice that can be conducted in home or ambulatory settings. We showed that these alternative places of care can serve the needs of consumers in a much broader way than they have in the past. As a result, we believe the home and ambulatory markets, from primary care through ambulatory surgery, look to be set for tremendous growth.

Attendee polling results

Do you plan to overweight or underweight healthcare across your equity portfolios in the next year?

Attendee polling results from the healthcare session.

Source: BlackRock. Number of respondents = 317.

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Dr. Gianrico Farrugia
CEO, Mayo Clinic
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Mark McCombe
Chief Client Officer, BlackRock
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Dr. Craig Thompson
CEO, Memorial Sloan Kettering
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David Wichmann
Chief Executive Officer, United Health
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Erin Xie
Head of Health Sciences Investing, Active Equities, BlackRock
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BlackRock Future Forum 2020
Explore our series of discussions with policy makers and industry experts from the technology, healthcare, and energy sectors on the topics that are driving markets and impacting society.
BlackRock Future Forum 2020