Mario Schlosser
@mariots
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Following
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Statuses
1,264
Co-founder & President of Technology @OscarHealth ; former Bridgewater, McKinsey, Eigentrust, Vostu, Stanford CS visiting scholar, U Hannover.
New York
Joined April 2009
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Pinned Tweet
(Part 1/3) “A spinor is the most basic mathematical object that can be Lorentz-transformed”: Obscure sentence that shows how a huge chunk of how our universe works emerges from very little. Three ingredients necessary to explain: special relativity + group theory + light…
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@DavidSacks
This is a very well-known consequence of the fact that the non-farm payrolls report comes from a different survey than the unemployment report. Hedge funds, traders, economists know this. It says that on page 1: "This news release presents statistics from two monthly surveys."
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@nntaleb
@jordanbpeterson
@lexfridman
Life would be better if we all adopted this as Peterson's 13th rule for life: "Peterson, you idiot, stay out of this"
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@jeffiel
One of the insane knowledge management issues in an organization is that the longer you've been there, the more Google Drive document access you have. If I tell newbies at Oscar to search the g drive for something, they get few hits. Weird superpower of veterans
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I still think that to be a real company, you have to be a public company. But I can confirm that losing 94% of your value is as soul-crushing as it seems (not to mention for our investors). I always felt confident that we had all the bones to get the company on track, but when…
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We
@OscarHealth
are publishing our use cases, prototypes, ideas & research notes on using LLMs in healthcare. AI research moves too fast for companies to do this work behind closed doors, so we’re sharing ours for others to read & comment: . 1/
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@pickover
Any natural phenomenon where repeated independent tries occur with same probability creates a normal distribution. Best way to visualize that physically: the Galton Board or quincunx - balls falling from the top down sequential left/right junctions
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This is exactly right.
@vkhosla
and
@SamirKaul1
invested in Oscar 10 years ago, and Vinod still shows up with a day notice at the office to quiz us on when AI is finally going to reduce our healthcare costs by 90% & offers to brainstorm. Legend. Thanks!
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@DavidSacks
1) Interview is in German (which I speak) & you're badly mangling his words: 1) frontal massed attacks didn't work, 2) Ukraine already switched & is having success now, 3) more long-range weapons will significantly tilt balance. Also, Reisner is a favorite to quote on Russian TV
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Google draws some low-stakes pictures wrong and the stock crashes; United crashes half the healthcare system and the stock is up. Couldn't find a better illustration of how little product performance and competitiveness matter in healthcare vs all other industries
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Surprised
@DavidSacks
hasn't congratulated Putin to his hard-earned election victory. What a lack of civility
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Large-scale AI models are a once-in-a-generation opportunity to improve healthcare. 28 of the most forward-thinking payers and providers got together to figure out how we leverage frontier AI models to drive the change we want to see in healthcare. Here are our commitments:…
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Technology grind in healthcare: we chose to build our own EHR for the Oscar Medical Group back in 2020. The OMG providers didn't like it for a long time (I guess that's par for the course for EHRs, but still, painful). Finally it's looking up. Lots of small improvements. Plus…
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@DavidSacks
But keep tweeting your takes, you're around 100 putinophile tweets away from that Japanese soldier who hid in the jungle after WWII and was the last one to realize they'd lost
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Oscar's growth to 1.3M members is a case study in the power of long-term trends and the fallacy of short-term blips. It always seemed obvious to us that a well-functioning U.S. individual healthcare market would eventually win out. But that it had to go through early legislative…
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@Churchill198400
@DavidSacks
Those two surveys have a decades-long history of co-existing in ways that are extremely well-understood. We live in an economy of 23 trillion dollars. Sure, it's complex to measure unemployment. Has never really mattered beyond small, short-term deviations.
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@toxvaerd1
The Lagrangian density of the electromagnetic field, with F the field tensor, and the greek symbols the Einstein summation notation (just means they run from 0 to 3)
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U.S. healthcare is full of this type of financial doom loops:
- Set a fantasy, artificial, inflated price
- Invent a business that negotiates a bit of a discount
- Charge for the imaginary cost savings.
Another great example here, Multiplan & out-of-network pricing:…
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@LinusEkenstam
This is an adventure game that uses GPT-4 to give itself formal structure and then executes the game. GPT-3 tended to get confused with it, GPT-4 does it impeccably well
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@APompliano
@WClementeIII
Right, because if you light a hundred dollar bill on fire, the ashes are worth $100. I have an urn to sell you
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Some numbers on why you need LLMs behind the scenes in customer service teams: in the Oscar concierge teams, we store all of our knowledge in one (pre-LLM, simple search) system. When care guides can't answer a member question, they escalate it to a content expert. When the…
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@JennaEllisEsq
@RealMarkFinchem
@elonmusk
That's the guy who complained that his website wasn't showing up in Google when he had a noindex directive in his site. So my advice here would be to maybe first check if his computer is turned on.
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One of the more counterintuitive issues in U.S. healthcare is insurers explaining claims denials to providers. Counterintuitive, because in theory claims adjudication is 100% deterministic, so there should be no doubt about exactly why a particular claim didn't get paid. In…
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@ggreenwald
@amasad
@Osinttechnical
Same is true for you, buddy. At least
@Osinttechnical
a) tries to get it right & isn't afraid to admit when he's off, and b) appears to be generally on the side of those appreciating human civilization, not the kind of nihilists whose bidding you too often seem to do, whether…
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One of the biggest missed opportunities in U.S. healthcare is that as a society, we could be investing in better outcomes for everyone, which would save money in the long term - but often doesn’t happen because it costs more in the short term.
Here is a hands-on example that…
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Here is another iteration of our LLM-based claims denial explainer. The root cause of claim denials can be notoriously intractable to understand for providers, causing unnecessary friction and overhead in the healthcare system. We created Ocebot, a system that uses GPT-4 to…
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The fourth law of thermodynamics: when health insurers run out of ideas, they start merging with other health insurers
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@alexandr_wang
I used to think it's bad that videogames train kids on infinite iterations (save games & do over if you die). I think my kids' exec functioning is worse bc of that. However! Post-transformer creation is all about costless iteration, so maybe this is actually the future
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@zebulgar
Don't disagree w your point. But that chart has weird issues. Better to look at it in PPP. Also, ppl under-appreciate how much population growth matters for GDP. US still better in GDP per capita (= best intuition for how rich country feels), but way better in pop growth.
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This annual chart by
@Rock_Health
is always a great illustration why the employer-sponsored healthcare model is such an ineffective idea: nobody wants their employer playing a role in managing their healthcare. (Nobody wants the tech companies either btw.) ICHRA FTW
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Data from the Oscar Medical Group's AI-written messaging summaries: the time it takes to document visits to virtual care providers via secure messages dropped by around 30% with automated summaries. The chart below shows how providers are using the AI-written summaries.…
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We've reached peak HLTH vendor spam, I just got this: "Let’s talk about the health of your critical data fax capabilities at HLTH"
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In the category of "everybody knows this but every time you look at it it's still insane": price per colonoscopy in various Oscar markets. Always stunning how much higher outpatient prices are vs ambulatory surgery centers. But what's even more interesting is how ambulatory…
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@chrissyfarr
One of our first investors tried to fire us when we said we want to do subway ads. But it's harder to build trust for someone's offline life with online ads, and a lot of healthcare still happens offline. So it worked for us. (We still do it outside of NY state)
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Good to remember that hospital EHR adoption really isn't very old at all (chart below has % hospitals with EHR). If you look at it this way, EHRs being widely used at hospitals are a more recent innovation than bitcoin
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@aeyakovenko
@DavidSacks
@TheStudyofWar
Why do you think
@davidsacks
is piping up? Probably picking up on discomfort from his Eastern friends who urgently need to buy some time. After all, can't happen every day to lose a ship to a country without a navy. (Actually HAS recently happened every day.)
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The Oscar Medical Group (the virtual primary care group that operates our virtual care plan designs) has been using GPT-summarized lab test results for a few months. When lab results come back, the Oscar EHR creates an automatic summary. Some learnings: when it comes to the…
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@MarkGaleotti
The other place where that is clearly going on is Fox News. Entire homepage devoid of any Ukraine/Russia mention. And because consistency in ideology isn't their strength either, they do have a headline complaining about European withdrawals from Mali & ISIS
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Not that anyone is going public any time soon, but here is an important post-IPO learning that I bet most founders underestimate: turnover. Here is a chart of Oscar voluntary turnover vs the Oscar stock price (now back at $8.41, I think one of the best-performing healthcare…
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@micsolana
Weren't you guys the ones who were all about being free speech maximalists? Has that position gotten inconvenient?
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Full view of Oscar's code base. Most proud of the Prolog code
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Here is Oscar data from the last (partial) eclipse in NY in 2017. Conclusions:
- The medical term for "staring at the sun too long" is solar retinopathy
- Members were 30x more likely to seek care for solar retinopathy in the month following the eclipse vs. a regular month
-…
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Simple insight in how members select primary care physicians: first chart shows what happens when Oscar auto-assign primary care physicians based on various metrics like cost and quality - the farther away, the less likely the member is to actually visit. Second chart shows the…
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The 2024 Medicare Advantage enrollment period is the first time that the number of people turning 65 every year is stagnating, and from now on will only go sideways/down. (Medicare Advantage for 65+ has been the biggest profit drivers for most health insurers for the past 10…
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Some notes from augmenting our 'find care' search with LLMs: the Oscar app has long had an omni-search bar that is able to distinguish between reasons for visit, providers, facilities and drugs. Way back in the days we had a SNOMED- and Unified Medical Language System-based…
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This article in the New York Times about record enrollment in the ACA has a photo of an enrollment kiosk from Las Madrinas ("the godmothers"). There is an incredible story here. Odalys and Mercy, the two founders, were individual AIG life insurance agents in Miami. They realized…
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@mcuban
@B_Madden4
Generally true. With one big caveat: you seem to say employers are the solution. In fact, employers are by far the biggest enabler of this rent-seeking system. We're asking the least quantitative people in any organization to manage healthcare costs. On a more or less random and…
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@nearcyan
Remarkable; but you also need this perspective: That bridge improvement supports a much larger economic multiplier than in 1937. Look at it in % nominal GDP: the bridge cost 0.037% of nominal GDP back then (inflation-unadjusted). Those nets cost 0.000002% of GDP today. We spend…
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Oscar is turning 10! What better way to celebrate than by showing some charts, because that’s the Oscar way. Here is how many distinct providers we have paid claims to: 1/13
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@molly0xFFF
But they say they are going to solve it by building their own sidechain for their own NFTs. It will probably consist of, like, 9 nodes, like the infamous and now very much hacked Axie Infinity sidechain. Welcome to 1992, we've successfully reinvented the web server
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@GameHistoryOrg
Even worse for online games, because making a copy isn't enough, you'd need to clone a server. How many once massively popular 2008-12 era Facebook games are still online? Probably not many.
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Oscar telemedicine conversations that are about covid appear to have a decent & consistent lead of 2-3 weeks at the turning points over actual U.S. covid case count
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@zachweinberg
Actual non-ironic quote from Balaji's book: "It’s really crucial to understand that the US establishment is not more ethical than the CCP when it comes to civil liberties. It’s just less competent!" Late-night-dope-smoking college ramblings with too much Silicon Valley money
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New Kindle didn't connect to the family account, so I had to call an Amazon help line. Let me just say the idea that Amazon will ever be any good at anything serious in healthcare seems laughable after that experience. Harder than submitting a claim via Change Healthcare
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@realdschmidt
Maybe try to do something constructive in your life for once? Like, build a Lego set. If you work hard, you can finish those that say "under 6 years" in just two years. I believe in you!
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@newhouseb
Well done. The paper "Towards Revealing the Mystery behind Chain of Thought: a Theoretical Perspective" takes a similar approach of implementing addition in "transformer logic". Same for string edit distance.
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@LinusEkenstam
This works in GPT-4 (it didn't in GPT-3): "Plug eq 1 into eq 2 & show that eq 2 is correct. Eq 1: D(x - y) = \int \frac {d^{4}k}{(2 \pi)^{4}} \frac {e^{ i k ( x - y)}} {k^{2} - m^{2} + i \varepsilon}. Eq 2: - (\partial ^ {2} + m^{2}) D(x-y) = \delta^{(4)}(x-y)"
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@SBF_FTX
Not backwards, it always works like this. Here are dollar reserves by the Argentinian central bank before the dollar peg broke in 2001. Very, very easy to satisfy the first money out. See how reserves ROSE 1996-00. Until it stops! Get out of $tether while you can.
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@amasad
I thought the tiny uncommented observations were the most insightful to understand how he operates. Like: Optimus and Raptor engine meetings are rambling affairs that can drift off into chatting about movies & where others need to pull him back to an agenda. (Honestly we should…
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I loved talking to
@HarryStebbings
. His combination of brilliance and warmth gets the best out of people
So Oscar Health is a fricking insane story…
🏦 The company IPO’d at $7.1BN
📉 Then tanked 94% of its market cap!
💸 It has rebounded but still today revenues are 2x market cap
My 6 takeaways from sitting down with
@mariots
👇
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The "funniest" thing about the United hack is that United, the insurance company, isn't even impacted because... they aren't using their own systems. That should be the dictionary entry under "opposite of dogfooding"
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LLMs are awesome and all, but my favorite research papers are those that show where they fail. It's easier to understand hard limits than soft capabilities. Here are some recent papers with good examples for the limits of current LLMs.
(1/4) First one: "TravelPlanner: A…
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@molly0xFFF
I'm waiting for the next crypto game to be announced to be built in Flash and Actionscript because that's how it worked in the 2000s and apparently we have decided to reverse the arrow of time
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@waitbutwhy
There are some things that are actually as obvious as they seem. I wouldn't want the guy who happens to have a knife next door to do my open heart surgery, and I wouldn't want to rely on the guy next door who happens to have a gun to stop an active shooter. So, tighten laws.
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@waitbutwhy
Yes, but what is even crazier is that an electron is yet millions of times smaller than an atom, and with quantum electrodynamics we've figured out how to estimate its magnetic moment to a precision that's comparable to measuring the size of the Atlantic Ocean to a hair's width
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Power of consumer market pressure in healthcare at work: chart below shows ACA premiums, employer premiums (Mercer survey and Kaiser Family Foundation data), indexed to 2018, compared to inflation. Employer costs super-inflationary, ACA premiums deflationary.
@chrissyfarr
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@LinusEkenstam
Use this to have GPT-4 summarize meetings for you: Google Colab notebook that uses Whisper to transcribe a meeting, to identify speakers, then save in file. Copy and paste file content into ChatGPT and start asking away.
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Emails on mental health topics that we send to Oscar members immediately after they searched for mental health benefits have a click-through rate of 9%, more than double our usual email comms CTR. The lift effect weakens over time but is still there after a few months. Lots of…
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A persistent issue with LLMs is that while they generate next-best-token probabilities, they don't currently generate "next-best-concept" probabilities - i.e., a degree of confidence in their general answer to a problem. It turns out that you can use the LLM itself to grade its…
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Unpopular opinion that is not mine but our data's: work-life balance is the WEAKEST correlation with whether you recommend your workplace. (Calculated as the correlation of answers across teams to Oscar's regular employee satisfaction survey.) I remember prior surveys where it…
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@SBF_FTX
This happened so many times in economic history. Indonesia 1997, Thai baht crisis 1997, Mexican peso 1994 & all of those were actually monitored by serious people including the IMF. Absolutely laughable to think $tether has even close to that "stability".
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Here is "What Oscar Does", 2023 edition - our analysis of the market failures in healthcare, the role of insurers, and their future challenges:
Some of my favorite charts below
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@AlexKontorovich
As your smiley face suggests, they never meet, because if the two circles were truly tangent, the lines would be perpendicular to the line connecting all three circle centers and thus parallel to each other. Those drawn trick circles actually overlap in two points in the image
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@realchrisrufo
I can't tell if "Harvard night school" is a real thing or a euphemism/joke for hanging out in Cambridge bars
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We've seen over and over again that simple personalization of outreach works in health care: automated introduction message from your Oscar virtual PCP cut appointment no-show rates by 20%
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@molly0xFFF
This is really mindblowing. I run an actual fully licensed insurance company. US insurance regulators have been extremely clear that anything that acts like insurance IS insurance and needs a license. Even clearer than securities laws. That this exists is just totally out there.
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@DavidSacks
Every time
@DavidSacks
digs himself deeper into his self-delusional hole of lunacy, it reminds me how he screwed
@parkerconrad
: . All fun & games on Twitter. Just don't let this man near the boardroom, banking system regulators, or international diplomacy.
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Proudest achievement today: getting blocked by
@naval
. (Covid tweet, Naval said "better to have natural disasters than govt-made disasters", I said bring back potato famines, who needs civilization).Well, famously if you annoyed good old Socrates he'd etch you off his papyrus too
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@DavidSacks
@RobertKennedyJr
This makes me realize in how different of a reality you & I live in. I expected some misleading quotes chosen to confuse the factless. Instead, I saw hardworking leaders predict what happened - lower hospitalizations & falling infections. Your ideological blinders are strong.
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Recommend building this hexapod robot with your kids, from Freenove, powered by a Raspberry Pi 4. Only issue is that Pis are hard to find at the moment, so get one while you can!
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Useful to have done IPO to now interpret other people's IPOs: Instacart said they'll price at $26-28 per share. Which means they'll do roadshow this week, IPO next Wed. If the roadshow is going well (conversion rate from meeting to investor commitment > 85%), they will increase…
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@sacjai
What is the evidence that non-profit entities drive better costs/outcomes? Recent RAND hospital study again showed little correlation for cost & quality. Most expensive hospitals in NY are non-profits & high costs are the biggest destroyer of better outcomes in US healthcare.
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Good post by
@vijaypande
. One additional observation: order execution speed in the stock market has increased orders of magnitude over the past 20 years. Claims payment speed in healthcare hasn't changed at all (still takes weeks). I think one difference is that high-frequency…
100% of stock trades used to be made by humans. Today, 80% are made by computer algorithms.
AI is about to bring a similar revolution to healthcare. And many don't realize how big this will be.
"Underestimating AI in Healthcare" --
@daisydwolf
@JayRughani
@adelatomsejova
…
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.
@QuantaMagazine
is just the best math, physics, computer science publication, and this is some more great writing by
@stevenstrogatz
. Looking forward to his new podcast.
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Unpopular opinion, but you observe the reflexive anti-bureaucracy theater a lot more from people who have never run a "real" (-world) company. Like, nuclear power plants and oil tankers don't run because a lone genius pushes all the right buttons all the time. The sophisticated…
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@BillAckman
@terra_money
100%. People love comparing the $terra depeg to the 1992 Soros GBP trade & that's a self-own. 1992 GBP was held at inflated rate, incompatible w/ inflation & growth. So it reset to new level compatible w/ econ. conditions. So, crypto rate level compbl w/ econ conditions is... 0.
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