Ep 69: Cadence Founder Chris Altchek on the Future of Chronic Disease Care

Chris Altchek, founder and CEO of Cadence, joins Nikhil and Jacob to discuss how AI is changing the way chronic disease gets managed at scale. Cadence treats 100,000 patients a day across major health systems and has published some of the largest cost and outcomes studies in the space, including a nearly 17,000-patient analysis in Mayo Clinic Proceedings and a 24,000-patient study in the Journal of the American College of Cardiology. The conversation covers the three phases remote patient monitoring has gone through since before COVID, why hospital-at-home has struggled to scale despite strong clinical outcomes, and how AI voice agents cut Cadence's average alert response time from 1.8 hours to 3.5 minutes. Chris also explains Cadence's "proactive titration agent" for adjusting medications in real time, an unexpected discovery that their monitoring system catches early signs of sepsis, and why he believes digital health companies have a responsibility to engage with new CMS payment models like ACCESS, even when the economics aren't ideal on day one. They close on how Cadence is rethinking hiring and internal workflows as AI changes what the job requires. (0:00) Intro (1:22) Remote Monitoring Three Phases (3:44) Why Hospital at Home Stalled (6:06) Cadence Vision and Scale (8:50) GenAI Boosts the Product (13:45) Where AI Still Breaks (18:30) Building Proactive Workflows (22:50) Outcomes and Surprising Savings (25:07) Access Program and Payment Model (30:10) Engaging Seniors at Scale (34:42) Wearables FDA and Device Costs (37:59) Running a Company with AI (41:15) Quickfire Out-Of-Pocket: https://www.outofpocket.health/