Max’s Back Pocket Vol. XIII

Well, here we are in the 13th edition of Max’s Back Pocket. I think we are starting to catch up to the never-ending Rocky series. We had a nice long weekend and a pretty low key Memorial Day. I was able to extend my streak of biking to the hospital all four days again. There was a slight misfire on Thursday, though. I tried to jump a curb I had no business jumping and popped my back tire. I was about a mile into my 2.1-mile commute and just walked the rest of the trip. No big shakes. I borrowed Mrs. Max OOP’s bike for the Friday commute and will fix mine today.

Today’s project

As I mentioned last week, I use the IRS valuation to calculate my net pick up from bike riding to work. So that’s another $9.68 back in my pocket for a total of $19.36. My vehicle has not left the house in two weeks.

$2.42 per day X 4 days = $9.68

We will see how next week goes. I have been anxious to get back to the gym and I found out mine opens up Monday by appointment only. A colleague from work and I have been working out for some time, and he scheduled us a slot. The gym is on the other side of town, maybe a few miles, so I will have to decide if I want to schedule the time to bike down there or drive in the days we work out. We will see, maybe I will test out the ride this weekend.

On to Max’s Back Pocket.

Max’s Back Pocket

Over the last several years, I have absorbed a ton of great content from a lot of talented people in and around the internet. Several of those ideas even got drawn into my personal finance strategy. Some of these writers are professionals, but a lot of them are just amateurs throwing their weight around in a random niche. I like to think I am pretty good at the intersection of healthcare and personal finance, but there are plenty of people out there much smarter than me.

Up until now, most of these ideas just landed in my back pocket. There they would sit for my own benefit whenever I needed them. They were rarely shared or exchanged with anyone in my personal network. These days, that is no longer the case. Max will start scouring the entire internet for these ideas in a weekly effort to not only spread but recognize the wealth of knowledge that is out there. This weekly check-in will also give me an excuse to catch up on what’s going on around here more often. What are we calling this idiomatic experiment?

Max’s Back Pocket.

Personal Finance

This was a “non-pay” week for us, so not much going on in our personal finance world. I stumbled across a new blog this week I hadn’t heard of called We Want Guac. Darcy reflects on reaching a $100,000 net worth back in 2019 with What it Means to Have $100,000 in Savings. This was done in her 20’s, and she beat me by a year or two. She mentions that having a six-figure wealth means you have more money than roughly two-thirds of the US population and you are one of the wealthiest people on the planet. If you live in a bubble, it’s easy to forget this type of thing.

She goes on to talk about the security, income, confidence, and the skillset created by putting up a 100k net worth. I would only add that having this type of security could also really help a person through a health crisis. Not having to worry about money during those times is huge.

She also shared a cool little calculator that’s worth playing with. Evidently, their data comes from the 2016 Federal Reserve Survey of Consumer Finance. We don’t own a home, but a lot of my peers do. When I run the same calculation including primary home equity, the calculator suggests my age group has an average net worth of about $34,000. Considering my medical office building portfolio alone eclipsed 50k this year, I am feeling pretty good about everything.

Including primary home equity, most people don’t hit 100k until 50.


Here at Max Out of Pocket, we did an extensive review of How Much Should Molecular Genetic Testing Cost? This was in response to the Dragon Guy’s 9-year cancer update where he let us all know he is still in remission!

I zeroed in on a very specific lab test that is represented by CPT code 81206. It is basically looking for a mutation of a gene often found in patients diagnosed with chronic myelogenous leukemia (CML).

I pulled pricing from Stanford Health Care, Beaumont, and Johnson Memorial Hospital in Indiana. I went through my usual spiel about the “problem gap” which is the difference in reimbursement between the Medicare program and commercial insurance.


When I initially launched the Max’s Back Pocket series, I thought I would have a weekly review of a podcast to talk about. Since I live at the intersection of healthcare and personal finance, I am always listening to podcasts that fall into those two categories. Although I have not been doing regular write-ups about them, that doesn’t mean I haven’t been listening.

I found Dr. Zeev Neuwirth’s podcast Creating a New Healthcare way back in July 2019. He really pulled me in with episode #68 featuring an interview with Dr. Stephen Klasko, CEO of Jefferson Health. I probably should have featured that interview at some point, but it wouldn’t do it justice. Just go listen to it. It will fire you up.

When I switched to Google Podcast a few months ago, his show somehow fell off my feed. So I just started catching back up. This last week I listened to his 100th episode.

I wanted to congratulate Dr. Zeev Neuwirth on 100 episodes, excellent work!

Creating a New Healthcare – Episode 100

Creating a New Healthcare – Episode #100: ‘How COVID-19 is Reframing Healthcare in America’ with Sami Inkinen, CEO & Founder of Virta

This story is pretty amazing.

Sami Inkinen sounds like a tremendous person. After dominating the real estate market by co-founding Trulia, he figured he would tackle type 2 diabetes next. Pretty amazing if you ask me. As an extremely healthy triathlete, he had an unexpected encounter with the condition.

His company, Virta, has a unique model for tackling type 2 diabetes. From the sounds of it, a lot of it is nutrition-based. Here is a quote directly from their website.

Virta is a proven treatment to reverse type 2 diabetes. Most of our patients achieve blood sugar control while removing medications like insulin, often in a matter of weeks.


Virta does a lot of this service through telehealth. By chance, the company’s care delivery model was practically pandemic-proof. It sounds like they take a set of labs when they intake the patient including a comprehensive metabolic panel but everything else is done through regular communication with the provider, mostly remotely.

Even though lab work is needed, they can take care of some of that with at-home testing.

How Do They Get Paid?

Working in billing, finance, and reimbursement, of course, I zero in on the payment model. I listened to this part a few times. Let me tell you, I love how they have this thing set up.

Virta’s economic model is purely outcomes-based. They don’t have to worry about billing codes that represent the extensive research and interaction they have with their patients. Dr. Neuwirth noted that the pandemic has shown how vulnerable the fee-for-service model is. Mr. Inkinen went on to suggest the pandemic has leapfrogged telehealth 3-5 years.

Sami Inkinen emphasized that they have this “bold promise” that their model can reverse type 2 diabetes or put it in remission. He wants to put their money where their mouth is by getting paid for the clinical outcomes that do just that. They only get paid by employers of government payers when outcomes are positive. In other words, they won’t be cranking out “extra” telehealth encounters just to get the fee for the service. This aligns everyone’s interest with that of the patient.

I actually wrote down this quote:

If you get paid for doing something, at some point, somebody is going to be doing more of that something.

Sami Inkinen

I agree, if we make that “something” outcomes instead of services, it certainly does seem to line the economic model up better. I also jotted down this quote by Dr. Neuwirth.

There is no CPT code for caring.

Dr. Neuwirth

I don’t think there is any better way to end this post.


I have no affiliation with Virta or Dr. Neuwirth.


2 Responses

  1. Speaking of calculators, my favorite one is Financial Mentor’s Ultimate Retirement Calculator. Unlike ones from the mutual fund companies or mass media, this one allows you to model one-time money inflows (like selling a house) as well as over time inflows (like consulting) and not just a drawdown of assets. It’s a good calculator for the FIRE community that typically has different side hustles and income streams.

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