Solving Problems and Changing Lives in Healthcare

Chief Medical Officer of FFF Enterprises Ross Hoffman, MD, is a physician entrepreneur, cardiologist and medical device and healthcare IT startup founder. Prior to his work at FFF, he served in many roles in healthcare, from working with health plan clinical and business leadership, product development teams, pharmacy benefit managers, specialty pharmacy businesses and corporate development teams to leading clinical programs concerning high-cost pharmaceuticals, cell and gene therapy, new technologies and procedures, and chronic care innovations. Dr. Hoffman advises investors, pharmaceutical, biotech and technology companies, health policy leaders, start-ups and innovation incubators and is a frequently invited guest speaker on high-cost drug access and affordability, health policy, value-based design, clinical care and network redesign, alternative payment models and emerging novel diagnostics.

BSTQ: Dr. Hoffman, you have served in many roles in healthcare. How did you first develop an interest in practicing medicine, and what led you to where you are today?

Dr. Hoffman: I am fortunate to have been blessed with insatiable curiosity, seeking a deeper understanding of how things work in our world, in the universe, in our minds and in our bodies. The field of medicine is full of unsolved mysteries that focus on humans, key players in the mystical game of life. Medicine offers an abundance of complex scientific problems while allowing us to deeply touch the lives of other people in meaningful and intimate ways. Engagement in the endeavor of fixing hearts and lives gives me great satisfaction and requires continuous learning.

The evolution of healthcare innovation, cost, financing, payment and care delivery has paradoxically deprioritized the needs of patients and those who deliver care. Having witnessed these changes, I have moved across multiple fascinating domains within healthcare, always with the goal of building teams and solutions that offer clinically meaningful, holistic, accessible, financially sustainable and scalable results. These principles continue to guide my professional pursuits.

BSTQ: FFF Enterprise’s motto is “Helping Healthcare Care.” How do you support that mission in your role at FFF?

Dr. Hoffman: The consolidation and corporatization of healthcare has reduced the personal touch in medical care, while jeopardizing the agency of key players in the healthcare domain: patients, their families and the physicians and other providers who are responsible for their care delivery.

FFF is a large enough platform to reach the lives of many key stakeholders in healthcare. In my role, I can address our nation’s need for healthcare quality improvement and efficiency, while valuing the patient and provider experience.

BSTQ: Consumer confidence in the pharmaceutical industry has decreased. Negative views seem to outweigh positive ones, and consumers are concerned about transparency, pricing and motives. What do you think could restore consumer confidence?

Dr. Hoffman: This is a very complicated and sensitive issue. Regarding trust, I think it all comes down to leadership.

I don’t view trust in the pharmaceutical industry as being an outlier. We have loss of trust across many domains of healthcare, including considering our storied healthcare agencies, such as the Centers for Medicare and Medicaid Services, the Food and Drug Administration and the Centers for Disease Control and Prevention. We have a third-party payment system, which is opaque and complex. Highly regulated product innovation businesses (drugs and devices) are built on financing and investment models rewarding the highest possible price rather than lower cost and high performance.

The bottom line here is that wise, compassionate and highly communicative leadership is required to reduce this complexity into more simple terms, so that people can understand our healthcare delivery in a manner that restores their faith, restores the belief that everyone in the system is working toward the same goal. It’s important to acknowledge and address the structural issues in U.S. healthcare delivery that do not align. Failure to reform this misalignment leads us to our current circumstances.

BSTQ: Drug access and affordability are major concerns for patients. It’s a big problem without an easy answer, but what do you think is a good step forward?

Dr. Hoffman: Affordability in all aspects of healthcare is a concern, and solutions must align with a society’s value system. Preferences and values (access vs. choice vs. cost) vary across cultures, geographies and countries. We all define “value” differently, and this is a fundamental issue. From an economist’s viewpoint, does one view healthcare as a cost center or a profit center? Health policy and business models are all subordinate to this initial viewpoint and values system.

There are numerous studies demonstrating that consolidation across the U.S. health industry is driving up the cost of care. So, consolidation is something that could be addressed. Consolidation is happening at every level and across all verticals. The Federal Trade Commission has attempted to examine this, and many of those efforts have stalled.

Other approaches could optimize access to some of the most frequently utilized (and inexpensive) medications in the world. For example, consider the World Health Organization’s (WHO’s) list of essential medicines. For a comparatively very small investment, it is possible for the U.S. government, or a public-private partnership, to offer broad access at a very low (or zero) cost for all these drugs. There are significant concerns to be addressed here: supply chain, manufacturing and logistics, and investment. However, I think this is readily achievable if we have conviction, committed financing and skillful political will.

BSTQ: Patient safety remains a top concern in healthcare, with medication errors a leading cause of injury and avoidable harm. Why do you think this is, and what do you see as a strategy for effectively decreasing medication error rates?

Dr. Hoffman: Higher patient volumes, reductions in staffing, staffing shortages, under investment in technology, non-mandatory interoperability and poor integration of information systems all increase the hazard of medical errors.

There are certainly best practices addressing continuous quality improvement, and the patient safety movement is well-established. In addition to these operational issues, continued efforts securing the integrity of our drug supply chain are also of critical importance.

At the patient level, the fragmented healthcare delivery system requires continued examination and improvement. Patients receive medications from multiple doctors in non-interoperable information systems, often via multiple pharmacies. There are small but successful examples of hyper-focused, highly vigilant primary care delivery, which offers team-based care with care managers, coaches and navigators who help patients to stay on the right path and minimize the number of avoidable escalations in care. Polypharmacy is an increasingly recognized complication of the typical chronic comorbid patient journey. This can and should continue to receive increased attention.

BSTQ: How do you foresee personalized medicine affecting the pharmaceutical industry? In your opinion, is this a positive change or a negative change?

Dr. Hoffman: We continue to decipher the true underpinnings and complex mechanisms of disease states. Truths we held 20 years ago have been disproved or significantly modified. With the knowledge explosion we have witnessed, precision approaches have the potential to transform care. We will need to refine care models as we refine our diagnostics so that we are more precisely able to manage our patients. Sometimes this leads to high-value companion diagnostics, which help predict responsiveness to a given drug or other intervention. This can certainly be beneficial to patients and improve provider decision-making.

Part of the challenge is rapid, efficient and accurate dissemination of the diagnostic information. Too often, we can see overuse or underuse of the correct diagnostics. The unintended side effect of “precision” drugs is that these are often marketed at premium prices, which may or may not deliver proven net health economic benefit.

Rigor of evidence matters. Consider the Alzheimer’s disease blood-based precision biomarker pTau217 (p-Tau), which is one of a new wave of biomarkers that are badly needed for this disorder. Emerging data suggests that we are getting closer to offering early diagnosis and intervention. While promising, challenges remain in standardizing p-Tau assays. Commercial efforts are promoting these tests (perhaps prematurely), while ongoing research aims to define the best use of these tools.

BSTQ: Digital technologies are increasingly bringing healthcare to patients. Do the benefits outweigh the drawbacks?

Dr. Hoffman: It depends. Care models that fragment the patient experience and disenfranchise primary care physicians are a problem. Thoughtful systems of care that combine high quality with convenience and accessibility can certainly be beneficial. The key elements here are taking a holistic view of the patient’s journey and encouraging longitudinal, high-integrity care, with an identified clinical (and sometimes nonclinical) quarterback so that care is both reflexive and anticipatory. Enablement of prevention and health maintenance (physical and behavioral) should be a constant for all our patients. The key here is efficacy and accountability of the care and the care model. The virtual or digital aspect is really a secondary matter.

BSTQ: Artificial intelligence (AI) has arrived. How is it transforming the practice of medicine, and do you think it is a positive change?

Dr. Hoffman: We are already seeing the advantage of large language models helping inform clinicians when rapid access to medical information can be beneficial. OpenEvidence is currently used by 25 to 50 percent of all physicians in the U.S. The tool is free to all verified physician users. The company has raised $100 million in total funding as of April 2025. It is an AI-driven medical platform designed to assist doctors by providing evidence-based answers sourced from peer-reviewed literature. Its graphic user interface (GUI) is similar to GPT; it’s easy and fun, and doctors have adopted quickly.

We are also seeing the widespread use of digital scribes. The application is already commodified, and it’s not yet clear whether this will be a net benefit (+ROI). Physicians have adopted these tools quickly. There are approximately 75 scribe tools in the market.

Another notable example is Hippocratic AI. As of April 2025, Hippocratic AI has raised a total of $278 million across three funding rounds. Hippocratic develops generative AI agents designed to perform low-risk non-diagnostic patient-facing healthcare tasks such as post-discharge follow ups and health assessments. As of early 2025, Hippocratic AI has signed contracts with 23 health systems, payers and pharmaceutical companies, and approximately 16 of these clients are already operational.

We’re already seeing some efficiencies in administrative functions, and I expect to see much more over the next few years. Some healthcare service companies are beginning to experiment with AI agents in a manner that will reduce the number of administrative tasks required by some of the technical medical staff and support staff.

AI applications are being introduced for data summarization: the aggregation and review of large volumes of medical information required in perfunctory processes such as prior authorization. There’s evidence these tools increase the efficiency of staff working the prior authorization queue.

Outside the United States, there has been more widespread acceptance of AI-enabled diagnostics —AI’s advanced interpretation of diagnostic images (radiology) is one example. Published studies have demonstrated the marked superiority of AI systems in identifying subtle findings on even simple radiographs, compared with expert panels of physicians. Given the speed, accuracy and accessibility of these tools, we are now able to provide services to populations for whom healthcare was previously inaccessible.

BSTQ: How can medical providers best maneuver through misinformation to help restore patient confidence in healthcare?

Dr. Hoffman: This is a matter of leadership and good doctoring that is skilled, informed, authentic and compassionate. We’ve all lived through a scary experience during the pandemic. For some of us, this resulted in life-changing trauma. As a country, we are smart to remember this. Navigating the path forward will no doubt bring up recent painful memories, in addition to great scientific advancements and discoveries. The intersection of politics, medicine, economics, justice, fear, hope and doubt is and has always been embedded in the arc of the history of medicine and scientific discovery. Good doctors can and will manage this with their patients.

BSTQ: In a time of great change in healthcare, what drives you to seek actionable solutions? What gives you hope? How do you stay grounded and focused?

Dr. Hoffman: Drive? People’s lives are at stake. And increasingly, financial toxicity is a side effect of the healthcare system. During my career, despite fantastic innovations, healthcare has become less accessible, less affordable, more challenging and frustrating to navigate for both patients and physicians. This creates a great sense of urgency.

Hope? The human spirit. It’s the resilience I have seen and continue to see. I learned this most from my sickest patients and families, who carried themselves with grace. And let’s face it, we have collectively survived 2020 and COVID and even recovered from ZOOM meetings without mute buttons.

Grounded and focused? Fitness (mind and body), family, faith, focus (on others), connection to nature, books and heavy doses of good music.