❌

Reading view

There are new articles available, click to refresh the page.

Gen Xers and millennials aren't ready for the long-term care crisis their boomer parents are facing

An elderly man sits thoughtfully in a wheelchair in a bright living room. He gazes out, possibly reflecting on past memories. The scene is serene and contemplative.
Privately-provided long-term care β€” including assisted living and home healthcare β€” is largely out of reach for the broad middle class.

Getty Images

  • The growing population of older Americans is facing unaffordable long-term care.
  • These costs will also burden many younger people caring for older relatives and kin.
  • Government incentives and public insurance could help address care affordability, experts say.

As the population of older Americans balloons, the financial costs associated with aging are, too.

Many millennials and Gen Xers are facing a stark reality: their parents and grandparents don't have the means to pay for long-term care β€” and they'll need to help foot the bill, especially since government aid often doesn't cover large parts of this care.

Many younger people end up leaving their jobs or working less in order to care for their aging family members β€” and that sacrifice can hurt them financially both today and in the future, including by shrinking their income and Social Security benefits, experts say.

"The bigger issue is you can create almost a cycle of poverty," Marc Cohen, a professor of gerontology at the University of Massachusetts Boston, told Business Insider. "It's not something that just sticks with one generation. The costs are borne communally."

Unprepared for a predictable crisis

Much like other forms of care β€” from emergency rooms to daycares β€” the labor and facilities needed for long-term care don't come cheap. A shortage of long-term care workers, coupled with inflation, has sent prices up in recent years. As the oldest members of the baby boomer generation near 80, the demand for these services is expected to rise sharply β€” putting upward pressure on costs.

Privately-provided long-term care β€” including assisted living communities and home healthcare β€” is largely out of reach for the broad middle class. Fewer than 15% of people 75 and over living alone in major US cities could afford to pay for assisted living or daily home health aide visits without dipping into their assets, per a 2023 report from Harvard Joint Center for Housing Studies.

"It's the affordability issue, particularly in the middle market, that concerns us the most," Lisa McCracken, head of research and analytics at the National Investment Center for Seniors Housing & Care told Business Insider.

Retirees and their families may not be able to rely on the government to help. Medicare, the government's health insurance program for older people, doesn't cover most long-term care, including assisted living, home healthcare, and nursing homes. Medicaid largely doesn't cover assisted living and home healthcare, and there are often long waitlists for the nursing home care it does cover. Some assisted living residents have been evicted after they spent down their savings and were forced to rely on Medicaid.

"A lot of people thought, 'Oh, well, doesn't Medicare pay for this?' and it does not," Cohen said. "And so people find out late in life that they don't have any protection against these costs."

That's what happened to Erika Gilles and her family. After Gilles' 78-year-old mother, Karen Proctor, was hospitalized for her chronic kidney disease last year, she quickly realized her mother's Medicare coverage wouldn't be enough to cover her long-term care. Overnight, her mother went from living independently in the house she's long owned to requiring dialysis treatment and constant care. But Gilles couldn't purchase private long-term care insurance because of her mother's pre-existing conditions.

Gilles, 57, found a group assisted living facility for her mother, who applied for a state subsidy to help cover the cost. If the subsidy doesn't come through, Gilles is worried they'll have to sell her mother's house in Sun City, Arizona.

"It's totally turned my life upside down. It's absorbed all of my time," Gilles said. "I don't think I'm ever going to retire."

It's not just a boomer problem

Gen X, many of whom are sandwiched between caring for their aging parents and dependent children, has fallen behind in their financial savings. A study conducted by Nationwide showed that 56% of Gen Xers were financially supporting either their parents or their kids. About a fifth of Gen Xers taking care of a parent said they had a significant amount of debt, and a similar portion said they were unable to save for retirement, the study found.

The number of US adults who care for a spouse, older parent or relative, or child with special needs has grown from 43.5 million in 2015 to 53 million in 2021, per a report from the insurance provider Guardian.

A separate survey of 35- to 60-year-olds conducted by Carewell found that 75% of those taking care of both a parent and a child said they struggled to save for retirement, while 63% said they lived paycheck to paycheck. Meanwhile, adult caregivers provided around $600 billion worth of unpaid labor last year, noted a separate report from the AARP.

Brandon Goldstein, a financial planner at Prudential, said he frequently works with clients struggling to care for their parents as they get older. In some cases, his clients are experiencing financial stress as a result of caretaking and have been forced to cut back on saving.

Some of them may need to bank on their own children taking care of them in the future, he suggested, given how much they've sacrificed in their own retirement savings.

"Having to reduce what you put towards retirement is going to put you in a situation where you might not have assets now, and you could β€” I don't want to call it a burden β€” but you might become this responsibility if you don't have assets to cover a facility," he told BI, adding that some may need to consider working for longer than they originally expected.

Ultimately, through ballooning Medicaid costs, taxpayers may be on the hook for the growing long-term care crisis. An increasing number of older people don't have kids or spouses to take care of them as they age, and those that end up needing long-term care may have to rely on Medicaid. About a fifth of baby boomer women don't have any children, and those who do have kids have fewer, on average, than previous generations.

A government-aided solution for long-term care?

Cohen argues that the private long-term insurance market is suffering from "a clear market failure" and policymakers need to step in to create a public option for middle-income people and their families.

McCracken said that in order to scale some of the most effective models of assisted living and other long-term care, private providers will need more government incentives and partnerships.

Cohen argued that public long-term care insurance would work well if most people paid into it because a relatively small number of older people require the most expensive care, like 24/7 nursing.

That option could resemble an earned benefit, like Social Security and Medicare, funded by a mandatory tax that people pay throughout their lives and collect when they retire. Rep. Tom Suozzi, a New York Democrat, has proposed legislation that would create a public insurance program for catastrophic long-term care funded by a payroll tax.

Some states have begun to address the issue. Washington State recently passed a 0.6% payroll tax to fund a new universal long-term care insurance program called WA Cares, which provides $36,500 in care per person, and will increase with inflation in future years.

Gilles said she wants to see the government or care providers figure out a way to lower costs.

"They've got to provide more support to families going through this," she said. "They've got to either make it more affordable, or they need to provide more resources, or not make it so expensive so that it's attainable for anybody at any income level."

Are you or someone you care for struggling with long-term care costs? Email this reporter to share your story: erelman@businessinsider.com.

Read the original article on Business Insider

My health insurance covered nearly $900K after 26 days in the ICU, but the real financial battle started after I left the hospital

Stella Shon in the ICU covered in burn-like wounds and her before the incident taking a selfie outdoors.
The author was diagnosed with Stevens-Johnson Syndrome, a rare, severe allergic reaction to medication.

Courtesy of Stella Shon

  • Stella Shon experienced burn-like wounds all over her body from an allergic reaction to medication.
  • One insurance provider paid almost $900K for the ICU. Her follow-up claims have been rejected.
  • Shon has paid over $20,000 out of pocket for related medical expenses since her hospitalization.

Editor's note: Business Insider has verified all medical expenses and payments mentioned in this article.

I'll never forget the day I opened my UnitedHealthcare app and saw nearly $900,000 in hospital charges.

In August 2022, what started as flu-like symptoms rapidly escalated into a life-threatening emergency, and I was diagnosed with Stevens-Johnson Syndrome, a rare, severe allergic reaction to medication.

After taking over-the-counter pain relievers and antibiotics, a rash spread across my body, and I was rushed to the ER with burn-like wounds, requiring immediate intubation in the burn ICU.

Nearly a month later, I was discharged from the hospital. It was a turning point in my life β€” not because I'd survived the ICU, but because the battle was far from over.

Long-term complications come with a cost

Over 26 harrowing days in the hospital, I lost my vision and developed raw wounds from my head to my torso. Just as my condition began to improve, I developed sepsis. Ironically, the treatment included a monthlong course of IV antibiotics β€” the same type of medication that likely triggered this nightmare.

In the first year of my illness, I attended over 50 follow-up appointments with specialists in ophthalmology, dermatology, gynecology, and infectious diseases and received a deluge of medical bills.

Overall, I was extremely fortunate that UHC fully covered the $885,855 cost of my hospital stay, except for my $5,100 out-of-pocket maximum. However, my ICU stay was only the beginning of the costs I would face in managing the long-term complications of the disease.

Prior to this incident, I had a flawless medical record. In the two years since I left the ICU, I've spent an average of $8,500 a year on health insurance, $11,000 on lenses to protect my damaged corneas, $1,400 on prescription eye drops, $3,000 on glaucoma surgery, and more than $5,000 on follow-up appointments with various specialists.

ItemOut-of-Pocket Cost (2023-2024)
Health Insurance Premium$17,000
Scleral Lenses$11,000
Prescription Eye Drops$1,400
Glaucoma Surgery$3,000
Follow-up Appointments$5,000

I've realized the cost of ongoing medical appointments and necessary treatments will become a lifelong financial burden.

My eyes were permanently damaged

Two weeks into my ICU stay, which happened to be my 24th birthday, I was taken off of a ventilator. I vividly recall the first time I tried to open my eyes and had to shut them immediately due to unbearable, searing pain. The condition left permanent scars on my corneas and meibomian glands, which are responsible for tear production. As my vision gradually returned β€” a miracle in itself, given that many SJS survivors lose their sight permanently β€” my doctor delivered a sobering prognosis: The damage to my eyes was permanent, with little hope for improvement.

Stella Shon sitting showing the healed burn scars on her face.
SJS left permanent scars on Sohn's face and upper torso and damage to her corneas.

Courtesy of Stella Shon

I refused to give up on my eyesight. Fortunately, my cornea specialist referred me to an optometrist who offered a glimmer of hope: scleral lenses. Unlike regular contact lenses, these dome-shaped lenses are filled with saline, creating a protective fluid layer over the eye. This design helps treat corneal and ocular surface conditions like SJS and costs $11,000 for both eyes.

In addition to the initial cost for the lenses, there were ongoing expenses to consider. Supplies, such as preservative-free saline and cleaning solutions, added about $100 a month to my budget.

Insurance providers denied coverage for my treatment

The next hurdle? UnitedHealthcare did not consider these lenses a medically necessary emergency and denied coverage. If I wanted a chance at reclaiming my life, I had to shoulder the entire cost up front.

I called customer service many times to appeal my claim, with documented proof from my optometrist and the cornea specialists who treated me, saying I needed these scleral lenses. Weeks passed, and I remained in pain. I felt my only choice was to pay for the full cost of the lenses while continuing to fight my insurance β€” ultimately without success.

It's not just a UnitedHealthcare issue, though. I've submitted five insurance claims related to my eyes, specialty contact lenses, prescriptions, and burn scars to various other insurance providers, and they've all been denied.

ClaimsResults
Scleral LensesDenied
Prescription Eye DropsDenied
Laser TreatmentDenied
Glaucoma SurgeryDenied
Scleral Lenses (second attempt)Denied

My friends created a GoFundMe to help me cover living and medical expenses

I'm deeply grateful for the support of my best friends, who stood by my side every day in the ICU and started a GoFundMe while I was intubated. This fund became a crucial lifeline, covering my out-of-pocket maximum and the cost of the life-altering scleral lenses that now allow me to live a relatively normal life.

The financial strain was unimaginable and extended far beyond medical bills β€” rent payments, along with other living expenses, continued to pile up.

I spent a few months on long-term disability leave before leaving my corporate job by the end of the year. At the beginning of 2023, I shifted to a freelance writing and editing career instead, which afforded me greater flexibility to attend follow-up appointments and address my long-term needs. The main drawback, however, was losing employer-sponsored health insurance.

I'm self-employed now, and it's clear the healthcare system needs to change

My experience raised the question of whether coverage denials are specific to certain insurance companies or indicative of a broader systemic issue.

I'm now a self-employed writer and no longer have employer-sponsored insurance through UnitedHealthcare. Over the past few years, I've been covered by Blue Cross Blue Shield, Cigna, and now the University of Utah Health Plans through the Affordable Care Act, which comes with substantial out-of-pocket costs. And I've continued to face coverage denials for a variety of reasons. For example, my autologous serum eye drops β€” which are derived from my own blood and provide significant relief for my dry eyes β€” aren't covered by insurance because they lack FDA approval and are labeled "experimental." I pay $660 for a three-month supply.

Stella Shon shows burn scars from SJS on her back, while sitting on hospital bed.
Shon has lasting scars all over her torso from SJS.

Courtesy of Stells Shon

While most of the scars have faded with time, many are still visible on my face and upper body. Last year, I had a series of laser treatments at the dermatologist, each costing me $250. These claims were denied by my new plan β€” highlighting that this issue isn't unique to one insurer.

After my experience, I understand why so much anger and frustration toward healthcare companies has bubbled up online since the murder of UnitedHealthcare CEO Brian Thompson. It was a shocking crime, but the conversations it has raised have helped me process the desperation and powerlessness I've felt in my two-year struggle to appeal my claims.

I recognize how fortunate I am to have regained my vision and avoided financial debt from my ICU stay. However, one thing is abundantly clear: Meaningful changes to the healthcare system are long overdue.

A UnitedHealthcare spokesperson sent the following statement to Business Insider:

Ms. Shon's plan was self-funded, and therefore, her employer was responsible for payment of covered claims. In assisting her employer in processing these claims, we requested information from one of her providers, but we received no response.

Read the original article on Business Insider

Datavant is on the M&A hunt as the $7B health data company bulks up before a potential IPO

Kyle Armbrester, CEO of Datavant.
Kyle Armbrester, CEO of Datavant, said the health data company is looking for one to two more acquisitions going into 2025.

Datavant

  • Datavant is on the hunt for more acquisitions in 2025, Business Insider has learned exclusively.
  • The healthcare data startup has made 11 acquisitions since its founding in 2017.
  • While Datavant isn't rushing to IPO, the startup's growth could signal an exit in the future.

Datavant is hungry for more acquisitions as the $7 billion healthcare data startup inches closer to an IPO. The company is planning at least "one or two" more acquisitions in early 2025, CEO Kyle Armbrester told Business Insider exclusively.

Datavant, which manages patient data exchanges between providers, payers, and life sciences organizations, has made 11 acquisitions since 2017. The company kicked off a fresh M&A rush in the fall, picking up data privacy organization Trace Data and two data analytics products from healthcare AI startup Apixio in September.

Datavant hasn't publicly announced funding since its $7 billion merger with Ciox Health in 2021. Private equity firm New Mountain Capital is the company's controlling shareholder.

With "well over" $1 billion in revenue and steady profitability, CEO Kyle Armbrester said Datavant expects to make these acquisitions with the cash on its balance sheet.

The M&A flurry could be a good sign for Datavant's IPO potential. Flare Capital Partners' Parth Desai told Business Insider in December that he expects private-equity-backed healthcare companies to make tuck-in acquisitions in 2025 as they look ahead to potential IPOs in 2026.

While Datavant won't be first in line to IPO when digital health companies start going public again, Armbrester didn't rule out the possibility of a Datavant IPO in the next year.

"If market conditions are right, and there's a need for cash to continue to grow the business, that's great," he said. But, he added, "there's no drop dead date."

AI's big data business

Datavant works with a range of customers, including health systems, insurers, and life sciences organizations, to digitize and manage patient data exchange for tasks like clinical research and population health analytics. Today, the startup says it works with more than 70,000 hospitals and clinics.

As demand for digitized healthcare data has exploded β€” even more so with the advent of AI, with mass amounts of data needed to train advanced models β€” Armbrester said Datavant's business is booming.

"There's been a pretty rapid pace of digitization of a lot of manual workflows in healthcare, and we've been a benefactor of that," he said.

With cash flowing into the business, Armbrester said, Datavant is looking for "one or two" additional acquisitions going into 2025. The startup is looking for companies building technology for healthcare providers and life sciences organizations, he said.

Armbrester said he's primarily hunting for great products with existing market traction that Datavant can elevate with its deep data pools and customer bases.

"We're large and diversified, and I think we're in a really good space to take a smaller smarter and apply their logic or artificial intelligence or analytics across that vast network to see a lot of benefit," Armbrester said.

Datavant could be a strong IPO candidate for the next wave of digital health IPOs, investors and bankers told Business Insider in 2024.

Armbrester's entry as Datavant's CEO also bodes well for the company's IPO prospects. Armbrester stepped up into Datavant's CEO role last June after six years leading Signify Health, where he steered the healthcare analytics and services provider through its 2021 IPO and its $8 billion acquisition by CVS Health in 2023.

While Datavant has stayed quiet in recent years about any fundraising, the outlet Buyouts reported in September 2023 that New Mountain Capital was looking to extend its investment into Datavant through a continuation fund in a deal that would give Datavant additional capital.

Armbrester didn't comment on the fundraising reports but acknowledged that Datavant's business maturation could lend itself to a public market debut.

"We're certainly at a size and scale where going public could be something that we contemplate," he said.

But Datavant isn't feeling any short-term pressure from New Mountain or the rest of its board to make an IPO decision. "We've got plenty of cash on the balance sheet to do all the M&A I've just described and fund product roadmap investment as well," Armbrester said.

Read the original article on Business Insider

Pro-Luigi Mangione content is filling up social platforms — and it's a challenge to moderate it

Luigi Mangione
Luigi Mangione is accused of killing UnitedHealthcare CEO Brian Thompson. Some people are praising Mangione on social platforms β€” and it's causing a moderation headache.

Pamela Smith/AP

  • YouTube and Threads have taken down pro-Luigi Mangione posts they've said violate their policies.
  • YouTube told Business Insider it forbids videos that glorify the murder of the UnitedHealthcare CEO.
  • The different moderation approaches among platforms are leaving some users confused.

Diana "Ladidai" Umana, a content creator based in New York, has been closely following the news of Luigi Mangione β€” posting her thoughts on various social media accounts.

Umana's posts are pro-Luigi (and some have unorthodox angles, like saying he wasn't the shooter, which authorities have charged him with). But she was surprised when her entire YouTube account was permanently removed for what YouTube told her were "severe or repeated violations" of its rules.

YouTube's content moderation policies forbid "content praising or justifying violent acts carried out by violent extremist, criminal, or terrorist organizations."

"This means we remove content that glorifies or promotes the suspect in the murder of [UnitedHealthcare CEO] Brian Thompson, as well as content that trivializes his death," Jack Malon, a spokesperson for YouTube, told Business Insider. "This enforcement began in the immediate aftermath of the incident, as part of our standard practice to address content related to violent tragedies."

Other social platforms have also taken down content related to Mangione.

Several subreddits devoted to him have been banned β€” like r/luigimangione2 β€” although there are still other active subreddits about him. Reddit didn't respond to a request for comment on its moderation policies about the topic.

TikTok also has a policy against "promoting (including any praise, celebration, or sharing of manifestos) or providing material support" to violent extremists or individuals who cause serial or mass violence. People have complained that TikTok has removed comments saying "Free Luigi" and some videos about Mangione.

On Meta's Threads, people have said some of their posts about Mangione β€” like a post about his astrological sign or a video montage of him set to an Olivia Rodgigo song β€” were removed.

Meta has similar guidance, banning the "glorification" of dangerous organizations and individuals, which it defines as "legitimizing or defending the violent or hateful acts of a designated entity by claiming that those acts have a moral, political, logical or other justification that makes them acceptable or reasonable."

However, Meta recently updated what it calls its dangerous organizations and individuals policy to allow for "more social and political discourse in certain instances including β€” peace agreements, elections, human rights related issues, news reporting and academic, neutral and condemning discussion β€” and to ensure users are not unduly penalized for sharing it."

A spokesperson for Meta pointed to this policy but declined to comment further.

Pro-Lugi posts can be difficult to moderate

You might imagine how, when it comes to posts discussing Luigi Mangione, there are some gray areas between what's considered praise vs. discussion of social issues.

That's where the deluge of pro-Luigi posts from American users on social platforms gets a little weird.

Mangione's popularity among some people online is complicated, and I won't try to untangle it here (read this or this for some smart analysis). But you've probably already observed some of this online: There are a lot of people posting about Mangione and running afoul of content guidelines that they'd never usually run up against β€” rules designed for posts praising ISIS or Mexican drug cartels, for instance.

The result is some confusion and frustration among users.

Content moderation is an art, not a science, and there's a spectrum of differences between a statement like "Luigi was justified" and a meme about his looks or an ironic fan cam edit video.

Mangione has been charged with first-degree murder "in furtherance of terrorism," which may clarify things for platforms about whether to consider him as a single accused murderer or an alleged terrorist when it comes to content policy.

For now, it seems that a lot of social media users are surprised or confused by what is or isn't allowed when talking about Mangione on social media.

Read the original article on Business Insider

Here's what Big Pharma could buy in 2025, from obesity drugs to precision cancer treatments, according to a top M&A banker

Red pills with $100 bills wrapped around them.
Chris Roop, head of M&A for the Americas at investment bank Jefferies, said Big Pharma will be looking for new drugs to boost growth in 2025.

GP Kidd/Getty Images

  • A top M&A banker said Big Pharma will be on the hunt for more acquisitions in 2025.
  • Major drugs including Keytruda and Eliquis will see patent exclusivity expire in coming years.
  • Pharma companies look at areas such as obesity to supplement growth, Jefferies' Chris Roop said.

Big Pharma will hunt for more acquisitions in 2025 as industry giants face patent expiration for some of their best-selling drugs, according to a top M&A banker.

Merck's cancer drug Keytruda, the top-selling medication in the world, will lose patent exclusivity at the end of 2028.

Eliquis, made by Pfizer and Bristol-Myers Squibb to treat and prevent blood clots, will lose its exclusivity earlier that same year. The two drugs raked in $25 billion and $12 billion, respectively, for their manufacturers in 2023.

When patents expire, pharma company revenue can take a hit as rivals create similar offerings to take market share. Developing brand new drugs is a long, expensive, and risky process, so acquisitions of other companies with new medications in their pipelines offer a potentially faster way to generate new revenue.

This is partly why Chris Roop, head of M&A for the Americas at Jefferies, is expecting biopharma M&A to pick up in 2025.

"The gaps to fill are significant when you think about replacing drugs that achieve peak sales north of $20 billion or $30 billion drug before patent exclusivity expires," Roop told Business Insider in a recent interview.

Large, successful pharmaceutical companies can become victims of their own successes when patents run out on blockbuster treatments, he added.

AbbVie's popular arthritis drug Humira saw its patent exclusivity expire in 2023. In the third quarter of 2024, with patients increasingly turning to similar drugs or other prescriptions, AbbVie saw its revenue from global sales of Humira fall 37% from the previous year's quarter.

To make up for looming revenue gaps, Roop said Big Pharma will increasingly turn to M&A next year, buying smaller biotechs developing drugs in major markets such as obesity and oncology.

2025's top drug targets

Obesity is positioned to be biopharma's hottest market in 2025, Roop predicted.

2024's biggest pharma acquisition was in obesity. Novo Nordisk's controlling shareholder Novo Holdings closed a deal in December to buy development and manufacturing company Catalent for $16.5 billion. The deal gives Novo Nordisk more manufacturing power for its obesity drugs Ozempic and Wegovy.

Novo Nordisk and Eli Lilly, which makes Mounjaro and Zepbound, have a significant headstart in the exploding field of GLP-1 weight-loss treatments. Originally created to treat diabetes, injectable GLP-1 medications have surged in popularity. In May, the Kaiser Family Foundation reported that one in eight US adults had tried a GLP-1 drug.

Many other pharma companies want a piece of that pie, Roop said.

"Obesity is going to be a $100 billion to $150 billion market, so even if you come up with a third or fourth entrant in that market and only achieve 2% to 4% share, you still have a multibillion-dollar drug on your hands," he explained.

Beyond obesity, Roop sees immunology and inflammation drugs as big targets for biopharma M&A next year. That market saw a few large deals in 2024, including Vertex Pharmaceuticals' $4.9 billion purchase of Alpine Immune Sciences, which has a drug in development that targets Berger's disease, an autoimmune kidney condition.

Chris Roop, head of M&A for the Americas at investment bank Jefferies.
Chris Roop, head of M&A for the Americas at investment bank Jefferies, said Big Pharma will be looking for acquisitions in areas like obesity and immunology next year.

Jefferies

Roop expects oncology to remain a focus area for Big Pharma next year.

He said pharmaceutical companies are especially interested in precision oncology M&A, including drugs targeting more specific cancers and even new methods of personalizing cancer treatment.

AstraZeneca made a precision oncology acquisition in March with its $2.4 billion purchase of Fusion Pharmaceuticals, which is developing a radiopharmaceutical drug, which uses radioactive isotopes to treat midstage prostate cancer.

Finally, Roop said Big Pharma will continue looking to buy companies with cardiovascular drugs in their pipelines. Heart disease and related conditions remain the leading cause of death. The global market for cardiovascular drugs was valued at about $150 billion in 2024, according to Precedence Research.

Novo Nordisk bought Cardior Pharmaceuticals in March in a deal worth up to $1.1 billion to strengthen its cardiovascular drug pipeline.

Roop said both private and public biopharma companies could be acquisition targets next year.

"A lot of what we're doing is trying to find that equilibrium to fund these companies to a point in time where pharma will say β€” on that data with that amount of patients and with a drug profile like this β€” I'm willing to take the risk, buy it from that point, and take it forward into late-stage development," he said.

"There are a lot of private and public companies that are in that lane today. We probably have more privates today with advanced data than we did three or four years ago," he added.

Roop said many of these private biopharma companies with advanced data are also well-positioned to potentially go public as the IPO window reopens.

Read the original article on Business Insider

Jimini Health is using AI for better mental healthcare. See the 22-slide pitch deck that helped it raise $8 million.

Jimini Health cofounders: CEO Luis Voloch, president Mark Jacobstein, and chief product officer Sahil Sud.
Jimini Health cofounders CEO Luis Voloch, Mark Jacobstein, and Sahil Sud.

Jimini Health

  • Jimini Health combines talk therapy with 24/7 support from an AI assistant.
  • The mental health startup secured $8 million in funding in November.
  • Jimini says it's taking a slow, evidence-based approach to using AI.

Technology hasn't done much to improve patient outcomes from talk therapy, according to recent research. Jimini Health is hoping AI can help.

Jimini's AI assistant, Sage, elevates talk therapy by conducting in-depth patient intakes and offering 24/7 messaging and personalized activities between sessions. That continuous engagement, the startup says, is the key to helping a patient retrain their brain.

"The way to improve this is not about that one hour a week of therapy. It's really about all the other hours in a week and helping people as much as possible there," Jimini co-founder and CEO Luis Voloch told Business Insider.

Founded in 2023, Jimini landed $8 million in funding in November from investors including Zetta Venture Partners, LionBird, PsyMed, BoxGroup, Arkitekt Ventures, and SCB.

The startup has been rolling out its tech since the spring. Voloch said Jimini has intentionally moved slowly to focus on safety and efficacy.

It's a response to previous healthcare startup controversies, such as government investigations into startup Cerebral, as well as concern about AI safety. Numerous unregulated chatbots on the market can simulate intimate relationships, prompting some experts to worry that AI companions may actually worsen isolation, according to a New York Times report.

Multiple lawsuits against startup Character.AI this year have alleged the startup's chatbots have harmed teenage users. Character.AI told BI earlier this year that it's introduced numerous safety features, and is working on more.

Voloch said he told potential investors that Jimini Health wouldn't be the fastest-growing startup, nor the first to bring its product to market. Other startups may make those moves faster, "and one of them is going to end up on the front page of The New York Times with a disaster story that could've been prevented," he said.

Jimini's careful, evidence-based approach draws on the expertise of its founding team. Before starting Jimini, Voloch cofounded cancer biotech Immunai, where he served as chief technology officer.

The team also includes president Mark Jacobstein, the former chief business officer at Immunai, and chief product officer Sahil Sud, a member of health data startup Ribbon Health's founding team. David Feinberg, former CEO of health data giant Cerner, is one of Jimini's advisors.

Voloch said Jimini's goal isn't to replace human therapists with AI but to integrate AI into their workflows. Therapists are interested in the startup's technology because they're so busy due to a shortage of experts in the field, according to Voloch. "They know there's so much more demand than they could ever handle," he said.

Jimini currently treats patients with low to moderate mental healthcare needs, but hopes to expand its capabilities to take on patients with serious mental illness in the future, Voloch said.

The startup has focused so far on selling directly to patients but plans to begin contracting with businesses next year. Voloch said Jimini will use its fresh funding to that end, as well as to continue improving its AI and building new features.

"We're going to be spending a lot more on fine-tuning and model training and development in 2025," Voloch said. "We feel like we've created an amazing patient journey that just scratches the surface of what we can do, and next year, we want to leave no stone unturned."

Here's an exclusive look at the pitch deck AI mental health startup Jimini Health used to raise its $8 million pre-seed round.

Jimini Health pitch deck slide 1

Jimini Health

Jimini Health pitch deck slide 2 β€” Therapy hasn't improved in decades

Jimini Health

Jimini Health pitch deck slide 3 β€” Therapy has not improved in decades

Jimini Health

Jimini Health pitch deck slide 4 β€” Previous generations of mental health companies

Jimini Health

Jimini Health pitch deck slide 5

Jimini Health

Jimini Health pitch deck slide 6 β€” Product and clinical approach

Jimini Health

Jimini Health pitch deck slide 7 β€” The best therapy experience ever: CBT-AI

Jimini Health

Jimini Health pitch deck slide 8 β€” The first major therapy innovation in decades

Jimini Health

Jimini Health pitch deck slide 9 β€” The current therapy problem

Jimini Health

Jimini Health pitch deck slide 10 β€” A magical first week of therapy

Jimini Health

Jimini Health pitch deck slide 11 β€” Deeper understanding enables hope and confidence

Jimini Health

Jimini Health pitch deck slide 12 β€” Continuous support drives clinical progress

Jimini Health

Jimini Health pitch deck slide 13 β€” Unparalleled client engagement

Jimini Health

Jimini Health pitch deck slide 14 β€” World-class executive team with deep clinical operations and technology expertise

Jimini Health

Jimini Health pitch deck slide 15 β€” Additional science

Jimini Health

Jimini Health pitch deck slide 16 β€” Therapy has not improved in decades

Jimini Health

Jimini Health pitch deck slide 17 β€” Building clinically integrated LLMs is very nuanced

Jimini Health

Jimini Health pitch deck slide 18 β€” Safety and clinical pitfalls of mental health bots

Jimini Health

Jimini Health pitch deck slide 19 β€” Jimini head AI advisor on goal-specific approach

Jimini Health

Jimini Health pitch deck slide 20 β€” Efficacy of continuous care for various populations

Jimini Health

Jimini Health pitch deck slide 21 β€” The potential for continuous practice

Jimini Health

Jimini Health pitch deck slide 22 β€” Closing slide

Jimini Health

Read the original article on Business Insider

Luigi Mangione's lawyer says New York's mayor is politicizing his arrest

Luigi Mangione at his arraignment on state murder charges.
Luigi Mangione is charged with murder in the killing of UnitedHealthcare CEO Brian Thompson.

Curtis Means-Pool/Getty Images

  • Luigi Mangione's lawyer said her client's criminal case was being politicized.
  • She criticized NYC Mayor Eric Adams' presence at Mangione's perp walk from a Manhattan helipad.
  • Mangione pleaded not guilty to both state and federal murder charges.

A lawyer representing Luigi Mangione said law enforcement was politicizing her client's arrest and prosecution, pointing to Mayor Eric Adams of New York City's attendance at Mangione's first perp walk in the state.

"Frankly, your honor, the mayor should know more than anyone of the presumption of innocence," the attorney, Karen Friedman Agnifilo, said at a Monday-morning hearing.

Mangione pleaded not guilty at the proceeding, which took place in the courtroom of Justice Gregory Carro of the New York Supreme Court, a trial judge in Manhattan's state-level criminal court.

He was arrested in Altoona, Pennsylvania, following a five-day hunt for the person who killed United Healthcare CEO Brian Thompson on a Manhattan sidewalk. At Monday's hearing, the Ivy League graduate looked polished, wearing a maroon sweater over a white collared shirt. His wrists were bound with heavy shackles as he walked into the courtroom.

NY Mayor Eric Adams on the helipad for Luigi Mangione's arrival to New York.
Mayor Eric Adams of New York City on the helipad for Mangione's New York arrival.

XNY/Star Max/GC Images

Adams, alongside Commissioner Jessica Tisch of the New York Police Department, stood for dramatic photos at the Manhattan helipad where Mangione was flown in on Thursday.

A large group of police officers walked Mangione from the helicopter, making for images that went viral on social media.

"I wanted to look him in the eye to say that, 'You carried out this terrorist act in my city, the city that the people of New York love,' and I wanted to be there to show the symbolism of that," Adams later said.

A grand jury has indicted Adams on federal corruption charges alleging he took bribes from the Turkish government. He's pleaded not guilty.

"Frankly, I submit that he was trying to detract from those issues by making a spectacle of Mr. Mangione," Friedman Agnifilo said at Monday's hearing, according to the Courthouse News reporter Erik Uebelacker.

Mangione previously appeared in Manhattan federal court Thursday afternoon on charges brought by the US Justice Department. He has been in federal custody in Brooklyn's Metropolitan Detention Center.

The Manhattan district attorney's office accused Mangione of first-degree murder "in furtherance of terrorism."

Federal prosecutors brought additional murder charges that, if Mangione is convicted, are death-penalty-eligible.

The district attorney's case will go to trial first, the Justice Department announced. A trial date has not yet been set.

Read the original article on Business Insider

VC's healthcare predictions for 2025: more M&A, fierce competition in AI, and a health insurance shake-up under Trump

A stethoscope wrapped around a white piggy bank on a blue background (Healthcare funding)
Investors are watching for a pickup in healthcare M&A deals in 2025.

Nudphon Phuengsuwan/Getty Images

  • After a slower-than-anticipated year for healthcare funding, investors expect sunnier skies in 2025.
  • 13 VCs from firms like ICONIQ Growth and AlleyCorp share their predictions for digital healthcare next year.
  • They expect more M&A, funding for AI agents and clinical decision support, and Medicare shake-ups.

The healthtech sector will see more private-equity-backed M&A and a fierce battle between AI-scribing startups next year, according to thirteen investors in the healthcare VC market.

At the beginning of the year, healthcare venture capital appeared poised for a rebound. Investors hoping to do deals again after a two-year funding drought watched as healthcare startups flooded back to the market to grab more cash.

Those VCs raced to break out their checkbooks for hot new AI startups in the first quarter, from scribing startups like Abridge to automated prior authorization players like Cohere Health.

A confluence of macroeconomic factors β€” from still-high interest rates to fundraising struggles for venture firms to the uncertainty of a looming presidential election β€” dampened the anticipated resurgence. 2024's funding appears to be, at best, on pace with 2023 levels, with $8.2 billion raised by US digital health startups in the first three quarters of this year compared to $8.6 billion through Q3 2023, per Rock Health.

Now, with interest rates expected to drop and a new administration on the way, VCs are anticipating sunnier skies in 2025.

A pickup in healthcare M&A and IPOs

After a slow year for healthcare M&A, investors want to see more deals in 2025.

With interest rates expected to come down β€” and investors facing pressure to deploy capital β€” private equity buyers should be more active in 2025, said .406 Ventures managing director Liam Donohue.

And Flare Capital Partners' Parth Desai said he's already seeing private-equity-backed healthcare companies looking to buy smaller startups. Their goal, as he understands it, is to make tuck-in acquisitions in 2025 that improve their growth stories as they look ahead to potential IPOs in 2026.

"Maybe they're not phenomenal outcomes, but at the end of the day, they'll create some liquidity," Desai said of those acquisitions. "I expect that to be one of the first exit windows starting to manifest in 2025."

Investors were hopeful but unsure that the IPO window would meaningfully reopen for digital health startups in 2025, despite startups like Hinge Health and Omada Health signaling their intentions to test the public markets.

Venrock partner Bryan Roberts said he expects the healthcare IPO market to remain relatively quiet. LRV Health managing partner Keith Figlioli suggested we won't see IPO activity kick off until the second half of the year after other exit windows open.

VCs said they're mostly looking for smaller deals next year, from mergers of equals to asset sales. Figlioli and Foreground Capital partner Alice Zheng said we'll see even more consolidation and shutdowns in digital health next year as startups run out of cash.

"Investors will have to make tough decisions on their portfolio companies," Zheng said. "We want to support all of them, but we can't indefinitely."

Alice Zheng
Alice Zheng, a partner at Foreground Capital, expects to see more consolidation and shutdowns as investors make tough decisions about their digital health portfolios.

Foreground Capital

Healthcare AI competition will get fierce

Healthcare startups using AI for administrative tasks were easily the hottest area of healthcare AI investment in 2024. Investors think the crop of well-funded competitors will face increasing pressures next year to expand their product lines.

ICONIQ Growth principal Sruthi Ramaswami said she expects the group of AI scribing startups that landed big funding rounds this year, from Abridge to Ambience Healthcare to Suki, to scale significantly next year using the fresh cash as hospitals scramble for solutions to the healthcare staffing shortage.

As these startups scale, however, they'll face pressure to expand beyond ambient scribing into other product lines, like using AI for medical coding and billing, said Kindred Ventures managing partner Kanyi Maqubela. Scribing technology could become a commodity sooner than later, with many providers trying free off-the-shelf scribing software rather than contracting with startups, Maqubela said.

"It'll be a race to who can start to build other services and build more of an ecosystem for their provider customers," he said.

Kindred Ventures Kanyi Maqubela, Steve Jang
Kindred Ventures general partner Kanyi Maqubela thinks medical scribe startups will have to race to find new product lines against commoditization.

Kindred Ventures

Some AI startups, like Abridge, have already been vocal about their plans to expand into areas like coding or clinical decision support. The best-funded AI scribing startups may be able to acquire smaller startups to add those capabilities, but other scribing companies will be more likely to get bought out, Maqubela said.

Flare Capital Partners' Desai suggested that healthcare companies already focused on RCM will try to pick up scribing solutions as the tech becomes a must-have for hospitals. He pointed to Commure's $139 million take-private acquisition of Augmedix in July.

Ramaswami said that demonstrating a high return on investment would be critical for these startups as hospitals pick their favorites among various AI pilots.

Sruthi Ramaswami, Iconiq Growth
Sruthi Ramaswami

Iconiq Growth

Health insurance in flux in Trump's second term

While many VCs quietly celebrated the potential for more M&A and IPOs in 2025 following Trump's election in November, the incoming administration could bring some big shake-ups for healthcare markets.

Trump could move to boost private health insurers, including Medicare Advantage plans, in his second term, Venrock's Roberts said. That could be a boon for young insurers like Devoted Health and Alignment Healthcare fighting for Medicare Advantage market share, as well as startups contracting with insurers to improve healthcare payment processes.

He suggested the new administration may even roll back changes made in the Center for Medicare and Medicaid Services' latest reimbursement model for Medicare, which went into effect this year and resulted in lower payments for many Medicare Advantage plans in the agency's attempt to improve payment accuracy.

Brenton Fargnoli, a general partner at AlleyCorp, said he expects to see health insurers respond to these risk adjustment changes and move to control higher-than-expected medical costs over the past year by launching a bevy of new value-based care partnerships in 2025 for specialties, including oncology, cardiology, and musculoskeletal care.

A photo of investor Brenton Fargnoli smiling, wearing a white t-shirt against a white backgorund
Brenton Fargnoli, a general partner at AlleyCorp, thinks insurers will launch a bevy of value-based care partnerships in 2025 for high-cost specialties.

AlleyCorp

Some healthcare experts are also concerned that the federal government could cut funding for Medicaid plans. These changes could force states to scramble for new strategies and potentially new partnerships to control healthcare costs for their Medicaid populations.

"If there is a significant shift in direction at the federal level, I think you're going to see certain states do much more than they have in the past to try to continue to address health disparities," said Jason Robart, cofounder and managing partner of Seae Ventures. "As it happens, that creates opportunities for private companies to leverage their innovative solutions to address the need."

Similarly, Muse Capital founding partner Rachel Springate said that while investors in reproductive health startups will be closely watching state-level regulatory changes that could impact their portfolio companies, those startups could see surges in consumer demand as founders step up to fill gaps in reproductive care access.

Some of the Trump administration's proposed moves could stunt progress for health and biotech startups by stalling regulatory oversight. Robert F. Kennedy Jr., Trump's pick to lead Health and Human Services, has said he wants to overhaul federal health agencies, including the Food and Drug Administration and the National Institutes of Health. Marissa Moore, a principal at OMERS Ventures, said the promised audits and restructuring efforts could lead to major delays in critical NIH research and FDA approvals of new drugs and medical devices.

Rachel Springate, Muse Capital
Rachel Springate, founding partner at Muse Capital, thinks reproductive health startups could see surges in consumer demand as founders step up to fill gaps in care access.

Muse Capital

What's hot in AI beyond scribes

In 2025, AI will be an expectation in healthcare startup pitches, not an exception, said Erica Murdoch, managing director at Unseen Capital. Startups have pivoted to position AI as a tool for improved efficiency rather than as their focal point β€” and any digital health startups not using AI, in turn, will need a good reason for it.

With that understanding, investors expect to see plenty more funding for healthcare AI in 2025. While many tools made headlines this year for their ability to automate certain parts of healthcare administration, .406 Ventures' Donohue and OMERS Ventures' Moore said they expect to see an explosion of AI agents in healthcare that can manage these processes autonomously.

Investors remain largely bullish about healthcare AI for administrative tasks over other use cases, but some think startups using the tech for aspects of patient diagnosis and treatment will pick up steam next year.

"We will begin to see a few true clinical decision support use cases come to light, and more pilots will begin to test the augmentation of clinicians and the support they truly need to deliver high quality, safe care," said LRV Health's Figlioli. He hinted the market will see some related funding announcements in early 2025.

Moore said she's also expecting to see more investments for AI-driven mental health services beyond traditional cognitive behavioral therapy models β€” "for example, just today I got pitched 'the world's first AI hypnotherapist."

Dan Mendelson, the CEO of JPMorgan's healthcare fund Morgan Health, said he's watching care navigation startups from Included Health to Transcarent to Morgan Health's portfolio company Personify that are now working to improve the employee experience with AI. The goal, he says, is for an employee to query the startup's wraparound solution and be directed to the right benefit via its AI, a capability he says he hasn't yet seen deployed at scale.

"These companies are racing to deploy their data and train their models, and we'd love to see a viable product in this area," he said.

Read the original article on Business Insider

Nursing has become a new frontier for gig work, and it's creating the same issues that Uber drivers face

nurse nursing
Some nurses are turning to gig work apps to find shifts at hospitals and other medical facilities.

Joe Raedle / Getty

  • Gig work has expanded to include nurses at hospitals and medical facilities, per a new report.
  • Many nurses who work this way face challenges similar to Uber drivers, the report found.
  • Nursing represents a high-stakes use case of gig work apps, one of the researchers said.

Gig work has expanded to the nurses who care for patients in hospitals and care homes β€” and it's coming with some of the same challenges that delivery and rideshare contractors have already pointed to, according to a new report.

Apps like CareRev, Clipboard Health, and ShiftKey have taken an approach similar to the one companies like Uber and Instacart have used to build up their workforces, and applied it to nursing at hospitals, care homes, and other medical facilities.

But the report, which the Roosevelt Institute released a summary of this week, found that medical facilities often turn to gig nursing services as a way to cut expenses, especially under the tutelage of private equity firms.

Medical professionals on the apps, which the report collectively calls "Uber for Nursing," also face many of the same issues that other gig workers do, from low pay to having their accounts on the platforms deactivated with little or no explanation.

The apps make pitches that are attractive to the nurses themselves, Katie Wells, a senior Fellow at think tank Groundwork Collaborative and one of the report's authors, told Business Insider in an interview. Wells wrote the report with Funda Ustek Spilda, a senior lecturer at King's College London and a research associate at the University of Oxford's Oxford Internet Institute.

Full-time nursing jobs often involve putting in long hours as well as working night or weekend shifts. COVID's strain on hospitals and other medical facilities also pushed many nurses to quit or consider finding other work.

Like rideshare and delivery companies, the apps say that they offer nurses more choices over how and when they work. ShiftKey's website, for instance, says that its users have "the freedom to make choices best suited to their lives" including how much they earn and "their relationship with work."

For a burned-out nurse, that can be an appealing pitch, Wells said.

"There is almost no flexibility and control," Wells said. "So it is no wonder that these apps become attractive."

Wells and Spilda interviewed 29 nurses and nursing assistants for their study. The interviewees all used at least one gig work app to find nursing shifts.

Like delivery and rideshare contractors, nurses who use the apps must claim jobs through them. The nursing apps often charge a fee for access, and workers bid with their pay rates. The user who offers the lowest pay gets the shift, according to the report.

Working the shift, however, can be tricky. When they show up for a gig, the nurses often have to navigate the facility themselves β€” even if they have never worked there before.

"At most hospitals and medical facilities, no orientations are required for gig nurses and nursing assistants," the report reads. "Workers do not know where supply closets are located, how to access patient portals with medical histories and current medication lists, and whom to contact in the chain of command."

And like Uber drivers or Instacart delivery workers, nurses who use the apps don't have a boss to contact when things go wrong. One Oregon-based nurse interviewed for the study said that she was barred from Clipboard Health's app for two weeks after she had a hernia on the job and had to leave early.

In another instance, the same nurse said that she went to work with COVID after learning that she couldn't cancel her shift without losing "attendance points" and hurting her chances of getting gigs in the future, the report reads.

"It sucks that there's nobody that you can get ahold of immediately," the nurse told Wells and Spilda.

"It's really as if AI has eaten the managers," Wells said.

The apps also advertise that nurses can make more on their platforms than at other jobs. One nurse interviewed by the researchers said she made gross pay of $23 an hour on ShiftKey. That dropped to around $13 an hour after accounting for fees that she paid to ShiftKey.

Despite the challenges, the report found that 19 of the 29 people interviewed planned to continue working for the apps, though some also said they also had jobs in other industries to make enough money to live.

The report says that gig nursing apps are often used by facilities that are trying to save money and are under pressure to produce returns for investors.

Wells told BI that bringing the gig economy to medical care creates risks not present in food delivery or rideshare.

"The stakes are higher because this has to do with patient safety, and the immediacy of health and care makes things more palpable," she told BI.

ShiftMed, which employs its nurses as W2 employees but still offers them much of the flexibility of gig work, said that it deactivates nurses' accounts for various reasons, from patient safety to legal violations.

"Nurses file an appeal by submitting a formal review through the app or support channel, after which ShiftMed conducts an internal investigation, reviews records, and determines the next steps," CEO Todd Walrath said in a statement to BI.

The company said that it also offers an orientation so that users "are fully prepared for any clinical setting by aligning health system-specific requirements, such as training or shadowing before they begin shifts," Walrath said.

CareRev, Clipboard Health, and ShiftKey did not respond to requests for comment.

Are you a nurse who works as an independent contractor with a story idea to share? Reach out to this reporter at abitter@businessinsider.com

Read the original article on Business Insider

Luigi Mangione: How parents of alleged shooters cope, and therapist advice.

Photo collage of Luigi Mangione and parental imagery

Jeff Swensen/Getty, Johner Images/Getty, Amaia Castells/Getty, Luke Chan/Getty, Lars Stenman/Getty, Tyler Le/BI

As a parent, you want to do your best. You focus on your child, ensuring they're emotionally safe, properly socialized, and academically challenged β€” anything to set them up for success.

It's hard to fathom a dark outcome: that your child would grow up to assassinate someone, or be accused of doing so.

That's what Luigi Mangione's parents experienced last week, as the 26-year-old accused killer of UnitedHealthcare CEO Brian Thompson was charged with murder as an act of terrorism. And the parents of 15-year-old Natalie Rupnow, who killed two and injured six others at a Wisconsin school before dying of a self-inflicted gunshot, according to police.

Working with parents who've watched their kids sink into dangerous behavior, family therapist Rachel Goldberg said it's very hard for them to heal. She said parents must strive to find self-compassion and "separate their identity from their child's actions," no matter how challenging.

Parents of shooters experience remorse and confusion

In her 2016 memoir, "A Mother's Reckoning," Sue Klebold, the mother of Columbine shooter Dylan Klebold, wrote about struggling to call her son a "monster" after he killed 13 people in 1999. "When I hear about terrorists in the news, I think, 'That's somebody's kid,'" she wrote in the book.

Peter Rodger, the father of Isla Vista killer Elliot Rodger, wrestled with similar confusion and guilt. He remembers sitting in horror, watching his son's retribution video, which he posted on YouTube before stabbing, shooting, and using a car to hit bystanders in 2014. "Elliot was far from evil," Rodger told ABC that year. "Something happened to him. He was the most beautiful, kind, sweetheart of a boy."

Such an event "forces us as parents to contend with our worst fears," Annie Wright, another family therapist, told Business Insider. "The lack of control, at some level, over who they become."

Mangione's family is wealthy and well-known in their community as the owners of a golf club and philanthropists. He attended the Gilman School, a prestigious private school in Baltimore, where he graduated as valedictorian and was described by his peers as "very social" and "very into sports."

Goldberg said that a parent's imagined worst-case scenario is usually that their child would become a lonely, unemployed adult living in their basement. If a child does the unthinkable, recovering as a parent can feel impossible.

Limits to a parent's control

Kids don't need to be out of the house to be mysteries to their parents. In the wake of the Wisconsin shooting, authorities are combing through Rupnow's online activity in search of a motive, finding a version of her life seemingly concealed from others, like her fascination with the Columbine shooters.

Once a child is over 18 and financially independent, parents' control over their lives becomes even more tenuous. In the Mangiones' case, their son stopped responding to messages for months before he was arrested.

For parents watching their adult kids slip into alarming behavior, their options are legally limited, Goldberg said. Often, their best defense is talking to their kid, but "it really depends how much their adult child is willing to let them in."

Wright said that involving third parties can help. Parents can try family therapy or find licensed professionals who can help manage their child's physical or emotional pain. Parents can also call their local authorities in extreme cases, such as when their child is in immediate danger or endangering someone else.

Goldberg said the best thing parents can do is know their child as well as possible and act when something feels off. "Don't wait until it gets really bad if you can possibly intervene earlier," she said.

Even then, sometimes, intervention falls short.

Rodgers, the Isla Vista shooter, was in therapy from the age of 9. Peter Lanza, the father of Sandy Hook shooter Adam Lanza, said his son had been assessed by mental health professionals multiple times.

Pain a parent can't fix

Loneliness and isolation can often be red flags when analyzing a child's behavior. Still, Mangione, who started a gaming club in college and was part of a fraternity, appeared surrounded by people.

This made it harder for him to disappear fully: In July 2024, when he cut off contact with his family, cousins and friends reached out on social media. In November, his mother filed a missing person's report in San Francisco, where Mangione has some relatives.

Despite his seemingly solid network of friends and family, Mangione had spondylolisthesis, a painful spinal condition. He frequented Reddit communities related to back pain, describing his symptoms as "absolutely brutal" and "life-halting." That can be isolating, Goldberg said.

"It is a very lonely place to be in pain all the time because you can't really be present with people," he added.

In 2022, when Mangione lived in a Hawaiian surf community, he experienced sciatica, debilitating nerve pain, in his leg. R.J. Martin, who owned the co-living space, told The New York Times that Mangione "knew that dating and being physically intimate with his back condition wasn't possible."

While parents can do a lot to relate to a child's pain, such as listening and doing their best to understand the nuances of what their child is going through, "empathy alone can't bridge every gap," Wright said.

Parents can still protect themselves

Goldberg's clients, particularly parents of kids with substance abuse issues, struggle to move past their guilt. Acceptance can take a lifetime.

"They live in fear of getting a phone call from the police or hospital; they question everything they have done," she said. "They often feel incredibly helpless and stuck."

Wright said the resulting grief from something like this can be "extraordinarily complex" and "often includes sorrow, not only for the victims and their families but for the loss of the child they thought they knew."

She suggested therapy and, for those with religious affiliations, seeking spiritual leaders they trust. Parents can feel so many conflicting emotions, and it's important to "allow these emotions to coexist without rushing to tidy them up," she said.

This is especially hard for the parents who felt they tried their best.

Upon learning of Mangione's arrest, his family released a statement contrary to the manifesto found with their son during his arrest. "We offer our prayers to the family of Brian Thompson, and we ask people to pray for all involved," they said. "We are devastated by this news."

Some parents try to find meaning in the tragedy. Klebold wrote her memoir and participated in press interviews. Chin Rodger, mother of Elliot, started speaking at threat assessment trainings. She hopes that people will get better at identifying the red flags of someone going through a mental crisis.

Still, some just wish it never happened. Adam Lanza's father blames himself for overlooking the warning signs. "You can't get any more evil," Lanza told the New Yorker in 2014. "How much do I beat up on myself about the fact that he's my son? A lot."

Read the original article on Business Insider

Luigi Mangione — now in solitary confinement — could join the same jail unit as Diddy and SBF as soon as Monday

Sam Bankman-Fried, Luigi Mangione, and Sean "Diddy" Combs
Sam Bankman-Fried, Luigi Mangione, and Sean "Diddy" Combs.

Fatih Aktas/Anadolu Agency, XNY/Star Max, Shareif Ziyadat/Getty Images

  • Luigi Mangione is under monitoring in a 9-by-7-foot federal solitary-confinement cell in Brooklyn.
  • On Monday, he may be moved to the same protective unit as Diddy and SBF, who are in the same jail.
  • A prison consultant called his conditions "miserable."

Luigi Mangione is being held in a 9-by-7-foot solitary-confinement cell at the federal jail in Brooklyn that also houses the rap mogul Sean "Diddy" Combs and the cryptocurrency fraudster Sam Bankman-Fried, Business Insider has learned.

The trio could be living together in the same 15-man protective-custody unit as early as Monday, Sam Mangel, a prison consultant who has knowledge of Mangione's housing, said.

Federal prison records confirmed Friday morning that Mangione, Combs, and Bankman-Fried were at Brooklyn's Metropolitan Detention Center.

Mangione is set to remain in solitary until at least Monday in one of MDC's small cinderblock Special Housing Unit cells β€” in a unit also known as "the SHU" and "the hole," Mangel said.

He'll eat meals in his cell, and inmates in his situation are typically allowed out for one hour of recreation or showering a day. Guards are supposed to check on him every 15 minutes.

"Miserable, just miserable," Mangel said when asked to describe conditions in federal solitary-confinement cells.

"SHUs are notoriously loud. You have people in there for psychiatric issues, for disciplinary reasons, and for withdrawal" from drugs, he said, adding: "So it is the loudest place in the jail β€” people are banging on their doors at all hours of the night."

Mangione is being held without bail on death-penalty-eligible federal charges in the December 4 ambush fatal shooting of UnitedHealthcare CEO Brian Thompson. He has yet to be arraigned on New York charges of murder as an act of terror, which carries a top sentence of life without parole.

Luigi Mangione
Mangione is being held in Brooklyn's notorious federal jail.

AP Photo/Pamela Smith

New, high-profile inmates are often monitored in solitary cells in the days before their units are assigned, said Mangel, who said he had been in communication with the defense team through Craig Rothfeld, a prison consultant.

Rothfeld, who was in the audience for Mangione's first federal court appearance on Thursday, declined to comment.

"It's a standard protocol," Mangel said. "This is especially true for a young man that, you know, might have some psychiatric concerns or his legal team or the BOP has concerns," he added, referring to the Federal Bureau of Prisons.

"Even though it's called the 'SHU,' it's not for disciplinary reasons. It's strictly for administrative reasons," Mangel said.

A Bureau of Prisons spokesperson declined to comment, saying: "For privacy, safety, and security reasons, we do not discuss the conditions of confinement for any individual including their housing assignments."

Karen Friedman Agnifilo told BI that neither she nor Marc Agnifilo, her cocounsel, had spoken to Mandel. They did not immediately comment on Mangione's jail conditions.

The husband-and-wife team's Manhattan firm, Agnifilo Intrater, also represents Combs, who is being held without bail while awaiting a trial scheduled for May 5 on federal sex-trafficking charges.

He has pleaded not guilty to the charges against him.

In representing Combs, the firm complained about conditions at MDC throughout three unsuccessful bail applications, arguing that there were frequent random lockdowns and that inmates were deprived of basic trial-preparation materials, such as folders and notebooks. Combs' attorney Marc Agnifilo called the conditions "horrific" in one court filing.

One former prosecutor described the federal jail as frequently too cold or too hot and crawling with cockroaches β€” basically, "hell on earth."

mdc brooklyn
The Metropolitan Detention Center in Brooklyn holds people before and after they go to trial.

REUTERS/Mike Segar

Mangione's solitary-confinement cell would be equipped with a metal bunk-style bed and a steel one-piece combination toilet and sink. If he's lucky, the cell has a small built-in writing desk.

"You're usually only allowed out for one hour a day, but it could be more restrictive due to staffing issues, where you're only allowed out three times a week to take a shower or walk in a small, enclosed area," Mangel said.

Mangione would also be allowed out of his cell for attorney calls and visits, Mangel said.

"The defendant is actually sitting in a cage during the call," he said. "It's like a fenced-in area that has a monitor, and it's behind plexiglass, and the defendant is able to talk and have an unmonitored legal call during that time, usually for one-hour blocks."

Defendants can find these calls canceled at the last minute "because there's lockdowns and staffing issues," Mangel said, adding: "You get everything arranged, and then we're on the call, waiting, and the defendant never shows up."

He said he expected Mangione would have better access to phones and visitors after he's moved to the jail's protective custody early next week.

Mangel said he had been a prison consultant for Bankman-Fried, who is serving a 25-year sentence for stealing $8 billion from customers of his FTX crypto exchange. Bankman-Fried has remained at MDC's protective custody unit since his arrest last year.

Mangione's next federal court date was set for January 18. As of Friday morning, a date had not been set for his Manhattan arraignment on state murder charges.

This story has been updated to include responses from the BOP and Mangione's attorney.

Read the original article on Business Insider

Luigi Mangione appears in court on new federal murder charges that are death-penalty eligible

Luigi Mangione
Luigi Mangione arrives in New York for his first appearance in federal court.

AP Photo/Pamela Smith

  • Luigi Mangione is in New York to face both state and federal murder charges.
  • His new federal indictment alleges he stalked and then killed UnitedHealthcare CEO Brian Thompson.
  • Manhattan prosecutors say state charges will "proceed in parallel with any federal case."

Luigi Mangione appeared in federal court Thursday on new federal murder charges that could result in the death penalty or life in prison.

It was Mangione's first appearance in a Manhattan courtroom, this one crowded with press and federal staff, on charges in the shooting death of UnitedHealthcare CEO Brian Thompson. He is expected to be arraigned on state murder charges in a courthouse one block away on Friday.

Mangione's voice was calm but firm as he answered the judge's questions.

"Mr. Mangione, do you understand what you have been accused of?" US Magistrate Judge Katharine H. Parker asked at one point before he entered his plea.

"Yes," he answered.

Edward Y. Kim, the acting US attorney for the Southern District of New York, has yet to say if he will seek the death penalty or a life sentence for the most serious charge in the four-count indictment β€” murder through the use of a firearm.

One former federal prosecutor called the death penalty a "remote" possibility, given Mangione's youth, and the chance that he may have suffered a mental breakdown in the six months before the shooting.

"In New York's federal courts, it's uncommon for them to seek the death penalty, and I think probably more uncommon for juries to want to authorize it, even assuming that Mr. Mangione killed Mr. Thompson in the way the government is alleging," said Michael Bachner, now in private practice.

Luigi Mangione's lawyers walk into a federal courthouse in Manhattan
Luigi Mangione's attorneys, Karen Friedman Agnifilo and her husband Marc Agnifilo, declined to answer questions as they arrived at a federal court mobbed by reporters on Thursday.

Laura Italiano/Business Insider

The other three federal counts against Mangione allege he possessed and used an illegal firearm, and that he traveled interstate β€” between Georgia and New York, in order to stalk and kill Thompson.

Mangione presented an orderly, if tense, appearance in the chilly 26th-floor courtroom.

He was clean-shaven and his bushy eyebrows neatly groomed. Mangione sat with his shoulders raised and held stiff and wore khaki pants and a navy quarter-zip sweater over a white collared button-down shirt.

His ankles were shackled together with thick chains beneath the table where he sat. He wore bright orange slip-on sneakers without shoelaces.

To either side of Mangione sat his lawyers, husband-wife legal team Karen Friedman Agnifilo and Marc Agnifilo. Both are veteran criminal attorneys and former prosecutors. Their firm, Agnifilo Intrater, LLC, also represents Sean "Diddy" Combs in his federal sex-trafficking case, scheduled to be tried in the same Manhattan courthouse in May.

After Parker read the charges aloud to him, Mangione's posture relaxed. He repeatedly raised his left hand to pat down the hair at the back and side of his head.

He crossed his arms and wore a skeptical expression on his face with his tongue poking out between his lips while Friedman Agnifilo demanded clarity on how different law enforcement agencies coordinated and would present evidence in the case.

Mangione's next court date was set for January 18. His lawyers did not apply for bail, though Friedman Agnifilo said in court that she may do so on a future date.

Earlier Thursday, in a Pennsylvania courtroom, Mangione abandoned his extradition fight and was whisked to New York in an NYPD aviation plane and, upon landing at a Long Island airport, via police chopper to a lower Manhattan heliport.

His arrival in federal court was greeted by dozens of reporters and a smattering of fans holding messages of support written on cardboard.

"Health over Wealth," read one.

Press and supporters of Luigi Mangione gather outside the Manhattan federal courthouse where he attended his first hearing in the murder of UnitedHealthcare CEO Brian Thompson.
Press and supporters of Luigi Mangione gather outside the Manhattan federal courthouse where he attended his first hearing in the murder of UnitedHealthcare CEO Brian Thompson.

Laura Italiano/BI

Mangione has yet to be arraigned on his first murder case, announced Tuesday by Manhattan District Attorney Alvin Bragg.

He faces up to life in prison on that state indictment, which alleges he murdered Thompson as an act of terror β€” a first-degree felony, the highest state charge and penalty available.

In a press statement after Mangione's federal appearance, Kim said he expects the state case β€” announced by Bragg just two days prior β€” would proceed to trial first.

In court Thursday, Friedman Agnifilo called the dual prosecutions "highly unusual" and said the charges between the Manhattan district attorney's office and the federal US attorney's office seemed to contradict each other.

The district attorney's indictment alleges Mangione killed Thompson in furtherance of "terrorism" that affects a "population of people," she said. But the federal charges accuse Mangione of stalking Thompson as an individual, she said.

Police and prosecutors say Mangione killed Thompson outside a midtown Manhattan hotel on December 4.

Mangione was arrested in Altoona, Pennsylvania, after a five-day manhunt, on local gun and false ID charges. A Manhattan grand jury later indicted on charges related to the killing itself, and the New York cases will take priority over the lesser charges in Pennsylvania.

While in jail in Pennsylvania, Mangione received 54 email messages and 87 pieces of mail, Maria Bivens, of the state Department of Corrections, told BI.

There were also 163 deposits made into Mangione's commissary account, Bivens said. Bivens declined to say how much money was deposited in total.

These accounts can be used to buy toiletries or additional food items in the jail's store.

Read the original article on Business Insider

AI tools could make healthcare processes simpler for patients and doctors

Photo collage featuring Doctors using digital tablet and laptops with AI help

Getty Images; Alyssa Powell/BI

  • Healthcare-focused AI startups are raising billions to help improve the US system.
  • AI can help streamline clinical documentation, drug research, and medical billing.
  • This article is part of "Trends in Healthcare," a series about the innovations and industry leaders shaping patient care.

The founder of Suki, a startup that uses artificial intelligence to automate healthcare documents, raised $70 million in funding from investors in a Series D round that was disclosed this past fall.

He said it really didn't take that much persuading: With an epidemic of stressed- and burned-out physicians, there was an obvious need for their AI software, he added.

"Most of the investor conversations over the last year and a half have been, 'Well, it looks like the market is here,'" said Punit Singh Soni, Suki's founder. "Are you going to be the winner or not?"

Suki sells an AI-powered assistant that takes notes during a conversation between patients and clinicians. The notes can be reviewed by the doctor and submitted as an electronic health record. This saves time on administrative tasks and allows physicians more time to take care of patients, a resource that's becoming increasingly limited among healthcare professionals.

Surveys have consistently found that doctors and other medical workers are burned out from working in an often overloaded, convoluted, and inefficient system. The US spent $4.8 trillion on healthcare in 2023, according to a January report from the Peter G. Peterson Foundation. The US also spends more per person than nearly all other developed nations, according to a report by the Organization for Economic Co-operation and Development. Despite this, health outcomes were poorer, with Americans facing a lower life expectancy, higher rates of treatable and preventable excess deaths, and less efficient healthcare systems.

Cash-strapped hospitals and private practices have lagged behind the financial-services and telecommunications industries in applying newer technologies, but the healthcare industry is increasingly considering artificial intelligence as it contends with high labor costs and a lot of opportunities to automate routine tasks. The pandemic exacerbated these challenges with staffing shortages as overworked doctors and nurses quit the profession.

To make healthcare more efficient, AI startups like Suki, Zephyr AI, and Tennr have raised millions with vast promises, including making repetitive tasks like billing and note-taking easier, improving the accuracy of clinical diagnosis, and identifying the right patient population for emerging treatments.

But the challenges are vast. The healthcare industry's budget allocations for generative AI are trailing those of many other core industries, such as energy and materials, consumer goods, and retail. Clinical diagnosis will continue to require a human in the loop, so the process can't be fully automated. The healthcare industry is highly regulated, and quite often, venture capitalists will wait for clarity on laws from the federal government before aggressively pushing AI tech advancements forward.

A $370 billion bet on boosting the healthcare sector's productivity

The consulting firm McKinsey estimates that generative AI can boost productivity for the healthcare, pharmaceuticals, and medical-products industries by as much as $370 billion by accelerating drug research, making clinical documentation easier, speeding up medical billing, and helping doctors make diagnoses.

Some big funding rounds announced in 2024 highlight the diverse use cases for AI in the healthcare sector. They include $150 million raised by the clinical-documentation AI startup Abridge in February, the drug-discovery AI startup Xaira Therapeutics bringing in $1 billion before its launch in April, Atropos Health's $33 million Series B in May to help doctors analyze real-world evidence with generative AI, and the medical-billing-automation provider Candid Health raising $29 million in September.

Parth Desai, a partner at Flare Capital Partners, has steered investments into healthcare startups such as Photon Health and SmarterDx. He said that healthcare organizations had been dedicating more money to bolster their AI strategies, beginning in late 2022 and accelerating through 2024. That's boosting demand for the tools these startups are developing. There's also less pressure to immediately prove a return on investment, which budget-conscious health systems have closely monitored in the past when allocating dollars for technology.

"The thing that we're really studying before making an investment decision is: Do budgets exist today to pay for this technology?" Desai told Business Insider. "Or are they going to exist in a large-enough fashion in the next five to 10 years to support this technology?"

Candid Health and Akasa aim to cut costs and automate medical billing

One area of particular promise has been medical billing, which could benefit from large language model automation. An LLM could, for example, analyze a large volume of claims in a client's system and accurately match them with insurers' unique billing codes, a process required for repayment to a physician for their services. Hospitals have traditionally relied on human medical coders to hunt down reimbursements from insurers.

"The software used to do billing was built a long time ago and basically wasn't kept up to date," Nick Perry, a cofounder and the CEO of Candid Health, said.

Malinka Walaliyadde, the CEO of Akasa β€” another medical-billing-focused AI startup β€” said the company builds customized LLMs for each healthcare institution it serves. Typically, the aim for these LLMs is to lower costs by lessening the reliance on human medical coders. This often reduces errors in billing and speeds up repayment cycles.

"We looked at what are the biggest pain points for health systems," Walaliyadde told BI. He said that Akasa's focus is on developing LLM products for medical coding and simplifying prior authorization, a process that requires approval from a health-plan provider before a patient can receive a treatment. "Those are the ones where you could really move the needle," Walaliyadde said.

AI for health screenings

George Tomeski, the founder of Helfie AI, is in the middle of pitching investors to raise as much as $200 million in a new round of funding that he hopes to close by the first half of 2025.

Tomeski said the funding would help Helfie scale as it exits beta testing for the company's app. The app, also called Helfie, uses a smartphone camera to do medical "checks" that screen for illnesses including COVID-19, tuberculosis, and certain skin conditions.

"We're targeting all the health conditions that lead to avoidable mortality," Tomeski said, adding that the app focuses on respiratory and cardiovascular conditions. The intention is for these checks β€”which can cost as low as $0.20 a person per screen β€” to serve as a form of preventive care and as an incentive to go see a doctor in person.

While some funding is going toward sales and marketing, talent acquisition, and ensuring adherence to regulations around privacy and healthcare data, a large chunk is still being allocated to product development as AI tech advances quickly.

Dr. Brigham Hyde, a cofounder and the CEO of Atropos Health, said his latest funding announcement, in May, was timed to coincide with the geared-up launch of ChatRWD, an AI copilot that can answer doctors' questions and quickly churn out published studies based on healthcare data. Hyde said he's keen to bring in big partners this time, including the pharmaceutical giant Merck and the medical-supplies and equipment maker McKesson.

But Hyde also had to show some restraint. He said that when Atropos Health moved forward with its Series B rounds, dozens of venture capitalists expressed interest in leading the round. The company was offered up to $100 million but took only one-third of that amount.

"I don't always think that's a good idea," Hyde told BI. "As a founder, you want to raise the right amount of money for your business and for the stage you're at."

It may be tempting to take more, as many healthcare AI startups β€” a vast majority still in the seed and early-stage funding rounds β€” are racing to outmaneuver rivals. Even if the technology is right, it has to get past regulatory approvals and persuade cautious hospitals and health systems to open up their wallets.

"You can build as much product as you want, but you can never build a market," Soni of Suki said. "It shows up, or it doesn't show up."

Read the original article on Business Insider

Culina Health nabs $7.9M to provide virtual access to registered dietitians

As a dietitian, Vanessa Rissetto’s main goal is to help people stay healthy. She also knew that there were some roadblocks to achieving that. For example, the Black community deals with pressing health concerns, in addition to a disproportionate lack of access to care. More than 80% of registered dietitians in the U.S. are white, […]

Β© 2024 TechCrunch. All rights reserved. For personal use only.

Luigi Mangione's NY judge, Gregory Carro, is tough on crime and sympathetic to victims

Luigi Mangione poses soon after his Pennsylvania arrest in the shooting death of UnitedHealthcare CEO Brian Thompson.
Luigi Mangione is expected to face a Manhattan judge Thursday.

Pennsylvania State Police/via REUTERS

  • Luigi Mangione's NY judge is Gregory Carro, described as tough on crime and sympathetic to victims.
  • Lawyers call him no-nonsense, and some say he leans pro-prosecution.
  • Carro has allowed video and still photography in his courtroom during past high-profile proceedings.

His cases have earned tabloid nicknames, including the "rape cops," a "killer nanny," and a "blowtorch hubby." In 2021, he presided over the moped hit-and-run death of Gone Girl actor Lisa Banes.

New York Supreme Court Justice Gregory Carro has had dozens of sensational β€” sometimes horrific β€” cases in his 25 years on the Manhattan criminal bench.

As early as Thursday afternoon, Carro will preside over his most high-profile media case yet, the prosecution of Luigi Mangione, who is accused of the ambush shooting of UnitedHealthcare CEO Brian Thompson.

With Carro on the bench in a likely-packed 13th-floor courtroom, Mangione, 26, will be officially informed of the first-degree murder indictment against him. Manhattan District Attorney Alvin Bragg announced Tuesday that the indictment alleges a top charge of murder as an act of terrorism.

After the charges are read, Mangione will have the chance to enter a plea of not guilty. Carro, who is expected to keep the case, will then set a next court date and order that Mangione be taken to a city jail to await that date.

A former Manhattan narcotics and homicide prosecutor, Carro was appointed to Manhattan's criminal court bench in 1998 by then-Mayor Rudy Giuliani.

Carro is the son of retired Associate Justice John Carro, who in 1979 was the first Puerto Rican appointed as an appellate judge in New York.

Luigi Mangione
Luigi Mangione is charged with the first-degree murder of UnitedHealthcare CEO Brian Thompson.

Jeff Swensen/Getty Images

A 'tough draw'

The younger Carro is known among defense lawyers at Manhattan Criminal Court as a "tough draw. "

If one lawyer tells another in a courthouse hallway, "I just learned my guy is going to be in front of Carro," another might commiserate, "Wow, that's a tough draw," veteran attorneys in the city told BI.

Prosecutors might say the opposite of Carro: "Good draw."

"Of course, in a case like this, there are no good judges," said longtime Manhattan defense attorney Ron Kuby. "You're not going to find any members of Antifa on the bench."

Kuby called Carro "harsh but not crazy," as Manhattan criminal judges go.

Five Manhattan defense lawyers interviewed by Business Insider said the judge leans pro-prosecution. None would say so on the record, because they may have cases before him in the future.

The most common descriptor among lawyers reached by BI? "No nonsense."

"He's a tough judge," said a former fellow jurist, Charles Solomon, a state Supreme Court Justice in Manhattan who retired in 2017.

"Very firm, very fair, and well-respected by his colleagues," Solomon said of Carro.

Manhattan D.A. Alvin Bragg, with NYPD Commissioner Jessica Tisch, announces the indictment of United Healthcare CEO killer Luigi Mangione charged with First Degree Murder.
Manhattan D.A. Alvin Bragg announced Mangione's indictment with NYPD Commissioner Jessica Tisch.

Derek French/BI

Judges are assigned at random

Solomon said that Carro would have been assigned as Mangione's judge through a strictly random process.

What likely happened was that on December 4, the day of Thompson's shooting, Mangione's lead prosecutor, Joel Seidemann, happened to be on call to "catch" new homicides.

Seidemann's team of prosecutors feeds all of its new cases into one of only two assigned courtrooms, and one of them was Carro's.

"This is the typical way a case gets assigned," agreed another retired state Supreme Court justice, Michael Obus, who served as a supervising judge in Manhattan Criminal Court from 2009 to 2017.

"He's a solid guy," Obus said. "He's a very good trial judge. In general, lawyers could do a lot worse than Judge Carro."

Jessica Tisch, the New York City Police Commissioner, and Alvin Bragg, Manhattan DA, at a press conference announcing indictment of Mangione.

Laura Italiano / BI

Law, order, and victims

At sentencings, Carro is an emphatic advocate for law, order, and victims, his many news clippings show.

"I can only imagine what memories are haunting the victim in this case and his significant other," he said last year at a recent high-profile sentencing, for the random, attempted slashing murder of a French tourist.

In 2011, Carro presided over the trial of an NYPD officer accused of raping a young fashion executive β€” a woman he'd been dispatched to help when she was too intoxicated to get out of her taxi.

A jury cleared the officer of rape and convicted him of official misconduct for the three caught-on-video visits he made to the woman's apartment during his shift that night.

Police misconduct offenses "rip at that fabric that holds us all together," Carro told the former officer, Kenneth Moreno, before sentencing him to a year at Rikers Island jail.

"You, sir, ripped a gaping hole in that fabric in committing those crimes."

It was Carro's biggest media case until now.

Moreno's lawyer, Joe Tacopina, was one of the lawyers to call Carro "no nonsense."

"Not easy on defendants or defense lawyers, for that matter," Tacopina said.

"Honestly, it doesn't matter what judge has this case," the former criminal attorney for President-elect Donald Trump, added. "There is such overwhelming evidence of guilt here. It is not a 'Who done it.' It is a 'Was he sane when he did it' case."

FILE PHOTO: Yoselyn Ortega, a nanny who is accused of killing Lucia and Leo Krim, ages 6 and 2 respectively, arrives for a hearing for her trial at Manhattan Supreme Court in New York, NY, U.S., July 8, 2013.  REUTERS/Lucas Jackson/File Photo
Yoselyn Ortega, a former nanny convicted of killing two young children in her care, standing before New York Supreme Court Justice Gregory Carro in a 2012 hearing.

Thomson Reuters

In his most high-profile murder β€” dubbed the "killer nanny" case by city tabloids β€” Carro allowed a jury to hear the insanity defense of Yoselyn Ortega, who in 2012 fatally stabbed two young children in her care.

Defense lawyers called two psychiatrists to the stand to testify that Ortega heard voices β€” including Satan's β€” urging her to kill the children. Jurors also heard that when the mother returned home to witness the carnage in her Upper West Side bathroom, Ortega was nearby, slashing into her own throat with the murder weapon.

The jury rejected the defense.

Carro called Ortega "pure evil" at her 2018 sentencing.

Then he sentenced Ortega to life without parole for first-degree murder, the same maximum penalty Mangione faces for the same top charge in his indictment.

Last month, the New York Times reported Carro sentenced a Long Island, New York man who admitted planning to "shoot up a synagogue" to ten years prison on a plea to possessing a weapon as a crime of terrorism.

Read the original article on Business Insider

❌