No matter how grand a vision for a particular industry, disruption in practice is hard. This is especially true in industries like healthcare, which have long been resistant to software-driven change. But sometimes you can innovate within the bounds of the industry, using those very constraints to move it forward — whether it’s understanding and working with the early adopters in healthcare to focusing on the bottomline. This conversation — recorded at our recent a16z Summit in November 2017 — between co-founder and CEO of Omada Health, Sean Duffy and CEO of Accolade, Rajeev Singh (moderated by a16z bio fund partner Jeff Low), considers how such innovation affects go-to-market strategies and pricing to measuring savings and the entire ecosystem of healthcare spend. As this generation of digital health tech companies begin to change the healthcare business — and scale — what effect are they having on the rising cost of heathcare overall, and the bottom line?