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Walmart Picks Transcarent: Tullman on First ‘Everyday Low Prices’ Offer for Self-Insured Employers

By JESSICA DaMASSA, WTF HEALTH

Walmart is looking to scale its healthcare business in a brand-new way: setting its sights on self-insured employers. Today the retail giant announced a go-to-market partnership with Transcarent that will make its “everyday low price” prescription drugs and healthcare services available to self-insured employers for the very first time. Transcarent’s Executive Chairman & CEO Glen Tullman drops in to give us the inside story on the deal with Walmart, what it means for the industry, and how it could once-and-for-all ignite the ‘disruption of the payer’ that we’ve been waiting for since JP Morgan, Berkshire Hathaway, and Amazon came together to found Haven.

Transcarent and Glen are hell-bent on re-making the healthcare payment model by eliminating as many middlemen as possible, reshaping the health and care experience along the way. So, what does this partnership with Walmart mean for that mission and for Transcarent? Is this “THE Deal” we’ll look back on as the one that catapulted Transcarent into a new phase of growth? Remember when Glen’s last company, Livongo, shot into the stratosphere after its deal with CVS Health? I ask Glen if he’s running the same play in a much bigger game and finally concede: Transcarent is NOT a healthcare navigator!

THCB Gang Episode 65 – Thurs September 30

It has been WAY too long and for too many reasons (conferences, travel, a hurricane flooding out 4 East Coast guests) we haven’t got together but #THCBGang is back.

Joining Matthew Holt (@boltyboy) will be fierce patient activist Casey Quinlan (@MightyCasey);  THCB regular writer Kim Bellard (@kimbbellard); ; medical historian Mike Magee (@drmikemagee); and board-certified patient advocate Grace Cordovano (@GraceCordovano).

We opined a lot on the latest machinations in Congress, we talked about access to data (especially images) and we really enjoyed getting in touch with each other for a great hour!

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

#Healthin2Point00, Episode 230 | Commure, Spring Health, UniteUs, Nomad & Xealth

It’s been quite a while since Jess & I did a Health in 2 Point 00 and that one was buried in our Policies|Techies|VCs conference in the first week of September. But, as John Malkovich says, We’re back…

Commure gets $500m and maybe one day we’ll know what it does, Spring Health adds to the mental health funding party, UniteUs buys competitor NowPow; Nomad banks $63m for its nurse hiring service, and Xealth adds $24m, even though I’m not sure it’s more than a feature! – Matthew Holt

Matthew Holt

Policies|Techies|VCs: What’s Next For Health Care–Virtual Conference is Sept 7-10

Policies|Techies|VCs: What’s Next For Health Care? is the conference bringing together the CEOs of the next generation of virtual & real-life care delivery, and all the permutations thereof. You can register here or learn how to sponsor.

This is a big week. We are one week out and we’ve started pre-recording a few sessions and they’ve been fascinating. Keynotes include government officials from the 3 most important agencies for digital health –Pauline Lapin (CMS), Micky Tripathi (ONC) & Bakul Patel (FDA). But wait there’s more! Keynotes from techies Glen Tullman (Transcarent), Sean Lane (Olive), Jonathan Bush (Zus Health), Jeff Dachis (One Drop) & Andrew Dudum (Hims & Hers). And we’re not forgetting the VCs sprinkled through the program, with a keynote from Andreesen Horowitz’s Julie Yoo.

Please look at the agenda for 20 power-packed panels and over 100 speakers – and then sign up!

Shout out to our sponsors – This week we welcome new Gold sponsor data privacy company Skyflow and new Silver sponsor Amwell. Thanks to both of them for supporting the conference. They join Avaneer Health (our Platinum sponsor) & exclusive Agency sponsor 120/80. Sliver sponsors are Transcarent & Lark . More sponsors are AetionMerck GHIFCrossover HealthZus HealthNewtopiaAetion & Big Health! Many of them will have sessions you can catch on the web site.

It’s going to be a great conference–no need to leave your seat as it’s happening virtually September 7-10. Register here!!Matthew Holt

Matthew’s health care tidbits

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

For my health care tidbits this week, I am getting very close to home. I live in Marin County, California which is an incredibly wealthy, well-educated, liberal place. My little town voted 90% for Biden and, as you’d expect, county-wide 87% of those eligible (over 12) are fully immunized with most of the rest on the way. But Marin also has a small hard core of anti-vaxxers, and by that I mean those who reject childhood vaccinations. At one Waldorf school nearby only 22% of kids are vaccinated (MMR et al).This week the CDC released a study about how this past May an unvaccinated elementary school teacher who was sneezing but didn’t wear a mask infected 55% of their class.

I know that public schools in Marin have insisted on their teachers and students wearing masks and have highly, highly encouraged vaccinations among teachers and staff. Furthermore that school had only 205 pupils which is well below the average for elementary schools (at least in my school district). So I am prepared to bet that the maskless teacher was at a charter school or other private school. (Post newsletter update: I found out that it was a parochial school in Navato)

Clearly we need vaccines for kids ASAP. But I also am starting to wonder that, as COVID-19 becomes endemic and probably never goes away and as studies like this show how rapidly it spreads, will the majority who believe in masking, vaccines et al start to impose more medical and social mandates and bans on those who do not?

Delta Double-Down: A Universal Health Plan Is Long Overdue.

By MIKE MAGEE

On March 25, 1966, during the Poor People’s March that the Rev. Martin Luther King Jr. said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

This week, my niece in Orlando, Florida, sent her 8-year old son, masked, back to public school. He has a history of severe allergies, including several anaphylactic episodes requiring emergency respiratory intervention. His class included a voluntary mix of masked and unmasked children. He now has a 105 degree fever and has tested positive for the Delta variant of Covid.

His crisis, and those of countless other children in Republican led states now lies clearly on their governor’s shoulders. It also suggests, as with voting rights, that we can no longer allow health planning and delivery to be captured entities of the states rights crowd. Dying children are just not acceptable in a civilized society.

The impassioned and illogical pleas of leaders like Florida Gov. Ron DeSantis are literally as old as this nation. As with many controversies in human endeavor, the easiest way to decipher history and meaning is often “to follow the money.” Such was the case in the battle between state and federal rights. This battle engaged early and often, with Thomas Jefferson and Alexander Hamilton on opposite sides of the spectrum.

Soon after the 1788 ratification of the U. S. Constitution, Washington’s Secretary of the Treasury, Hamilton, suggested a federal bank to manage debt and currency. Jefferson, then Secretary of State, opposed it for fear of a federal power grab. Regardless, in 1791, Congress created the First Bank of the United States with a 20 year charter.

When the charter ran out in 1811, it wasn’t renewed. But then the War of 1812 intervened, and in 1816 the Second Bank of the United States was created with the Federal government holding 20% of the equity. The divide led to the creation of two political parties – the Federalist Party and the Democratic-Republican Party whose members were committed to undermining the bank.

The battle came to a head when, in 1818, the Maryland’s state legislature levied a $15,000 annual tax on all non-state banks. There was only one – the Second Bank of the United States, which refused to pay. The suit rose to the Supreme Court with Maryland claiming the right to tax based on their reading of the 10th Amendment claiming state protection against extension of non-enumerated rights to the Federal government.

The landmark 1819 case – McCulloch v. Maryland, defined the scope of the U.S. Congress’s legislative power and how it relates to the powers of American state legislatures. In ruling against Maryland, Chief Justice Marshall argued that:

“Let the end be legitimate, let it be within the scope of the constitution, and all means which are appropriate, which are plainly adapted to that end, which are not prohibited, but consist with the letter and spirit of the constitution, are constitutional.”

It was the people who ratified the Constitution and thus the people, not the states, who are sovereign.

One hundred and thirty years later, on December 10, 1948, the newly formed United Nations, adopted the Universal Declaration of Human Rights. That day, Eleanor Roosevelt spoke for America, stating: “Where after all do human rights begin? In small places close to home…Unless these rights have meaning there, they have little meaning anywhere.”

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I am Dr. Groot

By KIM BELLARD

The healthcare world is abuzz with Dr. David Feinberg’s departure from Google Health – another tech giant is shocked to find healthcare was so complicated! – while one of those tech giants (Amazon) not only just surpassed Walmart in consumer spending but also is now planning to build its own department stores.  Both very interesting, but all I can think about is robots. 

Most of the recent publicity about robots has come from Elon Musk’s announcement of the Tesla Bot, or the new video of Boston Dynamic’s Atlas doing more amazing acrobatics, but I was more intrigued by Brooks Barnes’s New York Times article Are You Ready for Sentient Disney Robots? 

Like many industries that serve consumers, healthcare has long been envious of Disney’s success with customer experience.  Disney even offers the Disney Institute to train others in their expertise with it.  Disney claims its advantage is: “Where others let things happen, we’re consistently intentional in our actions.”  That means focusing on “the details that other organizations may often undermanage—or ignore.” 

You’d have to admit that healthcare ignores too many of the details, allowing things to happen that shouldn’t.  

One of the things that Disney has long included in its parks’ experience were robots.  It has had robots in its parks since the early 1960’s, when it introduced “audio-animatronics” – mechanical figures that could move, talk, or sing in very life-like ways.  Disney has continued to iterate its robots, but, as Mr. Barnes points out, in a world of video games, CGI, VR/AR, and, for heaven’s sake, Atlas robots doing flips, its lineup was growing dated. 

Mr. Barnes quotes Josh D’Amaro, chairman of Disney Parks, Experiences and Products, from an April presentation: “We think a lot about relevancy.  We have an obligation to our fans, to our guests, to continue to evolve, to continue to create experiences that look new and different and pull them in. To make sure the experience is fresh and relevant.” 

Enter Project Kiwi. 

In April, Scott LaValley, the lead engineer on the project, told TechCrunch’s Matthew Panzarino: “Project KIWI started about three years ago to figure out how we can bring our smaller characters to life at their actual scale in authentic ways.”  The prototype is Marvel’s character Groot, featured in comic books and the Guardians of the Galaxy movies (he is famous for only saying “I am Groot,” although apparently different intonations result in an entire language). 

By 2021, they had a functioning prototype:

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Matthew’s health care tidbits

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

For my health care tidbits this week, I am featuring the the Urban Institute report on the uninsured that’s released today. “Between March 2019 and April 2021 the percentage of U.S. adults reporting they had employer-sponsored coverage declined from 65% to 62.3%, a decrease of approximately 5.5 million adults. The share of adults reporting public coverage increased from 13.6% to 17.5% percent, an increase of approximately 7.9 million adults”. So like it or not we are slowly becoming a public health plan nation–of course the public health plan picking up the slack is Medicaid. And that in practice means we are 2 nations. “In April 2021, the uninsurance rate in non-expansion states was more than double that of expansion states (18.2% versus 7.7%)”.

Which means that Texas & Florida (the two big non-expansion states) really don’t care about their people’s health. And taking a look at their governors’ current attitudes towards COVID, you would not be surprised.

George Halvorson HIMSS Changemaker Lifetime Achievement Award Acceptance Speech, Part 2

Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably last year with his proposal for Medicare Advantage for All post-COVID. This month he was given a lifetime achievement award by HIMSS and we are running his acceptance speech in two parts. We ran part one last week, and here’s part two– Matthew Holt

We also initially have an important and continuously improving sense of the epigenetic processes that exist in all of us to develop our own responses to the world we are in at a biological level, and we should be able to use that information to improve our health and our care.

That is extremely relevant to you because it is very much a systems and coding issue to bring epigenetics into care delivery and care systems.

The magnificent, wonderful, and extremely powerful new CRISPR tool kit actually used computer like coding approaches and created a vaccine for Covid that explicitly triggered our body’s immune responses exactly as our epigenetics are naturally programmed and coded to do for other vaccine approaches.

We will be able to use that set of tools to improve our responses to cancer and multiple other diseases in a growing variety of important ways. We actually now can choose to evolve as a species because that particular tool actually allows us to change our genetic code in very channeled and intentional ways. That capability and reality is hugely important — and we will now be able to use those new tools in a growing range of ways.

We should be able to stabilize or reduce the amount of money we spend on care when we put these full sets of tools in place.

However — we also do need to become better and smarter buyers of care to make that full set of enhancements happen.

Every economic system on the planet does what it is paid to do. Care is not an exception to that reality.

That full connectivity level and organized team care for patients will only happen if we decide as a nation to stop buying all care by the piece — and if we move to paying for total care for our patients to teams of appropriately supported caregivers who are rewarded financially for continuous improvement.

Care sites everywhere in the world do what they are paid to do. They also do not do things they are not paid to do. They function as businesses everywhere, so they do what every business does in every industry and they give their customer exactly what the customer pays for.

No business in any industry uses any other model.

With that reality in mind — we all need to understand the fact that we Americans buy care very badly.

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#Healthin2Point00, Episode 228 | Mahana, Vera, Cadence, Commure & Ovia

#HealthIn2Point00 is still catching up on back deals from my HIMSS “vacation” when Jess lost track of me. Mahana Therapeutics gets $61m for its IBS related CBT DTx. Not everyone is happy! Vera Whole Health Clinic gets $50mm even if they don’t love Jess! Cadence gets $41m for RPM. Commure buys PatientKeeper from HCA, and LabCorp buys femtech co Ovia Health–Matthew Holt

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