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How Happify Health Became Twill: Inside the New Biz Model & What’s Next

By JESSICA DaMASSA, WTF HEALTH

Mental health digital therapeutics startup Happify Health has spent the past 5 years quietly ‘self-actualizing’ into a brand-new, tech platform company that just launched this week: Twill. This is a big pivot – not just a brand change – and we’ve got co-founder & President Ofer Leidner and newly-hired Chief Operating Officer Megan Callahan (who formerly ran Lyft Health) here to tell us how it all went down AND what will happen to the old Happify app.

Wellness-app-no-more, Twill has emerged as a health tech infrastructure company. Its core product (called Sequences) is the open architecture, digital back-end that ties together a health plan, employer, or pharma co’s various digital point solutions – wellness apps, digital therapeutics, virtual coaching, peer support groups, telehealth platforms, etc. etc. – to create one neat-and-tidy, hyper-personalized, automagically-navigated patient care journey based on condition or patient population.

Big brands like Elevance Health (Anthem), Biogen, and Almirall have already bought-in, with products already in market for conditions as diverse as maternal health, multiple scleroses, and psoriasis. Not forgetting its mental health roots, Twill is bringing in its own vast resources from the ole Happify days to run digital mental health support under each of these disease-specific point solutions. Ofer and Megan say that Sequences can be developed for ANY condition or to target specific populations of patients and they plan to launch 2-3 new Sequences each year.

What else is ahead for Twill now that it’s revealed from its stealthy start? Happify Health had raised $73 million in March 2021 in a big round lead by Deerfield Management Company – what should we expect next? Tune in for all the details on the transformation, the new products, and how other digital health companies can expect to work with Twill in the future.

Quickbite Interviews: NeuroFlow

I was at the AHIP conference in Vegas late last month and caught up with a number of CEOs & execs for some quick bite interviews — around 5 mins getting (I hope) to the gist of what they & their companies are up to. I am dribbling them out–Matthew Holt

Next is Julia Kastner, CPO & Chris Molaro, CEO, Neuroflow, and it includes a great brief product demo from Julia

Matthew’s health care tidbits: Texas is the present future of abortion care

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

In this edition’s tidbits, I have to return to the stunning impact of the Dobbs ruling. We know will happen because it is already happening in Texas where the 6 week law was already being enforced in contravention of Roe v Wade.

Taxpayer money is going to “pregnancy crisis centers” that flat out lie to vulnerable patients about the impact of abortions on their health. Doctors are questioning women who have miscarried–at a moment that is already terrible for them, and women who have miscarried are being denied basic D&Cs–which can kill them.

Don’t get me started on the absolute nonsense being talked–and passed into law –about ectopic pregnancies, of which there are over 130,000 each year in the US, being carried to term. How unlikely is it that an ectopic pregnancy makes it to term with no ill effects? Let me tell you a story. My dad was an OBGYN. He and his anesthetist saved the life of a woman and her baby who somehow had made it to term while being ectopic. During the surgery she needed 12 pints of blood (a normal woman has 7-8 pints in her body) and he considered it the greatest piece of surgery he did in his entire career. He thought that he and the patients were very lucky. So I demand that crazy legislation saying ectopic pregnancies have to be carried to term also mandates that my dad is around to do every single C-Section. Unlikely, as he’s dead, but no crazier than the legislation in Indiana.

Then there’s the impact on telehealth. Most abortions are done using drugs but more and more of the pandemic-era exemptions to prescribing drugs and seeing patients over telehealth across state lines are being withdrawn. Clearly the state-based licensing of doctors is itself ridiculous in an age of online commerce, but despite the DOJ statements the legality of prescribing abortifacients across state lines is very unclear and, as Deven McGraw explained in this harrowing piece on THCB Gang, HIPAA doesn’t protect patient privacy from local law enforcement. So what happens to someone in a state where abortion is banned if they have to go to hospital because of a complication from taking an abortifacient? Trump thinks they should go to jail.

What is clear is that bans on abortion don’t stop abortions. But they do endanger women. And if the pregnancy crisis center stops a woman from getting an abortion, do they help afterwards? Why yes, if you mean by “helping”, they have a celebratory dinner and light a fricking candle.

Quantifying Caregiving: ARCHANGELS CEO Alexandra Drane on The Caregiver Intensity Index

By JESSICA DaMASSA, WTF HEALTH

“Being an unpaid caregiver is the epicenter of Life Sucks Disease,” says Alexandra Drane, Co-Founder & CEO of ARCHANGELS, “but it’s also one of the most glorious, one of the most magnificent jobs we’ll ever have.” So, what’s the trick to managing the “sucky” side of caregiving? Data.

Alex’s company ARCHANGELS has invented the Caregiver Intensity Index, which she describes as a “two-and-a-half minute Cosmo quiz” that helps caregivers quantify the intensity of their caregiving experience and identify the top two things driving that intensity and the top two things alleviating it. The score coming out of this helps caregivers validate the intensity of their experience, offers a framework for communicating about it, and, as Alex puts it, delivers “data that gives them permission to believe” that the stress they are feeling is real. ARCHANGELS then uses the info to crosswalk caregivers to existing resources that can help them manage those intensity-driving challenges – whether they be related to financial stress, workplace stress, relationship stress or otherwise.

Knowing that health plans and employers are starting to “see the light” when it comes to caregiving and its impact on their workforce, Alex and I talk about just how much payers are really willing to contribute to supporting the resources needed to support caregivers and how the data ARCHANGELS is providing is helping demonstrate need and connection to health and well-being. Lots of interesting data points on caregiving in this one – particularly when it comes to mental health and how things have changed through the pandemic. Watch now!

American health care leaders are not blameless today

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By MATTHEW HOLT

It is a very sad day for America. Roughly 30% of our country is part of a quasi-religious cult. In general these people reject science and the enlightenment. This week the Jan 6th committee has shown they are prepared to use and support any tools or tactics–up to and including the overthrow of the government, in order to get what they want. 

The overturning of Roe vs Wade is the most visible artifact of a 40-year campaign. The campaign was funded by business leaders like the Koch brothers who want to revoke all environmental, labor and rational restrictions on their activities. Using dark money and the passion of religious zealots who want to control women’s bodies and discriminate against anybody who doesn’t believe what they believe, they have turned this nation back to the 18th century, using the Supreme Court as their vehicle.

The biggest of those dominos has now fallen and women’s right to control their own bodies has been taken away in most states. We can assume a nationwide ban (such as happened in Poland) will be coming here soon, maybe as soon as 2025 if the Republicans win the 2024 elections. And note that the rolling coup described by the witnesses at the Jan 6 hearings show that the Republicans are already blatantly taking over the supposedly neutral election process.

But the American health-care system is not blameless. Abortion and other reproductive health services are clearly part of health care. Yet uniquely in this country the provision of the services has not been from mainstream health care institutions. The leaders of our health care organizations, in particular our major hospital systems, have completely avoided delivering these services. They have been more than happy to allow Planned Parenthood and other specialist organizations to provide reproductive care, and have just looked the other way in the debate. 

Worse, many of our religiously affiliated institutions,  particularly those with a Catholic heritage which represent an enormous amount of hospitals in this country, have banned not only abortion but many other forms of reproductive health care such as female sterilization. The Hyde Amendment, ironically named after a religious bigot who was an appalling adulterer and hypocrite to boot, bans Federal funding for abortions. That means that private Medicaid plans which now cover most births in this country have never offered a full suite of reproductive health care.

Even in recent weeks when the fate of Roe became clear I have heard nothing from major leaders of hospital systems or health plans about this. Some of the newer provider organizations focusing on women, such as Maven and Tia, have been outspoken, as have many non health care-related employers. But the general silence from all major health care organizations in America on this topic has been deafening.

Today there is plenty of shame and blame to go around.

Matthew’s health care tidbits: Is Covid over for the health care system?

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

I am beginning to wonder, is COVID over? Of course no one has told the virus that it’s over. In fact infection rates are two to three times where they were in the post-omicron lull and new variants are churning themselves out faster and faster. We still have 300 people dying every day. But since we went past a million US deaths, no one seems to care any more.

For the health care system, COVID being over means a chance to get back to normal, and normal ain’t good. Normal means trying to get rid of that pesky telemedicine and anything else that came around since March 2020.The incumbents want to remove the public health emergency that allowed telemedicine to be paid for by Medicare, re-enforce the Ryan Haight act which mandates in-person visits for prescribing controlled Rx like Adderall for ADHD, and make sure that tortuous state license requirements for online physicians are not going away. This also means restrictions on hospital at home, and basically delays any other innovative way to change care delivery. Well, it was all so perfect in February 2020!

But there is one COVID related problem that doesn’t seem to be going away. People. They’re just not going back to work and nurses in particular are resisting the pull of the big hospitals. I don’t know the end game here, but there is a clue in the “return to office” data. Basically every large city is below 50% of its office space being occupied and companies are having to figure out a hybrid model going forward, no matter how much Elon Musk objects.

Hospitals aren’t going willingly into the night. The big systems still control American health care, and are prepared to fight on all fronts to keep it that way. But like office workers, nurses and doctors want a different life. The concept of virtual-first, community-based, primary care-led health care has been around for a long while and been studiously ignored by the majority of the system.

If hospitals can’t get the staff and keep losing money employing the ones they have, there will be new solutions being offered to clinicians wanting a different life-style. We just might see a different approach to health care delivery rising phoenix-like from the Covid ashes.

#HealthTechDeals Episode 35 | CapitalRX, EnsoData, CareAcademy, Inne, and Boulder Care

Hear the big news? Not only has Oracle bought Cerner, but Larry Ellison says “Interoperability! What interoperability? Oracle has fixed it!” Some new funding deals: CapitalRX raises $106 million; EnsoData raises $20 million; CareAcademy raises $20 million; and Inne raises $10 million; Boulder Care raises $35.7 million. Check out the AHIP Conference 2022 taking place in Las Vegas! We’ll be there! Tickets are $100 off with code THCB.

AHIP in Vegas next week. Not too late!!

If you want to come see the best of health plans and health tech aimed at them, plus try your hand at the craps tables, it’s not too too late to get a ticket to AHIP 2022 in Las Vegas next week! Plus meet Matthew Holt & Jess DaMassa as they tour/troll the exhibit hall and look for parties!. And you can still get $100 off if you use the code “THCB”

https://www.ahip.org/conferences/ahip-2022

Inside Boulder Care’s $36 Million Series B & Scaling Telehealth Addiction Treatment in Medicaid

BY JESSICA DaMASSA, WTF HEALTH

Telehealth addiction treatment clinic Boulder Care just closed a $36 million Series B. I’ve got Founder & CEO Stephanie Strong here to talk about the virtual care company’s medication-assisted approach to opioid and alcohol use disorder treatment, and its growing-bigger-by-the-day presence in the Medicaid market.

In fact, more than 95% of Boulder Care’s revenue comes in from Managed Medicaid plans, and this focus on making medications like Suboxone accessible to traditionally marginalized patients is not only better for patients (drugs like these can cut all-cause mortality rate by half or more) but also compelling for payers. Stephanie says patients suffering from opioid addiction who go untreated are 550% more expensive to the plan than those who are not, and these types of medications facilitate recovery by making it bearable, blocking withdrawal symptoms.

We get into the details behind Boulder Care’s approach, which includes a number of wrap-around support services, including those provided by the startup’s care delivery team that is set to grow as a result of this Series B funding. And speaking of scaling… Does Stephanie have any concerns about challenges that Boulder Care might face prescribing-and-managing controlled substances as a result of the scrutiny created by Cerebral’s bad behavior? Any additional concerns about changes to the clinic’s telehealth practices when the Covid19 public health emergency comes to an end? And…what about competition in this space?? Particularly as similar-looking Bicycle Health announced its $50 million Series B just days earlier? A great inside look at how virtual care is changing the specialized mental health care space.

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