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Past the Talking Points: Glen Tullman on Affordable Insulin, Payment Model Reform & Transcarent

By JESSICA DaMASSA, WTF HEALTH

Turns out, that if you’re lucky enough to catch Glen Tullman in an impromptu chat just off the main stage at ViVE 2022, he’s warmed up enough (we could maybe even call it ‘fired up’ enough) to kick it into overdrive, roar past the usual talking points, and tell us what he REALLY thinks about what’s happening in the healthcare market today.

Things are changing. And, if you listen to this chat from start-to-finish, one of the key, overarching themes is payment model reform. From the news about Civica RX’s commitment to $30-dollars-or-less insulin (an initiative Glen helped lead and fund via his family foundation) to the 10X growth of virtual care coming out of the pandemic and the rise of “Big Customer” (aka Walmart and Amazon) in healthcare, the bottom line is that we’re no longer talking about fixing the way care is paid for – it’s actually starting to happen.

What is Transcarent’s role in all this? For those who might still be confused, tune in. This IS confusing, but I think the candor of our situation here may have given rise to one of the best descriptions of the business yet. Glen goes point-by-point on the way Transcarent is attempting to shift the paradigm for cost-and-quality across five (5!!!) different aspects of care at one time, using different strategies, novel technologies, cross-industry partnerships, and never-before-seen relationships with health systems to deliver what “20 years working with payers and 5 years working navigators didn’t deliver” for self-insured employers and their employees.

#HealthTechDeals Episode 15| Clarify, Embedded Healthcare, Wildflower, Vivante Health, Gravie, Nice

We made it back from ViVE in one piece! Will Jess DaMassa stab me in the back Brutus-Style? Tune in to find out as we discuss deals: Clarify buys Embedded Healthcare; Wildflower raises $26 million; Vivante Health raises $16 million; Gravie raises $75 million; and Nice Healthcare raises $30 million.

–Matthew Holt

Transcript

Jess DaMassa:

Well, we made it back from Vive all in one piece and we landed squarely in the Ides of March. Will I stab Matthew Holt in the back Brutus-style? Tune to the March 15th episode of Health Tech DEALS. Oh Matthew Holt, those ruthless Romans, never trust an Italian. That’s the lesson here.

Matthew Holt:

Well, sad enough, I trusted you and you told me to buy some stocks. And now, have you seen digital digital health talks yesterday?

Matthew Holt:

Everybody off another 10%?

Jess DaMassa:

Okay, but how does that compare with the reality of everything else right now?

Matthew Holt:

I don’t know. Somehow, Teladoc was about 300 a year ago

Jess DaMassa:

Don’t even talk to me about Teladoc.

Matthew Holt:

Now it’s around 50.

Continue reading…

#HealthTechDeals Episode 14: Elemy, Health Gorilla, M_disrupt; Flume; and Homeward Health

In this episode of Health Tech Deals, Jess and I say hello to you from Miami! Together at ViVE 2022, we weigh in on some big funding deals! We also have a short cameo along the way (watch to see who it is)! Elemy raises $215 million; Health Gorilla raises $50 million; M_disrupt raises $6 million; Flume raises $30 million; and Homeward Health raises $20 million.

TRANSCRIPT

Jessica DaMassa:

Hello from Miami. I am at ViVE and look, the exhibit hall coming down around me. Here’s what the reg area looked like. People are leaving, everybody’s got their bags and ah, look who I’ve got. Weighing in with the big funding deals from ViVE, Matthew Holt. It is the March 10th episode of Health Tech Deals. Well, we’re selfie-style here, because we are on the move.

Matthew Holt:

Yeah. You had a fantastic professional cameraman and we decided not to use him

Jessica DaMassa:

No. Instead we’re using this, but I’ve interviews for you guys coming out of this.

Matthew Holt:

Even I did some, actually a lot of stuff going on in the show, pretty interesting. And there were a few deals announced.

Continue reading…

Will ‘DoorDash for Lab Draws’ Startup Sprinter Health Be What Speeds Up Virtual Care’s Growth?

By JESSICA DaMASSA, WTF HEALTH

Sprinter Health bills itself as “the “DoorDash for lab draws” – sending nurses and phlebotomists out to patients’ homes to collect blood samples and urine samples, check vitals, and even perform Covid tests. Their model has been received with some skepticism (most notably by my Health Tech Deals co-host and legendary health care curmudgeon Matthew Holt) so we get down to the bottom of what’s REALLY going on with CEO Max Cohen.

The long-term play is NOT to just rove the streets like some nomadic Quest Diagnostics; it’s to support the emerging market of virtual care and telehealth-based next-gen healthcare companies that will, ultimately, be limited in their abilities to diagnose-and-treat unless they can easily – and inexpensively – get patients lab tests.

Sprinter hopes to be that logistics company, extending the ‘value of virtual’ so it can live up to its promise of providing less expensive, more convenient care to patients. Max says only 15-20% of their business is made up of consumer-directed concierge calls; instead, the focus is on having a provider – think home health providers, specialty labs, virtual-first primary care clinics – dispatch Sprinter instead. Their pricing is built to attract these kinds of providers, giving Sprinter an advantage over, say the kind of medical transport services that are typically engaged to bring home health patients to the lab instead of the other way around.

Less than one-year old, Sprinter has already raised more than $37 million and counts health-tech-famous funds like Andreesen Horowitz, General Catalyst, Accel, Google Ventures – and even the real DoorDash’s co-founder and CEO Tony Xu – as investors. So, what’s ahead in the short-term to expand services out of LA, San Francisco, and Sacramento? We talk geographic expansion (hello, Texas and Georgia) and how Max is planning to continue to expand the utility and value of virtual care without increasing cost.

When Crypto Comes to Health Care

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By KIM BELLARD

The conflict between Ukraine and Russia has been called many things.  To most of the world, of course, it’s considered an invasion, a war between the two countries.  To Russia, it’s a “peacekeeping” mission.  The description that I can’t get out of my head, though, is one that I believe The Washington Post first used:  it’s the world’s first crypto war.  

“There is something about the war in Ukraine that feels different,” a former U.S. intelligence official told Nick Bilton. “We’ve seen wars documented on Twitter and images shared on the internet before, but this time it isn’t just bombs and bullets; this war is digital from the top to the bottom.” And, Mr. Bilton says: “At the center are cryptocurrencies.”  

If crypto has come to war, can healthcare be far behind?

Continue reading…

Mental Health Care & Medicaid State-of-Play: Circulo Health, Brave Health Execs Weigh-In

By JESS DaMASSA, WTF HEALTH

Two experts in mental health care for the Medicaid market stop by to help us get smart on the challenges facing patients and providers alike in this critical area of care. It’s not just the payment model that is different; stigma is different, patients are more racially and culturally diverse than those in commercial plans, support systems vary, and even the normalization of seeking mental health care manifests itself differently when it’s individually-driven as opposed to part of an “employer group.”

Anna Lindow, CEO of digital-first mental health startup Brave Health, and Vik Bakhru, Chief Health Officer of new managed Medicaid plan Circulo (the one built on Olive’s health tech platform) share what they know about this patient population, including what they are learning via the partnership they share to provide Brave Health’s services to Circulo’s members in Columbus, Ohio and Albany, New York.

The top of this conversation starts with the trend-talk and identification of the key issues facing Medicaid mental health care, then we get into some updates from Brave and Circulo, including how Circulo is examining “what it means to be a payer of care” and looking to innovate just one-year after launch.

Reflections From the Ukraine

By MIKE MAGEE

The English translator of Tolstoy’s epic Russian novel, “War and Peace”, Richard Pevear, writes in his introduction, “The book is set in the period of the Napoleonic wars (1805-1812) and tells the interweaving historical events of two very different families of the Russian nobility – the severe Bolonskys and the easygoing Rostovs – and of a singular man reminiscent of the author himself – Count Pierre Bezukhov. It embodies the national myth of ‘Russia’s glorious period’ as Tolstoy himself called it…”

On page 348, in a moment of intense introspection, the very same Pierre broodingly reflects, “What is bad? What is good? What should one love, what hate? Why live, and what am I? What is life and what is death? What power rules over everything?”

Pierre’s mind provides this very dark response, “You will die – and everything will end. You will die and learn everything – or stop asking.”

Continue reading…

#HealthTechDeals Episode 13: ModMed, Nayya, Sanofi, Dario Health, Ro, Dadi, and Daybreak Health

Here’s the big question of the day: VIVE or HIMSS or both? Jess and I offer our thoughts on both conferences and which ones we’re going to. Some deals in the past few days: ModMed buys Klara for $200 million; Nayaa raises $55 million; Sanofi and Dario Health have a $30 million deal; Ro acquires Dadi, an in-home sperm testing company; Daybreak Health raises $10 million—Matthew Holt

TRANSCRIPT

Jessica DaMassa:

All right, Matthew Holt, the big question of the day: ViVE or HIMSS or both? Ugh.

Matthew Holt:

Or neither?

Jessica DaMassa:

Hey, that’s the way to do it. It’s the March 3rd episode of Health Tech Deals.

Matthew Holt:

So, Jessica, I thought the big question was State of the Union versus invading Ukraine versus .. No, no, it’s all about ViVE versus HIMSS?

Jessica DaMassa:

ViVE versus HIMSS.

Continue reading…

Medicare Advantage Poses Challenges to Health Care Cost-Effectiveness and Equity

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BY NIRBAN SINGH AND AMY HELBURN

Introduction

Medicare Advantage (Advantage), originally conceived in 1997 during the Clinton Administration as ‘Medicare + Choice’, has progressively grown and become an established health insurance option for those 65 and older. According to data collected and aggregated by the Kaiser Family Foundation, Advantage has more than doubled in total enrollment between 2010 and 2021. In 2021 alone, 26 million people were enrolled in Medicare Advantage, which is over 40% of the total Medicare beneficiary population. In 2021, 85% of Medicare Advantage growth was concentrated among for-profit health plans, with UnitedHealthCare, Centene, and Humana leading the way.

Overall, the Medicare Advantage market is dominated by UnitedHealthCare, Humana, and CVS Health/Aetna, with this trio responsible for over half of all Advantage beneficiaries.As of October 2020, about 80% of Advantage enrollees directly purchased individual policies, while employer-sponsored Advantage enrollment has been steadily growing, comprising 18.1% of the Advantage market overall in 2020. Analysis from The Chartis Group indicates that half of all Medicare beneficiaries will be enrolled in Advantage plans by 2025, so the trio of existing leaders in providing Advantage plans may continue to innovate and profit immensely while new market entrants may grow their footprint rapidly, in response to growing demand.

Continue reading…

#HealthTechDeals Episode 12: Omada Health, Somatus, Qventus, Story Health, and Medibuddy

In this episode of Health Tech Deals, Jess is back! Where was she? Out in the wilds in Arizona, hiking in mountains. A big shoutout to Ian Morrison for filling in. Some recent deals: Omada Health raises $129 million; Somatus raises $325 million; Qventus raises $50 million; Story Health raises $22.6 million; and Medibuddy raises $125 million.

TRANSCRIPT

Matthew Holt:

Hang on. You’re not Ian Morrison.

Jessica DaMassa:

I’m not.

Jessica DaMassa:

He let me come back.

Matthew Holt:

Hang on, look. And we’re together.

Jessica DaMassa:

We’re together. I went from being completely away and replaced, to being right next to you.

Continue reading…
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