It’s the telehealth market reality check you’ve been waiting for! “Rouge” digital health consultant Dr. Lyle Berkowitz unpacks the numbers and the market potential for virtual care from the unique vantage point of a primary-care-physician-turned-health-tech-entrepreneur with nothing to lose. Having been 1) a clinician, 2) the Director of Innovation at Northwestern Medicine, 3) the founder of a health tech startup (Health Finch) that successfully exited to Health Catalyst, and 4) the former Chief Medical Officer at one of telemedicine’s biggest players, MDLive, few can boast such a wide-reaching, deep understanding of the inner workings of both the innovation and incumbent sides of the virtual care market — AND have a willingness to talk about it all with complete candor!
This is an analyst’s perspective on the telehealth market — with a twist of insider expertise — so expect to hear some good rationale behind predictions about how much care will remain virtual once hospitals and doctor’s offices return to normal, how “real” health system enthusiasm is for building out telehealth capacity to execute on the “digital front door” idea, and whether or not all these well-funded telehealth startups will have what it takes to win market share from traditional care providers.
BONUS on Primary Care: Is this the area of medicine that’s going to be the “battleground” where digital health and virtual care companies will be going head-to-head with incumbents for market share? Lyle says 50-plus percent of primary care “can and should be automated, delegated, virtualized, etc.” and boldly predicts that in 10-20 years we won’t even have primary care physicians anymore. Tune in to find out why starting at the 8:00 minute mark, where we shout out Crossover Health, Oak Street Health, Iora Health, and more.
Telehealth die-hards, don’t think for a second I’d miss this chance to also get some input on Teladoc-Livongo, Amwell, Doctor On Demand, SOC Telemed, the impending IPOs there, digital first health plans, virtual primary care, health systems (who Lyle hopes “don’t shoot themselves in the foot” with their opportunity to jump into the space) and, ultimately, who’s really going to ”WIN” in virtual care moving forward. For this, jump in at 17:00 minutes and hold on!
Digital Mental Health startups continue to scale up — in customers, revenues, and investments — as the covid19 pandemic wears on. One of these companies, Ginger, has tripled its revenue this past year, expanded its client base to count more than 200 health plans and self-insured employers, and, for good measure, just added a fresh $50M Series D to their coffers. How much more money can investors put into digital mental health startups? Are things “frothy” in this space, or is investment just “catching up” to meet a latent demand that’s just really been brought to light? And, what is one of this category’s leaders planning to do now that they’re extra flush with cash? (Don’t forget, they’re sitting on a $35M round that closed late 2019…)
Ginger’s co-founder & COO Karan Singh and CEO Russell Glass join us to weigh in on the mental healthcare market’s state-of-play, including the buzz around their own business as both a potential acquisition target and a potential acquirer of additional behavioral health tech. We cover everything from investment to healthcare incumbent’s recent cries for more clinical validation, but my favorite part of this whole interview is when we start talking about the competition and tackle Lyra Health’s recent $100M raise and $1.1B valuation. Tune in around the 15:55-minute mark for some very DETAILED competitive analysis about Lyra-versus-Ginger from Ginger’s own CEO.
As this market gets more crowded, competition heats up, and healthcare consumers receive the benefit of more solutions to access at lower prices, Karan and Russ also help me speculate on what’s ahead, including whether or not they think we’ll see a “digital mental health equivalent” of a massive game-changing-market-moving deal like we saw when Teladoc merged with Livongo to shake up of both the virtual care and chronic condition management spaces.
If you work in a large organization, especially one that has been around for at least a few decades, the words “legacy system” probably strikes angst in you. If you’ve dealt with such an organization, legacy systems probably contributed to problems you may have had with them. Think about health insurance claims systems, hospital billing systems, financial institution account records, or practically any government system.
Though these systems run practically every aspect of our lives, we don’t give them a second thought because, for the most part, they function. It doesn’t even occur to us that IT is something that needs constant attention to be kept in working order.”
Because they usually work OK, management often doesn’t want to risk the potential disruption of replacing or modernizing them, so they get older and older, with more and more layers built on them, and with the people who originally built them or understand the language they are written in (e.g. COBOL) gone.
From his vantage point at the helm of one of healthcare’s biggest IT infrastructure companies, Change Healthcare’s President & CEO, Neil de Crescenzo, has an unrivaled perspective at how covid19 has impacted hospital systems and payers. His business builds the “connective tissue” that not only supports the administrative management and patient engagement aspects of “Big Healthcare,” but it also literally helps those organizations make money, processing about $1.5 Trillion in claims each year. So, what’s he seen so far in 2020? And what’s ahead for 2021? Neil stops by to talk about current challenges facing healthcare provider orgs and payers — and what’s ahead in the “new” healthcare economy where “change” is the only constant. From HHS’s new interoperability rules to telehealth and the more dispersed healthcare system it will inevitably create, we dive into all things future of health including the details behind Change’s two recent health tech acquisitions (each over $200M), what Neil thinks about the Teladoc-Livongo merger, and how digital health startups have an unprecedented opportunity to help expand the healthcare system beyond its traditional footprint.
You might have missed it amongst all the headlines about the U.S.P.S., the 2020 elections, and, of course, that little thing we call the pandemic, but Fortnite got kicked off Apple’s App Store (and subsequently Google Play).
I’m not a gamer, but I am fascinated by gaming, because, as Steven Johnson put it, “The Future is where people are having the most fun.” Tim Sweeney, the founder and CEO of Epic Games, Inc., which makes Fortnite, seems to be having a lot of fun. And he thinks the future is the Metaverse.
Healthcare, take note.
The tech giants were reacting to Epic allowing “permanent discounts” on developer fees for in-game purchases made directly, rather than going through Apple or Google. Developers thus avoid the 30% commission charged in those Stores. Mr. Sweeney has been railing about the commission level for some time, leading to the recent decision.
Today, Epic Games took the unfortunate step of violating the App Store guidelines that are applied equally to every developer and designed to keep the store safe for our users. As a result their Fortnite app has been removed from the store. Epic enabled a feature in its app which was not reviewed or approved by Apple, and they did so with the express intent of violating the App Store guidelines regarding in-app payments that apply to every developer who sells digital goods or services.
Today, a special Health in 2 Point 00. Jessica DaMassa asks me about the biggest news in public digital health companies ever: this morning’s merger of Teladoc and Livongo. We discuss the deal, the implications for digital health, what’s next for Continuous Clinics, whether our T-Shirts will become a collectors item, and of course what about our book club on August 19! —Matthew Holt
Though it will be impossible to overstate the devastation that the COVID-19 pandemic is leaving in its wake, we can also acknowledge that it has pushed humanity to creatively adapt to our new, socially-distanced reality—necessity is the mother of invention, as they say. Telehealth is not a new invention, but the necessity of keeping people physically apart, especially those particularly vulnerable to COVID, has suddenly put virtual health care at the center of our delivery system.
Patients and providers quickly pivoted to at-home care as in-person visits were limited for safety, and use of telehealth spiked early in the outbreak. One survey of over 500,000 clinicians showed that by April—only about two weeks after the first stay-at-home orders were issued in the U.S.—14 percent of their usual number of pre-pandemic visits were being conducted via telemedicine. For many, that involved using unfamiliar technology and a big shift in procedures for providers. Congress recognized the need to support providers through this transition and allocated $500 million for waiving restrictions on Medicare telehealth coverage as part of the emergency funding bill that passed in March.
But, as restrictions have begun to lift and hospitals and medical offices are beginning to reopen for non-emergent care, we have seen the use of telemedicine start to taper off. The same 500,000 clinicians were surveyed in June, revealing that telemedicine was used for only 8 percent of the usual pre-pandemic number of visits. Providing quality, virtual health care won’t be as easy as flipping a switch, but we currently have an unprecedented opportunity to carry forward the best version of virtual care and create a more holistic health care system. As we work toward that goal, there are three components our virtual care system needs in order to be sustainable, feasible, and manageable for both patients and providers.
Today on Health in 2 Point 00, Jess helps me celebrate my birthday Kylie Jenner-style. On Episode 140, Jess and I discuss Humana investing $100 million in Heal, Lemonaid raising $33 million in a Series B, CVS Caremark announcing 5 new companies in their digital health platform—4 of which are about weight loss, and perplexing health intelligence company Sema4 raising $121 million in a seed round. —Matthew Holt
Today on THCB Spotlights, Matthew sits down with Paul Johnson, the CEO of Lemonaid. Lemonaid just closed a $33 million Series B led by Olive Tree Ventures, expanding their direct-to-consumer online services which provide primary care visits as well as pharmacy and medication delivery to your home and launching into more chronic areas of care, such as hypertension, high cholesterol, asthma and type 2 diabetes. Why did they wind up with an Israel-focused lead investor in Olive Tree as a San Francisco-based company? Where is Lemonaid in terms of growth and revenue? And how is Lemonaid differentiating itself against some of the other chronic care management and telehealth companies? Find out how the company aims to provide care for patients holistically and be the first point of contact for patients in seeking healthcare.
Today on Health in 2 Point 00, Jess and I cover some big news! Accolade has filed its IPO, so on Episode 132 I give my take on this health care navigation service. We also cover Somatus getting $64 million for chronic kidney disease care, NexHealth raising $15 million, Tatch raising $4.25 million for sleep apnea diagnosis, Simply Speak raising a $1.1 million seed round, and optimize.health raising $3.5 million for its remote monitoring platform.—Matthew Holt