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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.

THCB Gang Episode 95, Thursday June 9

Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday June 9 were THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); fierce patient activist Casey Quinlan (@MightyCasey); Principal of Worksite Health Advisors Brian Klepper (@bklepper1) & Queen of all employer benefits Jennifer Benz (@jenbenz)

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.

Can SameSky Health Fix the ‘Trust Issues’ Minority Populations Have with Big Healthcare?

BY JESSICA DaMASSA, WTF HEALTH

Healthcare needs to move into 2022 and get away from the one-size-fits-all approach that healthcare takes almost everywhere and, instead, treat people like who they are matters.” That’s the challenge coming from SameSky Health’s founder & CEO Abner Mason whose business is helping some of healthcare’s most notorious “one-size-fits-all-ers” (health plans) improve the way they engage with diverse populations.

SameSky has built a proprietary tech platform that creates an ‘n of 1’ approach to member engagement that is focused on using data to understand who each individual member is at a “cultural” level which, as Abner defines it, is not just about ethnicity or race, but about ALL the factors that go into how a person makes a decision about whether or not to seek care, where to get that care, and who they ultimately trust to deliver it.

You can call it “micro-targeting-at-scale” and Abner compares it to the way Netflix customizes movie recommendations based on what it learns about its users. SameSky is hoping to achieve the same level of consumer-focused customization among Medicaid populations, and is working with some of the biggest names in the biz (UnitedHealthcare, Anthem, Humana and others) to tailor an annual “journey” to each member that helps members build trust with their plan, helps the plan get to know their members, and, in the end, helps both the plan AND the member satisfy mutual needs when it comes to getting things like annual health screenings done.

Will we eventually get to a more equitable and personally-tailored healthcare system? Stick around until the last few minutes to hear what Abner finds exciting about some of the new federal regulations that impact health data collection and what he sees as their big-picture impact on the future of health equity. PLUS, a bonus for all those who may have been wondering: What prompted the name change to SameSky Health from ConsejoSano?? Is this REALLY because Matthew Holt could never pronounce it? The shocking backstory is revealed!

7WireVentures’ Lee Shapiro: What’s Ahead for Investment in Health Tech

By JESSICA DaMASSA, WTF HEALTH

What’s Lee Shapiro’s take on the health tech market’s state-of-play? 7wireVenture’s Co-Founder and Managing Partner stops by to talk early-stage investment, what’s hot and what’s not post-pandemic, and how he views the digital health funding frenzy of the past couple years which, one could argue, was kicked into high-gear by portfolio-company-slash-previous-employer Livongo.

Lee says there’s “enough broken business processes in healthcare to last a lifetime,” which means a lot of opportunity for consumer-minded health tech startups to change things, but does the recent slowdown in venture funding and pummeling of public market health tech stocks indicate that the category is in trouble before it even gets a chance to make a real impact? We get Lee’s opinion on whether or not the market is cooling, what he thinks will happen next with valuations, and what he views as the best way to scale a healthcare startup – particularly as we watch Glen Tullman run the ‘Livongo playbook’ at new business Transcarent. And, speaking of Glen… did Lee really teach him everything he knows?? We’re starting some trouble in this one!

An interview of, err, me by João Bocas

João Bocas is known as “The Wearables Expert” and has been talking, writing and innovating in health tech for a while. Last month he had me on his video series. It was a fun interview in which I talked about Flipping the Stack, the Continuous Clinic, and the slow pace of change in health care! With João’s permission I am reproducing that interview here–Matthew Holt

THCB Gang Episode 94, Thursday June 2

Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday June 2 were regulars Grace Cordavano (@GraceCordovano); patient safety expert and all around wit Michael Millenson (@mlmillenson); and policy expert consultant/author Rosemarie Day (@Rosemarie_Day1). Gun control, hospital quality and much more all came up and were interlinked. Quite the conversation.

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.

Russ Johannesson, CEO, Glooko

Russ Johannesson has been CEO of Glooko since 2018. In that time the diabetes data platform has expanded internationally, made a couple of acquisitions, and added support for digital therapeutics and distributed clinical trials. He brought me up to date with the latest–Matthew Holt

THCB Gang Episode 93, Thursday May 26 1pm PT, 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday May 26 were medical historian Mike Magee (@drmikemagee); Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune); and fierce patient activist Casey Quinlan (@MightyCasey). Plenty of conversation about guns as a public health crisis, and also much about data use, data reidentification and controversy there.

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

Virtual Care Regulatory Round-Up: Telehealth & Digital Care ‘State-of-Play’ by Nathaniel Lacktman

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BY JESS DaMASSA, WTF HEALTH

Just as HHS extends the Covid-19 public health emergency waivers until July, we kick-off a brand-new monthly interview series about the state-of-play for all things telehealth and digital care policy and reimbursement. Called the WTF Health Virtual Care Regulatory Round-up, we’re partnering with our friends at Wheel to feature health policy experts, lobbyists, health plan folks, and other virtual care experts and insiders who can keep us updated on the changing regulations and what they will mean to those health tech co’s whose businesses rely on virtual care.

Attorney-to-the-stars-of-telehealth, Nathaniel Lacktman, who chairs the Telemedicine & Digital Health Industry Team at Foley & Lardner and is a Board member of the American Telemedicine Association (ATA), kicks the series off for us with an update on those public health waivers and how he is coaching health tech businesses in preparing for the inevitable transition of care that will come when they come to an end.

What will happen to patients who live across state lines from their virtual care providers? What business decisions need to be made to avoid abandoning patients and maintaining continuity of care? Nate’s not bullish on a federal national license, but there are some cases where cross-state patient-provider relationships can continue to exist – they just might not work for everyone’s business model.

And, on the subject of telehealth business models, Nate gives us his take on where he thinks reimbursement will be headed, how policy around virtual prescribing will be impacted post-pandemic (particularly around controlled substances), and whether or not Medicare’s originating site requirement will be put back in place. We also get Nate’s perspective on which virtual care business models seem to be working best among health tech startups and what legal risk those more ‘reckless’ players might be creating for the rest of the field without even realizing it. Great education on virtual care and what’s happening in the space RIGHT NOW. Watch!

Special thanks to our series sponsor, Wheel – the health tech company powering the virtual care industry. Wheel provides companies with everything they need to launch and scale virtual care services — including the regulatory infrastructure to deliver high quality and compliant care. Learn more at wheel.com.

CVS Health’s Head of Enterprise Virtual Health Weighs-in: ‘What’s Next’ for Telehealth at CVS, Aetna

BY JESS DaMASSA, WTF HEALTH

What are the BIG questions a BIG healthcare company like CVS Health is trying to answer when it comes to virtual care and creating the healthcare business model of the future? I’ve got Dr. Creagh Milford, CVS Health’s Head of Enterprise Virtual Health, who’s purview covers both CVS Pharmacy (9,000+ stores including 1,100 Minute Clinics) and Aetna, which provides health insurance to 39 million people.

Creagh’s big concern right now: how to weave together existing care models with virtual so 1) the consumer has a single front door and 2) the provider workforce – which includes everyone from pharmacists to primary care docs and beyond – is coordinated and working together. As you’ll hear, there’s a lot of thinking about “pivot points,” or where the patient and provider meet in the virtual-and-in-person ecosystem. The goal is to make those interactions easy and seamless – for both patient and provider alike – and we get into the strategic thinking, clinical operations, and tech underpinnings that are evolving to make those transitions possible.

Long-term, Creagh believes that healthcare consumers have “voted with their fingertips” and that virtual care is here to stay, but as part of a hybrid model in which questions about quality and cost are still being worked out. Will incentives ultimately realign to make virtual care more enticing across the healthcare system? What types of technology will be next to augment the hundreds of thousands of virtual visits a year coming out of Minute Clinic, or happening as part of an Aetna plan benefit? Here’s how one of the biggest healthcare companies in the country is driving virtual care forward. Watch now!

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