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 week’s health care tidbits, Shannon Brownlee and her fellow rebels at the Lown Institute decided to have a bit of fun and compare which non-profit hospitals actually made up for the tax-breaks they got by providing more in community benefit. A bunch of hospitals you never heard of topped the list. What was more interesting was the hospitals that topped the inverse list, in that they gave way less in community benefit than they got in tax breaks. That list has a bunch of names on it you will have heard of!
Given how many of that list run sizable hedge funds and then do a little health care services on the side, perhaps it’s time to totally re-think our deference to these hospital system monopolies. And I don’t just mean making it harder for them to merge and raise prices as suggested by Biden’s recent Executive Order.
Today on Health in 2 Point 00, Jess and I cover Availity raising $50 million bringing their total to $200 million and a valuation at over a billion. Revenue cycle management company Visiquate raises $50 million, bringing their total to $70 million. Truveta raises $95 million for its data analysis platform, and finally Bayesian gets $15 million using AI to predict sepsis. —Matthew Holt
Stealthy telehealth startup Wheel just closed a $50M series B and CEO Michelle Davey is here to reveal the mystery behind the company’s very behind-the-scenes approach to selling white-label virtual care. The business model is built on a network of clinicians that Wheel has curated and credentialed specifically for virtual care delivery – for a rotating cast of clients, under any brand, at any time. Unlike the market-leading incumbent telehealth co’s that also sell virtual care infrastructure, Wheel does NOT have a patient front door, isn’t angling for one, and is so protective of its clients’ brands that Michelle won’t even name names about who her company is working with. She simply describes her clientele as those in the biz of “next gen” virtual care: retail players, care-plus-pharmacy-delivery startups, asynchronous care providers, labs, remote patient monitoring companies, and so on.
Wheel experienced 300% year-over-year growth — and 1200% growth from Q4-2020 to Q1-2021 — but is it sustainable as the pandemic wans and other plug-and-play telehealth infrastructure services also gain market traction and funding? And, what about the common criticism that telehealth is too transactional and that both patients AND physicians prefer the opportunity to build deeper relationships? Do providers really want to practice for multiple companies at the same time? We get a look inside Wheel’s 90% clinician retention rate to see what else might be satisfying the clinician’s need to connect, and talk about areas for growth now that the company’s received fresh funds.
When I think of elevator operators, I think of health care.
Now, it’s not likely that many people think about elevator operators very often, if ever. Many have probably never seen an elevator operator. The idea of a uniformed person standing all day in an elevator pushing buttons so that people can get to their floors seems unnecessary at best and ludicrous at worse.
But once upon a time, they were essential, until they weren’t. Healthcare, don’t say you haven’t been warned.
Elevators have been around in some form for hundreds of years, and by the 19th century were using steam or electricity to give them more power, but it wasn’t until Elisha Otis debuted the safety elevator that they came into their own. New engineering techniques such as steel frames made skyscrapers possible, but safe elevators made them feasible; no one wanted to climb stairs for 10+ stories.
Those generations of elevators weren’t quite like the ones we’re used to. The speed and direction had to be controlled manually, the elevator had to be carefully brought to a stop at a floor, and the doors had to be opened and closed. Managing all this was not something that anyone wanted to entrust to passengers. Thus the role of the elevator operator.
Elevator buttons were introduced in 1892, electronic signal control in 1924, automatic doors in 1948, and in 1950 the first operatorless elevator was installed at the Atlantic Refining Building in Dallas. Full automatic control and autotronic supervision and operation followed in 1962, and elevator efficiency has steadily increased in other ways.
Elevator operators gradually transitioned from being mechanical operators to concierges, helping passengers find the right floors and making them more comfortable. A 1945 elevator operators strike in New York City had a crippling effect. As Henry L. Greenidge, Esq. wrote on Linkedin, “The public refused to go near the controls despite having watched the operators work the levers numerous times. The thought that a layperson could operate an elevator was simply an outrageous thought.”
Today on Health in 2 Point 00, the funding reports are out: Rock Health is saying $14.7 billion for the first half of the year, and Startup Health is saying $20.1 billion. Those numbers are pretty much what the numbers were for ALL of 2020. Now onto some deals: on Episode 221, Jess asks me about Novacardia raising $57 million for its cardiology practice management business. Wellthy raises $25 million, bringing its total up to $50 million – this is a caregiving navigation concierge firm aimed at employers. Osso VR raises $27 million in a Series B, less than a year after closing their A, working on virtual reality for practicing surgery. Finally, Form Health raises $12 million in a Series A for its obesity telehealth platform. —Matthew Holt
Privia Health ($PRVA) went public a few weeks ago and the stock not only popped when it hit the market, but has continued to rise. When you look at the numbers – and hear about the business model from CEO Shawn Morris – it’s easy to get excited and see why. Privia calls itself a “physician enablement” business, which is the two-word marketing way of saying that they bring together different docs in a region and give them the systems to become part of a value-based care network while also maintaining their private practices. They’re more or less building accountable care organizations (ACOs) in a hub-and-spoke fashion, uniting docs around Privia’s common tech systems, workflow processes, value-based care strategies, and contracting power with commercial and government payers. The model is appealing to docs who want to make the switch to value-based care, but still want the autonomy of their own practices. The value prop has already attracted more than 2,700 providers in 650 different locations netting the biz $817 million in revenue in 2020 – and Shawn says they’ll only expand from here. What’s the growth plan? Value-based care models are often criticized as “un-scalable” – what does Shawn say to combat that? A great, detailed chat that pitches a hopeful end to fee-for-service healthcare and a promising future for a newly public healthcare co.
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. Today we add to last week's fantastic list of speakers with another 14 great speakers, including one CEO of a company that has just SPACed onto the public market (Sharecare), and another that is about to (Babylon Health)! You can register here or learn how to sponsor. This week's new additions are:
For community cancer centers that rely on patient reimbursement to stay afloat, a smart data-driven approach to clinical trials provides a foundation for future growth.
By TANDY TIPPS and BRENDA NOGGY
Covid-19’s tragic, devastating impact on cancer treatment is now well documented. Cancer screenings dropped by almost 90 percent at the peak of the pandemic. Billing for some leading cancer medications dropped 30 percent last summer. Studies found a 60 percent decrease in new clinical trials for cancer drugs and biological therapies.
Cancer centers, like every part of the US health system, have a lot of ground to make up. Those community cancer centers without grants and other institutional advancement funds, experience financial and human resources as major constraints to charting a path to growth. For them, successful programs which generate revenues for expansion or break even help them maintain fiscal health. Often, unfortunately, too often their research programs lose money.
Clinical trials have not been a viable revenue source because of the difficulty in accurately predicting patient enrollment and the challenges of managing trial portfolios, a task that requires streamlined feasibility processes that include querying baseline populations for new trials and potentially eligible patients.
The hard work of patient screening and trial matching requires clinical coordinators, physician investigators and research support staff to spend between three to eight manually scouring databases of electronic medical records and unstructured files to find patients eligible for trials based on increasingly complex inclusion and exclusion criteria. This costly process does not take into consideration the pre-screening efforts in patient matching that may not be reimbursable.
Resources are also needed to implement feasibility processes to accurately predict how many patients might enroll in a trial if they are eligible. Most community-based sites do not have an accurate ability to query their current patient populations by disease cohort or mutation in real time. They often rely on physicians’ memories to estimate patient numbers for trial feasibility questionnaires, which must returned to sponsors quickly, usually before cancer centers have definitive recruitment numbers.
As a result, before COVID, an average of only 5 percent of patients had a chance of participating in trials, 50 percent of clinical trials failed to meet enrollment goals and less than 14 percent were completed on time. Cancer centers still incur the administrative and clinical resources required to maintain the protocols in the first place, however.
On Thursday’s #THCBGang Matthew Holt (@boltyboy) was joined by regulars, employer health expert Jennifer Benz (@jenbenz); patient safety expert and all around wit Michael Millenson (@MLMillenson); THCB regular writer Kim Bellard (@kimbbellard); privacy expert and now entrepreneur Deven McGraw (@HealthPrivacy); and–we were thrilled to have back–fierce patient activist Casey Quinlan (@MightyCasey). Lots of discussion about Casey’s latest patient experience as she continues to undergo the #METSparty.
If you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels