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Category: Health Tech

Rumor Check with Vida Health’s CEO: Buyer Sentiment on Virtual Care, At-Risk Models, Mental Health

By JESSICA DaMASSA, WTF Health

To hear Vida Health’s CEO Stephanie Tilenius talk about what she’s hearing from payers, providers, and employers about at-risk value-based models, the shift to virtual care, and the growing importance of mental health services as a culture-builder for businesses forced into a part-virtual-part-in-office world, you get a sense of how her past work leading the various payments and commerce businesses of Google, eBay, and PayPal probably comes in handy. For example, the shift to virtual care, she says, is, “like the Internet in 1999…It’s happening.”

We get an update on exactly how Vida Health is making it happen themselves, and how they expect their newly expanded at-risk model will help. Vida’s always been fees-at-risk on physical outcomes related to diabetes management, hypertension, etc. BUT the mental health side of their offering (which experienced 6000% growth year-over-year during the pandemic) is now at-risk on outcomes too. With so much happening across the industry to move to value-based models, we deep-dive with Stephanie to hear what she’s hearing from her clients, including client-and-investor Centene and hear about growth in the employer market where she sees a major shift in how employers are thinking about healthcare as the new sexy job perk. “Instead of snacks or transportation or other benefits,” says Stephanie. “It’s all about healthcare.”

THCB Gang Episode 72, Nov 18 1pm PT – 4pm ET

Following last week’s sojourn in Europe where I couldn’t quite pull an impromptu European-based THCB Gang together, we are back on home turf. Join me at 1pm PT – 4pm ET Thursday 18th November when I’ll host delivery & tech expert Vince Kuraitis (@VinceKuraitis), the double trouble of vaunted futurists Ian Morrison (@seccurve) & Jeff Goldsmith, and Consumer advocate & CEO of AdaRose, Lygeia Ricciardi (@Lygeia).

The video is below and if you’d rather listen, the “audio only” version it is preserved as a weekly podcast available on our iTunes & Spotify channels a day or so after the episode — Matthew Holt

How Unhappy are Patients with Info Coming from Providers, Payers? Pega’s Survey Shows It’s Not Good

By JESSICA DaMASSA, WTF HEALTH

Is this a big surprise? Even during Covid, Pega’s annual 2,000-person Patient Engagement Survey shows that 63% of patients are unhappy with the communication they receive from their payers and providers. Which begs the question… just how bad was it before? (Answer: 86% unhappy– yikes!)

Pega’s VP of Healthcare & Life Sciences, Kelli Bravo, has run this survey three years and counting and drops in to share the highlights (if we can really call them that) of the survey results and how she thinks enterprising young health tech startups can capitalize on the opportunity to help.

For those in the business of trying to talk to patients — which is all of us — let’s look at this as a wake-up call. Let’s stop speaking “health care” and start using language everyone can understand about their care, what it will cost, and what all the options really are. Pega is attempting to do its part in that department, and we get an update on how they’re fairing at helping to make healthcare feel more like retail. The rise of the healthcare consumer is a real thing. Now, with new data to back up claims about what they’re demanding in terms of how they prefer to be talked to and communicated with.

Click to see the data and report on Pega’s site.

WTF Health: Transcarent, Walmart & The “Re-making” of Healthcare Payers: Glen Tullman on the Power of Big Retail

By JESSICA DaMASSA, WTF HEALTH

Days after announcing their deal with Walmart, Transcarent’s Executive Chairman & CEO Glen Tullman and meet again (in-person!) to pick up our conversation right where it left off. For the details about the deal, see our last interview; for what the deal signifies for the disruption of the healthcare payer and the ultimate rise of the healthcare consumer, tune in now and take note.

The plot of Transcarent’s story is starting to take shape. Their conflict is with the “big middle” of healthcare where drugs are marked up, care needs pre-authorizations, and docs labeled “this is NOT a bill” are ridiculous artifacts of a payer-first healthcare experience.

“The system behind our healthcare today is working exactly as its designed: for payers. We want to re-design that,” says Glen. “It’s not, ‘how do we get through that better?’ That would be navigating. It’s ‘how do we go completely around that and re-design the experience?’”

Glen talks us through the leverage retailers like Walmart and Amazon really have to help take on non-innovative payers what role Transcarent is playing in all of this, and how startups like GoodRx, Ro, and Capsule who are successfully challenging PBMs are demonstrating that payment model innovation is possible.

And, while we wait for the next big deal to come from ‘healthcare’s best dealmaker, we’ve got some foreshadowing: a quick mention of Oscar Health that registered on my radar as interesting, along with some very specific details about how Transcarent will expand its offering next, looking at MSK, cancer care, behavioral health (particularly for teens), and bringing in more “human voices” for their members to turn to for advice.

Update from Olive: CEO Sean Lane on Putting $850M+ Funding to Work

By JESSICA DaMASSA, WTF HEALTH

There was lots of chatter at HLTH 2021 about the fact that healthcare AI unicorn, Olive, showcased its brand-bedecked touring bus on the show floor. Some expressed disdain about whether or not this was really the best use of more than $850M in funding, while others quickly (and literally) jumped on the bandwagon of the company’s quest to go door-to-door to win over hospital-after-hospital with its “Internet of Healthcare” vision. But, to hear CEO Sean Lane talk about it all – including what’s happening at Circulo, the less-than-a-year-old Medicaid plan being built on top of Olive’s infrastructure – the bus might actually be a grand metaphor for a company continuing to “move fast and fix things” despite the typical stop-and-start nature of innovating in healthcare.

Sean gets us up-to-speed on the latest at Olive: its growth (he says the company is “growing by one mid-sized company each month”)… its expanding client base which now also includes more and more payers…and its own new status as a full-service clearinghouse, thanks to its Olive Assures product that instant pays claims to hospitals and completely eliminates the cost of collection associated with these types of payments. And this is just what you can see of the road ahead from the dashboard! On the horizon, is whatever will be built on top of the Olive infrastructure, and Sean gives us insight as to what’s on the itinerary.

Olive launched “The Library” at HLTH, which is a “marketplace” where other tech companies, including competitors, can sell into Olive’s client base any technology – clinical, operational, administrative, or otherwise – that can help automate healthcare. Sean talks about how this marketplace, along with Olive’s recently launched venture fund, are just parts of what they’re doing to build healthcare’s first TRUE platform business. (You’ll have to listen in to hear how he’s defining platform…) So, what’s in store for our legacy “platforms” like EMRs in the future if/when this more open, democratic type of platform thinking takes off? And, what about the first company already being created from scratch on said platform? You can see how passionate Sean is about building Circulo as the “Medicaid Plan of the Future,” and we get into some examples of elements this new plan will offer its members: primary health sites, “Circulators” that bring telehealth into neighborhoods via tricked-out Sprinter vans for those on the other side of the digital divide, and payment model features (zero prior auths, zero denials, payment immediately) that sound a lot like what Olive is enabling in hospitals with traditional payers. There’s a lot to hear in this one!

WTF Health: Included Health’s CEO Owen Tripp on Grand Rounds, Doctor-on-Demand Merger & New Name

By JESSICA DaMASSA, WTF Health

A sign of effective ‘merging-and-acquiring’ among innovative healthcare companies? How about a new brand-name? The company known as “Grand Rounds Health and Doctor on Demand,” which merged in March 2021 and quickly acquired LGBTQ+ virtual care company, Included Health, announced that the company would be moving forward as Included Health from here on out. We get into the strategy behind that name-change – and, more importantly, how the integration of the three companies is going – from CEO Owen Tripp.

This quick update covers how the navigation-plus-virtual-care co is prioritizing integration at-scale for millions of members – unlike other growing healthcare companies who Owen says have, “acquired companies, but haven’t put them together.” From member experience, clinician experience, and the business model backing all of this, we get a state-of-play on Included Health, including Owen’s take on the rising popularity of at-risk models among competitors Accolade Health and Transcarent, the legacy relationship the company has with Walmart, and how small/mid-sized employers are increasing area of focus for growth.

Reflections on HLTH2021: The Lens of the Patient and Carepartner

By GRACE CORDOVANO

Attending HLTH 2021 in-person in Boston solidified that there is no comparison between attending live vs. virtual conferences.  While content and presentations can be solid both virtually or in-person, it is the energy of the connections that are made between scheduled presentations and the conversations that are shared throughout that move the needle. Kudos to the organizers of HLTH 2021 for prioritizing the safety of all in-person attendees with COVID-19 vaccination requirements, proof of negative PCR testing within 3 days of arrival, and mask requirements on-site.

After reflecting on all the proceedings, the conversations, and the experiences at HLTH 2021, here are eight reflections on the event from the patient and carepartner perspective.

1) Patients and Carepartners (Not) Included

These words were the taglines of HLTH2021:

Dear Future: We’re coming for you. #HLTH2021

The largest and most important conference for health care innovation

A battle cry for improving health care, but I can’t help but wonder, who’s “we’re”?

The agenda and stages at HLTH2021 were filled with some of the biggest, most respected names in the health care ecosystem. Unfortunately, no patients were speaking from these stages. A search of the agenda and speaker list for “patient” showed entries for “patient experience” or “patient” in the form of an executive title. Many panels and discussions fell short of the real-world experiences of living life with a diagnosis or multiple comorbidities, the difficulties of barriers to healthier living that are caused by social determinants of health (SDoH), and disgraceful realities of the inefficiencies of workflows patients and their families face. There were no patient or carepartner champions sharing the positive impact that a company’s brand has had on their or their loved ones’ lives.

Continue reading…

THCB Gang Episode 70, Oct 28 1pm PT – 4pm ET

Joining Matthew Holt (@boltyboy) on THCBGang Thursday were policy consultant/author Rosemarie Day (@Rosemarie_Day1); Queen of all employer benefits related issues Jennifer Benz (@Jenbenz); ; fierce patient activist Casey Quinlan (@MightyCasey); and Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune).

With bills in Congress and billions in VC floating around health care, there was plenty of fodder for discussion. We also got into a robust discussion about Medicare Advantage versus traditional FFS. But just so happened that with Casey Quinlan H.U.M.A.N., Jennifer Benz, Jean-Luc Neptune, MD MBA & Rosemarie Day we had four people who are either cancer survivors or care givers for cancer patients or both. If you are Adam Pellegrini, Gena Cook, Liz Horgan, Maya Said or anyone else who cares about helping people with cancer navigate the system the last 10 minutes of this are market research gold for you

You can see the video below and the audio will be on our podcast channel (Apple/Spotify) from Friday — Matthew Holt

WTF Health: Inside the One Drop – Bayer Collaboration: New Cardiovascular Disease Product Is Just the Beginning

By JESSICA DaMASSA, WTF Health

Bayer’s $98M co-development-plus-investment in One Drop from August 2020 has yielded its first new product: a highly-personalized, AI-powered digital program aimed at preventing cardiovascular disease. While the solution itself is impressive in terms of its predictive analytics and integration into One Drop’s chronic condition precision health platform, what’s really remarkable about this milestone is that it demonstrates what’s possible when a pharma co and health tech startup are truly aligned as businesses, from R&D to go-to-market.

Bayer Pharmaceuticals’ CIO and Head of Digital & Commercial Innovation Jeanne Kehren and One Drop’s CEO Jeff Dachis take us inside their collaboration, with a very candid conversation about how their two orgs have not only developed a new product here today but how they’ve established a solid foundation for a working relationship that’s poised to revolutionize chronic care and define a new market around precision health.

We talk strategy: for Bayer-One Drop… for what the “digital disruption” will bring to pharma… and for “putting a lab on everybody’s arm” via One Drop’s sensor that’s under development. This chat reveals how the thinking behind incumbent-disruptor partnerships has truly evolved, and what it will mean for bringing digital technologies into healthcare in a big and meaningful way. For me, hearing Jeanne say, “it all starts with pharma being ‘self-aware’” and that they need to “we stop slicing things into therapeutic areas and consider the individual” AND recognize that “not everything is going to be process-oriented and shaped like we do for drugs” is a sea-change from what we were hearing only a few years ago from pharma execs about partnering with health tech companies. Things are changing! Tune in to hear so much more.

WTF Health: Inside Scoop – Medicaid Mental Health Startup Brave Health Lands $10M

By JESSICA DaMASSA, WTF HEALTH

Healthcare startups serving the Medicaid population are FINALLY catching the attention of investors and, this time, it’s for improving access to mental health services. Brave Health’s CEO Anna Lindow and I catch up in-person at HLTH 2021 – under super-secret embargo – to talk about Brave’s $10M Series B funding which was just announced today.

We get into Brave Health’s virtual-first approach to therapy, psychiatry, and outpatient addiction services, its tech underpinnings (which Anna hopes makes her services feel like “magic” to patients and providers alike), and the best-and-most-challenging parts about working with Medicaid plans.

This funding round, which takes Brave Health’s total funding to over $20M, should help with surmounting one of Anna’s biggest challenges: the extra effort required to expand to new states and the new set of Medicaid requirements and regulations that meet her every time she crosses state lines. Still, Brave Health has already expanded into 10 states in two years and, when utilized by Medicaid case managers, providers, and plans, is making a real impact on outcomes and cost of care. We dive into the details about meeting the mental health needs of a population that has typically been misunderstood and marginalized, and talk more about the nuances of supporting innovation and investment in solutions for people with Medicaid.

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