With all that has been going on, I’ve been remiss in reflecting on General Motor’s big announcement a couple weeks ago: it is going to have an all electric, zero emissions fleet of “light duty” vehicles (cars, SUVs, pickups) by 2035, and be carbon neutral by 2040. One of the largest manufacturers of internal combustion vehicles for over a hundred years is recognizing that its past is not its future.
Of course, I immediately wondered what the equivalent move in healthcare would be, and from whom.
In the announcement, GM Chairman and CEO Mary Barra declared:
General Motors is joining governments and companies around the globe working to establish a safer, greener and better world. We encourage others to follow suit and make a significant impact on our industry and on the economy as a whole.
You can just imagine Henry Ford fuming in his grave.
GM has had electric vehicles for some time, but they remain a small percentage of its business, as they do among the auto industry generally (Tesla’s market cap notwithstanding). GM had supported the Trump Administration’s policies efforts to rescind emission standards, which benefited internal combustion engines, but quickly changed course in light of Biden Administration priorities on climate change.
GM now plans to spend some $27b on electric and autonomous vehicles over the next few years. “We’re committed to fighting for EV market share until we are No. 1 in North America, Ms. Barra said at an investor’s conference. “EVs are core to creating GM shareholder value.”
Digital mental health startup Modern Health just closed a $74M Series D, bringing their funding total to $170M, and earning the company a $1.17B valuation that makes it the FASTEST-EVER female-founded company to hit unicorn status. CEO Alyson Watson explains what sets Modern Health apart in the incredibly crowded, well-funded, and highly-competitive mental health tech space where the growing issue of skyrocketing demand for care is likely soon to become a shortage of care providers.
Modern Health is hoping to win here by becoming a one-stop-shop for a full-suite of mental health services. They’re bundling together all the different kinds of mental health point solutions currently out there – from tech-enabled self-service cognitive behavioral therapy programs and peer-to-peer group therapy all the way to one-on-one virtual visits with clinicians – and differentiating by designing a better way to intake patients, so care can be more accurately and cost-effectively matched to patient needs. Says Alyson, “If you’re just solving mental health through the old-school way of connecting someone to a therapist, and that’s your be-all-end-all and your only solution…well, eventually, that bubble will burst.”
Founded in 2017, the company has grown both its client-base (220 employers) and coffers quickly. They’ve already acquired Kip, another digital mental health biz, and are looking for more. Tune in to hear what Alyson’s got on deck for 2021 and what she expects to be driving further growth in the mental health virtual care market.
Today on Health in 2 Point 00, Jess and I are back to cover more fun(draising) deals. First, Zocdoc raises $150 million and Jess asks me what’s going on with this old-school appointment scheduler? RapidSOS raises $85 million, bringing their total up to $220 in an infrastructure play for first responders, Capital Rx, which is a startup working to bring transparency to PBMs, raises $50 million, and eating disorder care startup Equip raises $13 million, bringing their total to $17 million.—Matthew Holt
Signify Health’s CEO Kyle Armbrester stops by on IPO day! Hours after ringing the bell on $SGFY’s launch on the New York Stock Exchange, Jess DaMassa digs into the health tech company’s $7.1B valuation and plans to help providers, payers, and self-insured employers scale-up their value-based care offerings. Kyle calls it “Value-Based Care 2.0” and, for the uninitiated, does a great job of stepping back and explaining this healthcare payment model’s history and how Signify is building its next-gen approach from the groundwork laid over the past decade.
What’s unique about Signify Health’s model is that it’s not just relying on tech to make it easier to find where managed care organizations can help cut healthcare costs and drive better outcomes – they also provide in-home health services that send nurses, doctors, and social workers out into patient’s homes to physically look for potential roadblocks to recovery and wellness. It’s in this critical “last mile” where Signify is possibly making the greatest impact, connecting the social determinants of health (physical environment, social support networks, economic status, etc) back into the healthcare system in a way that not only helps patients, but is also aligned with how all the stakeholders along the care continuum are incentivized. (And that includes Signify, which goes at-risk along with their clients and only gets paid when they drive better outcomes and cut-out costs.) So, what is the ultimate opportunity for this kind of “deep healthcare” business? We get into Signify Health’s business model, the competition, and its plans for growth and M&A activity now that they’re backed by $564M in capital from their initial day on the public market.
Just 45 days after Teladoc Health closed its $600 million acquisition of hospital telehealth provider InTouch last year, it turned around and announced a surprise $18B acquisition of Livongo, extending its reach into patients’ homes via the digital health startup’s remote monitoring platform for diabetes, hypertension, and more. Now, four months past the signing of that deal, and at the start of yet-another pandemic year expected to be big for virtual care, the two big questions healthcare market watchers have for Teladoc Health are: 1) how’s that double integration going? and 2) just how much pushback are you getting from health system clients that look at this “hospital-to-home” virtual care pathway as a little too close to their own business models? Jess DaMassa gets the latest from InTouch Health’s former CEO, now Teladoc Health’s President of Hospital and Health Systems, Joe DeVivo and Livongo’s former Chief Medical Officer, Dr. Bimal Shah, who’s now Teladoc Health’s Chief Medical Officer for Product and Analytics.
What’s the integration been like for our old friends from the InTouch and Livongo teams? What areas of the “hospital-to-home” digital infrastructure are priority for 2021? And, what about data integration? With more than 1-billion data elements from Livongo, 10.5 million visits on Teladoc’s platform, and 3.5-million Teladoc-enabled visits via hospital clients, it sounds like interoperability to provide “intelligence, not data” is paramount to the company’s strategy for driving growth. As Joe says, “Teladoc has just positioned itself to be “THE” partner to institutionalize virtual care for healthcare systems. Excellence around the delivery of care will always sit in the health system, but to the extent that we can improve the consumer experience in the onboarding into the healthcare system and to prop up our health system customers, all the better.” For lots more on winning over hospitals, outflanking the competition, and fully leveraging the AI-plus-AI engine Livongo built, tune in now.
The impeachment barely came up but several of us had direct experience of the chaotic vaccine rollout. Lots of speculation about what aspects of shoring up the ACA in the stimulus $1.9bn, and a bunch of discussion and disagreement about whether the lava is cooling in a new data and technology infrastructure on which to build a new health system. A great conversation.
The video is below but if you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.
For a vast majority of Americans, a coronavirus vaccine is like sleep for a new parent: It’s all you can think about, even if you have no idea when you will get it.
Because, as Kaiser Health Newsreported: “Many states don’t know exactly where the doses are, and the feds don’t either.”
Think about that: in 2021, we can’t – or don’t – track something as vital as where vaccine doses are, in the midst of the pandemic they were designed in record time to mitigate. Nor, as it turns out, are we doing a good job of tracking how many have already had them, who is now eligible for them, or assuring that essential workers or disadvantaged populations are getting them.
Amazon tells me when my purchases have shipped, where they are in the shipping process, and when they’ve been delivered. They even send me a picture of purchases sitting on my porch to make sure I notice. Walmart’s supply chain management is equally vaunted.
Health care executives evidently aren’t required to learn supply chain management.
Today on Health in 2 Point 00, we’ve apparently got 58 different SPACs looking to acquire health tech companies – so looks like Jess and I will be staying busy! On Episode 183, Jess asks me about Oscar Health filing their S1 and all the dirt people are digging up for IPO, Plume raising $14 million for their full stack clinic for transgender people, Sitka raising $14 million, and Alma raising $28 million providing practice management software for mental health providers. —Matthew Holt
The executive leadership team of UpHealth, the self-described “global digital health super-company” that’s headed toward the public market via a SPAC that’s brought together six companies, 10-years of health tech innovation, and a war chest of $285M dollars, stops by to talk about growth plans and grabbing market share. UpHealth’s Chairman & Founder, Dr. Chirinjeev Kathuria, Co-CEO & President Dr. Al Gatmaitan, and future COO Jamey Edwards talk through what Jamey says is “really a revenue story” about the fastest growth areas of digital health. Global telehealth, integrated care management, digital pharmacy, and behavioral health will be UpHealth’s sweet spots. The newco is positioning itself as a “one-stop shop” for the digital healthcare infrastructure that will support a local healthcare organization in rolling out digital care services and integrating them with their in-person care continuums. This is different than, say, a Teladoc or an Amwell, which in addition to providing infrastructure also have their own tech-enabled medical groups, which can sometimes be viewed as competitive to their customers. The global nature of UpHealth is another differentiator, particularly in how it hopes to ultimately make it possible for highly specialized care from the US to be “exported” to countries abroad AND for lower cost care for lower acuity issues to be “imported” in. With $190M in revenue projected for 2021 – and that’s NOT dependent on integrating the six companies – we talk through areas for potential growth, that aforementioned competitive landscape, and whether or not UpHealth is feeling the pressure to hurry their integration.
On January 26th, Philadelphia discovered that the 22-year-old organizer of its largest COVID-19 vaccination site, Andrei Doroshin, had turned away elderly members of the Philadelphia community from their vaccine appointments. Instead, he pocketed extra vaccine vials to administer to 4 friends and girlfriend. An RN witnessed the event and reported it to authorities.
For the people in the back: One can’t simply “Elon Musk” healthcare. We have seen this too many times – a privileged young upstart with little experience believes that s/he can transform healthcare and make millions – or billions – doing so. Examples abound: we only have to look a couple years into the past to remember Elizabeth Holmes, the Stanford dropout who founded Theranos and misrepresented its technology, or to Outcome Health, whose former CEO Rishi Shah defrauded investors by overinflating business metrics. If “move fast and break things” works in other sectors, many reason, why won’t it work in the 4 trillion dollar industry of healthcare?
Healthcare is simply not the kind of business where one can shoot a rocket into the sky and accept the risk that it might explode. Simply put, this is people’s lives we’re dealing with. But a deeper layer involves trust in the medical establishment. U.S. healthcare is already marred by multiple grave issues: a complex bureaucracy, serious health inequities, and astronomical costs that can bankrupt a person in just one hospitalization. The trust that people have in U.S. healthcare has steadily dropped over the years. Further, the politicization of the COVID-19 pandemic and the U.S. government’s bungled response to it has only sowed further distrust, especially among marginalized andminoritized communities.