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Category: WTF Health

Ribbon Health & Provider Data’s Holy Grail: The Accurate Provider Directory

BY JESSICA DaMASSA

It’s one of the greatest mysteries of the era of health data digitization: Why is provider directory still so hard to get right?? Ribbon Health’s co-founder & CEO Nate Maslak explains how Ribbon (which started out in the symptom-checker biz) pivoted to take on, once-and-for-all, the miserable state of provider data management to not only fix provider directories (which are still wrong 50% of the time!), but also referral management systems, health plan enrollment data, and now, thanks to those new price transparency rules, price lists.

“All of the different use cases we focus on around enrollment, referral management, provider data management for directory…” explains Nate, “These are actually the same problem that use different words to describe it because of the different parts of the ecosystem that we’re in.” So, as Ribbon gets the process right for provider directory by building an underlying tech platform that uses predictive analytics and network effect methodologies to work its magic to validate-and-verify that kind of healthcare data, then it can apply that framework to ANY healthcare data to the same end. And, maybe one day, layer member-facing services – like instant-booking with a doc – on top of them.

Backed by nearly $54 million from Andreesen Horowitz and General Catalyst, and we get into what makes this startup’s take on one of the oldest healthcare infrastructure issues so appealing. From platform to business model (which serves a mix of health plans, provider orgs and patient-facing solutions) to grand plans for the future (which include figuring out how “API as a platform” can further productize provider data management and power care decisions) we chat with Nate on all things Ribbon Health.

Meet Voice Tech Start-Up Cardiokol

BY JESSICA DaMASSA

Early-stage health tech start-up Caridokol is developing technology that listens to the sound of a patient’s voice over a mobile phone, landline phone or smart speaker to detect and analyze vocal biomarkers that indicate that the patient may be suffering from disease. The voice tech co is proving its case first in detecting arrhythmias, which are often asymptomatic and usually go undetected until they’ve led to a more serious issue like a stroke.

Cardiokol’s CEO James Amihood explains the tech behind this first use case – which already has one US patent granted and is pending approval on three more – and his plans to expand the company’s base of vocal biomarkers to enter into new disease states and new markets. The company is currently raising a Series A funding round and is planning to expand from Israel and Europe to the US. How could the technology change the game for disease prevention, starting with strokes? James connects the dots to the big vision for the company’s future as he explains how Cardiokol’s tech is already providing those most at-risk of arrythmia a very cost-effective, simple-to-use way to screen and monitor their long-term heart health.

BREAKING: Headspace Health Acquires Shine App, A Diversity & Inclusion Self-Care Platform

BY JESSICA DaMASSA

Headspace Health’s CEO Russell Glass and The Shine App’s co-Founder & co-CEO Naomi Hirabayashi give us the inside story on deal that makes The Shine App’s award-winning, inclusive self-care and mental health platform a part of the Headspace Health family.

This is Headspace Health’s second acquisition this year, and we find out why they chose to ‘buy instead of build’ when it came time to refine and enrich the inclusiveness of their meditation, self-care, and mental health care offerings.

The Shine App brings 45,000 subscribers and 90 enterprise clients to the table, but what Russ points to as ‘stand-out’ is the quality of the content that Shine is built on, and the depth of understanding that their team has realized when it comes to the unique mental health issues that are facing minorities and other traditionally underserved populations. For example? Naomi talks about “representation burnout” which is its own brand of burnout that is often-experienced-but-not-often-named by people who suffer the pressures of being the “lone representative” of a minority population in a vastly homogenous workforce. Wow.

Tune in for more on what this acquisition will mean for Headspace, what Naomi and her co-founder Marah Lidey intend to do as new Headspace employees, how Shine will help Headspace’s Leadership Training program, AND some extra surprise bonus gems. Apparently, the BIGGEST DEAL yet for the full integration of Headspace-plus-Ginger is on the horizon and, OF COURSE, I find out if Russ got a chance to meet John Legend as part of Headspace’s Super Bowl commercial shoot.

Deep-Dive Into Availity’s Acquisition of Diameter Health

by JESSICA DAMASSA

“There’s $4-$4.5 trillion dollars of annual spend in the healthcare system. A trillion of that is administrative. And, some big chunk — some BIG number that you measure in the 100’s of billions of dollars – is waste. So, the TAM for what Availity and Diameter Health are going to do together is huge.” Russ Thomas, Availity’s CEO, is clearly excited about his company’s recent acquisition of Diameter Health and we ask him – and Diameter’s President & COO Mary Lantin – why this is such a big deal.

In the end, what this comes down to is making more sense of all the data that flows between providers and payers to automate where possible, find insights to improve business processes and workflows, and, ultimately, cut out that notorious “admin expense” that adds to healthcare cost without creating any value.

For twenty years, Availity’s been in the business of “translating” data from providers into a language health plans can understand, so payors could refine their own business processes and automate pre-auths, pay claims, etc. Diameter, on the other hand, deals in the world of clinical data and “upcycles” it into concepts and “digestible bites” that a health plan can use to automate an administrative workflow process with a provider and – get this – build a longitudinal health record that now Availity’s robust supply of claims and health plan data can fully flesh out.

How excited are Russ and Mary about the idea of this comprehensive, longitudinal, fully-integrated clinical-plus-claims patient record? Much more excited than even I anticipated! Tune in for all the details on the merger and this BIG vision for scaling up the fight against healthcare’s massive spend on administrative waste.

The Tech Layer for Home-Based Care? Tomorrow Health Hopes To Network-ize Home Health

BY JESSICA DaMASSA, WTF HEALTH

Home-based healthcare is the stuff of tomorrow – literally. Tomorrow Health just closed a $60M Series B to grow their tech infrastructure biz into what CEO Vijay Kedar hopes will ultimately streamline and optimize how home health is ordered, delivered and paid for. This is the software that *could* be the thing that not only gets patients into home-based set-ups faster (vastly improving upon the up-to-90-minutes it currently takes providers to set-up home care for patients) but also creates a system for all stakeholders to track and monitor patient outcomes with an aim at the much larger, long-term opportunity: to realign incentives on value instead of fee-for-service.

Vijay came out of Oscar Health, meaning there is definitely a payer slant to the way this software is designed and deployed. Payers are Tomorrow Health’s clients, and it offers them a way to organize (or completely create, in some cases) home care networks out of the hundreds of different small, local market suppliers and providers that get medical equipment, skilled and unskilled services, and other in-home care elements to the doorsteps of the patients who need them. For a Geisinger Health Plan or Aetna – two of Tomorrow Health’s marquee clients – the software alleviates the pain of scaling this concept in every market while also providing a way to track what’s happening with the patient and build a “bridge” back into the health system that’s leading the patient care team.

With so many other players working in the home-health space – everyone from retail players like Walgreens/CareCentrix and Best Buy/Current Health to upstarts like Signify Health, Honor, and more – how will this tech stack approach play out against others that are one-stop-shops with frontline care and coordination layered on top? Will these ultimately be Tomorrow’s next clients?? Tune in to find out.

Quantifying Caregiving: ARCHANGELS CEO Alexandra Drane on The Caregiver Intensity Index

By JESSICA DaMASSA, WTF HEALTH

“Being an unpaid caregiver is the epicenter of Life Sucks Disease,” says Alexandra Drane, Co-Founder & CEO of ARCHANGELS, “but it’s also one of the most glorious, one of the most magnificent jobs we’ll ever have.” So, what’s the trick to managing the “sucky” side of caregiving? Data.

Alex’s company ARCHANGELS has invented the Caregiver Intensity Index, which she describes as a “two-and-a-half minute Cosmo quiz” that helps caregivers quantify the intensity of their caregiving experience and identify the top two things driving that intensity and the top two things alleviating it. The score coming out of this helps caregivers validate the intensity of their experience, offers a framework for communicating about it, and, as Alex puts it, delivers “data that gives them permission to believe” that the stress they are feeling is real. ARCHANGELS then uses the info to crosswalk caregivers to existing resources that can help them manage those intensity-driving challenges – whether they be related to financial stress, workplace stress, relationship stress or otherwise.

Knowing that health plans and employers are starting to “see the light” when it comes to caregiving and its impact on their workforce, Alex and I talk about just how much payers are really willing to contribute to supporting the resources needed to support caregivers and how the data ARCHANGELS is providing is helping demonstrate need and connection to health and well-being. Lots of interesting data points on caregiving in this one – particularly when it comes to mental health and how things have changed through the pandemic. Watch now!

Forget Micro-Networks: How Avaneer Health is Building The One Health Data Exchange to Rule Them All

By JESSICA DaMASSA, WTF HEALTH

What BIG thing is Avaneer Health building with its $50 million SEED round backed by not-just-investors-but-also-partners CVS Health, Aetna, Anthem, Cleveland Clinic, HCSC, PNC Bank, Sentara Healthcare and IBM Watson Health? CEO Stuart Hanson stops by to clear-up the mystery that IS Avaneer Health, and how the massive data exchange platform it’s building is meant to connect the data coming out of the biggest payers and biggest providers in healthcare, directly and in real-time.

Hang on – is this the blockchain-based data exchange healthcare has been talking about for more than a decade?? It sure is trying to be. And what Stuart says is different about Avaneer’s effort is, indeed, the fact that it’s backed by some of the biggest brands in the business and that they see the business case in being able to more effectively share their data with one another. As he explains it, “this problem of data interoperability and data fluidity is bigger than any competitive business model that they need to worry about…”

Stuart is careful to explain what Avaneer IS and what it IS NOT, and this is critical to the company’s growth plans and revenue model. Avaneer is NOT a data intermediary; it’s not about aggregating data, normalizing it, de-identifying it, or applying any fancy machine learning algorithms to it to deliver “insights” on it. Avaneer is strictly a platform for secure, compliant data exchange, so, for example, Anthem can connect to Cleveland Clinic in real-time and verify insurance coverage. The revenue model is currently built around access to the network and will one-day-soon also take in fees from ‘Solutions Innovators’ (aka data-aggregating, algorithm-loving, insights-dropping health tech companies) that will offer their services as add-on’s to Avaneer’s customers who are plugged into the network.

What’s ahead for this stealthy start-up as it scales? Could they REALLY be looking to raise a follow-on seed round?? Find out what kind of investors they’re looking for and what’s ahead on their product roadmap in this in-depth chat.

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.

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!

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