Joining Matthew Holt (@boltyboy) on #THCBGang on April 21 for an hour of topical and sometime combative conversation on what’s happening in health care are: patient safety expert and all around wit Michael Millenson (@MLMillenson); digital health guru Fard Johnmar (@fardj); delivery & platform expert Vince Kuraitis (@VinceKuraitis); and a special guest – Alexandra Drane (@adrane) the queen of caregivers everywhere.
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.
Joining Matthew Holt (@boltyboy) on #THCBGang on April 14 for an hour of topical conversation on what’s happening in health care and beyond were fierce patient activist Casey Quinlan (@MightyCasey); futurists Ian Morrison (@seccurve) & Jeff Goldsmith; Jennifer Benz (@Jenbenz); and policy consultant/author Rosemarie Day (@Rosemarie_Day1).
Lots of chat about McKinsey and conflicts of interest, what’s next with COVID, where employers are now, and Casey has a unique idea about how to profit from data brokers.
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.
In this episode of Health Tech Deals, Jess thinks the music has stopped as Rock Health reports Q1’s funding total being below Q4 2022! No $100m rounds today! But still $37m for Real; $40m for Iris Telehealth; only $16m for 9am Health but lots of Livongo connections; $30m for Eko and $15m for Papa-lookalike Duos
3 big deals for this episode of Health Tech Deals! Tiger, General Catalyst, and e-Patient Dave are back! Check out this episode to hear my thoughts on them and on new deals in health tech: Viz.ai raises $100 million, PocketHealth raises $16 million, Eleanor Health raises $50 million, Recora raises $20 million, and Vytalize Health raises $50 million.
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
None of this is any great surprise. Over the past three decades, the big hospital systems have become more concentrated in their markets. They’ve acquired smaller community hospitals and, more importantly, feeder systems of primary care doctors. Meanwhile they’ve cut deals with and acquired specialty practices. For more than two decades now, owned-physicians have been the loss leader and hospitals have made money on their high cost inpatient services, and increasingly on what used to be inpatient services which are now delivered in outpatient settings at essentially inpatient rates. Prices, though, have not fallen – as the HCCI report shows.
Source: HCCI
The overall cost of care, now more and more delivered in these increasingly oligopolistic health systems, continues to increase. Consequently so do overall insurance premiums, costs for self insured employers and employees, and out of pocket costs. And as a by-product, the reserves of those health systems, invested like and by hedge funds, are increasing–enabling them to buy more feeder systems.
What’s with my baseball hat? Find out in this episode! Apparently, someone thinks my hair is a bit out of control and needs some trimming. In this episode of Health Tech Deals, Jess and I review Clarify Health raising $150 million; Season raising $34 million; Altoida grabbing $20 million; nirvanaHealth getting $60 million; and Pluto Health raising $9 million–Matthew Holt
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
For my health care tidbits this week, the controversy about Medicare Advantage is getting louder and louder. There’s no question that it results in lower out of pocket payments for its members than traditional FFS Medicare. Medicare Advantage members use fewer services, and their care appears to be better “managed” –then again FFS Medicare’s “members” are barely managed at all.
But the big question is, Does Medicare Advantage save the government money? Critics (notably ex CMS veterans Berwick & Gilfillan) claim that risk adjustment games played by the private plans who run Medicare Advantage have cost up to $200bn over 10 years. Medpac (the independent body that advises Congress) estimates that “Medicare spends 4 percent more for MA enrollees than it would have spent if those enrollees remained in FFS Medicare” and go on to say “In aggregate, for the entire duration of their Medicare participation, private plans have never produced savings for Medicare”. However data from the Medicare Trustees and other research from ACHP & the trade group Better Medicare Alliance suggests that Medpac’s analysis is incorrect and that Medicare Advantage saves the government about 9% per enrollee.
THCB ran a long piece (pt 1, pt 2) about Medicare Advantage from former Kaiser Permanente CEO George Halvorson earlier this year, and a related one from current Permanente Federation CEO Richard Isaacs. But it’s much more nuanced than that. J Michael McWilliams has long piece on Health Affairs Forefront trying to capture the various strands of the argument. His conclusion? “The substantial subsidies MA receives are largely responsible for the extra benefits and have more than offset savings from any efficiencies, posing a net cost to Medicare and complicating assessments of MA’s added value.”
Meanwhile CMS has just changed the most controversial aspect of risk adjustment (which is the most controversial part of Medicare Advantage) by banning the plans from doing it, and only allowing providers to be involved.
Whether any of this is going to change CMS regulations or wider government policy regarding MA payments is less certain. CMS is currently dealing with its replacement for the even more controversial Direct Contracting (now called ACO REACH). But Medicare Advantage is the most profitable part of private health insurance and has many knock on effects for care services and technology. So I’ll be watching this space and you should too!
Exciting things are a-happening in the Medicaid space! Two new female CEOs are being announced today in City Block Health and in Centene! In this episode of Health Tech Deals, Jess and I discuss new leadership changes in the health tech space, as well as new deals: Huma buys Astra Zeneca Digital; Afterlife raises $22 million; Timedoc Health raises $48.5 million; Avive raises $22 million; Antidote Health raises $22 million.
Joining Matthew Holt (@boltyboy) on #THCBGang on March 24 for an hour of topical and sometime combative conversation on what’s happening in health care and beyond were fierce patient activist Casey Quinlan (@MightyCasey); patient safety expert and all around wit Michael Millenson (@MLMillenson); THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); and back from his travels in Mexico and medical historian Mike Magee (@drmikemagee).
Special guest this week was population health and primary care expert Ines Vigil, who developed that program at Johns Hopkins but now hangs her hat at Clarify Health &is the author of Population Health Analytics. We dived deep into what populations health means. What we need to do to make it work and whether it’s real or not!
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.
May the luck of the Irish be with the health tech sector and may everybody’s valuation go back to where it was for the St. Patrick’s Day episode of Health Tech Deals! In today’s episode, Jess asks me about Doctolib’s €500 million raise with a massive €5.8 billion valuation – this is a doctor booking service and more in Europe. We also cover specialty pharma company House Rx’s $25 million raise, bringing their total up to $30 million, SmithRx’s $27 million raise for its flat-fee PBM, Synapse Medicine’s $28 million raise doing medication management, and Kintsugi’s $20 million raise for its voice biomarker mental health tech. —Matthew Holt
TRANSCRIPT
Jessica DaMassa:
What’s that over there? Is that a little leprechaun sitting next to a pot of gold at the end of a rainbow? No, it’s just Matthew Holt. May the luck of the Irish be with the health tech sector and everybody’s valuation goes back to where it was in the summer of 2021. It can only be the March 17th ,St. Patty’s day, episode of Health Tech Deals.
Matthew Holt:
So, Jessica you’re from Chicago, right?
Jessica DaMassa:
I am.
Matthew Holt:
And they have the big St. Patrick’s Day Parade there and they dye the river green?
Jessica DaMassa:
They dye the river green. Nobody believes it but it’s true.
Matthew Holt:
So why don’t they dye it blue the rest of the year?