Today on Health in 2 Point 00, Jess and I are back from Europe and there is a LOT going on in health tech right now. In Episode 86, Jess asks me about United Health’s big moves, between acquiring PatientsLikeMe and their acquisition of DaVita Medical going through; integrated mental health company Quartet Health raising $60 million; Xealth closing a $14 million round (maybe now they’ll make Epic relevant); Collective Health’s $205 million raise led by SoftBank,; Vida’s $30 million round led by Teladoc (who knows why Teladoc didn’t just acquire Vida); European telehealth company Zava raising $32 million; and finally, Phreesia going IPO (wasn’t Livongo the one to watch?). —Matthew Holt
Today on Health in 2 Point 00, I’m back (despite Jess’s attempt to replace me). In Episode 82, Jess asks me about Talkspace’s $50 million raise, Heal getting flack for adding telehealth to their house call service, and Apple acquiring Tueo Health last year—and we’re just now hearing about it. Jess also gets riled up by Pokemon Sleep and Pillo’s $11 million raise. —Matthew Holt
By REBECCA FOGG
In the 20th century, hospitals completed their transformation from the hospice-like institutions of the Middle Ages, into large, gleaming centers of advanced medical expertise and technology that save and improve lives every day. But an unintended consequence of hospitals’ dazzling capabilities is a staggering cost burden that’s proving toxic to the American economy.
Today, hospital care accounts for approximately 33% of the US’ $3.5 trillion annual health care expenditures, according to CMS. The drivers of hospital costs are complex and hard to tackle, including (but not limited to) market consolidation that enables price hikes, heavy administrative burdens, expensive technology and patient usage patterns.
In The Innovator’s Prescription, Clayton Christensen et al. explained another important driver of high hospital care costs: conflation under one roof of business models designed to address very different needs—such as the need for diagnosis of unique, complex conditions and experimental treatments, versus that for highly standardized services (for instance, some surgical procedures). This common phenomenon makes optimization of either business model very difficult, and thus drives up overhead costs.
One solution to this seemingly intractable problem is to make home and community the default locations for care, where in many circumstances it can be provided less expensively, more conveniently, and more effectively than in a hospital. Fortunately, business model innovation toward this end is gaining traction.
By ANN MOND JOHNSON
I’ve worked in enough start ups to know that creating something from nothing can be hard. It is especially tough when you must create a market and explain to people that what you’re doing isn’t nearly as heretical as it may sound. When my friends and I started Subimo in 2000, people wondered why they’d use our product to learn about hospital performance when (in their words) all they really needed was to have their doctor to tell them which hospital they should use. What people eventually realized was that there is variation in outcomes by hospitals and even by service lines within hospitals.
That’s why the recent spate of articles about the newly emerging direct-to-consumer companies in health care – the ones that are condition-specific like HIMS, Ro and Keeps – fascinate me. These are companies that have leveraged all we know about direct-to-consumer marketing and have identified an unmet market need. In some respects, they’re not dissimilar from companies like Simple Contacts or 1.800 Contacts or Visibly – companies that offer a convenient way for people to get what they need (in this case, good vision). Or companies that offer behavioral health services directly to consumers.
What do these companies have in common? Aside from a strong marketing foundation, they have identified a market need that can be met with a new approach that leverages technology. They are convenient, offer a high level of customer service and may even be easier to work with than traditional players.
By JESSICA DA MASSA, WTF Health
According to Toby Cosgrove, 2019 is “THE YEAR of telehealth.” The former CEO of Cleveland Clinic, who is currently an executive advisor to Google Cloud’s healthcare and life sciences team, proclaimed it as such to CNBC, saying that this year is “THE YEAR” telehealth becomes ubiquitous.
That’s a pretty bold statement – particularly as utilization rates for virtual visits continue to fall short of expectations – so we double-checked this prognostication with Teladoc’s CEO, Jason Gorevic.
Does he think 2019 is going to be telehealth’s turning point?
Well, although he’d rather call the space ‘virtual care’ instead of ‘telehealth’ (maybe this will be the difference maker?), he confesses he’s pretty much on board with Cosgrove’s assertion that more consumers than ever will visit virtual exam rooms this year.
How does 2019 become “THE YEAR” of virtual care? Is this going to be an industry-wide boon, or is Teladoc just banking on its partnership with CVS and their new family member, Aetna?
Tune in to hear Jason get real about what’s impacting utilization rates, how things are going to change this year, AND whether or not he’s worried about competing with Apple, Google, and Amazon for screen time. (Hint: He’s not.)
On Episode 67 of Health in 2 Point 00, Jess is appalled at the CDC’s salmonella warning for hedgehogs. But in other news, Jess asks me about uBiome, which has raised over $100 million, laying off over 50 people; Planned Parenthood’s new chatbot that helps answer teenagers’ questions about sexual health; and Lively’s recent $16 million raise for their telehealth hearing assessment platform. Don’t forget to stop by our booth at HIMSS in 2 weeks! —Matthew Holt
WTF Health – ‘What’s the Future’ Health? is a new interview series about the future of the health industry and how we love to hate WTF is wrong with it right now. Can’t get enough? Check out more interviews at www.wtf.health.
I guess he warned us that Teladoc was feeling ‘A-quisitive’ — the question now is are they done? A few weeks ago I spoke with Jason Gorevic, Teladoc’s CEO at the new HLTH Conference about consolidation in the telehealth space and what’s next for the virtual care giant.
Although he was mum on the company’s $352M mega-buy of Advance Medical, there was a shopping list of other solutions that seem to have caught Teladoc’s eye — everything from tech that turns Alexa into a telemed access point to NLP plug-ins and any number of shiny devices that make remote monitoring easier, less expensive, and more effective.
Perhaps an indicator of where they’ll look next as they continue to sweep up market share? Listen in on some of the details about their CVS partnership (VIRTUAL Minute Clinic, anyone?) and the VERY interesting talks he’s having with the country’s largest payers on redefining benefit designs to push virtual care first.
In this edition of Health in 2 point 00, Jessica DaMassa asks me about enterprise sales (Qventus, Medicity, Health Catalyst), DTC vs Enterprises as a market, the VA allowing nationwide telehealth,, and the TEAP & TEFCA frameworks (that last answer may have overran the 2 minutes a tad!) — Matthew Holt
Last week Avizia, where I’ve been the Chief Medical Officer since 2014, was acquired by American Well (AmWell). From my perspective, the merger made perfect sense. Avizia has been focused on chronically and acutely ill patients—those more directly attached to a hospital system. AmWell, on the other hand, has been the dominant solution for community-based care; it’s an online consultation service for folks who might otherwise have gone to an urgent care for problems like fever, headache, or a sore throat. Combining these entities provides a solution that spans the spectrum of care, which aligns with the needs of many healthcare systems. Issues related to patient access and satisfaction (think: less acute, community-based care) are top-of-mind for many administrators. However, with 80% of the dollars going to 20 % of the population, managing the continuum for the chronically ill (which is more in line with the mission of Avizia) is imperative to provide better care at a lower cost.
The merger also marks a predictable milestone in the common transition pattern for big ideas (internet, aeronautics, GPS, etc.)—from the military, to academia, to scalable business.
Telemedicine started as a military-run effort. NASA, concerned that astronaut healthcare issues would cause mission failures, was the first organization to devote significant funding to telemedicine research. Early ATA meetings were opened with military-sponsored presentations featuring the Telemedicine & Advanced Technology Research Center, a branch of the Army.
Next came academia. Millions of dollars in grant money were offered, but academics were no longer focused on the health of astronauts. Instead, the goal was providing care at a distance—to the citizens of Rural America. Many early leaders of the ATA came from the universities that built and deployed this technology.
Entrepreneurs are the third wave.Continue reading…
The US Federal Communication Commission’s reversal of Obama-era net neutrality regulations sets the stage for broadband internet service providers (ISPs) to slow or block certain content from reaching their customer’s screens. This is likely to have a significant and potentially negative impact on a healthcare system poised to go fully virtual in the coming years.
Healthcare consumers already depend heavily on internet search results for advice when making healthcare purchases. Coupling preferred content with existing search engine optimization strategies will undoubtably steer consumer behavior. What will be the result? The American healthcare market is unique, both in its expense (higher than any other nation), and its shocking lack of value. Some of this is due to misinformed consumers swayed by direct-to-consumer marketing. Arguably, repealing net neutrality may amplify the problem.
Even more troubling is the prospect of an ISP partnering with a health delivery system. Telehealth – the use of electronic communication technology for healthcare delivery – will become standard of care in the coming years. National telehealth have already managed to get a foothold in today’s highly competitive healthcare market, supplying a disruptive and potentially cost-containing force in the healthcare market. With the elimination of net neutrality, larger, more well-established healthcare delivery systems, seeking to defend or expand their marketshare, can now partner with ISPs to preserve internet “fast lanes” for realtime video doctor’s visits. Smaller, possibly disruptive companies, unable to make these same financial commitment to ISPs, may be marginalized or lost.