Is healthcare on the way to ‘telehealth at-scale?’ We checked in with American Well’s Danielle Russella, President & GM of Health Plan Solutions, to rumor-check the buzz we’ve been hearing about “digital-first health plans” and what that means for the future of health plan coverage for telehealth services. From provider uptake and payment parity to patient awareness and utilization, Danielle weighs in on the state-of-play of telehealth/health plan relations and how digital health seems to finally becoming part of payer strategy talks within the C-suite. At American Well, that’s meant more growth in last 2 years than in the previous 8 years, says Danielle. Is that why we’re hearing those IPO rumors? Tune in to find out if there’s any merit to that chatter.
The drought is over! On Episode 93 of Health in 2 Point 00, Jess and I talk deals, deals, deals. Ginger, which provides digital mental health services, raises $35 million and is growing quite fast; VillageMD, one of numerous companies who are trying to figure out a new way to do primary care, raises $100 million; Health Recovery Solutions, which does remote patient monitoring, gets $10 million. In other news, Livongo’s stock price collapsed a little bit, but it was crazy when it first came out so now prices are more “normal”; uBiome files for bankruptcy, and Tula Health’s $2.5 million raise gets quite possibly the best press release we’ve ever seen (you’ve got to hear this). —Matthew Holt
“Kijan ou ye? How are you?” I asked my patient, a fifty-five year-old Haitian-American woman living in Dorchester, Massachusetts. It was 2008. I had been her primary care doctor for two years and was working with her to reduce her blood pressure and cholesterol levels. “Papi mal dok– I’m doing ok doc.” We talked for 15 minutes, reviewed her vital signs and medications, and made a plan. I then electronically transmitted a new prescription to her pharmacy. The encounter was like thousands of others I’d had as a physician, except for one key difference– I was in Rwanda, 7,000 miles away from Dorchester and 6 hours ahead of the East Coast time zone.
At the time, I knew that telemedicine – the practice of providing healthcare without the provider being physically present with the patient – was a resourceful means of working with rural populations that have limited access to healthcare. However, I had no idea that just ten years down the road, many health professionals and policymakers would laud the emerging tech field as the answer to inaccessible healthcare for rural communities. While I’m aware of telemedicine’s promising benefits, I’m certain that it cannot, on its own, solve the most pressing issues that continue to afflict the rural poor and underserved.
Ever since the invention of the telephone, providers have been practicing telemedicine. However, not until the advent of advanced technologies such as high-speed internet, smartphones, and remote-controlled robotic surgery, has the field of telemedicine started to beg the question: “Do we still need in-person interactions between patient and doctor to provide high quality healthcare?” This question is particularly important for patients who live in rural areas, where a chronic shortage of providers has existed for decades.
Today on THCB Spotlights, Matthew talks to Brooke LeVasseur, who is the CEO of AristaMD. AristaMD provides eConsults to empower providers to get patients faster access to care. The average wait time to see a specialist is one to two months, and the proportion of referrals to specialists that never happen can be incredibly high, at 40% in Medicare populations for instance. AristaMD aims to provide an efficient way for primary care providers to tap into the expertise of specialists to immediately start executing on a treatment plan without the patient having to wait or travel. Tune in to find out how AristaMD is actually rolling this out and get a demo of the platform.
Today on Health in 2 Point 00, Jess and I are getting in the spirit of things with this week’s Democratic debate. In Episode 87, Jess asks me about Omada Health’s $73 million raise, bringing its total to $200 million, and about what happened with nursing home telehealth startup Call9 shutting down. We turn to politics with Trump telling HHS to have hospitals publish their price list—and it’s unclear that this is even going to make a difference—and to health care coverage in the Democratic debate. —Matthew Holt
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
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.
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.
According to healthcare leader Toby Cosgrove, THIS is “the year of telehealth.” Although Teladoc CEO Jason Gorevic would rather use the phrase ‘virtual care’ to describe the space, he’s pretty much on board with the idea that more consumers than ever will jump onto the virtual care bandwagon this year. How will Teladoc’s partnership with CVS play a role? Any other acquisitions on the horizon? Gorevic gets real about what’s impacting utilization rates and whether or not he’s worried about Teladoc competing with Apple, Google, and Amazon. (Hint: He’s not.)
Filmed at JP Morgan Healthcare 2019 in San Francisco, January 2019.
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
