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Local Doctors Get the “Centers of Excellence” Treatment: Embold Health’s CEO on Data-Driven Quality

By JESSICA DaMASSA, WTF HEALTH

Apparently, self-insured employers hot on better managing their healthcare spend are finding truth (and dollars) in Embold Health’s mantra that “quality is the best, most sustainable way to control costs.” This health tech startup is applying the old “Centers of Excellence” framework to the individual physician level; helping identify high-performing primary care docs and specialists in local markets for employers who not only want to offer their employees better quality care, but also improve the healthcare system in the communities in which they live and work.

Daniel Stein, Embold Health’s co-Founder & CEO, explains the company’s model, which is being perfected with one of the most demanding-yet-coveted “health activist” employers out there: Walmart. In this particular case, Walmart is actually incentivizing its employees to go to the providers ranked highest by Embold’s assessment, which looks at physician performance along three categories: 1) appropriateness of care; 2) outcomes; and 3) cost-effective compared to peers in-market. Backed by the robust national BlueCross BlueShield dataset, the information Embold Health is collecting, analyzing, and doling out to employers can definitely cause some health systems to take pause — and their docs to bristle. So, how does Embold Health diffuse potential blowback? Here’s where the competitive nature of local healthcare, particularly in the world of primary care, becomes clutch. Tune in to hear the details, including some very interesting stats, as well as Embold’s latest endeavors to help docs make better referrals to specialists.

One-Price, 30-Day Warranty, Payment at Discharge: Carrum Health’s CEO on Changing How We Buy Surgery

By JESSICA DaMASSA, WTF HEALTH

No copays. No coinsurance. No surprise out-of-network anesthesiologist fees or pre-op imaging bills. Just one, single price (that you see in advance) tells you EXACTLY what you’ll be paying for your surgical care on Carrum Health. Backed by the recent close of a $40M Series A funding round, the health tech startup’s CEO Sach Jain talks through all the ways his company is looking to disrupt how we buy surgical care. Standardized bundle pricing is just the beginning. Carrum requires its Centers of Excellence (and each of their docs) to pass a proprietary 50-point inspection before they can join the platform, AND every surgery must be backed by a 30-day Warranty! How have they convinced providers to jump through these kinds of hoops? With a growing client-base of self-insured employers (Sach says they have several Fortune 100 and Fortune 500 clients) and payment-in-full made to providers upon discharge, the case for additional revenue and zero A/R days is pretty compelling to a health system. And what about the other side of the business model? Tune in to find out why Sach believes Carrum Health’s “marketplace” approach will appeal to the growing base of “activist” employers whose HR benefits administrators are becoming more and more adept at building-their-own healthcare networks.

Medable’s CEO: Covid19 Vaccine Will Start Big Pharma’s Era of De-Centralized Clinical Trials

By JESSICA DaMASSA, WTF HEALTH

Covid 19 vaccine development may have mainstreamed questions about how to hasten drug development timelines, but Medable, a health tech startup that offers researchers a way to de-centralize clinical trials, has been working to solve this problem for five years. Freshly funded with a $91M Series C raise, co-founder and CEO Michelle Longmire talks through the benefits of “liberating” clinical trials from academic research centers and sending them onto devices into patient’s homes. Traditionally, drug development processes average more than 10 years, cost millions of dollars, and are limited in the diversity of patients they can recruit because of the heavy focus on the geographic location of the research team conducting the trial. Medable’s digital platform breaks these limitations, reducing drug development timelines and costs by making it easier for researchers to draw study participants from anywhere. More importantly, it makes the novel medicines being tested by the trial available to a bigger, more diverse array of patients. Despite the gains made in 2020 toward the de-centralized clinical trial model (Medable’s revenue shot up 500%), there’s concern that Big Pharma may return to the business processes of old once the pandemic is under control. Does Michelle think last year make enough of an impact to change their business model for good? Find out what’s ahead for the future of pharma.

Hims & Hers CEO on IPO, Push into Primary Care, Target & More

By JESSICA DaMASSA, WTF HEALTH

On the eve of the finalization of their SPAC IPO and New York Stock Exchange debut as $HIMS, Hims & Hers CEO, Andrew Dudum, sat down with Jess DaMassa to talk about his wellness company’s transition into full-on healthcare provider. With new primary care, mental health care, and covid19 testing services launched as a result of the pandemic, Hims & Hers has expanded beyond their initial dermatology and sexual health core to provide telehealth-plus-pharmacy services for a growing range of chronic conditions, mental health issues, and everyday health concerns commonly tackled by PCPs. How far into healthcare delivery will Hims & Hers go? What types of acquisitions or innovations will be necessary to compete with the likes of Teladoc/Livongo, Optum, or the slew of virtual-first primary care clinics currently vying to be healthcare’s “digital front door”? And, what are we to make of that fact that Hims & Hers has gone retail: appearing on the shelves of every Target store in the US? Healthcare’s changing, and we get a fired-up Andrew to wax philosophical on why companies like his — that are consumer-focused, disrupting the healthcare “experience,” AND slowly eroding the healthcare payment model with a customer base willing to pay out-of-pocket — will be leading the way to a next-generation healthcare model.

Hinge Health’s CEO on $3B Valuation, Stretch Toward 2022 IPO

By JESSICA DaMASSA, WTF HEALTH

Hinge Health kicked off 2021 with a massive $300M Series D, driving the digital health musculoskeletal care company to a $3B valuation that, normally, would have sent health tech pundits into full-on IPO rumor mode…except that Hinge Health’s co-founder & CEO Daniel Perez beat them to it! We get into the details behind those comments (from what shall now be known as “the chatty Reuters interview”) where he not only revealed the company’s IPO plans, but also talked about how Hinge is well on it’s way to hit $200M in revenue. If 2021 is a year that Dan says will be focused on getting the business “operationally mature” enough to go public, what, exactly will be on the agenda? We dive into the competitive landscape, talk market size (Dan says more than 50% of employees on employer sponsored plans already have access to Hinge Health), and explore whether or not there are designs to expand into comorbidities common to back and joint pain, like mental health, obesity, diabetes, etc. Says Dan, “We’re going to use the capital to really invest in our innovation and R&D team and to stay different. We’re not just going to do the obvious moves.” Tune in for all the details on exactly what that means and why Dan thinks it’s central to Hinge Health’s market leadership in the MSK care space.

Comcast, Independence BlueCross’s Quil: Fast-Forward Past Video Content to Home Sensors for Seniors

By JESSICA DaMASSA, WTF HEALTH

It’s not just eyeballs that Comcast NBCUniversal and Independence BlueCross’s joint venture, Quil, is after these days. Carina Edwards, Quil’s CEO, paints a compelling picture of the full-scale business model for “health-in-the-home” that her company is enacting. What started out with trusted healthcare content for surgery prep (able to be deployed across a household’s army of devices, including their TV for those 1.3M Comcast Xfinity cable subscribers) is now expanding with more tech and more services to meet the needs of seniors aging-in-place and the fifty million unpaid caregivers looking after them. Ambient, “context-aware” sensors. Voice integrations with smart speakers. And that’s nothing to say of the caregiver-focused programming that addresses everything from caregiver burnout to tackling tough conversations about a range of issues from paying for care to end-of-life wishes. Quil’s pilot of this new senior-focused offering will be rolled out with Comcast’s help this winter, with the full direct-to-consumer commercial launch expected in Q3 2021. As Carina says, “Comcast knows how to pilot technology.” And, Quil has shown its ability to impact healthcare quality measures thanks to studies around its initial surgery-prep offering. Will it be enough to take on others looking to help turn our living rooms into exam rooms? Tune-in around 17:20 to hear just how integrated Comcast and IBX are in the strategy at Quil.

Bayer G4A Agents of Change: Digital Health & the Future of Pharma

By JESSICA DaMASSA, WTF HEALTH

Lots of changes at Bayer G4A: a new investment thesis, new additions to their portfolio, a new Global Head of Digital Health to meet, and a hot new virtual health forum (a free one!) coming up on November 18, 2020. Dominick Kennerson and Sophie Park join us from Berlin, where they’ve got their eyes on the trends shaping the worldwide digital health market. Are pharma companies changing the way they look at digital health companies in the face of the pandemic? Have we gone, well, beyond “beyond the pill”? Dom says Bayer’s been ahead of the curve when it comes to prioritizing digital innovation, and that we’re all going to be “very surprised” in the next 12-18 months about what we see come out of one of the world’s largest life sciences companies. For more clues and additional insight on Bayer’s priorities when it comes to digital health and the future of pharma, give this interview a quick listen then register for G4A’s Agents of Change event. HINT: From the “mad genius” herself…the agenda for the event is Bayer G4A’s roadmap. Bold move!

For more on the Agents of Change event, visit www.g4a.health.

Covid-19, the “Quarantine 15” & Healthcare’s Focus on Weight Management in 2021

By JESSICA DaMASSA, WTF HEALTH

Potential digital health trend for 2021? Weight loss and weight management. Not only has obesity been an “epidemic” of its own for a number of years (40% of U.S. adults are obese, another 32% are overweight) BUT it’s also considered a risk-factor if infected with covid-19 and is a common co-morbidity for a number of chronic conditions. Add to that all the banana bread we’ve been seeing on Instagram and the “quarantine 15” memes that sum up the weight gain brought about by our increasingly sedentary, baked-goods-filled shelter-in-place lifestyles, and you can see where this is likely to go. So, how can health tech help? As healthcare payers and employers look toward weight management as a way to help prevent adverse health outcomes (covid-related or otherwise), we get some advice from Dr. Greg Steinberg, a clinical innovation expert who gained experience piloting novel, health tech solutions for weight management at Aetna. We demystify the relationship between healthcare payers and weight loss solutions, talk about what matters from a cost/value perspective, and, of course, find out what makes for optimal end-user success.

Accolade’s CEO Raj Singh: IPO Backstory & Pop Health Predictions for 2021

By JESSICA DaMASSA, WTF HEALTH

When Accolade went public in July at a $1.2B valuation, the BIG question facing the health tech unicorn pre-dated the covid-19 pandemic and the chaos facing its clientbase of large, self-insured employers: Could they scale? Raj Singh, Accolade’s CEO, tackles the question head-on, buoyed by customer growth that has doubled twice over a fiscal-year-and-a-half and an expanded need for his company’s high-touch, concierge health benefits navigation services. As beleaguered employers struggle with making sure their employees have the health benefits they need to weather the pandemic, Accolade’s focus on making sure that those benefits remain as cost-contained as possible seems to be more attractive than ever. What else is resonating with self-insured employers these days? Raj talks about what will (and won’t) change when it comes to population health management in 2021 and gives us a reality check on whether or not employers and their employees are really using digital health tools like Livongo, Virta, Hinge, Kaia, Ginger, et. al when baked into their benefits ecosystem.

Telehealth, Digital Health Market Update from Europe & Frontiers Health Preview

By JESSICA DaMASSA, WTF HEALTH

Looking for more proof that telehealth has truly become a global trend in healthcare delivery? Our “man-on-the-street” in Italy, Roberto Ascione, CEO of Healthware Group, offers a detailed state-of-play on virtual care uptake across Europe, including how policy-makers, entrepreneurs, and investors are playing much more significant roles in spurning an increasingly “digital friendly” healthcare ecosystem in the wake of covid-19. On the eve of Frontiers Health 2020 — one of Europe’s leading health innovation conferences, of which Roberto is Chairman — we find out how those backing healthcare’s quickly evolving “tele-everything” revolution are planning to come together to push this agenda even further.

Note: Frontiers Health takes place THIS WEEK, on Thursday November 12 and Friday November 13. Check out the full agenda at www.frontiers.health.  Fans of WTF Health get a discount! Just use code FH20WTF25 for 25% off registration fees. See you there!

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