The Health Care Blog – Page 117 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Did Glen Tullman Just Launch Another New Category? Transcarent the ‘Health Experience Company’

Jun 29, 2021

By JESSICA DaMASSA, WTF HEALTH

For those keeping score at home, Glen Tullman is scaling up Transcarent faster than he did Livongo. The startup just closed a $58M Series B, bringing its total funding just shy of $100M. In less than 8 months. What’s the hurry? Have we ordered the balloons for the IPO yet? Glen says he’s out to fix the core problem first, and, in this interview, we get into the details about what that problem statement is all about and you might be surprised.

This is more of a payment model story than anyone may have all initially realized. And, while we may keep trying to put Transcarent into the “healthcare navigator” box or call it a “second opinion service” or a “centers of excellence play,” the truth is that those are all means to achieve a much larger end, which is about redefining the healthcare experience and its payment model for self-insured employers. Remember when Livongo created its own category of care (applied health signals) because they didn’t fit in with what a ‘chronic condition management’ company meant to the market? Well, I think Glen just used this interview to soft-launch a new category of healthcare company here again with Transcarent…

“People always try to put us in a category,” says Glen. “Are you a navigator? No, we’re not a navigator. We do navigation. Are you a health management company? No, we’re not. Are you a supplier? No, we’re not. Are you a PBM? No, we’re not. But we do all of those things to create an experience and that’s why, when you think about it, we’re a health experience company and that’s a new category that no one has.”

I get Glen to talk specifics about what this really means — directly managing healthcare spend for employers in a ‘category-creating’ completely at-risk way – and the examples really do help bring it to life. So does hearing about how he sees Transcarent as completely different than Accolade or Grand Rounds, which are often listed as competitors.

What other trouble do we get into in this 30-minute mega chat? OF COURSE I get his take on this year’s record-breaking investment into health tech, whether or not he thinks we’re in a bubble, and how Amazon, Walmart, and other non-traditional players are going to impact healthcare moving forward. Lots of insights in this one!

Health Tech: Part II –Powering Up The Vision

Jun 28, 2021

By MIKE MAGEE

Few can disagree that, in the fog of the Covid 19 pandemic, health technology entrepreneurs have been on a tear. In the first year of Covid’s isolation induced new reality, digital health companies experienced a $21.6 billion investment boost, double that of the prior year, and four times 2016 funding.

By year two, the investment community exhibited some signs of self-restraint by raising a few open ended questions. For example, in early 2021, Deloitte & Touche led a Future of Health panel at the J.P. Morgan Healthcare conference, reporting that “panelists suggested that entrepreneurs need to go beyond products that simply improve processes or solve existing problems.”

Panelists predicted that virtual health delivery services will expand; consumers will demand greater involvement including expansion of home diagnostics; and investment driven mergers and acquistions will explode – all of which has proven to be true.

Adding push to shove, Deloitte added this final nudge: “Entrepreneurs who define new markets, dominate them with a strategy people can understand, and extract value will likely be the most successful.”

Forty years ago, in the early beginnings of Health Tech, words similar to those above triggered cautionary tones from traditionalists. For example, Dr. John A. Benson, Jr., then President of the Board of Internal Medicine, stated “There is a groundswell in American medicine, this desire to encourage more ethical and humanistic concerns in physicians. After the technological progress that medicine made in the 60’s and 70’s, this is a swing of the pendulum back to the fact that we are doctors, and that we can do a lot better than we are doing now.”

He accurately described the mood then, and for most of the 20th century, of academic clinicians toward technology, a complex love-hate relationship that has rejoiced and cheered on progress, while struggling to accept and master change in a manner that would avoid driving a wedge between academicians, clinicians and patients.

#Healthin2Point00, Episode 218 | Bicycle, NexHealth, Stork Club, DrChrono & Pear Therapeutics

Jun 25, 2021

On Episode 218 of Health in 2 Point 00, it’s a big week in digital health for IPOs. Today Jess asks me about Bicycle Health’s $27 million Series A, bringing the substance use disorder startup’s total to $32.3 million. NexHealth, which is like Shopify for doctors, gets $31 million in a Series B, Stork Club raises $30 million in a Series A, and DrChrono raises $20 million for its EHR. Finally, Pear Therapeutics is SPAC-ing out with a $1.6 billion valuation. As we all know, DTx is my favorite category of health tech so tune in for what I have to say about this one. —Matthew Holt

Health Tech, Part I: Where We Are Going, Not Just How Fast We Can Get There

Jun 25, 2021• 4

By MIKE MAGEE

What will be the lasting impact of the Covid 19 pandemic?

We still don’t know the answer to that question in full. But one thing that can be said with some certainty is that it has strengthened the hand of Big Tech and all things virtual. Consider the fact that within the Biden White House administration, 13 senior aides have Big Tech resumes with time spent in firms like Google, Facebook, Twitter, Apple, Amazon, Microsoft and more.

This pandemic-induced scrape with mortality has instigated widely varied responses ranging from existential re-awakenings to explosive entrepreneurship.

In health care for example, health tech start-up’s are altering research, education, care delivery and coordination, data mining, patient privacy and financing.

As we know well from health care, intermingling profit, policy and politics can eventually lead to conflict and recrimination. The current controversy over NIH indirect funding of Shi Zengli’s Wuhan “gain-of-function” viral research through Peter Daszak’s New York based EcoHealth Alliance is a case in point.

But we’ve been there before. In the 1990s, James M. Wilson received a PhD and an MD degree from the University of Michigan, then completed an internal medicine residency at Massachusetts General Hospital and a postdoctoral fellowship at MIT. By 1997, he was one of the leading stars in the new gene-therapy movement, directing his own research institute at the University of Pennsylvania.

The institute focused on adjusting the genes of children born with a hereditary disease called ornithine transcarbamylase deficiency (OTD), which prevents the normal removal of ammonia in the body. Wilson’s experimental technique involved genetic engineering, splicing therapeutic genes into supposedly harmless viruses that, once injected into the body, could carry their payload to defective cells and repair the genetic errors.

Dr. Wilson was attempting to determine the maximum dose of genetically modified material that could be safely injected into affected youngsters. He had enlisted 18 participants, including a teenager named Jesse Gelsinger who had a version of the genetic disease in which some of his liver cells carried the genetic abnormality but other cells were entirely normal. Those who have the full-blown disorder die in early childhood. But with his mosaic, Jesse most of the time felt well, as long as he continued to take 32 pills a day.

Healthcare’s New “Operating System”: Amwell’s CEO Says Incumbents are Re-Thinking Telehealth

Jun 24, 2021

By JESSICA DaMASSA, WTF HEALTH

“We have to look at telehealth as an operating system.” Amwell ($AMWL) President & CEO Roy Schoenberg has a way with analogies, and some of his best land in this interview as we get a highly detailed, insider’s perspective about how payers and health systems are rethinking telehealth as a result of their experiences during the pandemic.

Bottom line: The pandemic taught us that telehealth can be used to deliver a much wider variety of healthcare services than just urgent care and, so the whole idea of ‘telehealth’ is changing from healthcare product to healthcare infrastructure. Mental health care, physical therapy, medication management, primary care, and more have all moved to telehealth and, along with that shift, the “rules of engagement” around those services have started to change.

Payers are looking to become the “digital front door” for their members – providing primary care and navigation. Health Systems are increasingly looking to use their own docs for urgent care, rather than outsource that relationship and miss the potential to build trust with local patients. And, in all this, Roy argues that healthcare’s biggest buyers have stopped looking at telehealth as a “product” and, instead, are starting to see the opportunity to “rewrite their future” around a view of telehealth as infrastructure, as one of healthcare’s “foundational systems” intertwined with (and as mission-critical as) their EHRs or claims and eligibility systems.

My favorite analogy starts around the 20-minute mark, when Roy explains this operating system idea by drawing comparison to how individual Microsoft programs (think Word, Excel, Outlook, PowerPoint) would be infinitely less powerful if they were not running on the same operating system and able to easily transfer information. Another good one? How both the buying and provisioning of healthcare is being re-thought digitally, just as online shopping not only changed buying habits but also changed supply chain for retailers. If you’re looking to hear the latest on what’s happening in telehealth post-Covid, learn how things have changed for payers and health systems, AND also want to dip into Amwell’s market positioning a bit, you’ll love this deep-dive.

THCB Gang Episode 59 – Thurs June 24, 1pm PT – 4pm ET

Jun 24, 2021

#THCBGang will feature special guest venture capitalist & massive over-achiever Justin Norden (@JustinNordenMD) from GSR Ventures. Also joining Matthew Holt (@boltyboy) will be regulars, patient safety expert and all around wit Michael Millenson (@MLMillenson); WTF Health host & Health IT girl Jessica DaMassa (@jessdamassa); futurist Ian Morrison (@seccurve); & THCB regular writer Kim Bellard (@kimbbellard)

Then video will be below at 1pm PT- 4pm ET. If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

Doctor-Patient Relationships: I Don’t Babysit – I Want to Empower

Jun 23, 2021• 1

By HANS DUVEFELT

I have known doctors that cultivated a dependence among their patients by suggesting their health and safety depended on regularly scheduled visits and laboratory testing for what seemed to me stable, chronic conditions. People would come in every three months, year after year, to review cholesterol numbers, potassium levels and glucose or blood pressure logs and have a more or less complete physical exam every time. Patients would also get scheduled for rechecks of ear infections and other simple conditions I always thought patients can assess themselves.

Compare the effort on the part of the physician with that type of practice versus seeing stable patients less often, doing more urgent care, and being more available for new patients. The first approach seems comfortable, possibly complacent, and the second more demanding, but also more satisfying, at least to me. My goal is always to make my patients as independent and self sufficient as they can be. I don’t want them to be dependent on me in an unhealthy way.

It is a matter of temperament, but it is also a matter of stewardship and resource management if we see ourselves as serving the populations and communities around us.

Maybe it is because of my Swedish upbringing and education, but I would feel guilty if sick patients or even relatively healthy people don’t even have access to a personal physician if I were to spend my days over-monitoring stable conditions.

In this medically underserved state, don’t we have a responsibility to consider whether we are getting too comfortable in our chronic care routines? Patients check their own blood pressures and glucose levels. They could get in touch if their numbers worsen. Do we really need to bring them in to make sure they don’t stray when there are people in our communities without access to care?

I sometimes actually use the phrase “I don’t babysit”. I don’t necessarily use the word “empower”, but that is what I always try to do with my patients.

Senior Caregiving Startup Papa: “Hanging Out & Helping Out” Backed by Health Plans & $91M in Funding

Jun 22, 2021

By JESSICA DaMASSA, WTF HEALTH

Since it was founded in 2017, “family-on-demand” senior care startup Papa has raised a whopping $91M from a veritable who’s who of health innovation investors. How has this startup that matches “authentically nice people” up with seniors to “help out and hang out” convinced the likes of Tiger Global, Comcast Ventures, and Canaan Partners (and those are just the investors who chipped in for Papa’s $60M Series C round this April) to invest? And, probably more importantly, how has Papa won more than 40 health plans as clients (a number set to triple for 2022) EAGER to foot the bill to provide their members with the support of a Papa Pal?

Founder & CEO Andrew Parker walks us through the business model and what it will and won’t be providing in the near future. Companionship, house help, chatting, and grocery shopping all fall under the purview of a Pal – so does filling non-clinical gaps in care like making annual check-up appointments, picking up prescriptions, and providing telehealth tutorials. Andrew says Pals are like “ninjas for a health plan,” building relationships and trust one weekly visit at a time. With 240 million people that could get access to a Papa Pal either via a Medicare, Managed Medicaid, or even employer sponsored health plan (good employees with aging parents need caregivers…) the potential for growth is tremendous. Will the biz hit a ‘supply’ issue? How long do Pals stick around? As we work to combat loneliness, isolation, and a myriad of social determinants of health issues within a rapidly expanding senior population, find out what Andrew thinks will keep Pals around and the service sticky for seniors, their real families, and their health plans.

Better Broadband for Better Health Care

Jun 22, 2021

By KIM BELLARD

Here’s a question that we don’t often ask: which is the U.S. more likely to accomplish – getting everyone health insurance, or broadband? Hint: it’s probably not what you think.

The health insurance part of it is often debated. We passed ACA, but the number of uninsured stubbornly remains at nearly 30 million, almost 10% of the population. Still, except for residents of those 12 states that have refused to pass Medicaid expansion, everyone in the country has at least access to public or private health insurance, with subsidies available to many.

Broadband hasn’t been around as long a health insurance, but it has become an integral part of our society, as the pandemic proved (ever try remote work or learning without broadband, much less telehealth?). Unfortunately, some 20 million households lack broadband; assuming an average household size of about 2.5, that’s some 50 million people, which is way more than the number of uninsured.

Welcome to the digital divide.

Everyone seems to agree increasing access to broadband is a good goal. It’s part of President Biden’s proposed infrastructure plan, and even many Republicans support some funding towards the goal, as in a recent bipartisan proposal.

We often think about the issue as being a rural problem, similar to the problem of electricity availability in rural areas before the Rural Electrification Act (1936). It’s just hard, or at least expensive, to wire all those vast spaces, those farms and small communities that comprise much of America.

The fact of the matter, though, is that of those 20 million households without broadband, some 15 million of them are urban households. A higher percent of rural households may lack broadband, but, in terms of actual numbers of households lacking it, it is urban dwellers. For the most part, broadband is available in their neighborhood; they just can’t afford it (or don’t see the need).

Connection Is Healthcare

Jun 21, 2021• 1

By TOMER BEN-KIKI

The American people can’t afford partisan politics that increase long-term healthcare costs.

When the GOP came to the table with a $1 trillion infrastructure proposal last week, I was pleased to see that they had increased funding for broadband access to $68 billion.

The President wants $100 billion for broadband expansion, but a meaningful increase before the soft deadline of June 7 was a positive step.

Politics aside, the pandemic made it clear how dependent we are on the issue of broadband internet access.after all, broadband underpinned nearly everything that was done to keep the economy on life-support during the lock-downs.

Without broadband access our ability to deliver education, run most businesses, and (most importantly) deliver healthcare, would have slowed to a glacial pace or – in some cases – ground to a halt.

The fact that the healthcare industry was able to make a lighting-speed pivot to telehealth during the COVID epidemic shows how quickly the government, insurers and providers can respond to deliver needed care. But, that pivot also exposed how social determinants of health, like economic stability and the built environment, still present serious challenges to care delivery for our most vulnerable populations.