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Saints, Sinners, & the Spirituality of the SPAC Church | Politics, Policy, Power

By EMILY EVANS

Takeaway: Policy changes have overtaken many health care SPACs but that won’t stop a lot of telegenic advocates; something is sure to go wrong.

Politics. Something is sure to go wrong.

Over 400 SPACs have formed and about 100 business combinations announced. At least as far as health care goes, excluding biotech and pharma, the quality of the business combinations has thus far been uninspiring.

Deerfield’s CareMax/IMC Medical, Jaws’ Cano Health are focused on the very crowded Medicare Advantage market just as demographic realities require attention to shift toward younger people. Falcon’s ShareCare, GigCapital2’s Uphealth/Cloudbreak, Hudson’s Talkspace are yet more digital platforms to manage care. VG’s 23andMe wants to monetize all the genetic data it has collected through drug development.

Absent durable business models that address the core challenges of health care such as price, efficiency and quality, SPACs seem to be relying on charismatic personalities to win over investors, great and small, regardless of their experience or credibility. So much so, Twitter entreaties from Chamath Palihapitiya’s fan-base have taken on the tone of religious followers. “@chamath give @Clover_Health some love on Valentine’s Day what’s your position are you optimistic, excited, hopeful of its future? We would love to hear from you…”

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1896 – The Birth of Radiology

By SAURABH JHA and JEANNE ELKIN

Mr. Smith’s pneumonia was clinically shy. He didn’t have a fever. His white blood cells hadn’t increased. The only sign of an infection, other than his cough, was that his lung wasn’t as dark as it should be on the radiograph. The radiologist, taught to see, noticed that the normally crisp border between the heart and the lung was blurred like ink smudged on blotting paper. Something that had colonized the lungs was stopping the x-rays. 

Hundred and twenty-five years ago, Wilhelm Conrad Roentgen, a German physicist and the Rector at the University of Wurzburg, made an accidental discovery by seeing something he wasn’t watching. Roentgen was studying cathode rays – invisible forces created by electricity. Using a Crookes tube, a pear-shaped vacuum glass tube with a pair of electrodes, Roentgen would fire the cathode rays from one end by an electric jolt. At the other end, the rays would leave the tube through a small hole, and generate colorful light on striking fluorescent material placed near the tube. 

By then photography and fluorescence had captured literary and scientific imagination. In Arthur Conan Doyle’s Hound of the Baskervilles, the fire-breathing dog’s jaw had been drenched in phosphorus by its owner. Electricity and magnetism were the new forces. Physicists were experimenting in the backwaters of the electromagnetic spectrum without knowing where they were. 

On November 8th, 1895, when after supper Roentgen went to his laboratory for routine experiments, something else caught Roentgen’s eyes. Roentgen closed the curtains. He wanted his pupils maximally dilated to spot tiny flickers of light. When he turned the voltage on the Crookes tube, he noticed that a paper soaked in barium platinocyanide on a bench nine feet away flickered. Cathode rays traveled only a few centimeters. Also, he had covered the tube with heavy cardboard to stop light. Why then did the paper glow?

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#Healthin2Point00, Episode 185 | Modern Health, Owlet, & Mymee

On Episode 185, Jess has beat us to an interview on WTF Health before we cover it here on Health in 2 Point 00 – Modern Health raised $74 million in a Series D, so how does this compare to other mental health and wellness companies? Owlet is going public via a SPAC for their infant monitoring tech, and Mymee raises $8.7 million for patient self-tracking on the autoimmune disease front. —Matthew Holt

THCB Gang Episode 43, Thursday Feb 18, 1pm PT – 4pm ET

THCB Gang was broadcast live on Thurs Feb 18

Joining me, Matthew Holt (@boltyboy) were THCB regular writer Kim Bellard (@kimbbellard), patient advocates Grace Cordovano (@GraceCordovano) and Robin Farmanfarmaian (@Robinff3), newly-minted VC Marcus Whitney @marcuswhitney, and medical historian Mike Magee @drmikemagee.

We touched on the impact of the extremes of global warming on health! And in a pandemic nonetheless!. Plus the wild world of SPACs, more funding for mental health, and the sausage making of health care’s place in the upcoming stimulus bill. But I’m not sure the group is ready for the big policy move that the pandemic may give us the opportunity to pursue! A great conversation nonetheless.

The video is below but if you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

The Habit Change Provider? Newtopia & the Case for a New Category of Healthcare Provider

By JESSICA DaMASSA, WTF HEALTH

Chronic disease prevention is often lumped into chronic disease management – but should it be? Aren’t there different nuances to preventing diseases than to treat them? Making the case that healthcare’s “primary prevention” businesses deserve their own category is the CEO of Newtopia, Jeff Ruby. Newtopia’s just announced the creation of a new category of healthcare provider, the Habit Change Provider, in effort to more accurately describe the role of companies working to change the way people behave in their everyday lives. What they eat, whether or not they exercise, how they deal with stress and anxiety – in short, this is the business of influencing the many micro-decisions that, cumulatively, add up to our overall health and whether or not we’ll be impacted by “lifestyle diseases” like diabetes, obesity, heart disease, mental health issues, and more.

Newtopia’s been in this business for over a decade, starting its path to commercialization with Aetna and a three-year randomized control trial of more than 2,800 Aetna employees that proved the power of prevention: physical risk reduction, clinical cost savings, and the “holy grail” of any population health model, in-year ROI. So confident is Newtopia in their approach that the company goes at-risk on outcomes, a compelling enough value proposition to attract clients like Accenture, JP Morgan Chase (and it’s now defunct joint-venture with Amazon and Berkshire Hathaway, Haven) and the whole of CVS Health (which acquired Aetna.)

Is this starting to sound different than those chronic condition management companies yet? Listen in to hear more about the details behind Newtopia’s approach, which even leverages genetic testing to “remove blocks for habit change” by helping people identify what they’ve inherited from their parents (slow metabolism, difficulty processing fats, body’s ability to handle stress signals) so they can get past blaming themselves and start developing healthy lifestyle improvements.

Health Care Needs Its Mary Barra

By KIM BELLARD

With all that has been going on, I’ve been remiss in reflecting on General Motor’s big announcement a couple weeks ago: it is going to have an all electric, zero emissions fleet of “light duty” vehicles (cars, SUVs, pickups) by 2035, and be carbon neutral by 2040.  One of the largest manufacturers of internal combustion vehicles for over a hundred years is recognizing that its past is not its future.

Of course, I immediately wondered what the equivalent move in healthcare would be, and from whom.   

In the announcement, GM Chairman and CEO Mary Barra declared:

General Motors is joining governments and companies around the globe working to establish a safer, greener and better world.  We encourage others to follow suit and make a significant impact on our industry and on the economy as a whole.

You can just imagine Henry Ford fuming in his grave.

GM has had electric vehicles for some time, but they remain a small percentage of its business, as they do among the auto industry generally (Tesla’s market cap notwithstanding).  GM had supported the Trump Administration’s policies efforts to rescind emission standards, which benefited internal combustion engines, but quickly changed course in light of Biden Administration priorities on climate change.

 GM now plans to spend some $27b on electric and autonomous vehicles over the next few years.  “We’re committed to fighting for EV market share until we are No. 1 in North America, Ms. Barra said at an investor’s conference.   “EVs are core to creating GM shareholder value.”

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Modern Health’s CEO on Becoming Digital Mental Health’s Latest Unicorn

By JESSICA DaMASSA, WTF HEALTH

Digital mental health startup Modern Health just closed a $74M Series D, bringing their funding total to $170M, and earning the company a $1.17B valuation that makes it the FASTEST-EVER female-founded company to hit unicorn status. CEO Alyson Watson explains what sets Modern Health apart in the incredibly crowded, well-funded, and highly-competitive mental health tech space where the growing issue of skyrocketing demand for care is likely soon to become a shortage of care providers.

Modern Health is hoping to win here by becoming a one-stop-shop for a full-suite of mental health services. They’re bundling together all the different kinds of mental health point solutions currently out there – from tech-enabled self-service cognitive behavioral therapy programs and peer-to-peer group therapy all the way to one-on-one virtual visits with clinicians – and differentiating by designing a better way to intake patients, so care can be more accurately and cost-effectively matched to patient needs. Says Alyson, “If you’re just solving mental health through the old-school way of connecting someone to a therapist, and that’s your be-all-end-all and your only solution…well, eventually, that bubble will burst.”

Founded in 2017, the company has grown both its client-base (220 employers) and coffers quickly. They’ve already acquired Kip, another digital mental health biz, and are looking for more. Tune in to hear what Alyson’s got on deck for 2021 and what she expects to be driving further growth in the mental health virtual care market.

#Healthin2Point00, Episode 184 | Zocdoc, RapidSOS, Capital Rx and Equip

Today on Health in 2 Point 00, Jess and I are back to cover more fun(draising) deals. First, Zocdoc raises $150 million and Jess asks me what’s going on with this old-school appointment scheduler? RapidSOS raises $85 million, bringing their total up to $220 in an infrastructure play for first responders, Capital Rx, which is a startup working to bring transparency to PBMs, raises $50 million, and eating disorder care startup Equip raises $13 million, bringing their total to $17 million. —Matthew Holt

A Stretched Profession: How Much Longer Can Healthcare Workers Hang On

By JUDY GAMAN

Among those in the field, it’s been referred to as the Covid Tour of Duty. Doctors, nurses, and support staff working around the clock on high alert, in many cases seeing the worst effects of our world-wide battle against the pandemic. Even those non-hospital workers, especially those in primary care, are being pushed to their limits with no definitive end in sight.

Long before the pandemic, the alarm bells were sounded due to an aging population, which by nature requires more healthcare. That population was being met with shortage of physicians and nurses. Couple that with the pandemic—which has claimed the lives of many healthcare workers, and burned out those that remain—and the shortage becomes the next industry crisis.

Patients with post-Covid sequelae will need ongoing care and may require more visits to their primary care for years to come. Without an adequate push for educating more doctors and nurses, the American population will be met with a continued shortage, now of massive proportion. Opening borders during a pandemic is equivalent to pouring gasoline on the fire, as the country is currently short pressed to take care of their own.

A survey from Mental Health America ( https://mhanational.org/ ) that surveyed healthcare workers from June through September 2020 showed that more than 75% were frustrated, exhausted or overwhelmed. In addition, 93% were experiencing symptoms related to stress. Those same workers are still going full-speed-ahead five months later.

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Why We Need Good Primary Care Physicians

By HANS DUVEFELT

I have made the argument that being the first contact for patients with new symptoms requires skill and experience. That is not something everybody agrees on.

One commenter on my blog expressed the opinion that it is easy to recognize the abnormal or serious and then it is just a matter of making a specialist referral.

That is a terribly inefficient model for health care delivery. It also exposes patients to the risks of delays in treatment, increased cost and inconvenience and the sometimes irreversible and disastrous consequences of knowledge gaps in the frontline provider.

UNNECESSARY SPECIALIST REFERRALS ARE COSTLY

Seeing a high charging, high earning specialist when the primary care provider can’t diagnose and manage the condition involves higher cost and, in many cases, a comprehensiveness that is based on the fact that the patient traveled 200 miles for their appointment. In such cases patents aren’t likely to come back for a two week recheck. Consequently, specialists tend to do more in what may be the only visit they have with a patient.

UNNECESSARY SPECIALIST REFERRALS CREATE TREATMENT DELAYS

For my patients, seeing a neurologist involves a one year wait for the out of state neurologist who does consultations almost 100 miles from my clinic, or a three to four month wait for an appointment more than 200 miles away in Bangor. The situation for rheumatology or dermatology is about the same.

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