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.
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.
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.”
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.
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
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.
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.
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.
In the wake of Pearl Harbor, FDR found our nation ill-prepared for war. He lacked manpower and tools. In response, he took deliberative action with the support of Congress, drafting soldiers and redirecting supply chains toward weapons of war. Compliance was requested, then demanded. Those industries that served, including Pfizer with penicillin production, benefited in the short and long-term.
FDR not only harnessed the power of industry and science, and ramped up the military, but also asked every family and every community to participate in the war effort. Community volunteering soared, and sacrifice for the public good was the rule, not the exception.
One idea was “victory gardens”, planted in back yards, to allow stressed food manufacturers the ability to focus on meeting the demand to “feed the troops.” These gardens in 1943 provided 1/3 of all the vegetables consumed in the states that year.
President Biden now finds himself in a similar predicament – the need to redirect our vast industrial productive capacity while mobilizing our citizens to both support and participate in vaccination efforts.
Our President and his team understand that interventional and privatized high science is of little avail if that science (in this case vaccines) is unable – by limited supply or logistic ineptitude or the absence of public trust – to find it’s way efficiently and quickly into the arms of our citizens.
Signify Health’s CEO Kyle Armbrester stops by on IPO day! Hours after ringing the bell on $SGFY’s launch on the New York Stock Exchange, Jess DaMassa digs into the health tech company’s $7.1B valuation and plans to help providers, payers, and self-insured employers scale-up their value-based care offerings. Kyle calls it “Value-Based Care 2.0” and, for the uninitiated, does a great job of stepping back and explaining this healthcare payment model’s history and how Signify is building its next-gen approach from the groundwork laid over the past decade.
What’s unique about Signify Health’s model is that it’s not just relying on tech to make it easier to find where managed care organizations can help cut healthcare costs and drive better outcomes – they also provide in-home health services that send nurses, doctors, and social workers out into patient’s homes to physically look for potential roadblocks to recovery and wellness. It’s in this critical “last mile” where Signify is possibly making the greatest impact, connecting the social determinants of health (physical environment, social support networks, economic status, etc) back into the healthcare system in a way that not only helps patients, but is also aligned with how all the stakeholders along the care continuum are incentivized. (And that includes Signify, which goes at-risk along with their clients and only gets paid when they drive better outcomes and cut-out costs.) So, what is the ultimate opportunity for this kind of “deep healthcare” business? We get into Signify Health’s business model, the competition, and its plans for growth and M&A activity now that they’re backed by $564M in capital from their initial day on the public market.
We are excited to announce that the campaign to pledge to the Participatory Medicine Manifesto is launching today — and we need your support!
Our Participatory Medicine Manifesto is a call to action for patients, caregivers and health care professionals to equally share decision-making and respect one another.
We want you and your organization to help us fix a broken healthcare system from the ground up. We want to put democracy back into the culture of healthcare by enabling patients, healthcare professionals and caregivers to all have an equal voice. We need your influence to inspire people. We will list individuals and organizations that support the Manifesto.
We have designed a promotional campaign encouraging people to pledge to the Participatory Medicine Manifesto. As part of this campaign, we created a pledge form and social media toolkit for people and organizations to use in spreading the work about Participatory Medicine.
And spread the word to your colleagues and friends to help us reach our goal. After you pledge you will find the easy to use social media toolkit.
We greatly appreciate your help and support!
Eric Bersh, Judy Danielson, Kevin Freiert, Matthew Holt, Dr. Danny Sands, Amber Soucy—all board members of SPM
