The Health Care Blog – Page 138 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Health in 2 Point 00 — with no video!

Dec 24, 2020

By MATTHEW HOLT (without JESS DAMASSA!)

Due to @jessdamassa being lost in America and my totally crap internet in the Sierras, there is no #HealthIn2Point00 this week.

So I’m going to write out a few things we would have said:

1. @OscarHealth raises another $140m and files to IPO. SPAC or no SPAC, a bunch of these startup health plans are going to try to get out the door while the window is open! 420,000 members ain’t a lot–I mean there are 5-6 Medicaid plans bigger than that in CA alone! I still predict someone big buys them but whether pre- or post crash I don’t know.

2. @LyraHealth is raising another $175m (apparently). That’s the 3rd trip to the well THIS YEAR! Mental health is sexy these days. Just how many online mental health cos can make it? I think Lyra needs to use these $$ for automated self-service tech, cos psychiatrists don’t scale, and they currently sell themselves as having a better network than anyone else.

3. @kyruus buys @HealthSparq (from @Cambia). No $$ announced. Unclear why a company that makes $$ routing patients to doctors within systems (& prevents “leakage”) needs a transparency tool that explains who’s charging what. But maybe an overall pivot to serving health plans?

4. @h1insights raises $58m (total is over $70m). It’s a database of doctors sold to drug companies to help them better target their marketing. Good to know that in the new world of health tech, helping big pharma push pills is a reliable way to make bank.

OK, so that’s what I would normally have covered in 2 mins on #HealthIn2Point00 yes, it’s much better with @jessdamassa on video and running the show while poking fun at me. Hopefully the internet works next week! #MerryChristmas2020

No Names, Please

Dec 23, 2020

By KIM BELLARD

Feeling good about your holiday spending? You’ve made it through most of this mostly horrible 2020, maybe lost a job or even a loved one, but still probably found a way to buy presents for your loved ones and maybe even to give some money to charity. Indeed, charitable giving was up 7.5% for the first half of 2020, despite the economic headwinds.

Then there’s MacKenzie Scott.

Ms. Scott, as you may recall, is the former wife of Amazon founder/CEO Jeff Bezos. She got Amazon stock worth some $38b in their 2019 divorce, which is now estimated to be worth around $62b. She just gave away $4.2b – and that’s on top of $1.7b she gave away in July.

In case your math skills are impaired, that’s $6b in six months, which Melissa Berman, chief executive officer of Rockefeller Philanthropy Advisors told Bloomberg: “has to be one of the biggest annual distributions by a living individual.” Ms. Scott has vowed: “I will keep at it until the safe is empty.”

Kenzie Bryant, writing in Vanity Fair, marveled: “It gives a whole new meaning to “fuck-you money.”

Private foundations are required to distribute at least 5% of their endowments each year; Ms. Scott not only has given away 10% of her net worth this year alone, but she hasn’t even used a foundation to do so. As The New York Times reported: “Ms. Scott’s operation has no known address — or even website. She refers to a “team of advisers” rather than a large dedicated staff.”

She doesn’t make recipients plead for money through grant applications. She doesn’t specify how the money is to be used, or require reports on how it is spent. She doesn’t expect her name on anything. She doesn’t even make public how much she is giving each recipient (although some choose to do so).

Olive CEO Sean Lane on 2020’s Big Numbers: 3 Funding Rounds, $450M, & a 5-Point Plan for the Future

Dec 22, 2020

By JESSICA DaMASSA, WTF HEALTH

Arguably 2020’s hottest health tech startup, Olive (olive.ai) closed THREE funding rounds this year, totaling $450M and valuing the company at $1.5B. Backed by a “who’s who” of technology, healthcare, and health tech venture capital, Sean Lane, CEO, clues us in about just what makes Olive so damn fund-able. The company boasts a “healthcare AI workforce” that tackles all the back-office processes hospitals use to run their organizations. This is not sexy stuff — filing and tracking insurance claims, ordering inventory, managing suppliers, etc. What’s hot, though, is how Olive is able to automate these tasks (according to Sean, currently many of these processes are handled by spreadsheets and faxes), “learn” as she’s doing it, and create efficiencies and cost savings across all of Olive’s 600+ hospital client-base as she does. Could this be the end of “admin expense” in healthcare? If what Olive is currently doing isn’t enough, we dive deep into Olive’s strategic plan — ALL FIVE POINTS OF IT (!) — to learn what’s next. My favorite? Number 3. The one where Olive starts to INSTANT PAY CLAIMS to completely disrupt hospital cash flow.

3 Patient Lessons: What Cancer Patients Teach Me

Dec 22, 2020

By YASMIN ASVAT

An estimated 1.8 million people in this country may face a cancer diagnosis this year, in what has already been a bleak year of isolation and loss.

While news of the COVID-19 vaccine rolling out across the U.S. offers hope in a year of 311,000 deaths, 11 million people face the financial pressure of unemployment, and, approximately 43 percent of the nation reports some symptoms of anxiety or depression.

It is understandable that a cancer diagnosis now may be too much to bear. And yet, somehow, many patients cope with the diagnosis and the associated uncertainty, fragility, and the threat of mortality with remarkable resilience.

As a clinical psychologist in the Supportive Oncology program at a major Midwestern cancer center, I witness these quiet heroics every day.

Since the beginning of the pandemic earlier this year, I have been striving to listen, empathize, support, and help cancer patients cope as their lives have been disrupted by both a cancer diagnosis and COVID-19. These are lessons these patients have taught me.

Courage is being faced with doing something that utterly terrifies you, and you do it anyway. One of my patients described that leading up to the day of chemotherapy treatment, she is highly anxious, has racing thoughts and worries, and has trouble concentrating and sleeping. The morning of treatment, she vents to her partner about how she doesn’t want to go to the clinic. During the drive, she braces herself repeating, “I don’t want to do this” over and over again.

Once in the clinic, she tells some of her nurses that she doesn’t want to be there because she worries about COVID-19 exposure, despite all the precautions the clinics have in place. She tells another set of nurses that she is scared of the side-effects of treatment – the disabling fatigue, the nausea, the suppressed immune system.

A Christmas Message to All Physicians From a Swedish-American Country Doctor in Maine

Dec 21, 2020

By HANS DUVEFELT, MD

Growing up in Sweden without a Thanksgiving holiday, Christmas has been a time for me to reflect on where I am and where I have been and New Year’s is when I look forward.

I have written different kinds of Christmas reflections before: sometimes in jest, asking Santa for a better EMR; sometimes filled with compassion for physicians or patients who struggle during the holidays. I have also borrowed original sentences from Osler’s writings to imagine how he would address physicians in the present time.

This year, with the pandemic changing both medicine and so many aspects of life in general, and with a gut wrenching political battle that threatens to erupt in anarchy or civil war within the next few weeks or months, my thoughts run deep toward the soul of medicine, the purpose of being a good doctor, even being a good human being.

We live in ideological silos, protected from dissenting opinions. News is not news if it is unpopular. Fake news and fake science are concepts that seemed marginal before but have now entered the mainstream.

As a physician, I serve whoever comes to see me to the best of my ability. But this year I have had to pay extra attention to the fact that so many people have already made up their minds about the nature and severity of the pandemic we are living with. If they don’t believe the country’s top experts, they are not likely to believe in me. Still, I try to gently state that we are still trying to figure this thing out and until we do, it’s better to be cautious.

I am starting to read about what some are now calling the Fourth Wave of the pandemic, the mental health crisis this winter may see in the wake of the physical illness we are surrounded by.

Two Surgeons—a Veteran and a Newcomer—Talk Fighting COVID Burnout

Dec 18, 2020

By MICHAEL E. LIPKIN and RUSSELL S. TERRY, JR.

Burnout has always been a concern in medicine, and that concern has been amplified by the added stress of COVID-19. Many months into an unpredictable and distressing situation, we have both hung on to our mental health and professional passion by seeking out strategies that work for us. We offer them in two perspectives: veteran and relative newcomer.

Dr. Lipkin: A Veteran’s Perspective

When lockdown began in March, we slowed down my practice for about 6 to 8 weeks, and then returned to full pre-COVID levels. It feels like the uncertainty has affected me most, since it has not been clear if and when things will get substantially better. Everyone is both experiencing and projecting persistent anxiety, stress and uncertainty. Isolation is a problem as well. I no longer have the time or ability to sit down with colleagues and vent over a beer, which was an outlet I counted on to mitigate burnout. At the same time, on a more concrete level, the pandemic has made everything we do incrementally more difficult, which is grindingly stressful. These tips are helping me cope and avoid burnout.

There are so many changes—just accept them. As COVID affects so many areas of practice, there’s a kind of low-grade stress that fluctuates with events. It seems like everything is a little bit harder. We have to shift some patient visits to telehealth and make sure they get COVID tests before surgery. We’re all looking over our shoulders, wondering who’s going to get us sick. There’s always the specter of more shutdowns and how they might affect our livelihoods. Budgets have been cut back, so hiring is frozen and there’s virtually no incremental spending. Everything will stay this way for now, so the best thing to do is accept that we’re going through a tough period and focus on the big picture, rather than the list of irritations.

THCB Gang, Episode 36, Dec 17

Dec 17, 2020

Today’s #THCBGang was an End of Year special. It’ll was a full “Hollywood Squares/Brady Bunch” with nine of us. Michael Millenson @MLMillenson, Deven McGraw @HealthPrivacy, Jessica DaMassa @jessdamassa, Maggi Cary @margaretcaryMD, Robin Farmanfarmaian @Robinff3, Mike Magee @drmikemagee, Rosemarie Day @Rosemarie_Day1, & Marcus Whitney @marcuswhitney all got on to talk about the vaccines, the future of investing in health tech, a little bit about HIPAA, the future of vaccine passports, and more.

Yup we rounded off the year talking about the good, the bad and the very ugly of 2020. And giving our forecasts for 2021. And then a bunch more of the Gang came on at the 50 minute mark to give their hopes for 2021

You can see the video below and it’ll be on our podcast channel (Apple/Spotify) from Friday

— Matthew Holt

Streaming, Baby Yoda, and Healthcare

Dec 17, 2020

By KIM BELLARD

I’ve never seen The Mandalorian. I don’t have Disney+. But I know who Baby Yoda is, and I’m pretty sure Disney is counting on that. Hollywood, in case you haven’t been paying attention, is going through some radical changes. There may be some lessons for healthcare in them.

2020 has been the year of streaming. Moviegoing isn’t entirely dead in the pandemic, but it may be on life support, with major chains like Regal and AMC barely staying out of bankruptcy. “Yes, there is pent-up demand to see movies in a theater,” Hollywood insider Peter Chernin told The New York Times. “But people change their habits.”

Indeed, they do. A new Press Ganey survey found that telemedicine visits shot to 37% of all visits in May, then settled down to around 15% – far above less than 1% pre-COVID-19. Habits do, indeed, change, even in healthcare.

Hollywood has made some startling announcements in the past few weeks that illustrate how swiftly changes are coming to the entertainment industry:

Disney: Disney expects to have 100 new titles – TV shows or movies – each year for the next few years. Disney chairman Bob Iger noted modestly: “The pipeline of original content we’re making is much more robust than originally anticipated.” Of particular note, though, CEO Bob Chapek said, “Of the 100 new titles announced today, 80 percent of them will go to Disney Plus.”

NYT characterized the move as: “Here is a 97-year-old company making a jump to direct-to-consumer hyperspace.” (If you don’t get the reference, you probably didn’t get the Baby Yoda one either).

The strategy appears to be working. Disney said that its year-old Disney+ streaming service already has 87 million subscribers; it had originally projected to reach this number by 2024. Now it expects to reach 260m subscribers by 2024. And those numbers do not include Disney services Hulu (39m) and ESPN+ (12m). Collectively, Disney now expects up to 350m subscribers by 2024.

#Healthin2Point00, Episode 174 | Cityblock, Elation, Modern Health, LeanTaaS & Well

Dec 16, 2020

Today on Health in 2 Point 00, Jess has me weigh in on Cityblock Health’s big raise of $160 million bringing their total up to 300 million to improve health for low-income patients. On Episode 174, Elation, which is Cityblock’s EMR as well as that for some other independent primary care clinics, raises $40 million and working their way into a tough market. Modern Health raises $50 million for the “fourth” pillar of care, providing another mental health platform. LeanTaaS raises $130 million, providing a digital front end for hospitals and smooth out patient access, in contrast to companies like Olive working on the backend. Finally, Well gets $40 million in a Series A using AI and behavioral economics to provide health information and coaching. —Matthew Holt

The Pathway to Health Leads Through Clean Energy Technology

Dec 16, 2020

By MIKE MAGEE

Health reporting this week is rightly dominated by the challenging worldwide distribution of the Pfizer vaccine for Covid-19. Bringing the virus to bay is job #1, not only to preserve human life but also our global economy. But this week, on the 5th anniversary of the Paris Agreement, we are reminded that our long term human health, including clean air and water, mitigation of weather-related human disasters, and regulations that lessen our chronic burden of disease, depend as much on energy policy as they do health policy.

Nowhere is this more evident (though largely hidden from sight) than in our planet’s positioning to address global warming. The Paris Agreement, the climate accord signed by 195 nations, was abuptly dismantled by Trump four years ago. But President-elect Biden has signaled that his first order on January 20, 2021, will be to rejoin the agreement.

As Trump patronized his fossil fuel funders, and promised that “we’re going to have clean coal and we’re going to have plenty of it,” the oil and gas industry wrote down the value of its assets $170 billion in the first 6 months of 2020.

Acknowledging as much this past week, a cabal of energy investors, with combined assets of $9 trillion, signaled a shift in their strategy with a pledge to harmonize their investments with net-zero carbon emissions by 2050.

Those investors haven’t suddenly “discovered religion.” No. They’re looking at the numbers.

Clean energy options like solar and wind, combined with the latest battery technology, are now 79% cheaper to produce than US coal production. Investors realize that 90% of the new energy capacity generated worldwide in 2020, as reported by the International Energy Agency, has come from clean energy.