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Forget Micro-Networks: How Avaneer Health is Building The One Health Data Exchange to Rule Them All

By JESSICA DaMASSA, WTF HEALTH

What BIG thing is Avaneer Health building with its $50 million SEED round backed by not-just-investors-but-also-partners CVS Health, Aetna, Anthem, Cleveland Clinic, HCSC, PNC Bank, Sentara Healthcare and IBM Watson Health? CEO Stuart Hanson stops by to clear-up the mystery that IS Avaneer Health, and how the massive data exchange platform it’s building is meant to connect the data coming out of the biggest payers and biggest providers in healthcare, directly and in real-time.

Hang on – is this the blockchain-based data exchange healthcare has been talking about for more than a decade?? It sure is trying to be. And what Stuart says is different about Avaneer’s effort is, indeed, the fact that it’s backed by some of the biggest brands in the business and that they see the business case in being able to more effectively share their data with one another. As he explains it, “this problem of data interoperability and data fluidity is bigger than any competitive business model that they need to worry about…”

Stuart is careful to explain what Avaneer IS and what it IS NOT, and this is critical to the company’s growth plans and revenue model. Avaneer is NOT a data intermediary; it’s not about aggregating data, normalizing it, de-identifying it, or applying any fancy machine learning algorithms to it to deliver “insights” on it. Avaneer is strictly a platform for secure, compliant data exchange, so, for example, Anthem can connect to Cleveland Clinic in real-time and verify insurance coverage. The revenue model is currently built around access to the network and will one-day-soon also take in fees from ‘Solutions Innovators’ (aka data-aggregating, algorithm-loving, insights-dropping health tech companies) that will offer their services as add-on’s to Avaneer’s customers who are plugged into the network.

What’s ahead for this stealthy start-up as it scales? Could they REALLY be looking to raise a follow-on seed round?? Find out what kind of investors they’re looking for and what’s ahead on their product roadmap in this in-depth chat.

Global Warming and Disease

BY MIKE MAGEE

A study eight years ago, published in Nature, was titled “Study revives bird origin for 1918 flu pandemic.” The study, which analyzed more than 80,000 gene sequences from flu viruses from humans., birds, horses, pigs, and bats, concluded the 1918 pandemic disaster “probably sprang from North American domestic and wild birds, not from the mixing of human and swine viruses.”

The search for origin in pandemics is not simply an esoteric academic exercise. It is practical, pragmatic, and hopefully preventive. The origin of our very own pandemic, now in its third year and claiming more than 1 million American lives, remains up in the air. Whether occurring “naturally” from an animal reservoir, or the progeny of an experimental lab engaged in U.S. funded “gain-of-function” research, we may never know. What we do know is that viruses move at the speed of light, or more accurately, at the speed of birds.

Continue reading…

#HealthTechDeals Episode 35 | CapitalRX, EnsoData, CareAcademy, Inne, and Boulder Care

Hear the big news? Not only has Oracle bought Cerner, but Larry Ellison says “Interoperability! What interoperability? Oracle has fixed it!” Some new funding deals: CapitalRX raises $106 million; EnsoData raises $20 million; CareAcademy raises $20 million; and Inne raises $10 million; Boulder Care raises $35.7 million. Check out the AHIP Conference 2022 taking place in Las Vegas! We’ll be there! Tickets are $100 off with code THCB.

AHIP in Vegas next week. Not too late!!

If you want to come see the best of health plans and health tech aimed at them, plus try your hand at the craps tables, it’s not too too late to get a ticket to AHIP 2022 in Las Vegas next week! Plus meet Matthew Holt & Jess DaMassa as they tour/troll the exhibit hall and look for parties!. And you can still get $100 off if you use the code “THCB”

https://www.ahip.org/conferences/ahip-2022

What’s Up, Docs

BY KIM BELLARD

Here’s how I’ll know when we’re serious about reforming the U.S. healthcare system: we’ll no longer have both M.D.s and D.O.s.

Now, I’m not saying that this change alone will bring about a new and better healthcare system; I’m just saying that until such change, our healthcare system will remain too rooted in the past, not focused enough on the science, and – most importantly – not really about patients’ best interests.

Let me make it clear from the outset that I have no dog in this hunt.  I’ve had physicians who have been M.D.s and others who have been D.O.s, and I have no indication that there have been any differences in the care due to those training differences. That’s sort of the point: if there are no meaningful differences, why have both?  

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Inside Boulder Care’s $36 Million Series B & Scaling Telehealth Addiction Treatment in Medicaid

BY JESSICA DaMASSA, WTF HEALTH

Telehealth addiction treatment clinic Boulder Care just closed a $36 million Series B. I’ve got Founder & CEO Stephanie Strong here to talk about the virtual care company’s medication-assisted approach to opioid and alcohol use disorder treatment, and its growing-bigger-by-the-day presence in the Medicaid market.

In fact, more than 95% of Boulder Care’s revenue comes in from Managed Medicaid plans, and this focus on making medications like Suboxone accessible to traditionally marginalized patients is not only better for patients (drugs like these can cut all-cause mortality rate by half or more) but also compelling for payers. Stephanie says patients suffering from opioid addiction who go untreated are 550% more expensive to the plan than those who are not, and these types of medications facilitate recovery by making it bearable, blocking withdrawal symptoms.

We get into the details behind Boulder Care’s approach, which includes a number of wrap-around support services, including those provided by the startup’s care delivery team that is set to grow as a result of this Series B funding. And speaking of scaling… Does Stephanie have any concerns about challenges that Boulder Care might face prescribing-and-managing controlled substances as a result of the scrutiny created by Cerebral’s bad behavior? Any additional concerns about changes to the clinic’s telehealth practices when the Covid19 public health emergency comes to an end? And…what about competition in this space?? Particularly as similar-looking Bicycle Health announced its $50 million Series B just days earlier? A great inside look at how virtual care is changing the specialized mental health care space.

Matthew’s health care tidbits: Hospital shooting reveals so much

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

In this edition’s tidbits, the nation is once again dealing with an epidemic of shootings. Now a hospital joins schools, grocery stores and places of worship on the the recent list. I was struck by how much of the health care story was wrapped up in the tragic shooting where a patient took the life of Dr. Preston Phillips, Dr. Stephanie Husen, receptionist Amanda Glenn, 40; and patient William Love at Saint Francis Health System in Tulsa.

First and most obvious, gun control. The shooter bought an AR-15 less than 3 hours before he committed the murders then killed himself. Like the two teens in Buffalo and Uvalde, if there was a delay or real background checks, then these shootings would likely have not happened.

But there’s more. Hospital safety has not improved in a decade or so. Michael Millenson, THCB Gang regular, has made that plain. And that includes harm from surgery. We know that back surgery often doesn’t work and we know that Dr Phillips operated on the shooter just three weeks before and had seen him for a follow up the day before. Yes, there is safety from physical harm and intruders–even though the police got there within 5 minutes of shots being heard, they were too late. But there is also the issue of harm caused by medical interventions. Since “To Err is Human” the issue has faded from public view.

Then there is pain management. Since the opiate crisis, it’s become harder for patients to get access to pain meds. Was the shooter seeking opiates? Was he denied them? We will never know the details of the shooter’s case, but we know that we have a nationwide problem in excessive back surgery, and that is matched by an ongoing problem in untreated pain.

And then there are the two dead doctors. Dr. Husen, was a sports and internal medicine specialist. Obviously there are more female physicians than there used to be even if sexism is still rampant in medicine. But Dr. Phillips was an outlier. He was black and a Harvard grad. Stat reported last year that fewer than 2% of orthopedists are Black, just 2.2% are Hispanic, and 0.4% are Native American. The field remains 85% white and overwhelmingly male. So the chances of the patient & shooter, who was black and may have sought out a doctor who looked like him, having a black surgeon were very low in the first place. Now for other patients they are even lower.

The shooting thus brings up so many issues. Gun control; workplace safety; unnecessary surgery; pain management; mental health; and race in medicine. We have so much to work on, and this one tragedy reveals all those issues and more.

Republican Health Policies Disproportionally Harm White Citizens in Their States

BY MIKE MAGEE

“As I’ve said before, I believe Dr. Ladapo is an anti-science quack who doesn’t belong anywhere near our state’s Surgeon General office, let alone running it. But now that he’s been confirmed, it’s my sincere hope that he and Governor DeSantis choose to focus on saving lives and preventing unnecessary illness instead of continuing their absurd promotion of conspiracy theories and opposition to proven public health measures — but I’m not going to hold my breath.”

If you identified these as the words of the former governor, and now Congressman Charlie Crisp, currently running to retake the office he once held, you’d be wrong. These are the words of another state Democrat who is running a distant 2nd in the Democratic primary battle set for this summer.

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THCB Gang Episode 95, Thursday June 9

Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday June 9 were THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); fierce patient activist Casey Quinlan (@MightyCasey); Principal of Worksite Health Advisors Brian Klepper (@bklepper1) & Queen of all employer benefits Jennifer Benz (@jenbenz)

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

Can SameSky Health Fix the ‘Trust Issues’ Minority Populations Have with Big Healthcare?

BY JESSICA DaMASSA, WTF HEALTH

Healthcare needs to move into 2022 and get away from the one-size-fits-all approach that healthcare takes almost everywhere and, instead, treat people like who they are matters.” That’s the challenge coming from SameSky Health’s founder & CEO Abner Mason whose business is helping some of healthcare’s most notorious “one-size-fits-all-ers” (health plans) improve the way they engage with diverse populations.

SameSky has built a proprietary tech platform that creates an ‘n of 1’ approach to member engagement that is focused on using data to understand who each individual member is at a “cultural” level which, as Abner defines it, is not just about ethnicity or race, but about ALL the factors that go into how a person makes a decision about whether or not to seek care, where to get that care, and who they ultimately trust to deliver it.

You can call it “micro-targeting-at-scale” and Abner compares it to the way Netflix customizes movie recommendations based on what it learns about its users. SameSky is hoping to achieve the same level of consumer-focused customization among Medicaid populations, and is working with some of the biggest names in the biz (UnitedHealthcare, Anthem, Humana and others) to tailor an annual “journey” to each member that helps members build trust with their plan, helps the plan get to know their members, and, in the end, helps both the plan AND the member satisfy mutual needs when it comes to getting things like annual health screenings done.

Will we eventually get to a more equitable and personally-tailored healthcare system? Stick around until the last few minutes to hear what Abner finds exciting about some of the new federal regulations that impact health data collection and what he sees as their big-picture impact on the future of health equity. PLUS, a bonus for all those who may have been wondering: What prompted the name change to SameSky Health from ConsejoSano?? Is this REALLY because Matthew Holt could never pronounce it? The shocking backstory is revealed!

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