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THCB Gang Episode 85, Thursday March 17th, 1pm PT 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be: double trouble futurists Ian Morrison (@seccurve) & Jeff Goldsmith; consultant focusing on platform business models and strategy Vince Kuraitis (@VinceKuraitis), & back after a long while analyst and Principal of Worksite Health Advisors Brian Klepper (@bklepper1).

Today there will be more discussion than usual about platforms and whether health care is ready for them!

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

“There Isn’t One Health Plan to Save Them All”: Flume Health’s CEO on New Build-A-Plan Biz

By JESSICA DaMASSA, WTF HEALTH

Two of the most notable payer venture funds, Optum Ventures and Cigna Ventures, just headed up a $30 million dollar Series A funding round for Flume Health, a startup that basically builds “challenger” health plans. How did this go down? Cédric Kovacs-Johnson CEO & Founder of Flume introduces us to his company which offers providers, digital health co’s, brokers, reinsurers, and just about any other healthcare org a tech stack for creating their own hyper-niche, super personalized health plans.

The suite of services to “build-a-plan” includes things like claim processing, payments, enrollment management, digital health point solutions integration, and other API functionality – replacing the traditional TPA with tech and the one-size-fits-all plan with a new opportunity for nichey-ness that can customize coverage for patient populations based on health conditions, location, employer, and so on.

Cédric talks us through the benefit to his target client – the care provider – who, while taking on more risk anyway, may consider building their own plan to capture more premium dollars and gain better control over the end-to-end patient experience. Wait a minute – is all this “Challenger Health Plan” talk just a re-brand of value-based care? I ask point-blank and get a new buzz phrase in return; welcome to the lexicon, “Commercial Advantage.” Lots to unpack in this one including Flume’s rev-gen model and plans for growth – they’re already onboarding one new challenger plan per month!

The (sort of, partial) Father mRNA Vaccines Who Now Spreads Vaccine Misinformation (Part 1)

By DAVID WARMFLASH, MD

Robert W. Malone, MD MS, is a physician-scientist who will live in infamy, thanks to the Joe Rogan Experience Podcast boosting his visibility this past December regarding his criticism of COVID-19 vaccines, particularly the mRNA vaccines (Moderna and Pfizer-BioNTech). Subsequently, Malone was banned from Twitter, which further boosted his celebrity status. Describing himself as the inventor of mRNA vaccine technology, he has been reaching a growing number of people with a narrative that makes COVID-19 vaccination sound scary. We cannot embed clips from the Rogan interview, which lasted about three hours, because it is accessed only on Spotify. But we can pull quotes from the interview transcript and we can see how Malone addresses non-scientists in shorter appearances, like the following clip from Wisconsin Morning news aimed at parents:

…Before you inject your child – a decision that is irreversible – I wanted to let you know the scientific facts about this genetic vaccine, which is based on the mRNA vaccine technology I created…

There are three issues parents need to understand:

The first is that a viral gene will be injected into your childrens cells. This gene forces your childs body to make toxic spike proteins. These proteins often cause permanent damage in childrens critical organs, including

Their brain and nervous system

Their heart and blood vessels, including blood clots

Their reproductive system

And this vaccine can trigger fundamental changes to their immune system

The most alarming point about this is that once these damages have occurred, they are irreparable

You cant fix the lesions within their brain

You cant repair heart tissue scarring

You cant repair a genetically reset immune system, and

This vaccine can cause reproductive damage that could affect future generations of your family….

Along with the alarmist theme, there are some phrases in the excerpt that people with little knowledge of biology could take the wrong way. The ‘toxic’ spike protein terminology warrants unpacking later, because Malone’s more farfetched ideas rest upon his disagreement with experts who have worked on that very spike protein. This is a protein that SARS-CoV2 (the virus that causes COVID-19) makes and uses to enter body cells, and is the basis of most of the COVID-19 vaccines that are approved throughout the world. In the case of the genetic vaccines (the mRNA vaccines of Pfizer-BioNTech and Moderna and the viral vector vaccines of Johnson and Johnson and AstraZeneca), the vaccines do not actually contain spike protein. Instead, they contain a recipe for cells of a vaccinated person (not all the person’s cells, but just a small sampling) to make spike protein —in very small amounts and for a very limited time— and display it on the outer part of their cell membranes. This allows the immune system to use that vaccine-generated spike protein for target practice, so you can build immunity against the virus without the virus infecting you.

Continue reading…

Quickbite Interviews: 1UpHealth& Cecelia Health

I was at the VIVE conference in Miami last week and caught up with a number of CEOs & execs for some quickbite interviews — around 5 mins getting (I hope) to the gist of what they & their companies are up to. I am going to dribble them out this week.

Up here are are Joe Gagnon, CEO, 1upHealth, a data integrator that works primarily with health plans, and Mark Clermont, CEO, Cecelia Health, a chronic care management company that also runs pharma patient adherence programs. — Matthew Holt

Clarify Health Solutions’ CEO on Data Analytics Startup’s Next Trick: Value-Based Payments Tech

By JESSICA DaMASSA, WTF HEALTH

Turns out, the Clarify Health Solutions story is about a lot more than data and analytics these days. Value-based payments? Acquisition of provider-focused, behavioral science startup Embedded Healthcare? Opportunities in real-world evidence??

Good thing founder & CEO Jean Drouin and I caught up at ViVE 2022. Not only do we get into the backstory of the business, which has built a self-service analytics platform for payers, providers, and life science co’s on top of “one of the largest-ever patient datasets” in the industry, but we also talk about the strategy that’s driving Clarify into the world of value-based contracting and how Embedded Healthcare’s tech will be used to augment and refine that new offering.

Jean talks in detail about his client mix, business model, and the two “healthcare golden rules” Clarify lives by as it scales up its business: 1) figure out how the payment method is going to work and 2) don’t mess with the work-flow.

Where Health Care Value Can Lead

By BRIAN KLEPPER

It seems inevitable that, in the near future, an innovative health care organization – Let’s call it The Platform – is going to seize the market opportunity of broader value. It will cobble together the pieces, and demonstrate to organizational purchasers that it consistently delivers better health outcomes at significantly lower cost than previously has been available.

To manage risk and drive performance, The Platform will embrace the best healthcare management lessons of the past decades: risk identification through data monitoring and analytics, driving the right care, quality management, care navigation and coordination, patient engagement, shared decision-making, and other mission-critical health care management approaches. It will practice care that is grounded in data and science, and is outcomes-accountable.

But The Platform will also appreciate that a few specialty vendors have developed deep expertise in dealing with clinical or financial risk in high value niches – where health care’s money is – like management of musculoskeletal care, chronic disease, maternity, surgeries, high performing providers, or specialty drugs. It will understand that it often makes sense to partner with experts who can prove and guarantee high performance rather than trying to learn to achieve high performance within each niche. The Platform also will realize that simplicity is a virtue, and that bundling specialized services under one organizational umbrella is easier for health plan sponsors to manage and for patients to negotiate than an array of individual arrangements.

Continue reading…

Past the Talking Points: Glen Tullman on Affordable Insulin, Payment Model Reform & Transcarent

By JESSICA DaMASSA, WTF HEALTH

Turns out, that if you’re lucky enough to catch Glen Tullman in an impromptu chat just off the main stage at ViVE 2022, he’s warmed up enough (we could maybe even call it ‘fired up’ enough) to kick it into overdrive, roar past the usual talking points, and tell us what he REALLY thinks about what’s happening in the healthcare market today.

Things are changing. And, if you listen to this chat from start-to-finish, one of the key, overarching themes is payment model reform. From the news about Civica RX’s commitment to $30-dollars-or-less insulin (an initiative Glen helped lead and fund via his family foundation) to the 10X growth of virtual care coming out of the pandemic and the rise of “Big Customer” (aka Walmart and Amazon) in healthcare, the bottom line is that we’re no longer talking about fixing the way care is paid for – it’s actually starting to happen.

What is Transcarent’s role in all this? For those who might still be confused, tune in. This IS confusing, but I think the candor of our situation here may have given rise to one of the best descriptions of the business yet. Glen goes point-by-point on the way Transcarent is attempting to shift the paradigm for cost-and-quality across five (5!!!) different aspects of care at one time, using different strategies, novel technologies, cross-industry partnerships, and never-before-seen relationships with health systems to deliver what “20 years working with payers and 5 years working navigators didn’t deliver” for self-insured employers and their employees.

#HealthTechDeals Episode 15| Clarify, Embedded Healthcare, Wildflower, Vivante Health, Gravie, Nice

We made it back from ViVE in one piece! Will Jess DaMassa stab me in the back Brutus-Style? Tune in to find out as we discuss deals: Clarify buys Embedded Healthcare; Wildflower raises $26 million; Vivante Health raises $16 million; Gravie raises $75 million; and Nice Healthcare raises $30 million.

Matthew Holt

Transcript

Jess DaMassa:

Well, we made it back from Vive all in one piece and we landed squarely in the Ides of March. Will I stab Matthew Holt in the back Brutus-style? Tune to the March 15th episode of Health Tech DEALS. Oh Matthew Holt, those ruthless Romans, never trust an Italian. That’s the lesson here.

Matthew Holt:

Well, sad enough, I trusted you and you told me to buy some stocks. And now, have you seen digital digital health talks yesterday?

Matthew Holt:

Everybody off another 10%?

Jess DaMassa:

Okay, but how does that compare with the reality of everything else right now?

Matthew Holt:

I don’t know. Somehow, Teladoc was about 300 a year ago

Jess DaMassa:

Don’t even talk to me about Teladoc.

Matthew Holt:

Now it’s around 50.

Continue reading…

Quickbite Interviews: Lark & Luma Health

I was at the VIVE conference in Miami last week and caught up with a number of CEOs & execs for some quickbite interviews — around 5 mins getting (I hope) to the gist of what they & their companies are up to. I am going to dribble them out this week.

First two up are Julia Hu, CEO of Lark, a conversational AI program for chronic & behavioral health that works primarily with health plans, and Adnan Iqbal, CEO of Luma Health, a patient messaging system mostly used by providers. — Matthew Holt

#HealthTechDeals Episode 14: Elemy, Health Gorilla, M_disrupt; Flume; and Homeward Health

In this episode of Health Tech Deals, Jess and I say hello to you from Miami! Together at ViVE 2022, we weigh in on some big funding deals! We also have a short cameo along the way (watch to see who it is)! Elemy raises $215 million; Health Gorilla raises $50 million; M_disrupt raises $6 million; Flume raises $30 million; and Homeward Health raises $20 million.

TRANSCRIPT

Jessica DaMassa:

Hello from Miami. I am at ViVE and look, the exhibit hall coming down around me. Here’s what the reg area looked like. People are leaving, everybody’s got their bags and ah, look who I’ve got. Weighing in with the big funding deals from ViVE, Matthew Holt. It is the March 10th episode of Health Tech Deals. Well, we’re selfie-style here, because we are on the move.

Matthew Holt:

Yeah. You had a fantastic professional cameraman and we decided not to use him

Jessica DaMassa:

No. Instead we’re using this, but I’ve interviews for you guys coming out of this.

Matthew Holt:

Even I did some, actually a lot of stuff going on in the show, pretty interesting. And there were a few deals announced.

Continue reading…
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