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#HealthTechDeals Episode 13: ModMed, Nayya, Sanofi, Dario Health, Ro, Dadi, and Daybreak Health

Here’s the big question of the day: VIVE or HIMSS or both? Jess and I offer our thoughts on both conferences and which ones we’re going to. Some deals in the past few days: ModMed buys Klara for $200 million; Nayaa raises $55 million; Sanofi and Dario Health have a $30 million deal; Ro acquires Dadi, an in-home sperm testing company; Daybreak Health raises $10 millionMatthew Holt

TRANSCRIPT

Jessica DaMassa:

All right, Matthew Holt, the big question of the day: ViVE or HIMSS or both? Ugh.

Matthew Holt:

Or neither?

Jessica DaMassa:

Hey, that’s the way to do it. It’s the March 3rd episode of Health Tech Deals.

Matthew Holt:

So, Jessica, I thought the big question was State of the Union versus invading Ukraine versus .. No, no, it’s all about ViVE versus HIMSS?

Jessica DaMassa:

ViVE versus HIMSS.

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THCB Gang Episode 84, Thursday March 3rd, 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:  fierce patient activist Casey Quinlan (@MightyCasey); patient safety expert and all around wit Michael Millenson (@MLMillenson); THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); and policy consultant/author Rosemarie Day (@Rosemarie_Day1).

The video will be below. If you’d rather listen to the episode, the audio is preserved from Friday as a weekly podcast available on our iTunes & Spotify channels

Medicare Advantage Poses Challenges to Health Care Cost-Effectiveness and Equity

BY NIRBAN SINGH AND AMY HELBURN

Introduction

Medicare Advantage (Advantage), originally conceived in 1997 during the Clinton Administration as ‘Medicare + Choice’, has progressively grown and become an established health insurance option for those 65 and older. According to data collected and aggregated by the Kaiser Family Foundation, Advantage has more than doubled in total enrollment between 2010 and 2021. In 2021 alone, 26 million people were enrolled in Medicare Advantage, which is over 40% of the total Medicare beneficiary population. In 2021, 85% of Medicare Advantage growth was concentrated among for-profit health plans, with UnitedHealthCare, Centene, and Humana leading the way.

Overall, the Medicare Advantage market is dominated by UnitedHealthCare, Humana, and CVS Health/Aetna, with this trio responsible for over half of all Advantage beneficiaries.As of October 2020, about 80% of Advantage enrollees directly purchased individual policies, while employer-sponsored Advantage enrollment has been steadily growing, comprising 18.1% of the Advantage market overall in 2020. Analysis from The Chartis Group indicates that half of all Medicare beneficiaries will be enrolled in Advantage plans by 2025, so the trio of existing leaders in providing Advantage plans may continue to innovate and profit immensely while new market entrants may grow their footprint rapidly, in response to growing demand.

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#HealthTechDeals Episode 12: Omada Health, Somatus, Qventus, Story Health, and Medibuddy

In this episode of Health Tech Deals, Jess is back! Where was she? Out in the wilds in Arizona, hiking in mountains. A big shoutout to Ian Morrison for filling in. Some recent deals: Omada Health raises $129 million; Somatus raises $325 million; Qventus raises $50 million; Story Health raises $22.6 million; and Medibuddy raises $125 million.

TRANSCRIPT

Matthew Holt:

Hang on. You’re not Ian Morrison.

Jessica DaMassa:

I’m not.

Jessica DaMassa:

He let me come back.

Matthew Holt:

Hang on, look. And we’re together.

Jessica DaMassa:

We’re together. I went from being completely away and replaced, to being right next to you.

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Raspberry Pi Health Care

By KIM BELLARD

Like many of you, I have been intently following the war in Ukraine, cheering for President Zelensky and the Ukrainian people, while hoping it doesn’t end up in WW3.  I thought about trying to write about it, then I saw that Raspberry Pi just turned ten, and I thought, yeah, that’s more my speed.

And, of course, easier to relate to healthcare.

For most of us, a computer is our smartphone, tablet, or laptop.  We buy them already designed and built, complete with an operating system and other useful software.  There’s an almost unlimited range of other software that can easily be downloaded to run on them.  Ease of use is paramount.  

This was not always so.  If you are of a certain age or have studied the history of computers, you’ll know that in the 1970s and early 1980s, (home) computers came in a kit.  You assembled them and figured out what you might want to use them for.  Then came Apple and the PC revolution. Our expectations about what computers could do grew as our expectations about what we had to do diminished.  Between 2006 and 2011, Eben Upton and his collaborators sought to change this.

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DEMO: Medstar Health’s digital front door – featuring b.well Connected Health

Medstar Health, a big hospital system in the Washington DC area, has been using a selection of digital health tools like Bluestream Health’s telehealth system for a while. Now they are showing to the world their implementation of b.well Connected Health‘s patient interface which as you’ll see is being used to create a digital first experience for their patients, enabling booking of virtual and physical appointments. I spoke with John Lock, Chief Digital Transformation Officer at MedStar Health & Kristen Valdes, CEO of b.well Connected Health, while Cathryna Nieves, AVP, Digital Transformation at MedStar Health gave a full demo of the experience. I don’t often head into the belly of the beast, but it’s very interesting to see how big incumbents like Medstar are working with tech vendors to react to the billions being spent by venture capitalists to create denovo virtual first health services–Matthew Holt

How to Talk to Clinicians: Forget Workflows, Just Tell Us How Things Work

BY HANS DUVEFELT

Workflows are all the rage with EMR people. But doctors, NPs and PAs are smart. Nothing burns us out as fast or as completely as being told how to do things instead of why. We are not circus animals.

Let me explain:

If we had no professional education at all, we would have clinical workflows memorized instead of clinical knowledge. For example, two weeks after starting an ACE inhibitor like lisinopril, order a basic metabolic profile. That sounds pretty straightforward, but if you add up all the possible clinical workflows we would need if we didn’t know medicine at all, that would be a huge burden – a massive amount of seemingly random and senseless rules.

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Pithiatism Redux

BY MARTIN SAMUELS

Those of us in medicine have all seen the famous painting of the Tuesday afternoon lessons at the Salpȇtrière in Paris in the 19th century. In Pierre Aristide André Brouillet’s painting, one can clearly see the great professor, Jean-Martin Charcot, holding forth while the patient, Blanche Whitman, is being supported by a tall young man, Joseph Jules Francois Felix Babinski, the Chef de Clinique (the chief resident) and allegedly the favorite to succeed Charcot. He never did as he was failed repeatedly on the exam necessary to become a faculty member at the university by a jealous, xenophobic, anti-immigrant rival, Charles Bouchard. Babinski was born in France and served in the army twice, but his name was Polish as his parents had emigrated to France to escape bias in Poland (sound familiar?).  Ironically almost no one remembers Bouchard (his only contribution being the Charcot-Bouchard aneurysm which may be the cause of some intracerebral hemorrhages), but there is no doctor on earth who does not know Babinski’s name. This is one of many reasons why Babinski is my neurological hero.  

A Clinical Lesson at the Salpêtrière, Pierre Aristide Andé Brouillet
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Seqster: The Salesforce of Healthcare?

By JESSICA DaMASSA, WTF HEALTH

It’s not difficult to get Seqster’s CEO Ardy Arianpour fired up, but to get to the details about his business and what he refers to as its “f-ing incredible tech stack,” takes a little doing. Is Seqster a health data analytics company like Clarify Health or Komodo Health, or more of a longitudinal patient health record startup like bWell or Picnic Health?

According to Ardy, these companies would actually make great Seqster clients, and that his tech would serve as the ideal, white-labeled operating system upon which they could engage with patients, collect their data, and examine it alongside EMR data, pharmacy data, social determinants of health data, and even genomic data. While those aforementioned health tech startups might be able to do many of these services themselves, the life sciences companies, health systems, health plans, digital health startups, and non-profit patient registries Seqster does count as clients are using its platform for everything from running decentralized clinical trials to providing patients with a longitudinal single-source medical record.

Ardy breaks down the “operating system” approach Seqster is taking, and how he sees his platform becoming as the “Salesforce of healthcare.” Beyond the specific examples that really bring this concept to life, we talk about what’s ahead for the business, which has raised $23 million in total funding and, interestingly, counts both Takeda Digital Ventures and 23andMe’s CEO and Founder, Anne Wojcicki on its cap table.

Get Ready for (Healthcare) Microgrids

BY KIM BELLARD

We depend on it.  Indeed, our daily lives are unimaginable without it.  The trouble is, it’s become unreliable.  Lives have been lost because it wasn’t performing when it needed to be.  It’s built around large facilities that are often decades old.  Parts of it don’t communicate/coordinate well with others.  Its workforce is aging and burnt out.  There is no person or agency charged with ensuring its resiliency. It badly needs to be rethought for the 21st century. 

Oh, you thought I was talking about our nation’s power grid?  I was talking about our healthcare system.  

The parallels are striking, and concerning.  They’re huge industries, based on early 20th century approaches, and beset by 21st-century challenges to which they may not be easily adaptable.  If we don’t manage their evolution to the 21st century right, we’re dead.  Literally.  

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