Weekly Health Tech Reads | 2/6/2022

News:

• Meditation app Calm acquired Ripple Health Group, a company that's built apps for caregivers. Calm is going to leverage Ripple to build out Calm Health, Calm's new employer offering that will replace Calm for Business. Ripple's CEO will be a Co-CEO of Calm, which should give some indication of how Calm views the B2B healthcare opportunity strategically (hint: large). It's hard not to see parallels to Headspace / Ginger deal as large consumer mental health companies seek to enter the B2B world. Ripple's fit with Calm is not quite as clear given its caregiving focus, but this almost feels like an acquihire of sorts in order to bring Ripple's CEO and team on board. Will be very curious to watch whether Calm can successfully enter the employer market.  Link / Slack (h/t Rohit Kabra)

• Kindbody, which recently expanded into at-home fertility testing, is now valued at $1.15 billion and acquired Vios, a group of fertility clinics. Kindbody now has 26 clinics, and is expanding to 40 locations by year end. Another data point for the trend of well-financed entities focused on growth gobbling up existing practices. Of course, we'll need to see how this plays out over the coming years in terms of operating models for these organizations. One of the biggest reasons why startup care delivery orgs are able to create better experiences is because they don't have the baggage of legacy care delivery organizations - and all of the complexity created by cobbling together acquisitions over time. As startups make these acquisitions, their operational models get significantly more complex.Link / Slack (h/t Justin Venneri)

• Cigna reported earnings this week, providing some interesting insights on its earnings call, including four areas they'll be potentially seeking acquisitions (international expansion, digital / in-home care delivery, behavioral health, and technology support) for Cigna. Link / Slack 

• Humana also reported earnings this week. The call provides some good insight into the dynamics of operating a Medicare Advantage business, including lots of discussion of the various channels Humana is using to acquire members, and challenges they've been having with higher member churn than expected within specific channels. On the care delivery side, Humana is now up to 206 primary care clinics, with plans to build / acquire 30 - 50 clinics per year moving forward. Humana anticipates each clinic driving $2 - $4 million of EBITDA per year at maturity, which takes 3 - 5 years to reach.  Link. 

• Telehealth provider SOCTelemed, which went public in 2020 via SPAC, was taken private at $3.00 a share by a private equity firm. While SPACs may have  been all the rage for a period of time, and presumably generated solid returns for SPAC sponsors, it's hard not to view an exit like this as a massive failure. Given the state of the public markets at the moment, and perceived difference in valuations companies can find on public versus private markets, you have to wonder if this is not the last public health tech company we'll see taken private this year.  Link / Slack (h/t Dan Ferris)

• This is an interesting partnership between UCHealth and Guild Education, an education and upskilling platform, to help provide career advancement opportunities. As Martin notes in the Slack, it seems like a massive opportunity to help upskill healthcare labor - turn more MAs into nurses, turn more nurses into NPs. The gulf between supply and demand for healthcare labor in this country only seems to be widening by the day - I'd imagine that over the coming years we'll see some companies emerge and grow very large by effectively training the next generation of healthcare workers in this country.  Link / Slack (h/t Martin Cech)

• PointClickCare announced it is acquiring Audacious Inquiry in a big deal in the health information exchange space. As discussed in the Slack, PointClickCare has dominated the SNF market and is leveraging these acquisitions (including Collective Medical a few years ago) to expand its business. Link / Slack (h/t Lisa Bari)

• The American Hospital Association is starting to throw some weight around in DC, pushing back at traveling nursing rates as data suggests that rates have gone up 67% from Jan 2020 to Jan 2022. The staffing firms predictably disagree with the AHA, arguing rate increases are reasonable given the stresses of the job.   Link

• Speaking of political battles, Elizabeth Warren called for an end to the Direct Contracting model as well as reforms to risk adjustment in Senate Finance Committee on Wednesday, citing concerns over "corporate profiteering". It certainly feels like this battle is escalating.  Link.

• Labcorp has launched an at home testing business. Makes all the sense in the world for Labcorp to test this out, although you have to wonder if they'll end up eventually choosing to acquire a consumer-friendly brand in the space (in addition to Ovia). Link.

Funding:

• ConcertoCare, an in-home primary care model for seniors, announced it raised $105 million and acquired a practice of NPs in the Pacific Northwest called Crown Health. Similar to the Kindbody / Vios deal, it's another good example of venture-backed organization acquiring more traditional practice presumably to drive growth. Based on Concerto's Direct Contracting Entity via Perfect Health in Boston, it looks like Concerto has roughly 20 NPs and a handful of MDs, while Crown Health also has ~20 NPs. So from a clinical headcount perspective it doesn't appear that Crown and Concerto / Perfect are all that different. Yet from a valuation perspective, they seem very different. It would appear Concerto is playing the role of PE aggregator rolling up practices like Perfect Health and Crown Health, while providing them with a tech platform to support performance in risk-based contracts. Similar to the Kindbody commentary, it'll be interesting to watch how these organizations integrate different providers and cultures over time. And check out the Slack if you want to see my rough math on guessing how much ConcertoCare purchased Crown for.  Link / Slack.

• Remote patient monitoring startup Athelas raised $132 million at a $1.5 billion valuation. It seems that the remote monitoring market is really taking off, as Athelas has ~20,000 active monthly users.  Link / Slack (h/t Ben Lee)

• League raised $95 million to build the leading "Health OS Platform". Link

• Future, a digital fitness company, raised $75 million from a bunch of celebrities / athletes and... Optum Ventures?! Given UHG's broader interest in consumerism, it's really interesting to see Optum placing a bet in this space. Link / Slack.

• Vynca raised $30 million for its palliative care platform. Link

• Jasper Health, a support platform for individuals with cancer and their caregivers, raised $25 million. Link.

• Summus Global, a virtual specialty care platform, raised $22 million. Link.

• Getlab, a startup building a network of phlebotomists to do at-home blood testing, raised $20 million. Link.

• Marigold Health, a digital peer support platform for mental health, raised $6 million. Link

• Synapticure raised $6 million to build a tele-neurology company to treat ALS. It's founded by an individual with ALS and his wife / caregiver, which is really cool to see. Link / Slack.

• GoodBill, a startup working to help patients dispute surprise medical bills, raised $3.4 million. Link / Slack (h/t John Prendergass).

• Neura Health raised $2.2 million to create a virtual care delivery model for neurological conditions, starting with headaches / migraines. Link

• Lover, a digital therapeutic for sexual health, raised $2 million. Link.

• Curation Health, a clinical decision support platform for value-based care, raised an undisclosed round from Echo Health Ventures. Link.

Opinions:

• Oak Street's CMO Ali Khan shared his perspective of the impact of advanced primary care models like Oak Street on health equity. Worth noting that Oak Street shares that in one ACO in 2020, it created $1,200 in annual taxpayer savings per patient versus the CMS target. Of course this is notable as it runs counter to the argument that MA models are increasing costs for taxpayers - will be worth watching if we see more of this data emerging.  Link / Slack

• This is an interesting piece to read on how retirement communities are getting a makeover and becoming more like consumer brands. It then takes a 90 degree turn right into healthcare, highlighting Honor, Papa, and Patina Health. That portion comes as a bit of a surprise given the first half, but the stuff on the aging communities is certainly interesting to check out. On the theme last week of care delivery in communities - couldn't you imagine these upscale retirement communities having a little doctors office with an outpost for / telehealth connectivity to Mayo Clinic (or pick your name brand associated with quality care that can be used as a selling point for seniors). It sure seems that models like Pine Park are well positioned for growth over the next few years. Link

• Thomas Insel penned an article looking at the ability of digital technologies to transform mental health care delivery. He focuses on digital health's opportunity to improve upon three things traditional care delivery has struggled with: 1. patient engagement; 2. quality of care; 3. financial incentives.  Link / Slack

• This is a good look at Anthem's value based care strategy following up on some details shared in their earnings call last week. Anthem's strategy is a bit different than UHG / Humana, which makes a lot of sense given the historical roots of Blues plans as local partners to providers. Anthem is taking more of a flexible partnership strategy in working with providers to expand value-based contracts.  Link

• This is a really interesting read on Crisis Text Line, a non-profit that provides a free text-based service for people in crisis, and its botched attempt to monetize user data. Crisis Text Line created a for profit entity, Loris, which was given access to the text messages via a data sharing agreement. The FCC recently asked the non-profit to end the data sharing agreement, as it raises a number of questions around what patients can actually consent to and what purpose data is shared for. Link / Slack (h/t Matt Sakumoto)

• This article provides some good insight on how payers are starting to cover providing access to broadband internet so that members can access telehealth services. It looks at how some Medicare Advantage plans are providing these benefits, including Humana, Wellcare, Healthfirst of New York, and Devoted. For all the arguments around Medicare Advantage, articles like this provide a good reminder of they types of benefits these plans can provide.  Link.

Data:

• McKinsey suggests that $265 billion of care delivery services could move into the home by 2025. The chart below articulates the services that could be shifted to home. Interesting to see some of these numbers, including primary care at 25% - 30%, so low. Worth noting that its based on a survey of physicians currently serving the Medicare population.  Link / Slack (h/t John Yedinak).

• Physicians are still overwhelmingly paid by volume instead of value according to this survey of a group of physician leaders. The vast majority of physicians shared that increasing volume was by far the top action they could take to get paid more. Link.

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