Weekly Health Tech Reads | 7/25/21

News:

• Kroger joins the fray as the latest retailer to get further into healthcare, announcing it has partnered with Anthem to launch a Medicare Advantage plan. Will be curious to see how many folks sign up for this Kroger plan. Link.

• UnitedHealth Group announces it is working with Peloton to provide individual and fully-insured commercial members with a year free access to the Peloton app. Lots of discussion in the slack community on this topic centered around how good of an open enrollment marketing tactic this will likely be within employer sponsors and potentially the individual market. You can certainly imagine brokers will like selling the new shiny object. Link.

• CMS is increasing the penalty for hospitals that don't comply with the price transparency rule. The penalty increases the $300 per day tap on the wrist to a more consequential $5,500 per day to drive up the meager hospital compliance rate of 5.6% found in a study by the Patient Rights Advocate group. Next hurdle is getting more than 1 in 10 patients to know hospitals are publishing prices (or supposed to). Link.

• Anthem reported earnings. Interesting to see the analyst question about the virtual and digital initiatives are playing up and what impact those will have on medical trend. The CEO sidesteps the question, but it remains to be seen how Anthem justifies the focus on digital. Link.

• Anthem and Humana have partnered with SS&C (raise your hand if you have heard of SS&C before...) to develop a new PBM called DomaniRx. SS&C will own 80% of DomaniRx, which is being capitalized with almost $140 million up front. Link.

• Collective Health launched a partner program with 10 digital health companies to help employers evaluate and manage various digital health vendors. Link.

Funding:

• Primary/urgent care provider Carbon Health raised $350 million, setting its sights on going public as soon as early 2022. The Forbes article linked here is worth perusing, as it provides a lot of interesting details on Carbon's model. One of the more interesting elements here is that Carbon is only charging Medicare rates, and still aiming for a 25% - 35% EBITDA margin across its clinics (which it says it is already hitting in older clinics). Cue PCPs around the country collectively scratching their heads at how a PCP org can get to that margin on Medicare rates - is it from COVID tests? Is it from reduced staffing costs? Some sort of other magic? And for all the virtual care startups, the article presents some really interesting thoughts on customer acquisition costs via bricks & mortar versus digital. In the Bay Area, 95% of Carbon's patients are from word-of-mouth / walk-bys, versus 5% from paid channels. This is going to be a fun S-1 to check out eventually. Link.

• WoeBot, a mental health chatbot going down the prescription digital therapeutic commercialization route, raised $90 million. Link.

• Quit Genius, a telehealth startup working on addiction treatment, raised $64 million. Link.

• b.well raised $32 million to build a digital experience for payors, employers, and health systems. Link.

• Turquoise Health, a startup building tools on top of hospital price transparency data, raised $5 million. Link.

• Data analytics startup Trilliant Health received a strategic investment from Bon Secours Mercy Health. Link.

Opinions:

• This is a fascinating NYTimes article on the state of home care and how demand for home health providers is outpacing supply, creating significant challenges for folks trying to help loved ones stay at home. Link.

• HealthPopuli highlights IQVIA's report on the the proliferation of digital health tools and the importance of evidence in driving reimbursement, and therefore, adoption over time. Link.

• Lisa Suennen shares her perspective on a recent panel with four VCs who all had very different takes on where valuations are going moving forward. Interesting times we live in. Link.

Data:

• Here's a paper looking at how Commonwealth Care Alliance and a local community-based housing organization partnered to help reduce homelessness in CCA's dual-eligible members. For non-NEJM Catalyst subscribers, there's a tweetstorm describing the paper. Link (Twitter). Link (NEJM Catalyst).

• A JAMA article reports American medical debts in collection agencies hit $140 billion last year, the largest type of debt owed to collection agencies. But oh, whats that you say, there might be a way for states to help reduce medical debt or their citizens? Check out the rather stark difference between states that have and have not expanded Medicaid. Link.