Weekly Health Tech Reads | 8/22/21

News:

• Alphabet / Google announced that Google Health is shutting down this week, prompting a chorus of "healthcare is hard" statements from the healthcare community.  Although it's a blow for an organization that has struggled into healthcare, it sounds as though all of the projects under Google Health will continue elsewhere in the organization, so perhaps this isn't as much of a told-ya-so moment as it's being made out. One notable departure from Google Health' in this change is CEO David Feinberg moving to a new gig as CEO of Cerner. It will be certainly be interesting to watch what happens next out of Google in the healthcare space. Link.

• In another signal Alphabet perhaps isn't rolling over entirely in the health care space, Verily acquired SignalPath, a clinical trial management system. Link.

• UnitedHealthcare acquired PreferredOne, a local insurer with 250,000 lives here in the wonderful state of Minnesota. The majority of those members are in commercial plans. This is a reminder of how hard it can be for insurers to grow membership in markets - UHC entered the Minnesota market back around 2017, and even with all the benefits of being one of the largest employers in the state offering insurance in their backyard, they are still choosing to grow by acquiring lives from another insurer. Link.

• Inovalon, a data platform for virtually every healthcare stakeholder (payors, providers, pharmacy, life sciences), is being taken private at a $6.4 billion valuation. Link.

• Social determinants of health platform Unite Us acquired Minneapolis-based Carrot Health, a data analytics startup (It's been a while since we rang the Minneapolis start-up alert bell but here we go!!!). Link.

• HCA and General Catalyst announced an incredibly vague strategic partnership this week, which includes Commure (General Catalyst's itself vague healthcare platform thing-y) acquiring HCA's provider software platform, PatientKeeper. HCA itself acquired PatientKeeper back in 2014. PatientKeeper is an old school health tech startup, getting its start back in the 90s building medical software for Palm Pilots. The announcement makes the PatientKeeper move feel like HCA finding a new home from an asset that perhaps hasn't grown quite as originally intended beyond HCA's staff using the tool. I'll be curious to see if more details of the GC and HCA partnership come out over time... because I have no idea what it is based on the press releases here. Link.

• BCBS Michigan acquired a MSO called Triarq Health as it joins the ranks of payors moving into the provider business. Link.

• Cityblock announced this week that it's work with BCBS North Carolina is expanding to include Managed Medicaid. BCBS NC continues to build on its efforts launched back in 2019 bringing a number of advanced primary care startups to market - Cityblock, CareMore, and Iora. Rather interestingly, Galileo appears to have been added to that list rather quietly since it first came out. Link.

• Minnesota-based (!!!) insurer Medica launched a JV with midwest health system SSM, which includes Medica investing in SSM's provider sponsored plan, Dean Health Plan. Medica and Dean will work together to do your typical partnership activities - improve member experience, operations, tech, etc. Given the Oscar earnings call the other day about focusing on provider-sponsored health plans... I'd you'd like to see their name here rather than Medica if you're an investor. Although it is understandable as us Minnesotans are a tough bunch to compete with. Link. 

Funding:

• Women's telehealth startup Maven raised $110 million. Link.

• Carrot Fertility, a fertility benefits startup, raised $75 million from Tiger Global. Link.

• Closedloop.ai has raised $34 million to build a data science platform for care delivery. Link.

• Opya, an autism care startup, raised $15.4 million. Link.

• element5, a robotic process automation platform for post acute care, raised $15 million. Link.

• Soda Health, a startup working to address health inequities by helping members take advantage of insurance benefits, raised $6 million. Link.

• bttn. raised $5 million to build a platform for medical supply procurement. Link.

• River, a telehealth / Rx startup, raised $1.5 million. Link.

• DocSpace, a platform for helping providers start their own businesses, raised $1.2 million. Link.

• Meetcaregivers, a platform helping match seniors with care givers, raised $1 million. Link.

Opinions:

• If you're interested in Carbon Health's approach to the primary care space, this is a fascinating deep dive on what they're up to. The second half of the article starts focuses more specifically on Carbon. A couple of points stick out to me: Carbon started as a tech platform for primary care clinics, but quickly found that behavior is hard to change that way. Instead of using the software to decrease costs, clinics were viewing it as a premium add-on to justify *higher* prices. So Carbon decided to go "full-stack" and bought one of its customers, a chain of urgent care clinics. During the pandemic, the original Carbon clinic was seeing 120 patients a day, all COVID-19 related. It's now seeing 60 patients a day, for more general needs. That patient volume shift highlights how it'll be worth watching what Carbon's financials look like in a post-pandemic world (hopefully that day comes at some point). It's also quite interesting to see Carbon's CEO describing the vision of the company as "building the worlds largest hospital system". They're intending to build out 1,500 clinics by 2025, up from 81 today.  But the article also hints that over the longer term, Carbon wants to sell its software to other providers. Those three sentences all feel like the makings of very different potential strategic paths for a company at Carbon's stage. Certainly makes for an interesting set of strategic questions moving forward, and what will eventually be a very fun S-1 to read. Link.

• Speaking of the world's largest hospital system, the American Hospital Association is apparently upset that antitrust regulators are scrutinizing hospital mergers. So naturally it wrote a letter to the FTC, DOJ, HHS, and the National Economic Council complaining that the regulators are spending too much time and attention on hospital consolidation, citing a study showing that hospital consolidation is, in fact, beneficial. Of course, don't mind all the other studies showing the opposite, or that the one study cited was financially supported by the AHA. Oh, the letter also informs federal regulators that they are not focusing on the real bad guy here - the insurers - for their anticompetitive behavior. This feels like the kind of argument a 5-year-old makes about their sibling, yet here it is happening publicly at the highest levels of politics. Wonderful. Link.

• This is an interesting look at how we can learn from the success of value-based models in Medicare Advantage and apply those learnings to Medicaid. The last point on accurate patient attribution seems to be a particularly important one for all value-based models moving forward. Link.

• Here's yet another perspective on healthcare payment innovation over the next ten years and what we can do to improve. This one focuses on four suggestions to implement more payment innovation - specialist provider participation in value-based models, focusing on multi-year investment periods, aligning models across payors, and reducing admin burden. All make sense, some seem more politically feasible than others. Link.

• For folks thinking about taking venture funding from health systems, this Washington Post article provides a good perspective on the challenges those relationships can face. The article describes how one health system, Cone Health, invested $12 million in a diabetes app, only to shut it down after a challenging path full of missteps that appear to be common across many failed health system innovation attempts. Link.

• Business Insider featured a deep dive on Optum's new direct-to-consumer offering, Optum Store. It'll be really interesting to watch whether Optum can succeed in the D2C-brand space in the same way Ro and Hims have. Link (paywalled).

• Anthem's Chief Strategy Officer Bryony Winn talked to Business Insider about Anthem's primary care strategy. As opposed to owning primary care, they're looking at building a platform to partner with PCPs. Link (paywalled).

Data:

• KFF data suggests Medicare Advantage spending per beneficiary is higher and growing faster than traditional Medicare. Link.

• This data from Peterson-KFF Health System Tracker shows that as of April 2021, care hasn't rebounded to predicted levels based off their analysis of Epic data level. Link.

• A McKinsey survey finds that hospital inpatient admission volumes are back at, or above, 2019 levels. Quite interesting to see the projected relative increase in the back half of the year for 2021 and think about the implications of this chart combined with the chart above, particularly when thinking about insurer's challenges managing MLRs in Q2. Link.