Weekly Health Tech Reads | 9/12/21

News:

• South Dakota health system Sanford Health received a $350 million dollar donation from its namesake Denny Sanford, to build a virtual care center. That sure is a lot of money to build a virtual care center - worth keeping an eye on what Sanford is able to build with this, and it certainly has the potential to help change how care is delivered in rural communities. It's also a reminder that if you've got a lot of money apparently it excuses you from a number of things, including being under investigation for child porn, as Denny Sanford has been for the past few years. I would not want to be in the Sanford foundation office debating the morality of taking a gift like that. Link.

• CareMax, one of the recent South Florida Medicare Advantage primary care SPACs, hosted its investor day. The investor presentation linked here is worth checking out if you're interested in the primary care / value based care market. The deck provides a nice overview of the CareMax model, associated financials, and its growth strategy. CareMax is leaning into two partnerships to grow - one with Anthem and the other with The Related Companies, an affordable housing real estate developer. CareMax plays up its experience working in affordable housing in the presentation, as well as its heavy concentration of dual-eligible populations - 65% of its MA members are duals vs 45% - 50% for its peers (slide 22). The medical expense ratio reduction over time is pretty wild - going from 107% for members in Year 1 to 51% for members in Year 6+ (slide 22). At some point you'd think insurance regulators will look to regulate that margin in the same way insurance products are, right? Link.

• Amazon is expanding Amazon Care, which according to the article now has ~40k members, to 20 new cities in 2022. Of course Amazon's name involved in this roll-out is what makes this news interesting, we will see if Amazon is able to do it differently from the many other competitors scaling primary care models. Link.

• Ciitizen, a company that helps patients leverage their health records to identify treatment options and research diseases, was acquired by Invitae, a public company in the genetics space, for $325 million. Link (press release). Link (investor deck).

• CMS released an evaluation of Vermont's All-Payer model this week. It appears early results are good from the model, which was launched in 2017 featuring a statewide ACO. It's finding statistically significant cost savings and improved quality of care as well. Link.

• Blue Shield of California and Walgreens announced a partnership where Blue Shield's commercial members are able to get common health services as Walgreens Health Corner locations. Link.

• Optum has teamed up with OutHealth to launch a virtual LGBTQ education program for providers. Link.

Funding:

• Flo, an app for period tracking, raised $50 million at an $800 million valuation. The usage stats for Flo are pretty impressive - over 200 million users, one billion menstrual cycles tracked using the app, and 43 million women use it on a monthly basis. Presumably they'll start expanding use cases from here - will be curious to watch how they choose to do so. Link.

• Corti, a Denmark-based virtual care platform, raised $27 million. Link.

• DotCom Therapy raised $13 million for its pediatric tele-therapy model. DotCom has been focused on expanding access to pediatric therapists in schools, providing services for 400+ schools. It'll use the funding to start expanding to work health systems. Link.

• Psychadelics startup Journey Colab raised $12 million to conduct a trial of mescaline alongside talk therapy for patients with alcohol use disorder. Link.

• Neuroglee raised $10 million to build a digital therapeutic for mild cognitive impairment in partnership with Mayo Clinic. Link.

Opinions:

• This is a good perspective from Providence's digital health leader Aaron Martin on the role big tech can play in healthcare moving forward, the competitive threat it represents to care delivery, and how health systems should respond to the threat. The piece highlights well the advantages health tech players have over the existing care delivery community: "They are digital first; have fewer financing constraints; have lower fixed cost and capital infrastructure; they target only our profitable services; have (sometimes) massive audiences; and they have a focused value proposition and brand." The basic recommendations for health systems stems from Providence's experience thus far, although I think it stops short of recommending what is really needed for these health systems to successfully reinvent themselves as digital organizations - nothing short of full a organizational redesign. It's a tough hill to climb, and I think Providence itself is indicative of the challenge - despite its relative success, there still aren't many quantifiable proof points provided. Link.

• Here's an interesting perspective from 7WireVentures's Alyssa Jaffee on the looming provider shortage in this country and how digital health can potentially help solve some of the issues. The suggestions - expanding geographic reach of providers, clinicians practicing at "top-of-license", leveraging non-clinicians, and using tech to expand provider capacity - Seem like a good starting point for conversation, and each come with some good examples of digital health startups working on the issue. But interestingly, most of those suggestions don't necessarily require that much tech (aside from perhaps the last one). Really, they require regulatory changes, incentive redesign, and similar to the last paragraph, new organizational designs.  Link.

• Also from the 7wireVentures crew, here's a market map of the digital pharmacy space. Link.

Data:

• KLAS conducted a survey of hospital leaders and found that at the vast majority of organizations, telehealth is now less than 20% of visits - and where it is not, it is still being inflated by COVID-19 and they expect it to come down. This is an interesting chart (pg. 6) looking at where various specialties are using telehealth. Of course mental health is attracting all the attention now, but it highlights other areas where we're likely to see activity moving forward. Link.

• Meanwhile Fair Health's monthly telehealth utilization tracker found that telehealth visits are down to 4.5% of total claims for June, dropping 10% from May. Link.

• UHG released data suggesting consumers save an average of $680 per procedure when the procedure is moved to an ASC from hospital outpatient. The overall price drops from $7,716 on average to $3,157. Link.

• Digital health vendor Kyruus took a look at the current state of digital health tools at the top 20 health systems in the US. Not surprisingly they find some room for improvement on a number of fronts - i.e. letting new patients search and schedule a visit with a provider. Link.

• Administrative complexity is a hassle for patients, as this study examines. It finds nearly 25% of patients are delaying care due to administrative tasks they need to complete for their care. It also references a KFF study finding the 26% of people avoided care due to cost. Presumably there is a quite a bit overlap in those numbers but would be an interesting insight if that is not the case.  Link.