Weekly Health Tech Reads | 5/10/20

Reads for the week of 5/3 - 5/9

News:

• Ok at this point I’m a bit fatigued by Q1 2020 - aka COVID-19 update - earnings season, which has wrapped up this week if I’m not mistaken. Some earnings call highlights from the past week:

  • CVS saw a 600% increase in virtual visits year over year. Some interesting comments about how they’re seeing some shifts in consumer sentiments - i.e. there’s a significant uptick in people who want to get flu shots in a retail pharmacy setting instead of a doctors office. Link.

  • Livongo shared their Q1 results, and surprise! COVID-19 is good for remote monitoring business. Livongo saw 100% growth in their diabetes membership year over year, and they signed some notable contracts including a systemwide roll-out of their mental health product at Kaiser Permanente. Livongo’s CEO made some really interesting quips about Livongo’s entrenchment in the HR Benefit community, the most interesting one to me being: “And I was on the phone with one HR Benefits Director recently, and they said, "You don't get fired for buying Livongo." And that was just here recently.” Seems like a really nice spot for a company to be. There was lots of good dialogue this week on this topic over on Slack as to whether employers are going to continue paying for digital health tools as benefits for their employees in this economic downturn - worth keeping an eye on Livongo to watch how this space plays out. Link.

  • Tenet had their earnings call, providing more data on how far utilization fell in April - hospital admissions down 33%, hospital outpatient stays down 60%, emergency department visits down 50%, ASC surgeries down 80%. Link.

• I am really bummed to hear that politicians in Colorado have decided to shelve their insurance public option for the foreseeable future. You might remember from previous newsletters that the state of Colorado was attempting to create a low cost insurance option for Coloradoans by capping hospital rates at 155% of Medicare. The effort made it quite far, but apparently has been derailed by the pandemic. For those thinking that this crisis is the opportune time to fix the way care delivery is paid for… this should serve as a reminder just how hard meaningful change is going to be to deliver on in this industry. Lots of entrenched interests that are going to fight this kind of change tooth and nail - this illustrates just how challenging it is to get legislation like this all the way over the goal line. Link.

• Babylon, the AI chatbot company, and Mount Sinai Health Partners, a primary care network in New York, have partnered to include Babylon as part of the primary care network. Seems like a big move for them into the U.S. in partnership with primary care providers. Link.

• LetsGetChecked, a startup that sells a variety of at-home test kits to consumers, raised $71 million. Link.

• Wellth, a startup that gives people cash incentives to help motivate them to stay on their care plan, raised $10 million. Link.

• Monogram Health raised $7 million for its kidney care disease management program. Link.

• Limbix, which is creating a digital therapeutic addressing mental health for kids, raised $9 million. Link.

• TimeDoc Health raised $5.7 million for a virtual care coordination platform for providers. Link.

• LifePod, a startup building voice enabled caregiving services to help seniors age in place, raised $5 million from Commonwealth Care Alliance. Link.

• First Dollar raised $5 million for a consumer-friendly HSA. Link.

Opinions:

• This is an interesting read from Chrissy Farr from a health system perspective on how much money they’re losing as a result of COVID-19. The American Hospital Association has come out and suggested its $50 billion per month, with other estimates putting it around $1 billion per day. A leader at UCSF suggested that their system alone is losing $5 million per day. Just crazy how big these numbers are. Link.

• And while health systems are happy to share with us all about how they’re losing money due to COVID-19, it’s a different story when it comes to sharing how much they charge insurers for care. The American Hospital Association has brought a lawsuit against the Department of Health and Human Services, which has tried to pass price transparency rules that require hospitals to post their prices for ‘shoppable services’. The AHA is arguing, among other things, that such requirements violate hospitals first amendment rights by requiring them to post confidential and proprietary information. Hooey. Link.

• Nikhil Krishnan wrote a good piece tearing down some of the common ideas tech folks have on how they’re going to save the healthcare industry - starting with the notions of paying patients for outcomes and building new EMR platforms. Link.

• I found this to be a well put together white paper from Gene Agency on the wide ranging impacts of COVID-19 on healthcare with a focus on the consumer viewpoint. It hits topics including health and wellness, telehealth, home visits, mental health, aging, and employer benefits. They did a nice job providing some interesting anecdotes in each category to think through. Link.

• Chilmark also shared a blog post looking at what the lasting impacts of COVID-19 will be for the health industry, positing that virtual care is here to stay, payment models will shift away from FFS, and more. Link.

• Here’s a piece from the CEO of Welbe Health, a startup providing primary care services for PACE plans, on how PACE could be used to rethink care for seniors in this country. It’s a well done piece and articulates the many benefits of PACE - but then I can’t get one number out of my head: PACE programs serve just over 50,000 seniors today. With an estimated eligible population of over 2 million. Why do we have this idyllic-sounding programs in this country with almost no uptake? What gives? Link.

Data:

• A new study in Health Affairs looked at pricing and found that, on average, commercial inpatient and outpatient prices were about double Medicare rates, and professional services were 60% higher. The paper also suggests that if you paid hospitals at government rates instead of commercial rates it’d cut their overall revenue by 35%. No wonder hospitals didn’t like the Colorado public option. Link.

• Here’s a link to the American Hospital Association report that hospitals could lose $200 billion from COVID-19 between March and June. I am confounded by the stance the AHA seems to be taking on behalf of hospitals at the moment: we’re going to need bail out money because we’re sacrificing all of our profitable volume and incurring tremendous losses, but we’re also going to sue you to prevent anyone from knowing how much we charge for care! Seems rather… opaque? Link.