Weekly Health Tech Reads | 5/3/20

News:

• Wheeee more earnings from this week which meant another group of healthcare execs sharing with Wall Street analysts their perspectives on COVID-19 impacts:

  • Centene increased their revenue guidance for the year by $6 billion, $4 billion of that increase coming from projected increases in unemployment rates (Centene largely sells Medicaid plans, which is where most people will end up getting insurance through when they no longer have insurance through their employer). Link.

  • Molina saw a 30,000 member bump in Medicaid membership, due to state Medicaid agencies suspending eligibility determinations. Some interesting questions were asked about the type of risk that they’ll see signing people up in both Medicaid and the exchanges. Link.

  • Community Health Systems reported their Q1 results, seeing net operating revenue decline 3.5% on a same store basis due to the impact of COVID-19 hitting in the second half of March. Interesting to compare and contrast here with HCA, which still saw revenue go up in Q1. Color me confused. Link.

  • Humana also had their earnings call, sharing they’re seeing 30%+ declines in medical utilization. They shared that they view ~15% of medical spending as truly elective. Link.

• Molina is buying Magellan Complete Care, Magellan’s managed care business unit, for $820 million. Link.

• Apparently hell started to freeze over near Madison this week as Epic decided to… partner with another company? They entered a partnership with Twilio to create a solution for video visits. There was some interesting perspective on the Slack channel this week about how Twilio is growing in the healthcare space by providing telecom infrastructure for digital health solutions. Link.

• Also from the Slack channel this week was a good discussion of how MassHealth, the Medicaid program in Massachusetts, is making a bunch of moves in the digital health space. This week they announced a partnership with Doctor on Demand for COVID-19 care. Over the past few weeks it seems that they’ve also launched partnerships with Maven (digital women’s health clinic) and Galileo (virtual care clinic). Whoever is running these programs at MassHealth is going to have a really interesting case study on their hands as to how people utilize various digital care offerings from their insurers. Link.

• Optum is rumored to be buying AbleTo, a behavioral health telehealth company, for close to $500 million. Seems like a nice bit of validation for Optum Ventures, which invested in AbleTo in 2019. Link.

• CMS announced additional rule changes this week expanding telemedicine access (upping payments and expanding provider types) and providing some financial relief to ACOs. Link.

• Tomorrow Health raised money from Andreessen Horowitz and others to build a Amazon-like marketplace for home health medial supplies. Link.

• Vida Health, a virtual health coach platform, raised $25 million. Link.

• Medici, a telehealth platform, raised a $24 million Series B. Link.

• Particle Health, a startup building APIs to help digital health companies to access patient electronic medical record info, raised $12 million. Link.

Opinions:

• Andreessen Horowitz is clearly very long on the unbundling of healthcare, evidenced by two articles over the last few weeks on the topic. I found both to be good high level starting points for conversation and to provoke some thoughts, with many questions that need to be answered on each topic on how things play out.

  • Julie Yoo wrote about the unbundling of primary care. I think it should be clear to everyone who reads this blog by now that this is a trend that isn’t going away anytime soon, and this article serves as a good jumping off point into the topic. Link.

  • Jorge Conde wrote about how healthcare is moving outside the hospital. Link.

• This is a good look at one of the regulatory changes that has investors everywhere gaga over the kidney care space. In 2021 individuals with end stage renal disease will now be able to sign up for Medicare Advantage plans (whereas you weren’t allowed to before). Link.

• Here’s a summary of the breadth of the financial challenges the healthcare system is dealing with as a result of COVID-19. Link.

• McKinsey shared a piece suggesting a five step process for healthcare organizations to think about how to recover from COVID-19. Link.

Data:

• One Medical & Collective Health released data in JAMA this week suggesting that One Medical’s primary care model generated cost savings of 45% for an employer with 22k covered lives. First off, kudos to them for publishing the data and putting it out there like they did. Second off, wait - what? 45% savings in an employer population? Uhhh… I am skeptical that the savings is real. But regardless of the cost savings data, there are some really interesting other points made in here, covered below. Link.

  • 22% of the population used an aspect of One Medical’s primary care services, but only 9% of that group used it as their primary source of primary care. That means that 57% of people who tried One Medical out still got the majority of their primary care elsewhere. I would be quite curious to know what that population cost given the double payment (for traditional primary care and One Medical’s fees).

  • For a good example of how a few high cost outliers can drive a outsized chunk of medical spend - check out the 5 individuals identified as high cost outliers in Table 2. The PMPMs costs for those individuals were $73k, $61k, $60k, $46k, and $35k.

  • 6.4% of the overall population used virtual care, and 19% of the population who used the One Medical clinics used virtual care.

• Data from Kaufmann Hall this week illustrated well just how big of an impact this is having on health care delivery operating margins. Link.

• Here’s another look at how the decline in healthcare spending is a driving force behind the economic recession. And here it seems is the elephant in the room when it comes to healthcare costs in this country - nobody is happy with how high costs are, or the outcomes we get for them, or the crappy experience - but how do we get out of this tangled mess without causing the economy to collapse? Link.