Weekly Health Tech Reads 10/2/22

Google’s OneFifteen effort to combat substance abuse, Medicaid initiatives in Oregon & Mass, the CBO on commercial insurance prices, & more 

This week's newsletter is sponsored by Geneticure.

Geneticure is a Mayo Clinic-backed pharmacogenomics (PGx) company leveraging genetic information to identify which anti-hypertension treatment is most likely to work for each patient based on their DNA. It’s a really unique approach in PGx with their peer-reviewed clinical and health economic evidence, often lacking in the space, and focus on the genetics of integrative-physiology in chronic disease. If you’re a care delivery organization with patients with hypertension and interested in learning more about what they’re up to, check it out here.

News of the Week:

  • This Bloomberg article on Google's efforts to transform substance abuse treatment is a fascinating read about the limits of technology's ability to transform care delivery. The article dives into Google's OneFifteen program, an ambitious endeavor to leverage technology create a "learning health system" that fundamentally changes substance abuse treatment. While OneFifteen had large ambitions of using machine learning to start predicting relapses, it is hard to build those machine learning algorithms when you are only treating a few thousand patients over multiple years. Instead, OneFifteen looks and feels a lot like a local care provider that is providing high quality care in the face of a broken system with challenging financial incentives. It'll be interesting to watch how this initiative evolves over time if it continues to fail to reach the scale that Verily might have been hoping for while also having a positive impact in the Dayton community - what does Verily do at that point? Does it continue supporting a program as public infrastructure for the good of the Dayton community? Or does it act like a public for-profit entity and move on to more profitable pastures?  Link / Slack (h/t Vikram Pradhan)

  • Some interesting news out of the Medicaid space this week as CMS announced new section 1115 initiatives in Oregon and Massachusetts to provide for continuous Medicaid enrollment for children up to age 6. Lots of interesting implications from this announcement, and we took the opportunity to ask HTN friend and Medicaid nerd Dr. Lindsey Leininger for her perspective on the news - which you can see in the HTN summary link below. She provide lots of helpful perspective on the meaning of this announcement and what we can expect the impact to be moving forward, including many other states that will likely follow the Oregon trail.  Link (press release) / Link (HTN summary)

  • Grow Therapy, a platform helping therapists launch their own practices, raised $45 million in equity (and $30 million in debt). I'll be curious to watch how this space evolves over the next few years. We now have a number of really well funded startups competing to attract mental health practitioners, as it seems like VCs have identified there is a land grab opportunity in this space. Between Grow, Alma, Headway and others, a number of startups seem to be competing to be the platform that aggregates therapists, and whichever reach scale seem like they're in a great position.  Grow Therapy currently has 3,500 therapists and is attracting 40% of its new therapists via word of mouth growth, which seems like a solid start, but what happens to growth in this space when these platforms have penetrated more of the market and are competing for therapists' attention?  Link 

  • Interwell, the recently created value-based kidney care venture, acquired another Fresenius-related company, Acumen Physician Solutions. Acumen is an EHR / practice management software for nephrologists. The move raises a lot of questions for me as to the value of Cricket in the recent three-way merger that created Interwell. If you'll remember in that acquisition, Cricket was supposed to be bringing patient engagement and data assets into the combined entity. Acumen certainly appears to be a competing platform, at least at surface level. I suppose that Cricket could still be bringing data analytics capabilities, but it seems hard to imagine those capabilities are going to translate over to Acumen's platform easily.  Link

Other Announcements:

  • Instacart announced the launch of Instacart Health this week, and it appears to already be doing some interesting work supporting the food-as-medicine space with last mile logistics. Seems like an interesting entry into the healthcare space with the opportunity to do some meaningful good. Will be curious to see if other food delivery startups see this as a new revenue opportunity and follow suit.Link / Slack (h/t Misha Nasrollahzadeh)

  • Oncology startup Jasper and Memorial Sloan Kettering partnered in a rather interesting example of a startup partnering with large incumbent provider. I continue to be curious at what point we might start to see health systems acquiring digital health solutions. A relationship like this, in which Jasper appears to be a distribution arm for MSK's clinically-validated capabilities, provides an interesting path to this type of activity happening more. Should Jasper prove effective in doing so, why not bring it in house if you're MSK to add more clinical solutions?  Link / Slack

  • Penn Medicine is investing in Independence Blue Cross's primary care enablement platform, Tandigm. As part of the deal, Penn will add ~375 providers / advanced practitioners to the platform that currently has ~400 PCPs in the Southeastern Pennsylvania area. Interesting to see an academic medicine institution getting into the VBC primary care game. Link

  • Cigna is launching a new "concierge care" platform called Pathway for MSK patients that are on biologic drugs. Calling this a concierge platform seems like a nice consumer-friendly marketing twist on case management / disease management programs that payors have long offered to high cost patient populations. Link

  • Town Hall Ventures raised a new $350 million fund to invest in underserved communities. Link

  • Rippl raised $32 million in seed funding for a new virtual care model for dementia treatment.  Link

  • Kahun raised $8 million for an AI chatbot that combs medical literature to help patients answer questions about areas of potential concern they should talk to a provider about. Link

Opinions:

  • The CBO released a fascinating report this week looking at various policies and their ability to impact commercial prices in healthcare. It finds that price transparency has a very small impact on prices, promoting competition among providers has a small impact on prices, and capping prices has a moderate to large impact on prices. The graphic below in particular is a helpful explainer of the various interests that lead commercial insurance prices to be so high. Link / Slack (h/t David Schwartzman)

  • It's not only health systems facing the wrath of the NY Times these days, as McKinsey also comes under the spotlight this week for its role in addicting our country to things like opioids, cigarettes, and nicotine vapor. It's an interesting read on an organization that seems to have taken the value of putting client interests first to an extreme. You'll recall McKinsey also featured prominently in last week's NY Times piece as the consulting firm that devised Providence's strategy to hound low income patients for payment. Lovely. Link 

  • KHN wrote about the disconnect in the Dallas market, between hospitals that are quite profitable and patients who have a very high level of debt. Dallas and Tarrant Counties report 22.5% and 27% of individuals with credit reports have medical debt, respectively, with the mean amount of medical debt at ~$1,000. It'd be shocking if we weren't so used to shocking figures like this at this point. The report prompted an interesting conversation on Slack about whether or not hospitals are getting an unfair brunt of public criticism lately compared to insurers. Link / Slack

Data:

  • This is some interesting research looking at the rise of digital health in clinical trials. It's interesting to see how few of the trials are sponsored by industry, as I would have expected that to be a much higher number. Cool to see the trend over time. Link

  • There is apparently a lot of duplicate text in medical records - according to this study 50% of words in clinical notes were duplicated from prior notes in the EMR. Link

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