Weekly Health Tech Reads | 5/15/22

This week's newsletter is brought to you by Rightway.

Rightway, a health tech company simplifying the healthcare experience for employers and their employees through optimized care navigation and pharmacy benefits solutions, is hosting a conversation on the impact of leadership on improving employee experiences and creating a better healthcare ecosystem. 

You'll hear perspectives from Nitin Nohria (Exec Chair, Thrive Capital and former dean of HBS) and Eric Larsen (President, The Advisory Board) along with Rightway's CEO Jordan Feldman, so it should make for an interesting dialogue. Sign up here if you're interested in joining.

News:

• In addition to the Babylon, Clover, Oscar, and Privia calls we mentioned above, there were a number of other earnings calls this week, including:

  • AmWell posted a net loss of $70 million on $64 million of revenue, up from a $40 million net loss on $58 million of revenue Q1 2021. They spent a lot of time discussing the rollout of the new tech platform Converge, which now has 10% of total AmWell visits running through it. It sounds like the deployment of Converge is driving up costs in the short term for AmWell, which is worth watching. Link (release) / Link (transcript)

  • GoodRx tanked after sharing that a grocer (widely reported as Kroger) stopped accepting prescription drug discounts, which is GoodRx's core business model. As a result, they're pulling guidance for the year.  Link (release) / Link (transcript)

  • Hims posted a strong quarter hitting $100 million of revenue in a quarter for the first time. The company focused on three core areas of its flywheel driving the growth being 1) new partnerships to drive brand awareness with an emphasis on retail, 2) delivering on that brand awareness with a new app experience delivering more content and cross selling opportunities and 3) driving operational leverage via fulfillment vertical integration. Relative to its peers (more specifically Ro), Hims & Hers still seems more focused on delivering on the lifestyle/wellness aspect of the brand rather than expanding into some of the more difficult/traditional conditions to treat. Doesn't seem like a bad place to live for now with its over 700k subscribers to continue developing customer relationships, get to profitability and figure out how far into more in-depth care really makes sense. Link (release) / Link (transcript)

• Two leading regional health systems, Advocate Aurora Health and Atrium Health, announced they are merging. The new entity will be called Advocate Health, serving 5.5 million patients across six states in the Midwest and Southeast. It's interesting to see the six areas the organization is looking to have a positive impact on: clinical pre-eminence and safety, health equity, affordability, next-generation workforce, learning and discovery, and environmental sustainability. Seems like a pretty good pulse of what health system leaders are thinking about today. Link / Slack (h/t Neil Sanghavi)

• VC firm General Catalyst announced another rather cryptic partnership with a leading health system, this time Intermountain Healthcare. Good luck deciphering from the press release what is actually going on here. Given the long paragraph about Intermountain's non-profit interoperability platform, Graphite, it appears that this relationship is going to involve connecting General Catalyst's portfolio with Graphite. But beyond that I have no idea what is going on here. If anyone reading this has any understanding of whether there is any financial value exchange in this partnership, we'd love to hear about it. Link / Slack (h/t Neil Sanghavi)

• Two virtual alcohol abuse treatment platforms announced a merger this week as Monument is acquiring Tempest Health. Post-acquisition, Monument will have an audience of 300,000 people rethinking their drinking. It'll be interesting to watch this model grow over time. It also seems like a sign of the times from a market perspective - I think we'll be seeing many more acquisitions like this over the coming months. Link / Slack (h/t Ryan Gallagher)

Funding:

• Osmind raised $40 million to build a new EHR for mental health practices, helping providers manage medications like ketamine and psychedelics. Will be curious to see how this platform chooses to expand over time in terms of how it services mental health practitioners. Link 

• Turquoise Health raised $20 million for its price transparency platform. As part of this raise, Turquoise announced it is launching a new contracting platform between payors and providers. It's a logical leap for a platform like Turquoise as it seeks to find a business model for its data asset, although obviously will require the creation of a new muscle for the organization. It's interesting to see one of the leading startups leveraging data generated by the price transparency requirements - which providers have generally pushed back against - leveraging that data to now support providers as a core part of its business model. It highlights the challenges of trying to build outside of the system, and the necessity to support existing players when seeing out a viable business model - there's an interesting conversation in here about disruptive versus incremental innovation in healthcare.   Link / Slack (h/t Krish Maypole)

• Ness, a fintech startup creating a credit card that rewards wellness, raised $15.5 million. As part of the financing, Ness also announced it is acquiring Wellsky's network of 4,000 wellness practitioners, ranging from health coaches to dietitians to doulas. I applaud the idea here of making wellness more affordable. I'm not sure I fully understand how the acquisition of 4,000 practitioners fits into the strategy at this point in the company journey, so it'll be interesting to watch what they do with those folks. Link / Slack (h/t Derek Flanzraich) 

• Handspring, a new hybrid virtual / in-person pediatric mental health practice, raised $6.2 million. Link.

• Simplifed, a virtual care model for lactation consultants to support people with feeding babies, raised $6 million. Link / Slack (h/t Maggie Moore)

• OncoHealth, a platform for cancer care, received a strategic investment from Arsenal Partners and McKesson.  Link

Opinions:

• We're now just over a week into the leaked draft of the Supreme Court decision to overturn Roe v Wade, and there have been a number of good articles looking at the various implications within the healthcare landscape. Of course, we'd be remiss to discuss the impact this decision has on the industry without acknowledging the impact this decision, assuming it becomes final, has on women's rights. Regardless of personal views on the topic, it is clear this decision will have major ramifications throughout the healthcare industry, as the articles below highlight. These range from the role telehealth can play in abortions - where startups like Hey Jane and Just the Pill center stage - to the scramble amongst patients, providers, and legislators to understand what the current laws are around abortion services in states. As Paul Keckley notes in his article below, it seems that this ruling will necessitate that all healthcare organizations take a stance here as women will inevitably continue seeking abortion services from these organizations, and the role healthcare organizations play at the beginning and end of life. Here are some of the articles we've found helpful on this topic:

  • Katie Jennings provides an overview of facts related to abortions in the US. Link.

  • Kim Bellard on the limitations of state licensing for telehealth. Link.

  • Paul Keckley on the short and long term implications of this ruling. Link.

• Chrissy Farr penned a fascinating article about what it's like to be a telemedicine provider today, including the fact that there are only currently around 50 providers with licenses to practice in all 50 states, a number that is up from only 14 providers back in 2019. I would have guessed that number would have been a bit higher, although there was an interesting dialogue on Slack about why it doesn't make sense as a strategy for organizations to pursue more licenses for providers, and maintaining all those state licenses for an individual practitioner would be quite the challenge apparently. I'm still not sure I understand why all of this needs to be so hard, but that's healthcare for ya. Link / Slack

• This is a good framework in NEJM that categorizes various types of innovation in primary care models. Like any framework, if you start staring at it for too long you start scratching your head a little bit on the categories. But I think this is more a function of the fuzzy distinctions across space than anything else at the moment - it's a good reminder that companies like Livongo, Cityblock, Grand Rounds, and Aledade all have many of the same underlying components that they're bringing together in different manners for different segments, financial models, and care models. Link / Slack (h/t James Lu)

• Jan-Felix Schneider and Brendan Keeler tag-teamed creating an article looking at the challenges of the patient scheduling space and potential paths forward. For those new to the space, it seems like a relatively simple technical challenge to solve in healthcare. But like many things in healthcare, as you dive in, you realize that the challenge isn't really a technical problem at all, but instead is a business model one - nobody has an incentive to make scheduling easier. Still, there are a lot of companies working on this space in a variety of ways at the moment, and lots of opportunity to improve upon current state.Link / Slack (h/t Jan-Felix Schneider) 

• Blake Madden shared a good overview of the provider enablement space, breaking down some of the differences between the various players (agilon, Privia, Apollo, and others) across a few different key parts of the enablement journey - integrating provider groups, migrating technology platforms, and transitioning practices to risk.  Link / Slack (h/t Matthew Conboy)

• The WSJ is reporting that hospital chains including HCA and Universal Health Services are seeking to pass on rising nurse salary costs to payors, and are looking to increase prices in payor negotiations by 7.5% to 15%. Leaving aside whether health systems should be doing this, it seems like this will be one of the bigger topics in payor-provider relationships over the coming year and will be interesting to watch how it impacts network composition.  Link / Slack (h/t Carm Huntress)

Data:

• The Better Medicare Alliance released a study suggesting that Medicare Advantage beneficiaries spend $1,965 less on out-of-pocket costs and premiums than Medicare FFS. It's starting to feel like these sorts of study results are more political bargaining chips than anything else as political battle lines get drawn in this fight over whether MA is good or not. Link / Slack (h/t Duncan Reece)

• A randomized controlled trial testing the clinical effectiveness of a remote patient monitoring program among 552 adults with heart failure post-discharge did not find any improvement in readmissions or mortality rate. The remote monitoring program included a scale, a smart pill bottle, and financial rewards for adherence. As noted in the Slack convo, I'd bet that a version of this trial that included a person who approached these patients with empathy and tried understanding actual intrinsic motivations rather than simple financial rewards, along with the remote monitoring technology would see much better outcomes.  Link / Slack (h/t John Pearson)