Weekly Health Tech Reads | 9/11/22

CVS gets Signify, UHG & Walmart partner, care ops survey data, OIG on telehealth fraud, & more

This week's newsletter is sponsored by Tegus.

Tegus, a research platform that facilitates calls between investors and Key Opinion Leaders, posted a white paper with transcripts of calls exploring how benefits leaders are evaluating implementing digital health startups. The interviews highlight the personalities of different benefit leaders, how buying decisions are made, and varying goals of different employers.

For folks who are selling into employers, there is a ton of useful, tangible info here on things like why one benefits leader is choosing to switch from Livongo to CVS's diabetes product. Link (you'll need to input your info to access the paper)

News of the Week:

  • CVS emerged victorious in the Signify bidding war, acquiring it for $30.50 per share, a valuation of roughly $8 billion. CVS seems to view Signify as acquiring two key assets in one - first, a home health asset that gives CVS a health risk assessment platform, and second, a primary care ACO enablement asset via Caravan Health (which Signify acquired earlier this year). Given CVS's stated ambitions here, both are certainly quite logical capabilities for CVS to add. Via Signify, CVS now owns a network of 10,000 clinicians who are credentialed and deployable into homes across all 50 states, and via Caravan it also owns 700,000 MSSP ACO beneficiaries. It's not a huge surprise to see CVS come out as the winner in this auction given their stated intentions about expanding in primary care and home health via acquisition this year. It's a meaningful step forward for CVS in building a healthcare giant that has the capabilities to present a competitive threat to UHG. Link / Link (Investor Slides)

  • UHG and Walmart partnered on a 10 year deal that seems to combine three elements: 1. a co-branded Medicare Advantage plan in Georgia, 2. Walmart's 15 health clinics will be using Optum technology for value-based care, 3. Walmart Health's virtual care offering will be an in-network provider in UHC's Choice Plus network. Seems like a smart move with obvious benefits for both parties here, albeit a relationship that is still in early days. UHG gets a retail partner, which seems increasingly important as CVS and potentially Amazon present themselves as a competitive threat. For Walmart, this essentially appears to be a do-over on the ill-fated relationship it launched with Clover a few years back, but this time it's doing it with the industry leader. I will be curious to watch how the details of this relationship unfold over time, as both parties have to have bigger ambitions here than 15 clinics in Georgia / Florida. Walmart's healthcare leader was quoted here saying "this isn't a pilot... it is a long term commitment to work together..." which seems to inadvertently highlight that this is more or less a pilot. Calling this a 10-year relationship without being able to articulate a clear broader objective hints at the risk here for both parties - it seems like there are still a lot of details yet to be worked out, which could bring with it a high "failure-to-launch" risk. It seems like there are two options for what this deal looks like in ten years, with very little in between room: 1. it's successful and UHG / Walmart are tightly intertwined partners or 2. it fizzles out quietly in a few years. Link / Slack (h/t Ben Hughes)

Other Announcements:

  • Primary care enablement platform Privia Health partnered with Ohio Health. Together they'll be launching a new medical group for independent providers in Ohio. It'll participate in Ohio Health's CIN and ACO, helping independent providers move into value-based arrangements.  Link

  • Amazon is apparently working on a project to build a Ro / Hims competitor and is testing the initiative on its employees.  Link (BI Paywalled) / Slack

  • LetsGetChecked raised $20 million from Morgan Health to own patient care in the home. Link / Slack (h/t Tamra Lair)

  • CertifyOS, a platform helping healthcare organizations with provider credentialing, licensing, and enrollment, raised $14.5 million. CertifyOS has 35 customers now, with VillageMD and Thirty Madison as the largest. Link / Slack

  • The FTC apparently will look closely at both the CVS / Signify and the Amazon / One Medical deals.  Link (CVS) / Link (Amazon)

  • Hinge Health acquired Shine, a mental wellness app for the BIPOC community. Link

  • Patient engagement platform Upfront Healthcare raised $10.5 million. Link

Opinions:

  • Optum leadership wrote an interesting piece on the future of home care last week. In it, they share out their view on the key components of a home and community care platform, which includes: patient assessments, care transitions, at home emergent care, home-based primary care, and a technology infrastructure. It lays out the work Optum has done building out these pieces (Optum HouseCalls, NaviHealth, and Landmark Health), and also calls out DispatchHealth as another key component, and it's not hard to imagine that Dispatch would be on the top of a list of Optum's M&A priorities at the moment. Provides a nice roadmap for where Optum (and likely others) are heading from a home care perspective. Link

Data:

  • CareOps, an initiative by Awell in collaboration with HTN, released a survey looking at the state of CareOps across various types of care delivery organizations. The survey includes 140+ folks working in product and clinical operations roles and the findings are pretty interesting. Unsurprisingly, there seems to be very little in terms of consensus for developing / implementing care pathways. It’s a bit disheartening to see that only 36% of respondents suggest that their company is using clinical outcomes or patient reported outcomes data to inform their care pathways. For any of the promise of digital health improving care for patients to materialize, that number seems like it needs to be a lot higher. CareOps will be hosting a panel including Ali Khan of Oak Street Health, Dhruv Vasishtha of Firsthand, Wayne Li of Headspace Health and Stephanie Strong of Boulder Care to dive deeper into the results on 9/28. Link / Webinar Registration

  • This is an interesting paper looking at rise of NPs for mental health, finding that psychiatrist office visit volume fell 29% between 2011 and 2019. Over the same time period, NP visits increased 111%. In rural areas, NP visits surpassed visits with psychiatrist. Link / Slack

  • Mayo Clinic released some interesting data on telehealth use at Mayo during COVID. During a one month period in 2020, Mayo did ~100k virtual visits. Of those, only ~7k visits were for new patients, and almost one third of those patients still had to go in for a visit. Link / Slack

  • OIG released a report on potential fraud, waste, and abuse within Medicare telehealth use during COVID. Of 742k providers who billed Medicare for telehealth services over the year long period, they identified 1,714 providers at high risk for abuse. Of those, 41 worked at telehealth companies, which actually seems like a surprisingly low percentage. The report goes through some pretty egregious behavior by providers - i.e. two providers who work for the same telehealth company and billed telehealth services every single day of the year, a total of 76,000 services for 4,300 beneficiaries. Yes, that is 17 visits per beneficiary. Those two providers received $1.4 million in Medicare payments for those services.  Link / Slack (h/t Nathaniel Lacktman)

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