As many of you can probably tell from previous blogs, I’m a proud Minnesotan. It has been a difficult week up here - first watching a Minneapolis police officer murder George Floyd and then watching the city go up in flames for the past few days. It makes the healthcare news of the week seem a bit… trivial. So, I’m hoping you’ll allow me this interlude to express my feelings on the events of the past week in Minneapolis before getting to the healthcare stuff.
As a white male, I can’t claim to understand what exactly the black community is, and has been, going through or feeling as they watched the death of yet another black man at the hands of the police. I also can’t understand the feeling of being hunted as prey day in and day out, as 12-year old Keedron Bryant shared in his song reflecting on George Floyd’s death. But as a human who saw the video of a police officer kneeling on George Floyd’s neck for eight minutes while he died - including almost three minutes where George Floyd was unresponsive - I am sad and I am angry that this is the city and country I live in. And as a family friend shared this week: “We need people of good conscience and spirit to take action and make a change. We must internalize that silence and apathy is consent. It can’t just be black people crying for change. We need your allyship.”
As President Obama said so eloquently in his statement on the matter, this shouldn’t be normal in 2020 America. We shouldn’t have leaders who quote segregationist police chiefs from the 1960s with veiled threats of violence, and who then claim ignorance as to the origination of the quote. We shouldn’t have black news reporters being arrested for reporting the news. George Floyd shouldn’t be dead. Ahmaud Arbery shouldn’t be dead. Breonna Taylor shouldn’t be dead. The list goes on. Instead of watching these events unfold silently, it’s well past time that we all talk about, and take action on, creating a new normal in this country. To that end, I wanted to share a few of the reactions to the events of the week that have caused me to pause, think, and process the events that have unfolded. Hopefully it can help spur more conversations on where we go from here. Be safe everyone.
Barack Obama shared his feelings that this should not be “normal” in 2020 America.
Killer Mike, former rapper & current activist, made an emotional statement on the anger he is feeling and how to channel that anger productively to make this system better instead of burning down the towns we live in.
If you’re looking to support the Minneapolis community as it rebuilds from this week, here’s a good list of the places / organizations to support. Link.
The Pacific Business Group on Health - a coalition of some of the largest employers in the U.S., including Walmart, Boeing, Salesforce, and Tesla - has been throwing its weight around the past few days trying to influence how healthcare delivery bailout dollars are doled out. The coalition is trying to avoid more provider consolidation, specifically of primary care practices, arguing that such consolidation increases costs, in two separate forums:
They sent a letter to Congressional leaders asking them to ban the mergers of any healthcare provider receiving any of the $170 billion of government bailout dollars for the next year. They’re worried about anti-competitive behavior and specifically the demise of the independent primary care physician. Link.
They called on California leaders to protect independent primary care practices by paying out prospective payments to primary care practices. They cite the fear that if these practices aren’t supported financially, they’ll end up being acquired by health systems or private equity groups, which will drive up costs. Link.
Higi, which has over 10,000 health station kiosks in grocery stores and other community settings across the country, raised $30 million in a round led by Babylon Health, the company that has raised $550 million itself to build a chatbot for primary care. I can certainly understand the rationale to partner for both parties - Higi gets to add another feature to its kiosks and Babylon gets access to potential users in the U.S. market. But I’m a bit confused what Babylon is doing leading funding rounds. Why not just buy Higi outright? Link.
Oncology Analytics raised $28 million, helping health plans to manage their oncology spend by standardizing care pathways. Link.
Tia raised $24 million for it’s women’s health model. I’m really interested in the approach Tia has taken by starting with a digital-only presence and then building a physical clinic once they have significant demand. I’ll be curious to see how COVID-19 influences their digital vs physical footprint plans moving forward. Link.
Bright.md raised $16.7 million to grow its telehealth platform. Link.
Orbita raised $9 million for its AI chatbot solution. Link.
Cariloop raised $6 million for a coaching service for families that are taking care of loved ones with health issues. Link.
MDMetrix raised $1.1 million to help hospitals take care of COVID-19 patients. Link.
Sachin Jain, former CEO of CareMore, wrote a good piece on lessons he’s learned over the years in trying to change healthcare. There’s a ton of wisdom in this piece for folks attempting to drive change in healthcare. The comments on it being easier to write about changing things than actually do something about it hits close to home for me, particularly this week. Link.
Here’s a good look at the massive investment portfolios of large health systems. Something does seem broken in a model where a not-for-profit system like Providence is sitting on $12 billion of cash being invested in traditional Wall Street investment vehicles - private equity, hedge funds, venture capital, etc - while at the same time Providence is receiving $500 million from the federal government to cover its operating losses due to COVID-19. This question posed in the article is a good one: “If you accumulated $18 billion and you are a not-for-profit hospital system, what’s it for if other than a reserve for an emergency?” When the answer to a question like that starts with “well, it’s more complicated than that”, it doesn’t seem like a good enough answer. Link.
This is a good profile on Bind, the Minneapolis-based health insurance kinda-startup / kinda-UHC product with a cool new brand. They’ve quietly raised $142 million from UHG and Ascension Ventures, with over 65,000 members enrolled at employers like Medtronic, Best Buy, and Target. They’re expecting 3 - 4x membership growth over the next year, which would put them around 200k members, if my math is right. Will be curious to watch whether COVID-19 ends up being a tailwind or a headwind for Bind enrollment. Link.
Here’s a decent overview of investor interest in the digital health space at the moment. It hops around a bunch of different examples of companies doing well - Livongo, Teladoc, etc - and shares some interesting perspectives and data points. The most interesting data point: Ochsner Health has done over 120,000 virtual consultations this year, versus 3,300 in the entire year of 2019. Crazy. Link.
The number of Medicare members receiving telehealth services according to claims data increased by 11,718% between March 7th and April 18th - increasing from ~11,000 members per week to ~1,300,000 members per week over that time. This should serve as all the proof anyone needs for aligned financial incentives being the key to unlocking “innovation” in healthcare. Link.
This KFF data suggests that nearly half of Americans have delayed receiving medical care due to COVID-19. Link.
In case for whatever reason you need more evidence that workplace wellness programs don’t work, here’s another study showing that a workplace wellness program has no significant impact on health outcomes or healthcare utilization after two years. Link.
This is a good look at how often different types of specialist providers are billing out of network - cardiologists are at the low end around 18% while emergency department docs are the highest at just under 50%. Link.
A teacher in Colorado received a bill from the hospital for COVID-19 treatment, which included two weeks in the ICU. The bill total? $840,386.94. Holy moly. Link.