Kevin's Weekly Health Tech Reads 9/20

A RAND Corporation study on commercial health care prices; Oscar prepping for an IPO; Olive, MDLive & others raise funding; & more

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News:

  • Oscar has apparently heard my pleas and decided to hire banks ahead of a planned 2021 IPO. I would cancel all my plans between now and the end of the year to prepare myself for the S-1 to drop but thanks to COVID I have no plans to cancel so I suppose that’s a… win? I would assume Bright isn’t terribly far behind Oscar here too so it seems it will be an interesting 12-18 months for insurance startups. Link.
  • Walmart was in the news on a few fronts this week:
  • It is expanding clinics (7 more in Georgia, 2 in Chicago, and 7 in Jacksonville, with conversations underway in Orlando and Tampa) and using a partnership with BLOX to build the clinics. Link.
  • It announced a partnership with Zipline to test drone delivery of medical / health supplies. They’re trying it out near Walmart Headquarters - the Zipline drone can deliver goods within 50 miles of a Walmart location. Cool. Link.
  • Olive raised $106 million to grow its robotic process automation platform for hospitals. It currently is being used at over 600 hospitals, representing 22% of the top 100 health systems in the country. The automation of back office functions in hospitals continues to seem like a really straightforward investment opportunity given the current state of hospital finances. Link.
  • MDLive raised raised $50 million of equity + another $25 million in debt saying that the primary use of funds will be for expansion of its virtual primary care offering. I get that everyone likes the notion of virtual primary care, but it is odd to see it as the headline of press releases from companies like MDLive (and Grand Rounds last week). It sure feels like we’re approaching peak hype cycle on the notion of virtual primary care. I get that it’s becoming something of a catch-all phrase for these companies trying to articulate that they want to own the virtual patient relationship. Link.
  • Momentum continues to build in the dual-eligible market as CMS’s innovation center launches a new risk based model. Link.
  • Medigate raised $30 million to build its data security platform for hospitals to protect the data coming from medical devices. Link.
  • European startup Joint Academy, a startup building a digital therapeutic for chronic joint pain, raised $23 million to expand into the US. Link.
  • This week’s latest in payor / provider collabs:
  • Horizon Blue Cross Blue Shield of NJ created a JV Medicare Advantage plan with Hackensack Meridian Health and RWJBarnabas Health. They expect membership of 15,000 in year 1(!). Link.
  • CareFirst BlueCross BlueShield entered into a value-based care partnership with Medstar. Link.
  • UnitedHealth Group’s CEO Dave Wichmann mentioned at a conference that UHG / Optum is seeing a surge in providers interested in taking on risk. Link.
  • Plum, a telehealth startup providing access to hormone replacement therapy (HRT) for the transgender community, is expanding to offer its services as an employee benefit. Link.

Opinions:

  • This is a really good read on the story behind Tia, the super cool women’s primary care startup. Quite interesting to hear more about their evolution from an online question / answer product to building a physical clinic in NYC (now with 3,000 patients) to converting the primary care model to virtual due to COVID-19. Interesting to see that they intend to grow both their physical and virtual presence with the funding - will be curious to see what the physical clinic rollout looks like over the next few years. Link.
  • Insurance execs spoke at a Morgan Stanley industry conference over the week, expressing optimism for 2021 but also a bunch of conflicting opinions as to how to price 2021 products. The article here does a nice job summarizing how a bunch of the big insurers - Centene, CVS / Aetna, Humana, etc - are viewing the next twelve months. Link.

Data:

  • Data from the RAND Corporation suggests that commercial insurance plans pay 247% what Medicare pays for healthcare services at hospitals on average across the country. There was a pretty wide range, too, with some states approaching 350% of Medicare while others were <200%. What’s most wild to me is the price variation *within* health systems - check out the chart below. For instance, HCA’s lowest relative price is down around 100% of Medicare while its highest is up at 700%. How in the world do you help consumers understand the cost of healthcare when there functionally is no price? The discussion section in the white paper (starting at pg 22) is worth a read for anyone thinking about employer strategies to try to address these prices. Link.
  • Also on the topic of price variation in healthcare, here’s an interesting article in Forbes looking at a recent Health Affairs article on healthcare costs in Massachusetts. It provides a nice summary of how different costs can be in a local geography, and the difference between inpatient and outpatient prices for common services. Link.
Chart depicting how much more expensive routine health services are when they are provided in acute care hospitals versus other settings.
  • Doximity released a report on the state of telemedicine, with the headline being that they expect telehealth spending could increase to $106 billion by 2023. I get a kick out of how the chart on pg. 10 regarding physician adoption of telehealth has no axis labels - how low are those adoption rates that they’re removing the axis labels? Link.