Weekly Health Tech Reads | 3/20

Coverage of Oak Street & agilon's investor days, lots of interesting data, & more

Wheel released a survey of ~400 doctors and nurses, providing some interesting insights into the state of the workforce. The results are quite bullish on virtual care, with 2 in 3 clinicians indicating virtual-only or hybrid care better fits their lifestyle and 3 in 5 predicting that virtual primary care will bypass in-person primary care in the next 5 years. Given these trends, it’s easy to see why Wheel is working to build the leading workforce of virtual providers. Check out the survey results and an interview with Wheel’s Head of Clinical Ops on the topic.

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News:

  • Oak Street's investor day was on Wednesday. Oak Street per usual provided a really good does a nice job telling a very simple and compelling story, focused on the profitability of clinics at maturity and how Oak Street consistently moves clinics towards maturity. Of course, focusing the story on that has the benefit for Oak Street of shifting the narrative away from how much money it is losing today as the vast majority of clinics aren't yet at maturity. We dive into our key takeaways from the session for HTN members at the link below (note: paywalled) - ranging from the Walmart deal, the lack of ACO REACH discussion, the impressive consistency Oak Street always shows, and the question of how important the tech platform really is. Check it out for more.
    Link (HTN article - paywalled) / Link (slides) / Slack (h/t Varun Sawhney)
  • Clarify Health acquired Embedded in a rather interesting move in the value-based care analytics space. Embedded has a very high profile founding team focused on using behavioral economics principles to incentivize provider behaviors. It seems like a sensible addition to a data platform like Clarify to make the platform more actionable. It's interesting timing for Embedded, which you'd think would have had no problems raising a massive funding round.
    Link / Slack (h/t Neil Sanghavi)
  • Real world data platform Komodo Health is apparently prepping for an IPO this summer. The Stat article here provides an interesting glimpse into the state of the public markets, as it suggests many companies that have been prepping for IPOs are now focusing on a sale with an IPO as the second option. The IPO market has essentially shut down this quarter, with only 16 IPOs so far this year, compared to 102 in Q1 last year.
    Link / Slack (h/t Raihan Faroqui)
  • MedPAC released its 600+ page annual report, again warning that Medicare Advantage is driving over $12 billion of overpayments.
    Link (summary) / Link (MedPAC report) / Slack (h/t Kevin Wang)
  • The rebrand of Direct Contracting to ACO REACH doesn't appear to have ameliorated political concerns regarding the program, as the House Progressive Caucus is again calling for the immediate halt of the program.
    Link.
  • Google announced it is partnering with Meditech to integrate Google Health's Care Studio with Meditech's EHR.
    Link / Slack (h/t Brendan Keeler)

Want access to HTN exclusive analysis like the Oak Street and agilon Investor Day reviews? We'll be publishing more exclusive analysis like these to HTN community members moving forward. If you want access to those sorts of insights on an ongoing basis, join HTN as a community member here.

Funding:

Correction: Last week we covered a funding round for Elemy, which we later realized occurred back in October 2021. Apologies for any confusion.

  • Doctolib, a French telehealth provider, raised $549 million at a $6.4 billion valuation. It sounds like in many ways Doctolib is further along than any telehealth platform in the US, as 60 million people have used the platform across France, Germany, and Italy. Apparently 300,000 healthcare workers are on the platform, along with 250 hospitals. It started as a scheduling platform, but has expanded into telehealth, and apparently has a much broader vision including a PHR-like product. One to watch.
    Link / Slack (h/t Elie Goldfarb)
  • HouseRx raised $25 million for a specialty pharmacy platform.
    Link / Slack.
  • Embold Health, a data analytics platform providing provide quality data to insurers and employers, raised $23 million.
    Link / Slack (h/t Grant Parker)
  • Canopy, an oncology care platform (not to be confused with Oak Street's platform), raised $13 million.
    Link.
  • Vira Health, a menopause support app, raised $12 million.
    Link / Slack (h/t Rik Renard)
  • OpenLoop, a platform offering white-labeled telehealth services, raised $8 million.
    Link / Slack
  • J2 Health raised $4.2 million to build a data platform that helps payors optimize their provider networks.
    Link / Slack

Opinions:

  • We shared our perspective on agilon's investor day for HTN community members, highlighting a number of takeaways from the session including more on agilon's health system partnership, the payor narrative, the depth of its relationships with providers, and more. It's interesting to look at the different approaches of agilon and Oak Street to improving primary care for Medicare Advantage members. Will be interesting to look back in 5-10 years and see what the lasting impact of the provider enablement and the de novo clinic approaches to see the impact of both. Certainly the enablement play seems more cost efficient, with the ability to scale to more providers faster. But in the de novo clinics you have more control over driving better outcomes. Per usual, it seems to boil back down to who can better support empathetic, trusting relationships between clinicians and patients.
    Link (paywalled) / Slack
  • Here's a good look at Centivo's model and the impact its been having with employers in the Milwaukee area. Centivo is a new insurer helping employers construct plans with narrow networks of high quality physicians. It's interesting to note both the employer perspective (that they're not expecting cost savings near term) and the provider perspective (they're having to explain to providers why some are in the network and some are not). Goes to show how many moving pieces there are in launching a new plan like this.
    Link / Slack
  • This Bloomberg article covers report released by the 32BJ union, a New York union of ~30,000 residential building workers, sharing some data on the crazy variation in healthcare prices. This includes C-section costs that can vary from $55k to $18k at different New York hospitals. Apparently the union is looking to band together with other unions to fight these prices, and may have the support of the mayor in doing so. Love the energy here, but as other states have found (Colorado and Montana come to mind), as soon as the local hospitals view the initiative as a threat, it becomes a political quagmire really fast.
    Link (Bloomberg) / Link (Report) / Slack.
  • This is a nice read on Papa's model, highlighting the impact that Papa Pals are having on Medicare Advantage members. Papa seems really well positioned at the moment with its workforce of 25,000 Papa Pals, and its ability to engage 12%+ of Medicare Advantage plan members. Given the various trends in the industry, both in terms of limited provider supply and increasing demand from an aging population side, it seems like Papa has a lot of runway in front of it.
    Link / Slack
  • This is an interesting read from Lisa Suennen looking at how digital health has been traversing the hype cycle. It's starting to feel like we're passing the peak of inflated expectations reading articles like this, publicly calling into question things that people have been wondering privately for a while about how real many digital health businesses actually are. Is there revenue there? Are there better outcomes? Lots of questions left to be answered in the space to be sure.
    Link.

Data:

  • A paper leveraging Humana data has shown that value-based care in Medicare Advantage has improved clinical outcomes if the risk is two-sided, but interestingly if its only one-sided, there is little improvement over fee for service care. It's interesting looking at this combined with Oak Street's Acorn ACO performance discussed during their analyst day as it provides two pretty compelling data points for MA. Of course then I read MedPAC's report and can't tell up from down anymore, at least on the cost side. On the quality side it seems pretty clear these models are performing better than FFS care.
    Link / Slack (h/t Duncan Reece)
  • A Chartis survey of health system executives suggests health systems view telehealth as a primary competitor. Despite all of the data recently calling into question how much telehealth is really being used, this shift in mindset seems be be very indicative of the broader change at hand, which seems consistent with the Wheel survey results above. Pre-pandemic, I'd surmise very few hospital execs thought of telehealth companies as their top competitor. The fact that they now see telehealth as an equal competitor with other health systems speaks volumes to the change at hand.
    Link / Slack
  • This Commonwealth Fund report compares primary care in the US to other high-income countries. A number of the charts in this are pretty confusing to me - for instance the report suggests that 89% of adults in the US have a regular doctor or place to go for care, which is significantly higher than I would have guessed. There is no way I buy that 89% of adults have a regular relationship with a care provider. It is interesting to see the vast difference in access to home health visits - 37% of US adults have access (again this is higher than I'd expect) versus 80%+ for most other high-income countries.
    Link / Slack

Featured Jobs:

  • Evergreen Nephrology, a platform for nephrologists to provide value-based kidney disease care, is hiring a VP / Sr. Clinical Officer. Link.
  • Humana's Healthcare Strategy team is hiring a Strategy Advisor. Link.
  • Robin Health, a startup building a platform for medical documentation transcription, is hiring a Head of Data Science & Analytics. Link.
  • SCAN Health Plan's foundation, SCAN's public charity, is hiring a VP of Corporate Development & Operations. Link.

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