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Category: WTF Health

The Tech Layer for Home-Based Care? Tomorrow Health Hopes To Network-ize Home Health

BY JESSICA DaMASSA, WTF HEALTH

Home-based healthcare is the stuff of tomorrow – literally. Tomorrow Health just closed a $60M Series B to grow their tech infrastructure biz into what CEO Vijay Kedar hopes will ultimately streamline and optimize how home health is ordered, delivered and paid for. This is the software that *could* be the thing that not only gets patients into home-based set-ups faster (vastly improving upon the up-to-90-minutes it currently takes providers to set-up home care for patients) but also creates a system for all stakeholders to track and monitor patient outcomes with an aim at the much larger, long-term opportunity: to realign incentives on value instead of fee-for-service.

Vijay came out of Oscar Health, meaning there is definitely a payer slant to the way this software is designed and deployed. Payers are Tomorrow Health’s clients, and it offers them a way to organize (or completely create, in some cases) home care networks out of the hundreds of different small, local market suppliers and providers that get medical equipment, skilled and unskilled services, and other in-home care elements to the doorsteps of the patients who need them. For a Geisinger Health Plan or Aetna – two of Tomorrow Health’s marquee clients – the software alleviates the pain of scaling this concept in every market while also providing a way to track what’s happening with the patient and build a “bridge” back into the health system that’s leading the patient care team.

With so many other players working in the home-health space – everyone from retail players like Walgreens/CareCentrix and Best Buy/Current Health to upstarts like Signify Health, Honor, and more – how will this tech stack approach play out against others that are one-stop-shops with frontline care and coordination layered on top? Will these ultimately be Tomorrow’s next clients?? Tune in to find out.

Quantifying Caregiving: ARCHANGELS CEO Alexandra Drane on The Caregiver Intensity Index

By JESSICA DaMASSA, WTF HEALTH

“Being an unpaid caregiver is the epicenter of Life Sucks Disease,” says Alexandra Drane, Co-Founder & CEO of ARCHANGELS, “but it’s also one of the most glorious, one of the most magnificent jobs we’ll ever have.” So, what’s the trick to managing the “sucky” side of caregiving? Data.

Alex’s company ARCHANGELS has invented the Caregiver Intensity Index, which she describes as a “two-and-a-half minute Cosmo quiz” that helps caregivers quantify the intensity of their caregiving experience and identify the top two things driving that intensity and the top two things alleviating it. The score coming out of this helps caregivers validate the intensity of their experience, offers a framework for communicating about it, and, as Alex puts it, delivers “data that gives them permission to believe” that the stress they are feeling is real. ARCHANGELS then uses the info to crosswalk caregivers to existing resources that can help them manage those intensity-driving challenges – whether they be related to financial stress, workplace stress, relationship stress or otherwise.

Knowing that health plans and employers are starting to “see the light” when it comes to caregiving and its impact on their workforce, Alex and I talk about just how much payers are really willing to contribute to supporting the resources needed to support caregivers and how the data ARCHANGELS is providing is helping demonstrate need and connection to health and well-being. Lots of interesting data points on caregiving in this one – particularly when it comes to mental health and how things have changed through the pandemic. Watch now!

Forget Micro-Networks: How Avaneer Health is Building The One Health Data Exchange to Rule Them All

By JESSICA DaMASSA, WTF HEALTH

What BIG thing is Avaneer Health building with its $50 million SEED round backed by not-just-investors-but-also-partners CVS Health, Aetna, Anthem, Cleveland Clinic, HCSC, PNC Bank, Sentara Healthcare and IBM Watson Health? CEO Stuart Hanson stops by to clear-up the mystery that IS Avaneer Health, and how the massive data exchange platform it’s building is meant to connect the data coming out of the biggest payers and biggest providers in healthcare, directly and in real-time.

Hang on – is this the blockchain-based data exchange healthcare has been talking about for more than a decade?? It sure is trying to be. And what Stuart says is different about Avaneer’s effort is, indeed, the fact that it’s backed by some of the biggest brands in the business and that they see the business case in being able to more effectively share their data with one another. As he explains it, “this problem of data interoperability and data fluidity is bigger than any competitive business model that they need to worry about…”

Stuart is careful to explain what Avaneer IS and what it IS NOT, and this is critical to the company’s growth plans and revenue model. Avaneer is NOT a data intermediary; it’s not about aggregating data, normalizing it, de-identifying it, or applying any fancy machine learning algorithms to it to deliver “insights” on it. Avaneer is strictly a platform for secure, compliant data exchange, so, for example, Anthem can connect to Cleveland Clinic in real-time and verify insurance coverage. The revenue model is currently built around access to the network and will one-day-soon also take in fees from ‘Solutions Innovators’ (aka data-aggregating, algorithm-loving, insights-dropping health tech companies) that will offer their services as add-on’s to Avaneer’s customers who are plugged into the network.

What’s ahead for this stealthy start-up as it scales? Could they REALLY be looking to raise a follow-on seed round?? Find out what kind of investors they’re looking for and what’s ahead on their product roadmap in this in-depth chat.

Inside Boulder Care’s $36 Million Series B & Scaling Telehealth Addiction Treatment in Medicaid

BY JESSICA DaMASSA, WTF HEALTH

Telehealth addiction treatment clinic Boulder Care just closed a $36 million Series B. I’ve got Founder & CEO Stephanie Strong here to talk about the virtual care company’s medication-assisted approach to opioid and alcohol use disorder treatment, and its growing-bigger-by-the-day presence in the Medicaid market.

In fact, more than 95% of Boulder Care’s revenue comes in from Managed Medicaid plans, and this focus on making medications like Suboxone accessible to traditionally marginalized patients is not only better for patients (drugs like these can cut all-cause mortality rate by half or more) but also compelling for payers. Stephanie says patients suffering from opioid addiction who go untreated are 550% more expensive to the plan than those who are not, and these types of medications facilitate recovery by making it bearable, blocking withdrawal symptoms.

We get into the details behind Boulder Care’s approach, which includes a number of wrap-around support services, including those provided by the startup’s care delivery team that is set to grow as a result of this Series B funding. And speaking of scaling… Does Stephanie have any concerns about challenges that Boulder Care might face prescribing-and-managing controlled substances as a result of the scrutiny created by Cerebral’s bad behavior? Any additional concerns about changes to the clinic’s telehealth practices when the Covid19 public health emergency comes to an end? And…what about competition in this space?? Particularly as similar-looking Bicycle Health announced its $50 million Series B just days earlier? A great inside look at how virtual care is changing the specialized mental health care space.

Can SameSky Health Fix the ‘Trust Issues’ Minority Populations Have with Big Healthcare?

BY JESSICA DaMASSA, WTF HEALTH

Healthcare needs to move into 2022 and get away from the one-size-fits-all approach that healthcare takes almost everywhere and, instead, treat people like who they are matters.” That’s the challenge coming from SameSky Health’s founder & CEO Abner Mason whose business is helping some of healthcare’s most notorious “one-size-fits-all-ers” (health plans) improve the way they engage with diverse populations.

SameSky has built a proprietary tech platform that creates an ‘n of 1’ approach to member engagement that is focused on using data to understand who each individual member is at a “cultural” level which, as Abner defines it, is not just about ethnicity or race, but about ALL the factors that go into how a person makes a decision about whether or not to seek care, where to get that care, and who they ultimately trust to deliver it.

You can call it “micro-targeting-at-scale” and Abner compares it to the way Netflix customizes movie recommendations based on what it learns about its users. SameSky is hoping to achieve the same level of consumer-focused customization among Medicaid populations, and is working with some of the biggest names in the biz (UnitedHealthcare, Anthem, Humana and others) to tailor an annual “journey” to each member that helps members build trust with their plan, helps the plan get to know their members, and, in the end, helps both the plan AND the member satisfy mutual needs when it comes to getting things like annual health screenings done.

Will we eventually get to a more equitable and personally-tailored healthcare system? Stick around until the last few minutes to hear what Abner finds exciting about some of the new federal regulations that impact health data collection and what he sees as their big-picture impact on the future of health equity. PLUS, a bonus for all those who may have been wondering: What prompted the name change to SameSky Health from ConsejoSano?? Is this REALLY because Matthew Holt could never pronounce it? The shocking backstory is revealed!

7WireVentures’ Lee Shapiro: What’s Ahead for Investment in Health Tech

By JESSICA DaMASSA, WTF HEALTH

What’s Lee Shapiro’s take on the health tech market’s state-of-play? 7wireVenture’s Co-Founder and Managing Partner stops by to talk early-stage investment, what’s hot and what’s not post-pandemic, and how he views the digital health funding frenzy of the past couple years which, one could argue, was kicked into high-gear by portfolio-company-slash-previous-employer Livongo.

Lee says there’s “enough broken business processes in healthcare to last a lifetime,” which means a lot of opportunity for consumer-minded health tech startups to change things, but does the recent slowdown in venture funding and pummeling of public market health tech stocks indicate that the category is in trouble before it even gets a chance to make a real impact? We get Lee’s opinion on whether or not the market is cooling, what he thinks will happen next with valuations, and what he views as the best way to scale a healthcare startup – particularly as we watch Glen Tullman run the ‘Livongo playbook’ at new business Transcarent. And, speaking of Glen… did Lee really teach him everything he knows?? We’re starting some trouble in this one!

Virtual Care Regulatory Round-Up: Telehealth & Digital Care ‘State-of-Play’ by Nathaniel Lacktman

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BY JESS DaMASSA, WTF HEALTH

Just as HHS extends the Covid-19 public health emergency waivers until July, we kick-off a brand-new monthly interview series about the state-of-play for all things telehealth and digital care policy and reimbursement. Called the WTF Health Virtual Care Regulatory Round-up, we’re partnering with our friends at Wheel to feature health policy experts, lobbyists, health plan folks, and other virtual care experts and insiders who can keep us updated on the changing regulations and what they will mean to those health tech co’s whose businesses rely on virtual care.

Attorney-to-the-stars-of-telehealth, Nathaniel Lacktman, who chairs the Telemedicine & Digital Health Industry Team at Foley & Lardner and is a Board member of the American Telemedicine Association (ATA), kicks the series off for us with an update on those public health waivers and how he is coaching health tech businesses in preparing for the inevitable transition of care that will come when they come to an end.

What will happen to patients who live across state lines from their virtual care providers? What business decisions need to be made to avoid abandoning patients and maintaining continuity of care? Nate’s not bullish on a federal national license, but there are some cases where cross-state patient-provider relationships can continue to exist – they just might not work for everyone’s business model.

And, on the subject of telehealth business models, Nate gives us his take on where he thinks reimbursement will be headed, how policy around virtual prescribing will be impacted post-pandemic (particularly around controlled substances), and whether or not Medicare’s originating site requirement will be put back in place. We also get Nate’s perspective on which virtual care business models seem to be working best among health tech startups and what legal risk those more ‘reckless’ players might be creating for the rest of the field without even realizing it. Great education on virtual care and what’s happening in the space RIGHT NOW. Watch!

Special thanks to our series sponsor, Wheel – the health tech company powering the virtual care industry. Wheel provides companies with everything they need to launch and scale virtual care services — including the regulatory infrastructure to deliver high quality and compliant care. Learn more at wheel.com.

CVS Health’s Head of Enterprise Virtual Health Weighs-in: ‘What’s Next’ for Telehealth at CVS, Aetna

BY JESS DaMASSA, WTF HEALTH

What are the BIG questions a BIG healthcare company like CVS Health is trying to answer when it comes to virtual care and creating the healthcare business model of the future? I’ve got Dr. Creagh Milford, CVS Health’s Head of Enterprise Virtual Health, who’s purview covers both CVS Pharmacy (9,000+ stores including 1,100 Minute Clinics) and Aetna, which provides health insurance to 39 million people.

Creagh’s big concern right now: how to weave together existing care models with virtual so 1) the consumer has a single front door and 2) the provider workforce – which includes everyone from pharmacists to primary care docs and beyond – is coordinated and working together. As you’ll hear, there’s a lot of thinking about “pivot points,” or where the patient and provider meet in the virtual-and-in-person ecosystem. The goal is to make those interactions easy and seamless – for both patient and provider alike – and we get into the strategic thinking, clinical operations, and tech underpinnings that are evolving to make those transitions possible.

Long-term, Creagh believes that healthcare consumers have “voted with their fingertips” and that virtual care is here to stay, but as part of a hybrid model in which questions about quality and cost are still being worked out. Will incentives ultimately realign to make virtual care more enticing across the healthcare system? What types of technology will be next to augment the hundreds of thousands of virtual visits a year coming out of Minute Clinic, or happening as part of an Aetna plan benefit? Here’s how one of the biggest healthcare companies in the country is driving virtual care forward. Watch now!

ATA’s CEO Ann Mond Johnson Takes on the “Telehealth Cliff”

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By JESSICA DaMASSA, WTF HEALTH

The BIG takeaway from ATA’s Annual Meeting is best bottom-lined by ATA’s big boss, CEO Ann Mond Johnson, in this interview: “From an overall perspective, we just don’t want to go over that ‘telehealth cliff.’”

ATA, the re-branded American Telemedicine Association, has not only evolved along with virtual care through the pandemic, but has also been critical in redefining telehealth as modality for healthcare and re-framing access to it as a bipartisan issue that everyone in DC can get behind.

Ann talks through the high-level changes she’s witnessed for telehealth adoption over the past two years and gives us her predictions for what’s going to happen next – particularly when it comes to the business of virtual care, consumer demand, and, most importantly, regulations and reimbursement. Lots happening thanks to ATA’s new affiliated trade organization, ATA Action, which is lobbying to ensure that the waivers that enabled the acceleration of telehealth during the Covid-19 public health emergency become permanent. The time is NOW for health tech co’s to get involved! Tune in to find out how.

Vida Health Starts Prescribing: Meds, Labs, Devices, & More for Mental Health & Diabetes

By JESSICA DaMASSA, WTF HEALTH

Big news coming out of Vida Health today as the chronic condition care startup announces that it will now be able to prescribe meds, med devices, lab tests, and more to its members. This puts Vida Health among the first of the digital health chronic care companies to evolve its offerings beyond apps-and-coaching, leading on this trend to take digital health chronic care into a more full expression of virtual care.

Vida Health’s Chief Medical Officer, Dr. Patrick Carroll, introduces us to the new offering which he tipped us off about when we met him a few months ago, new to his role at Vida and coming in hot from Hims & Hers where he built similar services as he took that company public as CMO.

The new prescribing services will cover both sides of Vida Health’s integrated model: mental health and cardiometabolic health, but in different ways. On the mental health side, Pat says members will be able to receive prescription meds for anxiety and depression ONLY at this time; on the cardiometabolic side, members working with Vida Health will NOT be able to get prescription drugs to help with diabetes or heart health, but would instead be able to get continuous glucose monitors (CGMs) prescribed, specialized diets, and labs, like A1C testing, that require a script.

Do these prescribing services begin to turn Vida Health into a primary care provider? If not, how do these new prescribing and medication management roles integrate with whatever other primary care offering is in place through a member’s plan or employer without adding cost or confusion to the patient experience? We talk through the evolution of both care model and business model as Vida Health adds another layer to its full-stack chronic condition management platform.