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WTF Health: Transcarent, Walmart & The “Re-making” of Healthcare Payers: Glen Tullman on the Power of Big Retail

By JESSICA DaMASSA, WTF HEALTH

Days after announcing their deal with Walmart, Transcarent’s Executive Chairman & CEO Glen Tullman and meet again (in-person!) to pick up our conversation right where it left off. For the details about the deal, see our last interview; for what the deal signifies for the disruption of the healthcare payer and the ultimate rise of the healthcare consumer, tune in now and take note.

The plot of Transcarent’s story is starting to take shape. Their conflict is with the “big middle” of healthcare where drugs are marked up, care needs pre-authorizations, and docs labeled “this is NOT a bill” are ridiculous artifacts of a payer-first healthcare experience.

“The system behind our healthcare today is working exactly as its designed: for payers. We want to re-design that,” says Glen. “It’s not, ‘how do we get through that better?’ That would be navigating. It’s ‘how do we go completely around that and re-design the experience?’”

Glen talks us through the leverage retailers like Walmart and Amazon really have to help take on non-innovative payers what role Transcarent is playing in all of this, and how startups like GoodRx, Ro, and Capsule who are successfully challenging PBMs are demonstrating that payment model innovation is possible.

And, while we wait for the next big deal to come from ‘healthcare’s best dealmaker, we’ve got some foreshadowing: a quick mention of Oscar Health that registered on my radar as interesting, along with some very specific details about how Transcarent will expand its offering next, looking at MSK, cancer care, behavioral health (particularly for teens), and bringing in more “human voices” for their members to turn to for advice.

Tying Health Care Investment to Performance

By BRIAN KLEPPER and JEFFREY HOGAN

GoodRx’s planned initial public offering recently made the news, notable because the company, launched in 2011, has been profitable since 2016. Evidently, it’s become unfashionable for investors to demand proof of performance, so GoodRx’s results shone like a beacon. By contrast, most health care firms seeking funding convey bold aspirations and earnest promises. Investors throw in with them and hope for the best. 

But few new entrants seem to do the necessary advanced due diligence to assess exactly where and how their product, service or innovation should be positioned in the health care ecosystem to derive maximum value. Ironically, COVID has intensified and highlighted the fragility of the health care ecosystem, as well as the greater disruption opportunities available to new entrants. 

Health care has become irresistible to investors, the outgrowth of the industry’s dominant players’ spectacular financial performance. Over the past 45 quarters, for example, major health plan stock prices have grown 4-6 percent per quarter, 1.2-2.2 times the growth rates of DJI and S&P (See the table below). Investors hope to either 1) capitalize on the health care’s ongoing culture of overtreatment and egregious pricing, or 2) support and share in the savings associated with rightsizing care and cost.

Continue reading…

Health in 2 Point 00, Episode 153 | GoodRx’s massive IPO, Olive, Bright Health & more

Today on Health in 2 Point 00, Jess is in Jacksonville hanging out with Jackson the dog and trying to replace me with @barkyboy. On Episode 153, we cover the biggest IPO we’ve seen yet—GoodRx—with a valuation of $18 billion, which is more than Teladoc, Livongo, and even Cardinal Health. In other news, Olive gets $106 million bringing their total to $220 million; Olive is a back office automation system using AI for hospitals and this round is practically financed by royalty. Bright Health gets $500 million for their health plan; they’ve raised about $1.5 billion and are planning to expand into more markets. Finally Osso VR raised $14 million in a series A, helping surgeons practice performing surgeries through their VR platform. —Matthew Holt

Health in 2 Point 00, Episode 148 | A colonoscopy story (& other health tech news)

Today on Health in 2 Point 00, Jess might be a little wary of my colonoscopy story, but it reveals just how well insurance companies communicate. In this episode, Jess and I cover GoodRx filing an S1 to go public, Trellus Health raising $5 million in seed funding for its platform for inflammatory bowel disease (IBD) and other chronic conditions, Klara Health raising $15 million for patient engagement, and Castor raising $12 million for its clinical trial platform. —Matthew Holt

Health in 2 Point 00, Episode 96 | Amazon Care, Echo, OneDrop & more

Today on Health in 2 Point 00, Jess and I catch up on loads of news in health tech. In this episode, Jess asks me about Amazon Care, doing telehealth, house calls, urgent care, drug delivery for their employees—could it change health delivery? Also, Eko raises $20 million for their smart stethoscope; Bayer leads a $40 million round for OneDrop’s blood glucose meter; GoodRx buys telehealth company HeyDoctor; Rock Health investing $10M in InsideRx, and an undisclosed amount to Arine; and Peloton IPO’s today and everyone’s looking at it as a healthcare company (but no, it’s not). We end on some gossip, so tune in. —Matthew Holt

Health 2.0 Launch! Finalists Announced

Since we first put it on at Health 2.0 in 2008, Launch! has introduced over 45 new companies and products, including Unity Medical, Remedy Ventures, TheCarrot, and the WSJ’s 2010 top (and not just in health!) start-up company, Castlight Health. Launch! is the first time a company has demoed at a conference, and the product must either be coming out soon or have been in very limited beta to this point. This year, we’re seeing some larger better funded companies on Launch! but everyone’s had to compete to get on and there are some teeny start-ups here that you’ve never heard of that might just blow you away. It’s 10 continuous 4 minute demos, and the winner gets a main stage spot next year, not to mention bragging rights. Who wins? The audience decides. Yes you can still get one of the last few tickets (but we’ll sell out in next day or two).

Below (in alphabetical order) for the first time, we’re thrilled to announce the Launch! finalists for 2011:

  • Basis–There’s been lots of excitement in the Health 2.0 offices about getting hold of one of these devices. It looks like a watch but it tracks heart rate more than time. CEO Jef Holove will finally show us what they’re like.
  • Clarimed–CEO Nora Iluri will show us her ambitious attempt to measure devices and much more in health care and communicate the results to lots of constituencies including consumers
  • CareCoach–Almost everything we hear in a doctor’s office is lost by the time we get to the parking lot. But a visit to the doctor is an expensive and important time that should be captured, reviewed and shared with family. CEO Jeff Kozloff shows how CareCoach does that.Continue reading…