TTA’s Brrrrr Season 1: Rock Health’s ’22 funding roundup; CVS talks primary with Oak Street, invests in Carbon Health; Teladoc boosts $; Verily lays off; global M&A/fundings; Theranos updates, more!

 

 

Weekly Update

A mulligan stew of a week. CVS moving in on primary care with (possibly) Oak Street, funding Carbon Health in-store clinics while the latter downsizes. Walgreens’ VillageMD closed on Summit Health and Teladoc paints a brighter revenue picture with BetterHelp. Rock Health quantified a deflated 2022 year in funding, but M&A/VC investment still proceeds in its ‘boring’ way. Verily, Alphabet’s wandering ‘bet’, finally gets a needed trim. And Theranos is still in the news from appeals to post-prison requirements.

Weekend short takes: Theranos’ Holmes post-prison mental health + more on Shultz and Balwani; global M&A, funding roundup
Rock Health puts a kind-of-positive spin on digital health’s ‘annus horribilis’ 2022–a boring 2023
Mid-week roundup: Teladoc gets BetterHelp to boost Q4 ’22 revenue; fundings for Array, Paytient, Telesair, three others; layoffs hit at Alphabet’s Verily, Cue Health
CVS works their plan in Oak Street Health buy talks, Carbon Health $100M investment + clinic pilot; VillageMD-Summit finalizes (updated)
Theranos trial updates: Holmes’ freedom on appeal bid opposed; Balwani files appeal to conviction

Two surprises not under the Christmas tree or New Year’s hat. The ITC upheld AliveCor patents and damages versus Apple, pending their PTAB appeal, and Amazon got its first state approval for One Medical. As expected, telehealth’s national Medicare reimbursement was extended for two years, setting policy for health plans. And NHS advanced rapid stroke diagnosis with Brainomix trial in 22 hospital trust trial, tripling near-full recoveries to 48%.

Weekend news roundup: GE Healthcare spins off, adds CTO; Allscripts now Veradigm; NHS Brainomix AI stroke trial success; Withings home urine scanner; Careficient buys Net Health EMR; CommonSpirit’s class action suit on data breach
Amazon-One Medical gains conditional OK in Oregon–a preview of coming scrutiny?
(What happens at the big state and Fed level?)
Telehealth extensions signed into US law with Federal FY 2023 omnibus bill (Major breakthrough to widen nationally reimbursed telehealth)
Split decision! ITC rules that Apple violated AliveCor patents; enforcement held for PTAB appeal (David v Goliath continues!)

A potpourri of news wraps 2022, starting with confirming how telehealth can stand on its own even in specialty care visits and its continued strength in mental health. In the US, most telehealth expansion is confirmed for two years. But as predicted, DEA is going hard after ADHD misprescribing — a unicorn may lose its horn as a result. Oracle is erasing Cerner’s home town presence as Epic stomps a patent troll. And beware of DDoS–it may distract from more nefarious cybercrimes.

We wish our Readers all the happiness of the season, as we look forward to the start of the New Year. We’ll be back with new articles after 2 January. 

We wish our Readers a happy, healthy holiday season and New Year!
News roundup: DDoS attacks may be ‘smokescreen’, DEA slams Truepill with ‘show cause’, telehealth claims stabilize at 5.4%, Epic squashes patent troll, Cerner meeting exits KC, MedOrbis, Kahun partner on AI intake (From cybercrime to Cerner, c-c-c-changes roll)
Telehealth two-year extensions included in US Federal ‘omnibus’ budget bill (Tucked into a Moby Dick-sized whale of a bill)
Few specialty telehealth visits require in-person follow up within 90 days: Epic Research study 2020-2022 (Findings, though, may be pandemically skewed)

It’s a week of contrasts as the holiday season starts. There are ‘green shoots’ in startups and fundings, yet so many organizations have run into the red, with a high human cost. A literal bright spot–a lighting system that can detect and report falls. And the Holmes Defense Team files an appeal for a new trial that may delay her delivery to Club Fed for a long time. (Hoping the Feds will forget?)

Rounding up fundings and startups: Override(ing) pain; brainy Synchron and In-Med Prognostics; Click off migraine; Cardiosense and CHF detection (A touch of seasonal cheer)
Smart lighting that detects and reports falls in older adults–and more–debuts in UK and Ireland (Lighting up fall detection is a big step forward)
10 reasons for a new trial? Elizabeth Holmes’ legal team files appeal, delay in prison start (updated) (Foot dragging strategy continues as financial penalty to be decided)
Mid-week roundup: Wisconsin’s Marshfield Clinic zeros out telehealth staff; Komodo Health lays off 9%; epharmacy Medly’s Ch. 11, PharmEasy layoffs; OneStudyTeam releases 25% (Coal in too many stockings)

Windups as the holidays and year-end loom. AliveCor loses its David vs Goliath patent battle with Apple, with consequences to come. The Theranos drama nears its end with Balwani’s sentence. But in new developments, robotics for care support and care becomes part of…energy management? And can VIMPRO help NHS manage its patient population crush?

Theranos’ Balwani gets an unlucky 13 year sentence, restitution to come (No tears, no dramatic statements, little media scrum, and a lighter sentence than expected)
AliveCor loses Patent Office ruling with Apple; three patents invalidated (This one isn’t over–the stakes are high)
News (and robot) roundup: ElliQ companion robot upgrades, named to 2022 TIME list; Robin the Robot introduced for older adult care; Utilita acquires Canary Care (UK) (Robots advance, interesting integration of care with energy management)
Perspectives: Could the telehealth VIMPRO model save the NHS from drowning in demand? (A smarter approach advocated in managing patient populations )
Optum Labs creates and funds digital health research hub at Cornell Tech NYC (Reviving NYC in digital health, or gathering ideas for Optum to develop elsewhere?)

Something a bit different this week with two maximum roundups. athenahealth may IPO–again. Amwell may bolster telemental health with Talkspace. Cerebral and former CEO dueling in court. Taking bets on where Theranos’ Elizabeth Holmes will spend her sentence–and when. Plus…year-end buys and fundings. 

Who’s buying, selling, funding wrapup: athenahealth IPO deux?, NextGen EHR buys reseller TSI for $68M, Cloudwave buys Sensato; fundings for Lumen, UpStream, Aide Health
“Big Story” update: where Elizabeth Holmes will spend 11 years, Cerebral sues former CEO Robertson, Amwell buying Talkspace? 

As usual in the rollup to (US) Thanksgiving, it was a light news week. Our two roundups include Babylon Health’s encouraging Q3 results, DOJ’s appealing to block the UHG-Change buy–already closed (!)–an senior exec move from Walmart Health to JPM, and digital health/health tech funding yellow flagged to 2025 by Very Important Investors.

Mid-week news briefs: House members’ ‘grave concerns’ on two deaths tied to Oracle Cerner VA rollout; care.ai’s $27M funding; Clear Arch’s new mobile RPM platform; digital health investment in rough times
News roundup: Babylon Health Q3 revenue up 3.9x; surprise–DOJ to appeal UHG-Change buy approval; Walmart loses senior health exec Pegus to JPM

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Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine, and health tech, worldwide–thoughtfully and from the view of fellow professionals

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

CVS works their plan in Oak Street Health buy talks, Carbon Health $100M investment + clinic pilot; VillageMD-Summit finalizes (updated)

CVS, Walgreens, Amazon, Walmart all chasing the same type of companies to expand their service continuum. During their Q2 2022 earnings call, CVS Health announced that they were determined to enhance their services in three categories: primary care, provider enablement, and home health. And CVS’ CEO Karen Lynch was pretty blunt about it: “We can’t be in the primary care without M&A” (sic). So CVS’ latest moves should come as no surprise.

Oak Street Health: CVS is in talks with this value-based care primary care provider for primarily older adults in Medicare and Medicare Advantage plans. With 100 offices nationally, it’s not too small, not too large to combine with other operations. As a public company traded on the NYSE but puttering along in the $13-$22 per share range since the fall from a high of $30 in August, the news of CVS’ interest has boosted them above $28 and a market cap of just under $7 billion. Although Oak Street has previously maintained that they have no interest in a sale, it has never been profitable and is on track to lose $200 million this year. That is not a good look for CVS but they are working a strategy. Previously, CVS walked away from primary care group Cano Health [TTA 21 Oct 22]. Bloomberg News (paywalled) reported that CVS could pay $10 billion which would be over $40 a share. Healthcare Dive, Reuters

Carbon Health: CVS leads their Series D with a $100 million investment plus piloting Carbon Health operations in primary and urgent care clinics in their retail stores. However, the deal came at a price. Last week, prior to the investment announcement, Carbon announced that it would wind down lines of business in public health, remote patient monitoring, hardware, and chronic care programs, cutting 200 jobs in addition to a June cut of 250, at the time about 8% of their workforce. Carbon will now concentrate on their clinic core business. 100 are presently located across Arizona, Nevada, Colorado, Kansas, Florida, Massachusetts, and California (San Francisco, Bay Area, and San Jose).

In the last two years, Carbon raised $350 million and grew by acquiring four clinic chains. It diversified by buying Steady Health (chronic care management in diabetes) and Alertive Health (remote patient management)–both businesses they are departing. Reportedly last month they bought Inofab Health, an Istanbul-based digital health platform for patients with asthma, chronic obstructive pulmonary disorder, and cystic fibrosis. Crunchbase, FierceHealthcare, Mobihealthnews, SF BizJournal,

CVS is still working its Signify Health acquisition past the Department of Justice (DOJ) and the Federal Trade Commission (FTC). It went into a Second Request for information in late October under the Hart-Scott-Rodino Antitrust Improvements Act of 1976 (HSR), which adds 30 days to the review timetable after the Second Request has been complied with. There is some competitive overlap between CVS and Signify in home health management and accountable care organization (ACO) operations, and some divestitures may be necessary. A closing in Q1 as planned seems optimistic. Acquiring Oak Street may complicate matters since their clinics operate as a Direct Contracting Entity (DCE, now ACO REACH). This present administration is not friendly towards healthcare consolidation of any type, especially with entities participating in Federal programs. (See UHG’s acquisition of Change Healthcare, with court approval being appealed by DOJ.) Reaching (so to speak) deep into CMS programs could be a red flag.

Walgreens’ VillageMD finalized their Summit Health acquisition for $8.9 billion yesterday (9 Jan) (updated). Now with 680 provider locations in 26 markets and 20,000 employees, the group adds to VillageMD’s primary care practices specialty practices in neurology, chiropractic, cardiology, orthopedics, and dermatology plus 150 City MD urgent care locations. 200 VillageMD locations are already adjacent to Walgreens locations. Walgreens Boots Alliance (WBA) and Evernorth, the health services business of Cigna, were the two investors. WBA raised full-year sales guidance from $133.5 billion to $137.5 billion. The current chair and former chief executive officer of Summit Health, Jeffrey Le Benger, MD, will be the interim president until VillageMD finds a permanent president reporting to VillageMD CEO Tim Barry. Release, RevCycleIntelligence, Forbes  At this point, Walgreens hasn’t moved forward with the rumored acquisition of ACO management services organization Evolent Health [TTA 1 Oct 22], which would be far more complex. 

Amazon is still awaiting Federal approval for One Medical as well as in multiple states (Oregon only the first; expect scrutiny). It is also closing Amazon Care and opening asynchronous non-face-to-face telehealth service Amazon ClinicWalmart continues on an internal strategy of opening Walmart Health clinics in underserved areas. Earlier in 2022, they announced the opening of more health ‘superstores’ in Florida, having established 20 in Arkansas, Illinois, and Georgia starting in 2019. Walmart’s approach to retailing health services and products, since getting serious about it in 2018, has wavered with multiple changes of strategy and executive departures [TTA 22 Nov 22]

TTA’s New Year Surprises: AliveCor wins ITC round v Apple, Amazon-One Medical Oregon OK, telehealth expansion done for 2 years, NHS advances effective stroke diagnosis, recovery by 48%, Allscripts now Veradigm, more!

 

 

Weekly Alert

Two surprises not under the Christmas tree or New Year’s hat. The ITC upheld AliveCor patents and damages versus Apple, pending their PTAB appeal, and Amazon got its first state approval for One Medical. As expected, telehealth’s national Medicare reimbursement was extended for two years, setting policy for health plans. And NHS advanced rapid stroke diagnosis with Brainomix trial in 22 hospital trust trial, tripling near-full recoveries to 48%.

Weekend news roundup: GE Healthcare spins off, adds CTO; Allscripts now Veradigm; NHS Brainomix AI stroke trial success; Withings home urine scanner; Careficient buys Net Health EMR; CommonSpirit’s class action suit on data breach
Amazon-One Medical gains conditional OK in Oregon–a preview of coming scrutiny?
(What happens at the big state and Fed level?)
Telehealth extensions signed into US law with Federal FY 2023 omnibus bill (Major breakthrough to widen nationally reimbursed telehealth)
Split decision! ITC rules that Apple violated AliveCor patents; enforcement held for PTAB appeal (David v Goliath continues!)

A potpourri of news wraps 2022, starting with confirming how telehealth can stand on its own even in specialty care visits and its continued strength in mental health. In the US, most telehealth expansion is confirmed for two years. But as predicted, DEA is going hard after ADHD misprescribing — a unicorn may lose its horn as a result. Oracle is erasing Cerner’s home town presence as Epic stomps a patent troll. And beware of DDoS–it may distract from more nefarious cybercrimes.

We wish our Readers all the happiness of the season, as we look forward to the start of the New Year. We’ll be back with new articles after 2 January. 

We wish our Readers a happy, healthy holiday season and New Year!
News roundup: DDoS attacks may be ‘smokescreen’, DEA slams Truepill with ‘show cause’, telehealth claims stabilize at 5.4%, Epic squashes patent troll, Cerner meeting exits KC, MedOrbis, Kahun partner on AI intake (From cybercrime to Cerner, c-c-c-changes roll)
Telehealth two-year extensions included in US Federal ‘omnibus’ budget bill (Tucked into a Moby Dick-sized whale of a bill)
Few specialty telehealth visits require in-person follow up within 90 days: Epic Research study 2020-2022 (Findings, though, may be pandemically skewed)

It’s a week of contrasts as the holiday season starts. There are ‘green shoots’ in startups and fundings, yet so many organizations have run into the red, with a high human cost. A literal bright spot–a lighting system that can detect and report falls. And the Holmes Defense Team files an appeal for a new trial that may delay her delivery to Club Fed for a long time. (Hoping the Feds will forget?)

Rounding up fundings and startups: Override(ing) pain; brainy Synchron and In-Med Prognostics; Click off migraine; Cardiosense and CHF detection (A touch of seasonal cheer)
Smart lighting that detects and reports falls in older adults–and more–debuts in UK and Ireland (Lighting up fall detection is a big step forward)
10 reasons for a new trial? Elizabeth Holmes’ legal team files appeal, delay in prison start (updated) (Foot dragging strategy continues as financial penalty to be decided)
Mid-week roundup: Wisconsin’s Marshfield Clinic zeros out telehealth staff; Komodo Health lays off 9%; epharmacy Medly’s Ch. 11, PharmEasy layoffs; OneStudyTeam releases 25% (Coal in too many stockings)

Windups as the holidays and year-end loom. AliveCor loses its David vs Goliath patent battle with Apple, with consequences to come. The Theranos drama nears its end with Balwani’s sentence. But in new developments, robotics for care support and care becomes part of…energy management? And can VIMPRO help NHS manage its patient population crush?

Theranos’ Balwani gets an unlucky 13 year sentence, restitution to come (No tears, no dramatic statements, little media scrum, and a lighter sentence than expected)
AliveCor loses Patent Office ruling with Apple; three patents invalidated (This one isn’t over–the stakes are high)
News (and robot) roundup: ElliQ companion robot upgrades, named to 2022 TIME list; Robin the Robot introduced for older adult care; Utilita acquires Canary Care (UK) (Robots advance, interesting integration of care with energy management)
Perspectives: Could the telehealth VIMPRO model save the NHS from drowning in demand? (A smarter approach advocated in managing patient populations )
Optum Labs creates and funds digital health research hub at Cornell Tech NYC (Reviving NYC in digital health, or gathering ideas for Optum to develop elsewhere?)

Something a bit different this week with two maximum roundups. athenahealth may IPO–again. Amwell may bolster telemental health with Talkspace. Cerebral and former CEO dueling in court. Taking bets on where Theranos’ Elizabeth Holmes will spend her sentence–and when. Plus…year-end buys and fundings. 

Who’s buying, selling, funding wrapup: athenahealth IPO deux?, NextGen EHR buys reseller TSI for $68M, Cloudwave buys Sensato; fundings for Lumen, UpStream, Aide Health
“Big Story” update: where Elizabeth Holmes will spend 11 years, Cerebral sues former CEO Robertson, Amwell buying Talkspace? 

As usual in the rollup to (US) Thanksgiving, it was a light news week. Our two roundups include Babylon Health’s encouraging Q3 results, DOJ’s appealing to block the UHG-Change buy–already closed (!)–an senior exec move from Walmart Health to JPM, and digital health/health tech funding yellow flagged to 2025 by Very Important Investors.

Mid-week news briefs: House members’ ‘grave concerns’ on two deaths tied to Oracle Cerner VA rollout; care.ai’s $27M funding; Clear Arch’s new mobile RPM platform; digital health investment in rough times
News roundup: Babylon Health Q3 revenue up 3.9x; surprise–DOJ to appeal UHG-Change buy approval; Walmart loses senior health exec Pegus to JPM

Legal matters led this week, with Friday’s sentencing of Elizabeth Holmes to over 11 years in Federal prison and Cerebral’s ex-CEO fishing for evidence to use in legal actions. Amazon unveiled Clinic, a low-budget messaging platform for common condition diagnosis. Women’s health Maven rounded up $90M but Sema4 exited that testing field, losing 500. 

Breaking–The Theranos denouement: Elizabeth Holmes sentenced to 11.25 years with an investor loss of ~$121 million (Loss to be finalized at later date, sentence to start 27 Apr 2023)
Ousted Cerebral CEO may sue company, accuses management of scapegoating on Schedule 2 prescribing (Set up for legal action–or more settlement to go away)
The Theranos denouement: ‘Humble, hardworking’ Elizabeth Holmes sentencing Friday; prosecution and defense paint different pictures (updated)
News briefs: ResMed-Verily’s Primasun sleep solution; Maven Clinic’s $90M Series E; Mount Sinai genomics spinoff Sema4 lays off additional 500, exits women’s health
Yes, Virginia, there is an Amazon Clinic, after all; non-face-to-face consults for common conditions (Amazon’s Chevrolet–or Yugo–entry?)

 

Have a job to fill? Seeking a position? See jobs listed with our new job search partner Jooble in the right sidebar!


Read Telehealth and Telecare Aware: https://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Legrand/Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, DHACA, HIMSS, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. 


Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine, and health tech, worldwide–thoughtfully and from the view of fellow professionals

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

Amazon-One Medical gains conditional OK in Oregon–a preview of coming scrutiny?

Amazon has approval for the $3.9 billion One Medical acquisition from the Oregon Health Authority (OHA)–but with conditions.  OHA’s task is to review transactions such as these in how they affect patient cost, access, quality, and equity. OHA’s key comments were positive on cost and access, equivocal on quality, and expressed concern on equity (28 December PDF here):

Cost: “…the transaction will not meaningfully change Amazon and One Medical’s market share for primary care services in Oregon. Commercial insurance payment rates for One Medical are negotiated through the partnership with Providence [Health & Services].” In the Conclusions, they noted that “Amazon, with its advanced supply chain and purchasing power, may generate efficiencies and savings for One Medical, though any savings would not necessarily be passed to consumers.

Access: The few One Medical clinics were found to be in urban areas where there is good access to healthcare. “The entities have also stated that they plan to expand One Medical’s network of clinics, which may provide additional access to services.”

Quality: “OHA has limited insight into quality for One Medical locations, since its [five] Portland clinics opened in 2020 and 2021 and One Medical does not participate in some programs that require regular quality reporting.” However, they noted that “Amazon’s business model also has the potential to impact quality.”

Equity: concern on “One Medical siphoning off commercially insured patients with higher payment rates from clinics that serve more Medicaid and Medicare-covered patients.”

Conditions for approval are in reporting on these areas. Amazon is to report on the services it provides and the quality of care, plus any governance or organizational changes, every six months for five years after the acquisition closes. OHA then must perform follow-up analyses on the impact of the transaction on the commitments Amazon makes on cost, access, and quality of care. 

One Medical’s limited Oregon footprint proved to be helpful to Amazon in gaining OHA approval–but may be a Preview of Coming Difficulties. One Medical operates in 29 markets including NYC, Los Angeles, Boston, and Atlanta, with 815,000 members and 8,000 company clients. States like New York, Massachusetts, Connecticut, and California are not exactly pushovers for approval, with California alone having two approval entities. Then there are the Feds. Back in September, Amazon disclosed the Federal Trade Commission (FTC) was scrutinizing the acquisition, with no resolution announced yet. One Medical also owns Iora Health, which has a full-risk value-based care model for patients in Medicare Advantage (MA) and Medicare shared savings across seven states–HHS and CMS territory. Two more shoes yet to drop: the SEC and the Department of Justice (DOJ). DOJ of late casts a gimlet eye on any healthcare merger–just ask UnitedHealth Group and Change Healthcare, which they are still fighting.

This Editor will stand by last year’s prediction: Iora will be sold either before or immediately after closing. The higher cost/higher care needs Medicare market doesn’t fit with Amazon’s monetization model. It is less profitable and requires advanced risk management, a skill set that Amazon doesn’t have and likely doesn’t want. MA and MSSP (Medicare Shared Savings Program) routinely face regular Federal scrutiny, which Amazon doesn’t do well either. Amazon can use the cash; it is facing major league bad press with its planned layoff of 18,000 workers, about 6% of its 300,000-person corporate staff. One wonders if many of its shareholders (other than Jeff Bezos) approve of this massive investment in a relatively small provider organization.  Reuters 

Mobihealthnews, FierceHealthcare

Short takes: Will there be an Amazon Clinic?, Transcarent and Teladoc, perfect together?, Get Well partners with Palomar Health, expands with Veterans Health Administration

Did Amazon prematurely leak an initiative? Or was it an error? The Verge reports that a video was uploaded to Amazon’s YouTube page on Tuesday–then taken down–describing a new service that would offer assessment, diagnosis, and treatment of common conditions such as allergies. The Amazon Clinic video depicts a user taking an online questionnaire about their symptoms, After paying a fee, a clinician reviews it, diagnoses, and prescribes as needed, sending to the patient’s pharmacy. The disclaimer: “Telehealth services are offered by third-party healthcare provider groups.” The video directs to amazon.com/clinic which is not live. Another Amazon Mystery. Amazon Care is shuttering and the company is jumping through Federal hoops to get approval to close their buy on OneMedical. Hat tip to HISTalk today.

HISTalk also pointed to a Forbes article on health navigator companies such as Castlight and Firefly Health, with a bit of a ‘sting’ at the end. Transcarent, a health navigator that takes on risk integrating its services into employee benefits, is the latest enterprise founded by Glen Tullman, a serial entrepreneur who founded Livongo, investor group 7Wire Ventures, and built up Allscripts as CEO. The writer speculates that Tullman should buy Teladoc to give Transcarent a distribution system–a built-in network of physicians and health system relationships. Yes, this is the same Teladoc that Tullman sold Livongo to for a tidy $18.5 billion, then earlier this year wrote off $6.6 billion as an impairment. This one drips with irony. With its stock down nearly 90% from its January 2021 high, it’s never been cheaper!

Get Well, an RPM, patient care management, and workflow automation company, announced new and expanding partnerships. The new one is with Palomar Health, a health system in Escondido, California. This will implement Get Well services in four phases in five areas to improve patient experience: digital care management (GetWellLoop), inpatient experience (Get Well Navigator and a workflow automation for hospital staff), emergency department experience, care gap closure, and health equity through additional features. Becker’s  The second is an expansion with the Veterans Health Administration (VHA) into 70 Veterans Affairs Medical Centers (VAMC) and a fifth Veterans Integrated Service Network (VISN) with nine facilities. They also now have a FedRAMP “In Process” designation for cloud services which is enabling expansion of GetWellLoop care plans with a VAMC. Release (Business Wire)

VillageMD opens the Walgreens purse, set to buy Summit Health for $8.9B

Moving from rumor to deal in a New York Minute. Primary care provider VillageMD has moved to a definitive agreement to acquire specialty/urgent care provider Summit Medical in an $8.9 billion deal including debt. This was heavily rumored last week [TTA 1 Nov]

This will create a provider behemoth of 680 provider locations, 750 primary care providers, and 1,200 specialty care providers in 26 markets. The fun facts:

  • VillageMD has 342 total primary care clinics in 22 southern and northeastern markets covering 15 states, with 152 co-located with Walgreens; these will eventually increase to 200.
  • Summit Health has 370 locations in New York, New Jersey, Connecticut, Pennsylvania, and central Oregon. VillageMD and Summit do not overlap (except in NJ) on markets.  
  • VillageMD consists of primarily owned and affiliated primary care practices; Summit Health specialty practices (neurology, chiropractic, cardiology, orthopedics, dermatology) plus 150 CityMD urgent care locations.
  • VillageMD has successfully mastered value-based care models in Medicare and entered advanced Medicare ACO models early and vigorously (Editor’s information). Summit Health presently is primarily is fee-for-service with some participation in value-based programs.

The participation in this one is interesting: 

  • Walgreens Boots Alliance (WBA) will invest $3.5 billion through an even mix of debt and equity 
  • Cigna’s health services organization Evernorth will become a minority owner; the exact percentage is not disclosed at this point
  • It’s not disclosed at this time whether Summit Health’s current majority owner, Walburg Pincus, will retain an interest in the combined companies. 

WBA remains the largest and consolidating shareholder of VillageMD, but with this acquisition, reduces its ownership share from approximately 62-63% to 53%. WBA’s other US non-retail healthcare interests include specialty pharmacy company Shields Health Solutions and at-home care provider CareCentrix.

Based on their release, the acquisition is expected to close in January 2023, subject to the usual Hart-Scott-Rodino Act (HSR) premerger notification and report with the DOJ and the Federal Trade Commission (FTC) that initiates a 30-day waiting period.

Bet on VillageMD and Summit closing deeper into Q1–but closing. This Editor’s over/under is that this is overly optimistic given the current DOJ and FTC’s scrutiny and apparent dislike of healthcare acquisitions, even though the provider groups don’t overlap except in a minor way in NJ. But perhaps Amazon, with a healthcare footprint primarily in pharmacy and shuttering Amazon Care, thought OneMedical would move smartly. CVS thought the same with Signify Health, yet both are on information Second Requests that extend the waiting period. DOJ is after all smarting hard with a Federal District Court nixing their challenge of UHG’s Optum with Change Healthcare, but it’s hard to throw typical antitrust at this one.

Go big or go home, indeed.     Healthcare Dive, Becker’s

VillageMD considering $5-$10B merger with Summit Health provider group: reports

Two large provider groups, VillageMD and Summit Health, reportedly are considering a merger. VillageMD, which now is majority owned (62%) by Walgreens Boots Alliance, has 342 total primary care clinics in 22 southern and northeastern markets covering 15 states, with 152 co-located with Walgreens eventually increasing to 200. Summit Health has 370 locations in five states, including specialty practices and CityMD urgent care locations. Summit Health is majority owned by Walburg Pincus.

This reinforces a trend of cross-healthcare sector buys, consolidations, and control. VillageMD’s move from a co-location deal with Walgreens to majority ownership (but controlled by an independent board) was one step starting during the pandemic in July 2020 [TTA article series here].

  • Amazon agreed to acquire OneMedical (1Life) for $3.9 billion at the end of July, and abandon Amazon Care, though now running into FTC/DOJ review headwinds with a second request for information [TTA 15 Sep].
  • CVS Health has made no secret of its desire to acquire primary care, provider enablement, and home health companies (Signify Health, also under DOJ scrutiny), but apparently has abandoned or put on hold a deal with Cano Health [TTA 21 Oct].
  • Walmart continues to go direct by opening full-service clinics, announcing the expansion of 16 based in the Tampa, Jacksonville, and Orlando areas in 2023 (Healthcare Dive, Healthcare Finance News).

Valued at $12.9 billion and with Walgreens’ backing, VillageMD has the ‘go big or go home’ resources to execute Walgreens’ version of this strategy.

Why this very well may happen. The two do not overlap (except in NJ) on markets. VillageMD is primarily owned and affiliated primary care practices; Summit Health specialty practices (neurology, chiropractic, cardiology, orthopedics, dermatology) and CityMD urgent care. VillageMD has successfully mastered value-based care models in Medicare and entered advanced Medicare ACO models early and vigorously (Editor’s information); Summit Health primarily is fee-for-service with some participation in value-based programs. More to come. Bloomberg, Becker’s, and a very big hat tip to research from Jailendra Singh of Truist Securities  (paper here)

Breaking: CVS’ Signify Health buy under DOJ scrutiny in ‘second request’

Not unexpectedly, the US Department of Justice (DOJ) is taking a hard look at the Signify Health acquisition by CVS Health. The two companies were notified Wednesday on DOJ’s Second Request for information. This was disclosed on an SEC Form 8-K. The DOJ now has 30 additional days to investigate antitrust aspects of the merger, once that additional information is received. 

The timetable goes like this:

  • 19 Sept: CVS filed its premerger notification and report with the DOJ and the Federal Trade Commission (FTC) under the Hart-Scott-Rodino Antitrust Improvements Act of 1976 (HSR). This initiates a 30-day waiting period.
  • 19 Oct: At deadline, the request for additional information initiated by the DOJ was received by both CVS and Signify (Second Request)
  • The Second Request extends the waiting period under the HSR Act by 30 days after both CVS and Signify have substantially complied with the Second Request. The DOJ can terminate the waiting period earlier, or move it to an agreed-upon later date. 

CVS continues to affirm closing the deal by first half 2023 as planned, which is a fairly wide window.

The current government’s DOJ and FTC have made no secret of their policy-driven yen for using antitrust in the name of lowering healthcare costs (even favored pharma). The crashing failure of DOJ’s antitrust motions against UnitedHealthGroup and Change Healthcare [TTA 20 Sept] must have smarted. What this usually initiates is the search for a quick and easy win to put said embarrassment behind them. CVS Health is certainly a high-profile target, though Signify even at $8 billion, like Change, is not except in the industry. 

Signify’s competitive overlap with CVS/Aetna isn’t as large or obvious as UHG’s Optum with Change, but there is some: home health management and (in this Editor’s view), ACO management services with Signify’s Caravan, which participates in multiple Federal shared savings models where Aetna also is. One wonders if some divestment will be demanded by DOJ. Even before the auction, Signify started the complicated and long exit from the failing Bundled Payments for Care Improvement (BPCI) programs inherited from the Remedy Partners buy.

Could the DOJ action have played a role in CVS’ sudden cold feet in acquiring Medicare/Medicaid primary care provider Cano Health? [TTA 20 Oct] The timing is certainly close. 

DOJ is not working alone. The FTC also has a yen for Amazon in their 2 September second request for information on their acquisition of OneMedical, which also added 30 days to the Hart-Scott-Rodino (HSR) clock after compliance. Amazon is already going through this with their iRobot acquisition [TTA 15 Sept]. Reuters, FierceHealthcare, Home Health Care News

News briefs, catchup edition: UnitedHealth/Change decision October?, CVS wins $8B Signify Health auction, Walgreens majority buy of CareCentrix, FTC requests more info on Amazon-One Medical

Your Editor is semi-returned from Almost Two Weeks in Another Town, with a few more days to close out September (and summer into autumn) coming up. A lot of big news broke despite the usually slow Labor Day holiday week.

UnitedHealthcare Group/Change Healthcare Federal lawsuit to be decided in October–reports. The bench trial in the US District Court in Washington DC pitted the Department of Justice and state plaintiffs against UHG’s massive $13 billion acquisition of claims and EDI/data processing giant Change. It concluded 16 August with closing arguments presented 8 September. Dealreporter via Seeking Alpha reported that UHG and Change effectively countered DOJ’s antitrust objections to the acquisition. Change Healthcare had previously sold their claims editing business to TPG Capital to ease antitrust concerns.  Whether that will be enough in the current environment with greater sensitivities around healthcare consolidation remains to be seen. If approved, Change will be folded into OptumInsight. For a deeper dive into the issues, see TTA’s earlier reporting 3 August and 23 March.

CVS Health beat out other contenders with an $8 billion cash bid for Signify Health. It was a busy Labor Day for CVS as Signify’s board met and decided that day on CVS’ cash offer of $30.50 per share in their unusual auction. Amazon, UnitedHealth Group, and little-known Option Care Health were the other bidders. Signify is a strategic boost for CVS in becoming a major player in primary care, provider enablement, and home health as we’ve summarized here from CVS’ Q2 earnings call. Signify’s capabilities in in-home health delivery and provider services were cheaper to buy than to develop. Based on the weight given to it in the CVS release, Signify’s Caravan Health and their Medicare ACOs furnishing value-based care management services to 170 providers was a significant factor in the top price paid.

New Mountain Capital and their investors own 60% of Signify and will be exiting. Signify had in July announced their own exit from the costly and problematic Episodes of Care/BPCI business acquired with Remedy Partners back in 2019. This led to most of the over 480 staff layoffs announced last month. The sale is, as usual, pending regulatory approvals and isn’t expected to close until first half 2023. Kyle Armbrester, Signify’s CEO Kyle Armbrester will continue to lead the company as part of CVS Health. Healthcare Finance, FierceHealthcare

Rival Walgreens Boots Alliance completed their acquisition of a majority share of home care coordination platform CareCentrix. Walgreens’ final payment was $330 million for 55% of the company at an $800 million valuation. As noted previously, Walgreens ‘go big or go home’ strategy in primary care kicked off in 2020 with growing investments in VillageMD, culminating in last year’s $5.2 billion for 63% of the company. The plan is to co-locate Village Medical offices with 600 Walgreens locations by 2025 [TTA 14 Oct 2021]. CVS’ recent actions can be seen as a reaction to Walgreens’ aggressive moves. Healthcare Finance

Amazon now under FTC scrutiny for One Medical acquisition. If shutting down the much-publicized Amazon Care wasn’t quite enough last month, the Federal Trade Commission (FTC) will be reviewing Amazon’s $3.9 billion buy of One Medical. This was announced in a 1Life Healthcare (parent of One Medical) 8-K filing with the Securities and Exchange Commission (SEC). Both 1Life and Amazon received requests for additional information on 2 September, above and beyond the usual required Hart-Scott-Rodino Act (HSR) reports that will be reviewed by the FTC and DOJ. Effectively it extends the HSR waiting period by 30 days after One Medical and Amazon have substantially complied with the additional information ‘second request’.

The FTC isn’t winning popularity contests with Amazon’s legal department, as the agency is reviewing their acquisition of iRobot, maker of robot vacuum cleaners. Mobihealthnews

Babylon Health exits last NHS hospital contract as a ‘distraction’, looks to US market for growth

Babylon Health’s rollercoaster ride continues. Today’s news was that their last of three NHS Trust contracts, with Royal Wolverhampton NHS Trust (RWT), was ended by Babylon two years into a ten-year contract. This follows the end of two other contracts that drew a fair amount of controversy (see our index here)–the 2020 one-year Royal Berkshire NHS Foundation Trust with an accident and emergency triage app that was discontinued by Babylon, and with University Hospitals Birmingham NHS Foundation Trust (UHB) for a virtual A&E app that was ended in July.

In the UK, Babylon will continue its GP At Hand service that took over a GP office in Fulham, London in 2016. It now currently covers about 155,000 patients. It will also maintain the AI-based chatbot used for triaging patients. GP At Hand is not profitable. GP practices work on a flat fee per patient that averages £155 ($183) per patient per year.

Babylon and RWT contracted in 2021 for a digital-first primary care service that would cover 55,000 patients, with a patient portal that would enable them to view their health records and view appointments. The app would also monitor conditions and like the AI chatbot, help to diagnose illness and actions. Babylon is ending the ten-year contract after two, which would make it 2023.

From the bubbly Digital Enthusiasm of former Health Minister Matt Hancock (left) in 2018 to the storm around @DrMurphy11, a GP who raised performance issues with the Babylon chatbot that escalated to BBC Two’s Newsnight in February 2020, founder and CEO Ali Parsa is now in an unenviable position in two countries. He 1) has semi-exited the UK market, 2) ruthlessly cut costs to the bone because the stock is down 90%, and 3) shifted to the far larger but unforgiving market of the US. The bright spot here is that US patients covered have already topped 6 years of effort in the UK. Parsa has now moved to the US.

Parsa noted in a recent results call [Seeking Alpha-Ed.] with analysts. “Those two or three small NHS contracts that you refer to—and those are not our significant primary-care contracts— those are marginal contracts for us, more in that category of contracts where we could not see a significant contribution to our profit margin,” he said. “And they also had a rather small contribution to our revenue. And therefore we saw them as a distraction and terminated those contracts.”

This Editor has previously noted Babylon’s layoffs/redundancies of at least 100 staff to save $100 million by Q3, which we are now in. Expansion in the US has to take place with static staff to make goal. And as to the US being unforgiving: VCs are snapping their capacious purses shut, Mr. Market’s gone into rehab, and inflation is shrinking healthcare budgets from providers to payers to self-insured companies. The Big Kahunas with Big Bucks–CVS Health, Allscripts, UnitedHealth Group, Amazon, Walgreens, Walmart–and out-of-left-field players like Option Care Health bidding on Signify Health, are snapping up, as we’ve earlier put it, “healthy health tech companies at the right (discounted) price that fill in their tech gaps”. And making life difficult for single players like Babylon Health. Wired. And a snappy hat tip to HISTalk.

Signify Health bidding war ensues, waged by Amazon, UnitedHealth Group, CVS, Option Care Health

What a difference less than two weeks makes. We noted on 11 August that in-home health and value-based provider services company Signify Health was up for sale in an unusual auction, with CVS Health the first disclosed bidder. Yesterday, three more companies jumped into the mix, UnitedHealth Group (the 9,000 elephant of US health), Amazon (with One Medical still pending), and little-known Option Care Health, a public (Nasdaq: OPCH) home infusion care company.

Reports in the Wall Street Journal (paywalled) indicate Signify’s value in the auction may top $8 billion. Bids are due around Labor Day. The board will be meeting next Monday to discuss the bids to date. Signify’s current value is about $5 billion.

The share price closed today just above $27, a major rise from last week’s close of $21 (Yahoo Finance).

The UHG bid is above $30, with Amazon close by, according to Bloomberg News sources. The CVS bid is not known. A buy by Amazon would put the company in Instant Major Healthcare Player territory. This Editor believes that with UHG and CVS, antitrust may factor in, especially considering Signify’s recent ownership of the ACO MSO Caravan Health.  

Option Care may not be well known, but it has impressive backing from Goldman Sachs and has been profitable. Their interest is Signify’s home health network and access to providers through Caravan. Another backer, Walgreens Boots Alliance, just sold 11 million shares on the secondary market, reducing its holdings from 20.5 percent to approximately 14.4 percent.

There’s no bar, of course, to the board ending the auction at any time and awarding the company. Healthcare Finance, FierceHealthcare

Friday short takes: was there a bidding war for One Medical? A concussion risk wearable tested. Get Well’s monkeypox digital care plan

Amazon’s scoop-up of One Medical apparently was not all Skittles, Rainbows, and Unicorns. Large companies like Amazon, Walmart, Allscripts, and CVS are on the hunt to fill gaps in their portfolio and technologies, but only “healthy health tech companies at the right (discounted) price that fill in their tech gaps.” Of course, some of these companies have more chips on the table and in the safe than others.

We know from earlier reporting [TTA 7 July] that One Medical and CVS had some talks, but that One Medical spurned the offer. It did establish that One Medical was in play. Some digging by Heather Landi at FierceHealthcare, taking a walk through SEC documents according to a regulatory disclosure with the US Securities and Exchange Commission (SEC) filed 10 August, found that CVS (identified as Party A) and 1Life Healthcare, the parent of One Medical, started their acquisition talks in October 2021. 1Life was short on cash, getting shorter, needing to expand, and was having trouble raising the $300 million they estimated they needed. Starting this past February, 1Life management started to negotiate with Amazon. On 1 June, CVS offered $17 per share, boosting it by $1 the following day, but were informed by 1Life that there was another suitor. By 2 July, Amazon put $18 in an all-cash deal on the table. When news leaked via Bloomberg on 5 July that CVS was in discussions, CVS bowed out. By the end of July, 1Life and Amazon closed on the deal [TTA 27 July].

It came down to this–Amazon needed One Medical more than CVS. Watch for CVS and Walmart to make more provider/primary care moves by the time the snow flies this year. We’ve already noted that CVS inked a deal with Amwell a few days ago as their provider for Virtual Primary Care and that Walmart outright owns a telehealth provider, MeMD, though their overall strategy remains a bit murky.. CVS also has resources through Aetna that are integratable, such as provider networks.

And speaking of Amazon, they just inked a deal with Ginger to add telemental health as an option for Amazon Care. Healthcare Dive

In the US, we are very close to football–and concussion–season. Multiple concussions lead to CTE, which took a long time to recognize as a cause of premature dementia. A mHealth wearable has been tested to measure head kinematics–head movement–and detect sudden neck strain, such as whiplash. Current systems are embedded in helmets or the X-Patch, which uses accelerometers.  According to the report in AAAS’ EurekAlert!, Nelson Sepúlveda of Michigan State University and colleagues developed a novel patch sensor using a film layer of thermoplastic material, a ferroelectret nanogenerator or FENG. “This produces electrical energy when physically touched or pressure is applied. The electrical signal produced is proportional to the physical strain on the neck and can be used to estimate the acceleration and velocity of sudden neck movement, two important markers for predicting concussion.” For this test, a dummy was used. Nature Scientific Reports, mHealth Intelligence

Monkeypox, its transmissibility, and treatment have also percolated this summer.  Get Well Network, which we noted last month in a JAMA study used its GetWellLoop RPM and monitoring in a Covid-19 home treatment study, released a new monkeypox digital care management plan. It will permit monitoring of symptoms from home using RPM, help direct patients to higher levels of care if and when needed, and aids hospitals in managing mandatory regulatory requirements for reporting and tracking infectious diseases. LifeBridge Health in the Baltimore area began offering Get Well’s monkeypox symptom monitoring tool last month. Release

Week-end wrapup: CVS plans to expand primary care, home health; Cera Care raises £264M; Linus Health’s AI enabled dementia screener, Cognito’s cognitive therapy slows brain atrophy

The sandal (it’s summer) drops at CVS Health in primary care–and maybe more. On their Q2 earnings call, CVS discussed that they are determined to enhance their services in three categories: primary care, provider enablement, and home health. The footwear that dropped was from CEO Karen Lynch: “We can’t be in the primary care without M&A” (sic). It was inevitable, given that rival Walgreens has a $5 billion deal with VillageMD for freestanding Village Medical clinics, Amazon with the pending One Medical buy–which it passed on only weeks prior [TTA 7 July], and Walmart picking along the edges with in-store clinics and telehealth. CVS’ criteria: strong management team, strong tech stack, strong scale, strong ability to build a pathway to profitability. (Certainly not an easy set of hurdles) CVS’ urgent care and in-store MinuteClinics have been doing well, with business up 12% to 2.8 million patient visits year to date. HISTalk, FierceHealthcare, Motley Fool transcript of earnings call

London-based Cera Care Ltd. raised £263.6 million ($320 million) in an equally split debt/equity round. Equity funding came from existing investor Kairos HQ, then the Vanderbilt University Endowment, Schroders Capital, Jane Street Capital, Yabeo Capital, Squarepoint Capital, Guinness Asset Management, Oltre Impact, 8090 Partners, and technology investor Robin Klein. Debt was not disclosed. The fresh financing will go towards expanding patient capacity in the UK plus Germany from the current 15,000 to 100,000.  Cera delivers in-home care, nursing, telehealth, and prescription delivery services using a digital platform and AI algorithms that use the data gathered to predict changes in patient status. TechCrunch, UKTechNews

Two developments from separate companies in the vital areas of improving dementia and Alzheimer’s diagnosis–and outcomes:

  • Linus Health has debuted its cognitive assessment and patient questionnaire platform for clinical use by primary care providers. The assessment tests for subtle changes in cognitive function, which in the preclinical phase will often go undetected. The concept is to push forward diagnosis and therapies to slow disease progression. It is based on an iPad and includes their DCTclock, an AI-enhanced version of the traditional paper-based Clock Drawing Test using a digital stylus or pen that can also spot symptoms of early-stage Parkinson’s. The evaluation including the DCTclock takes about 10 minutes. Release, FierceBiotech
  • Cognito Therapeutics is still in the investigational stage with its GammaSense headset which delivers sound and light therapy to cognitively impaired patients. The sensory stimulation evokes gamma oscillations in the brain that reduces neurodegeneration and brain atrophy. Their paper delivered last week at the Alzheimers Association conference tracked subjects who used the headset one hour per day for six months. The therapy reduced white matter shrinkage to about 0.4%, compared to a historical tracking of about 2%. An earlier study also showed slowdowns in the decline of memory and cognitive function. FierceBiotech

Mid-week roundup: UnitedHealth-Change trial kicks off; Amazon’s One Medical buy questioned; Cionic’s neural sleeve designed by Yves Behar; Medable-Withings partner; Orion Health’s new CEO; IBM Watson Health’s Simon Hawken passes

The Department of Justice lawsuit to block the $13 billion acquisition of Change Healthcare by UnitedHealth Group started on Monday. It is a bench trial in US District Court in the District of Columbia that will last 12 days, concluding on 16 August with a verdict date to be determined. The DOJ and the plaintiffs, including Minnesota and New York State, are presenting their case over seven days. UHG and Change will have five days. It’s expected that UHG CEO Andrew Witty and former chief David Wichmann will be testifying. The American Hospital Association (AHA) was a key player in pushing for a DOJ action (their article here). TTA recapped the main competitive issues in play on 23 March, along with this Editor’s opinion that the merger will be blocked given this current administration’s anti-trust stand. ‘It will be one for the books–the ones marked ‘Nice Try, But No Dice’. FierceHealthcare, HealthcareFinanceNews

Will Amazon’s acquisition of One Medical be reviewed by the Federal Trade Commission (FTC)? That is what Senator Josh Hawley (R-Missouri) is requesting. He cites that Amazon will have “access to enormous tranches of patient data. While HIPAA and other privacy laws exist to thwart the worst potential abuses, loopholes exist in every legal framework.” He also cites, somewhat broadly, that information of this type could be used to suggest over-the-counter blood pressure medications to a One Medical patient shopping at a Whole Foods Market. (What is meant here is that there are many supplements that claim to benefit blood pressure available OTC, such as Garlique; however, there are many OTC meds that can increase blood pressure such as decongestants.) This Editor agrees with Senator Hawley that the acquisition should be carefully reviewed by FTC and, to go further, HHS as it involves patient data.) Hawley Senate.gov page 

The Cionic Neural Sleeve, designed to aid people with mobility issues, is getting a design upgrade via Yves Behar and his fuseproject. The Neural Sleeve [TTA 30 June] aids the legs through sensors in the sleeve that monitor movement for muscle firing and limb position, then analyzes them through an app to optimize functional electronic stimulation (FES) delivered through the sleeve. The Behar team, according to the release, has delivered a neural sleeve “designed for everyday wear, and importantly, is easy to put on and take off – a critical design element for those with inhibited mobility. The lightweight, breathable fabric feels like an athletic legging, and is available in multiple colors and sizes. Paired with the intuitive CIONIC app, the sleeve enables the user to be in control of their own mobility journey.” Cionic is taking pre-orders for delivery in early 2023. Also The Robot Report.

Medable partners with Withings for clinical trials. Medable, a clinical trials platform, is partnering with Withings Health Solutions to connect Withings devices for monitoring at home. Withings devices will provide medical-grade measurements, including temperature, heart rate, blood pressure, sleep patterns, and weight to connect the data into Medable’s decentralized clinical trial platform. Direct monitoring also assists in attracting and retaining subjects in clinical trials, plus improving accuracy, by eliminating subject manual reporting and checkins. Financial terms and duration were not disclosed. Release, FDA News, FierceBiotech

Short international take: Orion Health, an Auckland, New Zealand-based health IT company headed by Ian McCrae for the past 30 years, announced he is stepping down for health reasons. Replacing him in late August as CEO will be Brad Porter, coming from Fisher & Paykel, a NZ-based medical device company. Mr. Porter is Mr. McCrae’s son in law.  Orion recently won what could be the largest health information exchange system in the world for Saudi Arabia, covering 32 million people. Healthcare IT News 

And a sad passing: Our UK and European Readers likely know Simon Hawken from his long career with IBM, including Watson Health (now Merative) and Merge Healthcare, and earlier with BEA Systems. HISTalk reported that he passed away on 25 July. This Editor has not been able to find other notices, so is asking for Reader help and comments.

Weekend roundup: telehealth claims ticked up again in January, Walmart opens Florida health ‘superstores’, Blue Shield California partners with Walgreens’ Health Corners

Telehealth now above 5% of January claims. Perhaps Omicron, winter weather, or the post-holiday blues, but telehealth visits after a long drop have risen to 5.4% of January medical claim lines. It’s also the third month in a row of increase: November was 4.4%, up from October’s 4.1%; December was 4.9%.

As a percent of the total, claims increased in November and December for acute respiratory and Covid-19, but leveled off in January. The numbers remained in single digits compared to the leading diagnosis code group, mental health conditions, which rose in January:

Month Mental health Acute respiratory Covid-19
January 2022 58.9 3.4 3.4
December 2021 55.0 6.0 4.8
November 2021 62.2 4.5 1.4

February and March claims will be the proof, but telehealth is leveling off to a steady 4-5% range of claims with seasonal rises, barring any mass infectious diseases. The FAIR Health monthly map also enables drill-down by region. Healthcare Dive

Walmart Health ‘superstores’ open in Florida, finally. The concept, which had gradually spread to 20 locations in Arkansas, Georgia, and Illinois starting in 2019, now has two locations in the Jacksonville area. Three additional locations will be opening by June in the Orlando and Tampa area. Openings were delayed from 2021 so that Walmart could debut their Epic EHR and patient portal in those locations. Plans for expansion in Florida, filled with areas with aging populations, have been hinted at but coyly not confirmed by Dr. David Carmouche, senior vice president of Omnichannel Care Offerings.

After a few false starts and retrenching, Walmart is leveraging its strong physical point in delivering health–retail supercenters–against competitors such as CVS, Walgreens, and Amazon. The centers provide primary and urgent care, labs, X-rays and diagnostics, dental, optical, hearing and behavioral health and counseling for a checkup priced around $90, with most under contract with payers. Walmart has not announced expansion beyond Florida or in current states, but prior statements have indicated their desire to open Walmart Healths across the country. Walmart release, Healthcare Dive, Miami Herald

And Walgreens is not far behind the curve with 12 Health Corners in California. Walgreens’ joint model with Blue Shield of California in the San Francisco Bay and Los Angeles areas is designed to boost community health, especially in areas with low health coverage or ‘health deserts’. Health advisers can provide simple in-store care along with guidance on preventive screenings, chronic care management and medications. Select health screenings, such as blood pressure checks and HbA1c tests will be available. 

Both in-person and virtual services through the Health Corner app are available at no additional cost to members enrolled in Blue Shield’s commercial PPO (Preferred Provider Organization) and HMO (Health Maintenance Organization) plans, who live within 20 miles of a Walgreens Health Corner location. It is part of both Walgreens’ enlarging of patient care offerings, including telehealth at a local level, and Blue Shield’s health transformation goals.

Their release promises an additional eight locations by mid-year. Healthcare Finance, FierceHealthcare

Weekend wrapup & reading: Amazon Health on talent hunt, Practice Fusion fined $200K for violating $145M prosecution agreement, and must-read studies and articles on older adults tech

Resumes and networking up! A writer at Becker’s Hospital Review tired of their usual diet of healthcare departures, ‘alarming’ rises of COVID rates by state, and cyber-attacks on hospitals to publish six top-level jobs opening up in Amazon’s healthcare areas. The lead is Head of worldwide health technology solutions to lead strategy in that area at the C-level. Two are in UX and software development at Alexa Health, a senior solutions architect, health artificial intelligence , a principal of behavioral health for digital health benefit programs, and a health information exchange specialist. So if your spring brings a yen for change….

Physician EHR Practice Fusion, now Veradigm owned by Allscripts, got another $200,000 spanking from the Feds. Back in January 2020, right before Pandemic Hell really broke loose on the world, the Department of Justice successfully resolved both criminal and civil charges against the EHR company. Practice Fusion was charged with “soliciting and receiving kickbacks in return for embedding electronic prompts in its electronic medical record (“EMR”) to influence the prescribing of opioid medications” as part of the platform’s clinical decision support (CDS) alerts. The kickback was $1 million from an unnamed ‘opioid company client’, The deferred prosecution agreement (DPA) was accompanied by 1) a $145 million fine and 2) maintenance of an Oversight Organization based on three specific requirements. DOJ in the District of Vermont found that Practice Fusion did not comply with the terms of the latter, charges that Practice Fusion denied. They settled with the DPA extended by 11 weeks with a fine of $200,000. Release, US Attorneys Office, District of Vermont 29 March, US DOJ release 27 January 2020

Weekend Reading. Laurie Orlov of Aging and Health Technology Watch has been hard at work, recently updating her Market Overview Technology for Aging and releasing The Future of Smart Homes and Older Adults. No time with spring cleaning to tackle long-form? Try three tart short takes on PERS smartwatches (not getting the ‘why’), did ‘voice first’ technologies meet their 2018 promises (not quite), and what she sees as the Seven Top Trends for tech to reach older adults–with the first being hospital to home (Optum and Humana have voted ‘yes’).