News roundup: Teladoc’s improved Q3, PursueCare resuscitates Pear’s apps, AMA removes 16-day RPM requirement in 2026, PatientPoint intros Innovation Network, PeopleOne’s $32B raise, Cigna-Humana again a no-go

October 31, 2024 | by

Teladoc beat the Street for Q3–even with a still gasping BetterHelp. Their Q3 under new CEO Chuck Divita was an improvement over their dismal Q2 [TTA 1 Aug] where Teladoc posted a $838 million net loss, largely made up of a $790 million impairment on BetterHelp’s sinking performance. BetterHelp, the direct-to-consumer mental health portion of their business, continues to sink in an overcrowded market even though telemental health remains in or near the lead in competitors’ recent funding rounds. Revenue this quarter decreased 10% to $256.8 million. CFO Mala Murthy admitted that BetterHelp is a “business in transition,” although the from-and-to remain opaque. 

That bit of bad news aside, Q3’s net loss was only $33.3 million, a big improvement over Q2 2023’s $57 million loss. This quarter also included $3.6 million in restructuring costs related to severance and office space reductions. Revenue declined by 3% to $640.5 million, following on Q2’s 2% decline, which is not a good trend. Adjusted EBITDA was $83.3 million, down 6%. Integrated Care (their main business) segment revenue increased 2% to $383.7 million.

For the nine months of 2024, revenue was off 1% versus prior year at $1.9 billion with a cumulative net loss of $952.8 million. Integrated Care’s revenue grew 5% to $1,138.2 million, with BetterHelp again declining 8% to $790.9 million. 

Divita and Murthy both attributed slowing growth to increased acquisition costs which impact the DTC model of BetterHelp–and that isn’t expected to change. They see greater opportunities for overall growth in international business, which also has less expensive international ad spending. The analyst quoted by FierceHealthcare believes that Teladoc is still in the process of adjusting to a slower growth model and focusing on profitability. Shares remain up slightly at around $9 since yesterday’s report, an improvement over their August lows at $6-7. Release

PursueCare revives Pear Therapeutics’ two FDA-cleared addiction apps. Both RESET and RESET-O have been relaunched by PursueCare, a Connecticut-based addiction recovery and behavioral health virtual care service. The two apps were cleared under Pear’s ownership and to date are the sole the only FDA-cleared prescription digital therapeutics (PDTs) for substance use disorder (SUD) and opioid use disorder (OUD). They provide a self-guided 12-week course of cognitive behavioral therapy (CBT), in which patients are incentivized to complete lessons, adhere to treatment, and abstain from drug use. PursueCare’s virtual clinic model uses a smartphone app and utilizes a care team model to provide telehealth treatment for opioids, alcohol, stimulants, and other substances, including medication assisted treatment (MOUD), counseling, psychiatry, case management, pharmacy, and treatment for addiction-related health conditions. Mobihealthnews, PharmaPhorum, Release

Not covered by Mobihealthnews is the backstory on PursueCare’s acquisition of Pear’s PDTs. As we reported when Pear was sold off by the US District Court in Delaware in bankruptcy to four companies, one of the big acquirers of Pear assets was its former CEO, Corey McCann MD, doing business as Harvest Bio LLC. Harvest paid $2 million for the ISF licenses and patents, plus Pear assets related to schizophrenia, multiple sclerosis, depression, and the remaining pipeline projects. They also bought the corporate trademarks, the PearConnect commercial platform, and the rights to the FDA-cleared reSET and opioid-specific reSET-O programs/apps. The two RESET apps were then sold to PursueCare last December along with RESET-A for alcohol addiction for an undisclosed price. This has FDA breakthrough device designation but is not yet marketed by PursueCare. PursueCare also raised $20 million in a Series B in January led by T.Rx Capital. McCann, one of T.Rx Capital managing partners, joined PursueCare’s Board of Directors at that time. Healthcare IT Today  Does this begin to resemble about three degrees of separation?

The American Medical Association (AMA) made life a little more marketable for remote patient monitoring (RPM) companies. As of 2026, the AMA in its remote physiologic monitoring CPT codes will no longer require 16 days of continuous monitoring within 30 days in order to qualify for coding reimbursement. It’s a pity it won’t kick in for over a year, so RPM companies will just have to hang in there till then. FierceHealthcare

PatientPoint launches Innovation Network, names chief experience and innovation officer. The digital health company that provides health information at 35,000 patient point-of-care locations announced at HLTH that their new CEO, Sean Slovenski, will be forming a network that connects leaders from various industries with a vision of transforming healthcare. The founding partner is Verizon joined by LG, GoodRx, and Thrive Global. Its purpose is to “foster collaboration to develop patient-first solutions that address some of healthcare’s most pressing challenges.” PatientPoint’s new chief experience officer Shawn Nason joined from his own consultancy six months ago as chief of staff and head of experience and is considered to be expert in disruptive innovation and human-centered design. Release

PeopleOne Health‘s value-based primary care hybrid model received a nifty $32.3 million Series B funding. It was led by GV (Google Ventures), with participation from investors including healthcare entrepreneur and Transcarent CEO Glen Tullman. Their nine clinics are presently in Pennsylvania with their newest expansion in Palatka, Florida, south of Jacksonville. Their model is employer-focused; employees are fully covered by employers with no copays, deductibles, or coinsurance. It’s claimed that they save up to 30% on healthcare costs. Mobihealthnews, Release

Cigna quashes Humana buy rumors–again. These revived in late summer like pumpkins, but on an investor call Thursday (today), Cigna CEO David Cordani said that instead, their free cash would be used to buy back shares. Unlike other payers, Cigna beat the Street with total revenue of $63.7 billion, up 30% versus prior year. Shareholders’ net income for Q3 was $739 million, less than prior year’s $1.4 billion. The positive picture was powered by strong demand for specialty drugs in Evernorth Health Services but dragged down by a May $1.8 billion write-off of Cigna’s investment in VillageMD [TTA 1 May]. Healthcare Dive, Release

CVS-Aetna hearing starts June 4; now only 6 witnesses called, for and against (updated)

May 13, 2019 | by

The next chapter of the ‘Perils of Pauline’ saga that is the CVS-Aetna merger won’t commence until June, as it turns out, but already the amici curiae are piling up on both sides. Judge Richard Leon of the US District Court for the District of Columbia has been lining up the witnesses he’ll be hearing from, both for and against. 

On the ‘anti’ side, testifying that the settlement agreement would be anti-competitive and not in the best interest of consumers, the American Medical Association (AMA) had called in three professors, the AIDS Healthcare Foundation three, and Consumer Action and the US Public Interest Research Group (PIRG) one. On the ‘pro’ side, put forward by CVS and for the Department of Justice, are five witnesses, healthcare executives and government consultants, who will testify that actions taken by CVS and DOJ will preserve competition and benefit consumers.

Certainly as we clock the ninth month after DOJ approved the merger and the companies have closed the deal, the drama continues, as Judge Leon continues to get coverage and the merger continues to be held up in this highly unusual proceeding. HealthLeaders 22 April and 7 May.

Update 13 May. The DOJ is challenging the three AMA witnesses, saying that they will be broadening the hearing beyond the settlement agreement which is what the review by Judge Leon is supposed to be about. On the other hand, the judge has already stated that the settlement covers “about one-tenth of 1%” of the merger, so he is already staking out a much larger territory. The AMA, of course, is quite pleased with the opportunity. Is this hearing pushing the envelope of judicial overreach in this judge’s interpretation of what a District Court can do under the Tunney Act? We can only wait and see. Healthcare Dive 13 May. Our coverage of the hearing to date here.  

Update 14 May. DOJ of course lost its fight with Judge Leon to limit the scope of the hearing and the AMA witness testimony, with the judge stating it is “essential” to understand how PBM affects Medicare Part D drug plans, though Aetna divested itself of the latter at DOJ’s direction. Both sides have three approved witnesses each for the three-day hearing. The ‘antis’ are Neeraj Sood (AMA), Diana Moss (Consumer Action/PIRG) and Michael Wohlfeiler (AIDS Healthcare foundation). The ‘pros’ are Alan Lotvin (CVS Health), Terri Swanson (Aetna) and Lawrence Wu (NERA Consulting). Healthcare Dive 14 May

Anthem-Cigna merger nixed, finally (US)

February 9, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /] Breaking News. Not with a bang, but a whimper. Late Wednesday 8 Feb, the anticipated decision derailing the $54 million Anthem-Cigna merger was released by the Federal District Court, District of Columbia. Judge Amy Berman Jackson’s decision denying the merger was very much along the anti-competitive and anti-trust rationales contained in the 19 January advance report by the New York Post. There’s little that hasn’t already been explored in our prior reports, so we will leave the rehashing to sources like CNBC. The general consensus is that the four Big Payer Merger participants (Aetna and Humana merger denied [TTA 24 Jan]) will be moving on, perhaps to their advantage as most of the premises for merging, based on ACA’s effects, are expected to change, drastically.

Cigna must also be relieved after its reported ‘merger remorse’ after too many rumored disagreements with Anthem. According to Bloomberg, Cigna is sitting on $7 to $14 billion deployable capital, with the high end including extra debt. (Does this include the $1.85 bn breakup fee that Anthem owes to Cigna? Stay tuned on how Anthem tries to get out of this.) And the American Medical Association is beyond delighted (release).

Of course, there’s a lot of speculation about all that loose cash being deployed on new merger targets, which include the Usual Suspects of Humana, WellCare, Centene and Molina. Some free advice: all these companies should, for the next year, sit quietly and breathe deeply (as many employees who would be redundant in any merger are). They should also take care of business (TCB!), refocus on serving their policyholders, make their processes far less onerous on providers, and let it all shake out rather than rushing out to find out Who To Buy. (New Attorney General Jeff Sessions was sworn in this morning, and many changes are coming in both healthcare policy and the judiciary.) Also Neil Versel’s pointed take in MedCityNews.

What it takes to make telehealth really work

September 6, 2015 | by

In line with my fellow editor, forgive this editor engaging in a little nostalgia – going back to 2006, when the Whole System Demonstrator was a still a wonderful idea, before the competing forces of academia and management consultancy put short-term financial gain before long term patient outcome improvement. Those were the days when we genuinely believed that recording vital signs was what it was all about.

Move on nine years and it’s clear from the American Heart Association review referred to in this column recently, and subsequent articles, that one key success factor is drip-fed education. To quote:

“The amount of information that must be conveyed and the support that is necessary to counsel and motivate individuals to engage in behaviors to prevent CVD are far beyond what can be accomplished in the context of face-to-face clinical consultations or through traditional channels such as patient education leaflets,” the researchers say. “Mobile technologies have the potential to overcome these limitations and to transform the delivery of health-related messages and ongoing interventions targeting behavior change.”

This is underlined by a recent study of attempting to control hypertension using just text messaging, which was far from an unqualified success.

Another major driver of course is cost saving, as demonstrated by (more…)

Unnerving mergers (US-UK); DoD’s EHR picked; EHRs & AMA

July 28, 2015 | by

Blues feeling Blue about…The Anthem-Cigna merger, finalized last week (but yet to be approved by the US and likely the UK Governments as Cigna issues policies there), gives them bragging rights over the Aetna-Humana merger and Optum/United Healthcare in their covering of 53 million US lives as the largest US health insurer. Unnerved is the Blue Cross and Blue Shield Association, of which Anthem is a part of with the Anthem and Empire Blue Cross plans plus others in a total of 14 states. But Anthem also competes with ‘the Blues’ in 19 additional states where it markets under a non-Blue brand, Amerigroup, primarily for Medicare and Medicaid (state low-income coverage). Many of the Blues are non-profit or mutual insurers; many are partial or single-state, like Independence, Capital and Highmark (PA/DE/WV) in Pennsylvania and Horizon Blue Cross of New Jersey. Their stand-alone future, not bright since the ACA, now seem ever dimmer in this Editor’s long-time consideration and that of Bruce Japsen writing in Forbes. Also Morningstar considers Anthem’s overpaying and the LA Times overviews.

Walgreens Boots Alliance, another recent merger of quintessentially American and British drug store institutions, named as its interim CEO Stefano Pessina. He previously ran Alliance Boots prior to the merger and is the largest individual shareholder of WBA stock with approximately 140 million shares, so one cannot call it a surprise. At a youthful 73 (see video), one assumes he also takes plenty of Walgreens vitamins and uses Boots No 7 skin care. Forbes.

Updated: The big EHR news is the US Department of Defense announcing the award of its Defense Healthcare Management System Modernization contract this week. At 10 years and $11 billion, even giant EHRs went phalanxed with other giant government contractors to face DOD: Epic with IBM; Cerner with Leidos, Accenture and Intermountain Healthcare; Allscripts with Computer Sciences Corp. and Hewlett Packard. Certainly there will be ‘gravitational pull’ that affects healthcare organizations, but the open and unanswered question is if that pull will include the far nearer and immediately critical lack of interoperability with the Veterans Health Administration’s (VA) VistA EHR. The Magic 8 Ball reads: Hazy, try again later.  Leidos/Cerner announced as winners close of business Wednesday 29 July. 

In other EHR news, US doctors vented last week on how much they hate the @#$%^&* things to the American Medical Association‘s ‘town hall’ in Atlanta. Bloat, diminished effectiveness, error, getting in the way of care due to design by those without medical background presently prevail. The AMA’s Break the Red Tape campaign asks CMS to “postpone” finalizing Stage 3 Meaningful Use (MU) rules so that it can align with new payment/delivery models. Better yet, they should buy thousands of copies of Dr Robert Wachter’s book [TTA 16 Apr] and drop them on every policymaker’s desk there, with a thud. Health Data Management