Week-end roundup of not-good news: Teladoc’s Q2 $3B net loss, shares down 24%; Humana, Centene, Molina reorg and downscale; layoffs at Included Health, Capsule, Noom, Kry/Livi, Babylon Health, more (updated)

Teladoc continues to be buffeted by wake turbulence from the Livongo acquisition. The company took a $3 billion goodwill impairment charge in Q2, adding to the $6.3 billion impairment charge in Q1. The total impairment of $9.3 billion was the bulk of the first half loss of nearly $10 billion. While their revenue of $592.4 million exceeded analyst projections of $588 million, adjusted earnings before interest, taxes, depreciation and amortization (EBITDA) of $46.7 million were barely up from projections and were down from $66.8 million year prior. Losses per share mounted to $19.22, versus $0.86 in Q2 2021.

Another weak spot is their online therapy service, BetterHelp, which in the US is pursuing a substantial TV campaign. CEO Jason Gorevic in the earnings release pointed out competitors buying the business at low margins and consumer spending pullbacks. Teladoc’s forward projections are bolstered by Primary360 and Chronic Care Complete. Projected revenue for Q3 is $600 million to $620 million. Shares on Thursday took a 24% hit, adding to the over 50% YTD drop misery. At best, Teladoc will muddle through the remainder of the year, if they are lucky. MarketWatch, Mobihealthnews, FierceHealthcare

Health plans are also presenting a mixed picture. 

  • Humana announced a healthy earnings picture for the quarter and YTD. It earned $696 million in profit for Q2, up nearly 20% year over year. For first half, Humana earned $1.6 billion, an increase of 14.8% from 2021’s $1.4 billion. Cited were growth in their primary care clinics, Medicaid membership, and investment in Medicare Advantage. Earnings surpassed Wall Street projections and Humana increased its guidance to $24.75 in earnings per share. At the same time, they announced a reorganization of its operating units that separates their insurance services (retail health plans and related) and CenterWell for healthcare services including home health. Some key executives will be departing, including the current head of retail health plans who will stay until early 2023, ending a 30 year Humana career. FierceHealthcare, Healthcare Dive
  • Under new leadership, Centene posted a Q2 loss of $172 million which in reality was a significant improvement over Q2 2021’s $535 million and looked on favorably by analysts.
    • Their ‘value creation plan’ has sold off its two specialty pharmacy operations to multiple investors, using third-party vendors in future, and agreed this week to sell its international holdings in Spain and Central Europe — Ribera Salud, Torrejón Salud, and Pro Diagnostics Group — to Vivalto Santé, France’s third-largest private hospital company.
    • Medicaid, their largest business line, has been growing by 7%.
    • Centene is continuing to divest much of its considerable owned and leased real estate holdings, which marks a radical change from the former and now late CEO’s* ‘edifice complex’ to house his ‘cubie culture’. As a result, it is taking a $1.45 billion impairment charge.  Healthcare Dive. [* Michael Neidorff passed away on 7 April, after 25 years as CEO, a record which undoubtedly will never be matched at a health plan.)
    • A cloud in this picture: Centene’s important Medicare Advantage CMS Star quality ratings for 2023 will be “disappointing” which was attributed to the WellCare acquisition (accounting for most of the MA plans), two different operating models between the companies, and the sudden transition to a remote workforce. For plans, WellCare operated on a centralized model, Centene on a decentralized one, and the new management now seems to prefer the former. (Disclosure: your Editor worked over two years for WellCare in marketing, but not in MA.) Healthcare Dive
  • One of the few ‘pure’ health plans without a services division, Molina Healthcare, is also going the real estate divestment route and going full virtual for its workforce. Their real estate holdings will be scaled down by about two-thirds for both owned and leased buildings. Molina does business in 19 states and owns or leases space across the US. Net income for the second quarter increased 34% to $248 million on higher revenue of $8 billion. Healthcare Dive

Many of last year’s fast-growing health tech companies are scaling back in the past two months as fast as they grew in last year’s hothouse–and sharing the trajectory of other tech companies as well as telehealth as VCs, PEs, and shareholders are saying ‘where’s the money?’. 

  • Included Health, the virtual health company created from the merger of Grand Rounds and Doctor on Demand plus the later acquisition of care concierge Included Health, rebranding under that name, has cut staff by 6%. The two main companies continued to operate separately as their markets and accounts were very different: Grand Rounds for second opinion services for employees, and Doctor on Demand for about 3 million telehealth consults in first half 2020. As Readers know, the entire telehealth area is now settling down to a steady but not inflated level–and competition is incredibly fierce. FierceHealthcare
  • Unicorns backed by big sports figures aren’t immune either. Whoop, a Boston-based wearable fitness tech startup with a valuation of $3.6 billion, is laying off 15% of its staff. (Link above)
  • Digital pharmacy/telemedicine Capsule is releasing 13% of its over 900 member staff, putting a distinct damper on the already depressed NYC Silicon Alley.  FierceHealthcare also notes layoffs at weight loss program Calibrate (24%), the $7 billion valued Ro for telehealth for everything from hair loss to fertility (18%), Cedar in healthcare payments (24%), and constantly advertising Noom weight loss (495 people). Updated: Calibrate’s 150-person layoff was reported as particularly brutally handled with employees. Many were newly hired the previous week, given 30 minutes notice of a two-minute webinar notice, then their laptops were wiped. Given that the company makes much of its empathy in weight loss, facilitating prescription of GLP-1 along with virtual coaching, for a hefty price of course. HISTalk 8/3/22
  • Buried in their list are layoffs at Stockholm-based Kry, better known as Livi in the UK, US, and France, with 100 employees (10%).
  • Layoffs.fyi, a tracker, also lists Babylon Health as this month planning redundancies of 100 people of its current 2,500 in their bid to save $100 million in Q3. Bloomberg

Funding roundup: new unicorn Capsule’s $300M, $100M for Caresyntax, Sesame Care’s $24M, UCM Digital Care’s $5M; MD Ally brings telehealth to 911

This week’s (so far) Big Raise is virtual pharmacy Capsule. Their new funding of $300 million, added to a previous $270 million in five rounds through a 2019 Series C (Crunchbase), now, according to CEO Eric Kinariwala, puts his company into $1 bn unicorn territory. Founded in New York City in 2015, Capsule now covers the NY metro plus a dozen markets in same-day delivery plus the option for pharmacist chat/text via mobile phone. Their goal is to reach 100 million people nationally by the end of this year. The fresh funding will be used for expansion and to upgrade technology. Durable Capital Partners led the funding round and was joined by new investors Baillie Gifford, T Rowe Price, and Whale Rock.

Capsule is in a hot niche sector of fast prescription delivery that has players large (CVS, Walgreens’ AllianceRx), Amazon (PillPack, Amazon Pharmacy), and smaller or local services like Blink Health, FetchMyRx, Medly, and your local pharmacy. Uber is also partnering with some for delivery. Earlier this year, Capsule partnered with Ginger to fill and deliver medications prescribed by their board-certified psychiatrists in metro New York City, Chicago, Minneapolis, Boston, and Austin. FierceHealthcare, Mobihealthnews, Bloomberg (may be paywalled)

Mobihealthnews also rounded up three additional digital health fundings from the seed to Series C range:

  • Surgery data/AI plus virtual consult platform Caresyntax, closed a $100 million Series C funding round led by PFM Health Sciences LP. Release.
  • NYC-area direct-pay healthcare marketplace Sesame Care added a $24 million Series B, for a total of $47.6 million to date (Crunchbase). Sesame offers in-person and telehealth care to patients, allowing them to compare prices and providers before booking and paying the provider directly. 
  • UCM Digital Health, a provider of emergency telemedicine and virtual health, announced today it closed a $5.5 million Series A funding round. Armory Square Ventures led the round with additional participation from Contour Ventures and River Park Ventures. Based in Troy, NY, UCM has a “digital front door” platform with a 24/7 telehealth treat, triage and navigation service marketed to employers, insurers, and providers. Release
  • Last but certainly not least, MD Ally added a modest $3.5 million in a seed round led by General Catalyst with participation from Seae Ventures. MD Ally triages 911 emergency services calls, rerouting non-emergency calls to telehealth services and expanding their scope of services. It integrates into existing dispatch systems with a unique range of codes that confirm for the dispatcher that the call can be safely routed to a telehealth provider. TechCrunch, release