PERS/RPM catchup: VRI bought by ModivCare for $315M; Connect America buys AI-powered RPM 100Plus, opens new SC center

ModivCare buys VRI. While your Editor was on holiday leave enjoying the beautiful beaches of late-late summer, the long-rumored sale of PERS and remote patient monitoring provider VRI [TTA 9 July] closed on 22 September. The buyer is a non-emergency medical transportation (NEMT), home care (Simplura), and meal delivery company once known as Circulation and now ModivCare. Purchase price is $315 million, subject to customary purchase price adjustments. VRI generated $56 million of revenue and $21 million of adjusted EBITDA for the twelve-month period ended June 30, 2021. The majority owner of VRI since 2014 was Pamlico Capital. VRI will remain HQ’d in Franklin, Ohio and Sullivan, Illinois. Jason Anderson remains as its CEO under ModivCare. Business Wire release, ModivCare news site. And PERS Insider has an insightful article with a link to the investor presentation

VRI gives ModivCare immediate revenue, as well as impressive capabilities in medical alert systems, established monitoring centers, connecting care in the home plus other residential settings, and cross-selling in ModivCare’s relationships with Medicare Advantage and Medicaid (state) plans. Your Editor became familiar with VRI as far back as 2006 in her QuietCare days, then when Andy Schoonover and Chris Hendricksen ran VRI (and your Editor wished they’d buy the company). Andy Schoonover is now the CEO of CrowdHealth, a community-based provider of health services.

ModivCare has managed 48.2 million trips through the industry’s largest network of contracted transportation companies. They recently signed another agreement with Uber Health to provide on-demand transportation in underserved communities. They claim to be the largest NEMT company in the US with a 40% market share and trades publicly on NASDAQ with a market capitalization of $2.3 billion. NEMT is one of the linchpins of social determinants of health (SDOH). 

And Connect America treated itself to a snack after the big meal of Lifeline. PERS Insider broke the news on their purchase of 100Plus, supposedly the first AI-powered RPM company. Terms, purchase price, and management changes were not disclosed. Their pitch is to providers with an essentially turnkey system: identify eligible patients, perform patient consent and training, ships devices directly to your patients ready to use, and a ‘virtual medical assistant’ to monitor patients. The AI part of this is Ava, an AI-enabled, text message-based chatbot. This strengthens Connect America’s small RPM division, ConnectVitals. Release  

Connect America also announced in August that they will be opening a new facility to consolidate the scattered Lifeline operations into a single purpose-built location. The new $1 million, 25,000 square-foot facility will bring 71 jobs to the area and will open by end of year. PERS Insider, Upstate Business Journal 

An ‘insider’ point of view on the Connect America acquisition of Philips Lifeline

This Editor, through a search initiated due to reader Adrian Scaife’s comment on the article below, happened on a back article from a news source on the Connect America acquisition of Philips Lifeline. Who knew (as they say) that there was a newsletter solely devoted to the PERS business? The article was written from a real insider point of view with a complete background on Connect America, Lifeline, and also why Philips put Lifeline up for sale.

  • It’s likely that Philips bought high and sold low. In 2006, Philips purchased Lifeline for a reported $750 million, then HealthWatch for an additional $130 million. At the time of the announcement, PE Hub put the value of the company in the $200-400 million range. It’s understandable that with the rise of smartphones and mobile, wrist-worn band-type PERS, the value of what is largely a traditional PERS company would suffer, but the best case is a 60 percent loss over 14 years.
  • The industry believes that Philips mismanaged the company. Example: dealers did not have 4G/LTE cellular equipment to replace the 3G in the field. The phrases ‘a mess’ for the organization and ‘run the Lifeline name into the ground’ aren’t used lightly.
  • For the past few years, Lifeline has been in the shadow of Philips’ other clinically-oriented healthcare systems. As this Editor noted, Philips has divested or spun off multiple businesses in North America.
  • Philips ran the business without understanding its unique dynamics, including dealer networks and a B2B +B2C market of home health agencies and senior housing combined with direct-to-consumer sales. They focused on the latter and kept it on short rations for the past few years.
  • They were also slow to market with innovations and had a significant amount of negative publicity on the performance of AutoAlert for fall detection starting in 2011 (Editor Steve) and in 2014.

The Philips Lifeline saga was a longer and more costly version of Tunstall’s acquisition of AMAC. At the time of sale, Lifeline was #1 in PERS, and AMAC was #3. Even with Tunstall’s expertise and the addition of remote patient monitoring, the US market was Too Tough For Tunstall. They sold in 2019 to…drum roll…Connect America.

The article includes excerpts from an interview with CEO Janet Dillione, a review of the Connect America team, and well wishes from those insiders. PERS Insider (Subscription to the weekly newsletter is free and found here.)

Another irony: Just prior to the acquisition, Dennis Shapiro, the former head of Lifeline, passed away on 16 February, aged 87. Mr. Shapiro was responsible for the company creating the first modern PERS radio pendant, telephone-connected base unit, and call center monitored service in 1980.

 

News/deals roundup: Connect America finalizes Philips aging/caregiving buy; Amedisys-Contessa $250M hospital-at-home; UK’s Physitrack $20M IPO, Dutch motion tracker Xsens

Kicking off our week….

Connect America closed today (6 July) the purchase of Royal Philips’ Aging and Caregiving line of business. This includes the top basic personal emergency response system (PERS) device provider, Lifeline. Purchase price by Connect America’s owner, Rockbridge Growth Equity, was not disclosed. For Connect America, they now top 900,000 subscribers to PERS and monitoring services. At this point, the combined business will have 1,500 employees and 3,000 provider partners. Lifeline also includes services such as 24/7 response with their products: the HomeSafe traditional home PERS with and without AutoAlert fall detection and GoSafe2 mobile PERS with AutoAlert.

There is no indication from the company release or the brief Mobihealthnews article on whether the Lifeline brand name or others from Philips will be retained. Lifeline’s history dates back to 1974, with Philips adding the AutoAlert, HomeSafe, and GoSafe product after their purchase in 2006. Other undisclosed considerations are integration and rationalization of the current Connect America PERS and monitoring products with Lifeline. There is also a promotional partnership agreement with AARP that likely–but not necessarily–will transfer with the purchase. This Editor can tell you that a seat at AARP’s poker table requires a tall stack of chips.

Our earlier article on the acquisition profiles Connect America, Lifeline, and the decline of traditional/mobile PERS with the rise of accessible wristwatch and band forms that don’t scream ‘I’m at risk of falling and not being able to get up!’

Home healthcare provider Amedisys announced their $250 million acquisition of Contessa Health, extending into hospital-at-home and skilled nursing-at-home. As our Readers who looked at Ziegler’s analysis [TTA 25 June], this is a hot and tech-driven care area. Amedisys is claiming that they are the first home health, hospice, and personal care service provider to expand into Contessa’s business, which is hospital-at-home and skilled nursing facility (SNF) at-home including palliative care services launched recently with Mount Sinai Health System (NY). Contessa will operate as a separate division of Amedisys, which plans to invest in both the future growth of Contessa and their proprietary informatics platform CareConvergence with the aim of creating a “premier home-based health system”. The acquisition is expected to close on 11 August. Contessa has both hospital partnerships, which are the bulk of Amedisys’s client business, and joint venture/payer partnerships. Amedisys release, Hospice News

The UK’s Physitrack quietly went public with a raise of over $20 million. The IPO was listed on 18 June on the Nasdaq First North Premier Growth Market (Nasdaq Nordic, Sweden and Finland) earlier this month with an original offering of SEK 40 ($4.69) per share with 4.4 million shares in the offering. The market value is estimated at SEK 624 million ($72.5 million). Unfortunately, you cannot look beyond this investor page if you are in the US, Australia, Canada, Hong Kong, Japan, New Zealand, Singapore, Switzerland, South Africa, or South Korea as citizens of these countries cannot invest in their shares. Physitrack is a digital physical therapy plus patient engagement company headquartered in London with offices in Santa Monica, Houston, and Utrecht. It was in the first group of the NHS’ Digital London accelerator program and now is distributed in 100 countries serving 1 million patients. Mobihealthnews, Baker McKensie (legal advisor announcement)

And keeping it physical, Xsens, a Dutch 3D motion capture and attachable sensor company for therapy and ergonomics study, is extending into Automatic Reporting as part of its online MotionCloud platform. A full report, graphs, and a digital recording of an avatar completing the movements can be available to physiotherapists, health specialists, and ergonomic consultants in under two minutes. In addition, they announced a new Awinda Starter system which has their proprietary motion-tracking technology at a more affordable price. Xsens press release, Mobihealthnews

Connect America acquires Philips’ Aging and Caregiving, including Lifeline

Connect America is purchasing Royal Philips’ Aging and Caregiving (ACG) line of business, including one of the top basic personal emergency response system (PERS) device providers, Lifeline. The acquisition is expected to close in a few weeks. Purchase terms, including staff, were not disclosed. The release by Connect America contains two unusual statements: both companies will remain competitive until the closing and that Philips will retain an equity stake in the company.

In the World of PERS and safety for older adults, this is big news. Our Readers will remember that Connect America, a medical alert company located in suburban Philadelphia, purchased Tunstall Americas in January 2019. Readers who follow the PERS taxonomy will recall that in 2011, Tunstall acquired AMAC, the third-largest PERS company, yet after multiple presidents and acquisitions, failed to make much of a dent in the competitive US and Canada markets. Connect America now has the major ‘name’ brand in PERS, other than Life Alert, famous for the ‘I’ve fallen and can’t get up’ TV commercials of yore and the real pioneer of the PERS pendant. Lifeline itself dates back to 1974 and was acquired by Philips in 2006. Of late, Philips has been on a divestiture tear, especially in North America.

The news hasn’t exactly made the headlines that it would have only a few years ago. One could say that the parade has passed traditional PERS pendants and home units. Replacing them are mobile and smartphones tied to assistance–GreatCall’s 5 Star services. There are bands and wristwatch forms, such as Buddi in the UK and UnaliWear’s Kanega, The latter haven’t yet the market penetration in the US but all three have in common one selling factor–none of them scream ‘old and frail at risk’ like a white pendant around the neck does. Classified now with PERS are more sophisticated but bulky devices mobile-based systems such as GreatCall’s Lively MobilePlus and Lively Wearable2, also listed as an AARP member benefit.

Connect America has been in business 35 years and has amassed a portfolio of PERS brands, traditional home and mobile devices including fall detection, plus 24/7 monitoring services. It claims to be the nation’s largest independent provider of medical alert systems under various brand names, with more than 1,000 healthcare network partners, and cumulatively over 1 million customers. Their other business is remote patient monitoring under the ConnectVitals brand and a cellular-connected device for medication management.

Another big win for Connect America is Lifeline’s agreement with AARP, marketed as part of their extensive member benefits, and other products that Philips has in this category. 

There are millions who still use traditional and mobile PERS pendants, including in the huge market of assisted living, and a multiplicity of brands, which indicate the size of the market and its longevity. The stats haven’t changed much since this Editor was with QuietCare, attempting to make PERS obsolete back in the mid-oughts. According to Freeus, the average customer is a woman, 78 years old, and keeps it for about 39 months–a little over three years. Not all of them, nor their families, feel comfortable with a smartphone which can be hard to use, break, or simply not be handy in the bathroom or bedroom. So the market is still there, albeit not a headline-making one. Hat tip to a UK Reader who wishes to remain anonymous.