Thursday news roundup: bet on Oracle-Cerner closing next week, VA EHR progress reports mandated, Homeward-RiteAid rural care, Medtronic-DaVita kidney JV, Withings reenters RPM, Lightbeam buys Jvion AI

June 1, 2022 | by

The Oracle acquisition of Cerner will close as early as Monday next week, no later than mid-June. Mid-June is the prediction of Seeking Alpha. They based it on Oracle-Cerner already passing Australia’s Foreign Investment Review Board, no questions posed by the UK antitrust authority, and the US waiting period expiring in February. As rumored [TTA 25 May], European Commission regulators approved it today (Barrons, paywalled) which predicts the close will be next Monday. Hat tip to HISTalk for their alert yesterday.

Scrutiny of Cerner’s $16 billion EHR implementation with the Department of Veterans Affairs by Congress ramps up. New legislation due to be signed by the president shortly will require the VA Secretary to submit regular reports 30 days after the last day of each fiscal quarter on the VA’s Electronic Health Record Modernization (EHRM) program. Content will include spending, performance metrics, outcomes, safety, transitioning from VistA to Cerner Millenium, interoperability, and progress or issues with all. Text of Senate bill, FierceHealthcare  TTA’s previous article on Cerner EHR interoperability problems with DOD and VA

Bringing healthcare to rural America is Homeward with a freshly inked deal with RiteAid. Founded by former Livongo president Jennifer Schneider, MD, Homeward will set up distinctive purple mobile van clinics at up to 700 Rite Aid location parking lots in rural communities starting Q3 this year. Michigan will be the first market. Homeward will accept regional Medicare Advantage plans and Medicare.

The company is targeting the 60 million Americans who live in rural areas and have been losing access to basic medical care as local practices and clinics close. Their technology enablement will be for appointments, checkins, telehealth, remote patient monitoring, and scheduling home visits. Homeward announced its launch at the recent ViVE2022 in March including $20 million in funding from General Catalyst. Other Livongo alumni with the new company are Brian Vandenberg, former general counsel, Amar Kendale, former chief product officer, and Bimal Shah, MD, former chief medical officer at Livongo. Nice to know that they have moved to another healthcare chapter of real need, versus cruising the Caribbean in very large yachts. FierceHealthcare, Homeward release

Medical device giant Medtronic and DaVita are establishing a joint venture by next year to advance kidney care therapies and technologies, including new products to be used in clinics and in the home. The intent of the JV is to increase the availability of kidney care including dialysis. 10% of adults worldwide–700 million people–have chronic kidney disease. 2.6 million have kidney failure. The JV is expected to be formed in early 2023 with each company owning an equal share. Initial investment is not disclosed. According to the release:

  • Medtronic will contribute its Renal Care Solutions (RCS) business including the current product portfolio (renal access, acute therapies, and chronic therapies), product pipeline, and global manufacturing R&D teams and facilities.
  • Both companies will provide an initial investment to fund the new company (NewCo) and future certain operating capital.

FierceBiotech, Medtronic release

Withings reenters remote patient monitoring with Withings RPM. Their initial entry was with MedProCare back in 2019 but apparently in the repositioning of the company since the buyback from Nokia in 2018, it was back-burnered. The new RPM will be based on an app that will:

  • track time for CMS-compliant billing reports and uploadable to the provider EHR
  • support billing for CMS codes 99453, 99454, 99457, 99458
  • a digital patient-facing assistant
  • full connectivity to Withings devices such as scales, blood pressure monitors, and sleep monitors
  • implementation support by their Health Solutions teams

Withings RPM page, Outsourcing-Pharma

Looking hard for an M&A that relates to us in this very quiet market, Lightbeam Health Solutions, a population health software company, is acquiring Jvion Inc. Jvion has AI-enabled prescriptive analytics and social determinants of health (SDoH) solutions which will be combined with Lightbeam’s health analytics and outcomes for payers and providers. Terms of the acquisition and leadership transitions were not disclosed. Lightbeam release

Optum rumored on the digital health acquisition hunt again with AbleTo virtual behavioral health

April 29, 2020 | by

Optum, the part of UnitedHealthGroup that runs engagement, technology, and financial services for UHG, is in advanced negotiations to acquire AbleTo, a New York City-based behavioral health and virtual therapy provider, according to CNBC. Unusually, there is also a number attached: $470 million, about 10 times their forward revenue.

AbleTo is already well acquainted with Optum, as their Ventures arm provided financing in January 2019 in a corporate round. Over the past 12 years, the company has raised close to $47 million through a Series D. Interestingly, one of the early investors was Aetna, pre-CVS. Crunchbase

Optum of late has been on an acquisition tear, with first dialysis provider DaVita for $5 billion and then telehealth/remote patient monitoring company Vivify Health for an undisclosed but certainly far less amount. AbleTo is attractive not only in the context of telehealth (at last the belle of the ball!) but also for the underserved behavioral health market. Confirmation of its attractiveness? A fresh crop of competitors such as Quartet Health, Lyra, and ‘traditional’ telemedicine providers such as Doctor on Demand.

AbleTo was founded by Michael Laskoff, at one time quite the ‘face’ in the NYC digital health scene, who went on some years back to found another behavioral health company, Annum Health, focusing on alcohol addiction. AbleTo is one of the pioneers of virtual therapy, both telephonic and audio/video, using care teams of coaches and LCSWs to provide short-term cognitive therapy sessions. It is certainly an underserved market with over 50 percent of those researched citing cost and stigma to not obtain treatments, with about 2/3rds surprisingly under age 50, but not surprisingly about half with one or more chronic conditions. Most of its business is with payers and self-funded companies, although it still offers individual therapy plans.   Mobihealthnews

A basket of reflections, considerations on CVS-Aetna: Epic, Cerner, the model, and hospitals’ role

December 14, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/canary-in-the-coal-mine.jpgw595.jpeg” thumb_width=”150″ /]With the holidays and the end of the year coming in a little over two short weeks, there’s plenty of room for thoughts, reasoned speculation, and some unusual takes on the CVS-Aetna merger. This Editor remains in her belief that among us, there’s a bit of exhaustion and an attitude of ‘wait and see’ around the topic among us. The canaries have a case of the vapors….

Let’s sort through some of the more interesting POVs expressed of late by our fellow pressies, which Readers can consider in between cups of good cheer and bites of All That Food. Bear in mind that this merger has a long road to go on a hard road, with potholes marked DOJ and (in this Editor’s opinion) HHS, before it’s a done deal in 2018.

  • A big win for Epic. Currently the EHR for CVS’ MinuteClinics and most recently the care management programs of CVS Specialty, Epic is bullish on the opportunities in what their VP of population health termed the ‘gray space’ in the patient experience outside of the traditional sites of care. In October, CVS added Epic’s Healthy Planet population health analytics platform to learn more about drug dispensing patterns and medication adherence–this Editor believes in preparation for merger talks. The open question this Editor has after all the glow in this article is how Aetna’s varied systems (e.g. ActiveHealth, Medicity, and others) would integrate into Epic, and the price of poker, because with Epic it’s never free. Ask any hospital. Healthcare IT News.
    • Certainly, their main competitor Cerner is feeling the heat after a slowdown in its VA plans, the single largest EHR implementation ever. Congress has held up initial funding making the contract effective (Washington Technology). It is geometrically more complicated than their simultaneous DoD implementation, with $10 billion estimated over 10 years (FCW). Other wrenches in the works: a fresh CliniComp lawsuit against Cerner based on infringement against their 2003 patent on remote hosting, and their appeal of the no-bid award to Cerner [TTA 23 Aug] against VA. Kansas City Business Journal, Healthcare IT News
  • Is it going to increase cost? It might. And what about info sharing with providers? A Harvard Medical School professor opined to Marketplace that instead of self-treatment at home for a cold, the patient might actually traipse to a MinuteClinic for care, thus driving up healthcare costs. This resembles the RAND logic around telemedicine consult expense we deflated in a series of articles back in the spring. Information sharing with regular providers is a bigger issue which urgent cares, telemedicine, and clinics already are dealing with. The paradox is that integration with a payer, with a retailer’s ability to track ancillary purchases such as OTC meds and DME purchases, might actually help that issue. But will it? Will a combined CVS-Aetna share information or hoard it, further disempowering patients? This Stat article calls on Mark Bertolini to promote shared information, engagement, and accountability to balance the scales.
  • Do we really need hospitals? If they don’t change, we might need a lot less of them except for highly specialized treatment. And this is likely a good thing. The HBR points out that CVS-Aetna is hardly the only threat to the traditional hospital–there’s Johns Hopkins’ Hospital at Home program for older adults, UnitedHealthcare’s growing network of providers under OptumCare, including the recent deal for DaVita dialysis centers, and free-standing, low-cost “neighborhood” hospitals, almost like pop-up stores. The article doesn’t mention ‘consult stations’ like Europe’s H4D, which is proving that the kiosk idea isn’t dead. 

The reality is that we won’t know what this merger entails until it actually happens, if it happens–and its final shape will take years to mold. Related: CVS-Aetna: the canary says that DOJ likely to review merger, Analysis of the CVS-Aetna merger: a new era, a canary in a mine–or both?, CVS’ bid for Aetna–will it happen, and kick off a trend? (what will Amazon and other retailers, including supermarkets, do?)

Rock Health announces its Top 50 in digital health (US)

December 6, 2016 | by

This Editor observes that digital health is at the state of maturity (so to speak) where entities assemble a Top 50 list and host a dinner to pass out awards. Rock Health, Fenwick & West, Goldman Sachs and Square 1 Bank cast a wide net from investment to startups in their just-released list. (Of course there will be a glitzy dinner, soon, at the kickoff of the JP Morgan Healthcare Conference, 9 – 12 January 2017 in San Francisco. Want an invite?)

Of great delight is an award to John Carreyrou of the Wall Street Journal as Reporter of the Year for his investigative work on Theranos. Other highlights are Validic (clinical/wellness data integrator) as Fastest Growing Company, Evolent Health for Best Performing IPO and BSX Technologies‘ LVL hydration monitor as Crowdfunding Hero (having raised $1.1 million when goal was $50,000). Rock Health website

What is increasingly curious to this Editor is that digital health companies, in nearly all cases, aren’t crossing borders and oceans. Every one seems to stick and be unique to its own country of origin, creatures of their own unique petri dish.

Also in other Rock Health news, having evolved a position as a venture fund/business support provider, they have added to their list of prominent partners kidney care and medical group operator DaVita. Rock Health release.

Drawing a parallel between healthcare and … newspapers

May 12, 2015 | by

…is the point that Dave Chase, who founded patient information/engagement portal Avado and sold it to WebMD in 2013 (and with them until last month), is making in this Forbes article. As newspapers found their readership leaving in droves for online websites that delivered ‘news they could use’ faster and more interestingly, healthcare systems are finding that their patients are finding healthcare services outside their bricks-and-mortar:

  • Onsite workplace clinics (including telehealth/telemedicine hybrids such as HealthSpot Station–Ed. Donna)
  • Direct primary care providers such as Iora Health, Qliance, DaVita’s Paladina Health
  • Retail clinics: MinuteClinic, TakeCare Health
  • Medicare Advantage-only programs such as CareMore [TTA 5 May] and Healthcare Partners
  • Domestic medical tourism by large, self-insured companies for elective surgeries

This Editor would argue that these forces are at work even in (and perhaps because of) centralized payment systems, and are worldwide, not just in the US. Certain communities such as Rochester, NY, Dubuque IA and Seattle are focusing on lower healthcare as attractions to business–and countries such as Costa Rica, Mexico, Brazil, Singapore, Hungary and India are capitalizing on US-quality facilities and doctors to gain medical tourism for elective and self-paid surgery.