Thursday roundup: Kaiser-Geisinger won’t close till ’24, Validic buys Trapollo, Veradigm’s ’22 financials delayed again, ORA telehealth’s $10M Series A, ATA adds 3 to board

Some more reveals on the Kaiser Permanente/Risant Health/Geisinger Health deal. Perhaps the most significant one in Kaiser’s quarterly financial statements was that the closing with Geisinger is projected to be sometime in 2024, subject to the usual regulatory approvals. As announced in April, Geisinger will be the founding system of a new non-profit group, Risant Health, that will bring together a targeted five to six non-profit community health systems. Financial disclosures were also made that were centered on the timing of substantial investments and commitments:

  • Kaiser’s financial commitments to Risant will be made in the five years following closing. The $5 billion previously announced is the upper end of the support. Confusingly, Kaiser is also committing to a minimum investment of $400 million over five years inclusive of funds generated by Risant Health. 
  • Risant’s support and investment into Geisinger will end earlier, in 2028, but in that time will make an investment of a minimum of $2 billion to support Geisinger’s hospital, technology, and strategic development. It will be inclusive of funds generated by both Risant and Geisinger.
  • Risant will also make available to Geisinger no less than $100 million” through 2028 to support expansions of Geisinger’s health plan and care delivery services into bordering Pennsylvania communities.
  • Risant will also make available to Geisinger funds for research and education for 10 years after the 2024 closing

Kaiser’s Q1 was far better than its money-losing ($4.5 billion) 2022, with $1.2 billion in net income. Geisinger has not yet reported Q1, but it had a $842 million net loss in 2022.  FierceHealthcare

Digital health/personalized care company Validic is buying Trapollo, a similar connected care company. Both have platforms facilitating chronic care patient management via remote care and EHR integration. The acquisition price and workforce transitions were not disclosed. Trapollo’s former owner, Cox Communications, will become a shareholder in Validic. Trapollo senior VP/general manager Steve Nester will have the same title at Validic. It will remain at the Validic HQ in Durham, NC, with Trapollo’s former distribution center remaining in Sterling, VA. This continues the trend of consolidation of businesses in similar or complementary services. Release

Veradigm, the former Allscripts, 2022 financials continue to be in a tangle. As previously reported [TTA 3 Mar], Veradigm delayed its Q4 and FY 2022 reporting due to a software flaw that affected its revenue reporting going back to 2021. On 22 March, this expanded to their extending their year-end audit and 10-K filing because of “internal control deficiencies related to revenue recognition.” In a recent SEC filing, they stated that they may be able to file their 10-K by 14 June, but cannot guarantee it. The revenue impact may be as high as $40 million and affect their 2021 closing. HIStalk 5/17/23

Singapore’s ORA Telehealth just scored the region’s largest Series A raise–US$10 million. It was co-led by TNB Aura and Antler with participation from Gobi Partners, Kairous Capital, and GMA Ventures for a total funding to date above US$17 million. ORA is unique in that it’s a vertically integrated platform that markets to a young customer base (average age: 38) on three platforms: Modules (676 different formulations of prescription skincare), OVA (women’s health), and andSons (men’s health).

The American Telemedicine Association (ATA) welcomed three additions to its board this week:

  • Marc Adelson, JD, Teladoc Health’s deputy chief legal and global chief compliance officer. Prior to joining Teladoc in 2011, he was  co-founder and executive legal director of the Institute for Patient Safety & Quality in Virtual Care, the first federally qualified patient safety organization (PSO) focused on virtual care.
  • Kavita Patel, MD, MS, a practicing primary care physician at Mary’s Center, a Federally Qualified Health Center in Washington DC and Maryland. She is also a venture partner at New Enterprise Associates, an NBC/CNBC/MSNBC contributor, and was formerly director of policy for the Office of Intergovernmental Affairs and Public Engagement in the Obama administration
  • Sarah Pletcher, MD, MHCDS, system vice president and executive medical director for strategic innovation at Houston Methodist, and responsible for advancing a wide range of virtual and other innovative care models and solutions.

Mid-week news roundup (updated 18 Aug): CVS eyeing Signify Health for in-home/VBC; Babylon Health mixed pic of revenue and losses up; Geisinger doubles telemed specialties; connected IoT devices expand cyber-insecurity (more); Owlet layoffs

CVS has dropped another sandal as to their quest to add primary care and home health to their portfolio [TTA 5 Aug]. Reports indicates that CVS Health is bidding to acquire Signify Health, which is up for sale. Signify is best known as a major provider of in-home health care in both evaluations and community-based services, with users such as health plans, health systems, community groups, non-profits, and government. In March, they added provider value-based care with Caravan Health, a mid-sized Accountable Care Organization (ACO) management service organization (MSO), for $250 million.  This would give CVS both leverage in in-home care and access to value-based care models in health systems and practices, adding a network of jumbo (100,000 lives+) ACOs to Aetna’s 500 ACOs.

Signify did take a bit of a bath with its acquisition/merger of Remedy Partners in 2019 which marked their entry into the Federal shared savings programs around Episodes of Care. While it created a $600 million company. Remedy’s Episodes of Care in the CMS Bundled Payments for Care Improvement (BPCI) program was always problematic for Signify on multiple levels (Editor’s experience). Signify announced its exit from the successor BPCI-A (Advanced) model last month to concentrate on home care and the Caravan business. The wind-down, which will take some time as these are Federal programs through CMS, will save Signify about $115-120 million in costs, compared to their annual direct and shared costs of $145 million. Restructuring costs such as severance may be only $35 million. After IPO-ing in February 2021 at $24 per share, it has only recently climbed to $23, having recently hit a 52-week low of $10.70. FierceHealthcare, HealthcareFinanceNews

Updated Perhaps in preparation for acquisition, Signify Health is shedding 489 people starting 1 October, including 45 in Connecticut, with the remainder in Texas, South Dakota, and New York. The information comes from required notices to the Connecticut Department of Labor. The majority of employees affected are remote workers. It appears to be related to Signify’s winding up of BPCI and Episodes of Care activity which are likely on calendar year contracts. The legacy company, Remedy Partners, had been headquartered in Connecticut with staff in New York. Moving forward with layoffs now makes the company more attractive for sale, as the separation expenses will not be an acquiring company liability. The 1 October start date is also a tell.  CT Insider, Becker’s

A mixed picture for Babylon Health. Its Q2 results were up substantially in revenue–4.6x year-over-year from $57.5 million to $265.4 million–along with key indicators such as US members up 220% and a 7.5% improvement in medical margins over three quarters. The US has been very very good to Babylon with value-based care membership growing 3.2x year-on-year to a total of approximately 269,000 US VBC members with 40% of its VBC revenue from Medicare contracts. However, losses are up along with growth–$157.1 million compared to $64.9 million loss PY. Babylon at end of July announced worldwide layoffs of at least 100 people of its current 2,500 in their bid to save $100 million in Q3. Babylon release, Mobihealthnews

Geisinger Health was one of the pioneers in telehealth and remote patient monitoring, from ur-days in the early 2010s to today. Much of its patient base in Pennsylvania is rural or semi-rural, living well away from care centers, with a clinician base equally scattered. They went with a single system–Teladoc–integrated into Epic. By the early days of the pandemic, Geisinger was able to expand their telehealth coverage from 20 to more than 70 specialties, 200 providers to more than 2,000 providers, and over two years (2020-2022) completing over 784,000 telehealth visits to homes, local clinics, or local hospitals. Case study in HealthcareITNews

If you’re a health system CIO managing lots of connected devices, you may need to go to a psychiatrist with your feelings of insecurity. That’s the gist of a new report, the Insecurity of Connected Devices in Healthcare 2022. A new-to-this-Editor cybersecurity firm, Cynerio, partnered with researchers at the Ponemon Institute to survey 517 executives at US health systems to find that their Internet of Medical Things (IoMT)/Internet of Things (IoT) vulnerabilities haven’t changed much since this Editor banged the gong about them well before the pandemic:

  • Cyberattacks–frequent: 56% of respondents experienced 1+ cyberattacks in the past 24 months involving IoMT/IoT devices; 58% averaged 9+ cyberattacks. Adverse impacts on patient care were reported by 45% and 53% of those resulted in increased mortality rates. 24% of hospitals noted an impact on their mortality rates.
  • Data breaches are routine: 43% of hospitals had one in the past two years
  • Risks may be high, but the reaction is sluggish: 71% rated security risks as high or very high, but only 21% report a mature stage of proactive security actions. 46% performed accepted procedures such as scanning for devices, but only 33% keep inventory.
  • Ka-ching! Goes the ransomware! When attacked, 47% paid the ransom, and 32% were in the $250-500,000 range.

The full report is available for download here. Those who prefer a webinar must wait till 17 August at 2pm (EDT)–registration hereCynerio release, HealthcareITNews

Updated. Having sat in on the webinar, some further information points from the Ponemon survey deepen the ‘gravity of the risk’:

  • IoT is different because a hack or cyberransoming prevents the device from working. It isn’t fixed by backup as data can be.
  • Health systems are still using IoT computer systems running Windows XT/95–and earlier (!)
  • The average total cost of the largest data breaches is $13 million–the most common cost is in the $1-5 million range. 
  • 88% of these data breaches involved at least one IoT/MT device
  • Risks are known, but action is lagging. 72% of health organizations report a high level of urgency in securing devices–yet 67% of organizations do not keep an inventory of IoT/IoMT devices that they scan
  • 79% don’t consider their activities to be ‘mature’
  • Security investment doesn’t reflect the gravity of the risk–only 3.4% of IT budgets focus on IoT/MT device security.

And in sad layoff news, Owlet Baby Care is shedding an unknown number of employees. Here is the notice on LinkedIn. We noted their FDA problems and a fast pivot last in February, but their going public via a SPAC has been rocky at best with shares lingering at $2 from the IPO at $8. Marketing a pricey baby monitor direct to consumer is expensive, even if it meets a need, and this is likely a cash crunch. At least the ‘leader of people & culture’ is giving them a proper sendoff of thanks–and more usefully, providing their contact information for potential job openings with other companies.

[This is in contrast to the gone-viral spectacle of the CEO of something called HyperSocial posting on LinkedIn his angst about laying off staff–along with a selfie of him weeping. Not exactly confidence-making and All About Him. This Editor’s comment is one of 6,000-odd posts which are largely doubtful to negative.]

Thursday’s short takes: Walmart’s delivery drones expand, AWS lands Geisinger for AI and cloud, UHG-Kaia Health partner for virtual MSK therapy

Look, up in the sky! If you live in Arizona, Arkansas, Florida, Texas, Utah, and Virginia, you might be seeing a Walmart delivery drone sooner than you think. By end of 2022, the DroneUp delivery service will be expanding to 34 sites in six states, including Orlando and Tampa, covering 4 million households. What stores in those states will fill these orders between 8am and 8pm haven’t been disclosed, but Walmart estimates that delivery may reach 1 million packages. They will be limited in weight to 10 lbs, promise a 30-minute turnaround, and the delivery fee will be a modest $3.99. “Certified pilots” will be flying these drones. A side business for DroneUp is aerial photography for city and state governments’ construction projects. Color this Editor skeptical, as she wonders how many packages will be dropped and drones shot at. Also, they need to stay clear of restricted airspace. Walmart release, Epoch Times, The Verge

Amazon Web Services (AWS) continues its foray into healthcare with a prime partnership with Geisinger Health, a regional (PA) integrated health system.  They will be transitioning to AWS as their strategic cloud tech provider including their EHR, over 400 applications, plus workflows, after a multi-year review. Geisinger has estimated that post-implementation, they will save several million dollars. Their EHR migration will be one of the largest AWS migrations to date. AWS for Health is rivaled by Microsoft with Teams, Azure IoT, and chatbots for clients such as Humana, plus Google’s partnerships with healthcare giants such as Mayo. FierceHealthcare, Geisinger release

UnitedHealthcare and Kaia Health are partnering for a musculoskeletal (MSK) virtual therapy program. United Healthcare members recovering from surgery or injury will be assessed and referred to the Kaia program when appropriate. These members will then be able to download the Kaia app for physical therapy, tailored to them via “artificial intelligence”. Progress is monitored by that person’s smartphone camera to record motion in real-time and offer suggestions via coaches either 1 to 1 or through the app’s chat feature. At this point, UHG will offer it only to their self-funded employer clients. FierceHealthcare

Friday news roundup: CVS filing for metaverse patents; Orbic-Verizon smartwatch debut, Amwell and LG partner for hospital digital health–and what *doesn’t* make for a good partnership

What’s a metaverse anyway? It’s a bright, shiny piece of jargon meaning the virtual reality or 3D virtual world. And CVS is rushing right to the US Patent Office to patent its goods and services–including their clinic services and telehealth–in the metaverse. While it’s hard to imagine prescription drugs, healthcare, wellness, beauty and personal care products being wholly virtual, shopping for them can be and obviously CVS doesn’t want to miss out on a world where we’re all wearing 3D headsets and ordering our healthcare in VR and AR. CNBC, USPO filing  

Orbic, a US-India manufacturer popular for being one of the more budget-friendly makers of mobile phones (including flips), tablets, laptops, routers, and accessories, has debuted a smartwatch in partnership with Verizon, the SmartWrist. It has monitoring features such as pulse oxygen levels, body temperature, heart rate, and sleep. It also sets and keeps track of fitness goals and, for those who need it, fall detection, autodial emergency services or contacts in event of emergency, and geofences safe zones. The watch face is 1.78” AMOLED, dock charging, and Android Go 8.1. All for an affordable $199. Our contact Erin Farrell Talbot tells TTA that the SmartWrist is integrated with EHRs plus currently going through FDA approvals that when completed will enable it to be prescribed for patients with medical issues or chronically ill.

Amwell goes into the hospital to connect with LG on TVs and monitoring devices. LG is the leading provider of smart TVs in the hospital market, and where Amwell will initially partner is with Converge, its unified provider-patient platform, inputting information from LG peripheral devices already in or being introduced into acute care. Amwell and LG are also looking beyond the hospital setting into home or sub-acute care. As Healthcare Dive noted, this is not Amwell’s first fling with TV-based care–they demonstrated at last April’s Client Forum a TV-based hospital-to-home integration with Solaborate. LG release (Yahoo)

Sometimes digital health partnerships start at a low level–and auger in from there. Becker’s Hospital Review quizzed three hospital executives, including one from Geisinger Health, an early adopter, on three signs that your digital health partner is not one for the long haul:

  1. It doesn’t have a genuine mission. The mission that hospitals are interested in are about patient outcomes and interest in the hospital partner’s business, not the digital health company’s funding or press.
  2. It hasn’t earned your trust. It seems obvious, but do your due diligence on how the company has handled other partnerships. Red flags include inadequate funding and the terms of the partnership fluctuating.
  3. It lacks responsiveness. This is a big one that this Editor has experienced as both a vendor and buyer. It’s a willingness to listen to and address pain points in “the never-ending troubleshooting” that’s across the board.

As a digital health company, the first is attitude, the second is performance, but #3 is generally the grind point where internal frustrations build and relationships go south.

Connected Health Summit 2017 San Diego — last chance to book!!

29-31 August, The Omni Hotel, San Diego

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/07/CH17-Banner_20Discount_300x145.jpg” thumb_width=”200″ /]Starting tomorrow, but not too late to book! Take a trip to Southern California for the end of the traditional summer season (sob!). This year’s Connected Health Summit, organized by research organization Parks Associates, spotlights health technologies as part of the Internet of Things (IoT) and the transformational impact of these connected solutions on the US healthcare system. Presentations are organized around:

  • Remote health monitoring for accountable care
  • Consumer-centric wellness and fitness solutions
  • Independent living technologies and services, including reinventing home health
  • Innovative virtual/convenience care models

Keynoters include 

  • John W. Cosgriff, Chief Strategy Officer, UnitedHealthcare
  • Saquib Rahim MD, MBA, Chief Medical Officer, Aetna
  • Vidya Raman-Tangella, Senior Vice President, and Head, UHC Innovation Center of Excellence, UnitedHealth Group
  • Dale Rayman, Senior Vice President, Actuarial Consulting & Business Development, Sharecare
  • Chanin Wendling, AVP, Informatics, Geisinger Health System

Latest press release info on the conference and the convergence of connected health, IoT, and smart home is here.

For more information and to still save 20 percent, click on the Connected Health Summit’s link here. Telehealth & Telecare Aware is pleased once again to be a media supporter of CHS 2017. Twitter at #CONNHealth17