TTA’s It’s Spring, Really 3: Kaiser & Geisinger, perfect together? Amazon shuts Halo, eVisit buys Bluestream, GoodRx top change, Holmes appeals, Clover wilts, earnings season hope, more!

April 29, 2023 | by

 

 

Weekly Update

A week marked by acquisitions, consolidations, shutdowns, and failures, with some hope poking through. Kaiser and Geisinger’s novel approach to preserving community health systems, while eVisit and Bluestream complement telehealth and workflow systems. Amazon finally shuts down Halo wearables, GoodRx changes out CEOs, and Clover wilts. VA and Congress start kicking Oracle hard as their EHR keeps failing. Elizabeth Holmes gets a little more freedom during appeal. But some optimism with Centene and Humana improving their earnings and home health advocacy.

Short takes: Amazon dims to black Halo wearable line, eVisit acquires Bluestream Health, Moving Health Home launches to lobby Congress, government (More consolidation)
Mid-week roundup: Kaiser Permanente to buy Geisinger, setup separate system; GoodRx co-CEOs step down; strong earnings for Centene, Humana; Clover Health stock woes, settles $22M lawsuit (Consolidation and pivoting)
Breaking: Elizabeth Holmes’ surrender stayed by 9th Circuit Court of Appeals (Putting off the inevitable is a bad strategy)
VA completely halts Oracle Cerner EHR implementation for ‘reset’; House introduces new–fourth–bipartisan reform bill–and another outage (Oracle MUST make fixing VA, MHS EHRs Job#1)

A busy week with HIMSS23 (take HIStalk’s random walks), Theranos denouements, lots of trouble in VA and Insurtech Worlds. Teladoc sees gold in weight loss care. And a battle royale between business giants may be developing at, of all places, Cano Health.

Weekend recap from HIMSS23: Glen Tullman’s 5 predictions, HIStalk’s random four-day walk, Oracle Cerner integration ‘going great’, Seema Verma to Oracle, Caregility’s debuts three enhancements (Your weekend reads, especially HIStalk)
Theranos’ Sunny Balwani reports to Federal prison (New home for 12 years)
News roundup: Cano Health board fight, board shakeup; Memora Health’s $30M raise; Teladoc enters weight management race (A battle of the giants brewing at Cano?)
Insurtechs in the widening gyre: Bright Health sued for claims non-payment, fined $1M by Colorado; Clover Health lays off 10%, outsources operations (This centre may not be holding)
VA, GAO push back against proposed House overhaul measures (Just what you’d think)
Theranos’ Holmes files appeal seeking to overturn ‘unjust’ conviction, ‘excessive’ sentence (updated) (Yet another appeal)
VA pulls out the stick in contract renegotiation with Oracle Cerner, slams brakes on further EHRM rollouts–and is this trouble? (updated) (Oracle called on the carpet–and beaten like one?)

This week, in preparation for HIMSS next week and with many on holiday or going, news was relatively light but sadly of the “Debbie Downer” genre. Pear Therapeutics signed off of digital therapeutics with its Chapter 11 filing, while virtual therapy Workit Health let go of 100 anticipating controlled substance prescribing restrictions. And two late 2010s scandals reach their final chapters: Theranos and Outcome Health.

Mid-week roundup: Pear Therapeutics’ Chapter 11; Workit Health pinkslips 100; Outcome Health principals convicted of $1B fraud (The other late ’10s scandal)
The Theranos Two lose their fight for freedom on appeal as Federal prison surrender dates near (Settle affairs, appeal from prison)

We hope you had a Happy Easter and Passover! We lead with a vastly different picture of digital health and healthcare versus a year ago. In the widening gyre, the center is not holding for companies when investors bolt a board and a star insurtech is failing before our eyes. Digital health funding has gone entirely sideways and making 2019 look good. But one story brings us back to our purpose to spread better health into more hands in remote places and save children at minimal cost. Let’s think renewal–and starting afresh in the true spirit of this holy week.

When ‘the centre cannot hold’: three board members exit at Cano Health, failure looms at Bright Health Group (Yeats’ ‘Second Coming’ fits two dramatic ‘must read’ company implosion stories)
TTA Bright: THINKMD, Save the Children partner for digital child health assessment (A ‘do-good’ story about purpose)
Digital health’s funding time machine dialed back to 2019–before the SVB implosion: Rock Health (Entering uncharted territory)

Happy April Fool’s Week! Last week was ViVE (rhymes with vibe) week and reports were positive. VCs confessed that they led to the demise of SVB (well, some of them) and for companies they back, it’s ‘about face, march!’ CVS closes Signify, Oscar faces future and hires the Pro of Pros who used to work at CVS. Wellvana scores $84M, hospital HIT execs want ROI NOW. And both Senate and House kick Oracle Cerner’s patootie about their VA EHRM failures with three bills–but are they concerned? 

ViVE post-script: VC panel opines in midst of digital health new reality (depression?), and extra ViVE from an attendee (VCs confess to greasing SVB’s skids and the Profitability Push)
Is Oracle Cerner’s VA EHRM implementation going to be tied up? Senate Veterans Affairs Committee says yes–with two oncoming trains (bills). (Bit off more than…?)
Mid-week corral: CVS closes Signify Health; Bertolini to lead Oscar Health; ViVE highlights from Wellvana, AWS, Everly Health; Better Therapeutics lays off 35%, CoverMyMeds 815 (Magic8Ball picture–and Oscar Gets Smart)

It’s spring, but there’s a chill in the air, as perhaps fits this challenged time. CVS and Amazon are not out of the Federal woods with Oak Street and One Medical respectively. The Theranos Two clutch at their freedom as the creditors come around and their former lab director sues for defamation. FTC clutches its cudgels and struts its strategy. But the ‘green shoots’ of funding and acquisitions are poking to the surface, though the numbers are lower.

Short takes and updates: FTC may not be done with CVS-Oak Street, VistA moves to cloud–why?, Oracle Cerner lays off 10%. at least (It continues)
Week-end update: Breaking–Theranos lab director suing Hulu, Disney for defamation; ‘green shoots’ for SonderMind, Cognito, Vital, MedArrive; 3 in Asia; Telstra Australia’s new CTO (Some hope in funding and a whistleblower strikes back) 
DOJ drops appeal to block UHG-Change; more hints that FTC will be hunting big game with Amazon (FTC priming itself for Amazon)
Theranos update: Holmes, Balwani reprieved on surrender–for now–and Theranos’ creditors try to claw back $25M (As the Theranos Two near Club Fed, prosecutors and creditors squeeze rocks)
FTC takes off the gloves, v2: a walk on the technical side of ad pixel tracking (Insight into their strategy)

Despite the banks investing in health tech forgetting about their own risk management, there is some good news: raises for Owlet, Zus, SpectrumAi, and OpenLoop, with PointClickCare picking up an EHR. TytoCare picks up another FDA clearance. ATA hot topic discussion on proposed post-PHE controlled substance prescribing procedures plus their Innovators Challenge winners.  But VA and Oracle Cerner can’t catch a break in the Senate either, with four deaths attributed to the EHR implementation and four major safety issues revealed by their own sprint team. Contract review due in May.

Week-end roundup: Owlet in rebuilding mode including FDA submissions, Zus Health raises $40M, Spectrum Ai’s autism therapy $20M Series A (Someone’s getting money)
VA EHR update: four deaths traced to Oracle Cerner EHR; four safety issues identified by VA EHRM Sprint Team (The Leaning Tower of Trouble’s contract is up for review in May)
Mid-week roundup: TytoCare’s Wheeze Detection clears FDA, OpenLoop telehealth’s $15M Series A, PointClickCare buys PatientPattern EHR, last info session for Health Wildcatters’ 2023 accelerator
News from ATA 2023: debate over DEA in-person prescribing requirement, winners of Telehealth Innovators Challenge, 2024 board chair announced 

Not a lot of articles, but a lot of news. A busy M&A week for a change with Transcarent, VillageMD, and WW buys. Will Theranos’ investors see a penny in restitution? All while prison dates loom for Holmes and Balwani. Plus digital switchover/TECS meetings courtesy of UKTelehealthcare, Best Buy’s move into hospital-at-home, and Color pop health/testing says bye to 300.

News roundup: Transcarent buys 98point6’s virtual care; Best Buy-Atrium hospital-at-home; Walgreens/VillageMD buys another practice group; WW-Sequence digital weight management; UKTelehealthcare events; 300 out at Color
Did Theranos collapse because of Holmes’ criminal conduct? Holmes says no–and no to investors’ claims (The restitution debate ensues–and the defendant’s accounts are empty)

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Mid-week roundup: Kaiser Permanente to buy Geisinger, setup separate system; GoodRx co-CEOs step down; strong earnings for Centene, Humana; Clover Health stock woes, settles $22M lawsuit

April 27, 2023 | by

Today’s big news was that Kaiser Permanente will be acquiring Geisinger Health. Technically, the acquisition is being made by Risant Health, a separate non-profit organization founded by the Kaiser Foundation Hospitals that will acquire other non-profit community health systems. Acquisition costs and a timetable for the transaction were not disclosed and will be subject to the usual state and Federal regulatory review and requirements.

Geisinger will be the founding system of Risant Health, a non-profit that will be headquartered in the Washington, D.C. area. Its current president, Jaewon Ryu, MD, JD, will become CEO when the acquisition closes. Risant’s purpose will be to advance value-based care by acquiring and connecting other multi-payer, multi-provider, community-based health systems in areas such as care model design, pharmacy, consumer digital engagement, health plan product development, and purchasing. 

Kaiser Permanente is a giant integrated care system with 12.6 million members based in California. It operates in eight states (California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington) and the District of Columbia. Geisinger Health is Pennsylvania-based, has 10 hospital campuses, its own health plan that covers more than 500,000 members, and the Geisinger College of Health Sciences with schools of medicine, nursing, and graduate education. Geisinger was also a pioneer in incorporating telehealth and remote patient monitoring into its healthcare system. The benefit to Geisinger joining Risant is that as the lead system, it will help to shape their operational model. Reportedly, Kaiser will spend $5 billion and acquire five to six health systems over the next five years. The health systems will retain their names and operational areas.

On the face of it, this seems to be a novel solution to both health systems’ challenges. Both have had operating losses and net losses in recent years and difficulty expanding out of their geographic areas. Kaiser has a tightly integrated health plan and service model that is location-dependent. Geisinger has been squeezed in Pennsylvania by UPMC and Penn Medicine along with other community systems. In 2020, it ended its effort to expand into southern New Jersey via a merger with AtlantiCare. However, this current administration and state regulators have not favored health system mergers, which has seemingly been anticipated by Kaiser in forming the Risant Health organization. Healthcare Dive, FierceHealthcare, Kaiser/Geisinger/Risant release

GoodRx names Scott Wagner as interim chief executive officer. Current co-CEOs and founders Doug Hirsch and Trevor Bezdek will be stepping down but staying with the company as chief mission officer and chairman respectively. Wagner was formerly CEO of GoDaddy and is a board member of other digital and advertising businesses. In February, GoodRx was the first ‘victim’ of the newly aggressive Federal Trade Commission policies on Meta Pixel and other ad trackers collecting user health-related data and sharing for revenue with Facebook, Google, Criteo, and other advertising sites. The FTC used the Health Breach Notification Rule, created in 2009, to GoodRx in a Federal court with misuse of consumer health information. Even though GoodRx is not a HIPAA-covered entity and they ended the practice in 2019, they settled with the FTC for $1.5 million. But the likely reason for the CEO change is that the company is still unprofitable. It ended 2022 with a net loss of $32.81 million and laid off 16% of staff last September. Mobihealthnews, FierceHealthcare

It’s earnings report season for payers. The news has been good for some, not for others. 

  • Centene reported year-over-year gains, with Q1 revenue of $38.9 billion versus prior year $37.2 billion. Q1 profitability also gained at $1.1 billion versus prior year $849 million, which missed Wall Street projections. Their outlook was scaled back due to Medicaid redeterminations, 2024 Medicare bids and investments. They also attributed the increased profitability through the strategic sale of Magellan Rx and internal reorganizations. Fierce Healthcare
  • Humana’s Q1 was also profitable and met Wall Street analyst expectations with earnings of $1.24 billion, or $9.87 a share (adjusted to $9.38/share), up from prior year $930 million, or $7.29 a share. This reflects investments in their Medicare Advantage business. Humana is projecting an aggressive target of a 17% membership increase, reversing from last year’s losses.  Fierce Healthcare
  • Clover Health’s Nasdaq notice, settles $22 million in SPAC class action lawsuit. Nasdaq notified Clover on 20 April that since their stock traded below $1.00 for 30 days, they have 180 days to 17 October to regain compliance with the Minimum Bid Price Requirement. This was disclosed in Clover’s SEC 8-K filing last week. There are other ways to maintain a listing (e.g. transferring to Nasdaq Capital Markets) but the anemic share price (closing today at $0.73, a drop of over 90% from the SPAC high) shows no signs of reviving. On Monday, Clover announced a $22 million settlement in a class action lawsuit filed in Tennessee around the company’s January 2021 SPAC. The following month, Hindenburg Research published that Clover did not disclose a Department of Justice (DOJ) investigation in 2020, claiming it was ‘non-material’ [TTA 9 Feb 2021]. The share price fell off the roof and kicked off multiple similar class action suits which are proceeding in New York and Delaware. Release

News and deals roundup: SCP Health-SOC Telemed, Epion Health-MSU, Sensyne Health’s new data agreements, Geisinger’s RPM app

May 26, 2021 | by

SCP adds more SOC. SCP Health, a clinical management company that provides both staff and services to hospitals, and SOC Telemed, an acute, post-acute, and specialty care telemedicine provider, are increasing their engagement. SCP presently provides specialty care staff for SOC’s Telemed IQ platform for acute care. SCP will be increasing engagement with the platform to expand into a hybrid clinical approach between onsite and virtual care for hospital medicine, emergency medicine, and critical care programs. SOC Telemed was an early SPAC less than a year ago in August 2020 and last month shelled out $196 million for competitor Access Physicians. SOC release

NJ-based Epion Health, which has a digital check in and patient messaging platform that includes telehealth, announced an agreement with MSU Health Care, the academic health center of Michigan State University. MSUHC’s 600 providers will use Epion’s platform for provider search, patient registration, check-in, patient education, and payment for services. Epion’s client base is primarily regional provider groups. Epion release.

Sensyne Health of Oxford inked two deals in the past week for expanding its already extensive medical dataset of anonymized and de-identified patient data, adding patient data from the Colorado Center for Personalized Medicine (CCPM) and St. Luke’s University Health Network (Pennsylvania and New Jersey). The strategic research agreements add their data records to Sensyne’s dataset, now at 18.2 million records. Sensyne mines the data primarily for use by life science clients. When Sensyne commercializes these discoveries, they will share proceeds with CCPM and St. Luke’s respectively. Sensyne releases for CCPM and St. Luke’s.

Geisinger Health launches ConnectedCare365 app + RPM for chronic condition patient management.  The app, developed by Noteworth, monitors and analyzes multiple vital signs provided by patients directly or through devices, combining them with information from Geisinger’s EHR to send information and notifications directly to the care team. The app also connects families and caregivers with the care team via messaging. Noteworth release.

Telemedicine virtual visits preferred by majority in Massachusetts General Hospital survey

January 22, 2019 | by

The results are far better than parity with in-person visits for follow up. A group of 254 patients and 61 health care providers were the subject of a survey conducted by researchers at Massachusetts General Hospital, part of Partners HealthCare, and Johns Hopkins. It found that virtual video visits (VVVs) are perceived by the majority of patients as the same as or better than office visits in convenience and cost, at the same level of quality and personal connection. It measured responses from both patients and providers in the MGH TeleHealth (sic) program, in place since 2012, in follow up care from providers in psychiatry, neurology, cardiology, oncology and primary care (the last two added late in the survey).

The results were: 

  • The vast majority (94.5%) of patients preferred the travel time (minimal) and time convenience (79.5%) of the VVV
  • Most patients (62.6%) and clinicians (59.0%) reported “no difference” between VVV and office visits on “the overall quality of the visit.”
  • When rating “the personal connection felt during the visit”, over half–but more patients than clinicians–said that there was “no difference” with the VVV (patients, 59.1%; clinicians, 50.8%), although 32.7% of patients and 45.9% of clinicians reported that the “office visit is better”.
  • They were also willing to pay for it–and that increased with distance from the doctor. Among those who traveled more than 90 minutes to an office visit, 51.5% indicated they would pay a co-payment of more than $50 for a VVV compared with 30.4% of those who traveled less than 30 minutes.
  • Results graphs are here

The survey results were published in the American Journal of Managed Care. This month’s issue also examines gamification in healthcare, asynchronous communication between primary and specialty care practitioners at Geisinger, EHRs–and the relationship between data breaches and not surprisingly increased advertising expenditures after the fact to rebuild lost trust. According to this last article, breached hospitals were more likely to be large, teaching, and urban hospitals relative to the control group.

Also UPI and HealthDay.

4 year telehealth study charts ~40 percent CHF readmissions reduction

October 9, 2014 | by

Finally an encouraging long-term, large N study on telehealth reducing same-cause hospital readmissions. Pennsylvania’s Geisinger Health Plan, the managed care arm of integrated health system Geisinger Health, has released findings from a four-year (2008-2012) study of 541 GHP Medicare Advantage beneficiaries with congestive heart failure. Hospital readmissions after 30 days were 44 percent lower and after 90 days 38 percent lower. Return on investment: “for every $1 spent to implement this program, there was approximately $3.30 return on this investment in terms of the cost savings accrued to GHP.”

Patients were assigned case managers and provided with a relatively simple program combining Bluetooth-connected weight scales and interactive voice response (IVR) calls to answer questions such as shortness of breath, swelling, appetite and on prescription medication management. The case managers used a platform to aggregate the data (more…)