TTA’s summer startup #1: Bright Health’s IPO, Noom’s $540M, UK news potpourri, CoverMyMeds big bang, pandemic health effects, deals and funding, more!

 

 

Weekly Update

 

A bumper crop this week as we ease into the unofficial start of summer and wind up May.

ATA2021 coming up (virtually) starting 1 June (At least you don’t have to get the jab before attending!)
News and deals roundup: CoverMyMeds ‘big bang’, Noom’s $540M Series F, insurtech Bright Health’s IPO, Grand Rounds-Included Health, GoodRx, Cedar-OODA, Huma, Bluestream Health’s outreach (So many we had to ‘short take’ them!)
UK news roundup: West Wales’ CONNECT project, WelcoMe app for disabled access, X-on Surgery Connect expands, Arc Health in 46 care homes, Alcove’s £75M contract with Suffolk County Council (Things moving along smartly)
An unappreciated long term pandemic health effect? Increased frailty among older adults. (Making up for lost time and health not easy or quick)
The Theranos Story, ch. 72: a little lifestyle and celebrity is admissible at trial–but not too much. And no profanity, please! (Hold the popcorn till Labor Day)
News and deals roundup: SCP Health-SOC Telemed, Epion Health-MSU, Sensyne Health’s new data agreements, Geisinger’s RPM app (Definitely ‘springing forward’)
Survey: 80% of Americans believe telehealth can provide quality medical care–up 23 points from 2020 (More confirmation of five years of progress in one)

From last week’s mini-update–our ‘top of the pops’ 

Tunstall excluded from Sweden’s framework agreements for municipal alarm and technology procurement (A software update that went sideways affects contracts in over 200 municipalities)

A small bombshell in the traditional PERS world (yes, it’s still there) is Philips’ sale of Lifeline to Connect America–which two years ago bought Tunstall Americas. Teladoc gets into the cognitive therapy app business–and sends a message–in a big way.

Connect America acquires Philips’ Aging and Caregiving, including Lifeline (Big news in aging services, though it’s Old Tech. And another Philips North America divestiture.)
Teladoc integrates the myStrength cognitive mental health app with their telehealth network (Sending a message to the smaller players?)

 

May may be chilly where you are, but we serve up some hot news in funding, wobbly Walmart’s dive into telehealth, Germany’s DiGA, a OnePerspective around stroke care, and a free webinar on what public health may look like post-Covid. And kicking off the month–a Theranos hearing (remember them?)

The Theranos Story, ch. 71: Holmes appears in court, lawyers argue celebrity, lavish lifestyle, Silicon Valley ethics (The consequences of ‘faking till you make it’)
News and funding roundup: Vida Health’s $100M Series D, Kry’s $316M raise, CVS and Advocate Aurora’s fresh funds, Boost Mobile offers K Health symptom checker (Substantial raises and more funding on the table)
Walmart Health moves into the hot telehealth area with MeMD buy (Continuing to be a puzzle)
What you need to know about Germany’s new DiGA fast tracking for health apps (New R2G research)
Webinar: Public Health and Responsible Innovation in a Post-Covid Europe 20 May
OnePerspective: Covid-19 accelerates digital stroke care for the East of England (Stroke Telemedicine Partnership with Visionable)

April closes with a !! NHS Digital appoints an interim CEO. A brace of UK virtual conference events starts in May–robotics is of interest internationally. Deals and funding include Buddi floating on the LSE this year, PlushCare bought for $450M, and Capsule’s $300 raise. Amwell raises its low profile a bit with a new platform and a surprise. And in dustups–David (AliveCor) takes on Goliath (Apple) about patent infringement on the core of AliveCor’s business. 

Breaking: NHS Digital appoints Simon Bolton interim CEO

2021 UK-RAS Network Robotics Summer Showcase 5 May-30 July and UK Festival of Robotics 19-25 June (If you’re interested in healthcare or other robotics, this is the place–and not just for the UK)
David sues Goliath: AliveCor claims patent infringement by Apple–ITC filing requests bar on Apple Watch US importation (Bring the popcorn, but it’s serious)
Amwell debuts new telehealth platform, Converge; previews Carepoint for hospital care into the home (Carepoint is the ‘stealthy’ move)
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 (No signs of cooling down in funding–but keep MD Ally on the radar which meets an unserved need)
Upcoming UK digital health events: The King’s Fund 24-27 May, UKTelehealthcare Marketplaces & Forum (Events are coming back–slowly)
News roundup: Buddi’s £500M LSE float, Accolade to buy PlushCare for $450M, Teladoc adds chief innovation officer, Tyto Care’s Italy expansion (Buddi a huge float for the UK)

And of continued interest–

News roundup: dogs sniffing out COVID, CVS rolling out OTC COVID tests, Hydrogen Health launches, Alcidion UK acquires ExtraMed (Man’s Best Friend can do anything but talk!)
Mayo Clinic creates AI-powered clinical decision/diagnostics support platform, two digital health portfolio companies (What Dr. John Halamka’s been up to)
A new event–and not all virtual! HLTH and CHIME to launch ViVE in March 2022. (Another sign of normal business)
Good news! Eight software functions no longer classified as medical devices under FDA. (One for the techies. And anything you don’t have to clear with FDA makes for a good day.)
News and deal roundup: Microsoft’s $20B deal for Nuance; Cigna Evernorth finalizes MDLive; GoodRx buys HealthiNation; Papa’s $60M Series C (And the money is still rolling)

 

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Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

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News and deals roundup: CoverMyMeds ‘big bang’, Noom’s $540M Series F, insurtech Bright Health’s IPO, Grand Rounds-Included Health, GoodRx, Cedar-OODA, Huma, Bluestream Health’s outreach

McKesson shmushes four units into CoverMyMeds. McKesson’s Big Bang combines four McKesson business units–RelayHealth (pharmacy networking), McKesson Prescription Automation (software), CoverMyMeds (medication access for patients), and RxCrossroads by McKesson (therapeutic and drug commercialization). They are being reassembled into one massive unit under the CoverMyMeds name. The unit will have about 5,000 people and will be headed by Nathan Mott. More here in a blog post/announcement posting that’s short on information and long on cheerleading.

And the funding rounds keep marching down the alphabet. Noom, the weight loss app, gained a generous Series F of $540 million led by Silver Lake with participation from Oak HC/FT, Temasek (Singapore), Novo Holdings, Sequoia Capital, RRE and Samsung Ventures. Valuation is now at $4 billion. Adam Karol, a managing director at Silver Lake, and former TaskRabbit chief executive Stacy Brown-Philpot will join Noom’s board. The fresh funding will be used to expand into areas such as stress and anxiety, diabetes, hypertension, and sleep.

Noom had a banner year in 2020, with $400 million in revenues as people tried to shed Pandemic Pounds (aided by a near-ubiquitous ad push). The app has had 45 million downloads to date in 100 countries, largely in the US, UK, Canada, Australia, Ireland, and New Zealand. According to a (paywalled) Bloomberg News report, feelers are out for an IPO which may be valued at $10 billion. TechCrunch, Reuters, FierceHealthcare

Bright Health Group filed its S-1 registration statement with the Securities and Exchange Commission (SEC). Their rumored $1 billion IPO will be on the NYSE and trade under the symbol BHG. Timing, share value, and number of shares are to be determined. It’s speculated that the valuation at that point is expected to be between $10 and $20 billion. Bright Health is an insurtech operating exchange and Medicare Advantage (MA) health plans under Bright HealthCare  in 14 states and 50 markets, covering over 620,000 lives. They also have a separate care delivery channel called NeueHealth, 61 advanced risk-bearing primary care clinics delivering in-person and virtual care to 75,000 unique patients. Last month, they purchased Zipnosis, adding their white-labeled telemedicine for large health systems business. Bright Health Group release, Mobihealthnews

Short takes:

Doctor on Demand and Grand Rounds, which finalized their merger earlier this month, have agreed to acquire Included Health. Terms and timing were not disclosed. Included Health specializes in care concierge and healthcare navigation services for the LGBTQ+ community. FierceHealthcare, Release

GoodRx acquired rival RxSaver for $50 million in cash in late April to bulk up against Amazon. FierceHealthcare

Medical billing and pre-visit tech company Cedar is acquiring payer workflow tech company OODA Health for $425 million deal in a mix of cash and equity. It’s expected to close at end of May. OODA’s co-founder, chairman, and co-CEO is Giovanni Colella, MD, also co-founded Castlight Health and founded RelayHealth (see above), so another successful exit for him. FierceHealthcare, HISTalk

London-based Huma, raised $130 million in a Series C. Leaps by Bayer and Hitachi Ventures led the round. The former, mysterious Medopad now seems to have settled on a platform that supports ‘hospital at home’ plus pharma and research companies in large, decentralized clinical trials. There’s an add-on of $70 million to the Series C that can be exercised at a later date. Release, HISTalk

White-label telehealth provider Bluestream Health is partnering with The Azadi Project to provide virtual care services to refugee women and girls fleeing from countries like AfghanistanIranIraq, and Syria for safety in Greece. “Bluestream Health has teamed with The Azadi Project to provide a virtual care platform that stretches around the world. The women fleeing war-torn and conflict-affected countries have suffered unspeakable abuse, and while seeking safety in Greece, they are further exposed to terrible living conditions and hostility.”  said Matthew Davidge, co-founder and CEO of Bluestream Health.  Release

News and deal roundup: Microsoft’s $20B deal for Nuance; Cigna Evernorth finalizes MDLive; GoodRx buys HealthiNation; Papa’s $60M Series C

Our Big Deal is Microsoft’s acquisition of Nuance Communications, a cloud and AI-based speech recognition company which has been a leader in healthcare for a few decades. Most recognizable are their Dragon and PowerScribe trade names. Microsoft is paying $56.00 per share, a 23 percent premium to the closing price of Nuance on 9 April, an all-cash transaction valued at $19.7 bn. Closing is projected to be end of 2021 as subject to regulatory and final shareholder approvals.

Nuance and Microsoft have closely worked together for some time with Microsoft Cloud using Nuance speech recognition and Nuance clinical speech recognition offerings built on Microsoft Azure. Nuance claims that in the US, 55 percent of physicians, 75 percent of radiologists, and 77 percent of hospitals use their products. It’s a big but expected bet for Microsoft in healthcare against Apple that is expected to double Microsoft’s total addressable market (TAM) in the healthcare provider space to nearly $500 billion. It also adds enterprise AI expertise and customer engagement solutions in Interactive Voice Response (IVR), virtual assistants, and digital and biometric solutions for companies outside of healthcare. Microsoft release, Becker’s Health IT

Cigna closed its purchase of telehealth provider MDLive on 19 April. Purchase price and management transitions were not disclosed. MDLive will be part of Evernorth, Cigna’s health services portfolio. That portfolio includes Accredo, Express Scripts, Direct Health, fertility health, and more. Earlier coverage 27 February. Evernorth release, FierceHealthcare. 

GoodRx closed its purchase of health education video producer HealthiNation. Sale price was not disclosed. HealthiNation’s video library will reinforce GoodRx’s consumer information on prescription prices for better consumer decisions. Release, Mobihealthnews  

Senior services and socialization ecosystem Papa now has a brand new Series C of $60 million, via Tiger Global Management. Papa connects seniors with Papa Pals, a ‘family on demand’ that appear to be heavily college students. Papa Pals visit with them and provide in-person and virtual companionship, assist with house tasks, technology training, and transportation to doctors’ appointments. Scheduling is done via a smartphone app. The company added Papa Health last year, connecting in ‘Papa Docs’ (an unnerving term for those who recall ‘Papa Doc’ Duvalier of Haiti) for primary care, chronic care management, and urgent care. Papa works extensively with Medicare Advantage plans such as Humana, Reliance, Florida Blue, and Aetna. Founded in Miami in 2017 with now total funding of over $91 million and available in 50 states, earlier round funders include Comcast Ventures and Canaan Partners. Release, Crunchbase, FierceHealthcare

Lasting effects of the pandemic lockdown on health and wealth

A PR hook for healthcare-related companies is a survey that tells us More Bad News about the effects of the pandemic and the US lockdown. Some of it is marketing content scrum, but the quantification of lasting effects has value.

  • Early surveys came from non-profits working with (largely) non-vendors, such as the Epic Health Research Network and Commonwealth Fund/Harvard/Phreesia studies.
  • Then later tracking studies such as those published in PLOS One, by FAIR Health and the Harvard study published in Health Affairs.
  • Focused studies such as those by GoodRx, the prescription discounter, with a surprisingly deep survey concentrating on the CoronaDepressed–mental health and the worsening of anxiety and depression, inferring from prescription usage. SECOM CareTech in the UK concentrated on the effects of ‘lockdown loneliness’ on older adults.

The latest survey comes from another free prescription coupon platform, RxSaver, concentrating on financial and medication adherence:

  • 51 percent of adults reported a negative financial impact resulting from the pandemic. 65 percent of them were Hispanic.
  • Over 60 percent of millennials reported continuing financial impact one year after the pandemic’s start.
  • Where are they economizing? Unsurprisingly, medication.
    • 15 percent of adults surveyed stopped taking medication in the past year. Of this group, the under 30 cohort comprised the largest demographic segment at 23 percent.
    • Trying to manage, 21 percent have used a prescription savings coupon, but 31 percent either didn’t fill prescriptions, skipped doses, or split their pills/capsules–all of which are risky.

Phoenix Research performed a Public Insights Survey for RxSaver, N=1,000 nationally representative adults ages 18 and older, and performed 20-22 January. There was no disclosure on survey methodology. This Editor hopes that other entities use this directional information in conducting larger and less product promotional research to be used by health organizations and policy groups. RxSaver web page, release.

News roundup: Milken Institute’s telehealth brief with ATA push on Congress, GoodRx confirms 62% are CoronaDepressed, Johns Hopkins’ COVID mortality risk study and calculators

The hot US health tech issue is retaining, consolidating, and adding to the gains that telehealth and remote patient monitoring (RPM) made during the pandemic. The influential Milken Institute (formally the Milken Institute Center for the Future of Aging, Center for Public Health, and FasterCures) has published a short white paper on how best to increase access to telehealth services and support innovation as part of that aim. Their five core recommendations are: 

  1. Permanently lift Medicare location restrictions on telehealth to ensure that older adults can receive a variety of services in their homes and communities, regardless of where they live. (This was also recommended by the Taskforce on Telehealth Policy (TTP) [TTA 18 Sep] which was jointly formed by the ATA, NCQA, and the Alliance for Connected Care.)
  2. Meet the growing need for behavioral health care by addressing barriers to remote care and expanding the availability of telebehavioral  health services.
  3. Increase equitable access to telehealth services through digital technology, literacy programs, and broadband coverage.
  4. Support development and implementation of innovative telehealth and mobile health technology for prevention, well-being, clinical care, and research.
  5. Develop and document clear data sharing standards to support transitions of care across acute, post-acute, and long-term care settings, including care provided in the home and in residential care facilities. 

The consensus is that CMS’ 2021 Physician Fee Schedule post-pandemic (public health emergency=PHE) does not do nearly enough in that it returns–of legal necessity–to the status quo ante geographic restrictions, though it devised a temporary Category 3 to store over 50 telehealth billing codes [TTA 3 Dec]. The American Telemedicine Association (ATA) was joined by multiple organizations on Monday in pressing Congressional leaders to extend national telehealth ‘flexibilities’ as part of the $1.4 trillion omnibus spending deal that is needed to avoid a government shutdown on Friday (yes, this Friday) at midnight. The organizations joining the ATA on the letter to Congress are the Alliance for Connected Care, College of Healthcare Information Management Executives, Connected Health Initiative, eHealth Initiative, Health Innovation Alliance, HIMSS, and PCHAlliance. ATA release.

We are shocked, shocked that CoronaDepression worsens in those already suffering. Prescription discounter GoodRx analyzed prescription fill trends for anxiety and depression meds and found that they reached an all-time high in 2020–9.5 percent higher than the previous high in 2016. It peaked in April as the pandemic was underway, and possibly reflected some stockpiling.

Of their sample of 1,042 individuals diagnosed with anxiety and depression prior to the pandemic:

  • 22 percent responded that their symptoms were “much worse”
  • 40 percent said they were “worse”
  • 28 percent stated that symptoms were the “same”
  • a surprising 10 percent said symptoms were “better” or “much better” 

One of the main factors in that 62 percent reporting worse/much worse was the length of quarantine. “Those who reported quarantining due to COVID-19 were far more likely to report “worse” or “much worse” symptoms compared to those who did not quarantine. Over 70% of those who reported quarantining for more than one week said their depression and/or anxiety symptoms were “worse” or “much worse.” Loss of job and income, plus COVID-related events affecting friends and family, were also key in worsening symptoms. Many also had difficulty reaching their doctors/therapists and renewing medication. The study was conducted 1-10 November. GoodRx study

More depressing news (sic) of mental health challenges to older adults in the Isolation Age: The Future of Remote Care Technology, Lockdown Loneliness feared more than COVID, and the PLOS One study.

But cheer up and carry on, your COVID mortality risk may not be as bad as you think. A team of researchers at the Johns Hopkins Bloomberg School of Public Health created a COVID mortality risk calculator, based on algorithms calculating factors such as age, gender, sociodemographic factors, location, and a variety of different health conditions. Risk scores are grouped into five categories from lower than average/close to average to high.  While primarily for public health authorities to prioritize populations for vaccination, uninfected individuals can use it to determine their personal risk of future infection and complications after infection. It’s easy to use and your results may surprise you. There is also an interactive US map of the risk level of major cities, counties, and states. The study is published in a paper that appears in the journal Nature Medicine.  Johns Hopkins release, risk calculator

News roundup: Amazon Pharmacy–retail, GoodRx threat, 81% of healthcare workers have remote IT issues, Epicor installs in Australia care homes, GrandCare for developmentally disabled adults

Rounding up lots of dogies here!

Amazon, to no one’s surprise, has formally entered the US pharmacy business with Amazon Pharmacy which can fill prescriptions for most common medications. There is a whole process of course to sign up (at right), and a separate program for Amazon Prime customers with discounts on Amazon Pharmacy with two-day delivery, PillPack, and at 50,000 pharmacies in 45 states. The Prime program is administered by Inside Rx, a subsidiary of Evernorth/Cigna.

Mr. Market downgraded pharmacy retailers CVS and Walgreens Boots stocks, again unsurprisingly. It isn’t just brick ‘n’ mortars feeling the heat; heavily advertised drug price comparison platform (lumped into ‘digital health’) and recent IPO winner GoodRx took a 20 percent hit as Amazon Prime also discounts, comparable to GoodRx Gold. The GoodRx network is about 70,000 pharmacies, including the largest retailers. Fierce Healthcare. Big hat tip to Jailendra Singh at Credit Suisse Equity Research for these analyses on Amazon Pharmacy and GoodRx.

81 percent of healthcare workers experience issues with systems and technology used in external care, out visiting and caring for patients, according to a ‘State of Mobility in Healthcare’ multi-national study (email signup required) by business mobility development company SOTI. 64 percent of UK healthcare workers (63 percent overall) are ripping out what is left of their hair due to IT/technology glitches leading to system failures within a normal working week. Only a quarter of respondents said that their systems were able to cope with COVID-19. Based on the Healthcare IT News EMEA edition article, UK respondents apparently reported a higher level of IT problems affecting their work. The bright spot is that 68 percent of UK healthcare workers/55 percent overall agree that investment in new or better technology could help save lives. The study had respondents in the US, Canada, UK, Germany, Sweden, France, and Australia.

Speaking of software, Epicor, a US-based software company, is providing to two Australian care home groups their Community Care workflow and information platform: Finncare, which is associated with services to the Finnish and Scandinavian communities, and MannaCare in the Victoria area. Healthcare IT News Australia

One of the Ur-companies (2005!) in the senior health monitoring sector, GrandCare Systems, announced that they are working with LADD, a Cincinnati Ohio-based non-profit that supports adults with developmental disabilities. LADD’s project, the Heidt Smart Living Home, will incorporate GrandCare’s communication, cognitive assists, telehealth, and social engagement tools, as well as innovations in accessibility, lighting, and sensory control, for residents. Release Hat tip to CEO Laura Mitchell via LinkedIn.

Drug discounter GoodRx plans US IPO; Ginger mental health coaching raises $50 million

The bubble bath got soapier with more IPOs and big raises on tap. 

GoodRx, the relentlessly advertised prescription discount scheme with spokespeople Martin Sheen and son Charlie, has filed initial paperwork with the US Securities and Exchange Commission (SEC) for a potential initial public offering (IPO). This has been in the rumor mill for a while. Timing would be about 4th Quarter or early in 2021, according to Reuters.

It may at least a partial exit for Sand Road PE giant Silver Lake Partners, which took a one-third interest in GoodRx in August 2018, creating an estimated value at $2.8bn. CNBC  Both their growth since then and key hires have indicated preparation for going public. According to MedCityNews, their revenue is up by 55 percent since 2018 and they now employ 350 people. As mentioned above, they advertise heavily on TV with celebrity endorsers. In June, two IPO-experienced executives joined the company (release): new president Bansi Nagji, McKesson’s former chief strategy officer who was on Change Healthcare’s board during its IPO; and CFO Karsten Voermann from acquisition company Mercer Advisors and who led Mercury Payment Systems through its 2014 IPO.

Ginger, formally known as Ginger.io, raised $50 million in Series D funding. Lead investors are Advance Venture Partners and Bessemer Venture Partners, with participation from Cigna Ventures, Kaiser Permanente Ventures, and LinkedIn Executive Chairman Jeff Weiner. Ginger provides on-demand mental health coaching as part of employee benefits within the US. Their release claims 200 companies, health plans Optum Behavioral Health, Anthem California, and Aetna Resources for Living, and tripled revenue in the past year. According to Crunchbase, this is their ninth funding round with a raise total of $120 million. Mobihealthnews