The boom may be over, between shrinking visit volume and a pileup of providers. Is a correction in the cards? The flood of funding that started in 2020 and has not abated was kicked off by the pandemic and a massive shift to telehealth visits in March/April 2020 from a barely-above-plant-life number in January/February.
Post-pandemic, the shift corrected.
- The peak of 69% of visits tracked by Epic in April had tailed off to 21% as early as May 2020 [TTA 2 Sept 20].
- National commercial claims data via FAIR Health was lower. They tracked its peak also in April 2020 at 13%, falling continuously monthly: May to 8.69%, 6.85% in June, 6% in August, and 5.61% in October [TTA 9 Jan].
- By mid-year 2021, the claims numbers continued to lose altitude: June 4.5%, July 4.2% (FAIR Health monthly report).
Despite the numbers, telehealth companies raised $4.2 billion of a total $15 billion in digital health funding in the first half of 2021, according to Mercom Capital Group, a global communications and research firm. So…what’s the problem with les bon temps rouler?
CB Insights notes the increased specialization of new entrants and, as this Editor has noted previously, the blending and crossing of business lines.
- Companies like Heal, Dispatch Health, and Amazon Care will send a clinician to your house for a checkup–no running to your urgent care.
- Kidney disease? Monogram Health. Musculoskeletal pain? Hinge Health. Child with an earache or fever? Tyto Care. Check symptoms first? Babylon Health.
- Telemental health has gone from cocktail party repellent to the belle of the ball, concentrating on cognitive remote therapies. For the past year, it moved to more than half of all telehealth claims, with currently over 60% of procedure codes–and it’s consolidating. AbleTo was bought by Optum, Ginger bought by Headspace, SilverCloud by Amwell.
So for the Major League–Teladoc, Amwell, Doctor on Demand, Grand Rounds, and MDLive–what does this mean? If this interview with Teladoc’s CIO is an example, they plan to segue to a ‘hybrid’ model of virtual quick response plus integrating providers into a continuing care model with patients, creating a relationship with history and familiarity. A model that’s very much dependent on IT, analytics, and connecting with willing providers. But in this free-floating sea of verbiage, it didn’t come into misty focus till the very end, when he mentions Primary360 [TTA 7 Oct] and a virtual primary care team. (And let’s not forget Babylon360 along similar lines.) He finally sketches a view of all the connections to conditions coming together on a very far horizon.
One can say it’s a cloudy crystal ball, indeed. FierceHealthcare, HealthcareITNews (Teladoc CIO interview)
Becker’s Health IT and CIO Review has written up a US-centric review of recent advances in telehealth and telemedicine but kicks it off with the confusion level between the two terms. Internationally, and in these pages, they are separate terms; telehealth referring primarily to vital signs remote monitoring, and telemedicine the ‘virtual visit’ between doctor and patient, between two clinical sites, or ‘store and forward’ asynchronous exchange (e.g. teleradiology). Somehow, in US usage, they have been conflated or made interchangeable, with the American Telemedicine Association (ATA) admitting to same, and American Well simply ‘just doing it’ in relabeling what they provide. On top of it, the two are incorporating elements of each into the other. Examples: TytoCare vital signs measurement/recording into American Well’s video visit; Care Innovations Health Harmony also providing video capability.
Of particular interest to our international readers would be the high rate of US growth in telemedicine utilization from 7 to 22 percent (Rock Health survey). Teladoc, the largest and publicly traded provider, passed the milestone of 100,000 monthly visits in November and the ATA estimates 1.25 million from all providers for 2016 (Teladoc release). Other US competitors include the aforementioned American Well, MDLive, and Doctor on Demand, the latter two also selling direct to consumer. They also compete against doctor-on-house call services like Pager and Heal. Reimbursement remains an issue both privately and publicly (Medicare and Medicaid) on a state-by-state level, with telehealth experiencing significant difficulties, as well as internet access, speed, and usage by older adults.
Denny Hatch, the master direct mail copywriter and creative thinker, for decades had a private direct mail marketing newsletter called ‘Who’s Mailing What!’ This came to mind with some very big funding rounds in the past few weeks:
- Omada Health’s Series C $48 million raise in September to boost validation, enhance its Prevention program and expand to state Medicaid for low-income patients. Current clients include Humana and Costco. Forbes attributed the size of the round to Omada’s approach in tying participant outcomes to over 50 percent of its compensation. MedCityNews.
- Propeller Health‘s Series C of $21.5 million. This is a sensor on asthma meds such as inhalers that connects to an app. With 45 programs and clients like Dignity Health and Molina Healthcare, Propeller has been growing intensively since this Editor last saw them at the 2014 NYeC Digital Health Conference. Their total funding is now $45 million. TechCrunch.
- And now that we mention it–don’t forget that TTA Readers receive a 10% registration discount on this year’s conference 6-7 December–use code TTA when registering. Click on the advert in the right sidebar to enter registration or view their event website.
- Spain’s biotech sector got a boost when Ysios BioFund II Innvierte exceeded the initial fund target of €100 million (US$110 million), closing at €126.4 million (US$140 million). It recruited existing investors and multiple Spanish and European economic interest groups. With their Biofund I, Ysios has €191.4 million (US$220 million) in assets under management. MedCityNews
- iRhythm closed its IPO on Tuesday with an over-allotment. Shares from last Thursday’s offering of 6.3 million shares at $17 on NASDAQ initially soared 65 percent to $28 before closing at $26.05. iRhythm’s Zio service is a cardiac monitor patch and long-term monitoring to determine whether a patient has an arrhythmia or atrial fibrillation. WSJ, Reuters
- And before you have that AFib, if you are living in California, Heal can provide you with an in-person doctor house call from your smartphone for $99, which may be covered by a participating insurer. Series A round of $26.9 million. VentureBeat