Short takes: a rumor of merger/buy with Cigna and Humana–what are the odds? (updated) And what’s up with the low number of HIMSS 24 exhibitors?

crystal-ballCigna and Humana, perfect together? Only if they can get the deal through the Feds and the states. Late this week, the Wall Street Journal revealed that Cigna and Humana were exploring either a merger or, as some theorize, a buy of Humana ($93 billion in revenue, $60 billion valuation) by much-larger Cigna ($181 billion in revenue, $78 billion valuation). Between them, it is estimated that they would have 35 million members. No transaction cost has been estimated, but the WSJ sources indicate it will be a stock-and-cash deal that could be finalized by the end of the year if all goes well.

On paper, industry observers like it but point out the overlap in one significant area.

  • Cigna earlier announced that it wants to sell its relatively small Medicare Advantage business, concentrating on its leadership in the commercial business and with its service businesses under the Evernorth umbrella.
  • Humana is exiting its commercial health plans to focus on MA and Medicaid, as well as its large footprint in the home health business with CenterWell.
  • Humana’s CEO Bruce Broussard is retiring next year, with newcomer to Humana Jim Rechtin joining as COO in January 2024 as his replacement. Cigna’s CEO David Cordani is a sprightly 57 and likely not to go anywhere.
  • The overlap area that could be problematic is pharmacy benefit management (PBM) with each having about 17-18 million in Express Scripts (Cigna), the second largest in the US, and Humana Pharmacy Solutions. 

Liking it on paper is one thing–FTC, DOJ, and 50 states may not feel so enthusiastic. It’s established through their actions that both Federal agencies are reining in M&A with new and restrictive merger guidelines scheduled to go into effect next year [TTA 20 July]. Healthcare is a major political hot button for this administration for cost–especially drug costs. That is where the reportedly equally sized in revenue PBM operations present the most major conflict to a merger or a buy, both in service and valuation. Both serve their own plan members as well as others, notably Express Scripts with 24% of claims, whereas Humana’s serves primarily its own plan members with 8% of claims. Neither are easy to divest without creating antitrust questions for acquirers and a major dent in Humana’s services. The final factor: Lina Khan, chair of the FTC, has never seen a merger that she’s liked based on her own statements [TTA 24 Aug].

Doomed to repeat history? In 2015, two payer mega-mergers involving these same companies were concocted: Cigna with Anthem and Humana with Aetna. They hit the buzzsaws of DOJ and before that, state approvals. The DOJ pursued them on antitrust in the Federal courts which derailed both by January 2017. Running up to that, every state got an approval vote through review by each state’s Department of Banking and Insurance or equivalent. Many did not approve or with conditions. The other factor is corporate. In the runup to the merger, Anthem-Cigna was marked by escalating animosity from the management suites to the worker cubes. After the deals were scuppered in the Federal District Court, Anthem and Cigna bitterly fought over damages and cancellation fees in Delaware Chancery Court. Aetna and Humana took their lumps and breakup fees, and went on. Aetna went on to merge with CVS, a deal that avoided most of the antitrust flak. Humana went on to acquisitions in other areas.

Our betting line. Both insurers will look at the financials in this hard-to-get-arrested year. Both will feel out the Feds before going forward. Both will calculate whether it’s best to start now or wait till next year and a possible change in administration. Neither company wants to be a political target in an election year. Defensively, Cigna may make noises about other combinations–Centene and Molina have been mentioned–which present their own difficulties and troubles, to strategically try to force the issue. Stay tuned! MedCityNews, Axios

Update: Other analysts suddenly are on board with this Editor’s gimlety view of the matchup, citing antitrust and how Federal regulators are primed to challenge major deals. The FTC is specifically probing the PBM business. The fact that the deal, according to JP Morgan, could take 12 to 24 months is no surprise as par for the course, but Mr. Market didn’t like it, dragging down both companies’ share prices every day since the rumor broke. (Hmmmm….do they read TTA?)  But a small lamp was lit by one analyst: a Cigna-Humana combo could present real competition to the 9,000 lb. elephant of healthcare, UnitedHealth Group, and that might help to put it over. FierceHealthcare

Another concern that occurred to your Editor: Cigna’s international footprint could mean additional approvals by UK and EU regulators.

According to Healthcare Dive’s analysis, the combined entity would have a PBM market share of 32%, right up against CVS Health-Caremark at 33% and UHG’s OptumRx way behind at 22%. It’s a small group with big barriers to entry which makes it a slam-dunk to antitrust regulators.  A whistle in the dark might be UHG’s long-drawn-out buy of Change Healthcare, but there were divestitures of business before closing and both parties managed to prove to the satisfaction of a US District Court that the separation to Optum Insight would not affect business relationships with other health plans. But here, both are health plans, and both have PBMs.

HIMSS 24 exhibitors, where are you? An item in today’s HIStalk on the ‘interesting’ choice as closing keynoter of football coach Nick Saban (U of Alabama Crimson Tide) at a healthcare IT conference went on to compare the number of booked HIMSS exhibitors to date with HIMSS 23’s floor total. This Editor, who for a few years booked the least expensive HIMSS space for the company she worked for back then well in advance, could not believe the low number of exhibitors three months from show time in March. Checking the HIMSS show website, there are 501 exhibitors listed. In 2023, according to HIStalk, there were 1,216. Many of these exhibitors have multiple booths in the Orange County (Orlando) Convention Center, but it still indicates the uncertain state of healthcare, pullbacks in marketing budgets, the rise of real competition in HLTH and ViVE, and perhaps some concerns about the show management transition from HIMSS itself to Informa. Are industry and IT influentials skipping HIMSS next year? Stay tuned or comment below!

More details on the HIMSS-Informa partnership on HIMSS24-Global Health Conference & Exhibition

HIMSS has confirmed to this Editor additional information on the open items in our 2 August article, as well as on the update produced by HIMSS for their media arm. As previously confirmed, the name of the conference for 2024 will remain the HIMSS Global Health Conference & Exhibition.

  • The partnership with Informa is only for the Global Health Conference at this time. HIMSS will continue to fully manage its international shows, such as the upcoming September APAC Conference and any planned European conferences.
  • When asked specifically about Informa managing HIMSS-branded international conferences, they emphasized the focus being on HIMSS24, with potential to grow the HIMSS brand.
  • Informa will fully manage the HIMSS24 show, including registration and travel arrangements, while HIMSS will provide the content for the conference. As previously noted, HIMSS is already soliciting speaker proposals for HIMSS24.
  • The contact at Informa for the show will be Ken McAvoy, president, South Florida Ventures at Informa Markets and at HIMSS, Elli Riley, VP Events & Exhibitions at HIMSS. However, as noted by HIMSS’ CEO Hal Wolf in the HIMSS Media interview was that their conference organizing people will be moving over to Informa.
  • HIMSS leadership started to seek a partner for the Global Conference more than a year ago. The discussions with Informa were ongoing for the past several months.
  • Of great interest to exhibitors who have already booked or are about to book for Orlando in 2024, they do not anticipate any significant changes to the logistics arrangements for HIMSS24, nor to any booked exhibition spaces. They are looking for ways to improve the onsite experience and create more value for customers.
  • At this time, HIMSS is not planning to revisit or revive regional conferences or Health 2.0.
  • HIMSS will continue to be a mission-driven nonprofit focused on a vision to realize the full health potential of every human, everywhere. An interesting statement was that “Governments are selecting HIMSS to do their analyses, and the largest employers of healthcare turn to HIMSS to help make the right operational decisions. HIMSS will continue to grow its thought leadership and take on initiatives and issues that are vital to health and healthcare.” which indicates growth in their consultancy area.
  • No financials were disclosed.

This is a developing story and will be updated.

Done (and split) deal! Informa to “manage” HIMSS Global Health Conference & Exhibition (updated)

Gimlet EyeIt’s now a “landmark partnership”. From a non-announcement announcement by Informa in its H1 financials to today (seven days), we have gone from Informa’s “exclusivity to acquire the HIMSS Global Health Exhibition/Conference” to a “partnership” as follows:  Informa will manage the HIMSS Exhibition, while HIMSS will oversee the content and programming. This will expand the combined conference and exhibition. (Informa taking over conference logistics aren’t specified, but assumed from later on in the release.)

No transaction costs are disclosed. The word ‘acquire’ is not used once.

It may be the best possible deal for both. The press release (on Yahoo Finance) and identically in the news section on content is masterful in saying very little in a lot of words. Here’s this Editor’s view of the deal:

  • It avoids the biggest problem–without HIMSS content, the conference would lack a strong reason why to go and spend money on participation and exhibiting. (This Editor guessed right on that.) Minus HIMSS, it would be easy for exhibitors and participants to walk away from it or say ‘maybe next year’. A lot of what has driven HIMSS is FOMO.
  • It would lose 50+ years of Society legitimacy, continuity, and goodwill as an unaffiliated conference
  • This gives HIMSS, as a society, an annual conference as part of member value (Guessed right on this too)
  • Informa would be hard-pressed to organize the conference content by year’s end, as there’s basically less than eight months to March
  • It absolves the HIMSS organization of being responsible for venue negotiations, expo design, logistics, travel arrangements, and all the messy expenses such as Freeman. Their vulnerability showed in the last-minute cancellation in 2020. It’s now in professional hands. 
  • It may generate some needed cash for HIMSS in this FY (not disclosed) 

HIMSS24 will be taking place in March in Orlando as originally planned, managed by Informa’s South Florida Ventures unit. Informa promises “improved digital features, enhanced registration processes, marketing tools, and cutting-edge product discover applications”. One would also hope improved travel arrangements.

There is no information in the release about Informa involvement in the 18-21 September APAC conference (too soon?) nor mention of any future international conferences, though Informa is certainly capable of staging and managing them.

Open issue–HIMSS Media is not mentioned in the release. Media tie-ins and merchandising are a substantial source of revenue for that division. But the lack of mention is not a ‘no’ and if HIMSS is generating the conference content, it’s likely that HIMSS Media will do the merchandising.

Surprisingly, the press ‘break’ is not yet up on HIMSS Media (Healthcare IT News, Mobihealthnews, Healthcare Finance News). Update–an 18 minute video hosted by editor Mike Miliard is up on Healthcare IT News 3 August.

  • The name will not be changed.
  • HIMSS has been considering bringing in an outside organization to manage the conference for some time and had been speaking with Informa over the past year.
  • Mr. Wolf of HIMSS stated that their conference organizing people will be moving over to Informa.
  • Mr. McAvoy of Informa touted the tools that HIMSS will now be able to access–enhanced tools that Informa has developed and amortized over multiple conferences.
  • More to come

A new day for HIMSS in a competitive conference market. Except the link to the conference page at the end of the release,–does not open the conference page but goes to a ‘page not found’. Oops! Hint: it’s misconfigured to include the period in the URL.

Previous coverage: More thoughts 2 August, Informa to acquire 27 June    Follow up 8 Aug, answers to questions:


More thoughts on the pending sale of the HIMSS Global Conference

In the absence of a real announcement, speculation has been everywhere on the not-yet-done deal between HIMSS and Informa. As reported last week [TTA 27 July], HIMSS will be selling the annual Global Conference to Informa PLC, the largest B2B trade show operator on the Planet Earth. There has been no communication as of this writing from HIMSS to members or chapters, nor any announcements in HIMSS Media. The only corporate confirmation came through Informa PLC’s H1 financial report.

From LinkedIn, Tom Foley, who is the head of GenieMD telehealth and also hosts a podcast called The Virtual Shift via HealthcareNOWRadio and Answers Media Network (headed by Roberta Mullin and Carol Flagg, with whom this Editor worked some years back) had two posts on the pending ‘exclusivity to acquire’. In the later post, he addresses the fact that HIMSS has already been booked by most exhibitors as HIMSS, not as a ‘third-party conference’, and asks for market responses. The earlier post is about the ‘announcement’ and is largely the same as his comment on TTA’s original article. Other than these and spinoff posts from other commenters, Other than we Happy Few, LinkedIn posts have been on the QT and very hush-hush on the subject. Interesting as so many on LinkedIn are HIMSS, HLTH, ViVE and other health conference exhibitors and attendees.

Which leads this Editor to turn to the pointed, yeasty HIStalk where their Editors have dug around HIMSS and turned up some interesting things. This Editor encourages Readers to go to the source articles linked below for their analysis. I will add some points and commentary to each, especially on the Form 990s:

  • Monday Morning Update 7/31/23 speculates on HIMSS’ financials reported in their Form 990 as a 501 (c)(6) non-profit. Their last FY filing is for fiscal 2020. Since HIStalk does not, here is the link to that Form 990 2020 in Candid, a public database on non-profits (the former Guidestar and Foundation Center). On the organization page, click on the Form 990 tab for the first 2020 dropdown, which is for their FY starting 1 July 2019 to 30 June 2020. In 2020, HIMSS had total revenue of $28.7 million, a severe drop from 2019 where revenue was over $111.9 million (line 12). Their expenses were over $82.6 million for an operating loss of over $53.9 million. This represents the effects of the cancellation of the 2020 conference, which in 2019 ‘conferences and meetings’ reported $42.8 million in revenue and in 2020 only $1.9 million. Using this information and from Informa’s track record, HIStalk does some calculations on projected sales prices.
  • This Editor also examined the second 2020 dropdown, which is a six-month first-half report from 1 July to 31 December 2020. Revenues rose to $65.1 million with expenses of $42.6 million for an operating profit of $17.9 million. Conference revenue was a tiny $8.7 million but higher than the full year. HIMSS under a joint Health 2.0 banner had a Middle East-based virtual conference in November and HIMSS Media promoted some ‘HIMSS20’ content as digital sessions.
  • News 8/2/23 has reader comments on a HIMSS initiative for vendors called Accelerate, which has apparently been inactive for some time, executive salaries, and speculation on why the delay on the Form 990s.

What remains problematic is HIMSS’ future involvement, if any, in a conference that has been branded as HIMSS for over 50 years and has already been sold into as HIMSS’. How will Informa handle that? Invite HIMSS to sponsor it? Then again, what will be HIMSS’ future as a member-based society without a conference and with a subsidiary, HIMSS Media, that makes money off sponsorships both pre and post and content during the conference? It seems that both buyer and seller would benefit from a shared relationship.

This is a developing story and will be updated.

Informa PLC to acquire HIMSS Global Health Conference and Exhibition (updated)

HIMSS to exit ‘HIMSS’. For more years than most of us care to remember, the five letters have meant more than the association (Healthcare Information and Management Systems Society). It’s been all about the annual conference in (usually) Las Vegas or Orlando. Prime expo booth locations are so prized that usually one member of the team is negotiating and pre-booking the next year at the conference. Thus it came as a major surprise to the industry that HIMSS plans to sell the Global Health Conference to Informa PLC. Transaction cost is undisclosed as it is “exclusivity to acquire” the conference and the deal is not closed. The news was buried in Informa’s half-year financial report (PDF, see page 5 under ‘Market Specialisation: Further depth in Healthcare Technology’ and isn’t even on Informa’s news page as of mid-afternoon EDT 27 July, nor on HIMSS’ website (Ed. note–neither as of mid afternoon 28 July). Hat tip to HIStalk today

It is not known if the deal will affect the upcoming HIMSS23 APAC conference in Jakarta on 18-21 September, nor how it will affect the 2024 Conference in Orlando 11-15 March which is already requesting speaker proposals.

HIMSS the Conference is the largest healthcare conference in the world and except for the off years around the pandemic, attracts on average 35,000 healthcare professionals from more than 90 countries to over 200 educational sessions and 1,200 exhibitors. Informa is a trade show powerhouse as the largest in B2B conferences grouped under Informa Markets, Informa Connect (including life sciences), and Informa Tech. Their recent Tarsus acquisition includes healthcare (Health Connect Partners) and anti-aging & aesthetics (A4M Spring Congress) plus a joint venture, Tahaluf, with the Saudis in the burgeoning Middle East conference market.

What will be left of HIMSS after the conference divestiture? It will be the society itself with a mission of reforming the global health ecosystem through the power of information and technology. The basics are benefits for members around professional development, where the conference originally started, and public policy/advocacy. HIMSS has an extensive series of initiatives such as Accelerate Health and Gravitate Health (list here). Not on the main website is HIMSS Media, which includes Healthcare IT News, Mobihealthnews, Healthcare Finance, and HIMSS TV, though losing the conference reduces a major link to advertisers and cash flow as part of a package and content, plus content syndication, custom webinars, and data/lead generation packages.

There is no mention of any continuance of HIMSS ties to the conference and content at this time, though as mentioned neither HIMSS nor Informa have announced the conference acquisition via the usual press releases–or HIMSS Media. The association with ‘the’ society for IT executives, CIOs, and technology was its ace card for over 50 years. Will HIMSS completely walk away, as CHIME did, bolting to ViVE in 2022, or lend its presence and prestige? Trade Show Executive, FierceHealthcare, Healthcare Innovation

Perhaps, and this is only your Editor’s speculation, the merchandising and lift around the HIMSS Conferences were so labor-intensive that HIMSS lost focus on its mission as a member organization. Their handling of the 2020 conference cancellation mere days before the event then not refunding registration and booth fees until 2021 and 2022 under duress was an unforced error that left a bad taste. Other large conferences such as HLTH and its digital health spinoff ViVE in the past two years have peeled off attendees, exhibitors, and ‘buzz’ in a way that other smaller conferences in the past did not. HIMSS the Conference was increasingly tagged as overly tied to Big Med Device and Big HIT, coming off as ‘stodgy’ and “awkward” post-pandemic. (That wasn’t supposed to happen with buying Health 2.0’s conferences squarely based among digital health innovators, but that was killed off even before the pandemic, as were HIMSS’ regional conferences.) With marketing cutbacks at many companies affecting booths and attendees, needing to pick where to spend your trade show dollars, that this was the time to sell could have been obvious. Informa could very well reinvigorate the conference as something new and different.

This is a developing story and will be updated.

ViVE post-script: VC panel opines in midst of digital health’s new reality (depression?), and extra ViVE from an attendee

Not everything at ViVE this week was fun and music. The organizers included a timely panel discussion with four VCs exploring the crash of digital health funding, enterprises, and whither the fall of the VCs’ favorite bank, Silicon Valley Bank (SVB). It was moderated by MedCityNews‘ editor-in-chief Arundhati Parmar, who published an interview with Zane Burke, late of Livongo and now CEO of Quantum Health, pointedly asking whether Livongo’s sale to Teladoc was a smart one given the troubling post-script [TTA 3 Feb]. The participants — Lee Shapiro, managing partner at 7wireVentures, Emily Melton, managing partner at Threshold Ventures, Richard Mulry, president and CEO of Northwell Holdings, and Ambar Bhattacharyya, managing partner of Maverick Ventures–evidently weren’t given a diet of softballs, either. 

Parmar started with a quote from a recent article in another publication: “The run on SVB was a textbook result of the myopia and egoism that has swallowed the venture capital industry whole.” This refers to the advice that many VCs gave their invested companies–get your money out now. That was the same invested money that the VCs insisted be in SVB, in accounts such as payables and receivables. At least these VCs seemed to realize that now, somewhat obliquely. Shapiro called it a ‘tragedy of the commons’, B-school terminology that refers to too many people using a common resource ruining it because no one is responsible for it. More to the point, he pointed to some in the VC ‘community’ advising their companies to move their money out of SVB, creating the self-fulfilling prophecy of a run on the bank killing it. Melton pointed to social media and everyone rushing to take care of themselves without reflecting on the consequences of their actions.

The next quote and chart that Parmar presented had to do with that Old Devil Profitability in companies that IPO’d. Only two of 17 are profitable and they’ll be a surprise–Privia Health (VBC models for providers), and Progyny (riding the fertility and benefits bubble). Rather abashedly, the panel admitted to valuation frothiness leading to over-valuation, and a new sobriety and realism leading to (drum roll) an emphasis on profitability. Bhattacharyya noted that VCs were pushing growth up until last year. Now, it’s value, ruled by the “Rule of 40” –combined growth rate and profit margin that exceeds 40%, even better cash flow positive, which are tough bars to achieve for all but the most well-positioned (and fortunate) companies. “That’s now the playbook. So we’ve all transitioned to that.” A defensive playbook, in Shapiro’s view. (A close to impossible one that may stifle innovation, in this Editor’s view, though bootstrapped companies have always earned her admiration.)

To that point, Melton, noted that now more than ever, banking institutions like SVB and similar institutions need to work with founders and VCs to bring innovations to market. “One of the things I’m very fearful of is that we get into an environment where people are risked off and retreat right when we need people to be actually leaning in more now than ever.” Larger banks will be happy to take the money–according to Kruze Consulting, an accounting firm that focuses on startups, about half of its clients that recently changed banks moved to JPMorgan Chase–but will a JPM take up ongoing startup risk? 

Does this begin to feel like Catch-22? (Apologies to Joseph Heller) Or health tech back around 2006-2010?  

One comment towards the end hit home for this Editor, having seen it way up close. Too many founders 1) have an idealistic view of the business they started and can’t separate from it, and 2) there’s a time to exit stage left and do something else with your life. One company that may pull it off in its changeover of CEOs is Oscar Health. I’d add that no CEO should be in that seat for more than 5 years, even in well-established, doing-well companies–much less coming close to dying in place as CEO after 25 years as happened recently at one large, publicly traded payer. Very important: every company should have a succession/coverage plan operative from Day 1, because Stuff Happens. The full article in MedCityNews here. Another shorter take, same panel, in Mobihealthnews.

The next chapter for SVB is that after a Federal bailout (and the realization that the SF Federal Reserve was wearing blinders when it came to watchdogging the bank’s health and solvency), it was mostly sold this past week to First Citizens Bank & Trust Company, a regional bank from Raleigh, North Carolina. SVB’s UK holdings were bought much earlier by HSBC. Also up for sale: Leerink Partners, an investment banker for health care and life sciences companies, that was rebranded as SVB Securities. Jeff Leerink, the founder who still heads it, is trying to get it back through a management buyout. WBUR

A more ViVEcious view of the meeting is over at HISTalk, The most substantive sessions this attendee heard were the opening Tuesday by Micky Tripathi, the National Coordinator for HIT at the Office of the National Coordinator (ONC) for Health Information Technology, and a presentation by Shiv Rao (Abridge) and Joon Lee (UPMC) on generative AI. The downside was that most of the Tuesday presentations came off like walking ads, the CHIME track was separate with some members-only, and that exhibitors got little value by staying over Wednesday as the crowd vanished to 20%. Money quote: “ViVE shoots for a vibe of youth, energy, innovation, and fun in its branding, themes, opening remarks, and evening entertainment. Sounds great until you remember that your ticket cost nearly $3,000.” Ouch! That stings! Well, nobody’s perfect. A successful 2023 means that ViVE will be landing in Los Angeles 25-28 February 2024. For many, it’s on to HIMSS23 in a couple of weeks.

Wednesday news roundup: PicnicHealth $60M Series C, can a downturn be good for digital health, Cerebral ran wild, a tart take on HIMSS and where it’s going

PicnicHealth had a bit of one, even in this down market. This company which uses machine learning to build data sets for life sciences by working directly with patients and giving them single-source access to their data raised a $60 million Series C via new investor B Capital Group, with existing investors Felicis Ventures and Amplify Partners. The new funding will be used to build 30 new patient-centered real-world data cohorts. Adam Seabrook, Partner at B Capital Group, will be joining the PicnicHealth board of directors. Their total raise to date is $97 million since 2014 (Crunchbase). The platform was launched in 2020. FierceBiotech, release

Funding news may be a little light nowadays, and if you’re public, you’re looking at double digit share price losses, but couldn’t you guess–the downturn may be good for digital health founders! That’s the view of Big VC General Catalyst’s Hemant Taneja, said at Collision 2022, a Toronto tech conference. Now before you’ve thought the man has totally gone out of his gourd with $5+ gallon gasoline (US), 10% inflation, and rolling blackouts looming on both coasts and the UK, it is true that businesses founded in downturns tend to be tough–my father’s business was founded at the start of the Great Depression. As Mr. Taneja put it, tighter times make for more mission-driven “better founders, better investors and better executives”. Secular trends are in their favor in tech and digital transformation, but there will be another correction coming as the market is over-capitalized. Is it the dot-com boom/bust all over again? Only time will tell, but the crackups are already piling up. FierceHealthcare

Speaking of crackups, Cerebral. A report in the annoyingly paywalled Business Insider tells a tale of Telemental Health Running Wild. Former employees and ~2,000 leaked documents claim that Cerebral had no more than a nodding acquaintance with clinical standards until the Feds stepped in. For starters, they took on patients they should not have, didn’t train their nurse-practitioners and other employees, pushed prescriptions to 95% of patients, disregarded state regulations putting licenses at risk, and generally had more twists than a barrel of pretzels. And this was a company prescribing Schedule 2 drugs that had at peak 210,000 active patients and 4,500 employees.  HISTalk summarizes the article, with our thanks. But it’s par for the course, according to a new JMIR (Journal of Medical Internet Research) study also mentioned that found that “many digital health companies have a low level of clinical robustness and do not make many claims as measured by regulatory filings, clinical trials, and public data shared online.” 

And returning to HISTalk (29 June news), there’s a group of comments from a “HIMSS insider” about how that organization is being managed that long-time observers of this organization will find interesting. Employees thought that HIMSS22 was “awkward”. New and cool conferences HLTH (which initially faltered) and ViVE (which HIMSS didn’t even bother to scout) have taken much of the ‘must attend’ and buzz away from HIMSS. Now this wasn’t supposed to happen with the buy of hipper Health 2.0, to which your Editor was connected–but H2O was HIMSS-ized and effectively killed off even before the pandemic. Regional conferences have disappeared, along with a fair number of employees. HIMSS Analytics is sold. Now this could be all one person’s opinion–but what do you think?

A new event–and not all virtual! HLTH and CHIME to launch ViVE in March 2022.

Does it seem like forever that there’s been a new digital health conference, fully in-person–and not labeled HIMSS? HLTH, a relatively new entrant to the big healthcare event calendar starting in 2018 in Las Vegas, and CHIME, The College of Healthcare Information Management Executives, will launch ViVE on 6-9 March 2022 at a location (TBD) in Miami Beach. They are positioning it as an annual event for digital health leaders innovating across the spectrum of health and care. 

The event will incorporate CHIME’s spring forum, a full plate of networking events and presentations, matchmaking, the ViVE Expo, and a gala. For more information on the event or to register interest as a sponsor or partner, see the ViVE page. Release

(This Editor admits that the thought of a new and in-person conference is exciting. It’s nice to contemplate normality!)

CHIME is a 5,000-member association of C-level and senior healthcare IT leaders across 56 countries. The organization parted from the annual HIMSS event this year in Las Vegas 9-13 August, which will be a hybrid in-person and virtual conference [TTA 4 Feb]. Registration and information on the event have been updated.

The HLTH 2021 next event is in Boston 17-20 October. Like HIMSS, it’s scheduled to be a combination in-person and virtual event. HLTH is more broadly inclusive of healthcare care models and consumer health issues. The in-person portion will be at the Boston Convention & Exhibition Center, located in the Seaport District. 

Deals and news roundup, April Fool’s Edition: SOC Telemed’s $196M acute care telehealth buy, HIMSS takes over SCAN Health, Livongo’s Burke joins Owlet board, CirrusMD text app raises $20M

(We’ve gone bug-eyed for 1 April!)

SOC Telemed ponies up a Spritely $196 million for competitor Access Physicians. The completed combination forms, according to SOC, the largest acute care telemedicine provider in the US serving 1,000 facilities, including over 700 hospitals, across 47 states. The deal is cash and stock. No transitional information other than the CEO of Access Physicians joins the SOC Telemed board. Both companies are in the enterprise acute care telemedicine area, facilitating virtual consults between specialists and to patient bedsides. In its SEC 10-K filing released earlier this week, SOC Telemed reported $59 million in 2020 revenue, up from $66.2 million in 2019. Q4 was a mixed bag: a 95 percent increase in Q4 bookings but a 13 percent revenue decline due to reduced hospital visits. Losses are limited–a net loss per share of $3.55 which is light for like telehealth companies (more in SOC release). For 2021, the projection is $107 to $113 million in pro forma annual revenue. SOC Telemed was one of the first digital health companies to use a SPAC to go public (amazingly) less than one year ago and with substantial assets at formation [TTA 4 Aug 20]. The combined company connects specialists in neurology, psychiatry, critical care, infectious disease, cardiology, maternal-fetal medicine, and nephrology. SOC Telemed release, Mobihealthnews, Becker’s Hospital Review 

HIMSS assumes the operations of SCAN Health, a networking and events company concentrating on best practices in the healthcare supply chain. SCAN was founded by the Canadian government out of the University of Windsor’s Odette School of Business. Their events are held with over 100 partners in North America and Europe, and will transfer to HIMSS effective immediately. SCAN’s founder, Dr. Anne Snowdon, launched the Clinically Integrated Supply Outcomes Model, a supply chain infrastructure strategic roadmap, with HIMSS Analytics in 2019. HIMSS release, Healthcare IT News.

Zane Burke, former CEO of Livongo, has joined another board–this time, with ‘sock’. Mr. Burke joins the board of Owlet, the baby monitoring sock company. In February [TTA 17 Feb], Owlet announced their SPAC estimated at $325 million. The transaction is expected to complete in Q2. Becker’s Health IT

CirrusMD, an on-demand text-first telehealth app, raised $20 million for its Series C led by The Blue Venture Fund and 7wire Ventures. Total funding to date is $47 million. Visits cover primary or urgent care, chronic condition management, women’s health, pediatrics, and behavioral health with text first then connection to a board-certified physician within one minute. Release, Mobihealthnews

Shock news: a very muted HIMSS 2021 set for 9-13 August, Las Vegas

Yes, Virginia, there will be a HIMSS21, of sorts, we think. The news of a HIMSS21 in Las Vegas next August (when it will be 110° in the shade) is like the forecast of rain for this parched-of-business convention city and the parched-of-contact health tech community. The basics, mostly from the FAQ:

  • Registration will open in January (date TBD). If you paid your registration for the canceled 2020 conference, your registration will automatically be carried over to the 2021 conference, with details to come. If you cannot attend, no refunds.
  • Programming, exhibits, and events will be held at the Venetian-Sands Expo Center, Caesars Forum Conference Center, and Wynn 
  • The program and topics are sketched in (see the website dropdowns).
  • Proposals for the education track are closed, but open till mid-January for the optional events.  

Exhibitor registrations and paid badges will be carried over (unless you don’t plan on exhibiting, then again, no refunds). For whatever reason, the exhibit floor will be worthy of a Woman’s Christian Temperance Union (WCTU) convention in Des Moines, based on the published rules:

  • NO SOLICITING OUTSIDE THE CONFINES OF YOUR BOOTH (replicating their capitals, including hotels–what fun is this?)
  • All demos and promo activities must be performed five feet set into your booth space. It’ll get cozy for the small, poor exhibitors in a 10 x 10! In fact, straying outside your booth for anything is apparently prohibited.
  • No megaphones, loudspeakers, or what is quaintly called ‘sideshow’ tactics, for instance, clowns, whistles, or high school marching bands in the aisle. Noise must be less than 75db. If there are speakers, they must face into the booth–and better be small.
  • Tchotchkes must have logos on them, so no running out for brand-name candy needed to fuel a looong floor day
  • You have to stay in your booth during exhibit AND non-exhibit hours. (I guess this means no food, event attendance, bathroom breaks–or scoping out/chatting up the competition, a key activity at any trade show.) And don’t wear lights or signage of any type on your clothes.
  • Speaking of clothes, they’re NOT optional–tops and bottoms required. At all times. Even though it’s HIMSS. And Las Vegas.
  • No cameras or video equipment on the floor. (I guess this means you can’t shoot reference pictures, booths you like, or cute videos to share on your blog, Twitter feed, and LinkedIn. Sounds like a closed shop for HIMSS Media.)
  • Exhibitors must use the official booker (onPeak), or you can lose your badges and booth. No economizing! Rough on the small, poor companies.
  • “Event Participants are expected to behave responsibly and to treat each other – and treat the community – with respect, kindness, and compassion.” If you don’t, you lose Exhibitor Points. (No comment!)

This Editor wonders that with all these restrictions and the mid-summer timing, how many exhibitors will simply walk away from HIMSS21 and its high expense? Or wait till March 2022 in Orlando? After all, 2020 booth expense was in last year’s budget and written off. Is going to HIMSS worth it to you?  Hat tip to HISTalk.

News roundup: docs dim on AI without purpose, ‘medtail’ a mall trend, CVS goes SDH, Kvedar to ATA, Biden ‘moonshot’ shorts out, and Short Takes

Docs not crazy about AI. And Dog Bites Man. In Medscape‘s survey of 1,500 doctors in the US, Europe, and Latin America, they are skeptical (49 percent-US) and uncomfortable (35 percent-Europe, 30 percent-Latin America). Only 20 percent fess up to actually using an AI application, and aren’t crazy about voice tech even at home. Two-thirds are willing to take a look at AI-powered tech if it proves to be better than humans at diagnosis, but only 44 percent actually believe that will happen. FierceHealthcare

This dim view, in the estimation of a chief analytics and information officer in healthcare, Vikas Chowdhry, is not the fault of AI nor of the doctors. There’s a disconnect between the tech and the larger purpose. “Without a national urgency to focus on health instead of medical care, and without scalable patient person-centered reforms, no technology will make a meaningful impact, especially in a hybrid public goods area like health.” The analogy is to power of computing–that somehow when we focused behind a goal, we were able to have multiple moon missions with computing equivalent to a really old smartphone, but now we send out funny cat videos instead of being on Mars. (And this Editor growing up in NJ thought the space program was there to market Tang orange drink.) HIStalk.

Those vacant stores at malls? Fill ’em with healthcare clinics! And go out for Jamba Juice after! CNN finally caught up with the trend, apparent on suburbia’s Boulevards and Main Streets, that clinics can fill those mall spots which have been vacated by retail. No longer confined to ‘medical buildings’, outpatient care is popping up everywhere. In your Editor’s metro area, you see CityMDs next to Walmarts, Northwell Health next to a burger spot, a Kessler Health rehab clinic replacing a dance studio, and so on. The clever name for it is ‘medtail’, and landlords love them because they sign long leases and pay for premium spots, brighten up dim concourses, and perhaps stimulate food court and other shopping traffic. Of course, CVS and Aetna spotted this about years ago in their merger but are working expansion in the other direction with expanding CVS locations and on the healthcare side, testing the addition of social determinants of health (SDH) services via a pilot partnership, Destination: Health with non-profit Unite Us to connect better with community services. This is in addition to previous affordable housing investments and a five-year community health initiative. Forbes, Mobihealthnews

ATA announces Joseph Kvedar, MD, as President-Elect. Dr. Kvedar was previously president in 2004-5 and replaces John Glaser, PhD, Executive Senior Advisor, Cerner. He will remain as Vice President of Connected Health at Partners HealthCare and Professor of Dermatology at Harvard Medical School. A question mark for those of us in the industry is his extensive engagement with October’s Connected Health Conference in Boston, one of the earliest and now a HIMSS event. ATA’s next event is ATA2020 3-5 May 2020 in Phoenix–apparently no Fall Forum this year.

The Biden Cancer Initiative has shut down after two years in operation. This spinoff of the White House-sponsored ‘moonshot’ initiative was founded after the death of Beau Biden, son of Democrat presidential candidate Joe Biden. Both Mr. Biden and wife Jill Biden withdrew due to ethics concerns in April. According to Fortune, the nonprofit had trouble maintaining momentum without their presence. However, the setup invited conflict of interest concerns. The Initiative engaged and was funded by pharmas and other health tech companies, directly for Initiative support but mainly for indirect pledges to fund research. Most of these organizations do business with Federal, state and local governments. Shortly after the formal announcement, Mr. Biden the Candidate announced a rural health plan to expand a federal grant program to include rural telehealth for mental health and specialized services. Politico   But isn’t that already underway with the FCC’s Connected Care Pilot Program, coming to a vote soon? [TTA 20 June]

And…Short Takes

  • Philips Healthcare bought Boston-based patient engagement/management start-up Medumo. Terms not disclosed. CNBC
  • London’s Medopad launched with Royal Wolverhampton NHS Trust (RWT) in a three-year RPM deal. DigitalHealthNews
  • Parks Associates’ Connected Health Summit will be again in San Diego 27-29 August with an outstanding lineup of speakers. More information and registration here.

And in other news, Matt Hancock holds tight to his portfolio as UK Secretary of State for Health and Social Care in the newly formed Government under new PM Boris Johnson. Luckier than the other 50 percent!



News roundup: Phreesia’s IPO, Chiptech enters UK telecare market, PatientsLikeMe goes to UHG, Medopad-Tencent UK Parkinson’s pilot, Oxford VR goes to HK, Cigna Singapore’s telehealth intro, HIMSS exiting Cleveland

Patient check-in tablet Phreesia is preparing for an IPO, filing of its S-1 form this week. The number of shares and pricing is not yet announced. Phreesia, which specializes in patient intake in the office via a rugged PhreesiaPad tablet and software that integrates with major EHRs such as Epic, Cerner, and Allscripts, has survived not only 14 years, but also in New York City. Phreesia has enjoyed a relatively low profile on the health tech scene, yet it has raised close to $100 million through a Series D (Crunchbase) and maintained much the same founding leadership (Chaim Indig, Evan Roberts, Michael Weintraub). Their business includes 1,600 health firms and 70 million patient intakes annually, for $100 million in revenue in its last fiscal year, up 25 percent from previous. Timing of the IPO is not yet forecast. Mobihealthnews, Business Insider.

Coming to the UK and Europe markets are New Zealand’s Chiptech telecare systems. Chiptech has both traditional in-home and mobile monitored PERS, pill dispensers, and a smartphone-based lone worker alert device. According to their website, they are the leading provider of monitored personal alarms in Australasia. Chiptech also announced a new CEO, veteran David Hammond, whose background includes leadership roles at UTC and Chubb. 

In M&A news, UnitedHealth Group bought the contested PatientsLikeMe, which runs an online service that helps patients find people with similar health conditions. PatientsLikeMe had raised $100 million in 2017, selling a majority stake to Shenzhen-based iCarbonX, backed by Chinese giant Tencent. That investment put the company under scrutiny by CFIUS–Committee on Foreign Investment in the United States. CFIUS is especially looking at Chinese investment in companies that deal with sensitive data, trade secrets, and national security–and coming down hard. Companies like Tencent are working with the Chinese government to amass millions of patient records and data points, with no regard for consent, and to build massive medical databases [TTA 17 Apr].

Tencent has multiple strategic investments in data-driven health companies, including an interesting Parkinson’s clinical trial in the UK with London startup Medopad, which developed an app that tests cognitive abilities across a series of tasks and captures it into what’s dubbed the Markerless Motion Capture and Analysis System (MMCAS). It is being tested on about 40 patients at a private mental health clinic in London called (appropriately) Dementech NeurosciencesForbes

Mental health is hot, and Oxford VR, a spinout of Oxford University, is pairing with AXA HK and the Chinese University of Hong Kong (CUHK) to develop treatments for common mental health conditions such as social avoidance, anxiety and depressive symptoms. ‘Yes I Can’ uses virtual reality (VR) sessions over three to six weeks. In the true Chinese model (it’s free, but you don’t control where your data goes), it will also be offered to AXA’s corporate customers as part of their employee benefits services to drive better mental health outcomes in Asia. Mobihealthnews

Elsewhere in Asia-Pacific, Cigna Singapore launched a telemedicine service, Cigna Virtual Clinic, where users can access real-time doctor consults via a mobile app. Cigna is using Doctor Anywhere for the service. Telemedicine in Singapore is supervised by the Singapore Ministry of Health’s Licencing and Adaptation Programme (LEAP), “a regulatory sandbox initiative that allows the safe development of new and innovative healthcare models to be piloted in a controlled environment”. Insurance Business Asia

Back in the US, HIMSS is exiting its 30,000 square foot bricks-and-mortar office in downtown Cleveland’s Global Center for Health Innovation (a/k/a the Medical Mart). The exit will be over the next year. This is after a three-year extension of its lease inked in 2018. According to Crain’s Cleveland Business, their sources “described the move as a shift in strategy by the nonprofit that has gone through a leadership change.”

News roundup: of logos and HIMSS roundups, Rock Health’s Digital Health Consumer Adoption survey, and the millennial/Gen Z walkaway from primary care

HIMSS19 was last week. Onsite reports to this Editor declared it ‘overwhelming’, ‘the place to be’, ‘more of the same’, and ‘stale’. With a range of comments like these, everyone’s HIMSS is different, but HIMSS is well, a place that for most of us in digital health, have to be (or their companies have to be). It is still a major commitment, and if you are small, a place where you might be better off with no display and simply networking your way through. 

HIMSS must be conscious of a certain dowdiness, because HIMSS is ‘reforming’ with a preview of a new logo and graphics here that changes out their Big ’80s curvy lettering and muted colors to hard edges in typefaces and equally hard blues.

Mobihealthnews (a HIMSS company) delves into blockchain (Boehringer Ingelheim and IBM Canada) and Uber Health’s continuing foray into non-emergency medical transport. Dimensional Insight’s blog takes some of the sessions from the data governance and healthcare business intelligence perspective, including the opioid crisis, AI to detect cancer (the link between falling hemoglobin rates and a cancer diagnosis), and pediatric disease registries. And there is the always incisive HISTalk with last Monday Morning’s Update, their 2/14/19 roundup, and Dr Jayne’s Curbside Consult on John Halamka’s world travels, including nascent care coordination in China and interoperability in Australia.

Rock Health’s survey of consumer attitudes towards digital health adoption leads with these insights:

  • Wearable use is shifting away from fitness toward managing health conditions
    • There was a 10% increase in use of wearables to manage health, corresponding to a 10% decline in physical activity tracking
  • Telemedicine adoption is climbing, with urban consumers more than twice as likely to use live video telemedicine than rural consumers
    • Paradoxical but true, in terms of adoption of at least one form, it was 67 percent for rural residents and 80 percent for urban residents.
  • Highly trusted entities like physicians and health plans lost credibility in 2018—consumers were less willing to share data with them than they were in 2017. There’s an increasing distrust of ‘big tech’ and confidence in their ability to keep private data private–a wise takeaway given the Cambridge Analytica and Facebook scandals.

More acceptance of healthcare tools, less intermediation–and not trusting that data is secure spells trouble down the road unless these issues are addressed. Rock Health surveyed 4,000 respondents of US adults age 18 and over.

They’re not trad, dad. Accenture’s survey (released at HIMSS) also tracks the rejection of intermediation and gatekeepers when it comes to millennials and Gen Z in choosing non-traditional modes of healthcare, such as retail clinics, virtual and digital services. They are two to three times more likely than boomers to dislike in-person care; over half use mobile apps to manage health and use virtual nurses to monitor health and vital signs. Over 40 percent prefer providers with strong digital capabilities. Also Mobihealthnews 

Robots’ largely positive, somewhat equivocal role in therapy for children with autism and cerebral palsy (HIMSS)

A Georgia Tech study presented at this week’s HIMSS19 conference presented findings of an eight-week study of children with specific neurological conditions who were assisted by robotics in specific therapies for movement and cognition. The study began with the simple attraction of children to robots. Robots also don’t have the negative connotations of therapists, and in fact, based on the studies cited, robots  are more trusted than humans by both adults and children.

For a child, robots ‘repetitive and predictable interactions’ can be reassuring (like Pepper in a Belgium hospital two years ago) , along with ‘gamified’ therapies and child-robot direct interaction as well as therapist-guided. The study’s approaches took several forms:

  • Virtual reality therapy games
  • Guided physiotherapy in movement–gross and fine motor skills
  • Cognitive therapy to improve attention span
  • ‘Gamified’ therapy
  • Robot therapy coaching
  • Tablet-based games

At the start of the study, physical and cognitive baselines were taken and retested at four weeks. By eight weeks the difference in movement parameters between normally developing children and those with cerebral palsy had largely equalized. In a second study, when the robots were withdrawn, their improvement decreased, but not back to baseline. The researchers’ concern was of course, dependency on the robots for therapy on a long term basis. HIMSS presentation by Ayanna Howard, professor of robotics at Georgia Tech is currently online–view quickly as usually they are withdrawn shortly after HIMSS is over.  Mobihealthnews

A preview of this week’s Connected Health Conference in Boston

[grow_thumb image=”” thumb_width=”150″ /]This week’s Connected Health Conference at Boston’s Seaport World Trade Center is themed around ‘Balancing Technology and the Human Element’, and over the three days of the conference the organizers will be tackling subjects such as social determinants of health, research, rapid prototyping of devices, and the very timely subject of the Apple Watch‘s ‘fall call lite’. This year day 1 on Wednesday 17 October is an ‘Immersion Day’ with separate registration (and separately priced) mini-conferences sponsored by The Society for Participatory Medicine, ECHAlliance, the VOICE Health Summit, and PCHAlliance’s ‘deep dives’ including one from Parks Associates. Days 2 and 3 on Thursday and Friday 18-19 October are fairly standard conference fare on a variety of stages and of course with a small exhibitor floor, ending after 3pm on Friday (and a good way to segue into a fall weekend in Boston).

CHC is organized by PCHAlliance, a non-profit formed by HIMSS, and incorporates the Boston conference previously organized by Partners HealthCare. Mobihealthnews offers a preview in an interview with  Senior Director of Connected Health Innovation at Partners HealthCare Kamal Jethwani, and Tufts University School of Medicine Associate Professor and Recycle Health founder Lisa Gualtieri. There is still time to register here (though hotel rooms are, as usual, scarce). (Unfortunately, Editor Donna can’t attend as she did in previous years due to other commitments.)

More events for your autumnal calendar, from Israel to Ireland to Santa Clara to NYC! (updated)

Startup of the Year, Mediterranean Towers, Ganei Tikva, Israel, Sunday 3 September, 6-8pm (Past–but there’s a winner!)

Mediterranean Towers Ventures, the investment subsidiary of the largest retirement living community in Israel, is sponsoring this competition featuring five finalists:

1. Facense – Facense Ltd. develops smartglasses with tiny thermal and CMOS sensors to measure vital signs unobtrusively and continuously, with one application being to detect a person having a stroke.
2. MyTView – My-TView’s proprietary technology enables dynamic modification and enhancement of real-time broadcasts, whilst numbing the “noise”.
3. – transforming existing non-medical data into an effective large-scale clinical prevention tool; a remote seamless population monitoring technology encourages independent and active lifestyle.
4. GaitBetter – A universal, VR based, expert system add-on transforming any treadmill to an operator independent motor cognitive training solution
5. TuneFork–a software audio personalization technology that gives you the optimal hearing experience anywhere you go. 

And there’s a winner–TuneFork. Their award includes free participation at the Aging2.0 Optimize Conference in San Francisco (14-15 Nov), professional mentoring by Mediterranean Towers Ventures, and the opportunity to be evaluated for investment. 

Hat tip to Dov Sugarman, co-CEO of MTV.

Health 2.0’s 12th Annual Fall Conference, Santa Clara, California, 16-18 September

This year’s conference, despite the corporate hand of HIMSS, may be as breezy as ever with a continued concentration on early stage companies and speakers like Lisa Suennen, late of GE Ventures, Sarah Krug of the Society for Participatory Medicine, and Sean Lane of Olive talking about AI. Register here, and dig deep for the ticket.

UK Health Show, ExCel, London, 25-26 September

A major and mostly free event for providers, NHS, local authorities, independent sector, and primary care that addresses system transformation and integration through digital technology, commissioning, procurement and cybersecurity. More information on their website here. Registration here (free full passes for providers and public sector, floor passes for vendors and commercial organizations)

Brain Health, Aging 2.0 Los Angeles, Thursday 27 September, 6-8pm

Not many details on this other than it will be in West LA and the topic will be Brain Health and Artificial Intelligence. The keynote speaker will be Adam C. Lichtl, Ph.D., CEO of Delta Brain, Inc. More information to come and RSVP for now on Eventbrite.

Inspiring Innovation in Digital Health: The UK Telehealthcare Marketplace Northern Ireland. La Mon Hotel and Country Club, Castlereagh, Belfast, Wednesday 3 October 10am – 3pm

UK Telehealthcare is traveling to Northern Ireland for their first event in the beautiful Lisburn & Castlereagh area, one of Northern Ireland’s fastest growing regions. It will be a showcase for digital technology to help people to stay safely and independently in their own homes for longer. A ‘don’t miss’. See the attached PDF for details including masterclass speakers and exhibitors. Free registration here. Hat tip to Gerry Allmark, UK Telehealthcare’s managing director.

Additional UK Telehealthcare events into December are listed on their main page which is linked through their advert on right or here. They are partnering with the UK Health Show (above) and exhibiting in the UK TECS Hub in the assistive technology area (blocks F98, F100, F92, F94).

MedStartr Momentum 2018, PwC Madison Avenue, NYC, Thursday-Friday 29-30 November

Put this on your calendars for after Thanksgiving. 20 startups, 9 Momentum Talks, 4 stakeholder panels, and Mainstream 2019. More here on Eventbrite and as in previous years, watch this website. TTA is a media partner and supporter of Momentum,  MedStartr and Health 2.0 NYC.