Signify Health bidding war ensues, waged by Amazon, UnitedHealth Group, CVS, Option Care Health

What a difference less than two weeks makes. We noted on 11 August that in-home health and value-based provider services company Signify Health was up for sale in an unusual auction, with CVS Health the first disclosed bidder. Yesterday, three more companies jumped into the mix, UnitedHealth Group (the 9,000 elephant of US health), Amazon (with One Medical still pending), and little-known Option Care Health, a public (Nasdaq: OPCH) home infusion care company.

Reports in the Wall Street Journal (paywalled) indicate Signify’s value in the auction may top $8 billion. Bids are due around Labor Day. The board will be meeting next Monday to discuss the bids to date. Signify’s current value is about $5 billion.

The share price closed today just above $27, a major rise from last week’s close of $21 (Yahoo Finance).

The UHG bid is above $30, with Amazon close by, according to Bloomberg News sources. The CVS bid is not known. A buy by Amazon would put the company in Instant Major Healthcare Player territory. This Editor believes that with UHG and CVS, antitrust may factor in, especially considering Signify’s recent ownership of the ACO MSO Caravan Health.  

Option Care may not be well known, but it has impressive backing from Goldman Sachs and has been profitable. Their interest is Signify’s home health network and access to providers through Caravan. Another backer, Walgreens Boots Alliance, just sold 11 million shares on the secondary market, reducing its holdings from 20.5 percent to approximately 14.4 percent.

There’s no bar, of course, to the board ending the auction at any time and awarding the company. Healthcare Finance, FierceHealthcare

Midweek heat wave roundup: GE Healthcare’s new name, hospital-to-home health trending big, over 2 million patient records hacked

GE’s breakup into three public companies, announced last November [TTA 12 Nov 21], has been formalized with brand names. No surprise, the healthcare business has but a teeny tiny change to GE HealthCare (logo left) and after the spinoff will be trading sometime in early 2023 under GEHC on Nasdaq because “GE HealthCare will benefit from the exchange’s profile and track record as a market for innovative, technology-led public companies, particularly in the healthcare sector. The heritage ‘meatball’ (as we called it in marketing internally, but formally the Monogram) will be retained but the color will change from poison green to “compassion purple” to reflect more humanity and warmth and achieve greater distinction”. The hardest hit part of GE, the energy businesses, will be spun off as GE Vernova and key color an ‘evergreen’. What is left will be GE Aerospace, retaining its name and change its color to an ‘upper atmosphere’ blue that is almost black. Outer space, anyone? GE release, interview on YouTube

Au courant is hospital-to-home (H2H) and home health, digitally enabled mais bien sûr.

  • Mass General Brigham (MGB) is reportedly expanding its current 25-bed program to 200 in the next 2.5 years. Since 2016, MGB has treated nearly 1,800 H2H patients. By end of 2023, they plan 90 hospital-at-home beds managed across Massachusetts General Hospital, Brigham and Women’s Hospital, Newton-Wellesley Hospital, and Salem Hospital. Their new head for home-based care will be Heather O’Sullivan, who comes from EVP and chief clinical innovation officer spots at Kindred at Home, acquired by Humana in 2021. FierceHealthcare
  • Out in rural Wisconsin, Marshfield Clinic is rolling out a H2H program with DispatchHealth, to coordinate medical care for injuries and illnesses including viral infections, COPD exacerbations, congestive heart failure, and more. The goal is to reduce non-emergency ED visits. DispatchHealth can also perform services such as onsite diagnostics, mobile imaging, and CLIA-certified labs for kidney function, electrolytes, and urinalysis. In March 2021, they closed a $200 million Series D bringing their funding to unicorn level. HealthcareITNews
  • UHG’s Optum has moved closer on its $5.5 billion acquisition of LHC Group home health and hospice [TTA 31 Mar] with shareholder approval on 21 June. Once closed later this year, LHC will be integrated into Optum Health. LHC operates in 37 states and the District of Columbia, employing about 30,000 individuals. Home Health Care News, Becker’s

And what would a week with a heat wave that melts runways at RAF Brize Norton and Luton be without a couple of big data breaches to heat up things? Stolen: an iPad chock full of 75,000 Kaiser Permanente patients’ PHI from Kaiser’s Los Angeles Medical Center’s COVID-19 testing center. While the information on the iPad included first and last names, dates of birth, medical record numbers, and dates and location of service (but not SSN or financial information), Kaiser was able to remotely erase the data. At this point, there is no evidence of theft or misuse. NBC Los Angeles, Becker’s   An even larger breach of 2 million records came via a February hack attack on health provider debt collector Professional Finance Company (PFC). Hackers got into PFC’s computers and accessed patient names, addresses, SSN, health insurance, and medical treatment data. Among the 650 client companies affected were Banner Health and Nevada physician network Renown Health. Healthcare Dive

UnitedHealth Group makes two jumbo buys for Optum: LHC Group home health for $5B, Refresh Mental Health

In two jumbo acquisitions that further diversify UnitedHealth Group (UHG)’s Optum into the hot sectors of home and mental health (and are bright spots of this so-far somewhat dim M&A year), UHG is acquiring LHC Group, a major home health and hospice provider, for $5.4 billion or $170 per share. After the buy closes in second half 2022, after the usual regulatory approvals, UHG will put LHC under Optum Health to integrate their services into their provider network and health plans, especially Medicare Advantage where home health utilization is part of value-based care and costs are increasingly scrutinized. LHG serves 960 locations in 37 states, with 30,000 employees and revenue of $2.2 billion last year. The management team based in Louisiana will be coming over to Optum Health. Interestingly, co-founders Keith and Ginger Myers will personally invest $10 million in UHG following the acquisition close. FierceHealthcareHealthcare DiveLHC release

Little noted–through LHC, Optum is acquiring Imperium Health, a good-sized ACO, population health, and management services company. It’s another fit as Optum is a major physician group owner, many of whom are also in ACOs. LHC acquired Imperium in 2018. According to their website, Imperium now manages 16 ACOs and is in partnership with a large ACO group. 

Also coming Optum’s way is Refresh Mental Health which owns and operates US mental health practices with specialized programs in psychiatry and substance abuse treatment. Optum is acquiring it from private equity firm Kelso & Company. Terms were not disclosed, but Kelso bought Refresh in December 2020 at a valuation of around $700 million with earnings of about $40 million. Refresh has 300 practice locations in 37 states. FierceHealthcare, AxiosPro (which broke and confirmed the story).

Meanwhile, UHG will be slugging it out this summer to convince a US District Court judge that their super-jumbo Change Healthcare acquisition isn’t anti-competitive in about a dozen ways, as the Department of Justice lawsuit maintains. TTA 23 March

CareCentrix files ‘corporate espionage’ on trade secrets lawsuit against Signify Health, former employee

Usually, laundry like this is not aired or dried in public, but it’s on the line nevertheless in a lawsuit. CareCentrix, a post-acute care/transitions of care management company, has sued in US Federal Court for the District of Delaware both Signify Health, a diversified home care company overlapping the same line of business, and CareCentrix’s former general manager, VP post-acute care Marcus Lanznar.  Initial charges were filed on 23 December and motions are piling up fast based on what is listed (paywalled, unfortunately) on PacerMonitor.

The Federal charge is covered under the Defend Trade Secrets Act of 2016 (DTSA), Cause 18:1836(a) Injunction against Misappropriation of Trade Secrets. The basics are that Mr. Lanznar was a senior executive of CareCentrix, had access to proprietary information, and had a restrictive covenant that would not allow him to go to a competitor for nine months. Yet he was engaged in interviews starting in July 2020, by August-September was having regular meetings with his counterpart, chief product officer Peter Boumenot, and passed CareCentrix information not only to his personal email but also to Signify into October, when Mr. Lanznar resigned. He joined Signify Health in November 2020 and is listed on LinkedIn as SVP product, though not on their management page. 

The lawsuit claims that Signify “targeted, recruited, and hired former CareCentrix executive Marcus Lanznar in a covert scheme that succeeded in providing access to CareCentrix’s confidential information and trade secrets” and also was aware of the conflict presented by the restrictive covenant. It seeks to prevent Mr. Lanznar and Signify Health from using its trade secrets and to award it damages and attorneys’ fees. 

This is a David versus Goliath matchup. Signify Health in February had a highly successful IPO gaining over $560 million and is valued with a market cap of over $7 bn. CareCentrix to date is most definitely the David in this scenario in terms of size, having raised all private equity funding via Summit Partners starting in 2011. However, it has made two acquisitions of its own recently: Vesta Healthcare at $30 million and Turnkey Health for an undisclosed amount (Crunchbase). The stakes are piled high in this hot segment of healthcare. 

There are a number of high-powered law firms dueling in this lawsuit, which also includes CareCentrix’s parent, NDES Holdings. Note: this article is based on both reporting in Healthcare IT News, which initially filed the story, and FierceHealthcare’s close on follow-up.

Funding update, 4 March: big Series Ds for new unicorn Dispatch Health and Tyto Care; USDA’s $42M for rural telehealth; UK’s Perfect Ward hospital inspection app secures £4m

Once upon a time for health tech companies, Series D funding and unicorn status were rare, especially when the tech relates to the under-the-radar, formerly unsexy area of home health. 

  • DispatchHealth, an in-home mobile care provider based in Denver, just closed a $200 million Series D led by Tiger Global with additional participation from Alta Partners, Echo Health Ventures, Humana, Oak HC/FT, and Questa Capital. This comes less than a year after a $135.8 million Series C led by Optum Ventures, The new total of $417 million in funding brings its valuation to a unicorn level of $1.7 bn. DispatchHealth is in the desirable, high potential cost-saving areas of care that replaces ER visits or hospital stays. The platform integrates in-home care services booked through a call, their app, or online by patients, care providers, payers, EMS, senior living, and health systems. The objectives of care are to substitute for ER visits, hospital stays, and to coordinate ancillary services. Currently serving 19 markets across 12 states with care to more than 170,000 patients in 2020, the new funding will be used for expansion to 100 national markets. DispatchHealth recently announced partnering with Humana for advanced hospital-level care for their Medicare Advantage members in several cities. Release, FierceHealthcare
  • More on the health tech side is Tyto Care’s remote diagnostic exam platform. Today they are announcing an additional raise of $50 million, doubling the earlier Series D and now totaling $100 million. Leading the extension is Insight Partners, with participation by Tiger Global (see DispatchHealth), Qumra Capital, Qualcomm Ventures LLC, Olive Tree Ventures, and Shenzhen Capital Group Company. Tyto’s funding is now $155 million and claims a doubling of its valuation. Release.

The US Department of Agriculture (USDA) is surprisingly now an investor in rural telehealth, in part courtesy of the CARES Act from March 2020. (Yes, there were considerable funds left over from that $2.2 trillion pandemic relief bill and now some of them are being used.) USDA is funding projects with a total of $42.3 million, including $24 million from the CARES Act, to improve infrastructure for telemedicine and distance learning infrastructure. Approved to go are 86 projects through the Distance Learning and Telemedicine grant program, to help rural education and healthcare organizations remotely reach students, patients, and outside expertise. USDA’s study found that due to population health, lack of insurance, and lower access to health facilities, there are higher rates of COVID-19 related deaths in rural areas. Healthcare IT News

A UK company that’s in an unusual area of health tech is Perfect Ward, which is designed to put on a laptop and mobile app the complicated process of health inspections of hospitals, care homes, and other health and social care organizations in the UK and internationally. Their £4 million round comes from Octopus Investments (Octopus Group). Current clients include King’s College, Barts Health, The Royal Free and London Ambulance Service. Release (Business Cloud)

The biggest care gap: the fear of going home after discharge

Roy Lilley’s NHS Managers.net newsletter is always interesting and worth subscribing to, but this week’s issue had a special resonance. Many of us have had to ‘manage’ a situation when you or a family member comes home after an illness, accident, or even minor injury. The actions you took for granted are now difficult, painful, or simply cannot be done. Climbing stairs, making a bed, lifting a full pot, even getting on a coat or jacket or tucking in a shirt are just a few. These have special resonance for those of us who have a few ‘cycles’ on us (as aviation terms a takeoff and landing), even if mentally we’re about 35 (!) Will we ever be quite right again? What happens when the home help goes home, or you’re by yourself?

Of interest to American readers is that the British Red Cross is pivoting to fill the care gap of discharge to home. The BRC has a long history of working with the NHS, which was a surprise to this Editor, as the American Red Cross’ emphasis is on disaster relief (of which we have aplenty). Home to the unknown: Getting hospital discharge right is their umbrella report with briefings for England, Scotland, and Northern Ireland. The BRC provides ambulance support, helps people get home from hospital, carries out home assessments and supports older and vulnerable people to live independently at home. As Mr. Lilley put it, referring to the traditional Red Cross mission:

Refugees? About 900,000 people used to get care and support from local council services. The eligibility criteria have been raised, now they get no help. They are refugees in our care system.

On a different note, this issue’s sidebar contains a link to a short article about the scientific pioneer Marie Curie and a few tidbits about anti-inflammatory drugs being used to treat depression, tick-borne diseases spreading in the UK, and medtech fighting breast cancer 10 ways. 

Deloitte’s consumer view of technology acceptance in home health

The Deloitte Center for Health Solutions (DCHS), the research division of Deloitte LLP’s Life Sciences and Health Care practice, conducted six focus groups late last year to gauge the acceptance of technology in home health. They tested two main home health scenarios among 42 younger (<44) and older (45-64) adults, both drawn from healthy and chronic condition patients and with a mix of demographics.

In this qualitative study, the two scenarios tested were: technology that would help manage chronic conditions and tech to promote healthy living. The first scenario gives a very advanced vision of chronic care management that involves telehealth, telemedicine and residential monitoring in the management of chronic conditions (diabetes and CHF). The second involves lifestyle factors including eating, activity and exercise management and managing travel.

Some findings in the report summarized and linked for download here, including implications for companies:

  • Overall they were open to and optimistic about using technology to enable better home care of older adults who require it–including embedded sensors.
  • ‘Smart home’ has appeal, but there is a preference for the less intrusive (stove burner/cooking range sensors, fall detectors) and resistance to perceived invasions of privacy (sleep, bathroom and activity monitoring).
  • They understood the balance of reward and risk in consideration of broad categories of nutrition, physical activity, prevention, and dealing with an acute episode (see quadrant below, click to enlarge)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/us-lshc-hcc-march1-my-take-p1.png” thumb_width=”200″ /]

Center Director Harry Greenspun, MD’s in his Health Care Current blog notes that TECS has the capability of providing services formerly provided only in a doctor’s office or hospital in the home, but “One question remains, “How quickly will consumers adapt and accept new technologies that bring care into their home?”–then answers his own question.

All of these innovations have given us a level of insight and capability we could not have imagined even a few years ago. At the same time, each raises privacy concerns.

So why do we do it? Because we get something out of it.