Midweek roundup: Transcarent closes Accolade; Walgreens beats Street; New Mountain Capital’s Office Ally buy-in; Neuralink Blindsight human trial coming up; PM Keir Starmer touts NHS data research; FTC’s PBM litigation break

Transcarent closes Accolade buy, changes its game. Transcarent’s $621 million acquisition of Accolade was wrapped up in record time (two months from announcement). This takes the Nasdaq-listed Accolade private and rewards its former shareholders with $7.03 in cash. For a stock that peaked in late December 2020 into January 2021 above $59.00, and within the past year was above $9.00, this was salvage not profit except for speculators. The combined company in corporate care management now has 20 million members and more than 1,700 employer and health plan clients.

Notably, and very much in keeping with Glen Tullman’s M.O., the lead in their release is a new and rather generic marketing statement: “one place for health and care”. Much space is devoted to combinations: Transcarent’s generative AI WayFinding with Accolade’s True Health Actions member database to deliver clinical guidance to members. Transcarent also is promoting its generative AI as reducing the administrative burden for clinicians. The combined company is merging executive teams and much of its software. But the reality is combining two companies with clearly opposing care management products: Transcarent with a cost-saving, software-based, risk pricing model for self-insured employers, Accolade with a traditional human-based per member per month service model incorporating corporate care navigators and benefits consultants. Neither Accolade CEO Rajeev Singh, nor other members of top management whose shares fully vested (Stephen Barnes, Robert Cavanaugh, and Richard Eskew), are not listed in the new management lineup, though earlier information indicated that retention bonuses were offered. CNBC, Mobihealthnews  Also TTA 19 Feb reviewing MedCityNews’ Arundhati Parmar’s take on the combo and updated background TTA 21 Feb.

Walgreens beats Street analyst expectations on revenue, narrows losses. Winding up its public financial reports before the Sycamore Partners acquisition is finalized, Walgreens reported on Tuesday their fiscal Q2. Revenue was up 4% versus prior year to $38.6 billion. Losses were reduced to $2.9 billion versus prior year’s $5.9 billion loss. Per share losses were $3.30 versus $6.85. The year-ago loss included a $12.4 billion non-cash impairment charge related to VillageMD goodwill, which resulted in a $5.8 billion charge attributable to WBA, net of tax and non-controlling interest, and a $455 million non-cash impairment charge related to certain long-lived assets in the U.S. Retail Pharmacy segment. Operating cash flow in the current quarter was negatively impacted by $969 million of legal payments primarily related to PWN/Everly Health [$595 million, TTA 26 Feb] and multiple opioid-related settlements. WBA also withdrew 2025 financial guidance with the sale pending by end of year.  Release, Healthcare Dive

VC New Mountain Capital makes investment in Office Ally. The NMC “strategic growth investment” in the practice management/payment clearinghouse/EHR company is alongside Francisco Partners, which will also reinvest alongside management. The investment amount is not disclosed. Vancouver, Washington-based Office Ally enables the exchange of more than 950 million transactions and works with 80,000 healthcare organizations. For the $55 billion in assets NMC, this was evidently a better investment than their quickly terminated bid for 23andMe. Release

Neuralink’s next move–overcoming blindness. The Elon Musk-backed brain-computer interface (BCI) company announced at a Wisconsin town hall streamed on YouTube that its Blindsight implant will be tested in humans by the end of 2025. “Neuralink has had in monkeys a working device we call Blindsight,” Musk said. “It has been working well, and the monkeys are healthy for a few years now.” (The video clip is at 6:15 in this independently produced Neura Pod video, credit to Ryan Tanaka who follows Neuralink). The Blindsight implant works to restore vision in individuals who have lost sight and even their eyes or optic nerves by stimulating the visual cortex. The implant received FDA Breakthrough Device designation last September. Ironically, reviewers of Elon Musk’s Neuralink project and other brain-computer interface companies were among the 20 fired at FDA’s Office of Neurological and Physical Medicine Devices [TTA 21 Feb]. Mobihealthnews

Short takes:

NHS being ‘turbocharged’ by PM as medical research center. Prime Minister Keir Starmer took the lead on this, not the NHS, in announcing the creation of a new health data research service based on NHS data. The intent is to make all NHS data accessible through a secure single access point for national-scale data sets. The UK government and the Wellcome Trust will invest up to £600 million. This is part of the government’s Plan for Change to set up a modern industrial strategy, unlocking the potential of the Oxford‑Cambridge growth corridor, and “pro-growth measures to build a strong, resilient economy with more well-paid jobs”.  Gov.uk release

A longish break for the major pharmacy benefit management (PBM) companies. The Federal Trade Commission (FTC) announced that it was staying its insulin pricing litigation against the three major PBMs: Caremark (CVS), Express Scripts (Cigna), and Optum Rx (UnitedHealth Group). The long-running action initiated last year by the now-departed FTC chair Lina Khan ran into FTC problems with the change of administrations. First, there are not enough commissioners at present to try the case, with the firing last month of two Democrat commissioners. Republican Melissa Holyoak recused herself. The new FTC chair, Andrew Ferguson, initially recused himself since he, while Virginia solicitor general, had advised the state’s attorney general on filing an amicus brief in a class action case against PBMs. He unrecused himself on 3 April (X statement) so that the case can continue when the FTC has enough commissioners. The PBMs countersued in November. The stay is 105 days followed by evidentiary hearings 225 days later, meaning that next February is the earliest the case can resume. It’s a break for their parent healthcare companies’ share prices, which have been weighed down by the FTC action. FierceHealthcare, Healthcare Dive

One step further towards smartphone-based health apps becoming autonomous

It’s my contention that telehealth, or whatever it is called then, will only start to have a really significant impact on reducing the burden on caregivers when the technology begins to move from decision support to decision taking; only then will clinicians be able to disengage from needing to be involved in every decision regarding a patient’s treatment and focus on those decisions requiring significant skill and judgement. Sure there are all sorts of genuine hurdles in the way like ensuring that the decision-making process is not compromised by other genuine – or rogue – processes taking place on whatever the smartphones is called in the future that is processing and transmitting information, and there have been several recent warnings on malicious hacking of medical devices, so it won’t be happening any time soon. However, given the way so many medical processes that began with manual involvement have moved steadily towards automation, from ECG to Point-Of-Care-Testing, hopefully one day these problems will be solved.

One pointer, reported in iMedicalApps, is three trials currently underway using smartphones to control artificial pancreases to manage diabetes. The smartphones in this case are completely locked down and are only used for the decision-taking process around closed-loop insulin delivery. Nevertheless it’s a step.