Telehealth’s primary care wars heat up: Teladoc’s Primary360, Babylon 360

The new fronts in the Telehealth Wars continue to expand, with this week Teladoc announcing that their virtual primary care offering, Primary360, is now available for health plans, employers, and other payers. Babylon Health, in its push into the US market and their upcoming SPAC, also announced that their similar program, Babylon 360, is also being offered to health plans.

Both these services connect the patient users with an assigned doctor and primary care team for ongoing care. They emphasize building a relationship with a doctor and team, not just a random selection previously typical of telehealth. Both Teladoc and Babylon are fully virtual in exams and checkups, sending equipment where needed, ordering lab tests and prescriptions, and accepting your prior health records, plus have 24/7 coverage for urgent situations. Babylon’s service also offers a symptom checker and connection to social determinants of health (SDOH) community services.

It’s obvious that the payer-provider walls are coming down in all directions–telehealth is one more. Babylon, as we noted earlier, acquired two California-based practice groups. Payers like lower-cost, more convenient visits, and after a fractious start, have for some time. Many of the insurtechs either have close relationships with providers or have bought practices (Bright Health’s NeueHealth)–copying the Optums which have affiliations with or ownership of practices all over the US. It’s also another pressure on primary care practices around reimbursement. Often the answer is to either sell out or enter into value-based care arrangements.

For the patient/member, there’s the benefit of convenient care, and a relationship with a team, albeit not with an in-person option right now–if these services are consistent in their promise and steady in their physician/clinician groups. Mobihealthnews (Teladoc)

Higi and Interpreta’s data mix partnership–questions on consent, data security

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/Interpreta-Higi.jpg” thumb_width=”150″ /]Higi (also higi), which has placed health monitoring kiosks in over 11,000 US retail locations and a 5.5 million signup base, and data cruncher Interpreta announced that they are partnering to blend Higi’s vital signs data with Interpreta’s claims, clinical and genomics data analytics. Based on Mobihealthnews’ article and the joint release, an individual’s health information taken at higi retail stations will be “prioritized within Interpreta in real time”. They also claim that for the first time, insurance payers and providers will be able to leverage biometrics data, clinical, claims and additional genomic information a person may obtain from genetic testing services into a ‘personalized care roadmap’ that closes gaps in care. This is positioned as a big advance in population health and it all sounds great.

Perhaps not so great are the details. What about consent and data security? Aside from absolutely no mention of patient consent and HIPAA compliance in the above news, this Editor suspects that past, current and future Higi users may not be made aware that their vital signs data recorded with Higi will be 1) sent into a non-Higi database and 2) integrated with other information that appears in Interpreta’s database. How is this being done? Is consent obtained? What then happens? Is it used on an identified or de-identified basis? Where is it going? Who is doing what with it? Can it be sold, as 23andme’s genomic information is (with consent, but still…)? “Interpreta works in the realm of precision medicine, continuously interpreting and synchronizing clinical and genomics data in real time to create a personalized roadmap to enable the orchestration of timely care.” but they do this for providers and health plans who are then responsible for privacy and data integrity. Consent for Higi to keep a record of your blood pressure when you drop into your local RiteAid or ShopRite is not consent for Interpreta to use or manipulate it. These questions should have been addressed in the release or an accompanying fact sheet. We welcome a response from either Higi or Interpreta.

And one last and exceedingly ‘gimlety’ observation by this Editor: kiosks get hacked, and here we have not a price to a McDonald’s meal but a portal to deep PHI. Here’s a two-part article in an industry publication, Kiosk Marketplace, if you are skeptical. Part 1, Part 2 

A ‘Game of Thrones’ analogy to potential health insurer mergers

The Wall Street Journal has likened the merger action pending among America’s largest insurers to the series ‘Game of Thrones’, said thrones occupied by Aetna, Cigna, Humana, UnitedHealthcare and Anthem. These more aptly remind this Editor of the final stages of airline deregulation, except that none are in a non-medieval bankruptcy court. Their actions reflects the payers’ urgent concerns that now is the time to reinforce a national presence, that revenues in a Obamacare environment (well, we’ll see the effect of that US Supreme Court subsidy decision due imminently) can do nothing but go down and that Medicare Advantage, commercial accounts, health system relationships (ACOs) and health IT systems are the place to be. What is missing: the fate of those independent, state and regional Blue Cross-Blue Shield (collectively, the ‘Blues’) which are not part of Anthem, many of which are ‘non-profit’ (note the quotes); the positive effect of competition on pricing and a fair consideration of the negative effects of monopoly. Ah, but there are no flung axes, regicide or poisonings to be found here. The real theme of ‘Game of Thrones’ is the effect of the powerful on the powerless (we the insured), which the WSJ writer doesn’t address…..Insurers Playing a Game of Thrones (if you hit a paywall, search on the title)

What’s the big thing behind the Cognizant acquisition of TriZetto?

The $2.7 billion acquisition of HIT payer-provider services company TriZetto by IT/BPO outsourcer Cognizant indicates the value that large, largely offshored companies are seeing in health data. According to Fortune, “The combined company has more than $3 billion in healthcare revenue, as well as about $1.5 billion of potential revenue synergies over the next five years from which Cognizant can cull further gains.” Cognizant’s healthcare and life sciences sector is about 26 percent of their $8.84 billion total annual revenue, but what they haven’t had is the provider-payer software and TriZetto’s IP.

So why the big number (which exits the investors quite nicely) which nearly equals the value of the combined companies in healthcare? The trend this Editor has spotted (more…)