Funding/new business roundup: General Catalyst’s HATco ‘health assurance’ venture and $6B portfolio merger, Brightside Health expands, Diana Health’s $34M, Headway’s $125M, Main Street Health’s $315M

October 10, 2023 | by

With HLTH 2023 this week in Las Vegas, there’s the usual deluge of investment and ‘big news’ announcements, both before and during the conference.

HLTH’s Biggest and Somewhat Mystifying News (so far) is that Big Investor General Catalyst now is getting directly into the healthcare transformation business with HATco. The Health Assurance Transformation Corporation is a fully-owned company that will be in the business of “health assurance”, defined as “a more affordable, accessible and proactive system of care” which is a very broad brush indeed that sounds like the promise of value-based care and the Triple Aim (remember?). HATco already claims  20+ health system partners plus a large payer that accounts for about 15% of healthcare revenue and is in 43 states and four countries. They will be building an interoperability model with technology solutions that include a subset of their healthcare portfolio companies to drive this transformation. Their next big step will be actually acquiring and operating a health system to show how this health assurance can work. The new venture will be headed by Dr. Marc Harrison, former CEO of Intermountain Health, with a big assist from managing director Hemant Taneja, who previously founded data OS/EHR/workplace asset tracker and staff safety system Commure. Release, Mobihealthnews, FierceHealthcare 

Speaking of Commure, it is merging with another General Catalyst-funded company, Athelas. It seems like a skillful rationalization of two portfolio companies in health data and workflow data systems, including Commure’s PatientKeeper EHR, with Athela’s addition of revenue cycle management and sensor-based software for remote patient monitoring. The combined entity under the Commure name will be led by Athelas’ CEO and founder Tanay Tandon, with Commure’s CEO Ashwini Zenooz, MD moving into a non-executive director role on Commure’s board. Taneja will retain his executive chairman title. General Catalyst is investing additional funds, valuing it at $6 billion, oddly fanciful given the current environment and their revenue; the current Commure expects to finish the year with $100 million in contracted annual recurring revenue with the combined companies achieving a $125-150 million run rate by end of year. The transaction is expected to close at the end of October. Commure release, Athelas release

Telemental health’s Brightside Health doubles covered lives with additional Medicare and Medicaid beneficiaries. These are from Optum–UnitedHealthcare Medicare Advantage members–plus new and expanded partnerships with Centene, Lucet (to serve Florida Blue members), and Blue Cross and Blue Shield of Texas. This drives up in-network covered lives by 50 million to over 100 million (not actual users). Brightside offers personalized psychiatry, clinically proven therapy and Crisis Care (a program for those with elevated suicide risk) through these plans. Fun fact: based on a Brightside study published in Frontiers in Psychiatry, telemental health is effective for people with reported incomes under $30,000 per year. Healthcare Finance

Diana Health’s $34M Series B to nationally expand women’s health/OB-GYN digital health platform and care teams. Diana partners with health systems to offer women their tech-enabled services in maternity care–preconception and family planning, annual well woman visits, wellness coaching, and virtual and in-person classes and events. Their focus is on improvement of outcomes and women’s satisfaction with maternity care. Diana also has an in-person practice in Smyrna, Tennessee as well as arrangements with health system clinics in Springfield and Cookeville. The funding round was led by Norwest Venture Partners with existing investors .406 Ventures, LRVHealth, and AlleyCorp for a total of $46 million to date. Release, Mobihealthnews, MedCityNews

Telemental health is still simmering with Headway’s $125 million Series C and new unicorn status. Headway, which works exclusively with health plans to provide members with therapy and psychiatry, is now officially a $1 billion+ valued unicorn. This round was led by Spark Capital with Andreessen Horowitz, Accel, and Thrive. GV, which had participated earlier in the $70 million Series B round in May 2021 plus the late 2020 Series A of $26 million, was absent. Funds will be used to go national and equip their providers with new technology and tools. FierceHealthcare, Mobihealthnews

Topping it off, rural health service provider Main Street Health scored a jumbo investment of $315M in new capital. Investors include Oak HC/FT as well as five of the largest national Medicare Advantage plans. Main Street equips rural partner clinics with Health Navigators who assist the clinic’s providers with patient care coordination, such as med pickup reminders, scheduling visits post-hospital discharge, scheduling preventative screenings, and assisting with social determinants of health (SDOH) services. They plan to expand to 26 states from the current 18. A typical clinic is located in a town of 3,000 to 5,000 people and has 2.5 providers, making this additional outsourced service valuable indeed. Release, FierceHealthcare

Ireland’s Clare Island as multimodal rural telehealth and telemonitoring testbed

June 30, 2023 | by

A ‘feel-good’ story figuratively and literally. Clare Island is an island off the west Irish coast in the Atlantic. It is located at the entrance to Clew Bay, part of County Mayo, with a lighthouse and abbey ruins that are tourist attractions. Its connection to the mainland is a 20-minute ferry service to Louisburgh on the mainland, generally adequate for its 138 people scattered in its 5 x 3-mile terrain. Galway, the largest city in the area, is nearly two hours south, and Westport is four hours. This makes it difficult when islanders need healthcare beyond their single small medical clinic with two resident nurses and weekly visiting GP.

The islanders are now part of a Digital Health Project designed by the University of Galway that can best be described as multimodal. The university’s Health Innovation via Engineering (HIVE) laboratory has been working on rural health projects at least since 2019 since the HIVE lab delivered via drone insulin from Galway to Inis Mór in the Aran Islands. On Clare Island, the HIVE lab has worked with islanders to connect them to better healthcare access on and off island, and also with each other.

  • Enabling video consultations with remote physiological monitoring, including blood pressure, weight, and blood glucose. This connects to clinics on the mainland, freeing up local clinic time. Irish company MyPatientSpace provides the platform.
  • The RPM for islanders is augmented by an artificial intelligence algorithm that allocates clinic slots if data readings for blood pressure or glucose readings indicate the need for an in-person clinic visit.
  • A recent demonstration showed how a drone could deliver an epipen to the local clinic, while MADRA the robot (Medical Autonomous Droid Remote Assistance–above left) scaled mountainous terrain to deliver first aid.

A private 5G wireless system was installed to facilitate video and RPM, as well as to connect a number of isolated islanders and their families on the mainland with always-on video, primarily to counter loneliness. Withings has also equipped islanders with Pulse HR watches. These enable self-monitoring both via the watch and through a supplied tablet. Over 80 islanders, aged from 18 to 90, have already signed up to the project, which began in September 2022.

The project is funded through a public-private partnership led by technology company Cisco and Cúram (Merative) software, the Science Foundation of Ireland Research Centre for Medical Devices at the University of Galway, in partnership with Ireland’s Health Service Executive (HSE).  The €1 million remote health project is intended to be a template for other rural areas in Ireland. The head of the project is Professor Derek O’Keefe, a physicianeer (physician and engineer) with resident Dr. Ian McCabe as project manager. His grandmother moved to Clare Island in 1939 as an operator connecting the island to the mainland via radioed Morse Code. Irish Times, RTÉ, University of Galway news archive (2022), EuroPMC paper 

Photo credit: Kevin Johnson/Clare Island Home Health Project. ‘Madra’ the robot (center). Jack Pinder (Public Patient Involvement), Dr Jennifer Doran (Project Physician), Dr. Ian McCabe (Project Manager), Prof. Derek O Keeffe (Project Lead), and Hemendra Worlikar (Project Engineer) 

CVS, Walgreens, Walmart….Dollar General health clinics?

January 24, 2023 | by

Can Dollar Tree and Family Dollar be far behind? A possible new entrant to the onsite clinic wars may be Dollar General in piloting DocGo clinic vans in three Tennessee stores. DG Wellbeing will be providing urgent, preventative, and chronic care at three locations, two days a week each, with two in Clarksville and one in Cumberland Furnace, from 10am to 8pm based on current FAQs. DocGo vans will be located adjacent to the stores, in the parking lot. Appointments and walk-ins, Medicaid, Medicare, TRICARE, some commercial insurances, and cash are accepted.

Certain lab tests plus blood work are done either onsite or sent out. Medical staff on the van can write prescriptions. Some referrals (e.g. imaging) are done while other referrals are not available.

As to their strategy, you have to hand it to Dollar General. They get some good press from this. They are starting small in working through the details, outsourcing the healthcare part, and seeing if there’s sufficient demand to 1) expand and if promising 2) model the customer demographics–what we marketers call customer personas. If it doesn’t work, no Theranos-sized holes in their budgets–it’ll be GoneGone to DocGo.

Dollar General started to make moves into health about two years ago by noting the scarcity of health products in rural and underserved areas. They started to add more healthcare products (what they know about) on their shelves as part of the initial phase of the DG Wellbeing initiative and appointed a chief medical officer, Dr. Albert Wu. Currently, Wellbeing is in 3,200 stores (of 18,000+) with up to of 400 items per store. This past July, DG created a healthcare advisory panel including Dr. Patrick Carroll, chief medical officer of Vida Health; Dr. Katy Lanz, chief strategy and product officer at Personal Care Medical Associates and former chief clinical officer at Aspire Health; Dr. Von Nguyen, clinical lead of public and population health at Google; and Dr. Yolanda Hill, a board-certified physician in pediatrics and adolescent medicine. On Dollar General’s third quarter earnings call last December, CEO Jeff Owen noted the expansion of stores and the test of the DocGo vans to expand their services into rural health. Watch out Walmart, CVS, and Walgreens! Healthcare Dive, Forbes, Mobihealthnews

Their healthcare provider, DocGo, last week announced a partnership with Redirect Health, a platform offering directed to enterprises that provides on-demand, urgent mobile care to businesses in New Jersey and New York. DocGo SPAC’d on Nasdaq in 2021 and, unlike other SPACs, hasn’t cracked. Other than one wobbly point last year, it’s generally held its share price within a dollar or two of its initial offering range, which in this past year has to be considered good news.

Thursday news roundup: bet on Oracle-Cerner closing next week, VA EHR progress reports mandated, Homeward-RiteAid rural care, Medtronic-DaVita kidney JV, Withings reenters RPM, Lightbeam buys Jvion AI

June 1, 2022 | by

The Oracle acquisition of Cerner will close as early as Monday next week, no later than mid-June. Mid-June is the prediction of Seeking Alpha. They based it on Oracle-Cerner already passing Australia’s Foreign Investment Review Board, no questions posed by the UK antitrust authority, and the US waiting period expiring in February. As rumored [TTA 25 May], European Commission regulators approved it today (Barrons, paywalled) which predicts the close will be next Monday. Hat tip to HISTalk for their alert yesterday.

Scrutiny of Cerner’s $16 billion EHR implementation with the Department of Veterans Affairs by Congress ramps up. New legislation due to be signed by the president shortly will require the VA Secretary to submit regular reports 30 days after the last day of each fiscal quarter on the VA’s Electronic Health Record Modernization (EHRM) program. Content will include spending, performance metrics, outcomes, safety, transitioning from VistA to Cerner Millenium, interoperability, and progress or issues with all. Text of Senate bill, FierceHealthcare  TTA’s previous article on Cerner EHR interoperability problems with DOD and VA

Bringing healthcare to rural America is Homeward with a freshly inked deal with RiteAid. Founded by former Livongo president Jennifer Schneider, MD, Homeward will set up distinctive purple mobile van clinics at up to 700 Rite Aid location parking lots in rural communities starting Q3 this year. Michigan will be the first market. Homeward will accept regional Medicare Advantage plans and Medicare.

The company is targeting the 60 million Americans who live in rural areas and have been losing access to basic medical care as local practices and clinics close. Their technology enablement will be for appointments, checkins, telehealth, remote patient monitoring, and scheduling home visits. Homeward announced its launch at the recent ViVE2022 in March including $20 million in funding from General Catalyst. Other Livongo alumni with the new company are Brian Vandenberg, former general counsel, Amar Kendale, former chief product officer, and Bimal Shah, MD, former chief medical officer at Livongo. Nice to know that they have moved to another healthcare chapter of real need, versus cruising the Caribbean in very large yachts. FierceHealthcare, Homeward release

Medical device giant Medtronic and DaVita are establishing a joint venture by next year to advance kidney care therapies and technologies, including new products to be used in clinics and in the home. The intent of the JV is to increase the availability of kidney care including dialysis. 10% of adults worldwide–700 million people–have chronic kidney disease. 2.6 million have kidney failure. The JV is expected to be formed in early 2023 with each company owning an equal share. Initial investment is not disclosed. According to the release:

  • Medtronic will contribute its Renal Care Solutions (RCS) business including the current product portfolio (renal access, acute therapies, and chronic therapies), product pipeline, and global manufacturing R&D teams and facilities.
  • Both companies will provide an initial investment to fund the new company (NewCo) and future certain operating capital.

FierceBiotech, Medtronic release

Withings reenters remote patient monitoring with Withings RPM. Their initial entry was with MedProCare back in 2019 but apparently in the repositioning of the company since the buyback from Nokia in 2018, it was back-burnered. The new RPM will be based on an app that will:

  • track time for CMS-compliant billing reports and uploadable to the provider EHR
  • support billing for CMS codes 99453, 99454, 99457, 99458
  • a digital patient-facing assistant
  • full connectivity to Withings devices such as scales, blood pressure monitors, and sleep monitors
  • implementation support by their Health Solutions teams

Withings RPM page, Outsourcing-Pharma

Looking hard for an M&A that relates to us in this very quiet market, Lightbeam Health Solutions, a population health software company, is acquiring Jvion Inc. Jvion has AI-enabled prescriptive analytics and social determinants of health (SDoH) solutions which will be combined with Lightbeam’s health analytics and outcomes for payers and providers. Terms of the acquisition and leadership transitions were not disclosed. Lightbeam release

More good news for telehealth, RPM in FCC approval of $100M Connected Care Pilot Program

August 9, 2018 | by

The Federal Communications Commission (FCC) moved relatively quickly to approve the Connected Care Pilot Program, approving broadband-enabled telehealth and remote patient monitoring services in underserved rural and remote areas. Funding for the program has been pegged at $100 million. The approval was unanimous on the program proposed by FCC commissioner Brendan Carr and Mississippi Sen. Roger Wicker.

CCPP will provide $100 million for subsidies to hospitals or wireless providers running post-discharge remote monitoring programs for low-income and rural Americans. An example is those run by the University of Mississippi Medical Center. The goal is to lower same-cause readmissions and improve patient outcomes. [TTA 13 July] Hearings late last month also were structured to support the program and start to fill out the details for a 2019 start [TTA 1 Aug].

Public comments are now open for a 2019 start to the program (see FCC website–look under Connect2Health which is the umbrella site for this and similar programs). Commissioner Carr had to look no further than the VA to see how Home Telehealth and other remote monitoring programs worked to drive down cost and improve patient outcomes. VA Health’s remote monitoring program cost $1,600 per patient compared to $13,000 for traditional care in one study. The trick is now translating this into an open system.

This is a nice boost to both real-time video and asynchronous remote patient monitoring in market development (and getting paid) in areas of great need. It’s also another Federal signal (so to speak) for 2019, following the proposed Medicare Physician Fee Schedule’s increased payments and broader applicability for both.  mHealthIntelligence, Mobihealthnews, FCC Release Hat tip to reader Paul Costello of Medopad.

Telemedicine changing Texas rural health and emergency medicine

August 2, 2018 | by

The expanded use of telemedicine in Texas–controversial and delayed by the state medical society, despite its use in distance medicine and prisons–is slowly starting to change rural health in the state. SB1107 passed the Texas legislature in 2017, removing the previous requirement for an in-person medical consultation. Texas, like many Western states, has an acute shortage of primary care doctors in 184 of 254 counties, according to the state health service.

Where telemedicine fills that gap is in areas such as emergency rooms in rural hospitals. In Van Horn, population 2,000, with the next hospital 90 miles away, telemedicine enables the ER  to operate two trauma rooms and for the state, have a doctor there well within 30 minutes away which is the state requirement for a basic-level trauma facility. The ER connects with an office building in Sioux Falls, SD to a nurse and doctor on immediate call to help oversee care via the Avera eCare telemedicine system.

Universities have also worked to diversify telemedicine use in other settings. Texas Tech University Health Sciences Center has pioneered its use in ambulances and schools. The regional TexLa Telehealth Resource Center helps anyone looking to start a telemedicine project. By 2020, the University of Texas will have telemedicine fully implemented on campus. Houston Chronicle

Telemedicine reduced hospital readmissions by 40% in rural Virginia: UVA study

June 28, 2017 | by

In last week’s Senate subcommittee hearings on the Federal Communications Commission (FCC)’s Universal Broadband Fund and Rural Healthcare (RHC) program, the University of Virginia’s Center for Telehealth chalked up some substantial results confirming the effectiveness of telemedicine in rural areas. In advocating further funding for an expansion of the program, they presented the following:

  • A 40 percent reduction in 30-day same cause hospital readmissions for patients with heart failure, acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, stroke, and joint replacement
  • It enabled over 65,000 live interactive patient consultations and follow-up visits with high definition video within 60 different clinical subspecialties
  • Their home remote monitoring program included over 3,000 patients and screened more than 2,500 patients with diabetes for retinopathy
  • UVA delivered 100,000 teleradiology consults and provider-to-provider consults supported by the Epic EHR.

The UVA analysis also quantified travel savings in areas where medical and hospital care can be hours away–17 million miles of rural travel including 200,000 miles by high-risk pregnant mothers. For these mothers, NICU hospital days for the infants born to these patients were reduced by 39 percent compared to control patients and patient no-shows by 62 percent.

Karen Rheuban, MD, director and co-founder of the UVA Telehealth Center, recommended that the FCC continue to fund the RHC’s $400 million budget, with the caveat of exploring additional federal revenues should that budget be reduced. She also recommended that Medicaid and Medicare reimbursement for telehealth services be increased, the addition of wireless technologies, and including emergency providers and community paramedics in RHC funding. mHealth Intelligence, Subcommittee information and hearing video (archived webcast)

HRSA sets $16 million fund for 4 rural telehealth grant programs (US)

August 24, 2016 | by

The Health Resources and Services Administration (HRSA), which is part of the Federal Health and Human Services (HHS) department, is making four grant programs available to support rural telehealth and quality improvement in 60 rural communities within 32 states, including a joint program with the Veterans Affairs Office of Rural Health. The four programs administered by the Federal Office of Rural Health Policy (FORHP) within HRSA are primarily three-year programs and include:

  • The largest amount, $6.3 million, will go to the Telehealth Network Grant Program: $300,000 each annually in a three-year program to 21 community health organizations for telehealth programs and networks in medically underserved areas, with a concentration on child health
  • The Flex Rural Veterans Health Access Program: $300,000 each annually in a three-year program to three organizations providing veteran mental health and other health services. This is a joint program with the VA totalling $900,000.
  • Small Health Care Provider Quality Improvement: $21 million will support 21 organizations over three years in improving care quality for populations with high rates of chronic conditions, and to support rural primary care.
  • Seven Rural Health Research Centers: $700,000 per year for four years, totalling $4.9 million, to support policy research on improving access to healthcare and population health in rural communities. (Funds that more usefully would have gone to veterans health?–Ed. Donna)

HHS release, Mobihealthnews, Healthcare IT News

Lessons learned from rural telehealth in Pennsylvania

January 13, 2016 | by

Several years ago, CJ Rhoads, a business professor at Kutztown University of Pennsylvania and CEO of consultancy HPL Consortium, asked Editor Steve and Donna for some background information on telehealth. According to her note last month to us, the results of her research were reported to the Pennsylvania legislature and The Center for Rural Pennsylvania (a legislative agency of the PA Assembly), in 2014 and now have been published in a more readable form by CRC Press-Taylor & Francis Group. An excerpt from their summary:

Improving the quality of healthcare, while increasing accessibility and lowering costs, is a complex dilemma facing rural communities around the world. The Center for Rural Pennsylvania believed that telehealth, the use of electronic information and telecommunications technologies to support long-distance clinical healthcare was a viable solution so it recently provided grants to conduct a thorough investigation into the factors involved.

Telehealth in Rural Hospitals: Lessons Learned from Pennsylvania reports the outcome of this year-long investigation. Illustrating telehealth implementations in rural settings, it supplies an overview of telehealth as well as an assessment of its economic impact.

The book skillfully intertwines the research and academic aspects of telehealth with helpful insights from the author.

From the table of contents, it appears to be an exhaustively researched book on telehealth and its impact in rural healthcare. It’s available to purchase on CRC’s website. Thanks to author CJ Rhoads for the heads up!

Is ‘pure’ robotic telesurgery nearing reality?

September 9, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Nicholson-Center-FL.jpg” thumb_width=”150″ /]Moving beyond robot-assisted surgery (e.g. the well-accepted use of the daVinci system with prostate surgery), controlled by a surgeon present in the operating room, is telesurgery, where a remote surgeon uses a robot to fully perform surgery at a distant location. The Nicholson Center at Florida Hospital in Celebration, Florida, which specializes in training surgeons and technicians in leading (bleeding?-Ed.) edge techniques, is studying how internet latency (lag time to the non-techie) affects surgical effectiveness. Latency is defined in this case as “the amount of delay a surgeon can experience between the moment they perform an action to the moment video of the action being carried out at the surgery site reaches their eyes.” Their testing so far is that internet latency for surgery between hospitals has a threshold of 200-500 milliseconds before dexterity drops off dramatically (not desirable)–and that given the current state of the internet, it is achievable even at a mid-range distance tested (Florida to Texas). Making this a reality is highly desirable to military services worldwide, where expertise may be in, for example, Germany, and the casualty is in Afghanistan. It would also be a boon for organizations such as the Veterans Health Administration (VA) where resources are stretched thin, rural health and for relief agencies’ disaster recovery. ZDNet

National telehealth plan to improve rural health called for in Australia

March 25, 2015 | by

Ahead of the forthcoming Australian Telehealth Conference 2015, one of the speakers has spoken to the media partner of the conference, Australian Aging Agenda Technology Review. In an article published on the Aging Agenda website, the speaker, Dr Shannon Nott, is quoted as saying “There needs to be a telehealth plan put in place in Australia. We need to start looking at telehealth and say this is something we should seriously invest in. We need to look at it and get it right from the start; that includes getting it right for indigenous communities [and] getting it right for rural and remote communities”.

Nott is said to have spent four months last year researching telehealth in rural and remote Alaska, Canada and Brazil including indigenous communities. The article quotes him as saying “In Alaska for every dollar that they spend on telehealth software and programs they save $10.50 in travel alone in terms of healthcare costs. Not to mention the hospital admissions avoided, the GP admissions avoided.”

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/ATC2015.jpg” thumb_width=”150″ /]The Australian Telehealth Conference 2015 takes place on the 23rd and 24th of April in Sydney.

Health apps presently of little use, says Australian telehealth expert

October 23, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/Margelis.jpg” thumb_width=”120″ /]”Immature” and “focused on low-lying fruit such as fitness tracking and not focused on the big issues of management of disease” are also two of the compliments that Dr George Margelis of the University of Western Sydney’s TeleHealth Research & Innovation Laboratory (THRIL) has bestowed on the current state of health apps. Until the collected data ‘plugs into other digital platforms’–he mentions the Australian government’s PHR, eHealth–apps will not help those who need it the most. “Unfortunately, managing these diseases, in particular the chronic diseases that are a major part of the current burden, requires more than just tracking a few physical parameters which is what the app world is up to.” Dr Margelis called for collaboration between app developers and healthcare professionals; while he scores Apple’s HealthKit, that may be the means to make his vision come true. It should be noted that Dr Margelis (more…)