TTA’s May Flowers 2: ‘Not for sale’ Transcarent’s $2.2B valuation, good earnings from NeueHealth and Oscar (!!), Amwell’s hopes, cyberattacks at Ascension and DocGo, telehealth extensions in House, more!

 

 

Earnings and endings dominated this week, along with Transcarent’s Series D, $2.2 billion valuation, and ‘not for sale’ sign. Even NeueHealth and Oscar had a good Q1, but Amwell and Steward didn’t. Telehealth flexibilities got an important ‘go’ in the House. Cigna + Oscar called it a day as did many at 98point6. And cyberattacks continued, this time at Ascension and DocGo.

Short takes: Medicare telehealth flexibilities may extend; ‘no interest’ in Transcarent sale; NeueHealth ekes out positive net income; Cigna and Oscar break up; DocGo, Ascension cyberattacked
News roundup: Transcarent raises $126M; 98point6 lays off; Oscar notches first profit; Steward Health’s Ch. 11; Amazon Clinic GM leaves; Amwell’s down but hopeful Q1; Hims founder gets political

Surprises and shockers abounded this week. If Walmart can’t make it in providing basic health services, what hope does a retail model really have? Optum and Walmart exit telehealth, while Teladoc grows–firmly in the red. Change Healthcare’s troubles led to UHG’s CEO grilling on both sides of Congress and humiliation on MFA. MobileHelp PERS up for sale, Owlet’s new partner, fundings, partnerships. And a shrinking Oracle goes to Music City!

News roundup: UHG CEO’s Bad Day at Capitol Hill; Kaiser’s 13.4M data breach; Walgreens’ stock beatup; Cigna writes off VillageMD; Oracle Cerner shrinks 50%; Owlet BabySat gets Wheel; fundings for Midi, Trovo, Alaffia, Klineo (A rough week for some)
Teladoc’s Q1: increased revenue, increased net loss, dealing with slowing growth–as is CVS Health (Teladoc in existential crisis?)
Midweek news roundup: Optum exiting telehealth, laying off; Advocate Health selling MobileHelp; VA notifying 15M veterans re Change PHI breach, Oracle moving to Nashville–maybe? (updated) (A lot of jettisoning)
Walmart Health shutters health centers, Walmart Virtual Care, in sudden move (updated–why?) (If Walmart can’t make it…)

Returning to the Cyberattack That Changed Everything, wondering how much and to whom UnitedHealth paid ransom–now that they’ve finally admitted it. Also returning to those Merger Guidelines and how they may change the face of healthcare M&A. VA and DOD hard at work on their EHRs and systems, Lumeris gains a luminous funding, but Optum staff are seeing pink slips.

Two studies: Telehealth underutilized, underbilled, even during pandemic–and accounted for only modest increases in costs, and quality (Perhaps undercaptured?)
Short takes: VA seeks vendor to support EHR testing; Defense Health seeks ‘digital front door’ vendor; GAO recommendations to Oracle; Nonin partners with Finland’s Medixine; Lumeris gains $100M equity funding 
What the DOJ and FTC Merger Guidelines mean for healthcare M&A–a Epstein Becker Green podcast (Legal department torture)
Breaking: UnitedHealth admits to paying ransomwareistes on Change stolen patient data (updated) (For what and how much?)
Who really has the 4TB of Change Healthcare data 4 sale? And in great timing, Optum lays off a rumored 20K–say wot? (UHG has some ‘splainin’)

Another packed week, with a few baffling events. Leading in bafflement is NeueHealth’s additional $30M from NEA, which now owns 60%. UHG battling on multiple fronts between the Change hacking and the House, Walgreens lays off more to cut costs, VillageMD sued on ad trackers, and Cerebral’s comeuppance costs $7.1M. VA may restart Oracle Cerner implementation, Epic and Particle Health feud. But restoring faith in health tech benefiting a neglected group is TandemStride. 

TandemStride launches platform to assist survivors of traumatic injury; a personal look (A real care gap)
News roundup: Congress hammers absent UHG on Change cyberattack–and more; 10% unhinged at Hinge Health; Steward Health nears insolvency; Two Chairs $72M Series C (UHG’s troubles cover the waterfront)
ISfTeH student contest and award 2024–deadline 26 April! (Move fast!)
Mid-week short takes: UnitedHealth’s $1.2B Q1 loss from Change attack, another Walgreens layoff, Dexcom-MD Revolution partner, Kontakt.io $47.5 raise, GeBBS Healthcare may sell for $1B (Walgreens still downsizing–what’s next)
News roundup: VillageMD sued on Meta Pixel trackers; Cerebral pays $7.1M FTC fine on data sharing, cancellation policy; VA may resume Oracle Cerner implementation during FY2025; Epic-Particle Health dispute on PHI sharing (Cerebral still in trouble)
The New Reality, Bizarro World version: NeueHealth gets $30M loan increase from NEA, now majority owner (Baffling)

This packed week was about righting listing ships. Teladoc’s CEO suddenly departs, Amwell at risk of a NYSE delisting–we look at What Happened and what needs to be done. VillageMD gets new COO to manage the shrinkage. And Change Healthcare data on sale from disgruntled ALPHV affiliate. Digital health funding continues to limp along. Clover looks at another delisting, Walmart Health applies the brakes. And we highlight innovations from Novosound, Biolinq, Eko, Universal Brain. 

Digital health’s Q1 according to Rock Health: the New Reality is a flat spin back to 2019 (Limping, but alive)
VillageMD names new president and COO as it shrinks to 620 locations (Ex Centene, Humana exec comes out of short retirement to clean up)
News roundup: Now Clover Health faces delisting; BlackCat/ALPHV affiliate with 4TB of data puts it up for sale; $58M for Biolinq’s ‘smallest blood glucose biosensor’ (Will UHG pay more ransom?)
Opinion: Further thoughts on Teladoc, Amwell, and the future of telehealth–what happens next? (A hard look at the follies, mistakes, and saving ships)
News roundup: Amwell faces NYSE delisting; Walmart Health slows Health Centers, except Texas; Novosound’s ultrasound patent; Eko’s Low EF AI; Universal Brain; Elizabeth Holmes in ‘Dropout’ + update
Teladoc CEO Jason Gorevic steps down immediately in shock announcement (Now what?)

A damp start to April leads with puzzling news. NeueHealth loses plans and big money in ’23–but gives a big bonus to its CEO. Cano Health reorganizing or selling by June. ATA kicks DOJ about expediting controlled substance telehealth regs. Apple keeps kicking around the ‘Davids’, but Davids won’t stop slinging either. And if you work with a PR or marketing agency, our Perspectives has some advice for you.

More New Reality: NeueHealth (Bright Health) CEO’s $1.9M bonus, 2023 financials–and does Cano Health have a future? (Two stories gone way sideways)
ATA requests expediting of revised proposed rule on controlled substance telehealth prescribing; announces Nexus 2024 meeting 5-7 May (DEA needs to get moving now, not later)
Davids (AliveCor, Masimo) v. Goliath (Apple): the patent infringement game *not* over; Masimo’s messy proxy fight with Politan (updated) (Seeing value in Masimo?)
Perspectives: Working with a PR Agency–How to Make the Most of the Partnership (Expert advice if you manage communications)

It was a pre-Easter week that started as quiet and got VERY LOUD at the end. Walgreens took the hard road, writing down VillageMD even before the closures were final and lowering forecasts. An important metastudy+ casts doubt on the efficacy of present digital health diabetes solutions but provides solid direction forward. And it’s definitely an early sunny spring for funding, but there’s continued bad weather forecast for UnitedHealth Group and Oracle Cerner’s VA implementation.

Facing Future 2: Walgreens writes down $5.8B for VillageMD in Q2, lowers 2024 earnings on ‘challenging’ retail outlook (Biting bullet early and hard)
Short takes: PocketHealth, Brightside fundings; VA OIG reports hit Oracle Cerner; Change cyberattack/legal updates; UHG-Amedisys reviewed in Oregon; Optum to buy Steward Health practices (UHG carries on as does company funding)
Can digital health RPM achieve meaningful change with type 2 diabetics? New metastudy expresses doubt. (Major digital health findings from PHTI)


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Short takes: Medicare telehealth flexibilities may extend; ‘no interest’ in Transcarent sale; NeueHealth ekes out positive net income; Cigna and Oscar break up; DocGo, Ascension cyberattacked (updated)

Two-year extension of telehealth flexibilities advances in Congress. A small telehealth victory was notched in the House, where the powerful Ways and Means Committee passed the Preserving Telehealth, Hospital, and Ambulance Access Act by a vote of 41-0. The bill would extend many of the Medicare and Federal program telehealth waivers and flexibilities established during the pandemic to the end of 2026. It is now expected that the House will bring the bill to the floor for a full House vote in the fall session. Ways and Means’ jurisdiction is over most financial and revenue-raising Federal measures, such as taxation, Social Security, and Medicare. Highlights of the bill:

  • Geographic and originating-site waivers
  • Ability for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to continue to furnish telehealth services
  • Expanded list of eligible Medicare providers, allowing physical therapists, occupational therapists, speech language pathologists, and audiologists to render telehealth services
  • Ability to offer audio-only services
  • Repeal of telemental health in-person requirement
  • Preservation of the Acute Hospital Care at Home Program through CY2029

Parts are controversial, such as the telemental in-person requirement, hospice recertification, and guardrails around durable medical equipment (DME) and clinical diagnostics requiring reports to prevent fraud, waste and abuse. The bill did not include remote prescribing of controlled substances. Expect further markups to be made before passage in the House, later in the Senate, and the joint bill. The American Telemedicine Association (ATA) applauded the bill with the main caveat being around telehealth controlled substance prescribing. Full text, FierceHealthcare, ATA release

Glen Tullman rules out a sale of Transcarent–but not an IPO. On the heels of a substantial $126 million in Series D funding and a  jumbo $2.2 billion valuation [TTA 8 May], Transcarent’s CEO Tullman, in an interview with MedCityNews, stated that he had “no interest” in selling the company. Transcarent is already run “like a public company”, has a strong leadership team already in place, and “we’ll make any exit decisions for the right reasons.” Mr. Tullman has already run four public companies and IPO’d three: CCC Information Systems (in auto insurance), Livongo, Allscripts (now Veradigm), and Enterprise Systems. Livongo was sold to Teladoc in 2020, with consequences. Veradigm, the former Allscripts, went public in 1999–25 years ago in a vastly different world. Their big bet in enterprise health navigation is now on AI for both physicians and members.

Back to the New Reality, Bizarro World edition. NeueHealth, which is achieving a world record in Dodging Disaster while paying out leadership bonuses, eked out a decent Q1. The former Bright Health Group managed to squeak out revenue of $245.1 million, operational net income of $5.7 million, and an adjusted EBITDA of $2.5 million compared to a Q1 2023 loss of $5.7 million. This doesn’t mean it was profitable because its net income for Q1 was a negative $28.5 million. Revenue dropped by 18%–$55 million–compared to Q1 2023. New Enterprise Associates (NEA) must be pleased, as they are now 60% owner of the operation with another loan of $30 million secured by penny warrants [TTA 16 Apr]. The full year guidance was reaffirmed at $1 billion in revenue with 70% coming from its NeueSolutions business (their management services for ACOs and IPAs), and adjusted EBITDA between $15 million and $25 million. What remains, of course, are the UXBs–the problems with their financial reporting as noted in their 2023 results and that ever-so-nasty $400 million in payments due to CMS in March 2025, as well as to Texas on their exited ACA plans. But NeueHealth has played both ends against the middle and tied up creditors in Gordian knots for a couple of years, so why not keep on keepin’ on for now? Release, earnings call transcript, FierceHealthcare   TTA 5 April

The much-touted partnership of big Cigna and insurtech Oscar Health is breaking up. The Cigna + Oscar joint program covers the small group business. As of the end of Q1, it had 61,428 members enrolled. The program, which had no forecast of profitability, will end in 2025. CEO Mark Bertolini’s statement was rather forceful in this regard. Oscar is shifting to marketing ICHRA, or individual coverage health reimbursement arrangements that permit small businesses to offer employees individual health plans subsidized by employer contributions. Cigna will continue to offer plans for the small and midsize group market. Becker’s

Cyberattacks strike DocGo, Ascension Health. DocGo reported a data breach in its 7 May Form 8-K filed with the SEC. It involved a limited but unspecified amount of protected health information (PHI) of patients using its ambulance services, but was confined only to that. No other report of the breach has been made. This followed a positive Q1 report of revenue up to $192.1 million, from $113 million in the same quarter 2023. Net income was $10.6 million versus last year’s net loss of $3.9 million. Adjusted EBITDA went up to $24.1 million versus $5.6 million. DocGo provides telehealth/RPM, mobile urgent care, disease management, and medical transportation services. It recently lost its lucrative but controversial NYC migrant service contract but retains city Health + Hospitals contracts and some smaller housing service contracts. Mobihealthnews Ascension Health, on the other hand, has had a serious disruption in some clinical operations affecting an undisclosed number of hospitals and systems, but was reported in Michigan. On Wednesday, Ascension detected unusual activity in select technology-network systems. They advised business partners to sever connections to their systems and have brought in Mandiant to assist in investigation and remediation efforts. Ascension is one of the largest health systems in the US, with 140 hospitals in 19 states plus the District of Columbia. Healthcare Finance, Detroit Free Press, Ascension website

Ascension Update: Reports since yesterday are now far more exact. Its EHR, MyChart, several systems for ordering tests and medications, plus some phone systems are unavailable across the system. Some appointments and surgeries have been postponed. There are emergency diversions of care in some locations. Ascension’s statements to media has been that ‘downtime procedures’ will be in place ‘for some time’. There is no timeline given for restoration. Becker’s, Healthcare Dive

 

Mid-week roundup: DEA extends telehealth prescribing waiver to November; telehealth usage continues to erode; NextGen EHR hacked, 1M records breached

The answer: 11 November. The question: how long was the Drug Enforcement Administration (DEA) planning to extend their telehealth waiver of in-person prescribing requirements on Schedule II and higher controlled substances?  Both the DEA and the Substance Abuse and Mental Health Services Administration (SAMHSA) issued the “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications”rule on 9 May before the Public Health Emergency (PHE) expired on 11 May. It’s a six-month reprieve for the beleaguered telemental health providers/prescribers and their patients–and sure to be hotly debated over the next few months as a final rule must replace the temporary extension rule and the Ryan-Haight Act isn’t going away. DEA release, TTA 4 May

FAIR Health’s tracking of telehealth medical claims has languished in the Fives–as in 5%–since last year. February is the latest month of tracking and it declined from 5.9% in January to 5.5% in February. Again, the vast majority of claims are for mental health codes (66.7%) far ahead of diagnosis #2, acute respiratory diseases and infections, where Covid-19 once resided. However, the latter accounted for 25.6% of asynchronous (store and forward) telehealth diagnoses. A new metric on the report is audio-only telehealth, which is only slightly more popular in rural versus urban areas. The greatest difference from the national norm is in the West, where February telehealth claims were 7.6%. Monthly national summary, FAIR Health main page for monthly and regional summaries.

NextGen’s EHR/practice management system hacked, 1.05 million patient records breached. Information stolen included patient name, dates of birth, addresses, and Social Security numbers. This was revealed in a filing with the Maine attorney general’s office since it included over 4,000 Maine residents. The hack of the NextGen Office system took place between 29 March and 14 April 2023. It’s been a bad year for NextGen’s IT and security teams, as it also experienced a short-term ransomware attack in January by AlphV/BlackCat. (The two couldn’t be related…could they?) No word yet on class action lawsuits or Federal penalties.  TechCrunch