Walgreens and VillageMD kickstarting the ‘Go Big’ strategy of over 500 co-located primary care offices

December 4, 2020 | by

Va-room! Back in July, Walgreens Boots Alliance and VillageMD announced a Really Big Deal that involved 500 to 700 co-located full-service Village Medical primary care offices in more than 30 markets over the next three to five years, along with a billion-dollar investment by Walgreens in VillageMD over the next three years. This week, they announced the opening of the first 40 “Village Medical at Walgreens”, in addition to the 5 pilot offices in Houston, by the end of summer 2021. The first openings will be in Phoenix starting in two weeks, with the remaining flight of offices in Houston, El Paso, and Austin, Texas, plus Orlando, Florida.

The coordination of the Village Medical office with Walgreens pharmacy and in-store services is apparent in the announcement, with much made of coordination among them in influencing patient medication adherence (right dose at the right time), health outcomes, and lowering the cost of care. Many of the clinics will be in traditionally underserved areas with high rates of medical disparities and multiple chronic conditions. In the July announcement, they pledged that over 50 percent would be located in HHS-designated Health Professional Shortage Areas and Medically Underserved Areas/Populations. Release.

For Walgreens Boots, it confirms that they aren’t wavering from their ‘go big or go home’ strategy, clearly targeted to revitalize their retail locations and pharmacy in higher potential markets. Since then, Amazon has opened up Pharmacy in addition to PillPack, CVS is integrating SDOH into pharmacy as a trial, and Walmart Health continues to waver with a limping expansion of 22 clinics in four states. Walgreens picked a very strong partner in VillageMD and Village Medical, which now have more than 2,800 physicians across nine markets, cover approximately 600,000 lives, and manage $4 billion in total medical spend in value-based contracts. They also haven’t slacked in their own efforts. Only last month, they acquired Complete Care Medicine in Phoenix, opening 17 clinics there by summer 2021, along with announcing 10 new offices in Atlanta. VillageMD is also featuring 24/7 telehealth and virtual care in its offices. 

News roundup: Amazon Pharmacy–retail, GoodRx threat, 81% of healthcare workers have remote IT issues, Epicor installs in Australia care homes, GrandCare for developmentally disabled adults

November 19, 2020 | by

Rounding up lots of dogies here!

Amazon, to no one’s surprise, has formally entered the US pharmacy business with Amazon Pharmacy which can fill prescriptions for most common medications. There is a whole process of course to sign up (at right), and a separate program for Amazon Prime customers with discounts on Amazon Pharmacy with two-day delivery, PillPack, and at 50,000 pharmacies in 45 states. The Prime program is administered by Inside Rx, a subsidiary of Evernorth/Cigna.

Mr. Market downgraded pharmacy retailers CVS and Walgreens Boots stocks, again unsurprisingly. It isn’t just brick ‘n’ mortars feeling the heat; heavily advertised drug price comparison platform (lumped into ‘digital health’) and recent IPO winner GoodRx took a 20 percent hit as Amazon Prime also discounts, comparable to GoodRx Gold. The GoodRx network is about 70,000 pharmacies, including the largest retailers. Fierce Healthcare. Big hat tip to Jailendra Singh at Credit Suisse Equity Research for these analyses on Amazon Pharmacy and GoodRx.

81 percent of healthcare workers experience issues with systems and technology used in external care, out visiting and caring for patients, according to a ‘State of Mobility in Healthcare’ multi-national study (email signup required) by business mobility development company SOTI. 64 percent of UK healthcare workers (63 percent overall) are ripping out what is left of their hair due to IT/technology glitches leading to system failures within a normal working week. Only a quarter of respondents said that their systems were able to cope with COVID-19. Based on the Healthcare IT News EMEA edition article, UK respondents apparently reported a higher level of IT problems affecting their work. The bright spot is that 68 percent of UK healthcare workers/55 percent overall agree that investment in new or better technology could help save lives. The study had respondents in the US, Canada, UK, Germany, Sweden, France, and Australia.

Speaking of software, Epicor, a US-based software company, is providing to two Australian care home groups their Community Care workflow and information platform: Finncare, which is associated with services to the Finnish and Scandinavian communities, and MannaCare in the Victoria area. Healthcare IT News Australia

One of the Ur-companies (2005!) in the senior health monitoring sector, GrandCare Systems, announced that they are working with LADD, a Cincinnati Ohio-based non-profit that supports adults with developmental disabilities. LADD’s project, the Heidt Smart Living Home, will incorporate GrandCare’s communication, cognitive assists, telehealth, and social engagement tools, as well as innovations in accessibility, lighting, and sensory control, for residents. Release Hat tip to CEO Laura Mitchell via LinkedIn.

News roundup: Teladoc closes InTouch, Samsung bets on tele-genomics, SURE Recovery app, Optimize.health’s seed round, Walgreens’ Microsoft boost

July 3, 2020 | by

Teladoc completed the acquisition of InTouch Health on 1 July. The purchase, announced at the JP Morgan soireé in January (and an eternity ago) took place just before the ’10 years in 2 months’ leap forward in telehealth services. InTouch’s telehealth offerings are primarily for hospitals and health systems, heavily based on multi-feature carts and camera setups. The purchase price of $150 million in cash and 4.6 million shares of Teladoc Health common stock, valued then at $600 million, may be a great bargain for Teladoc considering the rich prices that other telehealth-related companies commanded during the peak of the pandemic, and that Teladoc’s revenue boosted to almost $181 million in revenue in Q1 2020, up 41 percent versus Q1 2019. Release

Samsung makes a telemedicine bet with Genome Medical. Through its Catalyst Fund, Samsung is the lead among 15 investors in a $14 million Series B extension financing that includes LRVHealth, Revelation Partners, and Kaiser Permanente Fund. Genome Medical’s connection to telemedicine is on-demand, standard-of-care genetics and genomics through virtual health services, including counseling, patient drug response, and provider-to-provider consults through its platform. Release. CNet. Crunchbase.

Mindwave Ventures, which this Editor noted last December was opening up an office in the Leeds health tech hub, has continued its development and research with multiple platforms and apps in partnership with NHS and academic/research clients. One that came on our ever-whirling radar screen is the release of the SURE Recovery app, for those in recovery from alcohol and drug problems. It enables users to work with the SURE (Substance Use Recovery Evaluator) and SUSS (Substance Use Sleep Scale) measures, plus a personal diary, to track their recovery over time. Mindwave developed the app in conjunction with The King’s College London and theInstitute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London. The app is now available to download; search ‘SURE Recovery’ on the App Store or Google Play. The page on the Mindwave site is on their Clinical Research page–click the tab for SURE. Hat tip to Ellis Noble of KC Communications.

Connected to telehealth and RPM is provider reimbursement. Optimize.health is an early-stage company which provides a turnkey setup for practices for its remote patient monitoring platform, with the usual features such as patient engagement, integrated devices with the platform, and call center support. The apparent difference is the emphasis on sharing data and simplifying reimbursement, the hard part of any RPM or telehealth platform. Announced this week: a $3.5 million seed round led by Bonfire Ventures. A small boost to this part of the telehealth field which has not had the great success of virtual consults. Release.

Back in January 2019, Walgreens Boots announced a partnership with Microsoft to migrate their IT over to the Azure platform. It took a while for results to manifest to the public. When COVID happened, they rolled out a COVID-19 risk assessment tool on its website and mobile app based on Azure. Their Find Care platform doubled the number of virtual care providers and services available. Walgreens also provided a link to COVID-19 clinical trials through the Find My Clinical Trial program on its mobile app. This article in FierceHealthcare touts how they are maneuvering to stay even with CVS Aetna and Amazon, which is hardly waiting for its partners in the gone-pearshaped Haven.

Short takes: Outcome Health pays up, Teladoc’s up in double-digits, Walgreens closing 40% of clinics, a health kiosk for hospital employees?

October 31, 2019 | by

Outcome Health settles with DOJ, pays $70 million. Former health unicorn ‘patient ed’ company Outcome Health entered into a non-prosecution agreement with the US Department of Justice (DOJ). In return for settling up with its advertisers, with a fund now at $70 million, it has overhauled its procedures, including third-party auditing and internal controls. That includes a near-complete change of management. A summary of its earlier problems is here. Release

It also looks like Teladoc is on the right path after last year’s financial and moral rocky patch and this year’s NCQA corrective action with Q3 revenue of $138 million, up 24 percent year-to-year, and nine-month revenue up 34 percent to $396.8 million. The year forecast is tracking with total revenue estimated at $149 million to $153 million and the losses pared down to between $5 to 9 million. Seeking Alpha

The news that Walgreens Boots is closing 40 percent of its US clinics–about 150–by end of year is perhaps a sign that the in-store ‘minute clinic’ is not producing the kind of traffic that’s wanted. They will retain the clinics run in partnership with healthcare providers. In August, Walgreens also announced the closure of about 200 stores, about 3 percent of their national total. Is this also a concession that CVS and its clinic strategy are edging out Walgreens? Often the two chains are located within minutes (sic) of each other. USA Today

A city hospital is an unlikely place for a health diagnostic kiosk, especially for employees, but Tampa General Hospital is trying out neighboring Clearwater’s OnMed stations in its locations. The station is connected to OnMed’s virtual clinic via high-definition video and multiple diagnostic tools. The station is also its own pharmacy, able to store up to 1,000 different medications, which are dispensed if prescribed by the doctor on the consult. Interestingly, employees quoted in the article seemed to like it as fast and convenient–and free for their use. Tampa General and OnMed plan to co-brand in the area and roll out about 20 for public use, at an estimated $65-75 per visit. Tampa Bay Times

 

News roundup: Walgreens Boots-Microsoft, TytoCare, CVS-Aetna moves along, Care Innovations exits Louisville

January 17, 2019 | by

Walgreens Boots finally does something. Their teaming with Microsoft to migrate their IT infrastructure to the Azure platform will eventually lead to “more personalized care experiences from preventative self-care to chronic disease management. WBA will leverage the cloud for wellness and lifestyle management programs.” It was important enough to both companies to have a photo op with twin CEOs: Walgreens Boots’ Stefano Pessina and Microsoft’s Satya Nadella. The ‘consumerization of healthcare’ and ‘transforming healthcare delivery’ phrases liberally sprinkled throughout the article and the press release are today’s prevalent clichés, as ‘synergy’ was the buzzword of say, 1999. Healthcare IT News, CNBC  In the long run, this IT overhaul may actually mean more to their customers than, say, the Amazon-JP Morgan-Berkshire Hathaway hydra.

A vote of confidence in diagnostic telehealth pioneered by young Israeli company TytoCare. They added $9 million to their Series C from investors including Sanford Health, Itochu and Shenzhen Capital Group (and its affiliates). This adds to last year’s round led by Ping An Global Voyager Fund for a total Series C of $33.5 million. TechCrunch. TytoCare also was named one of Wired’s Best of CES (CBS TV video, at 1:35) and earlier this month announced the integration of Health Navigator’s symptom checker into their system.

The judge says ‘No Delay For You’! In the CVS-Aetna hearing, Federal Judge Richard Leon refused to give the Department of Justice any more time to submit comments in the CVS Health and Aetna merger case. The deadline remains 15 February despite the government shutdown furloughing much of the antitrust division. Judge Leon is reviewing the decree under the Tunney Act requirement that the merger meet the public interest. Healthcare Finance

Care Innovations ankles Louisville. A modest and mainly paywalled item in Louisville Business First may point to something larger at Care Innovations. After two years of operation and a much-touted expansion to one of Louisville’s better addresses, the telehealth/RPM company has quietly vacated its 7,200 square foot space at Brown & Williamson Tower and pulled its operations from the city. Reporters from the publication were unable to obtain a statement from Care Innovations, which is now in Folsom, California, closer to majority owner Intel. At the time of their Louisville expansion in April 2017 (still on their website), Care Innovations received a $500,000 KBI tax incentive to create 24 high-paying jobs, which now are departed. It is ironic as Louisville is a health hub dominated by insurer Humana but has successfully campaigned for health tech. Last July [TTA 17 July], CI sold its Validation Institute and their VA win disappeared from their website. Of late, there has been no news from the one-time Intel-GE partnership.

Retail health convergence and ‘Amazon Effect’ continues with Albertsons’ acquisition of Rite Aid (updated)

February 20, 2018 | by | 1 Comment

The perceived ‘Amazon Effect’ continues. As predicted when the CVS-Aetna merger proposal made its first news last October while the Autumn Leaves were falling (cue the Ferrante and Teicher), other retail shoes would be dropping. Today’s major news is supermarket Albertsons buying most of drug store chain Rite Aid–the 2,600 stores that Walgreens Boots was prohibited from acquiring due to antitrust concerns. (Their eventual deal was for 1,932 stores.)

The terms are cash and stock with an estimated value of the combined companies of $24 billion (WSJ). Present Rite Aid shareholders will take 29 percent of the combined companies and present Albertson shareholders over 70 percent. Another benefit for Albertsons–it’s a quick and easy way to go public without an IPO using Rite Aid’s public status to effect a reverse takeover merger. It solves for Rite Aid (and Walgreens) the large problem of the unsold Rite Aid stores. 

Albertsons’ 2,200 supermarkets are in 38 states and the District of Columbia and comprise multiple brands such as Safeway and Acme in addition to Albertsons. Rite Aid stand-alone stores will continue to operate under their brand name as will most in-store pharmacies. The Rite Aid CEO John Standley will become CEO of the combined company with the Albertsons CEO moving up to chairman. CNBC, Seeking Alpha

Updated: For your weekend reading, here’s Jane Sarasohn-Kahn’s measured take on this acquisition in her HealthPopuli.

Who’s next? Place your bets here in Comments!

Rounding up the roundups in health tech and digital health for 2017; looking forward to 2018’s Nitty-Gritty

December 29, 2017 | by | 2 Comments

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”100″ /]Our Editors will be lassoing our thoughts for what happened in 2017 and looking forward to 2018 in several articles. So let’s get started! Happy Trails!

2017’s digital health M&A is well-covered by Jonah Comstock’s Mobihealthnews overview. In this aggregation, the M&A trends to be seen are 1) merging of services that are rather alike (e.g. two diabetes app/education or telehealth/telemedicine providers) to buy market share, 2) services that complement each other by being similar but with strengths in different markets or broaden capabilities (Teladoc and Best Doctors, GlobalMed and TreatMD), 3) fill a gap in a portfolio (Philips‘ various acquisitions), or 4) payers trying yet again to cement themselves into digital health, which has had a checkered record indeed. This consolidation is to be expected in a fluid and relatively early stage environment.

In this roundup, we miss the telecom moves of prior years, most of which have misfired. WebMD, once an acquirer, once on the ropes, is being acquired into a fully corporate info provider structure with its pending acquisition by KKR’s Internet Brands, an information SaaS/web hoster in multiple verticals. This points to the commodification of healthcare information. 

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/canary-in-the-coal-mine.jpgw595.jpeg” thumb_width=”150″ /]Love that canary! We have a paradigm breaker in the pending CVS-Aetna merger into the very structure of how healthcare can be made more convenient, delivered, billed, and paid for–if it is approved and not challenged, which is a very real possibility. Over the next two years, if this works, look for supermarkets to get into the healthcare business. Payers, drug stores, and retailers have few places to go. The worldwide wild card: Walgreens Boots. Start with our article here and move to our previous articles linked at the end.

US telehealth and telemedicine’s march towards reimbursement and parity payment continues. See our article on the CCHP roundup and policy paper (for the most stalwart of wonks only). Another major change in the US is payment for more services under Medicare, issued in early November by the Centers for Medicare and Medicaid Services (CMS) in its Final Rule for the 2018 Medicare Physician Fee Schedule. This also increases payment to nearly $60 per month for remote patient monitoring, which will help struggling RPM providers. Not quite a stride, but less of a stumble for the Grizzled Survivors. MedCityNews

In the UK, our friends at The King’s Fund have rounded up their most popular content of 2017 here. Newer models of telehealth and telemedicine such as Babylon Health and PushDoctor continue to struggle to find a place in the national structure. (Babylon’s challenge to the CQC was dropped before Christmas at their cost of £11,000 in High Court costs.) Judging from our Tender Alerts, compared to the US, telecare integration into housing is far ahead for those most in need especially in support at home. Yet there are glaring disparities due to funding–witness the national scandal of NHS Kernow withdrawing telehealth from local residents earlier this year [TTA coverage here]. This Editor is pleased to report that as of 5 December, NHS Kernow’s Governing Body has approved plans to retain and reconfigure Telehealth services, working in partnership with the provider Cornwall Partnership NHS Foundation Trust (CFT). Their notice is here.

More UK roundups are available on Digital Health News: 2017 review, most read stories, and cybersecurity predictions for 2018. David Doherty’s compiled a group of the major international health tech events for 2018 over at 3G Doctor. Which reminds this Editor to tell him to list #MedMo18 November 29-30 in NYC and that he might want to consider updating the name to 5G Doctor to mark the transition over to 5G wireless service advancing in 2018.

Data breaches continue to be a worry. The Protenus/DataBreaches.net roundup for November continues the breach a day trend. The largest breach they detected was of over 16,000 patient records at the Hackensack Sleep and Pulmonary Center in New Jersey. The monthly total was almost 84,000 records, a low compared to the prior few months, but there may be some reporting shifting into December. Protenus blog, MedCityNews

And perhaps there’s a future for wearables, in the watch form. The Apple Watch’s disconnecting from the phone (and the slowness of older models) has led to companies like AliveCor’s KardiaBand EKG (ECG) providing add-ons to the watch. Apple is trying to develop its own non-invasive blood glucose monitor, with Alphabet’s (Google) Verily Study Watch in test having sensors that can collect data on heart rate, gait and skin temperature. More here from CNBC on Big Tech and healthcare, Apple’s wearables.

Telehealth saves lives, as an Australian nurse at an isolated Coral Bay clinic found out. He hooked himself up to the ECG machine and dialed into the Emergency Telehealth Service (ETS). With assistance from volunteers, he was able to medicate himself with clotbusters until the Royal Flying Doctor Service transferred him to a Perth hospital. Now if he had a KardiaBand….WAToday.com.au  Hat tip to Mike Clark

This Editor’s parting words for 2017 will be right down to the Real Nitty-Gritty, so read on!: (more…)

The Theranos Story, ch. 45: a ‘Christmas present’ $100 million loan from Fortress averts bankruptcy (updated 8 Jan)

December 28, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/11/jacobs-well-texas-woe1.jpg” thumb_width=”150″ /]A present or a Trojan Horse? Revealed on Christmas Eve by the intrepid John Carreyrou of the Wall Street Journal (paywalled) is Theranos’ securing of a $100 million loan from Fortress Investment Group LLC. This Editor notes the word ‘loan’, and loans come with conditions. Mr. Carreyrou revealed that according to an email sent by (unbelievably still in place) CEO Elizabeth Holmes on Friday 22 December and reviewed by the WSJ, it is “subject to achieving certain product and operational milestones.” 

As our Readers know, with the Walgreens Boots settlement in August, cash on hand from June was about $54 million with a burn rate of $10 million per month [TTA 3 Aug]. Technically, Theranos was out of funds by December. This Editor thought the next article on Theranos would be an obituary issued from their warehouse in Newark, California. Updated: As of 8 Jan, there is no announcement on the Theranos website or comment to press.

According to the article, Fortress specializes in distressed investments. “The loan from Fortress is collateralized by Theranos’s patent portfolio and the deal grants Fortress warrants for 4% of the company’s equity, Ms. Holmes told investors in her email. She said she anticipated the loan would provide Theranos “sufficient liquidity through 2018” which is quite a fan dance.

Interestingly, Japan’s SoftBank Group completed its acquisition of Fortress yesterday (release). 

Our takeaway is that the IP is worth far more than the company and that is what has been bought. SoftBank would dearly like another entree into Silicon Valley for their tech portfolio and can use that IP, if not at Theranos, elsewhere. For Fortress, which has $36.1 billion in assets under management and now backed by SoftBank, $100 million is pocket change with a smidge of lint. Remaining investors also have likely written down the value on their investment. It’s a bit of a tweak on the expected denouement, but do not bet on Theranos and Ms. Holmes rising like phoenixes from the ashes of their Edison lab equipment.

Updated: Theranos’ last words on their website tout their accepted/presented publications and posters, but there is no further word on Theranos’ actual sale of Zika virus detection technology or the much-touted miniLab. It’s all a far cry from the palmy days three years ago of co-marketing with Walgreens and Ms. Holmes headlining Forbes, Fortune, and dozens of healthcare conferences and accumulating nearly a billion in funding as The Greatest Thing Since Sliced Bread.

Prediction for 2018: Ms. Holmes will be removed and replaced, then the company will be reorganized and/or renamed.

Full WSJ article on Yahoo! Finance. CNBC. Gizmodo. Our prior chapters on the Theranos Story are here. 

Analysis of the CVS-Aetna merger: a new era, a canary in a mine–or both?

December 6, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/canary-in-the-coal-mine.jpgw595.jpeg” thumb_width=”150″ /]This Editor has been at two healthcare conferences in the last four business days (with tomorrow being a third). They should be abuzz about how the CVS-Aetna merger may transform healthcare delivery. To her surprise, there’s been a surprising lack of talk. There is a certain element of ‘old news’, as the initial reports date back five weeks but the sheer size of it ($240bn combined future value, $69bn purchase, an estimated $750 million in near-term synergies), being the largest health insurance deal in history, and the anticipated effects on the health delivery model normally would be a breaking news topic. To this Editor, it is a sign that no one truly knows what to make of it, and perhaps it’s too big–or threatening–to grasp for provider and payer executives especially.

For an overview of what we saw at the time as reasons why and possible competitor reaction, Readers should look back to our original article [TTA 28 Oct]. It’s being presented by both companies as a vertical merger of two complementary organizations, which already were moving towards this model, integrating their different services into “America’s front door to quality health care” (CVS CEO Larry Merlo)–a lower cost setting that saves premium dollars and brings integrated care to consumers’ doorsteps.

CVS brings to the table huge point of care assets: 9,700 pharmacy locations, 1,100 MinuteClinics, Omnicare’s senior pharmacy solutions, Coram’s infusion services, and the more than 4,000 CVS Health nursing professionals providing in-clinic and home-based care. Aetna has about 23.1 million medical members, 14.5 million dental members, and 15.2 million pharmacy benefit management (PBM) services members. Aetna also has a wealth of advanced data analytics capabilities through two subsidiaries, ActiveHealth Management and  Medicity’s health information exchange technology.

Seeking Alpha has an intriguing POV on this entry into a ‘new era’: that both CVS and Aetna consider this to be a long-term reshaping of their business model under the threat posed by Amazon, and are willing to do this despite little short-term financial benefit for either company. The problem as the writer sees it: execution. This is re-engineering care on a national scale, and its benefits are based upon combining intangibles, a murky area indeed especially in healthcare. Time is also a factor, as Amazon is getting pharmacy licenses in multiple states, and is rather an expert at combining intangibles.

Does it signal that the approach to a ‘new era’ in healthcare is accelerating? If this is a preview, 2018 will be extremely interesting. Our ‘canary in the coal mine’ may tweet–or fall over on its perch, asphyxiated.

Some additional points to consider: (more…)

Creepy data mining on medical conditions runs wild: where’s the privacy?

July 18, 2017 | by

Ever heard of AcurianHealth? If you are in the US, you may get a letter for one of their research studies or drug trials based upon your prescriptions, your shopping habits, or your internet browsing. Where do they get that data? Quite legitimately, based on consent, Walgreens Boots will mail invitations for studies organized by Acurian to their pharmacy customers, where the user identification is withheld from Acurian. The privacy policy by which Walgreens does business with you permits this type of contact with you. These letters direct users to a generic sounding website for the study–and then life gets interesting. A visit to the site, whether from a letter, a search, or an online ad, may capture your information. There’s a bit of code from a company they work with, NaviStone, that captures information from partial or unsent information requests or signups. NaviStone then matches it up with what you think is anonymous behavior with other databases, and voilá, mail is sent to you via their ‘proprietary technology.’ Acurian uses databases from large data broker/aggregators like Epsilon and cranks away. It’s creepy behavior that stretches the definition of privacy and consent. Not reassuring is that Acurian has a database of over 100 million people who are supposedly opt-ins. How a Company You’ve Never Heard of Sends You Letters about Your Medical Condition (Gizmodo) Hat tip to Toni Bunting

Breaking-The Theranos Story, ch. 41: settling, not fighting, with Partners Fund on fraud

May 2, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/04/The-big-dig.jpg” thumb_width=”150″ /]Breaking News and Updated. Settled–but not settled? Theranos’ May Day celebration was an announcement of a settlement with investor Partner Fund Management (PFM) LP on their two lawsuits alleging investor fraud. PFM’s funds had invested $96.1 million in Theranos’ February 2014 funding round. The amount and terms of the settlement were, as usual, not disclosed.

PFM’s original filing in Delaware Chancery Court in October claiming fraud on various representations that Theranos had made, such as 98 percent reliability on its small sample Edison labs. The second filing in April [Ch. 40] temporarily blocked Theranos’ added equity offer to investors, an offer which had the important condition of blocking further legal action once accepted [Ch. 38]. PFM had powerful and damaging evidence on its side from 22 deposed former employees and directors to bolster its allegations of investor fraud, which was revealed in snippets from unsealed documents last week.

This settlement, according to reports, ends both court actions and permits Theranos to continue their equity offer to investors. According to Theranos, 99 percent of investors were willing to accept it, which neatly heads off additional legal actions. The offer to C-1 and C-2 investors expires 15 May. Theranos release.

Yet the depositions obtained in this case appear to have taken on a life of their own. Digging down into the WSJ report (not yet paywalled if you go in through the ‘What people are talking about’ right-hand sidebar on LinkedIn, or if you have a subscription) is the interesting tidbit that “Federal investigators have obtained depositions taken in the Partner Fund litigation, including those of former Theranos employees and directors, according to a person familiar with the matter.” The WSJ also filed to have the depositions unsealed on Monday (1 May), which an outside entity can request under the rules of the Delaware Chancery Court even after a case is closed.

Despite settlements with PFM, the state of Arizona, and CMS, Theranos still faces a live investigation from the Securities and Exchange Commission (SEC) and the Justice Department (DOJ). There are also major lawsuits from Walgreens Boots seeking to recoup its $140 million investment (and remove the egg on their corporate face) and the Colman/Taubman-Dye suit in California. The latter action has the potential to become a much larger lawsuit, as the US District Court in Northern California has requested a show-cause from the plaintiffs on including third-party sellers (Lucas Venture Group, Celadon Technology Fund, SharePost) as defendants. It also personally charges Elizabeth Holmes and former CEO Ramesh ‘Sunny’ Balwani (ch. 39).

Time and money are running out–and with a Federal investigation in the mix, the future of Theranos still resembles our picture above.

  • In March, Theranos reported $150 million in cash holdings. With another settlement, how much is left in the bank?
  • That equity offer, expiring in two weeks, may be a moot maneuver. After investors do the math and look at the calendar, they may decide that legal action may be a better way of capturing whatever’s left, before it’s all gone or tied up in Chapter 11. Perhaps PFM is smart indeed in moving to settle early.
  • Federal investigations usually do not end happily, unless you are Mayor De Blasio of NYC. Who knows what high-powered maneuvering is going on behind the scenes to prevent Ms. Holmes’ black turtleneck from becoming orange? And where in the world is co-defendant ‘Sunny’ Balwani?

Additional coverage: TechCrunch, Bloomberg  Our index of Theranos coverage is here.

The Theranos Story, ch. 40: investor fraud revealed in equipment, fake demos, testing

April 25, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/04/The-big-dig.jpg” thumb_width=”150″ /]Theranos’ ‘Big Dig’ is larger than this German art installation representing a Hole to China. It was as smooth as the turf depicted. Set up some shell companies, buy equipment from Siemens, modify it to take the mini-samples for the Theranos Edison mini-lab–and run their customers’ blood tests on them. Get incentives from a credulous Arizona governor and legislature. Run fake tests for investors on this equipment. Promise $1 bn in 2014 gross profits. Then, when it all comes undone, tell the investors to take additional equity shares and not to sue, or else it’s Chapter 11. Oh yes, and settle with Arizona for nearly $5 million and CMS for $30,000 [Ch. 39].

The latest reveal in the Theranos Saga took place in busy Delaware Chancery Court in a lawsuit brought by investor Partner Fund Management (PFM) LP and two other associated funds, which invested over $96 million in 2014. The unsealed documents, part of the follow-up to a lawsuit originally filed in October 2016 [Ch. 21] and another filed this month to block the equity offer to investors, contain depositions from 22 former employees and (hold the presses) directors. The (paywalled) Wall Street Journal article revealed that Theranos bought commercial blood testing lab equipment from reputable companies including Siemens, modified them to take the miniature samples that Theranos collected, used them to conduct both customer testing and from the filing, “fake ‘demonstrations tests’ for prospective investors and business partners”. Theranos used a shell company, Protegic Procurement Company, to make the purchases. Former director Adm. Gary Roughead, USN (Ret.), was quoted as being unaware of the fact that there were “extensive commercial analyzers in use.”

Now it is not uncommon for competitors’ equipment to be used for reference purposes and testing, especially when the company still is in process for their regulatory approvals. However, the lawsuit claims that customer tests were run on these labs, and not for a limited time as Theranos claims. The demonstration test claims are even more damning as they show fraudulent intent to investors.

The other part of the PFM lawsuit alleges that Theranos investors, including them, were pressured to not sue and take the additional equity deal [Ch. 38] by an attorney representing Theranos, who suggested that the alternative was to seek Chapter 11 bankruptcy protection. “Theranos officials engineered the share offer in a way that would make it impossible for the funds to obtain “any recovery” as part of its bankruptcy filing.” The PFM filing to block was successful. On April 11, Theranos was stopped from going forward with the share-exchange plan, with that hearing scheduled for June 26, not ideal for a company which is buying time before the money runs out. Bloomberg

The ‘cherry on the fraud cake’ is Theranos’ wildly inflated projection of a $1 billion gross profit in 2014. Theranos, of course, states that “The suit is without merit, the assertions are baseless, and the plaintiff is engaging in revisionist history.” Is ‘fake news’ the next claim? Ars Technica, TechCrunch, Fortune, Engadget.

Rest assured that there are many other chapters to come, as the lawsuits continue, including one for $140 million by Walgreens Boots, and the Colman/Taubman-Dye suit in California. Our Theranos and related articles are indexed here.

The Theranos Story, ch. 38: take our shares, but don’t sue us; Murdoch writes it off

March 29, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/11/jacobs-well-texas-woe1.jpg” thumb_width=”150″ /]What? They’re not toast yet? Far from it. We’ve missed the impossibly twisty soap opera called Theranos, and our latest episode holds to the previous high standard.

CEO and controlling shareholder Elizabeth Holmes is offering shareholders, supposedly from her personal holdings, about two additional shares for each one purchased. This has been offered to the investors in the 2014-2015 $600 million round who bought in at about $15-17/share (ch. 27), such as Cox and Bechtel. The deal dilutes their share cost to about $5. The caveat? Don’t sue Theranos. According to the Wall Street Journal‘s report (Yahoo Finance as WSJ is paywalled), it was approved by Theranos’s board in February, and most investors have ‘signaled that they will sign off on it’. Others are the family of US Education Secretary Betsy DeVos, the Waltons of Wal-Mart Stores Inc. and John Elkann, the Italian industrialist who controls Fiat Chrysler Automobiles NV.

One who is washing his hands is News Corp. executive chairman Rupert Murdoch. He reached a separate settlement for a nominal sum–rumored to be $1–to sell back his shares and legally write off his $125 million investment.

Others are not so lucky. Early investors before that round are not included. (more…)

The Theranos Story, ch. 36: Their money–and time–are running out

February 22, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/11/jacobs-well-texas-woe1.jpg” thumb_width=”150″ /]A garage sale soon for Theranos? A report in the Wall Street Journal, citing sources on a January investor call, revealed that Theranos has $200 million on hand, but zero revenue in 2015 and 2016. $200 million on hand sounds like–and is–a lot. But Theranos is, once again, oh so special. It’s less than 25 percent of their over $900 million raise. They’ve made no money in the past two years and are likely to make none in 2017 with an unapproved miniLab. Their CEO cannot run a lab by Federal action. They’ve laid off all but 200+ employees, all of whom with any shred of intelligence are job hunting. Then think of all the lawsuits: Walgreens Boots seeking to claw back its $140 million, individual and class actions on behalf of other investors, and the looming Arizona state fraud action. It’s a mere pittance when Theranos has to hire armies of attorneys who charge Billable Hours Galore and will likely lose some if not all of the lawsuits. This Editor is making an educated guess that at least one legal team is working on a bankruptcy filing. Fortune, TechCrunch, Business Insider

Forbes, like TechCrunch once a hyper-overdrive cheerleader for Ms Elizabeth Holmes and Theranos, offers up a profile of John P.A. Ioannidis, MD, DSC who holds the C.F. Rehnborg Chair in Disease at Stanford University and is director of the Stanford Prevention Research Center at the School of Medicine. Dr Ioannidis, according to the article, was the first to raise questions about Theranos’ methodology based on the obvious–that Theranos had published nothing in scientific journals. Theranos’ general counsel then reached out to suggest co-authoring an article with Ms Holmes in a major journal. Per Dr Ioannidis, it would support “the company view that FDA clearance offered the highest possible level of evidence for any diagnostics blood test technology.” They also said, “recant your existing views and writings about these misgivings.” He did neither, to his credit. The article interestingly does not explore the heat he, in as prestigious a position as he was, must have received, based on the close ties this Editor and others have noted between Stanford and Ms Holmes. Hat tip to Bill Oravecz of Stone Health Innovations

“This is the way the world ends/Not with a bang but a whimper.” T.S. Eliot puts a fine point on a Hollow Company, indeed.

See here for the 35 previous TTA chapters in this Continuing, Consistently Amazing Saga.

The Theranos Story, ch. 27: investor ‘whales’ surface in class action lawsuit news

November 30, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/11/jacobs-well-texas-woe1.jpg” thumb_width=”150″ /]Don’t jump…you may land on one of them! In the Bottomless Well that is The Unicorn Losing Its Horn, The Transubstantiation of a $9 bn valuation to $9, to mix up a Whole Lotta Metaphors, the latest is that Certain Big Investors (‘whales’ in Vegas Lingo) and at least one minnow have lost their shirts, or maybe their sleeves and cuff links.

The first is via a class action lawsuit filed Monday against Theranos in San Francisco Federal Court by Hagens Berman Sobol Shapiro LLP, seeking to represent potentially hundreds of purchasers of Theranos shares from July 29, 2013, through October 5, 2016 .

According to the Wall Street Journal, the charges relate to “false and misleading claims about its operations and technology while soliciting money from investors.” Hagens Berman is representing Silicon Valley investment banker Robert Colman, who is the retired co-founder of Robertson Stephens & Co. (a legendary, now defunct, investment bank specializing in tech that blew up after the dot-com bust). He invested through a VC fund, Lucas Venture Group, who participated in Theranos’ Series G funding in late 2013. Lucas was invited to invest $15 million, and their principals had personal ties to Elizabeth Holmes, according to TechCrunch. The second plaintiff, Hilary Taubman-Dye, purchased Theranos shares at $19/share on SharesPost Inc., an online exchange for shares of private companies, in August 2015. Her claim is that she tried to cancel it after the Wall Street Journal exposé in October, but the purchase went through in December after Theranos, Elizabeth Holmes and an unidentified third party refused to buy back the shares as a secondary transaction. TechCrunch identified her as a “longtime technical recruiter who now works in investor relations for a TV production company” which means that her investment was likely no bag of shells for her. Their respective investments are not disclosed.

The second, according to a second article in the Journal, comes from the usual ‘sources familiar with the matter’ and papers filed by Theranos in Delaware and Arizona. These include some very atypical startup investors, such as Rupert Murdoch of News Corp. and family-controlled Cox Enterprises, at $100 million each in the 2014-15 round when shares were valued at $17/each, and an undisclosed amount by Riley Bechtel of Bechtel Group, who was later named to the board of directors. Other, more typical Silicon Valley investments date back to when Theranos was the more pedestrianly named Real Time Cures in 2004 and the shares were 15 cents each:

  • Oracle co-founder Larry Ellison
  • VCs from firms such as ATA Ventures and Draper Fisher Jurvetson. The latter’s Tim Draper and his daughter (!) have been quite critical of anyone, especially John Carreyrou of the WSJ, claiming that Ms Holmes was perhaps mistaken in her scientific and business practices. (Partner Jurvetson in reports has expressed a more ‘que será, será’ attitude.) (more…)

A tricorder one step closer: Tyto Care gains FDA clearance for its digital stethoscope (US)

November 2, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/11/Mom_using_on_child_ear.jpg” thumb_width=”150″ /]Only a few years ago, the Star of the Future of Digital Health was the ‘tricorder’–that all-in-one vital signs device that Bones on Star Trek wielded with such élan (when he wasn’t uttering ‘He’s dead, Jim’). We haven’t heard much from Scanadu since early last year when it raised $35 million for its Series B and when it teamed with with Northern Ireland’s Intelesens as a finalist for the seemingly never-ending Qualcomm Tricorder XPRIZE. (Seven finalists are now in consumer testing with awards in early 2017.)

In the meantime, others have been proceeding in bringing their devices into reality far sooner, for real people with everyday health problems who want to examine a child, another family member or even themselves at home. One of these companies is Israel’s Tyto Care (picture above at left), which received FDA 510(k) Class II clearance for its digital stethoscope snap-on to the main device to monitor heart and lung sounds. The device also includes a digital imaging otoscope for ear exams, a throat scope, a skin camera and thermometer swipe. The Tyto home device includes video guidance instructions as part of the smartphone or tablet platform to enable a correct reading. It connects to an online platform to send the information, either in real time or store-and-forward, to a primary care physician the user selects. Tyto Care has been in investigational marketing in the US as well as Israel, bolstered by over $18 million in international investment. They are targeting home DTC as well as professional markets through practices, payers, virtual visit providers and possibly retail (one of their investors is Walgreens Boots). Release If you are attending MEDICA 2017 in Düsseldorf on 16 November, you can see Tyto Care demonstrated at the 5th Annual MEDICA App Competition.

Another all-in-one device is Las Vegas-based MedWand, which is still in pre-marketing. MedWand seems to feature clinic and ‘group’ packages as well as the individual device which includes a pulse oximeter. They received another round of undisclosed financing from Maxim Ventures, the venture arm for semi-conductor developer Maxim Integrated Products at end of September. Release.