TTA’s autumn leaves: Amazon Rx kiosks for One Medical, VillageMD shrinks in TX, Rock Health’s odd take on Q3 investment, Trilliant Health’s dizzying what-ails-healthcare analysis

October 10, 2025 | by | 1 Comment

 

Friday 10 October 2025

Several quick looks at Amazon’s test of pharmacy dispensing kiosks in One Medical clinics, VillageMD’s Texas selloff, and Rock Health’s strangely ambivalent report on Q3 digital health investment. Today’s deeper dive is a Must Read–Trilliant Health’s diagnosis on what ails US healthcare and why a “return to first principles” is badly needed, detailed in a 100+ page free report.

Editor Donna will be taking a short additional hiatus; back w/o 27 October.

Editor Donna’s selective roundup: One Medical’s Amazon Rx kiosks, VillageMD sells off Texas, digital health investment’s Q3 boost

Will “expensive, complex and inefficient” US healthcare respond to six major demographic, cost, supply trends–and recuperate? Or further sicken?

From our last Alert: Editor Donna is back. Here’s the catchup.

Congratulations to James Batchelor MBE (Well Deserved!)

And a read with even more relevance now: Should free-falling UnitedHealth Group be broken up? Or break itself up to survive, before it becomes another GE? (updated) (Not a rant, more a ‘get going’ to avoid disaster!)

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donna.cusano@telecareaware.com

Telehealth & Telecare Aware – covering news on latest developments in telecare, telehealth and eHealth, worldwide.

Editor Donna’s selective roundup: One Medical’s Amazon Rx kiosks, VillageMD sells off Texas, digital health investment’s Q3 boost

October 9, 2025 | by

Amazon keeps trying to integrate healthcare and make One Medical work, using Pharmacy as leverage. Like CVS, Walmart, and Walgreens, Amazon succumbed in 2022 to the Gold Rush of buying up a health clinic network and attempting to integrate primary care delivery into its retail model–after stumbling badly and failing with Amazon Care (2019). While the former have either ditched (Walmart), pivoted (CVS–Oak Street), or spun off their primary care providers (Walgreens–VillageMD/Summit Health), Amazon is testing yet another integration with One Medical, their first being with Amazon Prime.

In its latest tweak, Amazon is delivering limited onsite pharmacy services via a dispensing kiosk to a group of five One Medical offices in the Los Angeles metro. Now Amazon never calls it a test–one has to get about halfway down their release to discover those kiosks won’t be installed till December–but it’s obviously one, with a rollout to other undetermined One Medical offices promised in the sweet bye-and-bye of 2026. The kiosks will dispense common prescription meds in a four-step process: prescription written, sent to Amazon Pharmacy, patient opts for in-office kiosk pickup and payment using their mobile phone to check it out in the Amazon Pharmacy app, and checks it out using a QR code at the kiosk.

Using these five locations (Beverly Hills! West LA!) is an adequate feasibility test, but doesn’t address the piously phrased rationale of 25% of neighborhoods as “pharmacy deserts” and where even in non-desert areas, 51% of patients report delays in filling prescriptions.

The kiosks will be storing basically common Rx meds such as antibiotics, blood pressure medications, and inhalers. 

Where this picture isn’t as revolutionary as my friend Sergei Polevikov maintains in his latest Substack essay (subscription required–and you should; also partially on LinkedIn), it’s another kick in the head for the traditional pharmacy retailers and the PBMs. They are already getting boot impressions by the Hims & Hers virtuals and Big Pharma on GLP-1 and ‘favored nation’ DTC deals. On one side, it reduces friction by making it onsite and easy. But suppose the kiosk doesn’t have my med or it’s out of stock. What do I do once the script is sent and I need to change it? This is also appealing to a younger and/or tech-savvy segment who live on their phone and Amazon apps. Suppose I’m an older patient and apps/QR codes do nothing but confuse me? For Amazon, what about the cost of kiosk installation, cleaning, stocking, monitoring, just like those telehealth kiosks from Forward (CarePods), Higi, and way back HealthSpot Station. They were the future–for five minutes. Apparently there’s also a little regulatory issue of self-dealing referral (hat tip to LinkedIn commenter Ajay Kumar Gupta).  Also Healthcare Dive

VillageMD continues to shrink. The formerly free-standing and co-located Walgreens clinic unit, spun off into a standalone company by Sycamore Partners while I was on medical leave (FierceHealthcare 28 Aug), has sold 32 Texas primary care clinics to Harbor Health, a primary care group and payvider in the Austin area. This adds San Antonio, El Paso, and Dallas as well as more Austin locations. Forbes From a significant almost-national primary and specialty care group, VillageMD is devolving into pieces for sale. One wonders about the extensive Summit Health/CityMD operation, very much tied in with Hackensack Meridian Health that dominates northern New Jersey, and disruption. (Disclosure: my family and I are Summit Health patients)  In other news, Tim Wentworth was replaced as CEO by Mike Motz, from another Sycamore portfolio company. Wentworth remains as director for the time being, undoubtedly working out his retention and various payouts. 

Rock Health breaks the cheerful news that Q3 digital health is an improvement over a dismal 2024 a/k/a 2019. YTD is $9.9 billion, exceeding the $8.4 billion raised through 2024 Q3. Deal size is also trending up: $28.1 million, increasing from $20.4 million in 2024. Where it’s still wobbly is middle-stage investment and anything with a Series letter. Rounds of $100 million plus thrived, with 19 of them accounting for 40% and $3.8 billion of 2025 YTD total funding. I won’t be doing my usual dive into their numbers due to time constraints, but Healthcare Dive summary will do. Rock Health’s Q3 report, usually putting the best foot forward, is weirdly downbeat, calling it ‘signals out of sync’. 

Way out of sync is the continuation of the partial Federal government shutdown, with no mercy on telehealth services and the donkeys doing what donkeys do…refuse to move. 

I’ll be on a short hiatus with no new articles until the week of 27 October.

TTA’s Blooming Spring: Walgreens tidies opioids for $350M, health AI more show than go, Blue Shield CA’s Googly breach, Veradigm’s CEO to depart, BCI meets telehealth for stroke, fundings, more!

April 25, 2025 | by

25 April 2025

Back at the desk….hope your holiday was great!

Cherry blossoms are blooming (finally) and so is the news. The roundups include Walgreens’ continuing Aisle 9 cleanup of their Federal opioid prescribing allegations, a huge and mysterious breach of Google Analytics sending member info to Google Ads, and Veradigm’s interim CEO will be taking the summer off. Our big reads include two surveys: the first on the state of healthcare AI (more show than go) and the second on RPM utilization–and effectiveness. Two raises, a BCI/telehealth merge, and international initiatives.

Product & funding very short takes: South Australia 1st with Sunrise EMR; S. Korea pain research, new emergency services app; BCI + telehealth for stroke patients; VirtuSense monitoring launches at Emory; Series B raises for Nourish, Healthee

Short takes: Veradigm’s interim CEO departing, Blue Shield CA breached 4.8M members’ PHI to Google, advice on expanded M&A premarket notification rules (You can’t blame that CEO for ankling! And Blue Shield has 2nd largest breach–involving Google Analytics.)

News roundup: Walgreens’ $350M opioid settlement, only 30% of healthcare AI pilots reach production, Medicare RPM usage up 10-fold despite benefit limitations (Walgreens cleans up again, and two surveys on AI and RPM for weekend perusal)

Two weeks ago, we were still going through a chilly Spring. Our big pre-Easter/Passover read for the weekend was Halle Tecco’s quantifying of the Cracked SPAC phenomenon and what’s happened with OpenAI. Transcarent closes its Accolade buy and changes its tune to ‘one place’, Walgreens doing a bit better. In touting, Keir Starmer’s bet on NHS data research and Elon Musk on human trials for Neuralink Blindsight. Hinge Health may postpone its long-awaited IPO and FTC pauses its long-awaited toss of the book at PBMs. Plus a new Perspectives on rural healthcare and telehealth.

The weekend read: why SPACs came, went, and failed in digital health–the Halle Tecco analysis/memorial service; why OpenAI is going to be a bad, bad business (Grab the cuppa and lunch for a good read and podcast. Updated–Also Tecco’s blog post on why she quit being an angel investor.) 

Extra, extra!: ATA Action forms Virtual Foodcare Coalition, Ophelia and Spring Health partner on opioid treatment, ISfTeH renews NSA status with WHO (More action from ATA Action and a partnership to watch in telementalhealth)

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

Rock Health’s digital health Q1: more money, fewer deals, more additions and partnerships in ‘leapfrogging’ (Still in a minor key this year)

News roundup: Hinge Health may postpone IPO, Rite Aid may enter 2nd bankruptcy, Veterans Affairs committees want new EHR costs & timeline, fired Texas health plan head hired private eyes to spy on members, providers, lawmakers (The last one is shocking)

Perspectives: Bridging the Gap in Rural Healthcare Through Telehealth (From Yosi Health)

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Contact Editor Donna for more information.

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Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Telehealth & Telecare Aware – covering news on latest developments in telecare, telehealth and eHealth, worldwide.

News roundup: Walgreens’ $350M opioid settlement, only 30% of healthcare AI pilots reach production, Medicare RPM usage up 10-fold despite benefit limitations

April 24, 2025 | by

Walgreens continues to clean up on Aisle 9 before it goes private. Walgreens settled the Federal allegations around illegally filling invalid prescriptions for opioids and seeking payment from Federal programs for $300 million. There’s an additional $50 million tagged onto it if the company is sold, merged, or transferred prior to fiscal year 2032. Since Walgreens has ‘done the deal’ with Sycamore Partners, the settlement amount will be the full $350 million. According to the Department of Justice’s press release, the settlement was based on Walgreens’ ability to pay. There was no statement on when the $350 million will be due.

This settles the complaint filed on 16 January (amended 18 April) in the US District Court for the Northern District of Illinois by the Department of Justice (DOJ), the Drug Enforcement Administration (DEA), and the Department of Health and Human Services Office of Inspector General (HHS-OIG). In the suit, Walgreens faced civil penalties of up to $80,850 for each unlawful prescription filled in violation of the Controlled Substances Act (CSA), plus treble damages and applicable penalties for each prescription paid by Federal programs in violation of the False Claims Act (FCA) for over 10 years–approximately August 2012 through March 1, 2023 The red flags included prescriptions for the ‘trinity’ of an opioid, a benzodiazepine and a muscle relaxant. If Walgreens had been found guilty, the penalty could have been billions. 

Given the numbers that in January presented a large impediment to a sale, settling rather than fighting makes sense. The projected Sycamore Partners closing is only two quarters away (Q4, TTA 11 Mar). The 35-day ‘go shop’ period has closed with no other offers. The DOJ has moved to dismiss its complaint in Illinois, while Walgreens will also move to dismiss a related declaratory judgment action filed in the District Court for the Eastern District of Texas. In addition to Illinois, the District of Maryland, the Eastern District of New York, the Middle District of Florida, and the Eastern District of Virginia participated in the complaint.

In addition to the settlement, Walgreens’ pharmacy operations are now under Federal scrutiny, based on multiple agreements with DEA and HHS-OIG attached to the settlement, addressing what they and the DOJ saw as compliance violations in dispensing controlled substances. From the release:

  • Walgreens and DEA entered into a memorandum of agreement that requires the company to implement and maintain certain compliance measures for the next seven years. 
  • Walgreens must maintain policies and procedures requiring pharmacists to confirm the validity of controlled substance prescriptions prior to dispensing controlled substances, provide annual training to pharmacy employees regarding their legal obligations relating to controlled substances, verify that pharmacy staffing is sufficient to enable pharmacy employees to comply with those legal obligations, and maintain a system for blocking prescriptions from prescribers whom Walgreens becomes aware are writing illegitimate controlled substance prescriptions.
  • Walgreens has also entered into a five-year Corporate Integrity Agreement with HHS-OIG, which further requires Walgreens to establish and maintain an extensive compliance and training program

Crain’s Chicago Business, Healthcare Finance, Settlement Agreement

Healthcare AI continues to be more show than go. A report by Bessemer Venture Partners surveying payers, pharma, and providers states that 95% of respondents said GenAI will be transformative, with 85% of provider and 83% of payer leaders expecting it to reshape clinical decision-making within three to five years. Yet only 30% of AI pilots — what the report calls “internally and externally developed GenAI proof of concept (POC) projects” make it to production. 

Generative AI applications are being developed by the organizations’ IT teams, building their own tools by partnering with horizontal AI labs (i.e., Anthropic), Big Tech companies, or going to current and new vendors. The impediments they face are cybersecurity, data readiness, integration costs, and limited in-house expertise. Procurement is shifting toward co-development; 64% of execs are open to co-developing with early-stage partners. A contradiction is that only 32% of executives believe GenAI solutions from startups are superior to those from large tech incumbents. yet 48% prefer working with startups over established players.

Yet with these “aspirations and expectations” in the 80-90th percentile, only half of the surveyed organizations surveyed have a clear AI strategy with 57% having an AI governance committee, with payers in the lead. Those in it are putting real money behind it and seeing some meaningful ROI (54%), however. 

Among the three surveyed segments, Bessemer identified 59 jobs-to-be-done. Yet 45% of these jobs are still in the ideation or POC phase, with far fewer actually in production. These jobs clustered as follows: 22 for payers (claims, network, member, pricing), 19 for pharma (preclinical, clinical, marketing, sales), and 18 for providers (care delivery, revenue cycle management). The survey was performed by Bessemer with Amazon Web Services and Bain & Company, across 400 leaders in the three segments. 

Remote patient monitoring (RPM) Medicare usage growing steadily, despite limitations on clinical effectiveness. This new report from the Peterson Center on Healthcare tracks how RPM usage has grown among Medicare (traditional, Medicare Advantage) and Medicaid beneficiaries since 2019, when CMS enabled Medicare codes for reimbursement. For Medicare, despite only 1% of beneficiaries using RPM, it grew exponentially–10-fold for traditional Medicare between 2019-2023 and 14-fold for MA between 2019 and 2022.

  • Top chronic conditions are hypertension (57%) with diabetes far behind at 13%. Also growing but much smaller is remote therapeutic monitoring (RTM), dominated by musculoskeletal (MSK) disorders.
  • Traditional Medicare spent $194.5 million on RPM and $10.4 million on RTM in 2023.
  • Clinical effectiveness tends to be short-term. In hypertension, RPM is most valuable within the first six months, when blood pressure medications are actively monitored. For diabetes, the prime target is likely patients with the highest starting HbA1c levels and those
    who are at critical transition points in their care plan, such as starting insulin. For RTM, the most effective gains occur in 2-4 months.
  • Yet utilization is increasing. The duration of continuous RPM in traditional Medicare in 2023 was 5.2 months, with 22% over nine months. For hypertension, the average is 6.6 months. For MSK RTM, the average was below effectiveness-only 1.7 months.

The Peterson Center’s policy conclusions advocate a reset:

  • Coverage and reimbursement need to be better aligned to actual clinical value
  • Adoption of high-impact remote monitoring services and minimizing or eliminating the use of poorly performing digital applications
  • Improved data collection for remote monitoring services for evidence-based coverage and reimbursement decisions

Evolving Remote Monitoring

TTA Where *Is* Spring? 3: SPACs–why they cracked, Hinge Health and FTC-PBM delays, Transcarent’s tune change, UK’s pivot on NHS research data, why OpenAI is losing its way, more!

April 11, 2025 | by

 

11 April 2025

It’s still a chilly Spring in your Editor’s whereabouts, but we have, fresh out of the hothouse, a bumper crop of news and opinion. The big read for the weekend is Halle Tecco’s quantifying of the Cracked SPAC phenomenon and what’s happened with OpenAI. Transcarent closes its Accolade buy and changes its tune to ‘one place’, Walgreens doing a bit better. In touting, Keir Starmer’s bet on NHS data research and Elon Musk on human trials for Neuralink Blindsight. Hinge Health may postpone its long-awaited IPO and FTC pauses its long-awaited toss of the book at PBMs. Plus a new Perspectives on rural healthcare and telehealth.

The weekend read: why SPACs came, went, and failed in digital health–the Halle Tecco analysis/memorial service; why OpenAI is going to be a bad, bad business (Grab the cuppa and lunch for a good read and podcast) 

Extra, extra!: ATA Action forms Virtual Foodcare Coalition, Ophelia and Spring Health partner on opioid treatment, ISfTeH renews NSA status with WHO (More action from ATA Action and a partnership to watch in telementalhealth)

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

Rock Health’s digital health Q1: more money, fewer deals, more additions and partnerships in ‘leapfrogging’ (Still in a minor key this year)

News roundup: Hinge Health may postpone IPO, Rite Aid may enter 2nd bankruptcy, Veterans Affairs committees want new EHR costs & timeline, fired Texas health plan head hired private eyes to spy on members, providers, lawmakers (The last one is shocking)

Perspectives: Bridging the Gap in Rural Healthcare Through Telehealth (From Yosi Health)

Last week: A relatively light news week in a so-far chilly, stormy Spring. Our top article is not one, but two dives into the Unicorn Known as Hippocratic AI. 23andMe’s sale isn’t attracting a lot of buyers (deliberate?) but presents even more problems for the users who took their surveys. Dr. Oz confirmed for CMS as HHS goes on a GLP-1 diet and then some. VA adds to their Oracle 2026 rollout, ATA Action enlarges, and DOJ seeks execution for Brian Thompson’s assassin.

News roundup: 9 additional VA centers named for Oracle 2026 EHR rollout; ATA Action acquiring, expanding with DTA; Dr. Oz to lead CMS while HHS cuts; DOJ seeks death penalty for Mangione  (VA creeps forward, ATA Action enlarges, HHS chops, justice awaits)
Are Hippocratic AI and AI “nurses” the wave of the future–or just another tide of hype? Two articles question. (A needed discussion on this particular unicorn and whether its AI capabilities are all they’re pitched to be)
23andMe’s slim list of prospective buyers–who must uphold privacy policies, according to the FTC. But what about that survey information? *Updated* (More problems with 23andMe’s sale–and if you took their surveys, they have more data on you)

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Support not only a publication but also a well-informed international community.

Contact Editor Donna for more information.

Help Spread the News

Please tell your colleagues about this free news service and, if you have relevant information to share with the rest of the world, please let me know!

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Telehealth & Telecare Aware – covering news on latest developments in telecare, telehealth and eHealth, worldwide.

Rock Health’s digital health Q1: more money, fewer deals, more additions and partnerships in ‘leapfrogging’

April 8, 2025 | by

There’s a small uptick and some optimism in the air for US digital health deals after all. After a 2024 that realistically was a ‘down round’ or Back To 2019, 2025 is picking its way through the New Reality of Global 52-Card Pickup, powered by a new US government and still-defining AI technology. Let’s unpack what Q1 was like in Rock Health’s view:

  • Funding was $3.8 billion across 122 deals, with an average deal size of $24.4 million. Compared to Q1 2024, total investment was up ($2.7 billion) as was the average size ($20.6 million) but number of deals were down (133).
  • Q1 funding also exceeded Q4 2024 funding in a pattern typical of the past few years.
  • 83% of deals were seed, Series A, and Series B rounds, not much different than 2024’s 86%. There were a few exceptions listed by Rock Health. By far the largest was Hippocratic AI’s $141M Series B but also Achira’s $33M seed, and Open Evidence’s $75M Series A. MSK player Vori Health sported a $53 million Series B in March
  • There were only 5 Series D or larger deals but three were jumbo sized: Innovaccer ($275M), Abridge ($250M), and Qventus ($105M), which pulled the average up to $105 million, nearly double that of FY 2024.

Rock Health is mum on unlabeled or funding not disclosed deals, such as the ones TTA noted through the quarter: Summer Health -Caraway, Neuroflow-Quartet Health, Iris Telehealth-InnovaTel, Dispatch Health-Medically Home, and Wysa-April Health.  It also doesn’t provide its usual analysis of healthcare value propositions and clinical indicators.

An interesting analysis in the shorter-than-usual announcement breaks down an approach they’ve dubbed ‘leapfrogging’, defined as ways companies can acquire knowledge or shift to respond to market dynamics:

  1. Tapestry Weaving. It’s a quaint way of saying that capabilities can be bought through M&A. (Business can be bought that way too–Transcarent closed its $621 million buy of enterprise care navigator Accolade today.) 
  2. Modular Tech Stacks. This type of tech design allows companies to switch out or add in tech as the market changes or better tech emerges.
  3. Channel Partnerships. Companies, by adding partners, add capability at low cost and reach, though the logistics of partnering, the integration cost and quality of service aren’t easy lifts.
  4. Engaging Disruptors. Companies invested in certain standard processes can expand by allying with their disruptors, versus viewing them as competitors. 

What’s not mentioned in the report are the high profile failures this quarter: 23andMe’s bankruptcy, Walgreens’ sale to Sycamore Partners, and Veradigm’s failure to sell itself.  Given the past few months, we’ll be doing a lot of ’embracing uncertainty’ this year!  Also FierceHealthcare

News roundup: Hinge Health may postpone IPO, Rite Aid may enter 2nd bankruptcy, Veterans Affairs committees want new EHR costs & timeline, fired Texas health plan head hired private eyes to spy on members, providers, lawmakers

April 8, 2025 | by

Isn’t April a bit early for roller coaster rides?

Hinge Health may postpone its IPO. This is absolutely to no one’s surprise. Virtual MSK provider Hinge Health had filed a SEC S-1 preliminary prospectus back in mid-March [TTA 14 Mar] with few specifics, and had not committed to any dates. With Mr. Market taking multiple rides on an old-school wooden roller coaster, Hinge is dangling a postponement. Business Insider spoke with the usual Insider who said rather minimally that the company intended to start speaking with investors towards the end of April and go public in May, but now may postpone. They might still go public on this schedule if Mr. Market sees Hinge as a good alternative buy. Supposedly, they have the cash on hand and don’t need the IPO to finance the business. By this stage, there’s a gaggle of investors hungry for a partial or full exit financed by Other People’s Money on their $826 million invested to date: 8% shareholders Coatue, Tiger Global Management, Whale Rock Capital Management, Bessemer Venture Partners, Insight Partners (19%), and Atomico (15%). Founders Daniel Perez (CEO) and Gabriel Mecklenburg (director), who own 18.9% and 8.2%, may also be eager to cash in. Hinge is keeping mum as they must. This Editor’s bet is that their IPO will be no later than June. Yahoo! Finance

Rite Aid may go through the Pain of Bankruptcy yet again. Sadly, the distant third in the pharmacy/retail healthcare market is rumored to be considering another bankruptcy as not seeing a sustainable way forward as a private company. Alternatively, they are exploring selling parts of its business, though it’s hard to imagine who would buy. In the October 2023 bankruptcy, the company went from 2,000 locations and 47,000 employees to 1,300 locations, exiting entire states to concentrate where they could have some market impact. They sold Elixir, their pharmacy benefits manager, and settled with major creditors. In March 2018, they had downsized by selling 1,932 store locations for $4.38 billion to Walgreens. Like Walgreens and CVS, they are also dealing with legal liabilities from opioid-related lawsuits. Reportedly, they are being advised by Big Law firm Paul Weiss to advise on options, such as what can still be sold and what kind of bankruptcy. Wall Street Journal, Chain Drug Review, Daily Mail

The VA and Oracle have some ‘splainin’ to do to Congress. As VA has put stakes in the ground with migrating 13 VA Medical Centers from VistA to Oracle, a few Members of Congress on Veterans Affairs committees in the House and Senate have been awaiting More Information on the Electronic Health Record Modernization (EHRM) program. What they want to know are the fundamentals: costs and updated schedules. VA has not yet provided a cost update that is mandated by laws and Office of Management and Budget (OMB) directives governing major acquisition programs. The Congress members from both parties requesting the information are: Sen. Jerry Moran (R-Kansas), Richard Blumenthal (D-Conn.), Rep. Mike Bost (R-Ill.), Rep. Mark Takano (D-Calif.), Sen. John Boozman (R-Ark.), Sen. Jon Ossoff (D-Ga.), Rep. John Carter (R-Texas) and Rep. Debbie Wasserman Schultz (D-Fla.). Senator Moran press release

Private Eyes Are Watching You. They See Your Every Move. Mark Sanders, CEO of Superior Health Plans in Texas, a Centene health plan, admitted before the Texas House Delivery of Government Efficiency Committee that he had hired private investigators to get “background information” on lawmakers and plan members, specifically about claims, in a 26 March hearing on Medicaid procurement. The Dallas Morning News had previously uncovered examples of members who were being investigated from 2017 on, when Mr. Sanders became CEO. He testified that “investigators had done “routine” background checks into several state representatives, senators, health care providers, patients and their families and a journalist.” The state officials included Texas Land Commissioner Dawn Buckingham, then a state senator, and Southlake Republican state Rep. Giovanni Capriglione, according to documents obtained by The Dallas Morning News.  One claim denied was, according to the paper, Linda Badawo of Mesquite, Texas, and her 3-year-old son D’ashon Morris. “D’ashon, who was denied private duty nursing despite emphatic protests from Linda, his doctors and nurses, pulled his trach out and was found not breathing, as his caregivers warned he would.” Mr. Sanders called these ‘routine background checks’ and ‘general research’  no longer being done. Rep. Capriglione is now chair of the committee holding the hearings, which surely meets the Sicilian Standard of revenge as a dish best eaten cold.

Superior used a Missouri-based security company, Griffin Personnel Group, to perform these and other investigations. One investigation the committee uncovered said that Griffin attempted to obtain the divorce records of Sen. Charles Schwertner, R-Georgetown, just a few months after his wife filed in early 2019. Sen. Schwertner and Rep. Capriglione were members of budget committees at the time. Centene is HQ’d in St. Louis, Missouri.

Texas Attorney General Ken Paxton almost immediately announced an investigation into Centene’s practices. Centene fired Mr. Sanders within hours, stating “The conduct highlighted yesterday during the course of the Texas House Committee hearing is not reflective of our values nor is it a practice Centene’s current leadership condones. To this end, Mark Sanders is no longer with our organization.” Perceptive Readers will note the subtle ‘dig’ at the previous CEO; in 2017, Centene’s CEO for then over 20 years was Michael Neidorff, who is no longer here on this planet to defend himself. Centene is now controlled by activist investor Politan Capital.) At stake are hundreds of millions in state Medicaid contracts.

(Disclosure: this Editor worked for an ACO management services organization owned by WellCare, not Superior, acquired by Centene, and technically worked for Centene for less than one year ending in 2020.)

News roundup: Walgreens settles 10 year running false claims suit for $5M; UniDoc to buy AGNES Connect; launches from Klarity Health, Tunstall UK, HSE Ireland; VITAL WorkLife survey finds yawning gap in clinician/management mental health perceptions

March 27, 2025 | by

Walgreens continues to tidy its accounts. The ten-year-old whistleblower-initiated Federal lawsuit charged that Walgreens violated  anti-kickback statutes for Medicare and Medicaid was settled for $5 million on Tuesday. The claim was that patients at the Cook County Health & Hospital System’s Ruth M. Rothstein CORE Center were induced to fill prescriptions at Walgreens’ specialty pharmacy by waiving copayments, an inducement that violated the False Claims Act. The lawsuits were filed in the Federal District Court for Northern Illinois by Sarah Castillo Baier and Rita Svendsen Baier in 2014, then by the Department of Justice and the state of Illinois filing their joint complaint four years later in 2018. The settlement will be divided between the two whistleblowers and the US and Illinois governments. This is Walgreens’ second settlement in the last month and pocket lint compared to the first; their $595 million bill for settling the $1 billion PWNHealth/Everly Health arbitration award came due at the end of February. Crain’s Chicago Business

UniDoc signs agreement to buy AGNES Connect from AMD Telemedicine. The Canadian ‘doc-in-a-box’ remote virtual clinic company has agreed to acquire the AGNES Connect business line, software, and customers to its present H3HealthCube product (right). Their NEIL Connect software for the HealthCube was already built on the AGNES Connect telemedicine clinical exam platform. Interestingly, UniDoc is acquiring the use of the AMD Telemedicine name for AGNES along with related goodwill and trademarks, for which they are paying a low US $175,000 in cash plus a revenue share. The Canadian Securities Exchange may have to approve, but the closing is expected shortly. The H3Health Cube was recently placed in Italy and Ukraine [TTA 13 Feb]. Release

This week’s three launches are:

  1. Klarity Health launches Kiwi Health. Telehealth and independent private practice management platform Klarity Health’s new Kiwi Health is designed as an an all-in-one marketing and communications tool. It provides practices with SaaS tools to set up and promote an online presence in 30+ clinical directories, professional website management, patient intake and scheduling, a patient portal, loyalty, and engagement. Klarity has operations in 40 states with practices serving over 100,000 patients while retaining 94.3% of its doctors–all on a slim raise of $12.5 million. Release
  2. Tunstall Healthcare UK introduces Communicall Digital. This fully digital warden call system is designed for supported housing and retirement communities including extra care environments. It enables residents not only to summon assistance through its alarm feature, but also to manage door entry and room-to-room video calls through a simple touchscreen system. The system also reports resident activity to care staff through the Central Management Platform. It is fully compliant with the UK’s digital transition requirements to the industry-standard BS8521-2 (NOW-IP) protocol. THIIS
  3. Ireland’s Ministry of Health launches the Health Service Executive (HSE) Health App. The initial release will enable Irish residents to access and store their health information including self-declared medications; view a list of medicines received through the Irish Drugs Payment Scheme or Medical Card Scheme; their European Health Insurance Card (EHIC); their medical Long-term Illness (LTI), Drugs Payment Scheme (DPS) and GP Visit cards; flu and COVID-19 vaccination records; maternity service appointments, and information on HSE services. Additional features will be rolled out during 2025. Ireland Department of Health release

Meanwhile, clinicians and their leadership stand waaaay far apart on burnout and workplace mental health. A study from VITAL WorkLife, a mental health provider for healthcare workforces including physicians and nurses, finds that there’s a Grand Canyon of a perceptual gap between clinicians and healthcare employer leadership.

  • 79% of clinicians feel unsupported — while 95% of leaders believe they are addressing healthcare worker burnout
  • 80% of clinicians believe that it’s urgent to address to address mental health challenges in their organization–but only half of the leadership agree
  • Over 70% of clinicians believe that their leadership considers organizational mental health a low-priority issue
  • 98% of healthcare leadership believe that they make workplace mental health a priority, while only 39% of clinicians agree–and believe that organizational performance is far more their concern.
  • 92% of healthcare leadership believe that existing programs are well tailored to organizational needs–but only 16% of clinicians agree. 33% disagree and an addition 51% find themselves in the ‘middle’. 

The online survey of 210 healthcare professionals across the US was taken over a three-week period in January 2025, with a cross-section of healthcare functions including leadership level medical, nursing, HR, and wellness staff, as well as clinicians. The full survey is available for download at this link. Release

These just in: drug compounders sue FDA over semaglutide scarcity removal; Sycamore’s Walgreens buy plans begin to show

February 27, 2025 | by

What the telehealth prescribers can’t do, the compounders are. A major drug compounder association, the Outsourcing Facilities Association, along with member North American Custom Laboratories, LLC, both based in Texas, filed suit yesterday (24 February) against the FDA to vacate the final action removing semaglutide, the active ingredient in GLP-1 drugs, from the shortage list. The FDA announced that it was being removed from the shortage list effective April-May, after months of compounders legally creating semaglutide-based weight loss drugs as permitted during the shortage. This was certainly good news for Novo Nordisk, the pharmaceutical company that developed and markets Ozempic and Wegovy [TTA 25 Feb].

The compounding was a boon for telehealth providers such as Hims and Hers, Ro, 23andMe (Lemonaid), Future Health, Weight Watchers, Lark, and many others. It allowed them to customize injectable formulations for customers on weight loss programs at a far lower cost than standard branded products. The FDA allows this only during times of shortage (compounded by Section 503A pharmacies and Section 503B outsourcing facilities as “essential copies” of FDA-approved drugs). Exceptions are also made if the standard drug is in some way inappropriate for the patient who then medically requires a customized version, e.g. with adjusted dosage, method of dosing, or added/deleted ingredients, but these are not ‘mass’ circumstances or situations. 

Among the grounds presented in the suit against the FDA are that the shortage is still going on with delays in prescription filling, leading to patient harm; that FDA’s delisting was arbitrary without the required notice with public comment nor was it published in the Federal Register; and that it is ‘arbitrary and capricious’. Novo Nordisk has admitted publicly that supply constraints could still exists. 

Continued ‘customization’ is vital to telehealth prescribers’ revenue, while branding is vital to the pharmaceutical developers undercut by compounding. In 2024, Hims alone earned $225 million in revenue from compounded semaglutide and other GLP-1 type drugs. Both Novo Nordisk and Lilly (Zepbound) have pushed back on the compounders on safety and risk, along with lower prices in new delivery types such as vials versus autoinjectors.

The suit was filed in the US District Court for the Northern District of Texas. Biopharma Dive

More intriguing details if Sycamore Partners takes Walgreens Boots Alliance private. Financial Times reported via Reuters that according to the usual “people familiar with the matter”, Sycamore’s plan is to separate WBA into three parts, like Gaul: US retail pharmacy, Boots UK, and US Healthcare (VillageMD, CareCentrix, and Shields Health Solutions). They would have distinct capital structures. There’s minimal information beyond that. Sycamore is not expected to have difficulty financing the take-private, and WBA chairman Stefano Pessina is expected to have an ownership stake. The news drove WBA shares up today about 5% and 10% in the last five days. But the news seems to be moving along. VillageMD’s on the market is assumed but it is not certain any sale would complete in time. Crain’s Chicago Business

This Just In: Walgreens settles PWNHealth/Everly Health arbitration award for $595 million, reduced from $1 billion

February 26, 2025 | by

A golden bird in the hand for PWN/Everly–and presaging something else for Walgreens? Walgreens has decided to settle with PWN/Everly the latter’s recently upheld near-$1 billion arbitration award for $595 million, about 60%. This amount is payable to Everly in a breathtaking two business days.

The arbitration between PWN/Everly and Walgreens charged Walgreens with breach of contract on their Covid-19 testing services agreement, adding in additional violations of the Latham Act on trademarks and more. The arbitrator’s award of $987 million last March was affirmed by the US District Court for the District of Delaware on 11 February. Walgreens declared it would appeal but stated in their SEC filing that any resolution might take up to two years. More details: TTA 12 Feb

Was this a ‘Deal Deal’ as a prelude to a more significant endgame for Walgreens? For this Editor strictly speculating, Walgreens not appealing but settling this quickly, agreeing to pay a reduced amount in record time, may point to something larger. If coupled with the speculated revival of the Sycamore Partners buyout deal [TTA 19 Feb], if Walgreens is actively in sale mode, they want to be as attractive as possible. That means taking off the table ongoing lawsuits and pending settlements that are future obligations–presenting the cleanest picture possible of and reducing their Mound of Misery. Where they can, like with Everly, it’s settling for less now, versus dragging out an appeal for two years that will be more costly to litigate, for example in legal fees and award interest, if almost certainly upheld again. These become future obligations for a buyer and make for more unattractiveness. It also follows on VillageMD/CityMD’s recent settlements with New York State and the Department of Justice [TTA 12 Feb] and state-level opioid settlements, though in January the DOJ filed a civil lawsuit against Walgreens on opioids and other meds violating the Controlled Substances Act [TTA 24 Jan] . Reuters, Crain’s Chicago Business

“It’s alive!” Walgreens’ deal with Sycamore Partners may be back on the table: report

February 19, 2025 | by

Resuscitated, according to Tuesday reports. CNBC’s David Faber, currently co-anchor of CNBC’s morning “Squawk on the Street”, said Tuesday (yesterday) that the take-private deal of Walgreens Boots Alliance by Sycamore Partners and possibly other entities, has gone from “dead” to “alive” in his books.

The Walgreens deal was reported, but called “rumors and speculation” by Walgreens in December right before the Christmas blackout [TTA 10 Dec 2024, 8 Jan]. It withered like sycamores do in a cold 2025 winter, when Walgreens piled up Heaping Helpings of Misery in the following weeks: January FY25 results, suspending its dividend, and arbitration awards, civil settlements, and penalties.

Yet…a little-noted report local to Chicago noted that as of January’s end, Sycamore had been approaching private credit firms trying to put together debt financing for a deal. Whether this was for WBA or another deal is unknown. But Sycamore is no newcomer to this. Crain’s Chicago Business

There isn’t much (right now) beyond Mr. Faber’s call in the news coverage, and certainly no comments by either WBA or Sycamore. But his show and his persona–a 30+ year veteran of CNBC known for his insider savvy and calls–are influential enough to drive the stock up a dollar from $9.70 to $10.98 on Tuesday. The price lingers on through today at $10.86.

What also lingers? The sheer difficulty of Sycamore pulling off a complicated and pricey deal with WBA. It is not one of the VC elite with a ton of money from limited partners aching to invest. But what it has is a track record in putting together complex deals and saving debt-ridden retailers before, notably with Staples in 2017 and more recently Chicos FAS and Playa Bowls. Its focus is retail and e-commerce, making it an odd (but not too odd) partner for Walgreens. It might be interested in kicking up a downsized retail operation and in Boots’ thriving retail/e-commerce business in the UK, leaving the healthcare/VillageMD, pharmacy, and PBM ownership to others. It’s led to speculation that their interest might be a cherry-pick as part of a breakup team. But, as mariners know, the wise sailor knows that it’s any port in a storm.  Crain’s Chicago Business, Yahoo! Business

This just in: New York State nicks Walgreens’/VillageMD’s CityMD for $14M+ in refunds, canceled debt on improper Covid-19 billing

February 12, 2025 | by

Here’s a few more inches added to Walgreens’ Mound of Misery. New York State’s Office of the Attorney General found that CityMD, now part of Walgreens’ VillageMD, improperly billed patients for Covid-19 tests. The $14 million total consisted of canceling $7 million in outstanding testing bills for over 87,000 patients plus refunds of about $7 million to over 215,000 patients who already paid. The CityMD tests were performed between March 2020 and November 2022. Many of the patients received billing up to two years after date of service, with added billing for late charges. In addition, CityMD will pay $95,000 in penalties to the State of New York for the improper billing with an additional fine of $5,000 per incident for any further billing.

Federal and state laws during the Covid-19 public health emergency prohibited providers and health plans from charging co-pays and deductibles for medically necessary Covid-19 testing and related services. CityMD’s website and staff stated that there would be no out-of-pocket costs for testing. There was also no posted cash price for services, violating NYS law. CityMD also refused to correct bills for individuals with previously issued billing. NYSOAG press release

This follows a $12 million June 2024 civil settlement with the US Department of Justice in the District of New Jersey on false payment claims for Covid-19 testing. The $12.04 million settlement under the False Claims Act resolves CityMD’s claims submitted from 4 February 2020 through 5 April 2022 to the Health Resources & Services Administration (HRSA)’s Uninsured Program that covered testing, treatment, and vaccination costs, reimbursing providers at generally Medicare rates. CityMD did not adequately verify that these individuals had health insurance coverage before submitting their claims to the Uninsured Program, including but not limited to individuals for whom CityMD had health insurance cards on file. This then caused downstream filings by labs claiming Uninsured Program payments based on CityMD information. The settlement includes a $2 million whistleblower payment under the False Claims Act to Steven Kitzinger, a patient of CityMD, who informed the clinic that he was fully insured but was told that CityMD would delete his insurance information. He separately sued CityMD. This will at least cover his legal costs ;-)  CityMD was credited by the DOJ for their voluntary disclosure, cooperation, and remediation. Healthcare Dive, US Attorney’s Office NJ release

To be fair, both incidents of improper and fraudulent billing occurred while CityMD was owned by Summit Medical, before Summit’s acquisition by VillageMD, with a Walgreens investment, announced in the palmy days of November 2022 and closing 3 January 2023. But it will be Walgreens doing the payouts where applicable.

Walgreens’ misery level rises some more: Federal court affirms $987M award to PWNHealth/Everly Health. Plus selling $295M in Cencora shares, drawing down to 6%.

February 12, 2025 | by

Walgreens’ Mound of Misery grows ever higher in two more ways. The US District Court for the District of Delaware ruled yesterday that last year’s arbitration award of $987 million to PWNHealth stands.

Walgreens originally contracted exclusively with PWNHealth’s Everly Health Solutions’ telehealth physician network in April 2020 to order Covid-19 tests that consumers requested through the Walgreens website. PWN/Everly had, with its network, the ability to administer nationwide Covid-19 testing including labs and follow-up. However, Walgreens in 2021 started to divert tests to their own pharmacists, while continuing to use the Everly trademarked logo and displaying that testing would be done by PWN/Everly’s network. This breached the exclusive Master Services Agreement (MSA) with PWN/Everly. Walgreens terminated the MSA effective 1 June 2022. PWN/Everly on 10 June 2022 then initiated the arbitration with the American Arbitration Association alleging breach of contract, a violation of the Latham Act on trademarks, plus additional breaches and violations. In March 2024, the arbitrator awarded PWN/Everly $987 million. This was 12 times the contractually specified $79 million in damages. Arbitration text and decision in Jus Mundi

Immediately after the arbitration, Walgreens filed suit in Delaware to vacate the ruling on the grounds that it contravened the contract’s cap on damages and that the arbitrator’s decision was “egregious and improper”.

The Federal judge in yesterday’s decision upheld the arbitration decision, finding that the arbitrator had the authority to interpret the contractual language and determine damages. The judge found no evidence that the arbitrator exceeded his authority or showed bias. Walgreens is, of course, appealing the decision in the US Court of Appeals for the Third Circuit. In its Securities and Exchange Commission (SEC) filing, Walgreens stated that it disagrees with the court ruling but that the appeal may take another two years. “There can be no assurances as to the outcome”. PWNHealth, of course, is “pleased with the court’s well-reasoned decision confirming the arbitration award.” Reuters, Crain’s Chicago Business, FierceHealthcare  

Walgreens needs some fast cash. One investment that they have been gradually cashing out is their interest in Cencora, a drug distributor originally called Amerisource Bergen. Last Thursday’s drawdown involved Cencora repurchasing about $50 million worth of its stock from Walgreens, with Walgreens selling about $265 million worth of additional shares. Deducting $20 million in early settlement fees, the net proceeds were $295 million. Walgreens (WBA) states that it will be used primarily for debt paydown and general corporate purposes. WBA’s stake in Cencora has been reduced to 6% from the earlier 10%. Walgreens has been steadily cashing out its Cencora interest with three sales in 2024 totaling 5% of shares [TTA 7 July 2024].  Release, Healthcare Dive, Crain’s Chicago Business

Given January’s Department of Justice (DOJ) civil suit over improper dispensing of opioids and and other unlawful medications over more than a decade, with possible penalties in the billions, Walgreens’ Mound of Misery is approaching Chicago’s Willis Tower (the former Sears Tower) heights.

The table stacks–and clears: fundings for RadAI $60M, The Helper Bees $35M, Bicycle Health $16.5M. Walgreens suspends stock dividends after 91 years. And has Transcarent zeroed out 98point6? (updated)

February 5, 2025 | by

February is the real opening of the New Year’s Casino. Investors place their bets–and the dealer’s stick clears the losers.

RadAI’s Series C racks up $60 million. The generative AI radiology company gained an oversubscribed round led by Transformation Capital, with participation from existing investors Khosla Ventures, World Innovation Lab, UP2398, Kickstart Fund, OCV Partners, Cone Health and others. It follows a $50 million Series B in May 2024 and boosts the company’s value to $525 million. RadAI’s two products to speed radiology workflows and findings are Rad AI Impressions, their first product, and Continuity for interpretation and follow up for potential new cancers. RadAI claims that their platforms are used by radiologists performing about 50% of all US medical imaging. In July 2024, it partnered with Bayer to bring its capability to Bayer’s Calantic Digital Solution customers.  Release, Mobihealthnews

The niftily named The Helper Bees nabbed $35 million in a Series C. This was a tidy amount for the formerly unsexy independent aging technology sector, led by Centana Growth Partners, with support from Silverton Partners, Impact Engine, Northwestern Mutual Future Ventures, and Alumni Ventures. The Austin, Texas-based company works through 43 health plans (payers) by providing national access to non-medical products and services such as in-home caregiving, home modifications, groceries and meals, pest control, housekeeping, lawn care, and transportation, closing significant care gaps in senior care and enabling aging in place. They support long-term care plans and Medicare Advantage. Their total funding is $54 million. Release, Mobihealthnews

Bicycle Health pedals to a $16.5 million raise, profitability. Bicycle’s telehealth platform for opioid use disorder (OUD) treatment has had its downs (a May 2024 layoff of 15% of staff) and ups (a $50 million Series B in 2022). Their latest up is turning profitable on an EBIT­DA and net in­come ba­sis as of Q4. In the middle is the just-announced unlettered down round led by existing investor Questa Capital, with participation from all other existing investors including SignalFire, Frist Cressey Ventures, City Light Capital, InterAlpen Partners, Valeo Ventures, and Hustle Fund, as well as new investor JSL Health. Added to the C-level roster are CFO Manu Kuppalli and COO Andy Thomas, with a background in brick-and-mortar behavioral health. Release, Endpoints, Mobihealthnews

On the loser’s side of the table

Walgreens suspends their quarterly dividend for the first time in 91 years. The rationale for ending the shareholder payments made since 1933 was announced late last Thursday “as management continues to evaluate and refine its capital allocation policy consistent with the company’s broader long-term turnaround efforts”. The admission was blunt: “The company’s cash needs over the next several years, including with respect to litigation and debt refinancing, were important considerations as part of the decision to suspend the dividend.” The share price promptly took a hit going from $11.43 at market close on Thursday to closing today (Tuesday) at $9.84, not exactly a desired result. Walgreens’ days as a ‘widows and orphans stock’ are long over. 

  • The litigation is a serious matter, with the Department of Justice (DOJ) filing a civil suit 16 January in Illinois over improper dispensing of opioids and other unlawful medications over more than a decade, in violation of the Controlled Substances Act (CSA).
  • The WBA Q3, announced mid-January, widened its net loss to $265 million. 
  • Walgreens is in the midst of closing 1,200 locations to get out from under real estate.
  • The rest is not much different than other retail–in-store theft, pharmacy sales erosion, and retail sales going online or elsewhere.
  • Mistakes such as buying VillageMD (and doubling down with Summit Health and CityMD) made it 10x worse.

Will this put the brakes on a sale? Certainly Sycamore Partners and other interested parties now must rethink their pricing and timing, though it may be positive if it improves WBA’s cash position. [TTA 10 Dec 2024, 8 January]   Release, CNBC, AP 

Did Transcarent, after paying $100 million for 98point6’s virtual care platform in 2023, just pull the plug on the service? This tidbit from a commenter on HIStalk News 2/5/25 indicates that Transcarent may have. Exhibit 1 is a notice from Allegheny College (PA), a service customer for about two years, on their blog that students and staff were notified on 19 December that the service was going out of business. The college is searching for a replacement telehealth service. The Allegheny page is also showing up high in Google Search results.

Transcarent has a live 98point6 page with FAQs about the service and buttons for downloads on Google’s and Apple’s respective App Stores. There is no notice on Transcarent’s 98point6 page, but their last blog posting mentioning 98point6 was October 2024. On Google’s App Store, the last update is listed as 5 June 2024, which is unusual for a telehealth app. The app ownership is credited to Transcarent so it is not a leftover from the original company. According to the HIStalk commenter, most staff was laid off by April 2024. (As we reported in our 8 May 2024 report, 98point6 had only 100 on staff, and the number of those laid off was unknown.)

Confusing matters is that 98point6 continues as a platform, but not as a telehealth service. After they sold their virtual care service to Transcarent [TTA 9 Mar 2023], they announced a pivot into licensing its real-time and asynchronous software to third parties, including Transcarent. Less than a year later, 98point6 bought the remaining assets of telehealth provider Bright.md not sold to Evernorth’s MDLIVE–17 asynchronous telehealth provider customers [TTA 19 Jan 2024]. We have reached out to Transcarent’s press office for confirmation. They are welcome to reach out to TTA (email Editor Donna).  Update: as of 14 February, there has been no response from their corporate communications folks. 

Updates: ATA on telehealth policy priorities, UHG investor group demands denied care report, DOJ sues Walgreens on illegal Rx dispensing, VA nominee supports Oracle EHR deployment, RFK Jr. HHS nomination hits Senate

January 24, 2025 | by

ATA urges nine telehealth priorities for the Trump Administration’s consideration. Acknowledging that HHS expanded Medicare telehealth flexibilities at the start of the pandemic in 2020 in the previous Trump Administration, the American Telemedicine Association’s list is long and detailed.

#1 was to withdraw last week’s Drug Enforcement Administration’s (DEA) proposed rule, “Special Registration for Telemedicine and Limited State Telemedicine Registrations”. This would create a framework for the remote prescribing of controlled substances that in ATA’s view, would create “untenable restrictions and significant barriers to care”.

The remaining eight include flexibilities that were part of the 2020 rules.

  1. Permanently Allow for the Remote Prescribing of Controlled Substances
  2. Work with Congress to Make Permanent the Medicare Telehealth Flexibilities
  3. Ensure Affordable Telehealth Services for the Commercially Insured
  4. Ensure Affordable Telehealth Coverage for Part-Time, Contracted Workers Who Don’t Qualify for Health Care Coverage
  5. Ensure All Provider Home Addresses Remain Confidential
  6. Expand the Medicare Diabetes Prevention Program
  7. Reinstate Virtual Cardiopulmonary Rehabilitation Programs
  8. Release Updated Regulatory Guidance on Medicare Telehealth Flexibilities

Additional details are in the ATA Action letter to President Trump and Vice-President Vance and the ATA release.

An institutional investor interest group demands a report on delayed and denied care from UnitedHealth Group. This takes the form of a proposal for the 2025 proxy that the UHG board of directors prepare a report on these practices that create increased costs and ‘macroeconomic risks’.  The proxy is usually filed in April for a meeting that is typically in June. UHG will respond at that time it files the proxy.

The group proposing the report is the Interfaith Center on Corporate Responsibility (ICCR). ICCR represents 300 faith-based institutional investors, such as asset managers, pension funds, and foundations, with over $4 trillion in invested capital. This institutional shareholder action is in the aftermath of the Brian Thompson assassination, which revealed widespread consumer anger about UnitedHealthcare’s practices in high rates of claims denials, including their use of AI in the review process, and prior authorizations to restrict utilization. UHG ignores this at its peril. By the time proxies are released and the shareholder meeting occurs in June, the trial of the assassin may be underway, putting this issue back in top news.  ICCR release, Healthcare Dive

Walgreens’ Mound of Misery gained a few hundred cubic yards with a lawsuit filed 16 January by the Department of Justice (DOJ) over improper dispensing of opioids and and other unlawful medications over more than a decade. The civil lawsuit filed in the US District Court for the Northern District of Illinois alleges that Walgreens and subsidiaries dispensed millions of unlawful prescriptions, violating the Controlled Substances Act (CSA). Since Walgreens then sought reimbursement from Federal healthcare programs, they violated the False Claims Act (FCA). The time frame is from August 2012 to the present. Specific allegations include that Walgreens pressured pharmacists to fill prescriptions despite clear ‘red flags’, in excessive quantities, and lacking a legitimate medical purpose and that they ignored the pharmacists and their own internal data. One of the red flags were prescriptions for the ‘trinity’ of an opioid, a benzodiazepine and a muscle relaxant. There are also four different whistleblower actions against Walgreens under the qui tam (on behalf of the government) provisions of the FCA that have been consolidated. If successful, Walgreens could face civil penalties of up to $80,850 for each unlawful prescription filled in violation of the CSA, plus treble damages and applicable penalties for each prescription paid by Federal programs in violation of the FCA. Timing and Walgreens’ response are not yet available. This lawsuit could be a massive stumbling block to the rumored Walgreens/WBA sale.  DOJ release, Healthcare Finance 

The VA Secretary nominee recommits to resuming the 2026 rollout of the Oracle Cerner EHR. Former House Representative for Georgia Doug Collins told members of the Senate Veterans’ Affairs Committee at his nomination hearing Tuesday that he would look at the Oracle Cerner EHR deployment with ‘fresh eyes’ and that “there’s no reason in the world we cannot get this done.” On 20 December, the VA formally stated that they were starting planning now for deployment in four Michigan facilities — Ann Arbor, Battle Creek, Detroit, and Saginaw–for implementation by mid-2016. He was critical of what has transpired to date in the limited deployment as ‘not acceptable’ and pointing out that VA facilities needed modernization of their computer systems. But perhaps a little overoptimistically, he’d like to see a faster implementation in 2016, though it should be done properly and not rushed. NextGov/FCW, Healthcare IT News

And in the Warp Speed World that is now DC, Robert F. Kennedy Jr. is scheduled to testify next Wednesday (29 January) before the Senate Finance Committee on his nomination as Health and Human Services Secretary. At HHS, he would supervise the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). He has promised major reforms including food safety and chemical additives, as well as the relationships between FDA and pharmaceutical companies. Healthcare Dive  Meanwhile, during the transition, HHS froze external communications or work-related appearances by staff. This is fairly standard procedure until review procedures are set up, but apparently no one planned for this in advance. This has derailed two conferences (AFCEA HIT Summit and the HHS Industry Summit) that were scheduled for this month and February. Exceptions to this are ‘mission critical’ and emergency communications. NextGov/FCW

Walgreens’ kicks off FY 2025 with a wider net loss of $265M; shares rise 25% as closures, sales, and cost-cutting continue

January 14, 2025 | by

Walgreens kicked off their FY 2025 on a sad trombone note–yet Mr. Market liked the music. In one of those contradictions that only make sense to Wall Street, Walgreens’s Q1 2025 earnings report, ending 30 Nov 2024 that reported last Friday, was dismal by any reading–but seemed hopeful to market makers who lifted the shares by over 25% as of midday 14 January. 

US retail pharmacy sales and operating losses were the main drags on WBA’s results.

First, the highlights from the earnings release:

  • Operating loss was $245 million, versus $39 million in Q1 2024. The increased loss was due to lower US retail sales and lapping prior year sale-leaseback gains. Another driver was the US Retail Pharmacy Footprint Optimization Program, unexplained in the release.
  • Net loss was $265 million, versus $67 million in Q1 2024, driven by operating losses.
  • It was a dismal quarter for US Pharmacy, which includes the retail stores, despite gains in pharmacy sales of 10.4% due to drug inflation. Retail sales (the front end of the store) decreased 6.2%.
  • A bright spot was US Healthcare, which includes VillageMD, CareCentrix, and Shields, had a smaller operating loss of $325 million, versus same quarter in FY 2024’s $436 million. VillageMD sales increased 9%, CareCentrix increased 16% and Shields increased 30%.
  • Another bright spot was Boots UK’s performance. Their ‘comparable’ pharmacy sales increased 10.9% versus prior year, retail sales  8.1 percent% and grew across all categories. Boots.com sales–22% of total retail sales–were up 30% boosted by Black Friday.

So why did Mr. Market kvell over this and immediately boost the same shares that fell 63% in 2024? Mostly from the earnings call with CEO Tim Wentworth and other C-levels:

  • Results beat the Street estimates (LSEG survey):
    • Earnings per share: 51 cents adjusted vs. 37 cents expected
    • Revenue: $39.46 billion vs. $37.36 billion expected
  • Guidance for FY 2025 estimates adjusted earnings per share at $1.40 to $1.80 per share with revenue in the $150 billion range.
  • CEO Tim Wentworth confirmed that retail locations will continue to close and will accelerate. 70 were closed in Q1 2025.
    • Their goal is to close 1,200 locations from 2024 through 2026, with 450 to 500 underperforming locations to shutter in 2025. Walgreens currently has around 8,500 retail locations.
  • The sale of VillageMD is underway but no potential acquirers were mentioned on the call.  Separately for Summit Health and CityMD, Walgreens is considering “best options” such as sale or restructuring. These units were snapped up by VillageMD in January 2023.
  • They are working to turn around retail sales which are declining due to consumers restricting spending due to inflation and the value in using online retailers.
    • One measure is around labor scheduling being redesigned to improve the in-store experience. Walgreens is launching a new scheduling model in about 200 locations based on store demand patterns.
  • In pharmacy, they plan to roll out digital and virtual check-in for patients plus micro-fulfillment centers for prescription processing.

Interestingly, Walgreens in the US is not promoting online sales–unlike Boots UK which has done well with it.

There was no comment on the reported consideration of sale to a private equity (PE) firm such as Sycamore Partners [TTA 10 Dec 2024, 8 January], which would remove it from the NYSE.

Street analysts are boosting the stock now, but state that they need to see a few more quarters of stable performance to feel more confident about WBA’s future. Whether that will happen and that the US retail/pharmacy picture improves is to be determined. HIStalk, CNBC, FierceHealthcare, Healthcare Dive