Omada Raises $192M for Chronic Condition Management

Almost by definition, chronic conditions require continuous attention beyond what a doctor can give in a few visits every year. On top of this, confounding factors often cause patients to develop multiple chronic conditions simultaneously, creating a need for integrated whole person care like that delivered by Omada Health.

Omada Health recently closed a $192M Series E round to help treat polychronic patients through a single platform, boosting the startup’s valuation to $1B and making it a likely candidate for an IPO once the current market choppiness (to put it lightly) begins to subside.

  • Since initially developing its platform for prediabetes management in 2011, Omada has expanded its virtual services to other treatment areas such as hypertension, behavioral health, and musculoskeletal conditions.
  • Omada’s programs combine virtual support from a personalized care team with connected remote monitoring devices, which feed data into the Omada Insights Lab to personalize interventions and drive behavioral change.
  • The company currently serves 1,700+ employer and health plan customers (up from 1k in 2019), with multi-product contracts accounting for 32% of last year’s new business, growth that suggests customers are embracing Omada’s single-platform approach. 
  • The latest funding will go towards hiring, integrating more point solutions into a unified service, and investing in the Omada Insights Lab to continue tuning its data-driven interventions.

The Takeaway

Omada’s single-platform strategy for treating multiple chronic conditions could give it an edge against a crowded landscape of competitors focusing on more specialized treatments, including Verily subsidiary Onduo and Livongo / Teladoc.

The more conditions Omada can bring onto its platform, the more comorbidity data it can feed into the Omada Insight Lab, driving its flywheel of more data leading to improved engagement, more behavior change, and ultimately better outcomes.

MindMaze Raises $105M for XR Neurorehab

What do you do if you’re an innovative digital therapeutics startup that recently raised $125M in October? If you’re MindMaze, you follow it up with another $105M to “supercharge” growth even further.

  • MindMaze develops mixed reality digital therapeutics that help patients recover from neurodegenerative diseases and brain injuries. The company combines AI-enabled software with hardware peripherals to produce immersive VR/AR experiences.
  • The FDA-approved platform would fit in a sci-fi novel just as well as in the hospitals currently using it. MindMaze’s solutions use wearables to sense a patient’s brainwaves and muscle activity while a proprietary motion capture camera system helps predict movements before they’re made.
  • As an example, a movement impaired stroke patient equipped with the MindMaze platform could attempt to move their hand and see a normal motion response in VR, which helps the brain create new neural pathways and regain real-world motor control.
  • These exercises are then gamified into situations such as driving a racecar to improve engagement and encourage patients to follow a recovery regime without constant touchpoints with a dedicated therapist. 

Solutions Follow Coverage

In its funding announcement, MindMaze called the latest CPT III codes for asynchronous physical therapy “a tremendous milestone” that allow new products to be brought to market. The referenced code (0733T) was issued in December for remote body and limb kinematic measurement-based therapy, widening the path to reimbursement for in-home solutions like the ones provided by MindMaze.

The regulatory support and fresh funding will be used to advance commercialization in the US through a partnership with the American Hospital Association that expands MindMaze’s footprint in neurorehabilitation centers while fast tracking its pipeline, which includes three new therapeutics for chronic stroke, Parkinson’s Disease, and age-related cognitive impairment.

Teladoc Launches Chronic Care Complete

The big are getting bigger with the announcement that virtual care giant Teladoc Health is expanding its services with a “first-of-its kind” Chronic Care Complete solution targeted at the one in three US adults living with multiple chronic conditions.

  • Chronic Care Complete is now offered through the Teladoc Health app and provides a comprehensive experience that leverages connected monitoring devices in combination with personal coaches to help patients achieve health goals.
  • The program also provides access to physicians who can review medications or order labs as needed, as well as licensed therapists to provide mental health support for those dealing with difficult diagnoses.
  • Integrated proactive insights help Chronic Care Complete patients achieve better outcomes by applying personal health data and social determinants toward driving timely outreach.
  • According to Teladoc, chronic conditions such as diabetes, hypertension, and obesity account for 90% of all healthcare spending, driven in part by the confounding mental health challenges that are often ignored by other solutions but are a core component of Chronic Care Complete.

The Takeaway
Teladoc’s scale gives it unique positioning to address the intertwined physical and mental health challenges faced by polychronic patients. Chronic Care Complete is the latest in a string of new solutions launched following Teladoc’s 2020 merger with Livongo, each aiming to leverage this scale to provide better whole-person care, including the mental health offering MyStrength and the primary care service Primary360.

Online CBT Improves Depression Symptoms

Amid a recent flurry of reports calling into question the effectiveness of virtual cognitive behavioral therapy, a new study published in JAMA Network Open found that computer-assisted CBT (CCBT) does in fact improve depressive symptoms in primary care patients.

  • Methodology – The study included 175 adult primary care patients at the University of Louisville who had scored 10 or higher on the Patient Health Questionnaire-9 (27 point scale), indicating at least a moderate case of clinical depression. Nearly 62% of participants made less than $30k/year, while 74% did not graduate from college.
  • Interventions – Participants were randomly assigned to CCBT or treatment-as-usual groups (TAU) for 12 weeks of active treatment, as well as 3- and 6-month follow ups. CCBT included 9 online CBT lessons and weekly 20-minute teletherapy visits, in addition to TAU, which included in-office treatment at the primary care practices. 
  • Results – CCBT led to significantly greater improvement in PHQ-9 scores than TAU (mean difference: -2.5), with the positive results maintained at 3-month (-2.3) and 6-month follow-ups (-3.2). CCBT remission rates were more than double TAU at all time points.

Conclusions and Relevance

This study was particularly interesting because of the treatment’s sustained results and because its participants largely came from groups that are often underrepresented in CCBT research. Although the study had some limitations (treatment-as-usual as a control can’t compare CCBT to regular CBT), the results suggest that CCBT has the potential to be particularly valuable for patients in diverse primary care settings.

Memora Raises $40M to Simplify Care Delivery

Although sky-high private valuations made a slowdown in healthcare venture activity a popular prediction for 2022, it sure doesn’t feel like that’s the case six weeks into the new year. Care automation platform Memora Health recently raised a $40M growth round to help more health systems provide proactive care from any setting.

  • Memora Health builds the technology infrastructure behind “learning health systems,” with an AI-enabled platform that automates complex care workflows and improves them over time by learning from the ongoing behavior of patients and providers.
  • The platform includes SMS-based patient messaging, reminders, and scheduling to create continuous patient touchpoints that allow providers to collaboratively manage care journeys and monitor progress.
  • Data from questionnaires and EHR integrations help triage concerns to appropriate care team members while providing patients with proactive communication about their conditions, ideally improving the efficiency of all parties involved.
  • The funding will help Memora meet commercial demand and drive new partnerships with health systems beyond the organizations it already works with, which include Mayo Clinic, Edward Elmhurst Health, and Penn Medicine.

The Takeaway

Memora is solving one of the most pressing challenges facing health systems by automating components of the care journey and allowing time-constrained providers to practice at the top of their license. In doing so, the company is simultaneously pushing the transition from episodic to continuous and always-on care, which seems like a pretty solid combination of goals to build around in the current healthcare landscape.

Doximity Adds Physician Scheduling With Amion Acquisition

Healthcare networking platform Doximity is expanding beyond its role as “the LinkedIn for doctors” with the announcement that it is acquiring on-call physician scheduling app Amion for $53.5M.

  • Amion adds a key component to Doximity’s physician cloud services by integrating scheduling into its existing suite of messaging, referral, and telehealth tools.
  • Doximity has over a million doctors as verified members, ranking it among the largest networks of healthcare professionals in the US.
  • The company went public last year at a valuation of $7B and has since found success with its strategy of cultivating a community of medical workers that it can then offer tools to in order to improve their day-to-day workflows.
  • In its recent conference call with investors, Doximity revealed that its revenue climbed 67% year-over-year to $97.9M, netting a healthy pre-tax earnings of $47M.

The Takeaway

Doximity CEO Jeff Tangney stated that the Amion move was primarily a product acquisition for the company, adding a valuable subscription business that manages over 200k physician schedules across thousands of hospitals.

By expanding Doximity’s roster of collaboration products, Amion’s scheduling tools have the potential to improve engagement across its acquirer’s entire network.

Signify Health Acquires Caravan for $300M

Signify Health is celebrating the one year anniversary of its IPO with style. The value-based care platform is acquiring Caravan Health for a lofty total of $250M, with another $50M set aside for future performance incentives. 

Upon closing, Signify will have one of the largest networks of providers engaged in risk-based contracts in the US, reaching over 3,200 health systems and covering more than 500k lives.

  • Signify’s technology platform and nationwide physician network help payors and providers develop value-based care programs and shift health services to the home.
  • Caravan enables accountable care organizations (ACOs) to excel in population health management and commercial risk arrangements, focusing primarily on medically underserved patients.
  • Signify’s mobile physician network and at-home services are well-positioned to assist Caravan’s ACO partners with improving access to care by extending the resources of local care teams.

Why It Makes Sense

Combining Caravan’s population-level insights with Signify’s at-home services creates an “end-to-end suite” of value-based care enablement, allowing organizations to manage larger populations while improving care coordination beyond traditional clinical environments. 

To top it off, Signify can also leverage its payor relationships and post-acquisition scale to improve provider participation in value-based care programs by increasing the percentage of patients in a provider’s panel that are covered by the arrangements.

McKinsey Predicts More Home Healthcare

In an effort to understand healthcare’s shift from the hospital to the home, McKinsey conducted a survey of physicians who serve the Medicare population, finding that $265B of care services could switch from traditional facilities to the home by 2025.

That figure represents a nearly fourfold increase in the amount of care being delivered in the home, which McKinsey thinks could be attainable without a reduction in quality or access. This chart provides an overview of how it might be possible.

McKinsey categorizes the services that can be delivered at home into three groups:

  • Services with capabilities in place that may benefit from scaling, such as primary care, outpatient-specialist consults, hospice, and outpatient behavioral-health visits. 
  • Services where capabilities exist that could be stitched together into a comprehensive offering, such as dialysis, post-acute care, and long-term care, and infusions.
  • Services with some capabilities but others that could be further developed, which includes a single service, acute care.

All of these services offer potential for growth within the home, although the pros and cons of transferring care outside of a traditional setting depends on the stakeholder (here’s a breakdown). Payors and providers will each have their own reasons for shifting care into homes over the next few years, but McKinsey points out that there’s one main driver behind the expected growth: more home care is good for patients.

Amazon Expands Telehealth Services Nationwide

It’s never great to hear that a competitor with deep pockets and an army of engineers is pushing into your market, and this week Amazon gave companies in the employer telehealth space a lot to be nervous about.

After launching as an internal service in 2019, Amazon is now expanding its Amazon Care health offering to employers across the US amid “growing demand” for hybrid care.

Amazon Care’s hybrid model consists of two main elements:

  • Telehealth-based primary care delivered by a dedicated Care Medical doctor
  • Nurse practitioners dispatched to patient homes when medical needs can’t be resolved over video

Virtual services are now available nationwide to meet the needs of Amazon Care’s growing roster of employer clients, which now includes TrueBlue and Whole Foods Market (a fairly self-congratulatory announcement considering Amazon acquired the grocer in 2017).

In-person services are also expanding beyond the 8 existing locations (Seattle, Baltimore, Boston, Dallas, Austin, Los Angeles, Washington, DC, and Arlington), with Amazon planning to bring its nurse practitioner network to 20 additional cities by the end of the year, including San Francisco, Miami, Chicago, and New York City.

Industry Impact

The telehealth landscape is crowded with companies promising to improve outcomes with video visits, but Amazon Care’s in-person component could prove to be its biggest differentiator.

The hybrid model allows Amazon to keep patients within its ecosystem when in-person care is needed, building off the logistical expertise of its retail business to coordinate at-home and virtual care. Amazon is aiming to make ordering healthcare as seamless as ordering any other product off of Amazon.com, a patient experience that the company could be uniquely positioned to pull off.

New HHS Data Highlights Telehealth Disparities

A new report from the HHS’ Office of the Assistant Secretary for Planning and Evaluation found that although telehealth use remains drastically elevated from pre-pandemic levels, access challenges are equally persistent.

The analysis stems from the Census Bureau’s Household Pulse Survey, which had a total of 808k US adult respondents between April and October 2021.

Overall, 23.1% of respondents reported using telehealth over the past month, with use levels similar among most demographic subgroups.

  • The lowest telehealth use was among those who were uninsured (9.4%) and young adults between the age of 18 and 24 (17.6%).
  • The highest telehealth use was among those with Medicaid (29.3%), Black patients (26.8%), and those earning less than $25k (26.7%).

The most significant disparities began to emerge when examining the modality used by different subgroups.

  • The share of telehealth visits by video was highest (meaning the share by audio was lowest) among those between the ages of 18 and 24 (72.5%), college graduates (67.4%), beneficiaries of private health plans (65.9%), and white respondents (61.9%).
  • The share of telehealth visits by video was lowest among those without a high school diploma (38.1%), adults ages 65 and older (43.5%), and Latinos (50.7%).

The Takeaway

Although reports on telehealth disparities are unfortunately quite common, the HHS survey’s modality analysis highlights the need for new strategies to ensure equitable access to video visits.

Audio visits lack several advantages of video visits, including the ability for providers to pick up on nonverbal communication or check on a patient’s home environment. As a result, the authors emphasize a need to keep barriers such as device ownership, broadband access, and digital literacy at the forefront of future regulatory conversations.

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