Brightline Raises $105M for Adolescent Mental Health

Virtual mental health startup Brightline recently closed $105M in Series C funding to broaden its services as it tackles the nation’s “pediatric mental-health crisis.”

The two-year-old company is a poster child for the rise of behavioral health startups during the pandemic, with a valuation of $705M after a quick total raise of $209M.

Brightline offers adolescents and their families virtual services and educational content aimed at treating anxiety, ADHD, depression, and other behavioral issues.

  • The company staffs over 85 care providers (psychiatrists, speech-language pathologists, behavioral coaches) trained to support children with unique needs such as cyberbullying or wearing masks in the classroom.
  • The services are offered through employers and as in-network benefits with major health plans, including Blue Cross of California, Blue Cross Blue Shield Massachusetts, Aetna, and Primera.

The new funding will help Brightline triple the size of its care team by the end of the year while exploring additional ways to deliver specialized care through more modalities.

  • This includes upcoming services specifically for the caregivers of young children with Autism Spectrum Disorder and youth who identify as LGBTQ+ and/or BIPOC.
  • Brightline expects to serve over 30k children and teenagers by the end of 2022, while doubling the number of lives covered through its health plan contracts to 48M.

The Takeaway

Psychiatrists are among the most in-demand specialists, and adolescent psychiatrists aren’t exactly easier to find. Some research suggests that upwards of 75% of US counties don’t have access to a single one. If Brightline can address this supply-demand imbalance with its virtual services it could have a big impact on families affected by behavioral health challenges, and the company’s swift funding pace suggests that investors are eager to wager that they can.

Optum’s Digital Health Acquisition Spree

To some investors, this year’s brutal pullback in health company valuations might be hurting their appetite for risk. Others, like UnitedHealth Group’s Optum unit, seem to be treating the lower multiples like it’s Black Friday at the M&A store.

Last week, Optum added home healthcare provider LHC Group and behavioral health clinic operator Refresh Mental Health to its already expansive portfolio of doctor groups, surgery centers, and remote care services.

LHC Group is one of the nation’s largest home health and hospice companies, providing over 12M in-home interventions to 500k patients annually. 

  • The acquisition values LHC Group at $5.4B and will see the company’s staff of 30k front-line care providers and support personnel join Optum after an expected close in the second half of the year.
  • Bolstering home health services aims to support UnitedHealth’s payor division, UnitedHealthcare, in expanding the role of home services as an efficient alternative to nursing homes and a way to reduce unnecessary hospitalizations.

Refresh Mental Health operates a network of over 300 outpatient mental health, substance abuse, and eating disorder clinics across 37 states.

  • Although the terms of the acquisition were net disclosed, Refresh was previously acquired by a private equity firm for $700M in 2020, and was reportedly generating $40M in revenue at the time.
  • Refresh gives Optum a large access point to the growing behavioral health sector, which has proven to see sustained patient demand and telehealth uptake as the pandemic draws on.

The Takeaway

One of the reasons why UniteHealth Group has grown into an industry juggernaut is because it’s successfully been able to create value through synergies between its payor and health services divisions (almost too much success according to the DOJ’s case against its Change Healthcare acquisition). Adding new at-home and behavioral health services through M&A makes perfect sense for companies that can turn a combined service portfolio into more than a sum of its parts, and that’s exactly what UnitedHealth Group is banking on with the addition of LHC and Refresh.

What is Google Doing in Health?

It was a big week for big tech in healthcare, with Google hosting its second annual The Check Up event to let teams across the company share updates on their latest health-related features.

The Search team had one of the biggest announcements of the event with the unveiling of a new feature that shows the appointment availability of nearby healthcare providers so users can easily schedule a visit. It’ll look something like this

  • Upon launching, the feature will first let users view open appointments at CVS MinuteClinics, but other providers can add their availability to their Google profiles through new scheduling integration with Kyruus and Stericycle.
  • Google emphasized that it won’t use any of the data for advertising purposes, a perennial concern as the search giant pushes further into healthcare.

YouTube is adding health source information panels designed to help viewers identify videos from authoritative sources, as well as health content shelves that more effectively highlight videos from these sources when searching for specific topics.

  • The features highlight Google’s plan to take an active role in combating health-related misinformation on its platforms, which has been a hot discussion topic since the start of the pandemic.

Fitbit announced that it submitted a request to the FDA for clearance to use photoplethysmography sensors to help detect atrial fibrillation after finding that the light-based PPG sensors identified the condition 98% of the time.

  • Fitbit already has the FDA’s go-ahead to use an ECG to monitor heart rhythms, but the PPG sensors are better suited for consistent long term monitoring.

Google’s Health AI team is teaming up with Northwestern Medicine to increase access to maternal health screening in low-income countries using a handheld ultrasound AI solution that helps lightly trained health workers and or even pregnant women conduct scans and interpret the results.

The Takeaway

Google’s latest feature updates illustrate the company’s revamped strategy of integrating health into its main service lines, which it announced following the dismantling of its Google Health business late last year. While none of the features are a huge shift individually, that isn’t necessarily a bad thing. Google seems committed to pivoting back to basics by bolstering the healthcare functions of Search and YouTube, which remain the foundation of its business.

TimeDoc Health Raises $48.5M for Virtual Care

Virtual care enablement company TimeDoc Health recently clocked in $48.5M in Series B funding to help physicians establish new remote care capabilities for a post-pandemic environment.

The latest financing pushes TimeDoc’s total raise to $58.2M, with recent demand for hybrid care and staff support creating a need to quickly expand the company’s growing roster of over 150 care coordinators.

  • TimeDoc’s virtual care platform aims to lighten the burden of overworked physicians through three major service lines: chronic condition management, remote patient monitoring, and behavioral health integration for primary care.
  • The company positions itself as a way to increase the bandwidth of primary care teams by allowing them to leverage additional personnel alongside its services as standalone solutions, or as supplements to existing approaches.
  • Unlike other care coordinators that often go D2C, TimeDoc works directly with PCPs so that they can better manage their patients in between appointments, while also driving reimbursements for remote patient monitoring and chronic care management.
  • The new funding will be put towards doubling the size of TimeDoc’s care coordination team and expanding its customer base beyond primary care practices towards more traditional health systems and accountable care organizations.

The Takeaway

TimeDoc is no stranger to the fact that the benefits of virtual care programs are best realized through long term engagement. By recognizing that care coordinators are instrumental in making this happen, then offering flexible services that tailor staff support to the needs of individual organizations, TimeDoc could gain an edge by truly meeting providers where they are instead of taking a one-size-fits-all approach.

Clarify Acquires Embedded to Scale Value-Based Care

Value-based analytics company Clarify Health is acquiring Embedded Healthcare to help cross what it refers to as the “last mile” of creating durable shifts in care models: behavior change.

Although the terms of the transaction were not disclosed, the acquisition comes on the heels of Clarify’s $115M Series C funding round in March 2021, which gave it plenty of capital to invest in companies like Embedded that help make insights from data platforms more actionable.

  • Clarify’s cloud-based applications are built on the Clarify Atlas Platform, which maps over 300M patient journeys to illuminate areas that can be optimized to improve value-based performance. The platform links clinical performance to financial impact to boost payer-provider collaboration.
  • Embedded was spun out of the UPenn’s Healthcare Transformation Institute in 2019 to apply behavioral economics principles to provider behavior change, such as selecting higher-value care sites for elective procedures. Embedded reports that targeted incentives delivered to the point of care have proven to change 10% of physicians’ decisions in under nine months.
  • Combining the Clarify Atlas Platform with Embedded’s incentive framework should help with targeting behavioral nudges at the moments when they’ll be most effective, such as giving early bonuses as soon as positive performance is identified.

Five Pillars of Value Based Care

In an interesting interview with Modern Healthcare, Clarify CEO Dr. Jean Drouin laid out what the company views as the five key pillars for value-based care technology:

  1. Trusted baseline to assess performance of care delivery
  2. Digital contracts to help automate progress tracking
  3. Contracts well-designed to align incentives
  4. Clinicians are aware of incentives before they make a decision
  5. Predictive analytics to reduce the lag between action and incentive

Clarify’s core analytics platform centers around the first pillar, while its acquisition of Apervita’s value-based care digitization business in summer 2021 took care of the second one. Now, Embedded’s behavior change technology directly addresses the third pillar, and it doesn’t seem like too much of a stretch to say that clinician communication (pillar 4) and predictive analytics (pillar 5) are now Clarify’s top priorities as it looks to round out its product portfolio.

HIMSS 2022 Digital Health Recap

It’s Thursday afternoon on the final day of HIMSS 2022, and although many exhibitors are still diligently stationed at their booths, the giant wave of announcements has already crashed and it’s time to round up some of the event’s biggest digital health stories.

Where last week’s ViVE conference highlighted the latest shiny platforms being used to interact with patients, HIMSS instead returned to its usual focus on the IT infrastructure that makes care delivery more seamless and works best when it’s invisible.

That said, there was still plenty of digital health news to go around, and the attendees seemed genuinely excited to finally see their peers in person and showcase the latest updates from their companies. So without further ado…

  • Andor Health is partnering with Microsoft to launch its ThinkAndor enterprise platform that helps health systems configure tailored hybrid care powered by Microsoft Teams’ device endpoint management and Microsoft Azure’s data integration features.
  • Amwell’s SilverCloud Health launched its Family Support Suite leveraging internet-based cognitive behavioral therapy to support the mental health of parents and their children, following a successful pilot of the six course program at MemorialCare.
  • Caregility debuted its Inpatient Virtual Engagement solution-as-a-service that enables hybrid care at scale with minimal upfront investment by integrating a point of care system for low acuity patients with a telehealth administration portal and an endpoint fleet management tool.
  • mPulse Mobile acquired Medicaid-focused communications platform HealthCrowd to combine its conversational AI with HealthCrowd’s engagement expertise to build tailored programs addressing challenges such as medication adherence and plan navigation.
  • Notable unveiled its Intelligent Scheduling solution designed to cut down on call center volume by automating appointment setting depending on patient care needs and provider preferences, proactively prompting visits after predefined events.
  • Relatient debuted a sleek new Dash platform that unifies the company’s scheduling, patient communication, and digital registration offerings into a cohesive offering, following its recent merger with Radix and a fresh $100M in funding.
  • TytoCare published its 2022 Virtual Primary Care Adoption Survey that does a great job exploring US consumers’ feelings towards digital care, such as the fact that 67% of patients are more likely to stay with a payor if it offers VPC with remote physical exams.
  • Unite Us successfully rolled out its Social Care Payments offering that extends financing beyond the clinical setting by connecting payors to community-based organizations and streamlining the implementation of social care funding programs.
  • VeeOne Health announced its VeeGo 360 RPM service that combines body sensors, a patient-facing mobile app, and a care team portal to enable post-acute and chronic disease monitoring from the patient’s home.
  • Woebot Health raised $9.5M in strategic funding from Bayer’s impact investment arm to help accelerate the development of its AI-enabled behavioral health platform, pushing the company’s total investment to $123.5M following a $90M Series B in 2021.

Two years after HIMSS 2020 became COVID’s first trade show casualty, healthcare’s leading IT conference returned to Orlando with a full exhibitor list and an energetic crowd that should be a good sign for future events as long as the pandemic cooperates. We hope that everyone had a blast if you made it to HIMSS, and welcome all of our new readers that we met at the tradeshow. Stay tuned for deeper dives into many of these announcements over the following weeks.

Homeward Debuts With $20M for Rural Care

Sometimes no disruption is the best disruption, which is why Homeward is launching with $20M in funding to rearchitect rural healthcare with a full-risk hybrid model that augments local providers as opposed to replacing them. 

At the helm of the new startup is ex-Livongo president Jennifer Schneider, MD, who is aiming to bolster access to both primary and specialty care services in less populated areas, like her hometown of Winona, Minnesota.

  • Homeward overcomes traditional barriers to rural care by combining a multidisciplinary care team, available virtually or in-person via mobile units, with cellular-based remote monitoring that doesn’t require a broadband connection.
  • Under Homeward’s model, which will focus initially on cardiology, a typical patient journey will involve proactive measures with RPM tools to detect heart problems, a visit from a mobile care unit to diagnose issues, and virtual visits for ongoing treatment.  
  • The company’s confidence in its model is seen in its commitment to becoming the first comprehensive provider to take on full risk in rural markets, giving it ownership of the economic benefits of delivering high-quality care at a lower cost.
  • To avoid displacing local primary care physicians and specialists, Homeward will work with regional Medicare Advantage plans to refer members to nearby facilities when appropriate, ensuring timely care while also reducing unnecessary hospital admissions.

The Takeaway

While the value-based model isn’t a new concept, its application towards the 60M Americans living in rural communities has been limited due to challenges with poor broadband and specialist availability. Telehealth as a standalone solution hasn’t been the remedy to these disparities, but Homeward’s cellular RPM devices and mobile care units could bridge the gap that other methods have failed to cross.

ViVE 2022 Recap and Major Announcements

ViVE 2022 is officially a wrap, and the collaborative event between HLTH and CHIME was as action packed as the Miami Beach streets surrounding it. The event put the spotlight right where it should be, on the companies working to bring innovation to areas such as health equity, patient engagement, and interoperability.

Although ViVE attendees shared enough news to fill multiple full issues of Digital Health Wire, this wrap up highlights some of the biggest partnerships and product launches announced during the event.

  • Amazon Pharmacy expanded its MedsYourWay card to allow Blue Cross and Blue Shield members in five states to compare medication costs while applying any purchases to their out-of-pocket maximums.
  • Cedar launched its Cedar Pre solution that delivers “concierge-style guidance” to patients preparing for care in order to create transparency as early as possible and help people make informed decisions while avoiding surprises later in the process.
  • eVisit debuted its eAnalyze reporting dashboard that allows providers to view visit metrics in user-friendly graphs and tables to help identify the dynamics behind visit traffic to prompt proactive changes that can improve operational efficiency.
  • Google Health is adding a new Conditions feature to its Care Studio that uses natural language processing of patient notes to provide physicians with a summary of a patient’s medical conditions along with context from labs, medications, and other sources.
  • Get Well is expanding its population health offerings to help payors and at-risk providers better manage rising-risk members by rapidly adjusting engagement to drive improvements in key metrics including wellness visit completions and CAHPS surveys.
  • Homeward emerged from stealth with $20M in Series A funding and a leadership team of ex-Livongo execs to help bring value-based primary and specialty care to rural communities by combining remote monitoring services with in-person visits via mobile units.
  • Luma Health launched its LumaBot chatbot that addresses provider burnout by helping patients handle tasks such as scheduling appointments and intake paperwork, then writing details such as appointment changes directly back to the EHR to save staff time.
  • Quil debuted its Quil Assure platform that uses ambient sensors placed around a senior’s living space to notify their ‘Care Circle’ of any unusual routine changes, helping seniors enjoy greater independence by reducing the need for unnecessary check-ins.
  • Salesforce showcased Safety Cloud improvements that help businesses scale health testing and status collection, including automation features for COVID-19 protocols and multi-factor credentials to streamline entry into events or buildings.
  • Unite Us launched a Social Care Payments solution designed to bridge the gap between payors and community-based organizations by streamlining the implementation of social care programs so that they can focus on improving outcomes.

Although ViVE contained plenty of news to satisfy most digital health appetites, there’s good news for those still craving more announcements. HIMSS22 kicks off next week, and while the themes will be similar, it should bring another wave of fresh releases from attendees.

Allscripts Sells Hospital EHR Segment for $700M

The quickly shifting EHR landscape saw another major move last week following Allscripts’ announcement that it is focusing its offerings by offloading its hospital EHR assets to Harris Computer, a subsidiary of Canada-based holding company Constellation Software.

Harris is set to acquire Allscripts’ Hospitals and Large Physician Practices business segment for $670M, plus an additional $30M tied to the segment’s performance in the next two years.

  • The transaction includes Allscripts’ Sunrise, Paragon, TouchWorks, STAR, Opal, HealthQuest, and dbMotion solutions, which together accounted for $928M of the company’s $1.5B total revenue in 2021, but have also been steadily losing market share.
  • The $700M valuation implies a 4.8x multiple on the hospital EHR segment’s expected earnings for this year, not particularly high given that other publicly traded EHR companies command an average multiple of over 10x, which reflects two consecutive years of shrinking revenue with another decline forecast for 2022.
  • By divesting the contracting division, Allscripts can now “maximize focus” on its healthier service lines like the Practice Fusion EHR for small practices and the Veradigm analytics solution, which has faster growth (up 4.6% to $552M in 2021) and healthier margins than the legacy EHR business.
  • Veradigm houses one of the largest EHR-linked patient databases available for research, transforming data from Allscripts’ clients into insights that help connect providers and payors to life sciences companies. The data flow won’t be affected by the hospital EHR division’s new ownership, and the platform will now serve as the core of the company’s operations moving forward.

The Takeaway

Allscripts has been committed to refining its offerings since posting a wide net loss in 2019, a process that included similar sales of its 2bPrecise genetic research arm and its CarePort patient coordination services. Offloading the business segment that generates a majority of its revenue highlights just how committed Allscripts is to focusing its portfolio on high growth areas, and the uptick in the company’s stock price following the announcement is a good indication that investors agree with that strategy.

Teladoc and Amazon Partner on Echo Voice Visits

Yesterday’s competitors are today’s collaborators, with Teladoc and Amazon inking a new partnership to bring voice-activated virtual visits to Alexa-equipped Echo devices.

  • “Alexa, I want to talk to a doctor” will now connect Echo users to a Teladoc call center to verify a patient’s medical history and health plan information ($0 if covered, or $75 direct-to-consumer). Within roughly 15 minutes, the patient will then get a call back from a Teladoc physician to treat mild needs such as colds, flus, or allergies.
  • The new service will initially be available in an audio-only format for supported devices such as the Echo Dot and Echo Show, but will add video functionality “soon” to make it easier to diagnose certain conditions.
  • The partnership greatly expands Teladoc’s consumer reach as part of its ongoing strategy to meet patients where they are. Amazon reports over 40M Alexa users in the US alone, and has delivered more than 200M Alexa-equipped devices globally.
  • This is the latest in a string of health-focused improvements to Amazon’s Alexa ecosystem, which have included capabilities for elder care coordination through Alexa Together, as well as medication management through the Care Hub… and those are happening outside of even bigger moves with Amazon Care.

Industry Impact

Despite the recent launch of Amazon’s own Amazon Care telehealth service, Teladoc’s virtual physician network is significantly larger, and this scale will be absolutely essential to keep up with what could be an insanely high call volume for the new service.

The Teladoc partnership marks Amazon’s first attempt at providing truly on-demand healthcare with Alexa devices, and if well executed, could go a long way towards breaking down barriers to care for many patients. Even though Amazon and Teladoc are now competing in the same arena, the collaboration shows that coordinated efforts are still on the table when there’s a clear benefit for both patients and the companies.

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-- The Digital Health Wire team