CVS Health Announces Virtual Primary Care

CVS Health’s push into omnichannel care delivery continued last week with its new Virtual Primary Care solution geared towards connecting the company’s clinical expertise and patient data on a single digital platform.

CVS Health Virtual Primary Care will provide eligible Aetna and CVS Caremark members with access to on-demand primary care, chronic condition management, and mental health services in either virtual or in-person settings.

  • The service’s physician-led care teams include nurse practitioners, RNs, and licensed vocational nurses. The care team will consult CVS pharmacists and help members identify appropriate in-network specialists and other services as needed.
  • An interoperable EHR will help patients transition between virtual and in-person care while allowing clinical data to be shared with other providers. A comprehensive data view will also enable providers to deliver personalized health alerts to patients.

The new program aims to enable timely access to care, and CVS cites reports that it currently takes 24 days to schedule an appointment with a primary care physician and twice that long to see a mental health professional.

  • Although the press release doesn’t go into too much detail on how CVS plans to staff the program, an active job listing for a virtual primary care provider indicates that they’re hiring two PCPs to cover the entire 17-state central US region.
  • If that ratio holds through next year’s launch it would suggest that CVS isn’t expecting significant patient volume through the platform, although it’s still early to make that call.

The Takeaway
The Virtual Primary Care launch continues CVS Health’s recent string of service enhancements designed to help it move beyond its corner drugstore image, including reimagining its stores as healthcare destinations and a strategic data partnership with Microsoft. The move also bolsters CVS Health’s overall care delivery strategy at a time when one of its most direct competitors, Walgreens, is doubling down on primary care by taking an ownership stake in VillageMD to streamline the launch of at least 700 connected clinics by 2027.

Innovation for Underserved Groups

Venture firm Rock Health recently published an interesting deep dive on the digital health adoption patterns of marginalized user groups that have carried a disproportionate amount of access disparities. The analysis was based on survey results from Rock Health’s latest Digital Health Consumer Adoption Survey of 7,980 US adults, which shed light on where digital health solutions are gaining traction, and where gaps still remain.

Rural households have one of the most persistent adoption gaps among all demographics, with rural respondents reporting lower rates of live video telemedicine use, wearable ownership, and digital tracking of health metrics… and not by a small margin. Rock Health found that rural residents trust health information from a doctor (88%) far more than from a website (52%), highlighting a need to invest in tools that empower rural providers.

  • Startups working to solve these problems include Main Street Health, which pairs rural MA beneficiaries with local health navigators to coordinate chronic care needs, and Homeward Health, which designed its RPM platform to function on cellular networks to bypass the need for a broadband connection.

Medicaid’s 80M beneficiaries account for over $650B in annual health expenditure, and the fact that they use digital health tools at similar levels to the survey average seems to bust the myth that people with low incomes or disabilities won’t use health technologies. 

  • Recent raises from startups like Waymark ($45M) and Clinify Health ($3.1M) have helped support Medicaid care hubs like Federally Qualified Health Centers, and Rock Health expects more innovation to be targeted at these community-based networks.

Women of color reported significantly lower satisfaction with digital health tools than women who identified as white, despite their strong adoption across all modalities. Although the survey didn’t explore the “why” behind the satisfaction levels, Rock Health believes that they may relate to disconnects between product design and the communities using the solutions.

  • Several startups have begun co-designing solutions with their communities to mitigate these satisfaction breakdowns, including Radical Health (online peer support for navigating healthcare journeys) and Grapevine Health (community-created health content that’s then distributed at scale).

LGBQA+ and transgender patients report some of the highest levels of discrimination in health settings, and their sky-high digital health utilization serves as a proxy for lack of trust in traditional care. Rock Health found that 85% of transgender respondents and 33% of LGBQA+ respondents delayed medical care in 2021, and several solutions are entering the market to ensure that care gap doesn’t persist.

  • Startups supporting queer and transgender patients raised a record $311M in 2021, including Folx, which raised $25M to expand its virtual clinical services, and Plume, which raised $14M to help deliver holistic gender-affirming care to anyone who needs it.

Amwell Launches Comprehensive Behavioral Health Program

It’s officially #MentalHealthAwarenessMonth, making it a great time to show some genuine support to your friends and colleagues, and an opportune moment for virtual care providers like Amwell to launch behavioral health solutions.

Amwell recently debuted the Amwell Comprehensive Behavioral Health Program, combining the digital cognitive behavioral therapy programs of SilverCloud Health (acquired last year) with virtual care provided by psychiatrists from Amwell Medical Group.

  • Members undergo individual evaluations before selecting either self-guided or coach-supported care, and can then be referred to virtual therapy and psychiatry as needed.
  • The solution can be tailored to meet specific population needs, enabling payors and providers to deliver personalized experiences for various severities and care delivery preferences.

The new program extends Amwell’s growing suite of behavioral health tools, which includes Amwell Psychiatric Care for acute psychiatric needs and ED clinical support, as well as the SilverCloud Health Family Support Suite to help new parents and their children manage mental health concerns.

  • Behavioral health is one of healthcare’s most capacity-strained areas, and the pandemic has only exacerbated the problem.
  • Amwell cites research that 60% of US counties don’t have a single psychiatrist, and that 41% of adults have felt anxious or depressed during the pandemic.

The Takeaway
Amwell is clearly committed to quickly scaling its virtual behavioral health portfolio, which is a pretty natural direction to pursue given the huge need and telehealth’s ability to help address it. Behavioral health might also be one of the only clinical areas where telehealth represents a truly preferred substitute to in-person care, and Amwell’s recent investment in the area should go a long way toward making its services durable as patients begin returning to in-person care.

Turquoise Health Closes $20M to Bring Transparency to Healthcare

New CMS price transparency rules have created a massive headache for hospitals looking to publish data often hidden in archaic systems and fragile spreadsheets, which is why Turquoise Health raised a $20M Series A round to help ease the pain and increase compliance. 

The Turquoise platform allows provider organizations and payors to digitize their service catalogs and pricing information, creating what it calls a “pre-revenue cycle” where patients know costs upfront and providers receive quicker compensation.

  • Although most of this data reaches care navigation platforms through an API, patients can also use a search engine on the Turquoise Health website to compare hospitals across all 50 states.
  • Turquoise’s recent investment will be put to work developing the software needed to aggregate the wide range of inputs contributing to a procedure’s final cost, as well as determining health plan coverage at each step.

In anticipation of new payor rate disclosure requirements arriving in July, Turquoise also announced the launch of its Clear Contracts platform, which streamlines the direct contracting process with premade agreements generated from its pricing data.

  • At launch, Clear Contracts will support single case agreements, retrospective out-of-network agreements, and group health agreements, with the boilerplate contracts allowing for a quicker back-and-forth during negotiations.
  • a16z’s Julie Yoo called payor-provider contracts “the tail that wags the dog for most healthcare navigation decisions,” and Turquoise’s mission to modernize them was a key driver behind her decision to lead the Series A.

The Takeaway

Leveraging data from the Turquoise platform to support contract negotiations seems like a smart move for a company looking to build a business model around a valuable data asset. CMS transparency rules, the No Surprises Act, and the upcoming payor rate disclosure requirements have created a sea of regulations that’s extremely favorable for startups that can help navigate these waters, especially if they can translate their data into supporting services like Clear Contracts.

Measuring Telehealth Outcomes During the Pandemic

Since the beginning of the pandemic, few studies have investigated the association of telehealth with outcomes of care, including patterns of care use after the initial encounter. New research published in JAMA Network Open set out to do just that, using a cohort of 40.7M US adults with commercial health coverage to examine the difference in outcomes between telehealth versus in-person encounters.

The study assessed Blue Cross and Blue Shield members from July 1, 2019, to December 31, 2020. Outcomes of care were assessed 14 days after initial encounters and included follow-up encounters of any kind, ED visits, and hospitalizations.

The key finding of the study was that telehealth has the potential to result in duplicative care, depending largely on the patient’s condition type. Telehealth patients with acute conditions were more likely to have a follow-up encounter than in-person patients, while telehealth patients with chronic conditions were less likely to require follow-up. 

In the cohort with acute conditions, the odds ratios for patients with an initial telehealth encounter were 1.44 for a follow-up of any kind and 1.11 for an ED encounter.

  • Ex: Patients with an acute upper respiratory tract infection episode were 65% more likely to have a follow-up if their initial encounter was a telehealth visit, compared to in-person.

The chronic condition cohort showed contrasting results, with odds ratios of 0.94 for follow-ups of any kind if the initial encounter was via telehealth.

  • Ex: Patients with essential hypertension were 37% less likely to have a follow-up if their initial encounter was a telehealth visit, compared to in-person.

For those that like to dive into the data, this table breaks down patterns of subsequent care by the clinical condition.  

The Takeaway

The contrasting patterns of telehealth follow-up care for acute and chronic conditions are relevant to both policy makers and providers. Telehealth use for the management of chronic conditions appears comparable, or even more efficient, than in-person care, with the opposite looking true for acute conditions. This trend was strongest for acute respiratory infections, but that also feels like a pretty natural result for a study conducted during a respiratory-related pandemic.

Osmind Raises $40M for Breakthrough Mental Health Therapies

Severe mental health disorders are complicated problems to solve, and the legacy documentation systems used by most psychiatrists don’t do much to help the rate of progress. Electronic health record startup Osmind raised $40M in Series B funding to equip psychiatrists with tools to better manage complex patients, while also starting to fill the data gap in research for breakthrough therapies.

On the surface, Osmind offers an EHR tailored to clinicians serving patients with treatment-resistant mental health conditions like severe depression and PTSD.

  • The Osmind EHR supports clinical and administrative functions with features that streamline charting workflows, automate outcome tracking, and drive engagement.
  • An integrated mobile app enables patients to record their thoughts and feelings in between visits, giving providers a clearer view of their patients’ overall well-being. 

The back end of Osmind’s platform is equally as important as the EHR. A real-world evidence engine takes the granular data from the EHR and makes it available to researchers studying breakthrough mental health treatments such as ketamine and psychedelics.

  • While other companies like Flatiron Health and Verily also leverage anonymized patient data to influence therapy design, Osmind has quickly compiled a leading dataset to help translate this strategy to the mental health arena.
  • Earlier this year, Osmind partnered with Stanford University School of Medicine to publish the largest-ever real-world data study on ketamine infusion therapy as a treatment for depression.

The fresh funding will be used to expand Osmind’s team as well as the types of data its software can capture to advance a wider range of clinical trials and therapies.

The Takeaway

Mental health startups have proliferated over the past few years, but few have focused on breakthrough treatments for the millions of patients who have tried and failed multiple other options. Osmind’s new funding will allow it to better help these patients, not with direct clinical care, but by supporting the providers and researchers already serving them.

Digital Health, Bubble or No Bubble?

Pandemic-fueled digital health adoption and regulatory changes have brought a wave of new entrants and climbing valuations, but a cloudy macroeconomic outlook has caused many to wonder when the music will stop playing. Digital health venture firm Rock Health recently published its thoughts on whether digital health is in an investment bubble, providing a framework for innovators to assess their individual bubble risk to help navigate a downturn.

Is digital health in an investment bubble? Rock Health assesses “bubbliness” with a six point rubric based on analysis of past bubbles. The rubric currently indicates that digital health is not in an investment bubble, but has more valuation risk than in the past.

To assess the bubble risk of an individual segment, Rock Health maps the segment’s market infrastructure (tech stack, regulatory framework, business models) to its market traction (adoption, outcomes, integration). The resulting framework (pictured here) lets companies plan different bubble strategies depending on their quadrant.

  • “Early days” startups have emerging market infrastructures and limited market adoption, giving them long growth runways but only if they can put in place mission-critical infrastructure pieces (scalable tech, sustainable business models). Example: VR therapeutics
  • “Disequilibrium” companies have high market traction that outpaces the maturity of the market infrastructure, creating the need to partner with companies that fortify this infrastructure with complementary assets (regulatory expertise, foothold in adjacent markets). Example: Consumer genetic testing
  • “Niche” companies have limited traction despite a mature market infrastructure, and Rock Health suggests that they should expand the types of customers they target in order to secure more stable (bubble-proof) revenue. Example: Personal health records
  • “Established” companies have a high degree of market traction and a mature market infrastructure, so continued growth hinges on expanding into novel use cases and investing in technology that reduces the chance of commoditization (cloud/AI, reimbursement mechanisms). Example: Telemedicine

The Takeaway

Rock Health’s current stance is that “digital health is not in an investment bubble, but it is frothy.”  That said, the report’s true call-to-action applies regardless of whether or not we’re in a bubble: now is the time for companies to evaluate their bubble risk and put a plan into place to prepare for whatever the market brings in the future.

Notable’s State of Automation 2022 Report

Burnout and staffing shortages are two of the biggest challenges currently facing the healthcare system, and at this point it doesn’t take another survey to prove that point. The more pressing issue is finding a solution to this well-documented problem, which is what healthcare automation company Notable set out to do with its latest research.

Notable’s State of Automation 2022 Report was based on a survey of over 1,000 US healthcare professionals, and a clear theme emerged in the responses: as workloads continue to increase due to the staffing shortages, health systems looking to grow need to unlock capacity for existing workers to refocus their time on patients.

The key findings echo the sentiment of most medical workforce polls from the last few years:

  • 57% of respondents said they are worried they will burn out due to the number of repetitive tasks required in their role.
  • 45% of respondents are frustrated with how little time is spent on patient care.
  • An average of 58% of staff time is currently spent on repetitive tasks such as data entry and documentation.

The responses also revealed a disconnect in the perception of time spent on repetitive tasks depending on the role, which as likely contributed to the slow relief of this issue:

  • 16% of patient-facing staff agree that “90%+ of staff time is spent on repetitive tasks,” while less than 10% of executives believe the same. 
  • Under 40% of patient-facing staff strongly agree that “their organization is using digital technology effectively,” while 63% of executives agree with the statement.

The Takeaway

The report recommends automating away cumbersome administrative tasks like patient intake and registration to help eliminate downstream work. Although this might be an obvious takeaway from a report conducted by an automation company, it’s hard to argue against streamlining repetitive tasks to support overworked employees.

Health systems today are up against some major obstacles to achieving growth, with patient expectations climbing at a time when expenses are inflating just as quickly. Until we see the supply of healthcare workers begin to rise to meet this demand, freeing up the bandwidth of existing staff to let them spend more time with patients seems like a solid step in the right direction.

Biofourmis Secures $300M for Personalized Care

Biofourmis is taking a two-pronged approach to the healthcare market, leveraging its FDA-cleared data platform to fuel insights for both remote patient monitoring and the development of digital therapeutics. The completion of a $300M Series D funding round will now advance the company’s progress on both fronts, while also minting a new digital health unicorn with a valuation of $1.3B. 

The Biovitals Analytics Engine serves as the foundation of Biofourmis’ services. It employs artificial intelligence to transform biometric data into personalized baselines for each patient, allowing providers to take action as conditions begin to escalate.

Biofourmis’ [email protected] solution uses Biovitals in combination with remote monitoring devices to detect early clinical deterioration and offer dynamic care pathways.

  • These insights are supported by a staff of licensed health professionals that can respond to alerts and update treatments while coordinating with primary care teams.
  • The new financing will be used to scale up these offerings, including the expansion of the recently announced Biofourmis Care service, focused on managing patients with chronic conditions like heart failure and diabetes. 

The other half of Biofourmis’ strategy involves developing digital therapeutics by pairing Biovitals with different medications to optimize dosages as patient health begins to deviate from their baselines. 

  • Biofourmis has a full pipeline of digital therapies, and its BiovitalsHF solution for congestive heart failure is poised to be the first to reach commercialization after receiving FDA Breakthrough Device Designation in July.
  • The influx of capital will be put towards clinical trials to develop new digital therapeutics while growing the product pipeline.

The Takeaway

Remote patient monitoring solutions often live up to their name by focusing more on “monitoring” than “management.” Biofourmis is aiming to change that through a Biovitals platform that enables not only proactive home care, but also individualized insights into the efficacy of digital therapeutics.

It’s the synergies between these service lines that Biofourmis is building around. As the company begins to commercialize its own digital therapeutics, its remote care operations could serve as the perfect distribution channel.

Get the top digital health stories right in your inbox

You're signed up!

It's great to have you as a reader. Check your inbox for a welcome email.

-- The Digital Health Wire team