DispatchHealth Lands $330M for In-Home Care

It looks like 2022 isn’t finished with the megarounds quite yet, with DispatchHealth hauling in $330M in a mix of debt and equity funding to build out its suite of in-home services.

DispatchHealth launched in 2013 to bring urgent care into patient homes, but has since expanded its offerings to cover a wide range of high-acuity needs.

  • The company partners with health systems, payors, and employers to provide in-home resources that help keep patients out of the hospital, such as mobile medical teams and Advanced Care hospital-at-home solutions.
  • These services are integrated within its Last Mile Care Technology Platform, which tracks care patterns to optimize utilization, forecast equipment requirements, and triage patients to outside resources when necessary.

The latest round lifts DispatchHealth’s total funding to over $730M as it shifts its focus to building out its high-acuity ecosystem in the 50+ markets it already serves – reportedly covering 75% of Medicare Advantage members in the US.

  • It’s easy to imagine that DispatchHealth is probably high on the list of acquisition targets for companies like UnitedHealth Group or CVS that are actively looking to round out their care delivery strategies with in-home assets.
  • That makes it interesting to see that UHG subsidiary Optum Ventures led the recent funding, with Humana and Blue Shield of California also participating.

The Takeaway

Against a backdrop of economic uncertainty and a slowdown in private funding, DispatchHealth’s nine-figure raise shows that investors still have an appetite for startups with a solid track record of improving outcomes. We’ve been covering plenty of stories about hospital overcrowding and struggling margins, and DispatchHealth is making it clear that it believes the home is the right setting to tackle both issues at the same time.

Inbound Health Connects the Dots for Home Care

Providing patients with at-home care is one thing, but determining which patients would benefit from it is a whole different story. Inbound Health is emerging from stealth to connect the dots.

Equipped with $20M in launch funding, Inbound is spinning out of Minnesota-based Allina Health and Flare Capital Partners to help other health systems establish their own hospital-at-home and skilled nursing-at-home programs.

The first half of Inbound’s platform covers all the bases of a robust at-home care program, including virtual care teams, in-person nursing visits, remote patient monitoring, engagement tech, and a command center to keep it all straight.

  • To help identify patients that would benefit from the program, Inbound provides AI-enabled analytics to filter candidates both medically and functionally in their home life, then confirms the fit with their physicians.
  • To help get those pieces in place, Inbound steps in with operational oversight, a comprehensive supply chain, and of course: performance-based contracts.

The overall partnership structure is flexible, allowing health systems to leverage their existing capabilities while only relying on Inbound to bridge the gaps necessary to scale these programs across their service areas.

  • Since beginning as a temporary program at the start of the pandemic, Inbound has now served over 4k patients across 185 primary diagnoses, reportedly lowering the total cost of care by 30%+ while often achieving better clinical outcomes than facility-based care.
  • While other home care enablers like Medically Home and Contessa Health are pursuing similar strategies, Inbound aims to set itself apart with “full stack of capabilities” that benefit outcomes enough to develop unique episodic-based payor contracts.

The Takeaway

At-home care is undoubtedly a hot corner of the market, attracting plenty of attention with its promise of lowering costs while increasing patient satisfaction. By bringing everything under one roof and tying its own success to its partners’ success, Inbound seems like it’s on the right path to making that promise a reality.

The Future of Home and Community Care

A bit of a slow news week gave us a chance to circle back on a recent NEJM commentary by Optum’s leadership, which laid out the key components of a futuristic home care model and the steps that Optum is taking to make it a reality.

The vision is to unite modular point solutions around the patient to enable timely interventions and care coordination that is supported by data and technology for a seamless experience and optimized care delivery across providers and care settings.”

Sounds great, maybe a little boilerplate-ish, but the individual solutions tie it all together:

  • Patient Assessments – The “pivotal first step” to identifying, engaging, and stratifying patient populations through annual in-home comprehensive clinical examinations of medical, behavioral, and social needs. Ex. Optum HouseCalls
  • Care Transitions – Appropriately managing a patient’s transition from acute care facilities is essential to keeping recoveries on track, and comprehensive programs should include post-discharge engagement and 90-day follow-ups. Ex. naviHealth
  • At-Home Emergent Care – At-home emergent care is convenient for patients while helping avoid readmissions, and the authors cite a 2018 hospital-at-home study demonstrating better outcomes than inpatient care. Ex. DispatchHealth   
  • Home-Based Medical Groups – The cherry on top of the proposed model is a call for more home-based medical groups to treat patients with chronic conditions. Services might include primary care, therapy, and dialysis. Ex. Landmark Health

The Takeaway

Although the article was mainly intended to provide a framework for successful home care, it also gave us a great peek at Optum’s priorities. It was interesting to see the companies that the authors held up as prime examples for each solution, and it’s easy to picture each of them as potential acquisition targets considering how active Optum’s been in the M&A space.

CVS Acquires Signify Health for $8B

The Signify Health acquisition saga has officially reached its conclusion, with CVS Health emerging as the winning bidder over other high profile suitors such as Amazon and UnitedHealth Group.

CVS closed the transaction at $30.50/share or roughly $8B, which should be music to the ears of Signify shareholders after the stock hit a low of $11 earlier this year.

Signify offers in-home health risk assessments and provider enablement services to help organizations transition to value-based care.

  • The company has a network of 10k providers across all 50 states and acquired ACO management player Caravan Health earlier this year to further expand its reach with Medicare patients.
  • CVS CEO Karen Lynch said that Signify “will play a critical role in advancing our health-care services strategy and gives us a platform to accelerate our growth in value-based care.”

Through the acquisition, CVS is adding to its rapidly expanding menu of healthcare offerings that already includes over 9k pharmacies, 1k MinuteClinics staffed with nurse practitioners, and the third largest payor in the nation, Aetna.

  • Acquiring a home care company gives CVS a new avenue to serve their large customer base at a time when more consumers are heading online for the everyday items that used to bring them into stores.
  • As a bonus, Signify opens the door for CVS to provide proactive care in patient homes while keeping them out of the hospital, which has the potential to dramatically cut down on expenditures for patients covered by Aetna.

The Takeaway

With the acquisition of Signify, CVS has cemented its move away from its pharmacy chain roots. The news arrives as CVS’ retail healthcare competitors are pushing aggressively into outpatient services, following close behind Amazon’s acquisition of One Medical and less than a week after Walgreens scooped up home care company CareCentrix.

CVS has made it clear that it plans to compete in healthcare by establishing itself as one of the nation’s largest primary care providers, and with such a large footprint of conveniently located stores, they have all the right building blocks to make it happen.

Homeward Raises $50M to Rearchitect Rural Care

Homeward’s “no disruption is the best disruption” strategy is picking up steam with $50M in Series B funding to rearchitect healthcare for the 60M Americans living in rural communities by augmenting local providers rather than replacing them. 

It’s the company’s second capital raise in the five months since it debuted under the leadership of former Livongo execs Amar Kendale and Jennifer Schneider, bringing its total funding to $70M.

Homeward is an in-network provider with the ambitious goal of evolving both payment models and care delivery models in rural communities hardest hit by the hospital closure crisis.

  • To accomplish this, Homeward utilizes telehealth services, in-home visits and mobile clinics for physical exams, as well as cellular-based RPM technology to monitor patients in areas without broadband.
  • The Series B follows shortly after a partnership with Rite Aid to send Homeward’s mobile clinics to rural locations and provide primary care services to Medicare members, referring patients to regional health systems and local specialists for complex needs.

The fresh funding will help Homeward scale its on-the-ground and virtual care teams while expanding into new markets through value-based contracts with health plans, the first of which was just announced with Priority Health out of Michigan.

  • Priority’s 30k Medicare Advantage members will have access to Homeward’s full suite of services, including its physicians and mobile clinics. 

The Takeaway

Homeward is one of the first comprehensive providers to take on full risk in rural markets, and its Series B will allow it to reach these populations even faster through new partnerships. This expansion will likely be focused on only a small handful of payors, with Homeward reporting that seven health plans cover 90% of Medicare-eligible beneficiaries living in rural communities.

Mass General’s Hospital-at-Home Expansion

Mass General Brigham is living up to its reputation as a healthcare innovator after laying out plans for a “massive expansion” of its hospital-at-home program to help contain costs and manage the ongoing capacity crunch at its facilities.

The health system intends to grow its current program from 25 patients to upward of 200 hospital-at-home beds by 2025, with 90 fully-operational beds expected before the end of next year.

MGB’s hospital-at-home service provides hospital-level care at a patient’s residence, allowing those who are stable enough to be monitored remotely to recover from the comfort of their home. Patients have access to virtual meetings with their care teams, as well as in-person visits from physicians, nurses, and case managers.

  • As part of the expansion, MGB appointed its first-ever president of home-based care, Heather O’Sullivan, who most recently worked for one of the country’s largest home care providers, Kindred at Home.
  • Over the next year, O’Sullivan will oversee the hiring of 200 additional workers to bring MGB’s total home care staff to 1k employees, and will ramp up its fleet of remote care vehicles from 2 to 10 to enable more home testing and medical supply deliveries.

Dr. Gregg Meyer, EVP of value-based care for MGB, compared the hospital-at-home program to a house call from a doctor, which not only gives patients more convenience, but also lets providers observe SDOH factors that might impact recovery.

  • MGB cited a 2019 study showing that its hospital-at-home service led to a 38% cost reduction compared to traditional care, while other programs have lowered readmissions and helped alleviate hospital capacity issues.

The Takeaway

Mass General Brigham ranks among the most highly visible health systems in the world, and all eyes are now on the results of its hospital-at-home expansion. If MGB can successfully create a more convenient recovery experience while simultaneously reducing costs, it could cause plenty of other organizations to replicate the model. That said, hearing a health system like MGB refer to 200 patients as a massive expansion also serves as a good reminder that scaling these types of programs is far from an easy task.

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.

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.

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.

ConcertoCare Raises $105M For At-Home Senior Care

Companies that deliver care outside of traditional settings are continuing to attract eye-popping amounts of fresh capital, with ConcertoCare recently raising a $105M Series B round to scale its operations across the US.

Concerto is a value-based provider of at-home comprehensive care for seniors “with unmet health and social needs.” The company’s model incorporates medical, behavioral, and social determinants of health to help improve outcomes from multiple angles

  • To help serve medically complex populations, Concerto enlists interdisciplinary care teams of physicians, pharmacists, behavioralists, and social workers to meet with patients either in-person or virtually.
  • These teams are equipped with a proprietary Patient3D decision support platform that assists with identifying the next best action for each patient, as well as a range of connected devices that enable the remote management of chronic conditions.
  • The Series B pushed Concerto’s funding total to $149.5M and will help it launch its Program of All-inclusive Care for the Elderly (PACE) later this year while expanding into new US markets outside of the 8 states it already serves.
  • Alongside the funding news, Concerto announced the acquisition of Crown Health, a home-based primary care provider serving the Pacific Northwest. The move aligns with Concerto’s 2021 merger with primary care provider, Perfect Health.

The Takeaway

ConcertoCare’s differentiator is its full-stack approach to improving outcomes for the country’s most medically complex seniors. According to Concerto, less than 5% of patients accounted for half of US healthcare expenditures in 2018, and these are the same patients the company is seeking to help. Concerto’s value-based approach could be a piece of the puzzle for successfully managing this vulnerable population, especially with 88% of seniors preferring to receive care in their home.

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-- The Digital Health Wire team