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.

Reimagine Care Secures $25M for Home Cancer Care

Home-centered care startup Reimagine Care recently raised $25M in Series A funding, its first round of outside capital that it hopes will help it live up to its namesake for US cancer patients.

Reimagine Care provides technology-enabled services that support oncologists in delivering value-based care remotely, while helping health systems, payors, and employers accelerate the shift to coordinated home-centered cancer care.

  • Taking inspiration from European models for home-based cancer treatment, the Reimagine Care platform gives patients access to a 24/7 virtual care center that allows them to view their treatment plan and communicate with their care team.
  • For providers, Reimagine Care offers remote patient monitoring and end-of-life care management solutions that have been shown to reduce ER visits and inpatient admissions.
  • For payors and employers, home-centered care is “a lever for value,” improving member satisfaction while reducing adverse events such as hospital-acquired infections that drive expenses.
  • The funding follows a survey that found that 66% of healthcare executives believe home-centered cancer care offers significant potential to grow their organization, and that 60% are concerned that their organizations may fall behind if they don’t make the shift to home-centered cancer care in the near future.

The Takeaway

With the pandemic as a catalyst, cancer patients and their families have begun seeking not only the best treatments, but also the best experiences. Reimagine Care believes that health systems that are first-movers in home-centered care will have a strong advantage over those who fail to make the leap, which rings true, but time will be the judge. The company has yet to begin taking patients, and its success will hinge on the ROI that they deliver when they’re fully operational later this year.

Medically Home Gains $110M Strategic Investment

The hospital-at-home space continues to pick up speed as Medically Home announces a new $110M round and a fresh set of strategic partners.

  • The round was led by medtech company Baxter International and mobile care provider Global Medical Response, joining Cardinal Health, Mayo Clinic, and Kaiser Permanente who added to previous investments. Each investor is now a strategic partner in Medically Home, a strong sign of confidence in the company’s expansion plans.
  • Medically Home’s platform enables in-home care for high-acuity patients through the use of RPM devices, emergency response systems, and durable medical equipment installation. Providers use these tools to continuously monitor and communicate with patients from a customized “command center.”
  • The new strategic partners strengthen Medically Home’s care delivery model. GMR’s network of 30k deployable clinicians will provide quicker response times, while Baxter’s involvement will give care teams access to a wider set of therapies for critical conditions.
  • Although the funding’s purpose was not explicitly stated in the press release, it’s clear that Medically Home is intent on expanding its capabilities, and $110M is a healthy amount of capital to begin scaling its services nationwide.

The Takeaway

Medically Home operates at the intersection of several key trends. The pandemic has made brick-and-mortar settings dangerous for the type of high-acuity patients that Medically Home treats, many hospitals are operating at or near capacity, and consumer preferences are increasingly shifting towards comfortability and in-home care. Medically Home’s services address each of these directly, and judging by its growing partner roster, many companies share a belief in the care model.

Babylon Accelerates US Expansion With Higi Acquisition

Babylon Health finalized its acquisition of Higi, which manufactures Smart Health Station kiosks frequently found in pharmacies and grocery stores.

Babylon became a strategic investor in Higi in mid-2020 before it began integrating its symptom-checking and care navigation solutions into the company’s kiosks, a pilot test that appears to have been successful. 

  • Babylon helps patients through two primary services: Babylon 360 (AI-enabled value-based care) and Babylon Cloud Services (cloud-based data analytics suite). The company’s AI platform is designed to improve provider decisions surrounding triage and symptom assessment, while also helping patients navigate their care journeys.
  • Higi’s network of over 10k FDA-cleared kiosks can be found within five miles of 73% of the US population, providing screenings for blood pressure, weight, and body mass index. The company pairs these stations with at-home devices and a nationwide clinical network to assist healthcare organizations with remote monitoring.
  • The acquisition follows Babylon’s $200M funding round in October, which was led by sustainability-focused firm AlbaCore to help the company provide care to under-served populations. The new capital was earmarked for expanding Babylon’s US member base and value-based care applications, and the Higi acquisition checks both boxes.

The Takeaway

Meeting consumers where they are has been one of the biggest digital health trends following the onset of the pandemic, and acquiring Higi’s large kiosk network is an on-theme way to kick off Babylon’s US expansion. Babylon can now extend its care platform to millions of existing Higi customers, while gaining a foothold in retail healthcare to serve as a new entry point to its care ecosystem.

Oxygen Saturation Monitoring for COVID-19 Patients

A new study published in Sage Digital Health found that at-home oxygen saturation monitoring helps identify early signs of clinical deterioration in COVID-19 patients, enabling them to seek appropriate care before the disease escalates.

  • Methods – Stanford researchers recruited 49 patients with a recently positive COVID-19 test in the outpatient setting, preferentially selecting for those with underlying comorbidities. Participants were mailed pulse oximeters and enrolled in a symptom-monitoring app (AIRx), which provided a daily questionnaire for clinicians to review.
  • Results – Of the six patients who required hospitalization, five sought care as a result of low pulse oximeter readings. Nearly all patients found the pulse oximeter useful, with 96% of those who did not require hospitalization reporting that the device gave them the confidence to stay at home. 
  • Impact – Keeping COVID-positive patients at home has the potential to reduce the spread of disease while preventing unnecessary strain on the healthcare system. The researchers recommend targeting this intervention at patients with a high risk for deterioration given the difficulty of obtaining and mailing pulse oximeters.

The Takeaway
While there have been several studies on the effectiveness of remote patient monitoring for COVID-19, few have assessed the patient experience. Although this study is limited by its small sample size and selection bias, the high levels of engagement and patient satisfaction suggest that pulse oximeters could be a simple intervention for COVID-19 monitoring if implemented on a larger scale.

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-- The Digital Health Wire team