Wire #95

  • One Medical Takeover: Bloomberg recently reported that concierge primary care company One Medical is considering its options after attracting takeover interest from CVS Health. Although the talks with CVS are apparently no longer active, sources close to the situation indicate that One Medical is now weighing offers from other suitors and holding discussions with several large payors looking to expand their primary care capacities and better manage their growing Medicare Advantage businesses.
  • SDOH Research: Addressing SDOH factors could reduce inpatient admission rates by 11% and ED visits by 4%, but the cost of those interventions might be greater than the savings they generate. That’s according to a new study in the Annals of Internal Medicine that randomly assigned 58k adult Medicaid patients to either 12 months of social needs case management or a control group, finding that while the intervention programs saved $3.4M in hospitalization costs, the total covered just 17% of the program’s yearly expenses.
  • New Rural Provider Type: In the wake of record closures of rural hospitals, CMS released the conditions of participation for the new Rural Emergency Hospital (REH) provider type that would enable them to take part in Medicare and Medicaid programs. The proposed rule requires REHs to provide emergency, laboratory, and radiologic services to meet the needs of patients in a manner consistent with Critical Access Hospitals, but adds more flexibility to staffing and outpatient services requirements to preserve access to care in rural communities.
  • Teladoc Primary360 Expansion: Teladoc introduced new features to its recently launched Primary360 virtual primary care platform to give members improved access to care and a more convenient user experience. The expanded services include in-network referrals and care coordination capabilities, same-day medication delivery from digital pharmacy Capsule, and on-demand home phlebotomy services from Scarlet Health.
  • Hospital Margins Update: Kauffman Hall’s latest National Hospital Flash Report shows that rising supply and labor costs contributed to the fifth consecutive month of negative hospital margins, which averaged -0.33% in May. Although gross operating revenues rose by 3% with a 4.8% month-over-month rise in patient days, the increase was not enough to offset the rising costs that are expected to keep margins below pre-pandemic levels for the rest of the year.
  • Tomorrow Health Funding: Home-based medical equipment marketplace Tomorrow Health raised a $60M Series B round to fuel new partnerships with health plans and expand into additional markets. Tomorrow Health enters into value-based contracts with payors to coordinate home care by intelligently matching patients with suppliers spanning 40k products and services to cut down on operating costs.
  • Patient Communications Landscape: KLAS’ Patient Communications Landscape 2022 report found that a growing number of provider organizations are looking past patient communication tech that solely provides automated communications like appointment reminders. According to provider interviews included in the report, versatile solutions such as WELL Health and Klara that prioritize a strong user experience for both patients and office staff consistently receive the highest performance scores, while KLAS determined that less versatile platforms are now at a high risk of being replaced.
  • April Telehealth Use: Fair Health’s Monthly Telehealth Regional Tracker showed that telehealth use rose across all US regions in April, accounting for 4.9% of all medical claims (up from 4.6% in March) as a rise in COVID-19 cases caused more patients to avoid in-person care. For the first time since January, COVID-19 was back in the top three telehealth diagnoses with a 2% share, along with acute respiratory diseases (3%), and mental health conditions (64%).
  • Sensible Care Raises $13M: Teletherapy provider Sensible Care secured $13M in Series A funding to expand to states with large populations covered under TRICARE military health plans, such as Texas and Florida. Along with virtual therapy for children and couples, Sensible Care offers transcranial magnetic stimulation, used for patients with depression who are non-responsive to traditional medications and therapies.
  • Job Flexibility: Paid sick leave and job flexibility are linked to better access to healthcare according to a recent study in Health Affairs. Researchers analyzed data from a nationally representative sample of US workers responding to the Medical Expenditure Panel Survey, finding that a one-unit increase in job flexibility was associated with a 2.15 percentage-point increase in the likelihood of having an office-based visit in the past year, while patients with paid sick leave had a 3.8 percentage-point increased likelihood of having a clinic visit.

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