Vytalize Health CEO Faris Ghawi

Value-Based Care

Vytalize Raises $53M for Medicare Expansion

When your target market is growing quickly, it takes funding to keep up, which is why Vytalize Health recently closed a $53M Series B round to help bring value-based care to Medicare enrollees and their primary care physicians.

The latest funding brings Vytalize’s total raise to just over $75M as it looks to enter new partnerships within a Medicare market that’s projected to double in size over the next decade.

Vytalize got its start as a Medicare-focused primary care practice in 2014, but has since developed a vertically integrated platform that combines a risk-bearing entity with an in-home clinic model to help other practices transition to value-based care.

• As an ACO, Vytalize connects physicians and specialists to wrap care around the Medicare population, aiming to improve preventive health services while reducing avoidable hospitalizations.

• The company doubled its patient base to 130k seniors over the past year, and is now partnered with 280 primary care practices across 16 states that account for a combined $2B in annual care delivery.

To help manage high-risk populations, Vytalize equips its clients with a virtual in-home clinic that helps practices deliver better care in the white space between appointments, a task made easier due to the acquisition of patient communication company MedPilot in 2021.

• The influx of capital will help Vytalize integrate a wider network downstream from its primary care partners (hospitals, specialty networks, ancillary providers), while also establishing relationships with more Medicare Advantage and commercial plans.

The Takeaway

The Medicare population is one of the hottest corners of the healthcare market, and many startups have sprung up to help providers transition away from volume-based reimbursement. 

These companies are making big moves to gain an edge – just look at Devoted Health’s hefty $1.15B Series D round or One Medical’s acquisition of Iora Health for some recent examples – but Vytalize’s latest funding could help it carve out a niche as a novel type of ACO focused on helping strengthening patient-provider relationships through value-based primary care.

Nuance’s Patient Engagement Must-Haves

Consumer demands are shifting, and they’re looking to get more out of their digital health technology. Nuance outlines the 5 must-haves for your patient engagement strategy here.

The Wire

• Optum Clinic Acquisition: Hardly a week has gone by in 2022 without UnitedHealth Group’s Optum division drawing some sort of headline, and now it finds itself in DHW once again as it looks to add Houston-based Kelsey-Seybold Clinic to its recent acquisition spree. Kelsey-Seybold is a multispecialty group that operates over 30 clinic locations and one of the largest ambulatory surgery centers in Texas. The acquisition will see 500 Kelsey-Seybold physicians join the ranks of Optum’s 60k-strong affiliated physician network, a number that’s been on a rapid rise as UnitedHealth Group leverages its scale to scoop up large physician groups with a history of managing risk.

• Voice Biomarker Breakthrough: Mayo Clinic Proceedings published a study demonstrating that a voice biomarker was associated with incident coronary artery disease events, notable results in the relatively new field of using voice to predict disease. Patients referred for coronary angiography (n=108) created three 30-second voice recordings using the Vocalis Health app to establish a biomarker baseline. At follow-up (median time of 24 months), a high baseline voice biomarker was significantly associated with chest pain-related ED visits and hospitalizations over the study period (hazard ratio: 2.61). Although preliminary, the findings could have exciting implications for CAD patients if replicable outside of the study setting.

• Olive Overpromises: It’s a bad day to be a publicist for health automation startup Olive, with Axios publishing a new investigation alleging that the company “inflates its capabilities” and only uses “rough estimations” while calculating the cost reductions provided by its software. The Axios martini got extra-dirty with the accusation that Olive’s automation processes do not employ any artificial intelligence despite the solutions being touted as “AI as a Service,” and instead rely on notoriously fragile practices such as using bots to scrape information from PDFs. Although this could be nothing more than a classic case of overpromising and underdelivering, the article itself seems like a good indication that digital health is maturing to the point where product promises without real results will start to draw some serious scrutiny.

• Hospital at Home Study: Hospital at home care (HaH) is both feasible and effective for socioeconomically disadvantaged patients, according to a new study published in the Journal of the American Geriatrics Society. After analyzing data from 289 HaH patients and 188 controls, patients with dual eligibility or living in high-poverty zip codes had similar hospital readmissions as patients with higher socioeconomic status. The findings indicate that HaH may actually result in better outcomes for lower socioeconomic status patients by allowing providers to observe the home setting and address social determinants of health, a takeaway that helps fill the dearth of research on issues related to healthcare equity in the provision of HaH.

• Northwell + Aegis = Ascertain: NY’s largest provider Northwell Health is teaming up with startup studio Aegis Ventures to launch Ascertain, an accelerator designed to commercialize healthcare AI companies that improve outcome quality and close health equity gaps. Ascertain brings $100M in funding to help young companies build novel solutions on top of its platform that combines healthcare leadership, expert technical teams, and Northwell’s diverse clinical datasets within a single ecosystem to validate effective solutions and quickly bring them to market.

• CareAlign Implementation: Penn Medicine recently published a study outlining the development and implementation of its Carelign digital workflow platform, an EHR-integrated rounding and handoff tool that was voluntarily adopted by 94% of available departments. The write up provides a great case study on the design of a workflow tool that physicians “actually want to use,” which resulted in CareAlign getting spun out as a standalone company. CareAlign positions itself as a combination of an EHR, communications platform, and population health software, unifying each component to create a single actionable view of a patient’s needs.

• LUVO Launch: Wound Care Advantage kicked off Limb Loss Awareness Month with the launch of the first digital network platform designed specifically for wound centers, LUVO. The platform modernizes referral management and operational reporting to enable program leaders to keep better track of key performance metrics while allowing them to focus more time on treating patients. LUVO also supports effective healing programs by including a direct line to WCA experts for chart reviews, audit assistance, and general guidance.

• All In on Admin AI: Although clinical AI gets most of the attention, a recent MIT Sloan Management Review editorial stated a compelling case for why “administrative AI may be a better bet.” The authors detailed clinical AI’s long list of adoption and ROI barriers (regulatory approval, physician acceptance, workflow integration, reimbursements, inefficiency), arguing that admin AI solutions avoid many of these barriers and target problems that are far more solvable and more likely to deliver economic ROI. After all, administrative tasks are responsible for 34% of US healthcare costs and probably an even higher share of healthcare waste.

• Komodo & Datavant Partnership: Komodo Health and Datavant are expanding their partnership to allow companies to connect proprietary and third-party clinical trial data to Komodo’s Healthcare Map of over 300M de-identified patient journeys. Deeper insights into the longitudinal outcomes of trial participants will help drive better analysis of gaps in care, therapy impact, and disease prevalence at a time when real-world evidence is becoming increasingly crucial for decision making in both the life science and digital health industries.

• Nursing Shortage Intensifies: The worst of the nursing shortage could still be on its way according to a recent survey of 300 US nursing leaders conducted by Wolters Kluwer. Over the next 18 months, 92% of respondents indicate that the nurse labor shortage will continue to intensify, driven by Baby Boomer retirements and younger nurses transferring to new positions away from the bedside. Although the survey gave plenty of reasons to be nervous about the situation, it pointed to the success of float pools during the pandemic as a way to use new care models to fight the ongoing labor shortage, as 92% of respondents plan to increase the use of float pools over the next 18 months.

• Forge Funding: Forge Health recently secured an $11M growth investment to help expand the reach of its hybrid model for mental health and substance use treatment. The funding will be used to build out its platform that integrates virtual care with in-person clinics to provide whole person care to patients with severe behavioral disorders, while also expanding its value-based partnerships with payors, health systems, ACOs, and employers.