Buoy Health CEO Andrew Le, MD

Digital Health

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.

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The Wire

• Google Hires Former FDA CDO: Google appointed the FDA’s former chief digital officer Bakul Patel to lead its global digital health and regulatory strategy. The hire looks like a clear sign that Google is getting more serious about its healthcare plans after reorganizing its Google Health division late last year. In a LinkedIn post announcing the move, Patel said that his “biggest northstar has been to make digital healthcare accessible and equitable for all,” a mission that’s well aligned with Google’s recently announced AI tools to improve early detection of complications with pregnancies and diabetes.

• AI Funding Cools Down: Healthcare AI startups haven’t been immune to the recent plunge in health tech funding, with CB Insights reporting that the sector raised 32% less capital (still $2.5B) during the first quarter. The AI news follows weeks after Rock Health reported an 18% funding dropoff across all digital health companies in Q1 2022, breaking a streak of consecutive increases dating back to 2019. Despite last quarter’s slowdown, healthcare companies still led the AI sector in total funding and mega-rounds over $100M (7), but CB Insights predicts that we might see things continue to cool off before there’s a rebound.

• Advocate Aurora + Atrium: Regional health systems Advocate Aurora Health and Atrium Health are merging to create one of the largest nonprofit health systems in the US, spanning 67 hospitals with $27B in combined revenue. The new system, called Advocate Health, gave a list of six key focus areas that the merger will support, which doubles as a cheat-sheet for anyone wondering about current health system priorities: clinical pre-eminence and safety, health equity, affordability, next-generation workforce, learning and discovery, and environmental sustainability.

• Heart Failure RPM: A UPenn study found no difference in 12-month readmissions and mortality rates between heart failure patients with usual post-discharge care (n = 280) or those in a remote monitoring program that included a digital scale, a smart bottle for diuretics, and financial incentives for providing daily measurements (n = 272). The results add to the growing body of research indicating that financial incentives do little to change behavior when not paired with other patient engagement protocols like coaching or automated reminders.

• Handspring Debut: Omnichannel behavioral health provider Handspring launched with $6.2M in seed funding to help make quality mental healthcare more accessible to children and their families. Handspring makes its clinical team available through both a virtual telehealth platform and in-person clinics, allowing it to better serve the children that it says are being left behind by new virtual-only solutions.

• Primary Care Framework: NEJM recently published a solid framework to untangle the various types of innovation underway in the primary care space. Although new models of primary care delivery and care enablement seem to be popping up every day, the authors do a good job categorizing the developments by target populations, financial models, and care models, then lay out plenty of example companies in a well laid out grid to illustrate exactly how their services are differentiated.

• PatientIQ Series B: Health tech startup PatientIQ closed a $20M Series B round (total funding now $26.2M) to accelerate the expansion of its patient data platform in the provider and real-world evidence markets. PatientIQ’s platform automates the collection of patient reported outcomes through procedure-specific education modules that help patients prepare for treatments and monitor their recovery.

• ED Navigator Success: After Mass General Brigham implemented its ED Navigator Program at three of its hospitals, patients with at least one interaction with an on-staff navigator had a 52% greater likelihood of a completed follow-up primary care appointment, as well as a 32% reduced likelihood of revisiting an ED within 30 days. Although the results are promising, a review of the program in The American Journal of Managed Care found that the navigator interactions did not influence patients with higher ED utilization, and that similar programs are better targeted at patients with lower levels of baseline ED utilization.

• Clarius & Turtle’s Home Fertility Alliance: Clarius Mobile Health and Turtle Health unveiled their at-home virtual transvaginal ultrasonography solution, combining Clarius’ handheld ultrasound and transvaginal scanner with Turtle’s virtual gynecology clinic. Although the solution is under FDA review, their initial study showed that it provided follicle count information that’s comparable to in-clinic exams with greater patient satisfaction ratings. The alliance also continues an influx in home ultrasound news, coming just a few days after GE Healthcare’s investment in home ultrasound startup Pulsenmore.

• Mayo’s Pre-Appointment Chatbots: A Mayo Clinic study showed that a text chatbot solution that they deployed to screen for signs of COVID before patients’ outpatient imaging exams achieved decent participation (58.1% of 4,687 patients), high patient experience scores (avg 4.6 out of 5), and flagged roughly 4% of scheduled patients with COVID symptoms or pending tests. Unsurprisingly, English speaking patients were far more likely to respond to the texts (odds ratio: 2.71).