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CVS + Signify | Inflation Reduction Act
August 10, 2022
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“We just don’t believe in breaking the old and starting afresh. Healthcare’s too important, it’s too large, it’s too complex to not co-opt incumbents.”

General Catalyst Managing Director Chris Bischoff

Value-Based Care

CVS In Talks to Acquire Signify Health

“People familiar with the matter” are hitting a hot streak with market moving healthcare news, especially after one of them informed the Wall Street Journal that CVS Health is in talks to acquire tech-driven value-based care enabler Signify Health.

The setup for this headline barrage started last week when the WSJ ran a separate piece about Signify enlisting Goldman Sachs and Deutsche Bank to help identify “strategic alternatives” that included a potential acquisition.

  • Signify’s platform helps payors and providers establish in-home care programs and transition to VBC – a combination that could draw interest from both private equity and managed care organizations.
  • The initial offers are due this coming week, and although there’s no guarantee any agreement will be reached, there’s also a non-zero chance that something gets announced and makes this old news before it reaches inboxes on Thursday.

It would be tough to come up with a better company than Signify to meet CVS Health CEO Karen Lynch’s description of an ideal acquisition target: “primary care, provider enablement, and home health… with a robust management team, background in tech, and that can grow quickly.”

  • Signify’s core VBC business already checks a lot of boxes, and its recent $300M acquisition of Caravan Health added ACO management and population health icing to the cake.
  • With a $135B market value and plans to expand its in-home operations by the end of this year, it makes sense why CVS has emerged as a frontrunner to scoop up Signify, which popped 20% to a ~$6B market value on the announcement.

The Takeaway
As CVS looks to expand into primary care and in-home health, it can either build or acquire the pieces to make it happen, and it’s been pretty transparent about which strategy it prefers. That said, the last time CVS threw its hat in the ring to acquire a high-profile company was for primary care provider One Medical, and we all know how that turned out.

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The Wire

The Inflation Reduction Act: What might end up being the biggest healthcare reform of the past decade recently passed the Senate with a 51-50 vote, sending the Inflation Reduction Act to the House for a final vote this Friday. The IRA would invest $64B to extend ACA subsidies through 2025, while also allowing Medicare to directly negotiate prices for the largest drugs (starting 2026) and placing a $2k cap on out-of-pocket drug costs for Part D beneficiaries (starting in 2025). Most healthcare groups welcomed the reform with favorable reactions, with the exception of Pharma, which called the plan a “tragic loss for patients.”

A Study of Studies of Studies of Wearables: If you’re looking for a mile high view of the current state of wearable technology, the Lancet Digital Health published a systematic review of 39 other systematic reviews and meta-analyses analyzing the clinical effectiveness of sensor-based devices (164k patients total). The researchers found that activity trackers improved physical activity and body composition (equating to ~1,800 extra steps per day), but determined that other physiological (blood pressure, cholesterol) and psychosocial (quality of life, pain) outcomes were usually non-significant.

Sharp & Sanford Join Dandelion: San Diego-based Sharp HealthCare and the nation’s largest rural health system Sanford Health have joined the Dandelion Health Data Consortium to work on an equitable data platform that improves diagnostics and drug development. The platform will allow healthcare organizations to ethically access patient clinical data (images, waveforms, health records) as they build AI tools better representing rural and urban populations from different regions across the country.

Redefining Digital PX: JMIR published an article proposing a new definition of the digital patient experience based on the themes presented in 45 individual studies. Without getting too stuck in the weeds on its creation, the final definition did have a nice ring to it: “Digital patient experience is the sum of all interactions affected by a patient’s behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health.”

“Staggering” CVD Rise: A study published in JACC projects steep increases in cardiovascular disease in the coming decades, with major patient care implications for health systems and chronic condition management companies. By the year 2060, the number of people with heart failure is forecast to increase by 33% (10M to 13M), myocardial infarction by 30% (12M to 16M), and stroke by 34% (11M to 15M). 

DeliverHealth Language Access: DeliverHealth is rolling out a new Language Access feature to give providers one-touch mobile access to interpreters within the DeliverHealth Platform. Language Access is designed to improve care for the growing number of patients with limited English proficiency in the US (currently reported at ~25M patients), while helping providers simplify reimbursements by generating EHR-integrated reports on interpreter language and session times.

Health Coverage Improvements: An HHS report showed that the percentage of Americans without health coverage recently dropped to an all-time low of 8% amid record enrollment in Affordable Care Act exchanges and Medicaid. Between 2018 to 2020, HHS found that the most coverage growth was for those living in states that expanded Medicaid under the ACA, while the largest gains seen from 2020 to 2022 were among people who earned below 100% of the federal poverty level.

Health Tech North Star: Bessemer wrote a solid article breaking down benchmarks for growing health tech businesses, specifically Healthcare SaaS and Tech-Enabled Services. The VC firm makes the case that early stage companies in this space should use gross profit as their North Star – as opposed to EBITDA – when measuring the efficiency of their operations and recruiting venture investors (Gross Profit = # of Patients * Annual Revenue Per User – Cost of Delivering Services).

Atropos Series A: Stanford University spinout Atropos Health closed a $14M Series A round to commercialize its physician consult service that brings real-world evidence to the point-of-care. Atropos will also expand its oncology consult product currently under development in partnership with ASCO CancerLinQ, which aggregates EHR data from oncology practices throughout the country to help answer specific cancer treatment questions.

Resident Physician Unions: Two JAMA editorials shed light on the rise of resident physician unions amid the increasing corporatization and consolidation of healthcare. The first editorial advised residents to consider the advantages of collective bargaining but warned that unions are “not a panacea,” while the second editorial emphasized how the culture of medicine perpetuates burnout and exacerbates the labor shortage. 

Bodyport’s Cardiac Scale: Bodyport received FDA 510(k) clearance for its Cardiac Scale, which allows patients with fluid management conditions such as heart failure or kidney disease to track their body weight, pulse, center of pressure, and peripheral impedance (a potential sign of fluid retention). Bodyport is positioning the Cardiac Scale as a way for remote care teams to noninvasively monitor fluid status changes and enable earlier interventions.

Creating an Exceptional Engagement Experience

With a surge in experience‑oriented disruptors entering the healthcare industry, patient engagement is becoming a crucial competitive differentiator. Get your copy of Nuance’s guide to  delivering intelligent interactions and a better experience at every touchpoint.

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