Carium CEO Rich Steinle

Value-Based Care

UpStream Lands $140M for VBC Services

Many VCs appear to be done waiting on the sidelines, with VBC tech startup UpStream Healthcare adding to the recent string of digital health mega-rounds with an eye-popping $140M Series B raise.

UpStream provides primary care physicians operating under full-risk, value-based arrangements with a suite of solutions designed to help manage complex populations such as seniors on Medicare. 

• To accomplish this, UpStream deploys pharmacist-led care teams into partner practices with the aim of improving patient outcomes (and generating shared savings) through careful prescription management.

• Upstream also equips PCPs with a tech platform built on top of Innovaccer’s unified patient record to enable custom chronic care workflows that predict health risks and provide clinically contextual patient engagement sequences.

• Providers get the benefit of offloading most of the administrative burden that comes with transitioning to VBC, as well as proactive compensation for delivering quality care through Upstream’s GAP-Q program.

The Series B raise will be used to help UpStream expand to 20 states over the next three years, with the goal of becoming profitable in each market within 24 months.

• UpStream currently has over 2,900 physicians contracted for 2023 across Community Care Physician Network in North Carolina, Tidewater Medical Group in Virginia, Primary Care Associates in South Carolina, and MUSC Health Alliance.

• Like most companies operating in this space, UpStream views provider burnout as one of its key adoption drivers, and it’ll be focused on bringing its solution to independent physicians, large health systems, and everyone in between.

The Takeaway
As more PCPs continue moving towards value-based care models, companies like Agilon, Privia, Tebra, and UpStream have each begun competing with their own unique flavor of resources to help enable the transition. UpStream’s pharmacist-centric approach seems like a solid way to help PCPs manage risk without adding more work to their plates, but the VBC-enablement landscape has plenty of competition and each strategy’s individual results will ultimately be what decides the victors.

Innovation Starts With Listening to Nurses

Nurses are the most valuable players in the healthcare system. Their wisdom and dedication serves as a constant reminder for what’s possible in healthcare when we listen. Check out the connectRN virtual experience to hear 10 powerful stories from nurses who want to disrupt the industry.

3 Ways to Ease the Pain of Provider Credentialing

Is provider credentialing adding cost and time to your bottom line? Check out Medallion’s new blog for three ways to ease the pain of provider credentialing so that you can focus on delivering quality care.

The Wire

• athenahealth IPO Plans: Less than a year after being taken private by PE firm Bain Capital, EHR vendor athenahealth is reportedly looking to make its return to the public markets. In an interview with the Boston Globe, athenahealth CEO Bob Segert said that the company is “ready to go public again” after creating “a ton of value” by abandoning its hospital business to refocus on smaller medical practices, although he didn’t divulge any info on revenue growth or a potential IPO date.

• Hospital Expense Comparison: KFF put out a great resource for anyone curious about hospital adjusted expenses per inpatient day, broken down by ownership type. The widget’s an easy way to see how different geographies stack up against each other, and the expense trend graphs make it obvious why care delivery orgs have been feeling the pressure since the start of the pandemic.

• November Jobs Report: The November Jobs Report revealed that the healthcare sector added 45k jobs last month, with ambulatory services, hospitals, and nursing and residential care facilities leading the job gains (23k, 11k, 10k). Although this month’s hiring slowed 17% from October, the Bureau of Labor Services reiterated that healthcare employment appears to be in a much better spot this year than last, adding an average of 47k new jobs each month (vs. 9k per month last year).

• Temedica Series B: Germany-based Temedica secured a Series B extension of €25M to build out its real-world data engine. Temedica collects data on a large scale (40B data points across 50k diagnoses) through its digital companion apps that are designed to help patients manage their conditions, in turn helping its Permea platform generate personalized medicine insights.

• CGM Use Cases: Continuous glucose monitor startups still have to prove their worth, or at least that’s the tagline of a recent Verge article that dove into whether or not CGMs make a real impact for consumers without diabetes. Following a recent crop of startups springing up to help everyday consumers manage their blood sugar, the author (without diabetes) and her friend (with Type 1 diabetes) documented their experiences wearing a CGM to see how they differ. It’s a well laid-out story that gives the impression that CGMs definitely aren’t a need-to-have device for non-medical use cases.

• Waiting Room Concierges: Clinic waiting room concierges might be a decent way for providers to improve their patient satisfaction scores, according to new research in the Annals of Family Medicine. After having an employee act “analogous to the greeter at Walmart” and helping patients with check-ins / delays, 90% of Stony Brook Primary Care patients reported top satisfaction scores, versus 60% prior to implementing the greeter.

• NovaWell Behavioral Health: Horizon Healthcare Services’ behavioral health affiliate  NovaWell launched a new suite of solutions geared toward helping health plans and health systems provide holistic treatment for patients with mental health and substance use disorders. NovaWell is building off of Horizon’s own success with its behavioral health programs by extending the availability of its NovaClinical, NovaConnect, NovaCommunityCare, and NovaNetwork solutions.

• Nudging Physicians, Patients, or Both?: Under half of US individuals who meet statin guideline criteria are actively prescribed the medication, so a UPenn-led team set out to find the best way to improve statin initiation: by nudging the physician, patient, or both? In the 4k-patient study, nudging both clinicians and patients increased statin initiation by 7.2%, performing significantly better than nudging clinicians alone (5.5%) or patients alone (no effect).

• PatientPoint Foundation: PatientPoint announced the launch of the PatientPoint Foundation, a 501(c)(3) charity aiming to bring relative health education to people in the communities most impacted by health disparities. The Foundation is partnering with local community members to bring their voices to PatientPoint’s point-of-care educational content in non-traditional care settings in order to help promote health literacy and healthy behaviors.

• Telehealth Flexibilities: An AHIP survey found that 82% of adults with employer-provided health coverage are in favor of Congress extending pandemic telehealth flexibilities. Of the 818 respondents, a bipartisan majority of Democratic voters (95%) and Republican voters (70%) wanted to extend telehealth flexibilities, citing reasons such as convenience (49%) and less traveling (35%).

• UNC + AWS: UNC-Chapel Hill is partnering with Amazon Web Services to use cloud technology to translate UNC-Chapel Hill digital health research into commercialized solutions. The collaboration will support 25 projects over 3 years, with the goal of creating, funding, and launching software startups focusing on health and wellness, patient / provider experience, and improving healthcare access.

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.

Prescription Assistance Made Easy

Synapse Medicine’s quick-deploy Prescription Assistance API and components can be up and running in less than a day and instantly connect your HCPs to the drug data and prescribing support they need in their everyday practice. Join Synapse CEO Clement Goehrs and Lead Strategist Martin Cech in their upcoming webinar on Tuesday, December 6 to discover how easy it can be to onboard reliable real-time drug data for your providers.

Hyperfine Brings MRI to the ICU

“It completely changes the way we think about MRI imaging.” Take a look at this video interview with Mass General’s Chief of Neurocritical Care to see how clinicians can use Hyperfine’s Swoop Portable MRI to eliminate care disruptions in the ICU by keeping critically ill patients in the unit throughout the neuroimaging process.