UnitedHealth Group CEO Andrew Witty

Digital Health

UnitedHealth’s Business is Booming Heading Into 2022

Last week, UnitedHealth Group (UHG) reported its full-year financial results for 2021, defending its title as the most profitable US healthcare company while serving as the earnings season bellwether for the broader industry.

Between its UnitedHealthcare payor operations and its Optum hybrid care service lines, UnitedHealth Group pulled in $287.6B in revenue for the year (up 11.8%), beating their initial projections by about $10B.

UnitedHealthcare is the nation’s largest commercial payor, and the company spent a lot of time in its conference call highlighting its success in Medicare Advantage (MA).

• UHG leads the MA space with 7.9M members, adding 800M in 2021 alone. Over the past year, total MA plan enrollment grew 8.8% to 28.5M beneficiaries, meaning that UHG accounted for nearly 1 in 3 new members – a huge revenue boost from the government at $1,000/patient/month.

Optum’s fast-growing health services business was no less impressive, serving 100M people at year end 2021 while growing revenue per consumer by 33% as it expanded the reach of its value-based care arrangements.

• UHG spent $100M in 2021 helping partners prepare for value-based contracts. This investment was divided between three primary work streams (clinician training, tech enhancements, network coordination), with similar investments expected this year.

The Forecast for 2022

Looking ahead to the rest of 2022, it’s difficult to forecast a scenario where UHG doesn’t continue its momentum. In the past few months the company’s expansion has only accelerated, with UnitedHealthcare debuting a virtual-first health plan NavigateNOW and Optum moving into the direct-to-consumer pharmacy arena.

UNG expects its 2022 revenue to grow roughly 10%, falling between $317B and $320B, and there’s even a kicker. That projection doesn’t include any gains from the pending acquisition of Change Healthcare for $8B, which has its April approval deadline quickly approaching.

Remote Care

Reimagine Care Secures $25M for Home Cancer Care

Home-centered care startup Reimagine Care recently raised $25M in Series A funding, its first round of outside capital that it hopes will help it live up to its namesake for US cancer patients.

Reimagine Care provides technology-enabled services that support oncologists in delivering value-based care remotely, while helping health systems, payors, and employers accelerate the shift to coordinated home-centered cancer care.

• Taking inspiration from European models for home-based cancer treatment, the Reimagine Care platform gives patients access to a 24/7 virtual care center that allows them to view their treatment plan and communicate with their care team.

• For providers, Reimagine Care offers remote patient monitoring and end-of-life care management solutions that have been shown to reduce ER visits and inpatient admissions.

• For payors and employers, home-centered care is “a lever for value,” improving member satisfaction while reducing adverse events such as hospital-acquired infections that drive expenses.

• The funding follows a survey that found that 66% of healthcare executives believe home-centered cancer care offers significant potential to grow their organization, and that 60% are concerned that their organizations may fall behind if they don’t make the shift to home-centered cancer care in the near future.

The Takeaway

With the pandemic as a catalyst, cancer patients and their families have begun seeking not only the best treatments, but also the best experiences. Reimagine Care believes that health systems that are first-movers in home-centered care will have a strong advantage over those who fail to make the leap, which rings true, but time will be the judge. The company has yet to begin taking patients, and its success will hinge on the ROI that they deliver when they’re fully operational later this year.

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

• Smartphone Signaling: A recent study published in JMIR of 51 patients with bipolar disorder found a significant correlation between passively collected smartphone data and self-reported moods, which could allow for earlier detection of worsening mental states and expedite treatments. Depressed patients tended to make phone calls less frequently than euthymic/stable patients (β=−.06) and missed incoming calls more frequently as depressive symptoms intensified (β=4.4), while the fraction of outgoing calls was higher for patients in manic states (β=2.7).

• Email Experiments: STAT recently reported on UCSF’s experiment with allowing physicians to charge for responding to patient emails, in part to address burnout, but also to encourage physicians to dedicate more time to their emails. It’s understandable that physicians are growing frustrated with the amount of time they spend responding to messages, just last week we covered this study that found that every message adds 2.32-min of EHR time per day, but some are worried that the new system could keep patients from seeking care.

• EHR’s Big Data Potential: A new study in PLOS Digital Health shared another example of how EHR data and AI could reshape our approach to population health. University of Utah and Intermountain Primary Children’s Hospital researchers mined, de-identified, and analyzed EHR data from 1.6M patients to analyze how comorbidities and demographics affect cardiovascular health. Among a long list of findings, they showed that patients with certain conditions (cardiomyopathy = 86x-higher, viral myocarditis = 59x), certain prescriptions (milrinone = 175x), and combinations (milrinone for cardiomyopathy = 407x) have far higher risks of requiring heart transplants.

• Cigna + RecoveryOne: Cigna became the latest payor to offer virtual physical therapy as an in-network benefit for Medicare Advantage customers by expanding its partnership with RecoveryOne. Outside of improving access to physical therapy, RecoveryOne reports that it’s platform reduces medical expenses by $751/member/month for MSK-related diagnoses, making it a particularly effective solution for MA members given that 3 out of 4 adults aged 65+ suffer from MSK conditions.

• Data Sharing Hesitancy: Consumers are hesitant to share data for health-related purposes depending on the source of the information, according to a recent study published in JAMA. The survey study of 3,543 US adults found that participants were most reluctant to share information about their finances (-0.56 coefficient relative to sharing EHR data), location (-0.28), and social media messages (-0.20), suggesting that new protections may be needed to give consumers confidence in sharing their personal information.

• The Heart Seat: Biometric sensor startup Casana closed a $30M Series B round to fund the FDA approval process of the med-tech device you didn’t know you needed: a toilet seat that tracks your heart health. Casana’s “Heart Seat” captures a person’s blood oxygen level, blood pressure, and heart rate with clinical grade accuracy, while the form factor addresses the adherence issues faced by other devices since it collects data without the need for any patient behavior changes.

• Omicron in SNF Patients: New data from care coordination company CarePort, powered by WellSky, reinforced that omicron is more easily transmittable and less lethal than other variants, especially among the skilled nursing home population. Although COVID hospitalization rates among SNF patients have reached close to the same level as the first wave (~34%), mortality rates have fallen from 16% in April 2020 to 8% in January 2022.

• KPMG Healthcare Survey: KPMG’s 2022 Healthcare and Life Sciences Investment Outlook Survey of 300 industry executives is beginning to make it look like we might be in for another record-setting year of healthcare investment. Over 70% respondents expect to increase their M&A activity in 2022, while 30% plan on increasing investment activity by 10% or more. The most attractive investment areas for the next 12 to 24 months were telehealth, EHRs, and clinical workflow solutions – all of which can be easily tied to addressing staffing issues and workflow inefficiencies.

• Yale & Rx.Health’s Enterprise Rollout: Yale New Haven Health will implement Rx.Health’s EHR-integrated digital health unification platform across the health system, after expanding their partnership across several service lines in recent years. The Rx.Health platform allows health systems to prescribe digital navigation pathways (DNPs), digital therapeutics, and health education content to patients using their preferred communication methods (email, SMS, interactive voice).

• Medical Device Vulnerabilities: According to a report from security firm Cynerio, 53% of internet-connected hospital devices are vulnerable to cyberattacks. IV pumps, ultrasounds, and cardiac monitoring systems were among the most vulnerable devices, as well as any equipment running Linux-based software (unfortunately that’s most medical equipment) since traditional Windows-based cybersecurity is incompatible. Cynerio notes that most vulnerabilities were due to simple problems such as weak default passwords, which are easily fixable if acted upon.