Behavioral Health Services Fueled Telehealth Adoption During Pandemic, Study Finds

Behavioral Health Services Fueled Telehealth Adoption During Pandemic, Study Finds

What You Should Know:

– Telehealth adoption for behavioral health services
jumped sharply during the first months of the COVID-19 pandemic shutdown,
according to a new RAND Corporation study.


Telehealth adoption increased sharply during the first
months of the COVID-19 pandemic shutdown, with the approach being used more
often for behavioral health services than for
medical care, according to a new RAND Corporation study. Prior to the pandemic, patients
frequently were reluctant to use telehealth because it often meant seeing a provider
other than their own physician. According to researchers, sustaining the
ability to see one’s own doctor through telehealth may be critical to making
telehealth a permanent part of routine healthcare.

The study conducted between mid-March and
early May 2020 reveals telehealth was used by more than 40% of patients with a
chronic physical health condition and by more
than 50% of those with a behavioral health condition,
according to findings published in the Journal of General Internal Medicine. Overall,
almost half of the people who were undergoing treatment when the pandemic
shutdown began reported using some form of telemedicine.

Key Findings

RAND researchers examined
the increase in telehealth by surveying 2,052 adults who are a part of the RAND
American Life Panel, a nationally representative internet panel. The
questions about use of telehealth were part of a larger survey about life
during the pandemic that was fielded between May 1 and May 6.

Researchers found that the use of telehealth
for behavioral health conditions was lower
among women and among people over the age of 60. Use of telehealth also was
lower among Non-Hispanic Whites relative to Non-Hispanic Blacks and was lower
among those with less than a high school education relative to those with a
college degree.

When the pandemic began, nearly 40% of the Americans
surveyed were being treated for a chronic physical health condition, while 15%
were being treated for a behavioral health condition. Since the pandemic
started, 16% had considered seeking care for a new or recurrent condition.

The study found that among patients who were receiving
care when the pandemic began,  11% had
used telehealth that included video conferencing from the middle of March to
early May, a period of less than two months. In contrast, a survey conducted
with the same panel in 2019 found that fewer than 4% had ever used video
conferencing with a doctor.

Among people who used telehealth services, researchers
found that the use of video telehealth was less common for physical health care
(14% of patients) than for behavioral health care (30% of patients).

Lack of insurance was associated with lower telehealth
use for new conditions, while use of telehealth was more common in the
Northeast than other parts of the nation.

“While the increased use of telehealth was widespread, some groups of Americans reported using the services less often than others,” said Dr. Shira H. Fischer, the study’s lead author and a physician researcher at RAND, a nonprofit research organization. “If telehealth use is going to remain high, we need to ensure equity of access, particularly for behavioral health care where education, age and gender were all associated with levels of use.”

“There is a wide expectation that telehealth will continue after the pandemic ends. Lessons from the use of telehealth during this period should inform policy for the post-COVID-19 era,” Fischer said.

COVID-19 Deferrals Lead to 3 Major Conditions Payers/Providers Must Address in 2021

COVID-19 Deferrals Lead to 3 Major Conditions Payers/Providers Must Address in 2021

What You Should Know:

– COVID-19 care deferrals lead to three major boomerang
conditions that payers and providers must proactively address in 2021,
according to a newly released report by Prealize.

– COVID-19’s hidden victims—those who avoided or deferred
care during the pandemic—will increasingly return to the healthcare system, and
many will be diagnosed with new conditions at more advanced stages. Healthcare
leaders must act now to keep this boomerang from driving worse outcomes and
higher costs.


Prealize, an artificial
intelligence (AI)-enabled
predictive analytics company, today announced the
publication of a new report that explores key medical conditions payers and
providers should proactively address in 2021. Healthcare utilization for
preventive care, chronic care, and emergent care significantly decreased in
2020 due to the COVID-19
pandemic
, which will result in an influx of newly diagnosed and later stage
conditions in 2021. Prealize’s
2021 State of Health Market Report: Bracing for Impact
identifies the
top at-risk conditions based on Prealize’s claims analysis and predictive
analytics capabilities.

Report Background & Methodology

Many procedures and diagnoses fell significantly in 2020,
with several dropping nearly 50% below 2019 levels between March and June. Total
healthcare utilization fell 23% between March and August 2020, compared to the
same time period in 2019.

To explore the full scope of healthcare utilization and
procedural declines in 2020, and assess how those declines will impact
patients’ health and payers’ pocketbooks in 2021, Prealize Health conducted an
analysis of claims data from nearly 600,000 patients between March 2020 and
August 2020.

Prealize identified the three predicted conditions likely to
see the largest increase in healthcare utilization in 2021:

1. Cardiac diagnoses will increase by 18% for ischemic
heart disease and 14% for congestive heart failure

These increases will be driven by 2020 healthcare
utilization declines, for example, patients deferring family medicine and
internal medicine visits. These visits, which help flag cardiac problems and
prevent them from escalating, declined 24% between March and August of 2020.

“Cardiac illnesses are some of the most serious and
potentially fatal, so delays in diagnosis can lead to significant adverse
outcomes,” said Gordon Norman, MD, Prealize’s Chief Medical Officer.
“Without early recognition and appropriate intervention, rates of patient
hospitalization and death are likely to increase, as will associated costs of
care.”

2. Cancer diagnoses will increase by 23%

Similar to cardiac screening trends, significant declines in
2020 cancer screenings will be a key driver of this increase, with 46% fewer
colonoscopies and 32% fewer mammograms performed between March and August 2020
than during that same time period in 2019.

“Cancer doesn’t stop developing or progressing because
there’s a pandemic,” said Ronald A. Paulus, MD, President and CEO at RAPMD
Strategic Advisors, Immediate Past President and CEO of Mission Health, and one
of the medical experts interviewed for the report. “In 2021, when patients
who deferred care ultimately receive their diagnoses, their cancer sadly may be
more advanced. In addition, an increase in newly diagnosed patients may make it
harder for some patients to access care and specialists—particularly for those
patients who are insured by Medicaid or lack insurance altogether.”

3. Fractures will increase by 112%

This finding, based on combined analysis of osteoporosis
risk and fall risk, is particularly troubling for the elderly patient
population.

A key driver of increased fractures in 2021 is the number of
postponed elective orthopedic procedures in 2020, such as hip and knee
replacements. These procedural delays are likely to decrease mobility, and
therefore, increase risk of fractures from falls.

“In elderly patients, fractures are very serious events
that too often lead to decreased overall mobility and quality of life,”
said Norman. “As a result, patients may suffer from physical follow-on
events like pulmonary embolisms, and behavioral health concerns like increased
social isolation.”

Why It Matters

“These predictions are daunting, but the key is that providers and payers take action now to mitigate their effects,” said Prealize CEO Linda T. Hand. “It’s going to be critical to gain insight into populations to understand their risk at an individual level, build trust, and treat their conditions as early as possible to improve outcomes. The COVID-19 pandemic has challenged every aspect of our healthcare system, but the way to get ahead of these challenges in 2021 will be to proactively identify and address patients most at risk. We’re going to see proactive care become an important driver for success next year, as providers and payers seek to mitigate unnecessary and expensive procedures that result from 2020’s decreased medical utilization. The right predictive analytics partner will be critical to providers and payers being able to take the right course of action.”


12 Telehealth & Virtual Care Predictions and Trends for 2021 Roundup

Dr. Paul Hain, Chief Medical Officer of GoHealth

Telehealth is Here to Stay in 2021

Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows patients, especially high-risk populations like seniors, to connect with their doctors in a safe and efficient way. Telehealth is valuable for many types of visits, mostly clearly ones that involve mental health or physical health issues that do not require a physical exam or procedure. It’s an efficient modality for both the member and provider.

With the growing popularity of telehealth services, we may see permanent changes in regulatory standards. Flexible regulatory standards, such as being able to use platforms like FaceTime or Skype, would lower the barrier to entry for providers to offer telehealth and also encourage adoption, especially among seniors. Second, it’s likely we’ll see an emergence of providers with aligned incentives around value, such as in many Medicare Advantage plans, trying very hard to encourage utilization with their members so that they get the right care at the right time. In theory, the shift towards value-based care will allow better care and lower costs than the traditional fee for service model. If we are able to evolve regulatory and payment environments, providers have an opportunity to grow these types of services into 2021 to improve patient wellness and health outcomes.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Dr. Salvatore Viscomi, Chief Medical Officer, GoodCell

2021 will be the year of patient controlled-health

The COVID-19 pandemic brought the realities of a global-scale health event – and our general lack of preparedness to address it – to the forefront. People are now laser-focused on how they can protect themselves and their families against the next inevitable threat. On top of this, social distancing and isolation accelerated the development and use of digital health tools, from wellness trackers to telehealth and virtual care, most of which can be accessed from the comfort of our homes. The convergence of these two forces is poised to make 2021 the year for patient-controlled health, whereby health decisions are not dictated by – but rather made in consultation with – a healthcare provider, leveraging insights and data pulled from a variety of health technology tools at people’s fingertips.


Bullshit Metrics: Is Patient Engagement Real?

Anish Sebastian, CEO of Babyscripts

Beyond telemedicine

Telemedicine was the finger in the dyke at the beginning of pandemic panic, with healthcare providers grabbing whatever came to hand — encouraged by relaxed HIPAA regulations — to keep the dam from breaking. But as the dust settles, telemedicine is emerging as the commodity that it is, and value-add services are going to be the differentiating factors in an increasingly competitive marketplace. Offerings like remote patient monitoring and asynchronous communication, initially considered as “nice-to-haves,” are becoming standard offerings as healthcare providers see their value for continuous care beyond Covid.


Rise of the "Internet of Healthy Things"

Daniel Kivatinos, COO and Co-Founder of DrChrono

Telehealth visits are going to supersede in-person visits as time goes on.

Because of COVID-19, the world changed and Medicare and Medicaid, as well as other insurers, started paying out for telehealth visits. Telemedicine will continue to grow at a very quick rate, and verticals like mental health (psychology and psychiatry) and primary care fit perfectly into the telemedicine model, for tasks like administering prescription refills (ePrescribing) and ordering labs. Hyperlocal medical care will also move towards more of a telemedicine care team experience. Patients that are homebound families with young children or people that just recently had surgery can now get instant care when they need it. Location is less relevant because patients can see a provider from anywhere.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Dennis McLaughlin VP of Omni Operations + Product at ibi

Virtual Healthcare is Here to Stay (House Calls are Back)

This new normal however is going to put significant pressure on the data support and servicing requirements to do it effectively. As more services are offered to patients outside of established clinical locations, it also means there will be more opportunity to collect data and a higher degree of dependence on interoperability. Providers are going to have to up their game from just providing and recording facts to passing on critical insight back into these interactions to maximize the benefits to the patient.


Sarahjane Sacchetti, CEO at Cleo

Virtual care (of all types) will become a lasting form of care: The vastly accelerated and broadened use of virtual care spurred by the pandemic will become permanent. Although it started with one-off check-ins or virtual mental health coaching, 2021 will see the continued rise in the use and efficacy of virtual care services once thought to be in-person only such as maternity, postpartum, pediatric, and even tutoring. Employers are taking notice of this shift with 32% indicating that expanded virtual health services are a top priority, and this number will quickly rise as employers look to offer flexible and convenient benefits in support of employees and to drive productivity.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Omri Shor, CEO of Medisafe

Digital expansion: The pandemic has accelerated patient technology adoption, and innovation remains front-and-center for healthcare in 2021. Expect to see areas of telemedicine and digital health monitoring expand in new and novel ways, with increased uses in remote monitoring and behavioral health. CMS has approved telehealth for a number of new specialties and digital health tools continue to gain adoption among healthcare companies, drug makers, providers, and patients. 

Digital health companions will continue to become an important tool to monitor patients, provide support, and track behaviors – while remaining socially distant due to the pandemic.  Look for crossover between medical care, drug monitoring, and health and wellness – Apple 

Watch has already previewed this potential with heart rate and blood oxygen monitoring. Data output from devices will enable support to become more personalized and triggered by user behavior. 


Kelli Bravo, Vice President, Healthcare and Life Sciences, Pegasystems

The COVID-19 pandemic has not only changed and disrupted our lives, it has wreaked havoc on the entire healthcare industry at a scale we’ve never seen before. And it continues to alter almost every part of life across the globe. The way we access and receive healthcare has also changed as a result of social distancing requirements, patient concerns, provider availability, mobile capabilities, and newly implemented procedures at hospitals and healthcare facilities.

For example, hospitals and providers are postponing elective procedures again to help health systems prepare and reserve ICU beds amid the latest COVID-19 resurgence. While level of care is always important, in some areas, the inability to access a healthcare provider is equally concerning. And these challenges may become even more commonplace in the post-COVID-19 era. One significant transformation to help with the hurdle is telehealth, which went from a very small part of the care offering before the health crisis to one that is now a much more accepted way to access care.
As the rise in virtual health continues to serve consumers and provide a personalized and responsive care experience, healthcare consumers expect support services and care that are also fast and personalized – with digital apps, instant claims settlements, transparency, and advocacy. And to better help serve healthcare consumers, the industry has an opportunity to align with digital transformation that offers a personalized and responsive experience.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Brooke LeVasseur, CEO of AristaMD

Issues pertaining to the COVID-19 pandemic will continue to be front-and-center in 2021. Every available digital tool in the box will have to be employed to ensure patients with non-COVID related issues are not forgotten as we try to free up in-person space and resources for those who cannot get care in any other setting. Virtual front doors, patient/physician video and eConsults, which connect providers to collaborate electronically, will be part of a broadening continuum of care – ultimately aimed at optimizing every valuable resource we have.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Bret Larsen, CEO and Co-Founder, eVisit

By the end of 2021, virtual care paths will be fairly ubiquitous across the continuum of care, from urgent care and EDs to specialty care, all to serve patients where they are – at home and on mobile devices. This will be made possible through virtualized end-to-end processes that integrate every step in patient care from scheduling, waiting rooms, intake and patient queuing, to interpretation services, referral management, e-prescribe, billing and analytics, and more.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Laura Kreofsky, Vice President for Advisory & Telehealth for Pivot Point Consulting

2020 has been the year of rapid telehealth adoption and advancement due to the COVID pandemic. According to CDC reports, telehealth utilization spiked as much as 154% in late March compared to the same period in 2019. While usage has moderated, it’s clear telehealth is now an instrumental part of healthcare delivery. As provider organizations plan for telehealth in 2021 and beyond, we are going to have to expect and deliver a secure, scalable infrastructure, a streamlined patient experience and an approach that maximizes provider efficiency, all while seeing much-needed vendor consolidation.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Jeff Lew, SVP of Product Management, Nextech

Earlier this year, CMS enacted new rules to provide practices with the flexibility they need to use telehealth solutions in response to COVID-19, during which patients also needed an alternative to simply visiting the office. This was the impetus to the accelerated acceptance of telehealth as a means to both give and receive care. Specialty practices, in particular, are seeing successful and positive patient experiences due to telehealth visits. Dermatology practices specifically standout and I expect the strong adoption will continue to grow and certainly be the “new normal.” In addition, innovative practices that have embraced this omni-channel approach to delivering care are also establishing this as a “new normal” by selectively using telehealth visits for certain types of encounters, such as post-op visits or triaging patients. This gives patients a choice and the added convenience that comes with it and, in some cases, increases patient volume for the practice.


6 Mental Health & Teletherapy Predictions & Trends to Watch in 2021

The executive team at AbleTo, a technology-enabled provider of behavioral healthcare shares six mental health and teletherapy predictions and trends to watch in 2021.

Trip Hofer, CEO at AbleTo

6 Mental Health & Teletherapy Predictions & Trends to Watch in 2021

1. Measurement and Outcomes

“The healthcare industry has made progress toward increasing access to mental health care and defining what quality care looks like. Now in 2021, the industry needs to focus on how we measure that quality. With mental health becoming an incredibly hot market and so much funding pouring in for new entrants, many leaders are concerned with the lack of rigorous, evidence-based standards for measuring patient outcomes. I share that concern, and want to stress the importance of sound methodologies for demonstrating outcomes.”

2. Market Trends

“The consolidation we saw in mental health during 2020 will continue into next year but I think we’ll see new trends appear too. There’s such a proliferation of investment dollars in the market that we can expect to see some organizations come and go if they don’t produce the expected returns. With so much money flowing into the mental health space, organizations that don’t show evidence-based rigor and good quality clinical care will fade, while those providing sound mental health care will succeed.”

“Provider networks will increase in importance given the shortage of trained behavioral health clinicians. Demand is increasing among patients who need more than an app to address their needs—they need the human connection. With a limited pool of providers, companies will have to compete to attract providers to their network. At AbleTo, we do this by setting ourselves apart on the basis of quality standards of care. That’s very appealing to highly skilled therapists seeking to join a network.”

“In 2021, the industry will need to address the regulatory environment around licensing behavioral health practitioners, as well as the use of remote care. When CMS relaxed cross-state regulations during the pandemic, this made navigating the regulatory framework even more complicated, since the varying licensing rules remain at the state level. We need permanent improvements to regulations so licensed therapists can more easily practice across state lines and meet the growing needs of remote patient populations.”

6 Mental Health & Teletherapy Predictions & Trends to Watch in 2021

Reena Pande, Chief Medical Officer at AbleTo

3. Solution Complexity

“We’ve seen such a promising shift towards focusing on behavioral healthcare. But the wealth of point solutions now available to address behavioral health needs has created an exceptionally confusing environment for payers and employers with some even telling us they have “point solution fatigue.” The fact is that there is no one right point solution. Mental health is not one condition requiring one solution; it encompasses a heterogeneous group of complex conditions that require different interventions. What the industry needs to focus on in 2021 is putting together a solution set that can address the complexity and nuances of mental health. The market needs to be more mindful of this over the course of the next year and avoid trying to oversimplify mental health.”

4. Access and Utilization

“Our payer partners saw a surge in utilization of telehealth broadly at the outset of the pandemic; but while utilization for physical health has lessened, telehealth use for mental health has continued. Given the acceptance of technology as an effective way to deliver mental health care, we expect it to continue into 2021.

This predicted increase in utilization will of course differ by socioeconomic status. Telehealth, like COVID, has laid bare underlying inequities that have long existed in the healthcare system. In 2021, we will see a larger focus on ensuring quality mental health care reaches all populations in need, with greater emphasis on access and cost-effectiveness.”

Naomi Pollock, Senior Director, Clinical
Program Development at AbleTo

5. Relationships

“While technology is driving so much positive change in healthcare and in mental health, we need to remember the value of the human connection. Clinical interventions depend on real people delivering care, and the voices of both patients and providers need to guide our approach to care delivery, including through technology like telehealth or virtual therapy. The relationships that providers and patients create with one another are the key driver of care, and technology should complement that human connection, not replace it.”

6. Clinician Challenges

“We [The industry] need to help our therapists measure the impact of the care they deliver to ensure they’re offering the right interventions to the right participants. This means educating providers around how to measure care outcomes, how to define measurement-based care, and what it looks like both on an individual level and a population level. At AbleTo, we’ve solved that missing piece to support the providers in our network. We need to focus on making this standard across the industry.”

“Our clinicians are facing unprecedented challenges during this pandemic. For months, they’ve been supporting patients struggling with the impacts of COVID while they are living through it themselves—working from home, seeing patients virtually, juggling their own personal and family lives. We need to support our care deliverers amidst this wave of mental health challenges they’re facing, similar to how we support frontline workers and medical practitioners.”

Cerner, Banner Health, Xealth Partner to Simplify How Clinicians Prescribe Digital Health

Cerner, Banner Health, Xealth Partner to Simplify How Clinicians Prescribe Digital Health

What You Should Know:

– Cerner Corporation today announced with Xealth new
centralized digital ordering and monitoring for health systems, starting with
Banner Health, to foster digital innovation.

– Health systems can prescribe digital therapeutics, smartphones, and internet apps directly within the EHR to address areas such as chronic disease management, behavioral health, maternity care, and surgery prep.


Cerner, today announced it’s building on the recent collaboration with Xealth to offer health systems new centralized digital ordering and monitoring for clients. These capabilities are designed to help health systems choose, manage, and deploy digital tools and applications while offering clinicians access to remote monitoring and more direct engagement with patients. Phoenix-based Banner Health, one of the country’s largest nonprofit hospital systems, is one of the first Cerner clients to use the new capabilities to benefit its clinicians and patients.

Prescribe Digital Therapeutics Via EHR

With the new capabilities, health systems can prescribe digital therapeutics, smartphones, and internet applications to address areas such as chronic disease management, behavioral health, maternity care, and surgery prep. This access to a more holistic view of the organization’s digital health solutions supports the clinical decisions doctors make every day and provides real opportunities to improve medical outcomes and enhance efficiency, meet the increasing demand for telehealth and offer remote patient monitoring.

For example, the new capabilities can help simplify how
clinicians prescribe tools such as mobile mental health apps to monitor anxiety
triggers or a glucose device to help trace blood sugar levels for diabetes
patients.

Digital solutions will be available in a single location in
the electronic health record where health systems can use apps based on
clinical and financial metrics. A wide array of digital health tools is
integrated with Xealth’s offering today and the list is ever-growing. Early
examples of companies that have previously deployed in health systems using
Xealth include Babyscripts, Glooko, SilverCloud Health, Welldoc, as well as
Healthwise Inc., GetWellNetwork and ResMed that have existing relationships
with Cerner.

“As digital tools are increasingly included in care plans, health systems seek a way to organize and oversee their use across the health system. We anticipate the emergence of digital and therapeutic committees to govern digital tool selection similar to how pharmacy and therapeutic committees have historically governed medication formularies,” said David Bradshaw, senior vice president, Consumer and Employer Solutions, Cerner. “Digital health has extraordinary potential to reshape the way we care for patients and, working with Xealth, we are answering the need and helping providers create more engaging and effective patient experiences.”

Why It Matters

Digital health has great potential to make an immediate difference, especially as it relates to automating patient education, delivering virtual care, supporting telehealth, and offering remote patient monitoring. Health systems with a digital health program and strategy in place have the ability to respond faster and more efficiently.

“Now, more than ever, extending care teams to meet patients where they are is critical,” said Mike McSherry, CEO and co-founder, Xealth. “As digital health programs roll out, they should elevate both the patient and provider experience. Cerner building out a digital formulary, with Xealth at its core, is listening to its strong clinician base by delivering tools to enhance patient care, without adding additional steps for the care team.”

Cityblock Health Reaches $1B Valuation, Raises $160M to Address Systemic Healthcare Inequity

Cityblock Health Reaches $1B Valuation, Raises $160M to Address Systemic Healthcare Inequity

What You Should Know:

– Cityblock Health, a transformative, value-based healthcare provider focused on improving healthcare outcomes for marginalized communities, today announced a $160M Series C round, bringing its total raised to $300M.

– Cityblock is a care delivery trailblazer working to right the injustices of a healthcare system that cycles vulnerable communities through frequent ER visits and hospital stays. Its tech-enabled model delivers primary care, behavioral care, and social services, virtually and in-person, to the Medicaid and lower-income Medicare beneficiary communities.

– Cityblock provides social services that address core
aspects of poverty in order to improve health outcomes, including access to
nutritious food and support to safely care for oneself.


Cityblock
Health
, a Brooklyn, NY-based healthcare provider for lower-income
communities, announced today the completion of a $160 million Series C funding
round and a valuation of over $1 billion. New Cityblock investor General Catalyst
led the round, with participation from crossover investor Wellington Management
and support from major existing investors, including Kinnevik AB, Maverick
Ventures, Thrive Capital, Redpoint Ventures, and more. The investment round
brings Cityblock’s total equity funding to $300 million, as they look to grow
their footprint to democratize access to community-based integrated care in a
more than $1.3 trillion market.

Care That Meets You Where You Are

Cityblock Health Reaches $1B Valuation, Raises $160M to Address Systemic Healthcare Inequity

Spun out of Sidewalk Labs, an Alphabet Company in 2017 and anchored in a first partnership with EmblemHealth, Cityblock is a transformative, value-based healthcare provider focused on improving outcomes for Medicaid and lower-income Medicare beneficiaries. The company provides medical care (both primary care and complex specialty services), behavioral health, and social services to its members virtually, in their homes, in the community, and in its neighborhood hubs. Their model reflects an underlying philosophy that improving health outcomes and minimizing systemic healthcare inequities requires fundamentals that address the root effects of poverty, like having access to nutritious food or the ability to safely care for yourself and others.

Value-Based Care Model

Cityblock Health Reaches $1B Valuation, Raises $160M to Address Systemic Healthcare Inequity

Cityblock leverages a value-based model, instead of a
fee-for-service basis, like most healthcare providers. Cityblock splits the
cost savings that come from better outcomes with the healthcare payer. Cityblock’s
financial structure squarely aligns the health needs of its members to continuously
deliver patient-centric care.

Cityblock is powered by Commons a groundbreaking care delivery platform that brings together distributed community-based care teams, care delivery workflows, data feeds, and multimodal member interactions. It allows social workers, pharmacists, doctors, paramedics, and our virtual care teams to all come together on the same page in real-time. With each new market we enter, our technology reinforces our care model, allowing us to serve more members while ensuring consistently high quality, empathetic, and effective care.

Integrated Care Team

Cityblock Health Reaches $1B Valuation, Raises $160M to Address Systemic Healthcare Inequity

Cityblock’s integrated care teams include doctors, nurses,
advanced practice clinicians, behavioral health specialists, licensed clinical
social workers, and community health partners, and leverage close partnerships
with existing healthcare providers and community-based social services
organizations.

Today, Cityblock provides care to 70,000 members in Connecticut,
New York, Massachusetts, and Washington D.C., with high member engagement and
NPS scores of high 80s to 90s across its markets. Over the past year, Cityblock
members have seen reductions in in-patient hospital admission rates and
improvements in quality outcomes, keeping people healthier and driving down
costs across the board, while more than doubling membership and revenue,
year-over-year.

The Impact of COVID Has Magnified Health Disparities

According to Cityblock, the COVID-19 pandemic has
significantly magnified health disparities highlighting three fundamental
problems:

–  Inequity of
America’s social infrastructure, including the legacy of systemic racism, has
created unacceptably disparate health outcomes

– Healthcare’s volume-based, fee-for-service payment model contributes
poor outcomes, especially for marginalized communities

–  The models that
have to-date addressed key components of these challenges have not successfully
scaled.

Story of Cityblock Member Sonia

Cityblock Health Reaches $1B Valuation, Raises $160M to Address Systemic Healthcare Inequity

The story of Sonia, a Cityblock member, is featured in the blog post announcing the raise. Counted out and considered
a ‘nuisance’ by the healthcare system, Sonia was visiting the emergency room
several times a week for care and services, resulting in poor outcomes for the
health system and for herself. Cityblock enrolled Sonia in their high-risk
short-term housing program, placing her into a hotel during the peak of her
community’s Covid-19’s outbreak. As her trust in Cityblock grew, Sonia worked
with Cityblock and its community partners to secure permanent housing. Over the
course of two years, Sonia saw a 21% reduction in hospital use and a 24%
reduction in monthly costs, and has had zero ER visits since April 2020. 

“The devastating impact of COVID-19 has been a painful
reminder of the vulnerability of lower-income communities and communities of
color,” said Iyah Romm, Cityblock Health co-founder and CEO. “We cannot turn a
blind eye to a healthcare system that cycles vulnerable communities through
frequent ER visits and hospital stays. We believe that new models of care
delivery, rooted in preventative care and augmented with social services, are
one major path forward to righting the injustices of our healthcare system.
This starts with listening to our members, extends through changing payment
models to create sustainability for primary care providers and building
technology to democratize access to the care models that we are building.”

Powered by Doctor on Demand, ArcBest Rolls Out Virtual Primary Care Health Plan to its 13k Employees

Powered by Doctor on Demand, ArcBest Rolls Out Virtual Primary Care Health Plan to its 13k Employees

What You Should Know:

– Publicly traded logistics company ArcBest announced its
deal with Doctor On Demand to introduce its virtual-first health plan to its
13,000 employees, who are largely “essential workers” as long-haul
truckers.

– Employees appreciated the convenience and safety of 24/7 virtual care – from their homes, from the road – and ArcBest is now doubling down on virtual care for 2021 – and offering a holistic, virtual-first primary care health plan – one where patients see the same PCP time and time again virtually and can receive many of the same services virtually that they’d typically receive in-person.


Doctor
On Demand
, the nation’s leading virtual care provider,
and ArcBest, a
multibillion-dollar leader in supply chain logistics, announced a partnership
to offer a new Virtual Primary Care health plan benefit to its employees and
their dependents nationwide. The partnership expands on the existing urgent
care and behavioral health services that Doctor On Demand has been providing to
ArcBest since 2017.

Virtual Primary Care Benefit

ArcBest is getting creative in how they deliver healthcare benefits to their thousands of field employees – many of whom are on the road or reside in rural areas throughout the country. As the pandemic hit, it became increasingly difficult or unsafe to seek in-person medical or mental health care, so ArcBest promoted the use of its telemedicine offering of urgent care and mental healthcare.

The new Virtual Primary Care benefit will be available to all 8,000 members who are covered under ArcBest’s medical plan starting December 1st. This benefit comes at a critical time as COVID-19 cases are spiking again, and as the country simultaneously heads into cold and flu season. As a provider of essential freight and logistics services, ArcBest has a large field employee population that operates 24/7, making it challenging to access routine in-person care.

Virtual Primary Care Improves Access to Care

ArcBest believes that investing in this new virtual health
plan upfront will have a major impact on employees’ health long term –
promoting preventative healthcare and driving down long-term costs associated
with employees waiting until their chronic back pain or chronic disease
warrants more costly interventions.

“At ArcBest, we have a unique set of healthcare benefit needs, and Doctor On Demand’s existing urgent and behavioral health care services have been invaluable, especially this year,” said Rich Krutsch, Vice President, People Services at ArcBest. “The pandemic has also prompted us to double-down on our investments in virtual care, and we’re excited to expand our program with Doctor On Demand to include much more holistic, integrated virtual care for our employees.” 

Employees Can Select Primary Care Doctor Through Doctor
on Demand

Eligible ArcBest employees and their dependents will now be able to select a primary care provider through Doctor On Demand and access a comprehensive set of services to support whole-person health, including preventive wellness check-ups, vaccination referrals, nutrition consultations, chronic condition management, and more. Additionally, members are able to continue to see the same physician over time, allowing them to build a consistent, trusted relationship via video.

Ensuring Telehealth Providers’ Virtual Care Dollars Make Sense

Ensuring Telehealth Providers’ Virtual Care Dollars Make Sense
Don Godbee Don Godbee, Mobile Solutions Architect at Stratix Don Godbee

Telehealth and virtual care are not brand-new phenomena suddenly cobbled together as a rapid response to the onset of the COVID-19 pandemic, but the average US patient could be forgiven for thinking that it is. Indeed, virtual visits to care providers and remote patient monitoring have been available for quite some time, delivering two key benefits: 

– Providing a platform to address cost-efficiencies and accessibility to quality healthcare for the populace at large 

– Playing a key role in managing a growing population of chronically ill seniors. 

Prior to 2020, however, the rules of reimbursement and implementation for associated telehealth services were difficult to navigate, wildly differing at the state and federal level with a host of regulations further complicating matters. Federal reimbursement policies are centered on Medicare, via the Centers for Medicare and Medicaid Services (CMS) – the single largest payer for seniors and chronically ill patients. Additionally, compliance with the Health Insurance Portability and Accountability Act (HIPAA) dictated rigorous standards for direct and monitoring communications between care providers and patients. Complicating matters further, US states offered a patchwork of individual telehealth laws dictating separate Medicaid policies. 

The result was a lack of clarity of how healthcare providers could overcome regulatory and financial reimbursement barriers to implement effective telehealth programs as well as a lack of parity in coverage services and payments for patients. To address this at the federal level, CMS released new guidance in 2020 to relax reimbursement restrictions for providers. Now, we’re at the cusp of a new era of telemedicine where providers could widely offer:

– Virtual office visits that address traditionally in-person services such as primary care, behavioral health, and specialty care (e.g. pulmonary or cardiac health rehabilitation)

– On-demand virtual urgent care to address pressing concerns and urgently needed consultations

– Virtual broader home health services such as remote patient monitoring, outpatient disease management, and various forms of therapy (e.g. physical, speech)

– Tech-enabled home medication administration helping patients receive injectable or consumable medication via monitored self-administration

This is all, of course, dependent upon the mobile technology (e.g. tablets, wearables, etc.) and associated services that telehealth providers will rely upon to make these services happen at parity and scale for their patients. Even more importantly, virtual care programs being scaled up to cover a larger percentage of patients will fall apart if providers don’t have the resources to offer robust support and maintenance options for these devices and services. Quality of virtual care is highly dependent on persistent device and service availability and dependability. 

Whether providers have already begun purchasing the mobile devices needed or are still struggling with the choice of what devices and services they need and/or can afford, however, they now face a different quandary: How to stand up these virtual care services at scale in a sustainable way that works within current budget resources and doesn’t pass on ballooning costs to your patients?

One way to make complex mobile technology deployments financially manageable is opting for a mobile device as a service (mDaaS) model which allows you to shift from a CapEx-based spending model to an OpEx spending model for purchasing hardware and allows telehealth providers to bundle or roll up a range of devices, accessories, services, maintenance and support into a single, predictable monthly per-device price. With mobile device technology rapidly evolving, telemedicine providers will need the operational agility to pivot to different solutions and quick technology refreshes as the need arises. 

When done with the right third-party partner, it offers the additional advantages of outsourcing end-to-end support and lifecycle management to highly trained agents, who can free up precious IT resources. Most importantly, it creates a level of control over technology and spend that makes standing up virtual care programs convenient and stress-free.

There are many options to consider when expanding telemedicine services rapidly to larger patient bases, whether during disruptive events such as the COVID-19 pandemic or in the years to come. The key to making these services sustainable is finding a financing model that will free up internal resources, offer greater spending flexibility, and offer end-to-end support for your healthcare mobile technology ecosystem. 


About Don Godbee Senior Mobile Solutions Architect at Stratix

Don brings a unique perspective to mobility in the Healthcare Vertical with over 25 years of consulting and delivery of critical solutions. Don has delivered various solutions from OEM integration of sensors in medical devices to mobile point of care solutions and services with major EHR software solution providers such as Epic, Cerner, GE Healthcare, Allscripts, and McKesson.

PointClickCare Acquires Collective Medical for $650M to Create to Largest Combined Acute and Post-Acute Care Network

PointClickCare Acquires Collective Medical for $650M to Create to Largest Combined Acute and Post-Acute Care Network

What
You Should Know:


PointClickCare announces its intent to acquire Collective Medical to create the
largest combined acute and post-acute care network in North America for $650M.


Collective Medical’s platform connects more than 1,300 hospitals, thousands of
ambulatory practices and long-term post-acute care (LTPAC) providers, as well
as accountable care organizations (ACOs) and every national health plan in the
country, across a 39-state network.

– With the acquisition of Collective Medical, PointClickCare will solidify its position as a high-growth, cloud-based SaaS leader, serving a large, diversified customer base across the acute, ambulatory, post-acute, and payer spectrum.


PointClickCare
Technologies
, a leader in senior care technology with a network of more
than 21,000 skilled nursing facilities, senior living communities, and home
health agencies, today announced its intent to acquire
Collective Medical, a Salt Lake
City, UT-based leading network-enabled platform for real-time cross-continuum
care coordination for $650M. Together, PointClickCare and Collective Medical
will provide diverse care teams across the continuum of acute, ambulatory, and
post-acute care with point-of-care access to deep, real-time patient insights
at any stage of a patient’s healthcare journey, enabling better decision making
and improved clinical outcomes at lower cost.

The acquisition follows a partnership, created between the
companies in August 2019, which streamlined the integration of Collective
Medical’s solution for care transitions with PointClickCare’s leading
cloud-based software platform. Hundreds of PointClickCare customers are already
leveraging this connection to the Collective platform to coordinate seamless
care transitions and influence decisions at the point of care.

COVID-19 Underscores Barriers to Care Coordination

Currently, hospitals, ACOs and health plans
lack the data and tools to effectively coordinate with LTPAC providers and
other disparate points of care – an issue spotlighted further by the COVID-19 pandemic.
And despite the healthcare system’s ongoing move to value-based payment
models
, barriers to care coordination
persist, especially for seniors and other complex patient populations. Through
this acquisition, the company will be uniquely positioned to address these
challenges.

PointClickCare supports a network of more than 21,000
skilled nursing facilities, senior living communities and home health agencies.
In the United States, 97 percent of all hospitals discharge patients to skilled
nursing facilities using PointClickCare. Founded in 2005, Collective Medical’s
platform connects more than 1,300 hospitals, thousands of ambulatory practices
and long-term post-acute care (LTPAC) providers, as well as accountable care
organizations (ACOs) and every national health plan in the country, across a
39-state network.

These providers come together via the Collective platform to
support patients suffering from a variety of complex conditions, including
substance use disorder, mental and behavioral health issues, and other care
needs requiring multiple interventions and transitions across disparate care
settings. The combination of PointClickCare and Collective Medical will enable
care to be more seamlessly delivered for the most complex (high-cost,
high-needs) patients, including the rapidly growing aging population.

The acquisition will connect care teams, post-acute
providers, hospitals and health plans with better data about their patients,
ultimately reducing administrative burdens and bringing down the high costs of
complex care. Providers and health plans will be empowered as they work to
solve the complexities around the senior patient population by leveraging
increased information across diagnoses groups and unprecedented access to drive
behavior change at the point of care.

Acquisition Establishes PointClickCare As Leader in Acute and Post-Acute
Care Network

With the acquisition of Collective Medical, PointClickCare
will solidify its position as a high growth, cloud-based SaaS leader, serving a
large, diversified customer base across the acute, ambulatory, post-acute, and
payer spectrum. As the shift to value-based care fuels growing market demand
for intelligence and collaboration tools, the company will be best positioned
to provide the most fully integrated set of real-time care coordination tools
across the entire continuum of care, powered by the largest network of its kind
in the U.S.

“The healthcare ecosystem is a mix of disconnected providers, systems, plans, processes and data. Healthcare costs and risk are on the rise, while patient care and provider-to-provider coordination are inconsistent. Our mission is to improve the lives of seniors, and we believe the best way to meaningfully advance this goal is by connecting disparate points of care,” says Mike Wessinger, founder and chief executive officer of PointClickCare Technologies. “Collective Medical offers the right fit of people and technology and together we will initiate a new era of data-enriched collaboration across the continuum that radically transforms how data and people are empowered to liberate health.”

The acquisition is subject to receiving regulatory
approvals, including from The Committee on Foreign Investment in the United
States (CFIUS), and other customary closing conditions, and is expected to be
completed by the end of December 2020.

Northwell Health Offers COVID-19 Screening Chat for NY Schools and Employers

Northwell Health Offers COVID-19 Screening Chat for NY Schools and Employers

What You Should Know:

– Northwell Health announced that its Northwell Direct unit, which works with large employers, will be offering Conversa HealthCheck to screen employees, customers, students, and visitors.

– HealthCheck is a quick, chat-based electronic screening
for symptoms and signs of exposure to COVID-19. If cleared, users receive a
digital “badge” that allows entry to a facility. If not cleared, they
are given additional information on staying home and steps for testing and
care.

– Employers use aggregated, de-identified results to
determine workforce needs and make decisions about reopening or temporarily
closing locations.


Northwell
Direct
today announced that it is partnering with Conversa Health to offer the COVID-19
HealthCheck, a screening chat tool for coronavirus disease 2019 (COVID-19). The
tool is easy to use, efficient and confidential, and allows retailers, schools,
hotels, sporting and entertainment venues and other employers to create and
maintain a safe environment for employees, customers, students and visitors.

The rollout marks the first introduction of the COVID-19
HealthCheck to the tri-state region. In use more than 125,000 times every
workday, HealthCheck has proven to help businesses, universities, health
systems and other venues across the country.

COVID-19 HealthCheck: How It Works

Employees use the HealthCheck from home before each workday,
clicking on a secure link on their phone, tablet or computer to engage in a
simple, conversational automated chat that checks for possible exposure to the
new coronavirus and potential symptoms of infection. The chat takes about a
minute and a half, and after completion, employees who are cleared for the day
receive a digital “badge” that they can display for entry to the workplace. If
they are not cleared, they are instructed to stay home and are given guidance
on the appropriate steps to take for testing and care. The process is similar
when colleges and universities provide the HealthCheck for use by faculty and
students.

Aggregated, De-identified Results of Workforce Daily
Screens

Employers who roll out the HealthCheck are notified of the
aggregated and de-identified results of their workforce’s daily screens,
providing information that can help them manage their business, adjust staffing
and make decisions about reopening or temporarily closing specific worksites.
The HealthCheck is continually updated to reflect the latest coronavirus
guidelines from the CDC and other scientific organizations.

Northwell Direct COVID-19 Solutions

Northwell Direct clients can use the HealthCheck solution on
its own or as part of a portfolio of tools built to help curb the spread of
COVID-19. For example, if a client uses Northwell Direct’s clinical concierge
service, employees whose responses raise any concerns will be guided to connect
with that service, which includes a 24/7 nurse line and an extensive care
management team.

Northwell Direct can also provide diagnostic (PCR) and
antibody testing for COVID-19 and
return-to-work assessments. Overall, Northwell Direct offers a holistic
approach that leverages the knowledge of Northwell Health’s experts in
infectious disease, occupational health, workforce safety, behavioral health
and well-being.

As businesses throughout New York and the country confront rising caseloads in their area, the first job of every employer is to ensure a safe and healthy workplace,” said Nick Stefanizzi, CEO of Northwell Direct, a Northwell Health company that provides customizable health care solutions to employers in the tri-state area. “Conversa’s COVID-19 HealthCheck is a fast, easy, evidence-based way to clear people for work or put them on a path to care – without compromising privacy or creating bottlenecks.”

Healthcare M&A: DAS Health Acquires Randall Technology Services

DAS Health Acquires Health IT and Medical Billing Conglomerate

What You Should Know:

– DAS Health Ventures acquires healthcare
and managed IT company Randall Technology Services (RandallTech).

– This acquisition adds Allscripts® PM
and EHR solutions to the DAS portfolio of supported products, and DAS Health
has now added additional staff in Texas that will create opportunities for
greater regional support of its entire solutions portfolio.


DAS Health Ventures, Inc., an industry leader in health IT and management, announced today it completed the acquisition of Randall Technology Services, LLC (RandallTech) healthcare and managed IT company based in Amarillo, TX. As part of DAS’ growth strategy, this most recent expansion further strengthens its position in the US healthcare technology space.

Acquisition Enhances DAS Health Market Reach

DAS Health actively serves more than 1,800 clients, and
nearly 3,500 clinicians and 20,000 users nationwide, with offices in Florida,
Nevada, New Hampshire and Texas, and a significant employee presence in 14 key
states. This acquisition adds Allscripts® PM and EHR solutions to the DAS
portfolio of supported products, and DAS Health has now added additional staff
in Texas that will create opportunities for greater regional support of its
entire solutions portfolio.

Increased Support for Existing RandallTech Clients

Randall Technology’s clients will gain an increased depth of support, and a substantially improved value proposition, as DAS Health’s award-winning offerings are robust, including managed IT / MSP services, practice management, and EHR software sales, training, support and hosting, revenue cycle management (RCM), security risk assessments (SRA), cybersecurity, MIPS/MACRA reporting & consulting, mental & behavioral health screenings, chronic care management, telemedicine, and other value-based and patient engagement solutions.

Financial details of the acquisition were not disclosed.

Recent Executive Hires: CVS Health New President, Cleveland Clinic/Amwell Joint Venture Leadership, Others

Neela Montgomery, EVP & President at CVS Pharmacy/Retail

CVS Health Corporation names Neela Montgomery Executive Vice President and President of CVS Pharmacy/Retail, effective November 30, 2020. Montgomery will oversee the company’s 10,000 pharmacies across the United States. Montgomery, currently a Board Partner at venture capital firm Greycroft, most recently served as chief executive officer of furniture retailer Crate & Barrel and has nearly 20 years of global retail experience.


The Cleveland Clinic and Amwell joint venture appoint Egbert van Acht as Executive Vice Chairman to the Board of Directors and Frank McGillin as CEO. Formed one year ago as a first-of-its-kind company to provide broad access to comprehensive, high-acuity care via telehealth, the company has made great progress scaling digital care through its MyConsult® offering. With an initial focus on clinical second opinions, the organization also offers health information and diagnosis on more than 2,000 different types of conditions including cancer, cardiac, and neuroscience issues.


Dana Gelb Safran, Sc.D., SVP at WELL Health

Healthcare industry veteran Dana Gelb Safran, Sc.D. has joined Well Health Inc. as Senior Vice President, Value-Based Care, and Population Health. In her new role, Dr. Safran will expand WELL’s uses to improve healthcare quality, outcomes, and affordability through partnerships with payers and Accountable Care Organization (ACO) providers.


Talkdesk®, Inc., the cloud contact center for innovative enterprises appoints Cory Haynes to lead Talkdesk’s strategy for the financial service industry and Greg Miller to lead the strategy for healthcare and life sciences. Haynes and Miller are key members of the Talkdesk industries team led by Andrew Flynn, senior vice president of industries strategy for Talkdesk.


Mark McArdle, SVP Products & Design at Imprivata

Imprivata appoints Mark McArdle to Senior Vice President of Products and Design. Mr. McArdle has more than two decades of experience in software development, Software-as-a-Service (Saas), in Cybersecurity, and advanced products for the enterprise, SMB, and consumer markets.


Jack Stoddard, Executive Chairman at Eden Health

Eden Health names Jack Stoddard as executive chairman of its board of directors. Formerly serving in COO roles for Accolade and Haven, Stoddard brings two decades of healthcare innovation and operating experience to the board position, providing leadership, wisdom, and counsel during a time of monumental growth and adoption for the company. 


Saurav Chatterjee, PhD., CTO at Augmedix

Augmedix names Saurav Chatterjee Chief Technology Officer. Prior to joining Augmedix, he most recently served as Vice President of Engineering at Lumiata, Inc., where he led the engineering team that built a leading AI platform, focusing specifically on transforming, cleaning, enriching, featurizing, and visualizing healthcare data, and on building, deploying and operationalizing machine learning and deep-learning models at scale.


Philip Vecchiolli, Chief Growth & Strategy Officer, Tridiuum

Tridiuum, the nation’s premier provider of digital behavioral health solutions names Philip Vecchiolli has joined the company as Chief Growth and Strategy Officer. Vecchiolli, who brings over 30 years of experience to the new role, has a successful track record of leading business development for large and mid-size healthcare companies.


Janet Dillione, CEO of Connect America

Connect America appoints Janet Dillione as its new chief executive officer (CEO). Prior to joining Connect America, Dillione worked in the healthcare information services industry as CEO of Bernoulli Enterprise, Inc., GM of Nuance Healthcare, and CEO of Siemens Healthcare IT.


Health Catalyst, Inc. announces that current Chief Financial Officer Patrick Nelli has been named President, effective January 1, 2021. Following Nelli’s promotion to the President role, Health Catalyst has named Bryan Hunt, current Senior Vice President of Financial Planning & Analysis, Chief Financial Officer, also effective January 1, 2021.

Two additional promotions, also effective January 1, 2021, include Jason Alger, Senior Vice President of Finance, to Chief Accounting Officer, and Adam Brown, Senior Vice President of Investor Relations, to Senior Vice President of Investor Relations and Financial Planning & Analysis. 


Rick Howard, Chief Product Officer at Apervita

Apervita hires health IT veteran Rick Howard as Chief Product Officer. In his role, Rick will oversee product vision, innovation, design, and delivery of Apervita’s digital platform, which enables digital quality measurement, clinical intelligence, as well as value-based contract monitoring and performance measurement.

Roberto Simon

Conversion Labs, Inc. appoints Roberto Simon to its board of directors and as the chair of its audit committee. Following his appointment, the board now has eight members, with six serving as independent directors. Mr. Simon currently serves as CFO of WEX (NYSE: WEX), a $6+ billion fintech services provider.


Dr. Isaac Rodriguez-Chavez, Ph.D., MHS, MS.

PRA Health Sciences, Inc. appoints senior FDA official Isaac Rodriguez-Chavez, Ph.D., MHS, MS, as Senior Vice President, Scientific and Clinical Affairs. He will lead the company’s Global Center of Excellence for Decentralized Clinical Trial (DCT) Strategy. Dr. Rodriguez-Chavez’s responsibilities will involve the continued growth and development of PRA’s industry-leading decentralized clinical trial strategy, regulatory framework creation, and clinical trial modernization.


Proprio appoints three global thought leaders to its Medical Advisory Board. Dr. Sigurd Berven, Orthopedic Surgeon and Professor at the University of California, San Francisco, Dr. Charles Fisher, Professor and Head of the Combined Neurosurgical & Orthopedic Spine Program at Vancouver General Hospital and the University of British Columbia, and Dr. Ziya Gokaslan, Professor and Chair of the Department of Neurosurgery at Brown University and Neurosurgeon-in-Chief at Rhode Island Hospital and The Miriam Hospital will apply their globally respected surgical and research expertise to the development of the Proprio navigation platform.


Andrew Bindman, MD, EVP & Chief Medical Officer at Kaiser Permanente

Kaiser Permanente names Andrew Bindman, MD Executive Vice President and Chief Medical Officer.  In this role, Dr. Bindman will collaborate with clinical and operational leaders throughout the enterprise to help lead the organization’s efforts to continue improving the high-quality care provided to members and patients throughout Kaiser Permanente. Dr. Bindman will report directly to Kaiser Permanente chairman and CEO Greg A. Adams.

Dr. Michael Blackman, Chief Medical Officer at Greenway

Greenway names Dr. Michael Blackman Chief Medical Officer at Greenway. Dr. Blackman will further support the company’s ambulatory care customers, ensuring providers are equipped with the solutions and services they need to improve patient outcomes and succeed in value-based care.


Suki expands its leadership team with six key hires to support the company’s rapid commercial growth. Tracy Rentz, formerly Vice President of Implementation at Evolent Health, joins Suki as the Vice President of Customer Success and Operations to lead all customer operations, with a particular focus around deploying new Suki customers. Brian Duffy brings over 20 years of sales experience to Suki, joining the team as Director of Sales-East, after having most recently served as Regional Director at Qventus, Inc. Brent Jarkowski will also join Suki’s sales team this November as the Director of Sales-West, bringing over 15 years of experience in strategic relationship management. Brent joins Suki after serving as Senior Client Development Director at Kyyrus. Together, Brian and Brent will head the company’s efforts in building new partnerships across the country. And Josh Margulies, who previously served as the Director of Integrated Brand Marketing for the Jacksonville Jaguars, will serve as Suki’s new Senior Director of Field Marketing.

COVID-19: How Can Payers Prepare for Mandates and Support Pandemic Relief Efforts

Elizabeth Bierbower, Former President of Humana’s Group & Specialty Division

Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest costs. Cost-sharing and insurance premiums are rising consistently since the last decade for employer plans, which covers nearly half of the country’s population. Plan members are shouldering a part of the healthcare cost burden, so they want to keep it as low as possible. At the same time, they want maximum value for their money with access to quality care.

CMS identified this as an opportunity and issued the Final Interoperability and Patient Access rule. The rule allows patients to access electronic health data through any third-party application of their choice. The rule intends to allow patients to take control of their data and determine who can see which data. It will also make transferring data from provider to provider easier. So that patients can be ensured that their provider is fully aware of their medical history. 

The Challenge of Providing Members Access to Healthcare Data 

The biggest challenge that health plans will face is to extract data from multiple sources in-house, clean and scrub it, and ensure it is in the appropriate format as required by the Centers for Medicare and Medicaid Services (CMS). Some health plans have been in business for a really long time. Patient data has been accumulating through these years in legacy systems. Providing access to that data through certified third-party applications will require a lot of effort on the part of health plans. The health plans also have to ensure tight authentication standards so that only the people requested by the members have access to their healthcare data. 

In addition, there are multiple problems associated with provider data. Incorrect data in the provider database costs close to $3 billion annually. CMS has also issued warnings for inaccurate provider directories, high claim-reprocessing volumes, and substantial encounter-data rejection rates. Payers have been addressing the data issues with short term solutions. But now they have to resolve the provider data problems for good and make health data readily available to the members.

The COVID Crisis Upended The Payer Compliance Initiatives

Payers are in solidarity with providers and patients in this time of crisis. While providers work tirelessly to help an increased number of patients access the required care, payers are providing support through fast track reimbursements and reduced utilization management.

 Many health plans are focused on ensuring that their members have access to resources to fight COVID, which is why CMS extended the deadline for the Final Interoperability rule. Utilization patterns are witnessing a significant change. Many members are not receiving scheduled care as some elective surgeries are rescheduled and some provider offices are shut down. There has been a drop in certain kinds of utilization. Conversely, there has been a dramatic surge in telehealth office visits and behavioral health services.

The Road Ahead for Health Plans

Healthcare payers have endured significant claims-based, economic, and operational challenges during the pandemic. While they battle those bottlenecks, they also have to ascertain and prepare for the future and devise ways to ensure that their members have access to quality care.

Health plans will have to try to anticipate what utilization patterns will look like in the future, especially in the next year. Telehealth utilization will not be the same as it was pre-COVID. They will also have to ensure that members have access to care. They will have to reach out to members, especially those who are the most vulnerable. They will have to make sure members are not suffering from social isolation, they are taking their medication and they have access to transportation to get to the doctor.

Provider Alliance for CMS Compliance

CMS is handing over the reins of the care journey to the patients to improve care delivery through the Interoperability rule. Providers will play a key role in enabling access to healthcare data to patients by streamlining data and closing coding gaps. Payers must assist providers with their data needs to ensure compliance with the CMS rules.

As the pandemic ends and CMS comes out with more definitive long term rules and coverages, it is going to be important to ensure that providers are on the same page with payers. Health plans can partner with providers to educate them about the acceptable telehealth codes and what type of services are to be performed using those codes. Providers want to take care of their patients and they want to do it well. They want to leverage technology to ensure patient access to care and ensure their safety, especially for patients who suffer from multiple comorbidities.


About Elizabeth Bierbower

Elizabeth Bierbower is a strategic leader with more than thirty years of executive experience in the health insurance industry. She has experience scaling cost-effective and profitable growth strategies through internal innovation, and a reputation as being one of the industry’s most fiscally responsible and progressive leaders. Bierbower currently serves on the Boards of Iora Health, the American Telemedicine Association, and is on Innovaccer’s Strategic Advisory.

Previously Beth was a member of Humana’s Executive Management Team and held various roles including Segment President, Group and Specialty Benefits, and was an Enterprise Vice President leading Humana’s Product Development and Innovation teams.


SPAC Mergers with 2 Telehealth Companies to Form Public Digital Health Company in $1.35B Deal

SPAC Mergers with 2 Telehealth Companies to Form Public Digital Health Company in $1.35B Deal

What You Should Know:

– GigCapital2 Inc has agreed to merge with UpHealth Holdings Inc and Cloudbreak Health LLC to create a public digital healthcare company valued at $1.35 billion, including debt, the blankcheck acquisition company said on Monday.

– The combined company will be named UpHealth, Inc. and
will continue to be listed on the NYSE under the new ticker symbol “UPH”.

Blank check acquisition
company GigCapital2 agreed to merge
with Cloudbreak Health, LLC, a unified telemedicine and video medical
interpretation solutions provider and UpHealth
Holdings
, Inc., one of the largest national and international digital
healthcare providers to form a combined digital health company. The deal is valued
at $1.35 billion, including debt. the combined company will be named UpHealth, Inc. and will continue to be
listed on the NYSE under the new ticker symbol “UPH”.

Following the merger, UpHealth will be a leading global
digital healthcare company serving an entire spectrum of healthcare needs and
will be established in fast growing sectors of the digital health industry.
With its combinations, UpHealth is positioned to reshape healthcare across the
continuum of care by providing a single, integrated platform of best-in-class
technologies and tech-enabled services essential to personalized, affordable,
and effective care. UpHealth’s multifaceted and integrated platform provides
health systems, payors, and patients with a frictionless digital front door
that connects evidence-based care, workflows, and services.

“We are excited to partner with UpHealth and Cloudbreak through our Private-to-Public Equity (PPE)™ platform. The combined UpHealth has all the hallmarks we look for in a successful partnership, including a world-class executive team and an exceptional business model with scale, strong growth, and profitability margins in the digital healthcare industry. We are particularly excited about the opportunity to provide our Mentor-Investor™ discipline in partnership with an exceptional global leadership team, as well as participate in a high-tech integrated platform that comprises a variety of cutting edge disciplines, such as the Artificial Intelligence platform being developed by Global Telehealth in conjunction with the tech-enabled Behavioral Health divisions. We are confident UpHealth is at the inflection point and positioned for accelerated growth.” – Dr. Avi Katz – Founder and Executive Chairman of GigCapital2

Combined Company Offerings

SPAC Mergers with 2 Telehealth Companies to Form Public Digital Health Company in $1.35B Deal

Upon closing the pending mergers and the combination with Cloudbreak, UpHealth will be organized across four capabilities at the intersection of population health management and telehealth:

1. Integrated Care Management: Thrasys Inc. (“Thrasys”) has reinvested $100M of customer revenue to
develop its innovative SyntraNet Integrated Care technology platform. The
platform integrates and organizes information, provides advanced
population-based analytics and predictive models, and automates workflows
across health plans, health systems, government agencies, and community
organizations. The platform plans to add at least 40 million lives to UpHealth
in the next 3 years to support global initiatives to transform healthcare.

2. Global Telehealth: will consist of a U.S. division and an international division
that, together, are anticipated to grow revenues by an additional $47 million
in 2021.

The U.S. division of
Global Telehealth following the combination, Cloudbreak, is a leading unified
telemedicine platform performing more than 100,000 encounters per month on over
14,000 video endpoints at over 1,800 healthcare venues nationwide. The
Cloudbreak Platform offers telepsychiatry, telestroke, tele-urology, and other
specialties, all with integrated language services for Limited English Proficient
and Deaf/Hard-of-Hearing patients. Cloudbreak’s innovative, secure platform
removes both distance and language barriers to improve patient care,
satisfaction, and outcomes.

The international
division of Global Telehealth following the combination, Glocal Healthcare
Systems Pvt. Ltd (“Glocal”), is a global provider of virtual consultations and
local care spanning the care continuum. It has designed proven, affordable and
accessible solutions for the delivery of healthcare services globally. The
platform provides a full suite of primary and acute care services, including an
app-based telemedicine suite, digital dispensaries, and hospital centers. The
platform has signed several country-wide contracts with government ministries
across India, Southeast Asia, and Africa.

3. Digital Pharmacy: MedQuest Pharmacy (“MedQuest”) is a leading full-service manufactured and compounded pharmacy licensed in all 50 states that pre-packages and ships medications direct to patients. The company also offers lab services and testing, nutraceuticals, nutritional supplements, education for medical practitioners, and training for organizations, associations, and groups. MedQuest serves an established network of 13,000 providers. The MedQuest platform is poised for strong growth via targeted product expansion and expansive eCommerce capabilities for the entire provider network. UpHealth and MedQuest have mutually executed a merger agreement, the closing of which is awaiting regulatory approval for the transfer of licenses expected by the end of 2020 or early 2021.

4. Tech-enabled Behavioral Health: TTC Healthcare, Inc. (“TTC Healthcare”) and
Behavioral Health Services LLC (“BHS”) offer comprehensive services
specializing in acute and chronic outpatient behavioral health, rehabilitation
and substance abuse, both onsite and via telehealth. UpHealth’s Behavioral
Health capabilities have dramatically expanded use of telehealth for medical
and clinical services and are leveraging UpHealth’s platform to increase
volumes across its services. UpHealth and TTC Healthcare have mutually executed
a merger agreement, the closing of which is awaiting regulatory approval for
the transfer of licenses expected prior to the end of 2020.

Global Financial Impact and Reach

UpHealth will have agreements
to deliver digital healthcare in more than 10 countries globally. These various
companies are expected to generate approximately $115 million in revenue and
over $13 million of EBITDA in 2020 and following the combination, UpHealth
expects to generate over $190 million in revenue and $24 million in EBITDA in
2021.

Intermountain Adds Omada’s Diabetes Prevention Program to At-Risk Patients

Intermountain and MDClone Team Up to Transform Patient Data into Actionable Insight

What You Should Know:

– Omada’s diabetes prevention program will be available
to Intermountain’s at-risk patient population as part of a limited engagement
in 2020 and 2021.

– Omada’s diabetes prevention program is personalized to
meet each participant’s unique needs as they evolve, ranging from diabetes
prevention, type 2 diabetes management, hypertension, behavioral health, and
musculoskeletal issues.


Deepening a collaboration that began in 2016, Omada Health
and Intermountain
Healthcare
 announced the availability of Omada’s Prevention Program as a covered
benefit to patients with prediabetes seen by Intermountain Medical Group
providers at Intermountain primary care facilities. As in-person healthcare
systems seek to integrate proven digital care and coaching for at-risk
patients, this new offering creates a roadmap for large health systems across
the country. Omada’s prevention program will be available to Intermountain’s
at-risk patient population as part of a limited engagement in 2020 and 2021
that launched at the end of August.

Omada’s diabetes prevention program is personalized to meet
each participant’s unique needs as they evolve, ranging from diabetes
prevention, type 2 diabetes management, hypertension, behavioral health, and
musculoskeletal issues. Omada combines professional health coaching, connected
health devices, real-time data and personalized feedback to deliver clinically
meaningful results.

Expansion Builds on Previous Successful Collaborations

This announcement builds on a series of milestones between
Intermountain Healthcare and Omada. In 2016, the two companies launched an
innovative partnership in conjunction with the American Medical Association to
deliver digital diabetes prevention services via physician referral. In 2019,
the Omada Program became a covered benefit for Intermountain employees and
their adult dependents, followed by an investment from
Intermountain Ventures, the strategic investment arm of Intermountain
Healthcare.

“Intermountain is focused on ensuring all patients receive the care and information they need –  where, when, and how they want it – with seamless coordination across the system,” said Elizabeth Joy, M.D., M.P.H., Intermountain’s Medical Director for the Office of Health Promotion and Wellness under Community Based Care and Nutrition Services. “We’ve enrolled nearly 2,000 participants to date from our caregiver population, and we anticipate that access to the Omada program will enhance patient engagement and improve health outcomes in a time when patients are seeking deeply human digital care.”

Why It Matters

“By expanding the Omada diabetes prevention program to our at-risk patients, digital coaches will help encourage and teach patients to proactively manage and improve their overall health and prevent a potentially deadly disease. This is one of the many ways Intermountain Healthcare is moving toward value-based care, which aims to improve patient outcomes and reduce healthcare costs, not just for patients, but entire communities,” said Rajesh Shrestha, VP and COO, community-based care at Intermountain and president and CEO of Castell, an Intermountain company focused on elevating value-based care capabilities.

NeuroFlow Joins Epic App Orchard for Behavioral Health Integration

NeuroFlow Joins Epic App Orchard for Behavioral Health Integration

What You Should Know:

–  NeuroFlow,
the leader in technology-enabled behavioral health integration, is now
available to healthcare providers through Epic’s App
Orchard marketplace
. NeuroFlow combines provider workflow augmentation
solutions, clinical care dashboards, and a patient-facing application to create
a clinical feedback loop centered around behavioral health.

– Patient generated data including validated assessment
scores, mood and sleep ratings, and journal responses are fed into NeuroFlow’s
provider-facing web platform, which leverages a combination of machine learning
and natural language processing (NLP) from patient journal entries to risk
stratify patients and enhance care coordination efforts.

– The NeuroFlow integration with Epic will
help organizations accelerate their efforts toward integrated care by
facilitating reimbursement for collaborative care codes and optimizing value-based contracts.

– The launch is an encouraging development for health
systems seeking to practice any of a range of collaborative care models, a
clinical approach integrating both the physical and mental health of
patients. Hospitals and health systems using Epic can deploy NeuroFlow to
streamline clinical workflows and scale existing initiatives for measuring and
treating patients’ mental health symptoms.

VHA, Ontrak Launch 3-Year AI Study to Help Prevent Veteran Suicide

Veterans Health Administration Taps Ontrak to Help Prevent Veteran Suicide

What You Should Know:

– The Veterans Health Administration has selected Ontrak
in collaboration with Harvard Medical School and Brown University to transform
suicide prevention care for veterans.

– Leveraging AI developed by a Harvard Medical School
professor and the core analytics of the Ontrak platform, the three-year study
will look at the effect of intensive care coaching in addition to the standard
of care for veterans at high risk of suicide after inpatient hospitalization at
a psychiatric hospital. The trial will include 850 patients at six VA
hospitals.

– Suicide prevention is a focus for the military as well
as for the population as a whole as the U.S. grapples with the COVID-19
pandemic.


Ontrak, Inc., an AI-powered
and telehealth-enabled,
virtualized healthcare company, announced a cooperative research and
development agreement with the Veterans Health Administration (VHA) to conduct
a 3-year research study on the effect of intensive care coaching in addition to
the standard of care for Veterans at high risk of suicide-related behaviors
after psychiatric hospital.

Research Study Details

The study will leverage AI developed by Dr. Ronald Kessler
of the Harvard Medical School, as well as the core analytics of the Ontrak
platform. Dr. Kessler is the McNeil Family Professor of Health Care Policy at
Harvard Medical School and a principal in the STARRS Longitudinal Study of
suicide prevention among US Army soldiers. “We are excited to have Ontrak
helping us evaluate the effects of an intensive intervention to prevent
suicidal behaviors among Veterans at very high risk,” stated Dr. Kessler.

 Why It Matters

Suicidal ideation has been elevated since the pandemic and
the CDC reported on August 14 that a survey of U.S. adults in June 2020
indicated that 11% had seriously considered suicide in the past 30 days, which
was twice as high as in the previous 12 month period.

Addressing Veteran suicide is a top VHA priority and Ontrak is proud to apply their AI and virtual care coaching model in a trial of 850 patients at 6 VHA hospitals selected from a total of 98 in the country. This study has the potential to not only reduce suicide risk but also to produce secondary reductions in risk through interventions that address co-occurring medical conditions.

Dr. Judy Feld, Medical Director of Ontrak, stated, “Suicide is the 10th leading cause of death in the U.S. with rates steadily increasing over the past decade and worsening during the Covid-19 pandemic. We know that individuals with behavioral health conditions such as depression, substance use disorder, and post-traumatic stress disorder are at higher risk for suicidal ideation or attempt. Importantly, the rate of suicide among our country’s military Vets is double that of non-Veterans. As a pioneer in the development of evidence-based interventions for engaging individuals in care for anxiety, depression, and substance use disorders, Ontrak is honored to partner with the VHA healthcare system and collaborators from Harvard Medical School and Brown University to advance the medical community’s understanding of the most impactful case management for Veterans at high risk of suicide after inpatient hospitalization.”

How to tackle the mental health crisis that will come with a second Covid-19 wave

To prepare for this next wave, healthcare systems and community mental health organizations must find ways to scale resources to efficiently screen patients for behavioral health conditions, match them with the right resources and then monitor their progress over time

Ontrak Acquires Science-Backed, Behavior Change Platform LifeDojo

Ontrak Acquires Science-Backed, Behavior Change Platform LifeDojo

What You Should Know:

– Ontrak acquires LifeDojo Inc, a San Francisco, CA-based
comprehensive, science-backed behavior change platform.

– The acquisition broadens Ontrak’s addressable market
and footprint to lower acuity populations enabling new interventions and remote
patient monitoring.


Ontrak, Inc., a
leading AI-powered
and telehealth-enabled,
virtualized healthcare company, today announced that it has acquired
LifeDojo Inc, a comprehensive, science-backed behavior change platform.
Financial details of the acquisition were not disclosed.

Behavior Change Platform for Consumers and Employers

Founded in 2013, LifeDojo is a platform that makes
transformative life changes possible for members in over 16 countries.
Supported by decades of public health research, the LifeDojo approach to
member-centric behavior change delivers lasting health improvement outcomes,
high enrollment, and better engagement than traditional programs. Clients
include Fortune 500 companies and high-tech, high-growth organizations who use
LifeDojo’s 32 behavior change modules.

COVID-19 Spawns Mental Health Surge

The Journal of the American Medical Association (JAMA) this month reported accumulating evidence of a “second wave” mental health surge that will present monumental challenges for an already greatly strained mental health system and individuals at high risk for mental health disorders such as anxiety, depression, and post-traumatic stress. A June 2020 survey from the Centers for Disease Control and Prevention of 5,412 US adults found that 40.9% of respondents reported “at least one adverse mental or behavioral health condition,” including depression, anxiety, posttraumatic stress, and substance abuse, with rates that were three to four times the rates one year ago.

4 Ways LifeDojo Acquisition Advances Ontrak’s Growth
Strategy

With the coronavirus pandemic rapidly increasing demand for
“telemental” health solutions, the acquisition of LifeDojo is expected to
advance the Ontrak growth strategy in four ways:

First, the acquisition adds a technology-first,
digital business deployed by blue chip customers in the employer space.

Second, LifeDojo enhances Ontrak’s market-leading
behavioral health engagement capabilities for new and existing customers, with
the addition of the LifeDojo digital tools that drive member value and lower
cost. The combination of behavioral health coaching and digital app-based
solutions meets accelerated payer demand for a comprehensive suite of
behavioral health services and solutions.

Third, the LifeDojo platform increases the company’s
addressable market by enabling the creation of lower cost, digital
interventions across behavioral health and chronic disease populations.

Fourth, LifeDojo’s member-facing apps enable remote
patient monitoring capabilities, initially focused on member reported data,
that will feed Ontrak AI capabilities and further personalize Ontrak’s
evidence-based coaching.

“As a public company and leader in virtualized healthcare, Ontrak is uniquely positioned to attract companies, products and technologies that expand our value proposition and footprint with health plan and employer partners. We will endeavor to make additional strategic purchases that expand our addressable market and maximize customer value. LifeDojo and these other intended acquisitions can possibly expand our total addressable $33.7 billion market by up to 100%,” said Mr. Terren Peizer, Chairman and CEO of Ontrak.

How is population health innovation unfolding in Louisiana? [Sponsored]

With the annual INVEST Population Health virtual conference coming up November 16-18, here’s a look at our collaboration partner New Orleans Business Alliance. It plays a vital role in helping to stimulate the local economy by supporting the development and advancement of the healthcare and biotech infrastructure.

Priority Health Launches Telehealth PCP Plans for Members in Michigan

What You Should Know:

– Priority Health launches its virtual-first coverage
option with MyPriority Telehealth PCP plans, using top platform Doctor On
Demand.

– Members who choose one of the MyPriority Telehealth PCP
plans will have a doctor assigned as their primary care physician (PCP) through
Doctor on Demand and all visits will take place virtually.


Priority
Health
announced the launch of their new MyPriority Telehealth PCP plans
that will go into effect on January 1, 2021. The new plans are designed for
consumers who are seeking health coverage that is virtual-first and are
comfortable with online interactions with providers. Priority Health is now the
first insurer in Michigan to offer this type of virtual-first product.

How It Works

Members who choose one of the MyPriority Telehealth PCP
plans will have a doctor assigned as their primary care physician (PCP) through Doctor on Demand and all visits will take place
virtually. The member will need a referral from their doctor to seek care in a
traditional office setting with a specialist, as needed. Emergency care does
not have this same restriction.

The new Telehealth PCP plan options, while virtual-first,
still provide members with the same level of comprehensive coverage as a
traditional plan. Members who choose a Telehealth PCP plan will have full
coverage for preventive care and will also have access to added benefits like
reduced copays on prescription drugs, diabetes and chronic condition
management, global emergency assistance through Assist America, and discounted
prices for gym memberships.

Why It Matters

“There is no doubt that telehealth is here to stay. Throughout the COVID-19 pandemic, we have seen a massive and sudden shift in the way health care is typically delivered, and many consumers used virtual care for the first time,” said Carrie Kincaid, Vice President of Individual Markets at Priority Health. “With more and more people realizing that telehealth can be a safe and convenient option for certain types of care, we knew that now was the right time to launch this innovative plan option.”

“This Telehealth PCP plan acts as a primary care doctor, urgent care, behavioral health, preventive health and chronic care provider all with the convenience of being able to seek care from the comfort and safety of home,” Kincaid noted. “We listened to what consumers want, and we are excited to bring this new offering into the market.”

5 Trends Driving The Future of Healthcare Real Estate in 2020 & Beyond

The COVID-19 pandemic has forever changed patient expectations for healthcare delivery, including offered services and health office operations. Although health systems have remained dynamic in adopting telehealth capabilities, their long-term capital, like real estate and supply chain management (SCM) protocols, have not adapted to match these expectations. Health systems must be aware of current trends in both areas to inform their future decisions. 

Divesting in healthcare real estate is also key to reducing unnecessary costs to a health system, especially if optimal use of these spaces is already lacking. The overwhelming costs of ownership and management lock money away in underutilized and obsolete real estate spaces. Divesting provides more capital liquidity, and frees capital to go towards investment in telehealth, diagnostic technology, and emerging specialties, assets that go towards increasing patient and workforce engagement and satisfaction. In addition, eliminating unused real estate assets allows freedom from liabilities and human capital investments, like facility maintenance and upkeep, not to mention the increased frequency of deep cleaning necessary in the post-COVID-19 bi-lateral operations era.

Further, years of mergers and acquisitions in the healthcare industry have left many health systems with the unwanted result of increases in real estate assets. This has led to increased consolidation of these assets, a trend that has been exacerbated by the pandemic pressure on health system funds. Future consolidation and reevaluation of assets should be informed by trends in patient expectations as well as trends in the market.

Here are five emerging trends driving the future of healthcare real estate and assets. Each encourages divestment out of health system real estate ventures or restructuring of existing spaces in order to better cater to forever changed patient expectations.

1. Rise of Telehealth

According to the Department of Health & Human Services, telehealth use is up around 50% in primary care settings since the beginning of the public health emergency and is projected to remain high in the time following. Most recently, in-person visits have increased and as a result, telehealth visits have declined due to the state’s reopening, and thereby some critics posit that this trend may not continue. However, that could not be further from the truth.

Moving forward, despite health system fear regarding long-term reimbursement may be lacking from federal, state, and commercial health plan payers for virtual care delivery, leveraging telehealth to augment traditional healthcare delivery will become a necessity because consumers will demand it and physicians in some studies have shown satisfaction with their video visit platforms. This will no doubt have an impact on office layout and services.

2. Convenience of Outpatient Services

Motivated in part by telehealth utilization, patients seek convenience and accessibility in their healthcare now more than ever. Health system expansion may therefore mean satellite offices in high traffic areas to cater to the patient’s need for accessibility, marking a movement away from the traditional, centralized hospital campuses.

3. Value-Based Care Transitions

As legislation and CMS regulation moves more towards a value-based care system, trends show a natural move towards lower-cost facilities that provide preventive care. These could also contribute to continued trends to more off-campus real estate and planning for alternative care delivery options, for example, mobile vans reaching more vulnerable, at-risk populations for care such as life-saving vaccinations. 

4. Pandemic Precautions

Bilateral operations are likely to be maintained for some time even after more normal operations return, and healthcare real estate, especially with consolidation, will need to accommodate this precaution, and others like it in all locations.

5. Technology

New diagnostic and testing tools are constantly being released, forcing health systems to reevaluate their current assets and make room for new ones which contributes to wasted space. Furthermore, remote monitoring apps will continue to proliferate in the market and become more affordable and accessible to consumers while advancing interoperability standards and federal information blocking requirements will allow information to flow more freely.  

Strategies to Optimize Healthcare Real Estate & Strategy

In order to unlock money trapped in assets, health systems should look to make their assets work better in response to current trends and patient expectations. To accommodate patient demands and changes to health industry regulation and reimbursement, it makes sense to ensure efficient use of all facilities and optimize real estate and assets using the following strategies:

– Divest underutilized assets of any kind: Begin with real estate and move smaller to reduce unneeded capital investment.

– Remove or reduce administrative spaces: Transition non-clinical workforces to partial or complete work from home status, including finance, legal, marketing, revenue cycle, and other back-office functions. Shared space or “hotel” workspaces are popular.

– Reconfigure medical office or temporary care buildings: As these are often empty several days a week, they must be consolidated. 

– Get out of expensive leases for care that can be given remotely or in lower-cost options or by strategic partners: Take full advantage of telehealth capabilities and eliminate offices that have become obsolete. 

Integrate telehealth into real estate only where it makes sense: Telehealth is more applicable to some services and care modalities than others. Offices should reconfigure to meet these novel needs where necessary, even if it means forgoing leases for the near term. 

– Assess other expensive assets: Appraise assets like storage and diagnostic tools. Those not supportive of the new post-COVID-19 care model or prioritized service lines and are otherwise not producing revenues should be sold or outsourced to strategic partners.

– Diversify with off-campus offices: Provide convenient access to outpatient care and new outpatient procedures by investing in outpatient medical offices in high foot traffic locations. 

– Create space for services in high demand: Services like preventive care and behavioral health should be given physical or virtual space in the system to cater to patient needs. 


About Moha Desai

Moha Desai is a Principal of Healthcare Strategy and Transformation where she focuses on driving forward strategic, planning, financial, revenue cycle, operational improvement, and patient engagement healthcare projects for providers, federal government health agencies, and various firms requiring growth, business development, and project implementation and management. She has previously served in leadership roles at Partners HealthCare, Deloitte Consulting, Bearing Point, etc. Moha received her B.A. in Economics and her M.B.A. at Yale University.

Were We Mentally Ready for COVID-19? Why It’s Time to Take Behavioral Health Seriously

Were We Mentally Ready for COVID-19? Why It’s Time to Take Behavioral Health Seriously
Dr. Jacob Lazarovic M.D., IMCS Group

As you read this, over 200,000 American deaths have been attributed to the virus. The influx of cases continues, while state and local economies are experiencing hardship, children are shuttered in their homes learning remotely, grown children are moving back home and the “new normal” disrupts nearly all of life’s plans. 

Yet, these issues don’t reveal all the traumas that Americans are experiencing 10 months into the pandemic. The pandemic’s impact continues to be swift and brutal, showing little sign of slowing down. Loneliness and isolation are gripping many American adults, as the nation settles in for a long fall/winter.

Growing evidence supports the notion that this virus is spread through aerosols, that is, person-to-person transmission by means of inhalation of infectious particles. With the onset of colder weather and the approaching holiday season, conditions are rife for spreading the virus. Flu season is imminent and COVID-19 cases are increasing.

While the safest choice is to isolate until the widespread availability of a vaccine arrives (within the next 6-12 months), this is an unwelcome option for some already suffering from “pandemic fatigue” and not really an option at all for others (like those who work outside the home).

Either way, America’s mental health is at risk. According to the CDC, reports of mental health conditions (anxiety, trauma, substance abuse, suicide) have considerably increased during the pandemic with more than 40% of American adults reporting mental health struggles. Frontline healthcare workers are particularly affected, and over 71% have experienced psychiatric symptoms, including depression, anxiety, insomnia, and distress. Even run-of-the-mill loneliness and isolation contribute to substance misuse and disorders, which, by the way, contribute to an increased risk for COVID-19.


Key Ways Mental Health Providers Can Help  

Because mental health threats are now part and parcel of living amid the COVID-19 pandemic, it is important to routinely gauge the health of those close to you, (and this is paramount for those recovering from COVID-19, frontline workers, and first responders.) Consider consulting a mental health provider if you notice any of these characteristics in yourself or someone you know:

– Displaying frequent, uncharacteristic anger, anxiety, irritation; 

– Withdrawing from friends and family;

– Ignoring personal hygiene;

– Engaging in high-risk activities, such as heavy drinking, illicit drug use, or self-destructive behavior;

– Exhibiting feelings of overwhelming sadness, hopelessness, grief, or worthlessness 

Nearly every American is impacted mentally, financially, and emotionally by the pandemic, and even the fortunate few who aren’t already personally affected are feeling the stress of an uncertain future. Mental health providers aim to improve coping skills, relationships, and self-care regimens to reduce anxiety, depression, or other mental illness. From generalized anxiety to neuropsychology related to recovery from COVID-19, behavioral health specialists are equipped to help in a myriad of ways such as these: 

1. Building resilience by introducing coping and stress tolerance activities, such as mindfulness and meditation, or a simple shift in perspective 

2. Shoring up social connections and relationships to serve as a layer of protection and diffusion from life stress

3. Ensuring self-care activities, such as adequate sleep, diet, exercise, and more to sustain mood and self-esteem

4. Delivering grief and loss counseling for those who have suffered acute human losses during the crisis

5. Counseling for substance abuse and addiction

6. Initiating a short intervention using cognitive behavioral therapy techniques

Those with pre-existing mental health issues, including depression, PTSD, social anxiety, agoraphobia, generalized anxiety and major depression, may benefit from an increased intensity in treatment, by frequency or duration.

For survivors of COVID-19 who have had significant cardiac and respiratory complications including prolonged periods of dyspnea (shortness of breath), hypoxemia (decreased blood oxygen levels), and hypoxia (decreased oxygenation of organs), neurocognitive screening and ongoing monitoring of mental status will be helpful.


Advances in Telemedicine 

Recent advances in computer-administered neurocognitive testing have allowed

clinicians to administer psychological and neurocognitive assessment instruments by telemedicine, and there are now many more neurocognitive assessment batteries available to aid in the detection and quantification of neuropsychological functional deficits.

Historically, psychologists, psychiatrists, and L.C.S.W.s have not done virtual sessions with patients, but COVID is changing that, and increasingly insurers are receptive to this practice. The technology, capability, and compliance aspects of virtual appointments were available prior to 2020, but COVID has brought “distance meeting” into the American vernacular. Medical doctors now treat patients via telehealth in numerous instances, and mental health patients can be treated using similar meeting applications.

Telebehavioral health could not be more timely. In the fight against isolation, virtual technology allows human beings to check on one another and meaningfully connect, at the same time allowing people seeking mental health services to receive treatment safely without risking infection from a devastating disease.  

Even as the pandemic presents a common threat like none other we have faced in recent years, it also offers us the opportunity to reach out and check on one another. Everyone is affected in some way by COVID-19, be it the disease itself or simply disruption to our routines and mass anxiety. It’s definitely time to take mental health seriously. Our technology ensures that we do not have to be alone in isolation, and relief may be just a call away. Through mutual understanding and effort, we can focus on the unifying experience of overcoming this crisis.


About Dr. Lazarovic

Dr. Lazarovic, M.D., F.A.A.F.P., has nearly 40 years of medical administration/managed care experience, including 18 years as Chief Medical Officer at Broadspire/CRAWFORD, a global third-party administrator of workers’ compensation, disability, auto and medical product liability claims. Experienced in clinical guidelines, medical cost control and strategic planning, Dr. Lazarovic has conducted and published original research and analytics and presented at multiple industry conferences. Dr. Lazarovic is currently the CMO responsible for the development of advanced, evidence-based clinical applications at MyAbilities Technologies, a medical software and services company in the workers’ compensation and disability sector.  


Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

What You Should Know:

– Humana Inc. and Fresenius Medical Care North America
(FMCNA) today announced an agreement to broaden their collaboration toward
improving the health of eligible Humana Medicare Advantage members

The
agreement between Humana and Fresenius Medical Care North America goes into
effect Jan. 1, 2021.


Humana Inc. and leading renal care company Fresenius Medical Care North America (FMCNA) announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage and commercial members with chronic kidney disease (CKD) and end-stage renal disease (ESRD) through more coordinated, holistic care.

The expanded partnership is in keeping with the goals
outlined in the 21st Century Cures Act, which enables people with ESRD to
enroll in Medicare Advantage Plans, and with federal initiatives that call for earlier diagnosis and
treatment of kidney disease; a reduction in the number of Americans developing
ESRD; and support for patient treatment options such as home dialysis or kidney
transplant as applicable.

The agreement between
Humana and Fresenius Medical Care North America goes into effect Jan. 1, 2021,
and encompasses the following:

Expanded Availability of Care Coordination Services:
FMCNA currently provides specialized care coordination services for Humana
members with CKD in three states: Iowa, Kentucky, and North Carolina. The
agreement expands the availability of these services to eligible Humana members
in an additional 39 states, with the goals of improving quality of life and
health outcomes, increasing access to care and minimizing care gaps, slowing
disease progression and lowering hospitalization rates, and reducing the cost
of care.

FMCNA’s care coordination services include early detection of CKD to slow
disease progression; medication reviews and regimen adherence guidance;
behavioral health screenings; nutritional counseling; strategies for managing
multiple comorbidities; education about – and support for – home dialysis
treatment when applicable and beneficial to the patient; transplant education;
and palliative care.

FMCNA partners with InterWell Health, a physician-led population health
management company working to improve clinical outcomes and lower medical costs
through its network of over 1,100 nephrologists across the country.

Transitional Care Units: These units are
designed to help people recently diagnosed with kidney failure learn about
treatment options available to them – including transplant and home dialysis –
and be more empowered in managing their own care. Transitional Care Units may be either a space within a
dialysis center or a standalone facility, offering comprehensive, hands-on
education from dedicated staff that is individualized for each patient. This
includes the importance of renal nutrition, medication adherence, and vascular
access care; assisting patients transitioning between modalities (e.g., from
in-center dialysis to home dialysis); and supporting individuals returning to
dialysis from transplant. The agreement is intended to locate Transitional Care
Units in select areas where Humana has significant Medicare Advantage
membership.

Value-Based Agreement: The expanded
collaboration also improves upon the parties’ existing clinic network contract,
which provides eligible Humana Medicare Advantage and commercial members with
ESRD access to dialysis at more than 2,600 centers of Fresenius Kidney Care, the dialysis services division of
Fresenius Medical Care North America. By implementing a value-based payment
model for in-center and home dialysis services and at Transitional Care Units,
as well as for CKD care coordination services, compensation will be based on
meeting agreed-upon quality improvement and patient outcome goals, and reducing
overall costs to the system.

Why It Matters

Value-based renal care is aligned with the objectives of
CMS’s recently-released End
Stage Renal Disease Treatment Choices (ETC) Model
, which encourages
increased adoption of home dialysis and greater access to kidney transplants.

Individuals with CKD have kidneys that do not filter blood
properly, which causes waste and fluid levels that can be dangerously high. CKD
and ESRD affect a wide spectrum of the population but the degree of impact is
not uniform. For example, kidney failure rates among Black Americans are about
three times that of white Americans. In total, approximately 15% of American
adults, or about 37 million people, have CKD, but many are unaware of their
condition. CKD management is complex, and failure to appropriately manage the
condition may cause considerable symptoms and worsening health outcomes,
including ESRD.

This agreement represents an evolution of our work with
Humana and leverages our over 10 years of industry leadership in value-based
care,” said Bill Valle, Fresenius Medical Care North America’s Chief Executive
Officer. “Our scale, integrated nephrology network, and standardized clinical
interventions and protocols uniquely position us to predictably and
consistently improve health outcomes and reduce overall costs. We welcome this
opportunity to offer more coordinated, holistic care to Humana’s members, with
a keen focus on education, comorbidity management, early detection, and
treatment options, including home dialysis. This approach also helps eliminate
barriers to keep renal disease treatment uninterrupted for at-risk
populations.”

Digital Behavioral Health: Addressing The COVID-19 Behavioral Health Crisis

digital behavioral health and addressing the COVID-19 behavioral health crisis
Victor Siclovan, Director of Medicaid Transformation Project at AVIA

Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these pernicious trends on overall mental health will take time. However, precedents like the Great Recession suggest that these trends are likely to worsen the conditions driving suicide and substance-related deaths, the “deaths of despair” that claimed 158,000 lives in 2017 and contributed to a three-year decline in US life expectancy among adults of all racial groups.

Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 2018 data showed that only 43% of adults with mental health needs, 10% of individuals with SUD, and 7% of individuals with co-occurring conditions were able to receive services for all necessary conditions. 

The treatment gap is staggering, and COVID-19 is exacerbating it: an estimated 45% of adults report the pandemic has negatively impacted their mental health, to say nothing of the disruption of essential in-person care and services. In a similar vein, a recent CDC report has highlighted the staggering and “disproportionately worse mental health outcomes, [including] increased substance use, and elevated suicidal ideation” experienced by “younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.”

Consistent with the CDC report’s findings, the crisis can be felt most acutely by the very workforce that must deal with COVID-19 itself. Hospitals, health systems, and clinical practices – together with other first responders – comprise the essential front line. They bear the burden of their employees’ stress and illness, and must also cope with the many patients who present with a range of mental illnesses and substance use disorder (SUD).

But providers don’t have to face this burden alone: numerous behavioral health-focused digital solutions can support providers in meeting their most urgent needs in the era of COVID-19. Many of these solutions have made select services available for free or at a discount to healthcare providers in recognition of the immense need and challenging financial circumstances. Some solutions also help systems take advantage of favorable, albeit time-sensitive, conditions, enabling them to lay the foundation for broader behavioral health initiatives in the long term. Several of these solutions are described below, in the context of three key focus areas for health systems.

Focus Area 1: Supporting the Frontline Workforce 

Health system leaders need to keep their workforces healthy, focused, and productive during this period of extreme stress, anxiety, and trauma. Providing easily accessible behavioral health resources for the healthcare workforce is therefore of paramount importance.

Health systems should consider providing immediate, free access to behavioral health services to employees and their families and consider further extending that access to first responders, other healthcare workers, and other essential services workers in the community.

Many digital product companies are granting temporary access to their services and are expanding their offerings to include new, COVID-19-specific modules, resources, and/or guidance at no cost. 

Fortunately, the market is rife with solutions that have demonstrated effectiveness and an ability to scale. However, many of these rapidly-scalable solutions are oriented toward low-acuity behavioral health conditions, so it is important that health systems consider the unique needs of their populations in determining which solution(s) to adopt.

The following are several solutions to consider:

Online CBT solutions. These tools are being used to expand access to lower-acuity behavioral health services, targeting both frontline workers and the general population. MyStrength, SilverCloud and others have deployed COVID-19-specific programming.

Text-based peer support groups. Organizations are using Marigold Health to address loneliness and social isolation in group-based chat settings, one-on-one interactions between individuals and peer staff, and broader community applications.

Focus Area 2: Maintaining Continuity of Care 

As the pandemic continues to ripple across the country, parts of the delivery system remain overwhelmingly focused on containing and treating COVID-19. This can and has led to the disruption of care and services, of particular significance to individuals with chronic conditions (e.g., serious mental illness (SMI) and SUD), who require longitudinal care and support. Standing up interventions — digital and otherwise — to ensure continuity of care will be critical to preventing exacerbations in patients’ conditions that could drive increased rates of ED visits and admissions at a time when hospital capacity can be in short supply.

In the absence of in-person care, many digital solutions are hosting virtual recovery meetings and providing access to virtual peer support groups. Additionally, shifts in federal and state policies are easing restrictions around critical services, including medication-assisted treatment (e.g., buprenorphine can now be prescribed via telephone), that can mitigate risky behavior and ensure ongoing access to treatment. 

The use of paraprofessionals has also emerged as a promising extension of the historically undersupplied behavioral health treatment infrastructure. Capitalizing on the rapid expansion of virtual care, providers should consider leveraging digital solutions to scale programs that use peers, community health workers (CHWs), care managers, health coaches, and other paraprofessionals, to reduce inappropriate hospital utilization and ensure patients are navigated to the appropriate services.

The following are several solutions to consider:

Medication-assisted therapy (MAT) via telemedicine. These solutions provide access to professionals who can prescribe and administer MAT medications, provide addiction counseling, and conduct behavioral therapy (e.g., CBT, motivational interviewing) digitally. Solution companies providing these critical services include Eleanor Health, PursueCare, and Workit Health.

Behavioral health integration. Providing screening, therapy, and psychiatric consultations in a variety of care settings — especially primary care — will help address the increased demand. Historically, providers have had difficulty scaling such solutions due to challenging reimbursement, administrative burden, and stigma, among other concerns. Solutions like Valera Health and Concert Health were created to address these challenges and have seen success in scaling collaborative care programs.

Recovery management tools for individuals with SUD. WEConnect Health and DynamiCare Health are both offering free daily online recovery support groups.

Focus Area 3: Leveraging New Opportunities to Close the Treatment Gap

As has been widely documented, the pandemic has spurred unprecedented adoption of telehealth services, aided by new funding opportunities (offered through the CARES Act and similar channels) and the widespread easing of telehealth requirements, including the allowance of reimbursement for audio-only services and temporarily eased provider licensure requirements.

Tele-behavioral health services are no exception; the aforesaid trends ensure that what was one of the few high-growth areas in digital behavioral health before the pandemic will remain so for the foreseeable future. This is unquestionably a positive development, but there is still much work to be done to close the treatment gap. Critically, a meaningful portion of this work is beyond the reach of the virtual infrastructure that has been established to date. For example, there remains a dearth of solutions that have successfully scaled treatment models for individuals with acute illnesses, like SMI or dual BH-SUD diagnoses.

Health system leaders should continue to keep their ears to the ground for new opportunities to expand their virtual treatment infrastructure, paying particular attention to synergistic opportunities to build on investments in newly-developed assets (like workforce-focused solutions) to round out the continuum of behavioral health services. 

COVID-19 has all but guaranteed that behavioral health will remain a major focus of efforts to improve healthcare delivery. Therefore, health systems that approach today’s necessary investments in behavioral health with a long-term focus will emerge from the pandemic response well ahead of their peers, having built healthier communities along the way.


About Victor Siclovan

Victor Siclovan is a Director on the Medicaid Transformation Project at AVIA where he leads work in behavioral health, chronic care, substance use disorder, and Medicaid population health strategy. Prior to AVIA, Victor spent nearly 10 years at Oliver Wyman helping large healthcare organizations navigate the transition to value-based care. He holds a BA in Economics from Northwestern.


Addressing behavioral health challenges for patients and employees: Video from MedCity INVEST Digital Health

mental health, face, human

In the latest video installment from INVEST Digital Health Virtual, a panel looks at behavioral health from the loneliness epidemic, workplace stress, and other challenges and the innovative tools developed to address these needs.

Accounting for the Social Determinants of Health During the COVID-19 Pandemic

Accounting for the Social Determinants of Health During the COVID-19 Pandemic
Andy Aroditis, CEO, NextGate

The COVID-19 pandemic is not just a medical crisis.  Since the highly contagious disease hit American shores in early 2020, the virus has dramatically changed all sectors of society, negatively impacting everything from food supply chains and sporting events to the nation’s mental and behavioral health.

For some people, work-from-home plans and limited access to entertainment are manageable obstacles.  For others, the shuttered schools, lost wages, and social isolation spell disaster – especially for individuals already living with socioeconomic challenges.

The social determinants of health have always been important for understanding why some populations are more susceptible to increased rates of chronic conditions, reduced healthcare access, and shorter lifespans.  COVID-19 is throwing the issue into high relief.

Now more than ever, healthcare providers need to gain full visibility into their populations and the non-clinical challenges they face in order to help individuals maintain their health and keep their communities as safe as possible during the ongoing pandemic.

Exploring correlations between socioeconomic circumstances and COVID-19 vulnerability

Clinicians and researchers have worked quickly to identify patterns in the spread of COVID-19.  Early results have emphasized the danger posed by advanced age and preexisting chronic conditions such as obesity, diabetes, and heart disease. 

Further, data from the Johns Hopkins University and American Community Survey indicates that the infection rate in predominantly black counties is three times higher than in mostly white counties. The death rate is six-fold higher.

Data from the Centers for Medicare and Medicaid Services (CMS) confirms the trend: black Medicare beneficiaries are hospitalized at a rate of 465 per 100,000 compared to just 123 per 100,000 white beneficiaries. Hispanic Medicare beneficiaries had 258 hospitalizations per 100,000, more than double the white population’s hospitalization rate.

Researchers suggest that the social determinants of health may be largely responsible for these disconnects in infection and mortality rates.  Racial, ethnic, and economic factors are strongly correlated with increased health concerns, including longstanding disparities in access to care, higher rates of underlying chronic conditions, and differences in health literacy and patient education.

Leveraging data-driven tools to identify vulnerable patients

Healthcare providers will need to take a proactive role in identifying which of their patients may be at enhanced risk of contracting the virus and experiencing worse outcomes from the disease.  

They will also need to ensure that person gets adequate treatment and participate in contact tracing efforts after a positive test.  Lastly, providers will have to ensure their public health reporting data is accurate to inform local and regional efforts to contain the disease.

The process begins by developing confidence in the identity of each individual under the provider’s care.  Healthcare organizations often struggle with unifying multiple electronic health record (EHR) systems and other health IT infrastructure, resulting in medical records that are incomplete, inaccurately duplicated, or incorrectly merged.

Access to current and complete medical histories is key for highlighting at-risk patients.  An enterprise master patient index (EMPI) can provide the underlying technical foundation for initiating this type of population health management.  

EMPIs help organizations create and manage reliable unique patient identifiers to ensure that records are always associated with the correct individual as they move throughout the healthcare system.

When paired with claims data feeds, health information exchange (HIE) results, and interoperability connections with other healthcare partners, EMPIs can bring a patient’s complete healthcare status into focus.

This approach ensures that providers stay informed about past and present clinical issues and service utilization rates.  It can also support a deeper dive into the social determinants of health.

Combining EHR data with standardized data about socioeconomic needs can help providers develop more comprehensive and detailed portraits about their patients’ holistic health status.  

By including this information in EHRs and population health management tools, providers can develop condition-specific registries to guide outreach activities.  Providers can deploy improved care management strategies, close gaps in care, and connect individuals with the resources they need to stay healthy.

Healthcare organizations can acquire socio-economic data about their communities in a variety of ways, including integrating public data sources into their population health management tools and collecting individualized data using standardized questionnaires.

Once providers start to understand their patients’ non-clinical challenges, including the ability to avoid situations that may expose them to COVID-19, they can begin to prioritize patients for outreach and develop personalized care plans.

Conducting effective outreach and interventions for high-needs patients

COVID-19 has taken a staggering economic toll on many families, including those who may have been financially secure before the pandemic.  Routine healthcare, prescription medications, and even some urgent healthcare needs are often the first to fall by the wayside when finances get tight. 

Healthcare providers have gotten creative about staying connected to patients through telehealth, drive-in consults, and other contactless strategies.  But they must also ensure that their vulnerable patients are aware of these options – and that they are taking advantage of them.

Contacting a large number of patients can be challenging since phone numbers, emails, and home addresses change frequently and are prone to data entry errors during intake. Organizations with EMPIs can leverage their tools to ensure contact information is up to date, accurate, and associated with the correct individual.

Care managers should prioritize outreach to patients with complex medical histories and known clinical risks for vulnerability to COVID-19.  These conversations are a prime opportunity to collect social determinants of health information or refresh existing data profiles.

Looking to the future of healthcare in a COVID-19 world

Combining technology-driven strategies with targeted outreach will be essential for healthcare organizations aiming to provide holistic support for their populations during – and after – the COVID-19 pandemic.

By developing certainty about patient identities and synthesizing that information with data about the social determinants of health, providers can efficiently and effectively connect with their patients to offer much-needed resources.

Taking a proactive approach to addressing the social determinants of health during the outbreak will help providers maintain relationships with high-needs patients while building new connections with those facing unanticipated challenges.

With a combination of population health management strategies and innovative technology tools, healthcare providers and public health officials can begin to view the social determinants of health as a fundamental component of the fight against COVID-19


Andy Aroditis, is CEO of NextGate, the global leader in healthcare enterprise identification.

Why Hasn’t A More Holistic Approach to Patient Care Become The Norm?

Why Holistic Healthcare Is Worth the Cost

When food production technology made it possible, wheat flour processors started to eliminate the tough exterior (bran) and nutrient-rich core (germ) of the kernel to get at the large, starchy part (the endosperm) only. The bread produced from this process is white and fluffy, and it makes great PB&Js and takes forever to grow mold, but it is almost totally lacking nutritional value.

Nutrition experts eventually pointed this out, of course, after which commercial bakers tried fortifying their bread by adding back essential nutrients stripped out by processing. It didn’t work. While white bread from refined flour is still available, nutrition experts strongly recommend whole grain products as the healthier alternative.

Opposition to this reductionist approach to nutrition is perhaps best captured by the idea of the sum being the whole of its parts: If inputs are lacking, the end result will fall short also.

Each human being is also a sum of parts, and the reductionist approach to healthcare is essential when it comes to advancing many aspects of medicine and healthcare.

“Historically, the invention of the microscope, the defining of Koch’s four infectious disease postulates, the unraveling of the human genome, and even intelligent computers are salient examples of the dramatic benefits of biomedical reductionism,” explained Dr. George Lundberg.

These successes, however, may have convinced many in both the medical community and society at large that reductionism is a necessary, if not sufficient, approach. The numbers say otherwise.

“Classical medical care interventions contribute only about 10 percent to reducing premature deaths compared to other elements such as genetic predisposition, social factors, and individual health behaviors,” Lundberg goes on to say. “Most contemporary medical researchers have concluded that the chronic degenerative diseases of modern Western humans have multiple contributory causes, thus not lending themselves to the single agent-single outcome model.”

Paging Dr. House. It turns out your particular form of genius just isn’t frequently that useful.

And nowhere is the single agent-single outcome model arguably less effective than in behavioral health and chronic disease management. What many in medicine and healthcare now realize is that a vicious cycle of alternating physical and mental ailments are the norm with both chronic illness and long-term mental health challenges.

“Depression and chronic physical illness are in a reciprocal relationship with one another: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses,” says Professor David Goldberg of the Institute of Psychiatry in London.

It’s an unsurprisingly intuitive conclusion to reach. A man with depression lacks the desire to eat well, exercise, often practice necessary daily hygiene. As his untreated depression deepens, his physical health declines as well. A woman with chronic, untreated pain feels like it will never end and her life is over. Faced with a seemingly unmanageable challenge, she falls into a funk that eventually metastasizes into full-blown depression.

A reductionist approach to these scenarios might be to encourage more exercise or prescribe antidepressants. While both are necessary, neither will likely be sufficient.

So why hasn’t a more holistic approach to patient care become the norm? In a nutshell, because it’s expensive. Chronic illnesses, generally, are the most expensive component of healthcare.

According to a New England Journal of Medicine study, patients “with three or more chronic conditions (43 percent of Medicare beneficiaries) account for more than 80 percent of Medicare health care costs.”

For this expensive, highly at-risk group, holistic care is what actually works.

The NEJM articles conclude that “an intervention involving proactive follow-up by nurse care managers working closely with physicians, integrating the management of medical and psychological illnesses, and using individualized treatment regimens guided by treat-to-target principles improved both medical outcomes and depression in depressed patients with diabetes, coronary heart disease, or both.”

Of course, the regimen included in the NEJM study is expensive—perhaps more so than what qualifies as holistic care now.

But it requires a certain type of twisted logic to argue for holding down costs by rationing care inputs—by reductively treating only just the most obvious health concerns—when this approach invariably leads to readmissions, more office visits, more disability payments, more days of work missed.

Indeed, a reductive approach to accounting—silos of financial impact across the continuity of a life lived—hides the fact that specific healthcare costs are not alone the measure of how chronic illness detracts from both individual life satisfaction and broader societal efficiencies.

The key, then, is to make holistic health both the norm and affordable. How can that be done? By creating initiatives designed to achieve a core set of goals:

Incentivize primary care: In the last two decades, the number of primary care providers (PCPs) available to patients in the United States has decreased by about 2 percent. This may not sound like a lot, but the decline comes as the population has increased, naturally, which means fewer patients have a PCP. As healthcare shifts to pay for performance, not services, the PCP is the natural quarterback of patient care. The country needs many more PCPs, not fewer, and the federal government has an opportunity to use loan forgiveness incentives and other tools to nudge medical school students in that direction.

Embrace technology: Arguably, holistic care only became possible with the digital age. Chronic disease management requires frequent measurement of patient vitals, which is very expensive without wearables and similar digital age technologies. Now, patients can regularly provide data with no clinical intervention, that data can automatically upload to an electronic health record, and that EHR can alert the clinician when results are alarming.

Make poor choices expensive: Perhaps only because smoking has become so socially unacceptable can the cost of cigarettes be so high ($7.16 per pack in Chicago with all taxes) without creating significant protests. But the data is clear that higher costs equal fewer smokers. The same types of behavioral economics programs can also apply to fast food, soda, etc. Yes, people will get upset and complain about the nanny state, but absent some attempt to change behavior, we may want to consider changing the name to the United States of Diabetes.

Reward smart choices: Healthy people use healthcare and insurance less often, which drives down costs. Duh. Combining technology and incentives (avoiding diabetes), Utah’s Intermountain Healthcare engaged almost 1,500 pre-diabetic employees in a program through Omada Health that collectively yielded 9,162 pounds lost. Omada billed Intermountain based on the level of success, and without speaking to specific numbers, Intermountain felt the cost of the program was a wise investment when compared with the costs of diabetes treatment.

These four bullets are probably just the most obvious suggestions, of course. They don’t account for the complexities of the American healthcare system focused on payment models, the profit motive, or what to do with the uninsured, homeless, and devastatingly mentally ill.

But the benefits of holistic thinking when reductionism is inadequate applies to both individual care and the healthcare system as a whole. Public health, for example, takes a holistic approach to communities by looking at how housing, transportation, and education impact general overall health. Where this approach is done well, the benefits are obvious.

Reductionist isolation will always be necessary when identifying specific genes or determining which natural elements are effective in treating disease. But it’s wise to always bring the right tools for the job.

Lyra Health Reaches $1.1B Valuation After $110M Series D to Meet Demand for Teletherapy

Lyra Health Reaches $1.1B Valuation After $110M Series D to Meet Demand for Teletherapy

What You Should Know:

– Mental health benefits provider Lyra Health raises $110M
in Series D funding, bringing its valuation to $1.1 billion.

– Lyra has grown significantly in 2020. So far this year,
the company has added more than 800,000 new members to the population eligible
to receive Lyra benefits, bringing its total member population to more than 1.5
million. 

– Amid, the COVID-19 pandemic, Lyra is focused on
expanding its enhanced teletherapy offering — Lyra Blended Care — which pairs
video therapy sessions with personalized digital lessons and exercises based on
Cognitive Behavioral Therapy (CBT) principles.


Lyra
Health
, a Burlingame, CA-based provider of mental healthcare benefits for
employers, today announced a Series D financing round of $110 million. Addition
led the round and was joined by Adams Street Partners and existing investors,
including Starbucks chairman emeritus and former CEO Howard Schultz, Casdin
Capital, Glynn Capital, Greylock Partners, IVP, Meritech Capital Partners,
Providence Ventures, and Tenaya Capital. This financing enables Lyra to invest
more aggressively in innovative, tech-enabled mental health treatments; to
partner with more customers; and to expand and diversify its high-quality
provider network.

Accessing and receiving mental healthcare is notoriously
challenging for many Americans today. Cost, social stigma, and navigating the
mental health system make it daunting for individuals to get the care they need.
In addition, only a small fraction of therapists in traditional health plans
are practicing proven methods and accepting new patients.

Founded in 2015, Lyra connects employees to high quality, effective mental health providers, and gives employees the flexibility of in-person care, live video therapy, and digital self-care tools. Lyra’s therapists only practice evidence-based therapies, like Cognitive Behavioral Therapy (CBT), and are available for appointments in just a few days.

Expanded Teletherapy Offering

The company is also focused on expanding its enhanced
teletherapy offering — Lyra Blended Care — which pairs video therapy sessions
with personalized digital lessons and exercises based on Cognitive Behavioral
Therapy (CBT) principles. Lyra Blended Care provides a scalable, tech-enabled
solution optimized for better care quality and clinical outcomes. In July, new
peer-reviewed Lyra research was published demonstrating the effectiveness
of this treatment program for clients with depression and anxiety. The company
plans to continue the expansion of Blended Care to serve Lyra members —
including couples and adolescents — who are experiencing a range of mental
health challenges. Lyra’s solution offers a simple and supportive member
experience, ensures immediate access to care, and prioritizes fast and durable
symptom improvement.

Why It Matters

American workers are experiencing a surge in mental health
challenges as they grapple with historic adversity amid the COVID-19 pandemic,
economic uncertainty, and a national reckoning with racial injustice. Arecent
study
 led by Lyra Health and the National Alliance of Healthcare
Purchaser Coalitions found that 83 percent of U.S. employees today are
experiencing mental health issues.

“Whether you’re dealing with a preexisting mental health condition that has intensified or new symptoms that have arisen during the pandemic, these are challenging times for many people. We are proud to support employers that are prioritizing mental health and will use this new funding to help even more organizations support the mental health and well-being of their most important asset — their people,” said David Ebersman, Lyra Health CEO and co-founder

Recent Traction/Milestones

Lyra has grown significantly in 2020. So far this year, the company has added more than 800,000 new members to the population eligible to receive Lyra benefits, bringing its total member population to more than 1.5 million. Lyra also is on track to surpass a milestone this month by delivering the one-millionth session of care through its exceptional provider network. In the last several months, leading employers in the retail, tech, energy, financial services, and the food and agriculture industries — including Morgan Stanley, Asurion, and Zoom Video Communications — have stepped up to prioritize workforce mental health by partnering with Lyra to offer employees immediate access to proven, evidence-based care from thousands of Lyra providers nationwide. This financing, on top of the Series C round completed earlier this year, positions Lyra to take advantage of the burgeoning market opportunity and the urgent need for better mental health solutions.

Boarding Appointments

The company also announced the addition of Kerry Chandler to its Board of Directors. Chandler is Chief Human Resources Officer at Endeavor, a global entertainment, sports, and content company, and she previously served as a senior executive at Under Armour; Christie’s; the National Basketball Association; ESPN; and ESPN’s parent, The Walt Disney Company. She has also served in human resources leadership roles of increasing responsibility at IBM, Motorola, Exxon, and McDonnell Douglas. Chandler brings an extensive background in human resources operations, strategy, and executive leadership.

Led by Mount Sinai, Trellus Health Nabs $5M for Precision Platform for Complex Chronic Conditions

Led by Mount Sinai, Trellus Health Nabs $5M for Precision Platform for Complex Chronic Conditions

What You Should Know:

– Trellus Health secures $5M in seed funding and
collaborates with Mount Sinai to deliver resilience-driven, connected care,
integrating expert clinical and behavioral health for better outcomes.

– The first disease Trellus will tackle is IBD, which is
one of the costliest chronic conditions with a high mental health burden.


Trellus Health, a New York City-based provider of resilience-driven care for people with complex chronic conditions, announced it has raised $5 million in seed funding to transform the way chronic conditions are treated, with an initial focus in Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis. The seed round was led by Mount Sinai Health System (MSHS) and EKF Diagnostics, a global medical manufacturer of point-of-care and central lab devices and tests. Trellus has also entered into an exclusive multi-year contract with MSHS to commercialize its patent-pending GRITT-IBDTM resilience assessment and personalized treatment methodology.

What Is Resilience-Driven Care?

Resilience-driven care incorporates positive psychology
principles into all aspects of chronic disease management, with a focus on
building acceptance, optimism, self-regulation, self-efficacy, and social
support. Proven health benefits of resilience include increased longevity,
cardiovascular, immune, and cognitive function, as well as physical well-being
and reduced risk for depression and anxiety.

Platform for Complex Chronic Conditions, Starting with
IBD

Through its multidisciplinary connected care platform,
Trellus coordinates expert whole-person care, including both clinical and
behavioral health, to improve outcomes and to reduce healthcare costs for
patients, employers, and the healthcare system. The Company leverages its
patent-pending GRITT-IBDTM resilience assessment and personalized treatment
methodology, developed at the Mount Sinai Health System, to support patient
resilience and wellness for better outcomes.

Key features of the platform include:

– Convenient telehealth interactions are coordinated with
in-person visits with local GI providers trained on the latest guidelines for
IBD diagnosis, therapy and medications

– Experienced professional health care team provides care
and coaching to build resilience and help prevent flare-ups with personalized
care plans for symptoms, triggers and lifestyle needs

– 24/7 access to digital tools for expert IBD management,
stress relief, nutrition, and continuous remote monitoring

Why It Matters

According to the CDC, 90% of the U.S.’s $3.3 trillion annual
health care expenditure is for chronic diseases and mental health conditions
with patients suffering from both chronic and mental health conditions costing
twice as much. Despite this, traditional care models fail to address the mental
health aspect of chronic conditions, and access to expert interdisciplinary
care resources to deliver specialist-level care is highly limited. 

The first disease Trellus will tackle is IBD, which is one
of the costliest chronic conditions with a high mental health burden. It
affects 3 million patients in the U.S. (7 million globally) and costing the
U.S. healthcare system over $51 billion a year, according to the ‘Cost of
Inflammatory Bowel Disease: An Initiative from the Crohn’s & Colitis
Foundation 2019.’ Since 2016, the company’s co-founders, Marla Dubinsky,
MD, and Laurie Keefer, PhD, who together bring close to 50 years of experience
managing IBD and serve as co-directors of the Mount Sinai IBD Medical Home,
have integrated resilience-driven multi-disciplinary care into the management
of IBD patients.

“Our research on over 200 IBD patients indicates that more than 70% believe their condition would be better managed if they had support for anxiety or depression,” said Dubinsky, who along with being a co-founder and board member, is also a Professor of Pediatrics and Medicine, Chief of Division of Pediatric Gastroenterology and co-director of Susan and Leonard Feinstein IBD Clinical Center at Mount Sinai. “By personalizing care to address the psychosocial needs of all IBD patients and applying the latest evidence-based clinical approaches, we can help patients achieve disease control and enjoy a significantly improved quality of life.”

Brightline Raises $20M for Virtual Pediatric Behavioral Health Platform

Brightline Raises $20M for Virtual Pediatric Behavioral Health Platform

What You Should Know:

– Brightline raises $20 million to bring its virtual behavioral
healthcare platform to kids and families across California and beyond.

– Brightline delivers integrated care through innovative
technology, virtual behavioral health services, and a collaborative care team
focused on supporting children across developmental stages and their families.


Brightline, a
Palo Alto, CA-based provider of technology-enabled pediatric behavioral healthcare,
announced it has raised $20M in Series A funding led by Threshold Ventures and
previous investor Oak HC/FT. Leading healthcare organizations Blue Shield of
California, Blue Cross Blue Shield of Massachusetts, and Boston Children’s
Hospital joined the round, as well as SemperVirens VC, Rock Health, and City
Light Capital. In addition, the company announced the expansion of its telehealth
services to children and families across the State of California, with
additional states coming soon.

Science-Backed Treatment

Founded in 2019, Brightline is reinventing behavioral health
care for children and families. Brightline’s treatment programs are grounded in
proven clinical methods and designed to track progress and move children
forward in their care. Their virtual behavioral health services available now
include:

● Behavior therapy with child and adolescent psychologists
and clinical social workers

● Psychiatry evaluation and medication support, in
combination with therapy

● Speech-language therapy

● Coaching support and training for parents

● Free clinician-led classes for parents

● Digital treatment programs families can use between
appointments

● Mobile app to make it all easier

Recent Traction

The round follows exciting news earlier this summer about
Brightline’s decision to launch four months ahead of schedule to bring urgently
needed telehealth services (including behavior therapy, psychiatry,
speech-language therapy, coaching support, and more) to families feeling the
overwhelming impact of a global pandemic on their kids. Brightline plans to use
the funds primarily to enhance its technology and innovations, expand
telehealth capabilities and treatment programs, and grow the team to support
children and families across the country.

We need behavioral health and developmental support for kids and their families more than ever,” said Naomi Allen, Brightline CEO and co-founder. “Bringing strong new investors and strategic partners into the Brightline family allows us to continue innovating on our breakthrough model of integrated clinical teams, coaching support for parents, and care through telehealth and our mobile app for families when they need it most. We’re thrilled to have an exceptional Series A investment to continue building a brighter future for families.”

Genesis Health Taps Bright.md to Power New Telehealth Offering

Genesis Health Taps Bright.md to Power New Telehealth Offering for Patients

What You Should Know:

– Genesis Health System has signed a partnership agreement
with Bright.md to offer patients in the Quad Cities of Iowa and Illinois access
to its Bright.md’s SmartExam solution.

– The new virtual care offering offers an affordable way to get care for hundreds of low-acuity conditions, mental health, urinary tract infections, and upper respiratory infections including the flu and COVID-19. 


Genesis Health System, today
announced it has selected Bright.md’s SmartExam solution to power its new telehealth offering
as part of an effort to expand its digital health strategy. Patients in the
bi-state region of the Quad Cities metropolitan area and the surrounding
communities of Iowa and Illinois will now have access to another convenient,
affordable way to get care for hundreds of low-acuity conditions.

How SmartExam Works

Bright.md’s care-delivery platform, SmartExam, works like a virtual physician’s assistant. The AI-powered platform automates 90% of a primary or urgent care visit, boosting provider efficiency 15x and increasing the capacity to treat hundreds of patients in a single provider shift. Healthcare systems use SmartExam to deliver treatment for hundreds of conditions, such as flu, pediatrics, dermatology, muscular-skeletal, and behavioral health issues.

By intelligently and automatically combining patient-intake data, interview information, electronic health records, and clinical-workflow integration, the platform enables providers to rapidly diagnose and treat patients with low-acuity conditions, escalating those with more serious conditions to a higher level of care.

Why It Matters

“Demand for virtual care options was growing even before people around the country were asked to stay home due to COVID-19,” said Dr. Kurt Andersen, Senior Vice President, Physician Operations/Chief Medical Officer President of Genesis Health System. “With Bright.md’s innovative telehealth delivery platform and our umbrella of convenient care services, we’re well-positioned to address the situation at hand—for both coronavirus-infected patients and those with other conditions—and be prepared to serve the needs of our patients in a post-COVID-19 landscape.”

The pandemic has shone a light on digital health and in particular telehealth. $5.4 billion has been invested in the digital health sector this year, and analysts predict that telehealth appointments could top $1 billion by year-end. Increased demand for virtual care solutions is fueling this funding frenzy. 

Genesis has offered virtual video visits with their providers since 2015. However, Dr. Andersen and his team recognized the demand for more innovative telehealth tools to complement their current convenient care of services, especially in times of high-demand due to the pandemic. “SmartExam gives Genesis patients another telehealth option and provider’s a greater ability to navigate, triage, and treat patients virtually,” said Dr. Andersen. “And because the automation built into SmartExam streamlines provider workflows, we know our providers will also agree it is a great tool to treat our patients.”

Eden Health Lands $25M to Bring On-Site and Virtual Care To Employers, Commercial Real-Estate

Eden Health Lands $25M to Bring On-Site and Virtual Care To Employers, Commercial Real-Estate

What You Should Know:

– Eden Health raises $25M to give employers and
commercial real estate owners and operators the ability to offer medical care on-site,
near-site, and virtually.

– Eden’s membership model makes high-quality healthcare an affordable benefit for the average employer, with low to no out-of-pocket costs for their employees.

– Since the first signs of the US coronavirus outbreak in
early February, Eden Health has worked with Boylan Bottling, Connell, Convene, Emigrant
Bank,Golf Magazine,
Harry’s, Kramer Levin, Newscred, evidence-based, medically-informed plans and
protocols for supporting essential workers and bringing workforces back. And
they’ve embedded dedicated, on-demand doctors (called Medical Directors) in the
C-Suites of several customers. 


Eden Health, a New
York City-based national medical practice, today announced it has raised $25
million in Series B funding led by Flare
Capital Partners
with participation from principals from Stone Point Capital, a private equity
firm that focuses on the financial services industry including the HR benefits,
insurance and real estate sectors. Existing investors who participated in the
Series B round include GreycroftPJCMax
Ventures 
and Aspect
Ventures
. The oversubscribed round brings Eden Health’s total
raise to $39M.

Founded in 2016, Eden Health is known for its innovative
direct-to-employer healthcare delivery model, bringing in-person and virtual
healthcare together to deliver an exceptional patient experience to the
employees of mid-market companies. Eden Health empowers employers to
supercharge their benefits packages whether or not they are self-insured.
Designed to meet the needs of companies of all sizes, Eden Health lets them
fill gaps in their employees care with a fully integrated healthcare option.

Eden Health membership services are not tethered to open
enrollment, meaning employees and their families can join at any time and begin
using services immediately. And one of Eden Health’s core services is insurance
navigation, to make sure employees get the care they need without surprise
costs Although Eden Health’s approach is direct-to-employer, its mission is to
ensure that superior care is as widely available as possible.

Eden Health’s medical practice provides members with a
dedicated Care Team. Care Teams are composed of highly credentialed clinicians
delivering evidence-based, top-quality care. Each Care Team offers digital care
around the clock, same-day in-person primary care, behavioral health services
and benefits navigation. Employees interact with the same dedicated Care Team,
regardless of whether they are communicating virtually or in-person. Where
necessary, Eden Health consults specialists to determine needs, before
connecting employee members with fully-vetted, cost-effective in-network
specialists.

Recent Traction/Milestones

Over the past four years, Eden Health has become a trusted
benefits partner for more than 33,000 employees, spanning more than 100
employers across a broad range of industries, including finance, retail, real
estate and technology. Since the very first signs of the US coronavirus
outbreak in early February, Eden Health has worked with Boylan Bottling, Connell, Convene, Emigrant Bank,Golf Magazine, Harry’s, Kramer Levin, Newscred, and others
to roll out evidence-based, medically-informed plans and protocols to support
workforce health. It has guided employers, property owners and workers through
the outbreak using real-time monitoring, proactive outreach, and team-based
care. And as employers and property owners began to phase workforces back into
offices and worksites, Eden Health introduced a comprehensive back-to-work
program spanning COVID-19 screening, virtual primary care, PCR testing,
on-site antibody testing, immediate triage and patient consults.

Through the crisis, Eden Health customers have also chosen
to embed dedicated Eden Health Medical Directors into their c-suites to manage
employee population health. Thanks in large part to early monitoring and proactive
protocols to slow the spread, Eden Health employers have been able to maintain
high levels of productivity, deploying essential workers safely while
protecting their health and the health of fellow employees.

Ginger Lands $50M to Expand On-Demand Mental Health Support Platform

Ginger Lands $50M to Expand On-Demand Mental Health Support Platform

What You Should Know:

– Ginger announces $50 Million in Series D funding to expand
access to its on-demand mental healthcare system led by Advance Venture
Partners and Bessemer Venture Partners; joined by Cigna Ventures and existing
investors.

– Company has more than tripled revenue over the past year, now brings access to on-demand mental healthcare to millions around the world through 200+ employer clients and leading health plans.


Ginger, a San Francisco, CA-based provider of on-demand
mental healthcare, today announced a $50 million Series D funding round led by
Advance Venture Partners and Bessemer Venture Partners. Additional participants
include Cigna Ventures and existing investors such as Jeff Weiner, Executive
Chairman of LinkedIn, and Kaiser Permanente Ventures. This latest round of
investment brings the company’s total funding to over $120 million. 

On-Demand Mental Health Support

Founded in 2011, Ginger’s on-demand mental healthcare system
brings together behavioral health coaches, therapists, and psychiatrists, who
work as a team to deliver personalized care, right through your smartphone. The
Ginger app provides members with access to the support they need within
seconds, 24/7, 365 days a year. Millions of people have access to Ginger
through leading employers, health plans, and its network of partners.

By delivering evidence-based behavioral health coaching,
therapy and psychiatry right from a smartphone, Ginger is the only end-to-end
telemental health provider designed to meet this skyrocketing demand at a
fraction of the cost of traditional care.

Key benefits of Ginger’s on-demand mental health platform
include:

On-demand, anywhere: On average, members in 30
countries around the world can text with a Ginger behavioral health coach
within 44 seconds, 24/7, 365 days per year; first available video appointments
with a therapist or psychiatrist are available on average within 10.5
hours. 

Measurement-based: The company’s proprietary
collaborative care model has been proven to be more than twice as effective as
standard therapeutic interventions; 70 percent of people using Ginger
experience an improvement in their depression symptoms within 10-14
weeks. 

Loved by members: Ginger members give an average
rating of 4.7 out of 5 stars after each session.  


COVID-19 Underscores Record Demand for Mental Health
Support

This announcement comes at a time when the world’s mental
health crisis has reached an all-time high following the onset of the COVID-19
pandemic. According to Ginger’s 2020
Workforce Attitudes Toward Mental Health Report
, nearly 70 percent of U.S.
workers believe this is the most stressful period of their careers, including
major events like the September 11 terror attacks, the 2008 Great Recession and
others. Ginger has observed record-high demand for mental health support;
during July 2020, weekly utilization rates were 125% higher for coaching and
265% higher for therapy and psychiatry when compared to pre-COVID-19 averages.

Recent Traction/Milestones

Millions of people have access to Ginger through the
company’s partnerships with innovative employers, health plans, and strategic
partners. Today, over 200 companies ranging from startups to Fortune 100s,
including Delta Air Lines, Sanofi, Chegg, Domino’s, SurveyMonkey, and Sephora,
partner with Ginger to cost-efficiently provide employees with high-quality
mental healthcare. Ginger members can also access virtual therapy and
psychiatry sessions as an in-network benefit through the company’s
relationships with leading regional and national health plans, including Optum
Behavioral Health, Anthem California, and Aetna Resources for Living.  

The company recently announced the formation of the Ginger Advisory Board, bringing together world-renowned experts from MIT, Massachusetts General Hospital, and the University of Washington to advance mental health research and innovation. 

“Our mental healthcare system has long been inadequate. But in the midst of a worldwide pandemic and a tumultuous sociopolitical climate, we’re facing uncharted territory,” said Russell Glass, CEO, Ginger, “People are demanding better care, and the largest payers of healthcare are recognizing the need to respond. Ginger is uniquely able to reverse the course of this crisis at scale. With this investment, we can accelerate our work to deliver incredible mental healthcare at a fraction of the cost to the hundreds of millions of people around the world who deserve it.”

Cerner Invests in Xealth to Jointly Develop Digital Health Solutions for Clinicians

Digital Prescribing Platform Xealth Raises $11M to Expand Digital Health Tools

What You Should Know:

– Cerner and Xealth announce a collaboration to foster
tighter physician-patient relationships by giving patients easier access to
digital health tools.

– These assets will be prescribed directly within the physician’s EHR workflow to manage conditions including chronic diseases, behavioral health, maternity care, and surgery preparation.

– Cerner and LRVHealth have together invested $6 million
in Xealth as part of this agreement, with Cerner and Xealth planning to jointly
develop digital health solutions that extend the value of the EHR.

– Already integrated into Epic, the integration puts
Xealth in the EHR of record for more than half of the U.S. hospital systems.


Xealth, a Seattle, WA-based company enabling digital
health at scale, and Cerner
Corporation
, today announced a collaboration that will bring digital
health tools to clinicians and patients to improve the healthcare experience.
As part of this agreement, Cerner and Xealth plan to jointly develop digital health
solutions that extend the value of the electronic health record
(EHR).
Already integrated into Epic, this integration puts Xealth in
the EHR of record for more than half of the U.S. hospital systems.

In addition, Cerner
and LRVHealth have together invested $6M in Xealth. Cerner joins Xealth
investors including Atrium Health, Cleveland Clinic, Froedtert and the Medical College of Wisconsin, MemorialCare Innovation Fund, Providence
Ventures and UPMC as well as McKesson, Novartis, Philips, and ResMed.

Xealth/Cerner EHR
Integration Details

At its core, the
relationship between Xealth and Cerner aims to give patients their own digital
data so they can be more engaged in their treatment plans. The Xealth platform
is designed to help clinicians easily integrate, prescribe and monitor digital health
tools for patients from one location in the EHR. Care teams will be able to
order solutions directly from the EHR to manage conditions including chronic
diseases, behavioral health, maternity care and surgery preparation. Incorporating Xealth into Cerner’s technology and patient portal
provides easier access to personal health information and gives care teams the
ability to monitor patient engagement with the tools and analyze the effects of
increased engagement on their healthcare and recovery.

The collaboration
between Cerner and Xealth will provide care teams and patients convenience and
help improve care accessibility. Better communications and engagement with key
members of their care team will create an experience that is connected across
settings before, during and after a care encounter.

Why It Matters

During the recent
surge of COVID-19 across the world, tools that automate patient education,
deliver virtual care, support telehealth and offer remote patient monitoring
have become even more prominent, creating new methods to inform care decisions
and keep care teams and patients connected.

“Today, we have the unique opportunity to improve people’s lives by allowing active participation in their own treatment plans,” said David Bradshaw, Senior Vice President, Consumer and Employer Solutions, Cerner. “Patients want greater access to their health information and are motivated to help care teams find the most appropriate road to recovery. Xealth and Cerner are making it easier and more convenient for patients and clinicians to accelerate healthcare in a more consumer-centric experience.”

Incorporating Xealth’s
digital health platform with clinician recommendations has been shown to
increase patient engagement rates as compared to a direct to consumer approach.
The company powers more than 30 digital health solutions, connecting patients
with educational content, remote patient monitoring, virtual care platforms,
e-commerce product recommendations and other services needed to improve health
outcomes.

“In order for digital health to have lasting impact, it needs to show value and ease for both the care team and patient,” said Mike McSherry, CEO and Co-Founder of Xealth. “We strongly believe that technology should nurture deeper patient-provider relationships and facilitate information sharing across systems and the care settings. It is exciting work with Cerner to simplify meaningful digital health for its health partners.”

“Combining our expertise in developing interactive digital solutions that improve the patient experience with Cerner’s world-class platforms creates immense opportunity for our clients to better meet the needs of today’s highly connected healthcare consumer,” concluded McSherry.

Virtual Behavioral Health Could Reduce Costs, Improve Patient Outcomes, Report Finds

What You Should Know:

– A new Accenture report called “Breakthrough Behavioral
Health Access: Think Virtual” finds that the use of virtual behavioral health could
expand care for more than 53 million Americans facing these conditions.

– Demand for behavioral health specialists significantly outweighs current availability; in addition to severe wait times of 25 days for first clinical appointments, we are projected to have a shortage of 250,000 behavioral health and mental health professionals by 2025.

– Just a 1% increase in treatment for these disorders would save $2.4 billion annually and could yield as much as $2.4 billion in medical cost savings annually.


The use of virtual delivery channels could expand treatment
to 53 million Americans suffering from behavioral health issues, according
to a new report from Accenture. The
report, “Breakthrough Behavioral Health Access: Think Virtual,” is
based on a survey of more than 3,400 people in the U.S. diagnosed with or
having symptoms related to specific behavioral health conditions such as
anxiety, depression, post-traumatic stress syndrome, attention deficit disorder
or reported themselves as having addiction or substance abuse issues.

Access to Behavioral Healthcare Barriers

Access to behavioral healthcare is especially challenging.
Beyond the burden on individuals, the challenges of accessing and delivering
behavioral health services have a ripple effect across healthcare. Payers,
providers, employers, government and life sciences companies are all impacted
differently.

“The behavioral health crisis in the U.S. isn’t new, but the pandemic is clearly exacerbating it,” said Rich Birhanzel, a senior managing director at Accenture who leads the company’s Health practice globally. “The rapid expansion of virtual care models during lockdown in the current pandemic created new expectations for effective and reliable healthcare at a distance. While our research found that only 38% of respondents hadn’t been widely using a virtual channel for such treatment in the prior three years, they’re now overwhelmingly willing to do so.”

Virtual Health Can Shatters Barriers

Virtual Behavioral Health Could Reduce Costs, Improve Patient Outcomes, Report Finds

Current data indicates that nearly 58 million adults and
8 million youth between the ages of six and 17 in the U.S. have mental
health and/or substance use disorders, yet only 43% of affected adults are receiving
treatment for them. Four in five respondents (81%) of the Accenture survey said
they would either definitely or probably engage in a virtual channel to manage
their behavioral health condition. Applying this finding to the 66 million
adults and youths impacted by these disorders suggests that virtual channels
could expand care to approximately 53 million people. Furthermore, the number
of people with such conditions is likely to rise due to the current environment
of COVID-19, record unemployment, and widespread social unrest.
 
Among the channels respondents said they’d be willing to use include on-demand
videos (cited by 55%), webchat (63%), individual therapy via voice (59%) and
individual therapy via voice plus video (56%).

The research shows younger patients are much more likely
than older ones to engage in virtual behavioral health services. The report
notes that this is critical insight for employers as they develop their
workforce and talent strategies, particularly since millennials comprise the
largest percentage of the U.S. labor force, followed by Gen Zers.

In addition to improving people’s lives, better access to
care and treatment is a potential breakthrough in terms of overall outcomes and
medical spending as behavioral health patients typically have co-occurring
medical conditions and as a result, can have two to three times the amount of
associated health expenditures. Related Accenture analysis shows that even a 1%
increase in treatment for behavioral health disorders in the U.S. could yield
as much as $2.4 billion in medical cost savings annually, due largely to the
fact that individuals with behavioral health conditions often have other
medical conditions.

From Tipping Point to Transformation

The report notes three fundamental factors that healthcare
providers should consider to remain relevant and responsive to consumers’
needs:

· Control the personal cost. Four in 10 respondents
(44%) said they would only use such channels if the services are provided at
low or no cost to them. Public and private organizations sponsoring these
solutions will need to think through how to lower costs to
consumers—particularly those in need. 

· Orbit around experience. Beyond cost, consumers want convenience and positive user experience. While consumers are hungry for behavioral health services through virtual channels, the design of the programs and consumers’ experiences will make or break adoption no matter the demand.

· Make all the connections. Coordination and integration of care with a whole-person approach is critical. Services should be offered in the context of individuals’ physical health, and data-sharing and interoperability among different healthcare stakeholders are critical to providing the most effective care.

Report Background/Methodology

For the Accenture 2020 Behavioral Health Consumer Survey,
Accenture surveyed 3,448 US consumers ages 13 and over to better understand
attitudes and behaviors related to virtual health options for treating mental
health conditions and substance abuse issues. All survey respondents were
either diagnosed with and/or had symptoms related to specific mental health
conditions such as anxiety, depression, PTSD, ADD/ADHD, or reported themselves
as having addiction issues. Survey respondents received anonymity and
represented a cross-section of the population based on age, location,
ethnicity, insurance coverage, gender and income. The survey was conducted by
Dynata in May and June 2020.

Provider Pilot Uses Video Games as Therapy for Children with Autism

Provider Pilot Uses Video Games as Therapy for Children with Autism

What You Should Know:

– Magellan Health launches a pilot program for a group of
providers that will begin using video games as therapy for children with autism
and other behavioral health conditions. 

– As part of the pilot program, patients will be given
access to the video platform developed by Mightier, a digital health company
born out of Boston Children’s’ Hospital and Harvard. 

– The games include a wearable heart rate monitor &
tablet loaded with 25 different games, each designed to help children learn how
to regulate their emotional reactions and manage stress, anxiety through deep
breathing, etc.


Magellan Health,
Inc.,
one of the nation’s leaders in behavioral health, today
announced a collaboration between Magellan Healthcare (Magellan), the
behavioral and specialty healthcare segment of the company, and Neuromotion,
Inc., developer of Mightier, an
in-home digital platform that empowers children to learn lifelong emotional
skills through play, to make Mightier available to certain Magellan members in
a pilot program.

“Children are increasingly being diagnosed with behavioral
health disorders and the impact is felt by the entire family,” said Matthew
Miller, senior vice president, behavioral health, Magellan Healthcare. “We are
proud to launch this pilot with Mightier as a cost effective,
outcomes-based treatment. By teaching children how to navigate daily challenges
through visual technology they learn how to cope and properly manage their
stress in a meaningful and fun way.”

Pilot Program Details

Developed at Boston Children’s Hospital and Harvard Medical
School, the Mightier program pairs video games with clinically validated
emotion calming skills to help kids learn through play. In addition to the
video game platform, caregivers are supported with a personalized dashboard to
track progress, access to the Mightier Parent community, and 1-1 coaching with
a licensed, master’s level clinician to tailor the program to
their individual family needs.

Over the last three years, Mightier has reached more than
25,000 families worldwide, with thousands of new families being added every
month. Over 75 percent of families report improvement made possible by an
unwavering commitment to building an engaging experience supported by clinical
expertise.

By combining Magellan’s market-leading clinical experience and network of providers specializing in autism with Mightier’s innovative technology, children and families participating in the pilot will receive high-quality care focused on positive outcomes.

Jason Kahn, PhD, Mightier’s Chief Scientific Officer says the collaboration will set the stage to positively impact families and improve outcomes for children with ASD. “Mightier is a new tool that supports the increasing diagnoses of autism and other behavioral health disorders. Our solution meets kids and families where they are: at home. The pandemic amplifies this need even further, we need new ways to support kids and families. Our digital program can play a significant role by providing evidenced-based, personalized interventions from the comfort of home.”

Emtiro Health Taps Innovaccer to Leverage the FHIR-Enabled Data Activation Platform

Emtiro Health Taps Innovaccer to Leverage the FHIR-enabled Data Activation Platform

What You Should Know:

Emtiro Health, an
innovative population health company in North Carolina has selected Innovaccer
to deliver data-powered solutions to enhance the efficiency and effectiveness
of care delivery. 

– Powered by Innovaccer’s FHIR-enabled Data Activation
Platform, Emtiro Health will create unified patient records that drive
comprehensive, whole-person care management, no matter where they are on the
care continuum. The FHIR-enabled Data Activation Platform will also deliver
highly actionable data, automated care management workflows, and smart patient
engagement.


Emitro Health, a
Winston Salem, NC-based population
health
company, today announced a partnership with Innovaccer, a San Francisco, CA-based
healthcare technology to enable the effective delivery of services to the
patients and providers supported by Emtiro Health.

Emitro Health Background

Emtiro Health supports providers, systems, and payers with unparalleled expertise and knowledge augmented by data and analytics. This platform enhances the patient experience and improves outcomes while delivering effective healthcare at a lower cost. Emtiro Health addresses the systemic barriers to total wellbeing and helps patients chart a course to brighter futures. The organization’s experienced team brings diverse backgrounds and skillsets to complement a whole-practice approach from practice optimization and transformation, data analytics, and quality reporting to the integration of services, such as clinical pharmacy and behavioral health.

Leveraging FHIR-enabled
Data Activation Platform

Emtiro Health Taps Innovaccer to Leverage the FHIR-enabled Data Activation Platform

Powered by Innovaccer’s FHIR-enabled Data Activation Platform, Emtiro Health will create unified patient records that drive comprehensive, whole-person care management, no matter where they are on the care continuum. The FHIR-enabled Data Activation Platform will also deliver highly actionable data, automated care management workflows, and smart patient engagement. Emtiro Health’s provider partners will be equipped with point-of-care insights that surface relevant information for patient health in real-time. The entire suite of solutions will enable Emtiro Health to improve the effectiveness and efficiency of both providers and care, management teams, allowing them to care as one for patients.

Unified Health Record

Innovaccer’s
FHIR-enabled Data Activation Platform helps healthcare organizations obtain a
complete picture through their unified patient record. The data is then
activated for smart analytics and decision support — so, care teams have the
crucial information they need to provide better care and to care as one.

“Emtiro Health selected Innovaccer to provide customized business intelligence and analytics solutions to our partners to revolutionize how the right level of care is delivered to the right patient at the right time. The Innovaccer data platform coupled with Emtiro Health’s expertise in delivering a total population health model of care management is a game-changer for providers and patients alike,” said Kelly Garrison, President and CEO of Emtiro Health. “In practice, this collaboration will mean more informed care, healthier individuals and healthier communities in North Carolina.”

Doctor On Demand Raises $75M to Expand Comprehensive Virtual Care Platform

Doctor On Demand Raises $75M to Expand Comprehensive Virtual Care Platform

What You Should Know

– Doctor On Demand raises $75M in Series D
funding led by General Atlantic to expand comprehensive virtual care.

– Doctor On Demand is seeing record usage
this year – up 139% – for COVID-19 screenings, routine health issues, chronic
conditions and behavioral health.

San Francisco, CA-based Doctor On Demand, today announced it
has raised $75 million in Series D funding led by General Atlantic, a leading
global growth equity firm, with participation from existing investors. The
funds will be used to accelerate Doctor On Demand’s investments in growth and
further expand access to high-quality, comprehensive virtual care for patients
nationwide.

Founded in 2012, Doctor On Demand offers immediate,
video-based access to top physicians and psychologists for just $40 per visit,
with no subscription fees for partners via the iPhone, iPad,Android and
desktop.  With over 98 million covered lives and a 4.9/5 patient
satisfaction rating, Doctor On Demand is the preferred
virtual care provider of consumers, health plans and employers. The company’s
unmatched technology platform and clinical model of fully employed providers
gives patients a continuum of care and the ability to build trusted, personal
relationships with their providers. 

Recent Traction/Milestones

Following robust growth in 2019, Doctor On Demand
experienced accelerated momentum in the first half of 2020, with the COVID-19
pandemic driving increased demand for the company’s integrated medical and
behavioral health services. The company more than doubled its covered lives in
the past six months, propelling Doctor On Demand to its 3 millionth virtual visit.
In response to the public health emergency, the company mobilized quickly to
roll out its critical virtual medical services to 33 million Medicare Part B
beneficiaries across all 50 states, just weeks after the Centers for Medicare
and Medicaid Services (CMS) expanded coverage to allow for the reimbursement of
telemedicine visits for this high-risk patient population.

While COVID-19 has driven a sharp increase in utilization of
Doctor On Demand’s urgent care and behavioral health services, more than half
of the company’s 2020 future growth is focused on the continued expansion of
its Virtual Primary Care offering. This service enables health plans and
employers to deliver cost-efficient, comprehensive virtual care inclusive of
integrated behavioral health, 24/7 everyday & urgent care, and chronic care
management to their populations while reducing costs.

“In April 2019, Humana and Doctor On Demand launched On
Hand™, a first-of-its-kind health plan that centered on comprehensive virtual
primary care,” said Chris Hunter, Segment President, Group and Military
Business at Humana. “This new plan design represented a paradigm shift in
healthcare, and demonstrated that our members can and will build long-term
relationships with primary care providers and care teams in a virtual-first
care setting.” 

“Even before the pandemic, we recognized the importance of
providing integrated, virtual medical and emotional health care for our
associates,” said Adam Stavisky, SVP, US Benefits at Walmart. “Our early
decision to partner with Doctor On Demand helped us respond quickly as the
crisis hit, allowing us to immediately meet the care needs of our associates
and their families where and when they need it.”