Good morning Hospitalogists! Hospitalogy, meet Bracketology. If you're into March Madness and you've filled out a bracket, join the Hospitalogy Bracket Challenge here. The winner gets something fun like…a newsletter shout out, or some Hospitalogy golf balls or something. No promises but you'll get something! Onto this week's news. Thanks so much to Unlock Health for sponsoring today's send. Check out our essay collaboration here. New Hospitalogy website coming soon! Remember: Thursday is Private Equity Part 2. Should be a fun one. Thanks for all your great responses so far. Currently sifting through them all! Welcome to Hospitalogy, my newsletter breaking down healthcare strategy, finance, M&A, and innovation twice weekly. Join 28,000+ executives and investors from leading healthcare organizations by subscribing here! |
Was this email forwarded to you? |
|
|
Hey guys! Blake here. I wanted to introduce you to Unlock Health, a healthcare-specific growth & marketing platform. Over the past few weeks, I've been getting familiar with Unlock's end-to-end, proprietary solutions for provider and risk bearing organizations. And given decades of experience in the healthcare industry, we decided it made a lot of sense to write an article together about what they're seeing out in the wild. So, alongside Unlock's Chief Revenue Strategy and Managed Care Officer Kevin Thilborger, we wrote about the 3 most common pain points facing provider organizations in 2024, along with an outlook and outline for potential strategies to mitigate frustrations. Learn more about what you and your colleagues are up against in 2024, and how Unlock helps address those challenges, in my latest essay here! |
|
|
MEDPAC MARCH REPORT TO CONGRESS |
(Yes, the Harry Potter reference) MedPAC's March 15th Report: Recommendations and Key Provisions Every March 15, the Medicare Payment Advisory Commission (MedPAC) releases a report on the state of Medicare fee-for-service payment adequacy for all healthcare services verticals, Medicare Advantage, and Medicare Part D. Here's the link. It's an insanely long overview of how they view the world, and what the Commission thinks would be the best path forward to balance financial sustainability with access. Here were MedPAC's payment update recommendations: Hospitals: increase inpatient & outpatient payments by 1.5% over and above base rates given inflationary pressures. If you're interested in what's going on with hospitals, start on page 64 of the report where MedPAC dives into the bifurcation effect we're seeing among hospitals today. It paints a pretty dire picture of where hospitals were in 2022: |
2 years ago, some folks on social media tried to tell me the unprecedented financial struggles stuff coming out of the hospital industry was 'propaganda' and that things weren't as bad as they seemed.
I guess MedPAC is spewing that propaganda now too. |
(takes a moment to feel vindicated) Back to regularly scheduled programming! Physician Services: Incorporate 50% of the increase in the Medicare Economic Index into base rate update to account for inflation (would be 1.3% above current base payment for 2025) End Stage Renal Disease: Update based on current law (status quo) SNFs: Cut base payment by 3% Home Health: Cut base payments by 7% (!!) a consistent theme over the past few years. MedPAC thinks payments for home health are 'excessive' despite the obvious advantages and potential the setting holds for patients. IRFs: Reduce base payments by 5%. Notice a theme in post-acute care?? Side note: there are 345 freestanding IRF hospitals. Encompass operates 157 of those!! Hospice: No base rate update for you, fam. Sorry. Some other useful tidbits I found interesting: - MedPAC for a couple years now has asked Congress to consider requiring ambulatory surgery centers to release cost data since there's no ability to do so right now - the concern being whether there's potential overutilization of ASCs
- Also don't forget MedPAC thinks Medicare Advantage is absolutely fleecing the federal government to the tune of $80B+ in annual overpayments.
- From page 376*: Since 2007, we estimate that Medicare has paid $507 billion and will pay $83 billion more for MA enrollees in 2024 than if those beneficiaries had instead been in FFS—a total of $591 billion. Over half (an estimated $338 billion) of the MA payments above FFS spending will have occurred in the last five years—from 2020 through 2024. These higher payments are increasingly driven by coding intensity, which we estimate accounted for the largest share of payments above FFS spending from 2022 through 2024
Check out page 394. MedPAC must read Hospitalogy - they have a solid section on vertical integration implications in MA which is a good read. |
|
|
Strategy and Policy Updates |
Key considerations for decision makers. Notable moves, policies, and strategies. |
HHS is launching an investigation into UnitedHealth Group stemming from the Change Healthcare cyber attack. FDA approves Wegovy for cardiovascular indications, specifically for adults who are overweight or obese. On that same GLP-1 note, take a peek at 413k+ individuals' median weight loss after being on the various drugs, at various dosages over 1 year: |
After Eli Lilly launched its DTC platform LillyDirect, it is teaming up with Amazon for prescription home delivery. Hard to know the scope of this deal nor how many folks are using LillyDirect versus other consumer-facing virtual providers. Strategy Odds & Ends - The ACA is here to stay.
- CommonSpirit adjusts its portfolio, investing in 'strongest markets,' says CEO.
- The Top 15 U.S. Pharmacies of 2023: Market Shares and Revenues at the Biggest Chains and PBMs were revealed.
- 29 healthcare leaders revealed their top priorities for the next 12 months.
- AI Does Not Meet Healthcare Technology Needs on its Own, as discussed on LinkedIn.
- New Mexico's Health Care Consolidation Oversight Act: An Overview was explained.
- Revisiting the Importance of Financial Planning is discussed by Kaufman Hall.
- Jefferson Health unveiled a $762M Philadelphia outpatient center.
- Unifying Academic Medical Center Departments is a Major Step in Harnessing Collective Expertise was announced.
- HIMSS24: How Epic is building out AI, ambient technology for clinicians.
- OCR launches a HIPAA investigation into Change Healthcare breach.
- Aledade expands Value-Based Care Support Nationwide for 2024.
- The Senate killing its Medicaid expansion bill without a vote continues work on a plan.
- Mercy CFO: Medicare Advantage is a good model 'when structured appropriately.'
- Florida Bills Intended to Curtail Physician Noncompetes fail.
- Maternal mortality in the United States: are the high and rising rates due to changes in obstetrical factors, maternal medical conditions, or maternal mortality surveillance? was investigated.
- Physicians at Mass General Brigham hospital vote to unionize.
- Northwell hospital nurses vote to strike.
- Incredible Health's 5th Annual US Nursing Report: Insights from 1 Million Nurses was released.
- President Biden issues an Executive Order and Announces New Actions to Advance Women's Health Research and Innovation.
|
Healthcare financial summaries and interesting merger activity |
- Baxter considers selling its kidney care unit.
- Specialist healthcare private equity fundraising is fueled by big vehicles, according to PitchBook.
- Elevance's CarelonRx is buying Kroger's specialty pharmacy business
- Sutter Health expands cancer care by acquiring 5 radiation oncology centers.
- NeueHealth reports a nearly quarter-billion net loss during Q4 earnings.
- UPMC reports almost $200M operating loss as expenses rise.
- Mayo Clinic closed out 2023 with $18B in revenue, 6% operating margin.
- A union objects to a 2-hospital acquisition in Providence, calling it 'not credible or viable.'
- Frazier Healthcare Partners announces the acquisition of RevSpring.
- HCAP Partners leads the formation of PAX Health.
- DirectMed Imaging acquires Titanium Medical Imaging.
- Healthcare M&A outlook: PE firms see brighter days ahead.
- Innovaccer announces the acquisition of Pharmacy Quality Solutions to accelerate value-based care in pharmacy settings.
- Medical Group of Central Georgia joins Southeast Primary Care Partners.
- Clover Health trends upward after Q4 earnings, posting an adjusted EBITDA loss of $19M.
- Henry Ford posts an $80M operating gain, 1% margin.
- Two Prominent San Gabriel Valley Orthopaedic Groups joined Cedars-Sinai.
|
Partnership, Products, and Pilots: |
Collaborations and launches to keep a pulse on. |
- Nomi Health and CHG Healthcare partner to meet the growing need for streamlined care in underserved communities.
- ThinkAndor® introduces AI-first technology aimed at transforming care delivery with ambient nursing and staff documentation.
- A new program is established to support Alabama IVF patients & clinics.
- Blue Shield of California and Zócalo raise awareness of colorectal cancer with screenings and health education.
- Ensemble announces a partnership with Beebe Healthcare.
- GE HealthCare and Mass General Brigham evolve their AI collaboration with medical imaging foundation models.
- Mercy Medical Center physicians collaborate with Frederick Gastroenterology Associates (FGA) to see patients.
- UCI Health and Sprinter Health collaborate to close care gaps in the community.
- A Sanford Health location in Fargo, N.D., adds Medtronic's GI Genius for AI-assisted colonoscopies.
- Best Buy supplies at-home tech to 8 of the largest health systems.
- HCA ups virtual nursing to over 10 hospitals.
- Georgia partners with Aetna Health for Georgia Unity, a social data platform for whole health integration.
- Wheel adds Mark Cuban Cost Plus, Talkspace, and Health Gorilla to its virtual care platform.
- Thyme Care unveils "Thyme Care Oncology Partners," a provider-powered value-based care model in partnership with more than 400 oncologists nationwide.
- Quantum Health, a healthcare navigation company, launches a navigation offering for Medicare Advantage plans.
- Eli Lilly and Company adds Amazon Pharmacy as a third-party dispensing provider for LillyDirect Pharmacy Solutions, offering home delivery services for certain medications.
- Abridge and UCI Health bring trusted AI-powered clinical notes system-wide.
- Sollis Health partners with Prenuvo to introduce a groundbreaking preventative health model to concierge medicine.
- Modern Health announces support for "Whole Human Health" with the launch of physical well-being pathways.
- Talkdesk extends AI and integration capabilities in healthcare, adding Talkdesk Autopilot for Healthcare with new use cases and deeper integration support.
- Children's Hospital Los Angeles rolls out Nabla Copilot after a successful pilot program.
- GE HealthCare & Mass General Brigham have a plan to accelerate their AI research, as detailed by MedCity News.
- Mark Cuban's drug company nabbed its 1st health system partnership, demonstrating a significant milestone for the company.
- Pearl Health and Wellcare announce partnership to advance value-based care access in primary care.
|
Cool initiatives and reasons for optimism |
Recent notable funding rounds. AI-generated. |
- Hippocratic AI raises $53 Million Series A at a whopping $500 Million valuation, and I'm in the wrong line of work. Interestingly, General Catalyst, which co-led the new round, characterized the opportunity as addressing the healthcare workforce shortage with 'AI Agents'
- Zephyr AI raises $111 Million in Series A Financing backed by Eli Lilly for precision medicine tech.
- CodaMetrix pockets $40M series B to build out AI-based revenue cycle tools.
- HiLabs closes a $39M funding round as the company enters the 'next phase of growth'.
- Legends launches out of stealth with $6M in Seed Funding.
- Nest Health raises over $4M in seed extension funding led by SpringTide.
- Foundation Health secures $6M to drive next-generation consumer experiences.
- Derma AI Cureskin bags $20M Series B funding and more from India.
|
|
| Here are some jobs that I'm curating for the healthcare industry. You can see the full list of jobs I've curated here. If you're looking to hire, use the promo code HOSPITALOGY to get your first job listing free on my curated job board. |
|
| Thanks for the read! Let me know what you thought by replying back to this email. — Blake |
|
|
.png) | Share Hospitalogy, Earn Rewards | Have friends who'd love Hospitalogy too? Click the link below to share Hospitalogy with your friends and earn awesome rewards! | |
|
PS: You have referred 0 people so far | | Share Hospitalogy! | |
|
|
|
|
Get your brand in front of 28,000 executives and healthcare decision-makers. |
I'm building an exclusive community for top healthcare executives. | Data Visualization Toolkit |
Workweek Media Inc.
1023 Springdale Road, STE 9E
Austin, TX 78721 Want to ruin my day? Unsubscribe. |
|
|
|
No comments