Happy Tuesday, Hospitalogists! Good afternoon to everyone except the hackers who apparently keep extorting Change Healthcare. Yikes. I'm playing a bit of catch up this week so today's post is short and sweet. Enjoy, and bear with me as I work through creating new templates and whatnot for the newsletter. If you have any feedback there I'm all ears. Also - join my upcoming virtual event with two seasoned vets in the value-based specialty landscape (cardiology & kidney care). It'll be a fun conversation around emerging & ongoing trends in the space! Register here. |
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Is the AI revolution in healthcare real or just buzz? A.Team's event The Gen AI Salon: The Future of Health is where you'll find some answers. Join us on April 24th to get the lowdown from experts like Carenostics' Co-Founder Kanishka Rao, who'll discuss AI's role in chronic disease, and Rachel Tornheim from Mount Sinai, shedding light on AI-enhanced clinical workflows. Plus, a panel featuring Jessica Beegle, former CIO at LifePoint, and Morris Panner, President at Interlad, will dive into AI in clinical decision-making. Don't miss out on this chance to see how AI could genuinely transform healthcare. Whether you're coming to the NYC Clubhouse or joining online, apply below to secure your spot! It's time to explore what AI is capable of. |
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MultiPlanned (see what I did there) The NY Times' expose on MultiPlan and the behind the scenes value extraction activity happening stemming from out of network billing. There's a little bit of abuse for nearly everyone across healthcare in this piece - egregious out-of-network billed charges, loopholes in lawsuits, private equity involvement & aggression post-takeover in 2006, payors taking advantage of employers and using MultiPlan as a scapegoat to push payor strategies forward by collecting fees on differences between billed and collected sums. This part stuck me as pretty ironic - Envision's (I'm assuming Envision) last laugh fueled this NY Times article against health insurers given that many of the unsealed court documents are referenced throughout: "UnitedHealthcare blamed "egregious" charges by out-of-network providers and suggested that criticism of its work with MultiPlan had been stoked by a private-equity-backed medical staffing firm that is suing the insurer." Also, I guess we never really got rid of balance billing - 'Legislation that took effect in 2022 now protects patients from certain kinds of surprise bills but does not cover a vast majority of the claims directed to MultiPlan.' Optum tries to buy Steward Medical Group: Among financial challenges and pressure mounting, many news outlets reported Steward was trying to sell its physician network subsidiary - a multispecialty group with 1,700 physicians and clinicians in 11 states - to Optum. My take/thoughts: - Optum already owns Atrius and holds a significant presence in the state, so this deal is getting some intense pushback from regulators.
- If not Optum, then who? Was this a competitive bid process? If this is a desirable asset shouldn't we have seen some interest from other healthcare players in the market?
- Many mergers are starting to get to a 'last resort' stage (see Optum & the Corvallis Clinic) and on the hospital side as well, many deals are done just from the standpoint of survival. If the state doesn't approve the deal, where does that leave these physicians and clinicians? If these groups can't survive without Optum coming in to save the day,
- CareMax struck a deal in 2022 to manage the population health for all of Steward's physicians. Where does this deal leave them, and what are the implications of Steward going under on CareMax given their close relationship, and Steward's option to buy 30%+ of CareMax's equity? Seems like a tough spot to be in if a huge vehicle for future growth organizationally is now owned by…Optum
Teladoc CEO out: After a long, impressive 15-year run, a pandemic-fueled stock rally nobody will soon forget, an $18B+ acquisition of Livongo, and finally a refusal to bend the knee to the reality of the commoditization of telehealth (leading to a 95%+ decline in stock value from pandemic highs), Jason Gorevic is stepping down from the helm of Teladoc. It is crazy to see a company that fueled so much innovation and change in healthcare down 34%+ from its IPO. Assuming he stays in the game, I'll be looking forward to seeing what Jason cooks up next. |
Kaiser-THV forms PACE startup: Together with Town Hall Ventures, Kaiser Permanente formed a new PACE startup called Habitat Health. PACE - short for Program of All-Inclusive Care for the Elderly - is an interesting post-acute care program providing fully integrated services to seniors with low incomes and most of the time, multiple chronic conditions. It also requires intense upfront capital investments to stand up a program, so there's a natural barrier to entry there. There's only one publicly traded PACE provider - InnovAge (recently held an investor day you can view here) and it seems as if the program takes a while to ramp and find financial success while helping seniors in a proven model. That being said, Kaiser is a good partner to partner on a venture with, and I'm looking forward to hearing more from Habitat Health. Hippocratic AI's $9 Nurse? "Hippocratic AI is developing a staffing marketplace where payors, health systems, and other stakeholders can "hire" generative AI agents to complete low-risk, non-diagnostic, and patient-facing tasks." The marketing language kind of sets itself up to be a nurse 'replacement' when in reality it sounds like they're building a supercharged AI nurse extension offering for folks who want to try out the AI healthcare agent as someone who can auto-follow up with patients on easy stuff without having a clinician in the loop. That way, nurses can focus on more important things. Hippocratic AI's thesis is clear: LLMs will solve the labor and productivity crisis facing American healthcare. Balancing productivity with trust will be key. - "Hippocratic claims its AI nurses outperform human nurses regarding bedside manner, education, and narrowly miss on satisfaction, according to a survey.
- The company's technology is being tested by over 40 healthcare providers around the country."
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Surescripts Sale: While rumors of a Surescripts sale have been floating for a while, talks seem to have picked up steam. Business Insider (paywall) reported the e-prescribing company is exploring a sale and hired a banker to facilitate those proceedings. CMS proposed rates & finalized broker comp for 2025: - 2.8% increase for IRFs
- 4.1% increase for SNFs
- 2.7%% increase for IPFs
- 2.6% increase for Hospice
- MA Broker Comp: CMS final rules on broker compensation (stricter rules and fixed fees - $100 - around financial conflicts of interest for brokers) and an added emphasis on health equity could create some major industry shakeup in brokerage land
Commure's product announcement around launching new AI products, including an ambient scribe. Walmart's decision to slightly push back the timeline on its Walmart Health clinic openings. This year it's opening 22 (down from a planned 30), 18 of which are in Texas and the remaining 4 in Kansas City. VC+Health Systems: Aegis Ventures' partnership announcement with 9 health systems, similar to recent announcements from a16z and General Catalyst, to form the Digital Consortium FTC Doubles Down: The FTC does not want the recent Novant-CHS deal to go through, stating the deal would 'irreversibly' harm competition. Sutter-Abridge: Abridge notched another health system partnership under its belt with California-based Sutter Health. Q1 2024 funding blues: Rock Health noted a muted funding environment for digital health in the first quarter of 2024: "Q1 2024 was the lowest first quarter by sector funding since 2019, noteworthy given that Q1 was the top-funded quarter of the entire year in 2022 and 2023." Still, while funding amounts are low, pace of deals is strong. |
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Ever wondered if AI could be the secret ingredient to revolutionizing healthcare? Find out at A.Team's Gen AI Salon: The Future of Health on April 24th. It's not just any event—it's a rendezvous of minds from Mount Sinai, Carenostics, LifePoint Health, and Intelerad Medical, all set to dissect AI's role in reshaping healthcare as we know it. Kickstart the evening at 5:00 PM at A.Team's NYC Clubhouse with cocktails, then dive into groundbreaking discussions and a panel on AI in clinical decision-making. Can't be there? Catch the action virtually from 6-7 PM. Hope to see you there! Reserve your spot |
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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. |
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Fun, random stories & updates from Blake This has been a big week for us as a society: - Eclipse (Everyone share their eclipse photos - I haven't seen ANY yet. But on a serious note …if you have a sick photo please pass it along!)
- NYC Earthquake
- Women's national basketball championship (shout out Caitlin Clark and also South Carolina for a perfect season)
- Men's national basketball championship (Uconn made it less than exciting)
- Master's week (my picks are below)
Finally, shout out to Kent's Bracket 2 for winning the Hospitalogy Bracket Challenge with a bracket in the top 98.1 percentile! Kent, if you're around, please feel free to give me a shout! We have some absolute bracket sharks in this readership. |
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Thanks for the read! Let me know what you thought by replying back to this email. — Blake |
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