Happy Tuesday Hospitalogists,
You're looking at (well…reading about) the two-time Big Jack Open Madden family golf scramble champion from the weekend. That's right - 2 years in a row. Will anyone stop me from the 3peat? Can anyone compete with the outfit game? Find out next year. |
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Don't miss NeuroFlow's upcoming webinar, Fighting the Maternal Mental Health Crisis: Innovative Strategies from Presbyterian & Prudential, on June 18th at 2pm ET. With 75% of women with perinatal mental health conditions not receiving necessary treatment, it's crucial for healthcare organizations to enhance support during pregnancy. This webinar will feature key insights from Dr. Kristin Tugman of Prudential, Megan Moore of Presbyterian Healthcare Services, and Julia Kastner from NeuroFlow. They'll discuss how proactive screening and tailored resources can fill critical care gaps. Now you can learn how to implement effective strategies in your practice to support maternal mental health. Secure your spot today for this important conversation. |
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The most important news from the week |
More Deets on Elevance's Enablement Play with CD&R |
Back in April, Elevance announced a partnership in the enablement space alongside Clayton, Dubilier & Rice to combine certain assets in the pursuit of capital-light, efficient, advanced primary care. I broke down the deal back in April, but here's a quick summary: - Together, the partnership will create the following entity serving 1 million + individuals with advanced primary care capabilities:
- Millennium Physician Group as a 900+ physicians / APP strong advanced primary group located throughout Florida with presence in Texas and North Carolina;
- apree health (the newly rebranded Vera Whole Health and Castlight entity) will focus on under-65 markets and care navigation services;
- Carelon Health's clinic footprint is small – the presser mentioned 30 sites today with an emphasis on high-risk, polychronic members.
At a recent investor conference (Bernstein's), Elevance leadership shed some more light on their ultimate expectations for the enablement venture. Here are some interesting tidbits to know:
1. It'll be payor agnostic, across all payors (Medicare, Medicaid, Commercial) and partnering with local clinicians within communities. The words "Local" and "Hyperlocal" were used several times throughout the discussion. Elevance also does not want to own / employ clinicians as part of its strategy in stark contrast to Optum. 2. It'll start with 1 million members in 3 markets 3. While the existing venture is off-balance sheet, Elevance ultimately wants to buy and own the asset within 3-5 years. - "And so the CD&R partnership is a good example of just one of those three pillars in services being built off balance sheet with scale to start, that will be a large-scale platform when we ultimately acquire it back in. We will own it in roughly 5 years from that first close. We'll probably start consolidating it in about 3 years. But that will become the core of the platform, the Care Delivery and Enablement business at scale. And so these pieces will work with each other, as Gail described, but not in every case. I think it really depends on sort of the local market dynamics."
4. It's being developed alongside Carelon efforts to build and integrate specialty-based enablement (oncology, MSK, behavioral health, and DME all were mentioned) 5. Employers are interested in the product: - "[Employers] want guaranteed access to primary care…They want integrated digital tools, which are built around this asset. They want the same experience we often talk about in Medicare Advantage, where we curate these provider groups that you haven't really seen in the Commercial marketplace. I think that's what makes this unique. And there's a lot of interest from employers about becoming part of this."
Amid a washout in the MA markets, it's interesting to see Elevance outperform its peers in 2024 and engage in Carelon & enablement growth in an efficient way. |
Retail Health Shutdowns: Walmart's $230M primary care loss, and Dollar General's Pilot Crashes |
An Endpoints article (paywall) dove a bit deeper into Walmart Health's losses on its retail health play. As it turns out, while we all KNOW 'healthcare is hard,' the quantified value of 'hard' for Walmart before it couldn't stomach burning any more cash on primary care was $230 million. Losses stemmed from Walmart's failure to attract MA members, missing expectations by an astronomical margin. It's a sad result and financial view into a once promising player entering the space. Maybe we'll see Walmart Health 2.0 hit headlines in a few years. On a similar note, Dollar General ended its mobile urgent care pilot with DocGo for good. It had already shut down one of three pilot locations last year based on low volumes (go figure), but the announcement is another sad end to a potential way to bring scalable primary care to rural markets. |
Waystar's IPO debut: cautious optimism |
On June 6, after pricing at $21.50 per share, or the midpoint of its expected range, Waystar successfully raised $968M in its IPO, giving the healthcare payments and revenue cycle management player a ~$3.7B enterprise valuation per this CNBC article. It's the first health IT public offering in quite some time, and even more promising is the fact the whole ordeal went …pretty well. Will Waystar thaw the IPO market? After a solid debut, you should expect to see more names wade in. Finally, here's an updated view of all-time health tech SPAC and IPO performance with recent gone-publics in mind (the Waystar price is as of 6/7). Blue text and boxes denote any name taken private or bankrupt. But like I've written before, the first wave of public digital health firms was terrible. There's really no other way to describe it. As many private, late-stage firms sit on the sidelines, here's hoping for some interesting activity in the next year or two! |
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Key considerations for decision makers. Notable moves, policies, and strategies |
Ardent Health, a private, for-profit health system, is potentially planning a second try at an IPO with plans to raise up to $400M per Bloomberg. UnitedHealth and Centene highlight rising concerns over Medicaid utilization as they shift focus from an also-underwater Medicare Advantage space. BCBS Kansas City exits the Medicare Advantage market, creating ripples of impact across the sector. Jared Strock's linked breakdown is a nice summary of everything you need to know. Uber Health's Caitlin Donovan departed to join General Catalyst. Hospitals face increased financial strain as state healthcare cost caps threaten to squeeze operating margins further, per Fitch. Scan Health Plan celebrates a legal victory by winning its Medicare Advantage star ratings lawsuit. Sutter Health is back in the legal spotlight as an appeals court revives a $411 million antitrust class action against the organization. Teladoc Health announces Chuck Divita as the new CEO, former EVP at GuideWell, marking a significant leadership transition. This move is poised to steer the company through its next phase of growth (or demise) as the space experiences significant changes and volatility. Baylor Scott & White and BCBS Texas are on the brink of a significant contractual split set for July 1. This looming separation could impact a large swath of patients, emphasizing the delicate nature of payer-provider negotiations. Guys, come to the Hospitalogy table and let's mediate this. I'm right in town! HHS is investing $15 million into strengthening rural maternal health. The funding is set to enhance healthcare access and outcomes for mothers and infants in underserved areas. |
Collaborations and launches to keep a pulse on. |
- AMSURG and Palomar Health form a strategic surgery center partnership.
- Tampa General Hospital selects Palantir's AI software to power connected care coordination, extending their long-term partnership.
- Clover Health announces Counterpart Health, a new SaaS and tech-enabled services solution to bring CA technology to all Medicare Advantage payors and providers.
- Pager Health and League partner for maternity care for underserved populations.
- HubSpot announces HIPAA-compliant tools in public beta.
- UltraSight and Mayo Clinic develop AI-powered algorithms for image analysis.
- Innovaccer expands its HXP capabilities with the launch of an AI-powered healthcare contact center.
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My favorite reads & resources from the week |
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Don't miss NeuroFlow's latest innovation to support maternal mental health. ⬇️ In May, they launched new digital care pathways tailored to each stage of pregnancy. These smart tools quickly assess and identify when expectant parents need enhanced care, offering resources for managing prenatal anxiety and spotting signs of postpartum depression. With 75% of women with perinatal conditions going untreated, integrating NeuroFlow's pathways can significantly improve maternal care in your healthcare organization. Check out how these tools can transform your approach to maternal health. Learn more |
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Random personal anecdotes and musings from me |
Who's everyone got in the US Open over the weekend? Respond with your thoughts. I'm tracking coverage of Pinehurst, and it looks like the greens are absolutely diabolical. It feels like a setup where someone like...Scottie...who doesn't make many mistakes and plays to conservative targets with good ballstriking, will get the job done. But my heart will always pull for Spieth. |
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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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