Venture capital
When AI capital doesn't necessarily mean value
Flare Capital's new examination of 4,000 healthcare AI venture capital deals looked at where investment has actually created value — that is, what early-stage, venture-backed technology matures enough to impact the health care ecosystem?
The analysis finds that health AI startups selling to health systems, insurers and the life sciences sector have raised a combined $60 billion in the last decade — 70% of that was raised in the last 5 years. But "[m]ore capital, however, does not universally equate to more value creation," authors write: Most AI startups selling to health systems haven't advanced beyond Seed or Series A and B stages; just 5% selling to health systems reach Series C or later, compared to about 10% of life sciences and 16% of health plan startups. Read more on Flare Capital's findings here.
payers
Highmark reboots coverage of digital treatments
My co-author Mario Aguilar recently took a closer look at Pittsburgh-based Highmark Health, a payer and provider group that's now covering digital treatments for chronic pain and other conditions. It's the company's second attempt at covering prescription digital therapeutics, and the policy could still evolve: Highmark scrapped an initial list of covered products last year in favor of just three new ones this summer (AppliedVR's chronic lower back pain treatment; Luminopia's virtual reality treatment for pediatric lazy eye, and Stanza, a smartphone app for fibromyalgia.)
"To give you some idea how much it has moved and changed and we've tried to adapt: Most policies in two years have two changes. This one had seven," Matt Fickie, a senior medical director at Highmark, told Mario. Read more.
White House finalizes payment parity rules
Some insurance news from Washington: The Biden administration said it would finalize a proposal forcing health insurers to pay for mental health care just like they cover treatment of physical health conditions, my STAT colleague Lev Facher writes. "It's simple: It shouldn't be harder for you to get care when you feel depressed than getting care when you have back pain," said Lisa Gomez, the assistant secretary for employee benefits security at the U.S. Department of Labor. "It shouldn't be harder for you to find a provider that can treat your eating disorder than it is to find a provider that can treat your ulcer." Read more from Lev.
mental health
Tom Insel talks telehealth apps, value-based care
Former National Institute of Mental Health director and serial entrepreneur Tom Insel spoke to a group of journalists including my colleague Brittany Trang yesterday on the sidelines of an event in Boston, touching on the topic of direct-to-consumer (or through employer) telehealth apps.
"I care less about whether it's a credentialed therapist or a coach and more about whether anybody's actually measuring outcomes the way we would for diabetes care or hypertension care," said Insel, pointing out that Zoom telehealth visits provide a wealth of data on voice, blink rate, and other mannerisms that could be used to assess whether the therapy is actually working." For the most part, it's been a story about 'how do you expand access?' Not a bad thing, but if it's access to crap, I don't know that that's actually progress. So I would much rather see people figure out a way to focus on quality. And that requires, actually, measurement."
Brittany tells us Insel also argued that fee-for-service payments for mental health incentivize providers to keep patients coming back, rather than to get them well. Insel has one company, Vanna Health, trying to shift to a value-based care model for mental health. He listed Author, Firsthand, and Amae as other startups also trying to shift mental health care to a more holistic approach.
big tech
Apple keynote: Smart watch pushes into sleep apnea detection
The iPhone and watch-maker has announced a new wearable feature designed to warn users that they may have sleep apnea, Mario reports from Apple's keynote event in Cupertino this week. The sleep apnea feature is just the company's latest attempt to market its watch as a tool to make wearers healthier; it also announced new capabilities for its wireless earbuds, which will be able to conduct a hearing test and later be used as an over-the-counter hearing aid, according to Apple's vice president of health Sumbul Desai.
Still, as Mario has reported, it's not clear how the new features nor the data they generate will be incorporated into clinical practice. Read more on the keynote, and potential hurdles, here.
STAT investigation
How a safety-net hospital is eliminating race from its algorithms
In the latest installment of STAT's breathtaking and thorough investigation of the bias embedded in clinical algorithms, my colleague Usha Lee McFarling takes us into a Brooklyn safety net hospital system that's trying to remove race from kidney disease risk calculations. Eliminating race would flag people with kidney disease sooner and potentially help more patients qualify for treatment or transplants sooner, Usha writes. One in four people in Central Brooklyn faces chronic kidney disease, and "[w]e are desperately not reaching people in need," hospitalist Sophia Kostelanetz, a proponent of eliminating race in clinical algorithms, told Usha. Read more here, and the previous installment, on ways medicine pathologizes Black patients' normal medical test results. You can find the entire series here.
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