Today on Health in 2 Point 00, Jess and Matthew catch up after HLTH 2021. Some massive deals in Episode 356: Oak Street acquires Rubicon MD for 190 million, 130 in cash; 23andMe acquires Lemonade (a virtual care and drug delivery company) for 400 million – 300 million in stocks and 100 million in cash; Babylon Health’s SPAC deal, 4.2 billion in market cap now; Everlywell acquires Natalist – their third acquisition in 6 months.
Greg Whisman is the Chief Medical Officer of Caremore, a venerable prepaid medical group caring for seniors. It’s been part of Anthem/Elevance for many years but this year spun off as part of a larger PE backed group called Millennium. We really got into the what and the how of primary care for seniors and, yes, we delved deep into the future of primary care. This is a topic that will never die on THCB and getting a real expert to opine on it was really valuable. This is a great conversation–Matthew Holt
Virta Health is in the diabetes reversal business. It’s a medical group that for a decade has been aggressively coaching people with diabetes and cardiometabolic disease to radically change their eating habits–basically to eat the right things for them, to saity. Some how in a nation obsessed with processed food and carbs they have succeeded for a lot of people. And the business is growing fast, with over $160m in annual run rate. Ten years in since it started I spoke with CEO Sami Inkinen about how and why it works, and what the future for this approach is in a world of GLP1s (and no there’s no GLP sales in that revenue number!)–Matthew Holt
Lisbeth Votruba, the Chief Clinical Officer and Dana Peco, the AVP of Clinical Informatics from Avasure came on THCB to explain how their AI enabled surveillance system improves the care team experience in hospitals and health care facilities. Their technology enables remote nurses and clinical staff to monitor patients, and manage their care in a tight virtual nursing relationship with the staff at the facility, and also deliver remote specialty consults. They showed their tools and services which are now present in thousands of facilities and are helping with the nursing shortage. A demo and great discussion about how technology is improving the quality of care and the staff experience–Matthew Holt
There are a lot of nurse practitioners in the US–over 400,000 (compared to around 900,000 MDs and DOs), and we are training 40,000 a year. But how they are going to be used is not entirely clear. Lynn Rapsilber is an NP whose organization, the National Nurse Practitioner Entrepreneur Network, is working to help her fellow NPs with their professional and business development. She came on THCB to discuss how NPs are developing and how she thinks NPs will contribute in the future as we deal with the current crisis in primary care–Matthew Holt
Tamir Gottfried, the Chief Commercial and Strategy Officer at TytoCare came on THCB to show us how their remote device works to deliver the last few inches of telehealth. Most telehealth is just a video call but with Tyto’s device, the patient can asynchronously (and/or synchronously) take their vital signs including videos and pictures of the skin, ears, mouth, heartbeat et al, and share it with their doctor. It actually amazes me that they haven’t been more popular but in the last few years Tyto has made significant inroads with health plans and providers delivering their devices, as well as adding chronic care management module, with a forthcoming smart clinic (AI) companion. Tamir explained who, how what and why to me, and gave a not too gruesome demo–Matthew Holt
Fawad Butt and Missy Krasner started a new AI company which is building a big platform for both plans and providers in health care. Penguin Ai has a cute name, but is serious about trying to provide an underlying platform that is going enable agents across the enterprise. They are health care only, as opposed to the big LLMs. But does health care need a separate AI company? Are the big LLMs going to give up health? And what about that Epic company? Join us as we discuss how this AI thing is going to be deployed across health care, and how Penguin is going to play. Oh and they raised $30m series A to start getting it done–Matthew Holt
Stephanie Strong, CEO and Marianna Zaslavsky, the (relatively new) Head of Growth at Boulder Care came on THCB to tell Matthew Holt about their service which delivers medication assisted treatment for those suffering from substance used disorder, via telehealth. Stephanie has been one of the leading advocates for getting patients, especially those on Medicaid, access to treatment. She led a campaign to get the DEA to continue to allow substance abuse treatment using medication via telehealth. Marianna joined this summer with the goal of helping patients get access via managed care plans. We discussed a lot about the potential for Boulder to continue its harm reduction strategy for patients, and also the potential limits that might be coming via Medicaid reductions as part of the BBB. Stephanie and Boulder are supporting a campaign called Majority for Medicaid which is raising awareness about the impact of Medicaid cuts on these patients.
Dr Kaelee Brockway is a professor of education and physical therapy who has built a series of AI based “patients” for her PT students to train on. Kaelee is a pioneer in using these tools for training. She showed me the personas that she has built with LLMs that are now being used by her students to figure out how to train their soft skills–a huge part of any training. This a great demo and discussion about how clinical professionals are going to use LLMs in their training and their work–Matthew Holt
“So far AI in health care is being used to drive existing profits on workflows and increase revenue per event that patients in the end have to pay for. That’s not a win for anyone long term!” Included Health’s CEO Owen Tripp dives into the present and future use of AI, LLMs, patient self-triage and self treatment and all that. Another interesting conversation on where patient facing AI will end up — Matthew Holt
Ingrid is one of the OGs of customer service in health plans, PBMs and as she insists startups. She and her co-founder Marin Nelson have built Sobrynth–a company that is taking a whole new approach to helping with (primarily) alcohol addiction in the workplace. Despite the rise of mental health solutions, EAP, the focus on substance abuse and a lot of DTC plays in alcohol use disorder (starting with AA and going on from there), there’s not much specifically for employers. Ingrid showed me the app, the process and we had a great chat about the problem and how Sobrynth can help–Matthew Holt
Ami Parekh is the Chief Health Officer and Ankoor Shah, is VP, Clinical Excellence at Included Health. I had a long conversation with them about the philosophy of how we are doing population health and how we fix the system that we have today. I’m arguing for more primary care, but Ami restated it and says, you need somone you trust who is an expert who can help you make decisions. And this might not be a human! How do we change the system, and how does telehealth work now and how will it change? Defining health from the person perspective, not the way the health system wants to define it! Matthew Holt
The super connector and super intelligent Emily Peters, (who has quite her own patient adventure story–tl:dr GO GIVE BLOOD) and has written several books including Artists Remaking Medicine, is working on another one called Money Remaking Medicine. She invited me on a show called the Positive Deviants Detectives which is kind of a book club called the Health Care Reinvention Collaborative all hosted by the very wise Dawn Ellison. We talked and the audience joined in about the history of money, HMOs and more in health care and whether we can re-fangle it to make the money do the right things. Matthew Holt
Steve Brown is a genuine digital health OG. Starting with video games for kids with diabetes he eventually turned Health Hero into one of the first disease management companies. It was used in the VA to manage patients at home with CHF, diabetes and more and eventually sold to Bosch. Steve left health care for 15 years, but then at the start of this year had his own health issue. Which turned out to be cancer. He turned to AI and has built an amazing early stage patient facing AI doctor, called CureWise. It essentially has turned LLMs into multiple doctors. He gave me a full and fascinating demo. This is clearly the future but it’s also the present for Steve who is patient zero and the first user as well as the CEO. Amazing stuff. — Matthew Holt
I got to interview V Bento the CEO of Sword Health. We had been in a little back and forth on Linkedin but this was the first time we actually had talked. Almost all of their business is in the US in MSK but they have recently added mental health and V is not shy in talking about the other areas they are heading into. They have had some controversial moments. They just raised money at an amount ($4 Bn) higher than larger rival MSK health outfit Hinge Health is trading at on the public market. Then I used it a year ago via Blue Shield of CA, and found it effective but expensive. Finally, there’s a lawsuit from the folks at Aging 2.0 who claim that they are owed equity from an accelerator Sword was part of in the 2010s. V talked about all of these, specifically about how they are now charging their clients, and why he thinks they are worth their valuation–which apparently has no special terms for general Catalyst which invested at that valuation. He wouldn’t talk about the lawsuit other than to say he was happy with his position. But we had a good discussion and got to hear about their new tech, including their use of AI, and why V is so bullish on the company moving beyond MSK. Matthew Holt
Dominique Wells is COO of Conduit Health Partners which is a spin off from the (now) Bon Secours Mercy Health system. Their role is to provide back up for nursing staff for health systems in very specific areas, notably patient transfer operations, nurse triage and patient communications. Dominique and her team showed me a brief demo of how the transfer operation works. We also got into the conversation about the role of AI in nursing, and how nursing has changed since the pandemic. An interesting discussion about how the most vital role in health care is changing and how new services are being developed to adapt to it—Matthew Holt
We are entering an age of at home testing and the team at Reperio just raised $14m to make weight, blood pressure and cholesterol/blood sugar testing available at home. But this is a relatively complex series of tests, intended to get people who haven’t been to a primary care doctor back into the system. How is the experience and can we expect people to do it? And does the result correlate with standard lab testing? They sent me the box for me to find out. I totally screwed it up the first time (apparently only 4% of people do), but they gave me another chance. So come along with me to find out how it works. Would you do this, or just go to Labcorp?! — Matthew Holt
Anmol Madan is CEO of RadiantGraph. He’s building an end to end solution that goes from data ingestion to applications to consumer connection via text/email and voice in order to let payers quickly roll out patient engagement plans. His idea is that plans/payers don’t need to fix their data, RadiantGraph’s AI can take the messy data and and then add an AI layer, and on that create specific applications–Anmol showed me a comprehensive demo. I also asked him if they are doing too much, or conversely if they need to do more!–Matthew Holt
So I thought I would try a little experiment. Following up on a recent primary care visit I got a couple of referrals. I went investigating as to what I could find out about the where to go and what the cost might be. And what the connection if any between my primary care group (One Medical), the facility and specialists I was referred to, and my health plan, Blue Shield. I hope you enjoy my little tour of this part of the online health system–Matthew Holt
H1 has raised over $200m to build out a very comprehensive data set of physicians internationally. Those products were primarily aimed at pharma. Now they are moving into the world of managing physician data for plans and providers, primarily via the 2025 acquisitions of Ribbon Health and Veda Health. I spoke with CEO Ariel Katz, and he took me through a demo of their system. I’ve had a nerdy interest in physician data for quite a while (I actually sketched out this product on a whiteboard at Microsoft in 2009!!) and what H1 has built is very impressive–Matthew Holt