The Healthy Muse (hospitalogy)

Welcome back to the Healthy Muse and the most lit healthcare news stories around. It’s good to be back after a much needed break.

• If you’re new here, 1) Welcome! 2) My name is Blake Madden, and I started this newsletter a couple of years ago in order to bring easy-to-understand, 5-minute healthcare reads to people on a weekly basis. I hope you enjoy learning about healthcare as much as I do.

This week’s edition is a doozy. We’re covering the best healthcare stories that happened in 2020 along with what’s going on in 2021 so far. Let’s get into it, and as always, I appreciate your readership!

• If you read all the way through this extremely long newsletter, you’re a legend. Please feel free to share with others who are missing out on the best healthcare newsletter around.

What you’ve missed so far in 2021…

First things first: Since I went AWOL for the first couple of weeks to start 2021, here’s what’s been happening in our lit world of healthcare:

• 2021 Megadeals:
  • UnitedHealthcare’s Optum will acquire Change Healthcare in a $13 billion deal. Change Healthcare, a health tech firm that provides hospitals with data analytics and other rev cycle tools, went public in mid-2019 debuting with a market cap under $5 billion. Everyone in healthcare is eventually gonna work for UNH. The acquisition seems highly strategic for UNH’s Optum wing.
  • Centene announced its acquisition of Magellan Health in a $2.2 billion deal – a 15% premium to Magellan’s share price prior to the announcement. The acquisition gives Centene an entry into behavioral health – which many believe will be the next major growth sector for healthcare.
  • Finally, Walgreens is selling its wholesale pharmacy business to AmerisourceBergen in a $6.5 billion deal. 2021 mega deals definitely aren’t starting off slowly, eh?
• Haven: The once highly touted Amazon-JP Morgan-Berkshire Hathaway venture into healthcare closed up shop at the end of 2020. But really the writing on the wall was here as early as May 2020 when the JV lost its 2 top executives. (Link)
• Tennessee: The Trump admin just approved the state’s request to reform Medicaid funding into a ‘block grant’ structure, which CMS says will help control health spending costs in the state. Critics argue that the capped spending will incentivize the state to cut healthcare for low-income populations. (Link)
• Adeptus: Once the darling of Wall Street, the freestanding ER firm filed for Chapter 7 bankruptcy, planning to liquidate all assets. (Link)

Where we were entering 2020.

In a previous newsletter, I wrote out what I considered to be the major trends affecting healthcare entering 2020. Let’s take a look at how the below trends have played out in 2020.

Global: Coronavirus

• Results: We’re not done yet – but with the rollout of vaccines and fingers crossed on no new variants, the pandemic looks to be ending before the end of 2021.

General Healthcare: Consolidation is happening industry-wide – to name a few sectors: physician practices, imaging centers, and home health. Consumer-centric healthcare is rapidly expanding, including direct to consumer services (hand in hand with “concierge medicine“), wearable tech, and telemedicine. More focus on social determinants of health. Rapid increase in private equity investments, Price transparency (learn more), data privacy (learn more), and vertical integration (learn more).

• Results: Most of these – most notably, telemedicine, consolidation, and price transparency – accelerated during 2020.

Policy: Election 2020 (learn more), rising drug costs (learn more), surprise billing (learn more), and the ACA back in court (learn more). Medicaid expansion, or Medicaid block grants? Time (and the 2020 election) will tell.

• Results: We all know what happened in the 2020 election. Drug costs are still a problem, but a solution to surprise billing passed Congress in late 2020. Medicaid is continually changing as some states pursue block grant structures or work requirements, the legality of which is questionable. Medicaid will expand under the Biden regime.

Digital Health & Innovation: Interoperability will create the need for stronger cybersecurity. Entrance of artificial intelligence in drug discovery/development (learn more), diagnostic fields (learn more), and other clinical settings (learn more). Continued growth of robotic assisted surgery (learn more). Big Tech is looking to disrupt healthcare.

• Results: We observed the fastest ever drug pipeline in 2020 with the development of the Covid vaccines. Big Tech continues to make headway into various sectors with incremental success.

Hospitals: Rural hospitals are closing at record rates (learn more). Staffing shortages will affect providers’ future financial performance and viability.

• Results: Rural hospitals are still struggling, and patient access to care in rural areas continued to suffer. These effects were exacerbated by the pandemic. Hospitals faced nursing and PPE shortages during 2020.

Post-Acute Care: The new home health & hospice payment model, PDGM, may cause mass home health closures and drastic consolidation. Encompass Healthcare – and all post acute providers, for that matter – is building inpatient rehabilitation facilities like crazy. Skilled nursing facilities are struggling.

• Results: Interestingly, the pandemic increased the longevity of home health agencies as they received bailouts and loans for staffing. Inpatient rehab build-outs are still occurring across the nation as the land grab for seniors continues. SNFs and assisted living facilities were hit hard by the pandemic.

Physician Practices: Physicians are all getting employed by health systems, private equity firms, or insurance companies like UnitedHealth. As a result, independent docs are getting harder to come by.

• Results: Physicians are still getting gobbled up by health systems, payors, and private equity alike. Primary care in particular suffered during the pandemic.

Health Insurance: Healthcare spending growth, looming Baby Boomer population (65+) resulting in massive Medicare Advantage growth.

• Results: Healthcare spending actually decreased for the first time in 2020 due to shutdowns. Medicaid enrollment is expected to see an uptick in 2021 while Medicare Advantage continues its growth – especially if the Medicare eligibility age drops to 60.

On to the best of 2020!

Healthy Muse Healthcare 2020 Year in Review.

Healthcare IPOs Everywhere

A slew of IPOs: With frothy market valuations and the forced shift to virtual and digital health in 2020, we saw a number of digital health IPOs – and IPOs in general – along with the emergence of special purpose acquisition companies (SPACs) which also helped a few healthcare firms hit the public markets.

• One Medical: The health tech primary care platform backed by Google went public in January. (Link)
• Ardent: Interestingly, privately-owned hospital operator Ardent Health Services called off its IPO plans in January. I can’t help but think the firm would have benefitted from such frothy market conditions, but of course hindsite is 2020, and I’m not a hospital operator. (Link)
• Accolade: The firm associated with helping employers navigate health benefits, debuted on the public markets in early July. (Link)
• GoodRx: Debuted to much success in late September, popping as high as $57 per share in its initial day of trading. Interestingly, since the Amazon Pharmacy announcement, GoodRx has traded down to $43. (Link)
• GoHealth: The tech enabled insurance enrollment platform raised more than $913 million in its IPO in mid-July. (Link)
• Oak Street Health: Went public in early August to – as expected – much success. The firm raised more than three times what it intended as the IPO market stayed red-hot in the back half of the year. (Link)
• Outset Medical: successfully debuted on the public markets in late September. The portable dialysis firm is looking to capitalize on the recently finalized end-stage renal disease payment model that encourages at-home dialysis treatment.
• SOC Telemed: As a part of another SPAC deal, SOC Telemed joined the public markets early November under the ticker $TLMD, valued initially at $720 million. The firm provides telemedicine and other tech services to hospitals in almost every state and is taking advantage of the boom in remote health care.
• Amwell: skyrocketed in its IPO in late September. That same week, Teladoc hit Amwell with several intellectual property accusations, claiming that Amwell infringed on several of Teladoc’s patents.
• Multiplan: Churchill Capital’s SPAC took Multiplan, a healthcare solutions provider that partners with managed care companies, public at an $11 billion valuation. (Link)
• Hims & Hers: Is expected to go public via SPAC with Oaktree Acquisition Corp. The unicorn will hold a value of about $1.6 billion when the deal closes. (Link)
• Clover Health: The health-tech managed care firm was acquired by Social Capital Hedosophia Holdings Corp III in October, valuing Clover at about $3.7 billion initially. (Link). Read this analysis of the Clover SPAC.
• Eargo: The hearing aids tech co. raised $141 million in its IPO in mid October. (Link)
• UpHealth and Cloudbreak: In healthcare’s latest SPAC deal, UpHealth and Cloudbreak are merging with blank-check company GigCapital2 to become the latest digital health conglomerate unicorn on the public markets. The new combination is a fascinating PROFITABLE play into telemedicine, patient care management, medical interpretation, prescription drugs, and more. (Ticker: $UPH).
• CareMax Medical Group and IMC Medical Group: Healthcare SPAC Deerfield is merging with the two in order to bring the firms to the public markets. The combination will create what I imagine to be similar to Oak Street Health – medical clinics for seniors under value-based contracts. (Link)
• On deck for 2021: Telehealth player MDLive, Highly touted unicorn Oscar Health, and more. The health tech IPO boom goes on! (Link)
  • In one of the most anticipated health tech moves, Oscar Health confidentially filed for IPO a week after raising $140 million in a pre-IPO funding round in late December. The firm is a self-described “full-stack technology platform” and serves primarily the Obamacare population as an insurance company. Read more about the company’s history here as one of the biggest contrarian plays in healthcare

2020 M&A Deals.

Teladoc: As the darling of health tech, it’s no wonder why Teladoc’s stock soared this year. The firm took advantage of the capital by acquiring InTouch Health first for $600 million and then later merging with Livongo in a deal valuing Livongo at $18.5 billion – one of the landmark deals of 2020.

• Combined, the digital health conglomerate boasted a market cap of $40 billion, which has since decreased slightly to $33 billion as of this writing. Chump change. (Link)

Centene: Finalized its purchase of WellCare in 2020. After gobbling up WellCare and now Magellan, Centene has sealed itself as a formidable presence in the payor space. In fact, some argued that the Centene/WellCare match-up was the most notable deal of 2020. (Link)

Steward Health Care: In June, Steward Health Care, a multi-state for-profit hospital operator, was purchased by a group of physicians. This transaction was very notable – the system just became the largest physician-owned healthcare company in the U.S. after buying the company back. Plus, the physicians bought the 90% stake from a private equity group, so it’s really quite intriguing. (Link)

Advocate Aurora and Beaumont Health: After announcing the deal in June, the nonprofit giants later canceled their intentions to merge to create a $17.5 billion system in the Midwest. (Link)

CHI Franciscan and Virginia Mason: The two nonprofits merged to form a 12-hospital system in the greater Seattle area. (Link)

Siemens Healthineers and Varian Medical Systems: Siemens Healthineers, one of the largest medical device and technology firms, announced its intention to purchase Varian Medical Systems for $16.4 billion. The transaction, pending closing, would be one of the largest healthcare acquisitions of 2020. (Link)

Sentara Healthcare and Cone Health: In August, the two nonprofit health systems announced their intent to merge into a 17-hospital, $11.5 billion health system in the Virginia, North Carolina, and Ohio area.

Mednax: The physician staffing firm – soon to be called Pediatrix, by the way – sold its radiology division to Radiology Partners in September for a little under $1 billion.

American Renal Associates goes private: In the first major public to private deal announced post-Covid, dialysis provider American Renal Associates is getting acquired by Nautic Partners, valuing the company a bit south of $900 million. Notably, ARA is getting bought at a 66% premium to its closing share price, meaning that Nautic thought that ARA was significantly undervalued by the public markets.

Select goes big on post-acute: In mid-October, Select Medical purchased fellow post-acute operator Kindred Healthcare’s skilled nursing and senior living service line (AKA, RehabCare) for an undisclosed-but-probably-large sum of money.

Sanford’s failed mergers: After a failed merger between Sanford Health and UnityPoint in late 2019, the nonprofit giant failed to merge once again – this time with Intermountain Healthcare. The canceled merger would have resulted in a system generating $15 billion in revenue. (Link)

Tenet’s Outpatient Purchase: The hospital operator just majorly expanded its outpatient footprint after buying a majority stake in SurgCenter Development. Tenet will add 45 surgery centers and surgical hospitals to its USPI division and is focusing its capital on its outpatient segments. (Link)

Encompass: The post-acute provider is considering spinning off or selling its home health and hospice segment. (Link)

Healthcare Trends in 2020.

Here are some of the more notable healthcare trends that were spotted in 2020.

The Coronavirus Catalyst and rise of the digital health conglomerates: Digital health deals are continuing at a rapid pace as the pandemic (and easy money policy in general) pushed investment into the digital health space. According to Mercom Capital, 132 digital health companies were acquired in the first 9 months of 2020, and deals have only gotten bigger.

As digital health evolves, we’re seeing the emergence of the digital health conglomerate, meaning that these companies are starting to offer healthcare services along the continuum of care. In other words, these firms are not focused on one facet of healthcare anymore.

• The classic example here is newly formed Teladoc-Livongo, where the once pure-play telehealth firm now offers chronic disease management services, a clear synergy to its platform.

Big Tech’s continued foray into healthcare: Big Tech has taken a variety of incremental steps into healthcare during 2020 (Link). One of the bigger ways these firms have done so is through cloud computing:

• Amazon is getting cozy with Cerner by integrating its Alexa products and Halo wearable with the EHR platform.
• Microsoft announced its plans to launch Microsoft Cloud for Healthcare in late September
• Apple continues to integrate with health system medical records nationwide
• Google has already gotten in trouble over working with patient data (if you remember the Project Nightingale PR nightmare)

Wearables: Continue to see increased efficacy. Blood glucose monitoring, remote patient monitoring, sleep cycles, heart rates, built-in EKGs, detecting disease infection prior to the onset of symptoms – the list of uses for wearables continues to grow along with the list of competitors:

• Amazon’s Halo, Apple’s Watch, FitBit, Whoop, Levels, and the Oura Ring continue to fight for market share in the growing space.
  • NBA players began wearing the Oura ring in order to track the onset of COVID symptoms prior to illness. (Link)

Online Pharmacy: As with most other facets of health, pharmacy services were pushed toward an online world. While the logistics of drug delivery haven’t been perfected, companies like Amazon, Ro, GoodRx, and others are expanding into the increasingly online sector. (Ro, GoodRx, Amazon) (Link) (GoodRx Link)

Revenue Cycle Automation: A small trend to watch – hospitals are looking to automate the boring elements of revenue cycle management – AKA, billing and collecting and accounting $$$.

• Meanwhile, Olive, an AI startup focused on healthcare and admin automation, just raised over $100 million. Interesting stuff – the administrative state of healthcare has plenty of opportunity for efficiency.

Other trends: Racism in healthcare and as a public health crisis (Link), and social determinants of health. (Link). And don’t forget about the mental health crisis. (Link). The CDC released a damning report concerning mental health during the pandemic, finding that about a quarter of young adults (18-24) have considered committing suicide during COVID-19. Pretty eye-opening for sure.

Healthcare Strategies in 2020.

Amazon: The retail giant has been busy chipping away into healthcare:

• In August, Amazon entered the health wearable space by launching Halo, a non-screen device that can track your sleep, interpret the tone of your voice to determine your mood, scan your body and estimate body weight, and more.
  • Learn more about Cerner’s expanding collaboration with Amazon including its Halo integration and cloud platform. The two seem to be closely partnered on healthcare initiatives.
• Amazon Pharmacy: Amazon finally made the fully-fledged leap into the pharmacy business by launching online prescription fulfillment in late November. Of course, Prime members will receive free drug delivery and prescription savings, which are easy synergies for the retail disruptor giant.
  • Details: Amazon won’t deliver Schedule II substances (think painkillers, etc.) but it IS offering a variety of drugs including birth control and insulin. The announcement solidifies Amazon’s foothold into the pharmacy biz after years of slow but steady entry. Big pharmacy stocks like CVS, Walgreens, and GoodRx were down significantly on the news – which is the so-called Amazon effect in full force once again.

Walmart Health’s major healthcare moves.

• Walmart expanded its health clinics to multiple states throughout 2020. The clinics provide a variety of primary care services at very competitive prices. While the clinics themselves are fascinating, Walmart didn’t stop there.
• In September, recently IPO’d Oak Street Health announced a partnership with Walmart to integrate its center model inside three Walmart super centers in the Dallas-Fort Worth area later this year.
• In early October, Walmart announced its partnership with Clover for an MA plan in Georgia.
• Later in October, Walmart announced its plans to become a MA broker in all 50 states, servicing plans from United, WellCare, Humana, and others. Notably missing? CVS/Aetna, a Walmart Health competitor given the HealthHUB strategy.
• Here’s a good summary of Walmart Health in 2020.

CVS HealthHUB and Walgreen’s VillageMD

• CVS: CVS’ HealthHUB strategy hit the main stage in 2020. The healthcare giant is rolling out the highly touted HealthHUBs to markets nationwide. How did they decide which areas to target first, though? That’s easy – by choosing markets where a high number of Aetna members were located. In healthcare, it’s all about A L I G N M E N T. The alignment continues to expand as CVS pharmacies go out of network with other major payors. (Link)
• Walgreens: While titans like CVS and Walmart are building out their own healthcare presence, Walgreens is outsourcing it to firms like VillageMD.

Mednax: Mednax shifted its focus in 2020 as the firm dealt with activist investors and surprise billing pressures. (Link)

CommonSpirit Health is doubling down on primary care by partnering with a Paladina Health, a new direct-to-employer primary care provider. (Link)

Ro: The telehealth startup kept busy in 2020 by expanding its offerings. Read the full business profile on Ro. (Link)

• Also notable: In October, Ro expanded its partnership with Pfizer to provide its patients with generic drugs. Ro’s strategy is centered around direct-to-consumer healthcare, of which providing cheap generics is a crucial component.

Read this deep dive on GoodRx: how they make money, what PBMs are, and how GoodRx fits into the drug supply chain maze. (Case Load) – side note – feel free to subscribe to Case Load as well. It’s top-tier content.

• More GoodRx: Read about the firm’s rapid expansion into telehealth. (Link)

Clover Health: After its combination with esteemed investor Chamath P., the ‘technology enabled’ managed care firm is eyeing expansive member growth in 2021. (Link)

Home health: Read about how home health titan LHC Group’s business strategy, including joint venture partnerships and customizing each one in order to optimize care in different types of markets. (Link). Read about the dynamic, constantly changing home health industry. (Link)

Select Medical Corp: Read about Select’s plans for growth in the post-acute sector after acquiring strategic post-acute assets from Kindred. (Link)

Biden’s in, Trump is out. What now?

Biden enters the presidency with a couple of health care things top of mind: The pandemic (obviously) and the ACA court case that began right after the election.

The Biden Agenda and the Democratic led Congress:

• Medicare to 60: Move initial Medicare eligibility to 60 from 65 (something I wrote about here). The move would have huge revenue ramifications for hospitals. (Link)
• ACA expansion: Biden plans to expand ACA subsidies. Premium costs would be capped at 8.5% of income.
• Public option: For the middle class – Biden wants to create a public health insurance plan that could compete against private commercial insurance. Middle class folks would get a tax credit to help with premium costs. Read more about a public option here. You already know that many players in the industry wouldn’t be fans of this proposal.

Other important initiatives for the Biden camp include combating high drug prices. Biden’s expected healthcare team for HHS can be found here.

Surprise Billing Resolution.

A Surprise Billing Solution: Out of absolutely left field at the end of the year, lawmakers from both parties announced that a deal had been reached in figuring out how to deal with surprise medical bills.

As a part of the second round of stimulus packages, the bipartisan deal ends a stalemate on legislation that had been gridlocked for YEARS.

• Background: Congress has floated two surprise billing solutions in the past – called benchmarking and arbitration (I explain those proposals here). The latest agreed-upon proposal favors arbitration.
  • Details: Under the bill, patients would pay in-network rates for their emergency care. Providers and insurers would then take 30 days to negotiate the out-of-network payment. If they can’t decide on a payment, then a third-party arbiter would decide for them by using median in-network rates as a starting point.
  • What this means for you: While you wouldn’t have to worry about receiving surprise medical bills, the policy COULD result in higher healthcare costs indirectly – in the form of higher premiums or deductibles. Tricky tricky.

Medicaid Reform.

Lawmakers and states have been busy as ever with Medicaid. We’ve seen expansion in certain states such as Oklahoma and Missouri. In other states – namely, Georgia and Tennessee – we’ve seen new programs created:

• Georgia: CMS approved Georgia’s reinsurance program waiver late last year. The waiver means starting in 2023, people in Georgia on ACA plans will have to purchase insurance directly through insurance websites or web brokers RATHER than through healthcare.gov.
  • As another key component of the 1332 state innovation waiver, CMS would incentivize health insurers to participate in these exchanges by offering protection against catastrophically high claims.
    • Critics of the waiver argue that the shift from Healthcare.gov could confuse people, leading to lower coverage for 500,000 individuals on ACA plans. Georgia has the highest uninsured rate in the country at 13.7%. Then there’s the whole question of whether the policy is legal under the ACA. Read the critics’ viewpoint here.
    • Proponents of the waiver think that the policy will lower health care costs in the state and provide more choice in plans for Georgians. CMS thinks that premiums could drop 13% on average beginning in 2023. Further, ACA enrollment dropped 22% on average between 2016 and 2019. Read the CMS press release here.
  • Bigger picture: What Georgia is doing could be the future of Medicaid under a conservative state regime.
• Nebraska: After voting to expand Medicaid in 2018, Nebraska plans to implement a controversial two-tiered Medicaid work requirement structure along with the expansion. So far, Medicaid work requirements haven’t held up in court. (Read about the Nebraska plan here).
• Tennessee: As mentioned above, the Trump admin just approved the state’s request to reform Medicaid funding into a ‘block grant’ structure, which CMS says will help control health spending costs in the state. Critics argue that the capped spending will incentivize the state to cut healthcare for low-income populations. (Link)

Supreme Court Cases.

Supreme Court Cases: Ruth Bader Ginsburg’s passing created massive health care implications for both the presidential campaign and the ACA.

• While a Democratic-led government probably makes the ACA case moot, the conservative lean of the court could have other implications for healthcare – namely, whether state Medicaid reforms like the upcoming Medicaid work requirements case or Medicaid block grants go into effect, the scope of abortion, the outlook of the 340B program, and more.

Everything CMS.

Site neutrality: Hospitals lost their appeals court case in 2020, which challenged the legality of site neutral payments. This was a significant development – historically, hospitals received a higher payment for the same type of healthcare service as compared to a freestanding site. Hospitals argue that they deserve higher payments because their operations require a higher level of overhead and expenses (big building, more administrative staff, etc.). Others think that all these higher payments do is drive up the cost of care while adding a layer of payor complexity.

• In addition to the above, CMS is ending the inpatient-only surgery list in an effort to move toward site neutral payments and further push care to the outpatient setting. The move was bashed by the AHA, which immediately released a statement criticizing the move. Read the statement here.

Price transparency: CMS finalized its price transparency rule this week. Starting in 2022, insurers and group health plans will be required to disclose in-network, out of network, and net drug pricing rates between the plans and their providers. Additional requirements will phase in beyond 2022.

Direct Contracting Model: CMS unveiled its direct contracting model for Medicare beneficiaries and touted it as one of the ‘largest bets on value-based care’ to date. Under the program, direct contracting entities will partner with ACOs, health systems, and other risk bearing entities to manage a population of Medicare fee-for-service beneficiaries in that specific region. (Link)

340B Program: As drugmakers drop out of the 340B program (maybe illegally), hospitals are asking HHS to intervene on their behalf. In fact, more than 1,000 hospitals are disputing drug makers like AstraZeneca’s and Eli Lilly’s recent moves in all but abandoning the program

Hospitals are accusing HHS of letting pharmaceutical companies side step the 340B program – which offers drug discounts to certain hospitals. (Link)

• Read all about the 340B program – the federal program that keeps insulin prices high. (Drug Channels)

Coronavirus Stories.

The Coronavirus Crisis led to more change, more rapidly in our healthcare system than ever before. Here are some ways the system drastically changed:

Telehealth: With the government easing access to telehealth this year, COVID-19 was a black swan event for the industry and lead to widespread adoption. Teladoc’s stock surged the entire year on increased demand for virtual visits. UnitedHealth and other payors expanded access to virtual care. Outpatient services like physical therapy and home health agencies were forced to transition to telemedicine for months as lockdowns plagued the country.

Biotech: Biotech firms working on COVID-19 treatments and vaccines like Moderna, Pfizer, and Gilead benefited from increased government spending and accelerated FDA deadlines, which has implications for drug development for years to come.

State lines broken: Up to this point, physicians have had to get licensed in individual states. With telehealth needed in increasing situations, governments eased licensing restrictions for physicians to practice across state lines. It remains to be seen whether this stays the case post-pandemic. (Link)

Payors: enjoyed historically low medical loss ratios during coronavirus as elective surgeries shut down during April.

Providers: To the detriment of hospitals and providers, the shutdown of elective surgeries severely hampered profitability among providers sector-wide.

Other interesting ‘Rona Reads:

• mRNA Vaccines: Read about how mRNA vaccines went from a dismissed technology to a vaccine leader during the 2020 vaccine race. (Stat)
• Utilization Trends: Take a look at how healthcare utilization and spending have changed during the year of Covid. (Link)
• Open your Eyes: The pandemic must be seen. (Wired)
• Mourning: “This Is a Time for Mourning”: Hospital Chaplaincy in the Age of Coronavirus (The Ringer)

My Favorite 2020 Stories

Kodak’s Moment: The U.S. government awarded Eastman Kodak Company (yes – THAT Kodak) a $775 million contract to produce and manufacture pharmaceutical ingredients to be used in generic drugs. When the news broke in late July, Kodak’s share price jumped 300% and was halted over 20 times. Then, the U.S. government had to investigate whether the news was shared inappropriately leading to insider trades. As of this writing, it looks like Kodak will get to keep the contract, but man. What a ride. (Link)

All About Ro: Read this Bloomberg feature about Hims, questionable prescribing practices, and a larger look at the drug industry in America. (Bloomberg)

Future of Healthcare: Read this transcript from one of my favorite podcasts, Invest like the Best. The episode was published in late November and discusses the future of healthcare and how value can get unlocked in our gridlocked system.

Martin Shkreli: Okay hear me out: this is…technically…a healthcare read, alright? But seriously, it’s well worth your time: the story of how Christie Smythe upended her life, divorced her husband, quit her job, and moved out – all for the infamous pharma bro Martin Shkreli. (Link)

Big Booze: Less than half of Americans know that alcohol is a carcinogen. Big Booze wants to keep it that way. (Link)

Virtual Therapy: The spooky, loosely regulated world of online therapy. (Link)

Antitrust: Sutter’s antitrust case and its feature in 60 Minutes. (CBS)

Teladoc: How Teladoc won: The inside story of how well-timed bets propelled it ahead of the competition. (Stat Plus paywall – lame)

Girl Power: Meet the woman who gave the world antiviral drugs. (National Geographic)

Systemic: Why Black Americans have negative sentiment toward the U.S. health care system. (The Undefeated)

The ghosts of JPMs past: How 20 years of deals, scandal, and science have shaped health care (Stat News)

Data analysis: Why conventional wisdom on health care is wrong. (Random Critical Analysis)

Moderna: Inside Moderna’s historic coronavirus vaccine program that transformed the biotech upstart into a $55 billion drug industry powerhouse. (Link – paywall)

Hospital Consolidation: The Health Care Cost Institute (HCCI) released a cool interactive report on hospital concentration in markets across the U.S. (Link)

My favorite newsletters in 2020…

And my favorite reads from each.

• Second Opinion: Why didn’t Haven work? (Link)
• Out of Pocket: How to keep people engaged by emulating characteristics of video games. (Link)
• The Caseload: GoodRx’s S-1, How PBMs Work, Another Telemedicine integration. (Link)
• Acute: How AbbVie usurped government regulators and created its own rule of law. (Link)
• Kevin’s Weekly Tech Reads: (Link)
• Healthcare Huddle: (Link)
• GHA Daily Note: (Link)

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