The Healthy Muse (hospitalogy)

healthy muse healthcare news.

• this week in healthcare: 14 largest health systems form a partnership to leverage patient data, More SPAC info for Sharecare, Sema4, and Uphealth, healthcare is officially one word according to the WSJ, 7 new Covid variants, everyone vaccinated by July, interesting post-acute trends, managed care earnings, declining hospital operating margins, New York’s hidden coronavirus data, and more.

Large Health Systems form Truveta, a bet on Big Data in Healthcare.

Hospitals are sitting on a treasure trove of data just waiting to be analyzed. That’s the thesis behind Truveta, anyway, which is a partnership between 14 of the largest health systems.

Formed in late 2020 as a for-profit entity but officially announced this week, Truveta plans to aggregate clinical-level, de-identified patient data to provide meaningful insights for researchers, physicians, biotech firms, and everyone in between. (Link to Truveta Blog Post)

• This partnership isn’t the first foray into the health data space. Remember Project Nightingale, the Google-led venture with Ascension that caused a whole lot of patient privacy controversy? While that partnership used identifiable patient data which was accessible by Google employees, this new venture with Truveta seems to indicate that the appetite for big data insights from health data is stronger than any potential backlash from a vast amount of data sharing – albeit, HIPAA-compliant data sharing.
• Other thoughts: I’m personally curious to see whether any actionable insights come from this venture. I also wonder how much competition Truveta will take away from firms like 23andMe and Ancestry, who are trying to leverage their DNA databases into actionable data for drug and other research.
  • Finally, I’m also curious whether these health system coalitions continue in the future. We saw Civica Rx form in late 2018, a partnership for addressing generic drug shortages. Now Truveta, a data sharing platform…what could be next? Hmm.

SPACs Surge On: More about Sharecare, Sema4, and Uphealth.

We’ve talked about the Sharecare and Uphealth SPAC announcements in past editions over the past few weeks. We’re now starting to learn a bit more about these companies from publicly disclosed SEC filings along with a newly announced health-tech SPAC announcement from Sema4.

Sharecare: Is going public via SPAC merger at a $3.9 billion valuation and will receive an investment from Anthem as part of the transaction. Right before debuting publicly, the firm also combined with health AI startup Doc.AI. Sharecare seems to be a conglomerate of all sorts of perks and benefits that works with health plans – including drug discounts. If you know exactly what this thing does, feel free to give me a shout. The co. will soon trade under the ticker $SHCR. (Sharecare’s Background)

• Link to 8K and merger documents (Link)
• Link to merger press release (Link)
• Access the investor presentation here. (Link)
• An informative Twitter thread on Sharecare. (Link)

Uphealth: Is merging with GigCapital2 (who comes up with these SPAC names?) and Cloudbreak at a $1.35 billion valuation, so a few orders of magnitude smaller than Sharecare’s transaction.

The firm, after its merger with Cloudbreak, appears to be positioned in several fast-growing healthcare sectors including telehealth, behavioral health, integrated care management, and digital pharmacy. The combined co. will trade under the ticker $UPH and will close sometime in the first quarter, so pretty soon.

• Link to press release (Link)
• Link to S-4, investor presentation (Link)
• Bigger picture: Through this merger, Uphealth & co. seems to be creating another digital health conglomerate – a tech enabled firm focused on a variety of service lines (e.g., Teladoc and Livongo).

Sema4: Chalk another one up on the board for digital health companies I don’t understand. CM Life Sciences is taking Sema4 public via SPAC in a transaction valuing the firm at about $2 billion.

Sema4 seems to run an operation similar to what 23andMe is trying to break into – i.e., using data analytics to help enable drug discovery for biotech firms and researchers, creating genomic maps, etc.

I’m personally hoping that all of these SPAC managers taking these confusing companies public know what they’re doing and aren’t just trying to make a quick buck. If not, the market might be in for a whole host of trouble one of these days…

• Link to informative article (Link)
• Link to investor presentation (Link)

Coronavirus updates.

Cases: continue to decline and will continue to decline until new, more contagious variants gain a stronger foothold in the U.S. By that time, I’m hoping that vaccinations help curb a majority of the spread. (Link)

Vaccinations per day are sitting at a run rate of 1.7 million over the past week, up from 1.5 million last week. We’ve now vaccinated about 53.8 million folks. (Link)

• Variant watch: Seven new variants have been detected in the U.S. They’re thought to be similar to the UK variant – more contagious and deadly. (Link)

Pfizer’s vaccine sharply reduces symptomatic COVID cases in the real world, according to Israeli researchers. Symptomatic cases and severe illnesses decreased by 94% and 92%, respectively. Great news. (Link)

• The biotech giant is planning to deliver 2 billion doses this year. (Link)

Supply: The U.S. has now secured enough doses to have everyone vaccinated by July. (Link) It may be an uphill battle to fight misinformation in order to vaccinate the last 30% of Americans who say they ‘probably’ or ‘definitely’ won’t get the vaccine. (Link)

• Based on a KFF analysis, a majority of seniors are not vaccinated yet. This trend is probably attributable to limited supplies which should alleviate over time by increased manufacturing. (Link)

Schools: The CDC set guidelines on Friday calling for schools to reopen nationwide. The guidelines include things such as mask wearing, appropriate distancing, hand washing, and vaccination as soon as supplies are available. (Link)

Other notables.

• The Biden Admin will begin shipping vaccines to health centers soon. (Link)
• China refused to give the WHO raw data on early Covid cases after the WHO learned that Covid may have been in circulation as soon as two months earlier than reported. (Link)
• Rapid at-home coronavirus testing takes another step forward. (Link)
• The FDA granted emergency use for Eli Lilly’s antibody Covid drug. (Link)
• Uber and Walgreens are partnering to offer free rides to vaccination sites. (Link)
• Dr. Fauci received a $1 million award from Israel for ‘speaking truth to power’ during the pandemic. (Link)
• Inside Joe Biden’s Covid ‘War Room’ (Link)
• The world’s second oldest person survived Covid at age 116!! (Link)

Quick Hits

Biz Hits

SPAC: Signify Health debuted successfully this week and is now valued at $7.12 billion. (Link)

Post-Acute: A couple of interesting articles in the post-acute space this week. According to Skilled Nursing News, the nursing home industry lost $34 billion in revenues and closed over 1,800 facilities due to Covid. Of any facility, nursing homes have been hit the hardest. This trend makes me super bullish on other post-acute care settings, especially including in-home care. I would also expect a ton of consolidation in the space in the coming years. (Link)

• Home Health Care News also published a list of the top 10 largest home health and hospice providers in 2020. Top of the list include Kindred at Home, Encompass, and Amedisys. (Link)

Earnings: The big Medicaid managed care players released earnings this week, both reporting sharp decreases in net income. Some brief highlights:

• Centene: Is cutting 3k jobs after an unprofitable quarter and a medical loss ratio of 88.4%. Centene execs were bullish on Biden’s multi-trillion-dollar stimulus bill since the bill would increase subsidies for ACA plans. (Link)
• Molina: Is expecting continued depressed healthcare utilization in 2021. In 2020, Molina estimates that depressed utilization resulted in $620 million in savings while costs associated with COVID amounted to about $200 million. (Link)

Hospitals: reported a median 55% drop in operating margin, according to Kaufman Hall. (Link) Tenet swung to a profit in Q4, but execs did not give a ton of detail on the 2021 post-pandemic recovery outlook. (Link). Kaiser also saw profits fall in Q4 amidst Covid costs. (Link)

Physician M&A: In another interesting private equity deal, the physician owners of U.S. Acute Care Solutions are buying out their PE partners Welsh-Carson-Anderson-Stowe. (Link). The deal reminds me of another recently announced transaction, where Steward Health Care doctors bought back a controlling stake in the biz. (Link)

Behavioral: A record amount of cash is flowing into the behavioral health sector. This article dives into what that means for valuations within the various sub-sectors. (Link)

Policy Hits

Medicaid Work Requirements: The Biden Admin is expected to rescind controversial Medicaid work requirements, which is a Republican-led policy requiring those on Medicaid to hit a certain number of worked hours in order to qualify for health insurance.

• Read this letter that the Biden Admin is sending to states like Arkansas. (Link)

Flip flop: The Justice Department notified the Supreme Court of its decision to switch sides in the ACA constitutionality case. (Link)

Stimulus: Along with a 7.4% proposed boost to Medicaid payments for home-based care services, (Link) a coalition of hospitals, insurers, and employers are calling for the stimulus to include ACA expansion. The expansion would create subsidies allowing up to 2 million additional individuals to get health insurance coverage. (Link)

Other Hits

• Plasticky: behind the world’s most dangerous cosmetic surgery – the infamous Brazilian Butt Lift. (Link)
• Hacked: As a seeming act of randomness, hackers decided to suddenly post detailed patient medical records from two hospitals. (Link)
• Malpractice: Read more about everything malpractice in the latest edition of Out-of-Pocket. (Link)

Thought-Provoking Editorials

• Value: Read about how radiation oncology’s new value based payment model could be a pioneer in shaping value-based care reform. (Link)
• Policy: A public option for health insurance could be a disaster, especially in times of crisis. (Link)
• Costs: Learn about a new nonprofit initiative, called the 1% Steps for Health Care Reform Project. The org’s goal is to find actionable solutions to healthcare spending in the U.S. My main gripe with the org is that it spells healthcare as 2 words…yikes. (Link)

Healthy Muse Top Picks

• Semantics: Maybe the biggest news of the week – the Wall Street Journal announced a change in its stylebook from “health care” to “healthcare.” It’s a massive rift in the industry. I’m in the one word camp – more efficient! (Link)
• Noah Smith: The U.S.’ vaccine rollout is world-beating. That doesn’t mean it’s good enough. But let’s take a moment to appreciate it. (Link)
• Shady: Not only did New York officials admit this week that they lied about nursing home deaths back in August, a state-run nursing home also gave dozens of veterans experimental treatments without their family knowing. (Link)
• Heroic? Read this gut wrenching story about a doctor’s decision to find 10 people for vaccine doses set to expire in 6 hours – and getting fired for that decision. (Link)
• Big Data: Read about the multitude (thousands) of health datasets across the nation, the challenges that this fragmentation provides, and the opportunities to address the scattered resources. (Link) – Medium soft paywall.

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