Fortnightly healthtech update #6

Firefly raises an additional $10m for concierge primary care, bags new CEO.

An incredibly low-tech way to spot patient deterioration early – listen to their loved ones.

A vision for the Internet of Medical Things (IoMT) in the UK

Apple announces three new health studies – but Jessica Baron at Forbes adds a big dollop of caution.

Corvia Medical and PhysIQ team up for a study in heart failure management.

Henry Ford in Detroit has some success cutting re-admissions with remote patient monitoring. Now it’s looking for partners to help it expand and grow.

Picking up on the thread from last time that value-based care might not be just around the corner: Stakeholders push back on bundled payments for oncology. Also, current value-based care models need greater emphasis on specialty care. Hard to argue with that. It’s true, patents with chronic conditions account for the majority of US healthcare spending. But, if we focused on preventative medicine instead of treating sickness – through a single payer system for example – arguably we wouldn’t need so much specialty care now would we.

Rapid advance in medical wearables runs headfirst into reality: Docs call for standards for blood pressure measurement.

Using a ballistocardiogram to monitor heart failure patients at home. It’s OK, I didn’t know what it was either…

Hospital execs in New Hampshire fret that high deductible health plans might be a barrier to care. Which is really hospital CEO code for “high deductible plans hurt our revenue”. And they’re right – but that’s part of the point. I can tell you from personal experience, a high deductible changes your thinking. If you’re personally paying 100% of the bill for everything It makes you spend only on the “must haves” in healthcare. And that’s OK. If we’re going to rein in healthcare spending – which we must, because it’s not sustainable – we need to give up the “nice to haves”. And providers will feel some of that pain, short term. But there is a perverse incentive with high deductible plans. What happens when you hit the deductible limit? Well, you just pile in and take care of all those “nice to haves” while the insurer is paying for them…

That said, high deductible insurance plans would be more effective if consumers had tools to compare both price and quality when shopping for healthcare. Often, they don’t. But, here’s a study showing that price transparency tools seem to work. Which is interesting, because Walmart just opened it’s first physician-staffed clinic with transparent pricing upfront.

One more reason for healthcare execs to fret: Amazon launches Amazon Careas a pilot for its’ employees. Coming soon to….probably pretty much everyone once they’ve worked out the wrinkles I imagine. It looks like a nice example of focusing on the customer need. Not the more traditional healthcare approach of “What can we do that we’ll get reimbursed for…?”.

And just to pile on the pressure, Sam’s Club (owned by Walmart) is introducing $1 telehealth visits with a subscription. This is interesting too. Telehealth options are usually offered by an employer. This is the first I’m aware of that is D2C. So what’s the target market…? Is it people without health insurance? Or, is it people who have insurance, but want a more cost effective/convenient way to access primary care?

An interesting history lesson: Americans already paid for universal health care. Just not for fellow Americans.

A good summary of how far Medicare has got down the road with value-based care. Not very. Just to reinforce that, although physicians participate in value-based care, most of their revenue come from good ol’ fashioned fee-for-service.

Eko raises $20m for it’s machine learning driven cardiac monitoring.

Also in funding news, InsightRX raises $10m for precision dosing – using data to optimize the therapeutic dose and minimize side effects.

Sad but true: Slowing the growth of healthcare costs – not actually cutting costs – is seen as  a triumph. But at least BCBSMA has achieved that with an 8 year value based program.

A long, but worthy read: How to avoid getting fleeced in the emergency room.