Value-Based Care News Digest - July 2019

July 12, 2019

This month's roundup highlights the myriad ways that health systems are seeking to grow and diversify revenue, innovations to address social determinants, and other moves reshaping health care value. 


Top Trending Themes

  1. Health systems are exploring different paths to growth and diversification
    • Health services revenue growth:
      • Horizontal integration: Some systems are taking a more traditional approach to grow via mergers, as Sanford Health/UnityPoint HealthNorthShore University Health System/Swedish Covenant Hospital, and South Shore Health/Wellforce announced M&A or partnership talks this month.
      • Primary care capitation: Yet, we are seeing other health systems begin taking approaches other than horizontal integration. Intermountain Health acquired HealthCare Partners Nevada from DaVita Medical Group this month, marking its expansion into Nevada. This move furthers Intermountain's primary care capitation strategy; it has 2,400 physicians and 160 Intermountain clinics as part of Intermountain Medical Group.
    • Non-health care revenue diversification:
      • M&A: Providence St. Joseph Health announced it will acquire Bluetree, a consulting firm that specializes in managing Epic electronic health record systems, noting the deal as part of the health system's efforts to diversify revenue streams. Bluetree has built a client base of more than 140 hospitals since it was founded in 2012 by former Epic executives.
      • Venture arms: Banner Health and UnityPoint Health both recently announced that they are launching investment arms, joining the ranks of other health systems who have done the same, such as UPMC Enterprises, Intermountain Ventures, Kaiser Permanente Ventures and Mayo Clinic Ventures. How many hospital system venture capital firms can the market support?
  1. Shopping spree: UnitedHealth Group acquired at least two businesses this month that it will add to Optum Health, which passed $100 billion in revenue for the first-time last year
    • Additions to Optum Health:
      • DaVita Medical Group practices in California, Colorado, Florida, New Mexico and Washington, from DaVita, Inc. for roughly $4 billion. The combination will serve more than 80 health plans and 16 million patients.
      • Equian, a health care payments firm, from private-equity firm New Mountain Capital for roughly $3.2 billion. Equian provides payment-processing services and tools that study insurance claims, aiming to lower overpayment risks. Mountain Capital says Equian represents 9 of the 10 largest health care payers, but the company sells to other types of insurers as well, giving UnitedHealth an opening to expand beyond health care.
    • Addition to United Health’s Research Operation:
      • PatientsLikeMe, which provides a social network on which patients can connect to people with similar health conditions, from China-based iCarbonX, for undisclosed terms. The health technology startup was forced by the Trump administration to sell because its majority owner was a Chinese company.
  1. Ride-sharing companies Uber and Lyft announce channel partnerships to help grow their health care user base—with each targeting different populations
    • Uber Health, focused on self-insured employers, announced new partnerships this month with:
      • Pack Health, which operates a health coaching platform for chronic care management, to help patients with chronic conditions get free rides to their medical appointments. Patients who need a ride do not need to have the Uber app; they will receive a text message with the time of the ride on their phone and can send a text message response when they are ready. The rides are covered by Pack Health as part of the membership of participating in one of Pack Health's programs.
      • Grand Rounds, which provides guidance to employees of partner organizations on their medical needs, to cover the cost of trips to the doctor. The Uber interface is being integrated directly into the Grand Rounds platform so members can book rides there. Grand Rounds works with more than 100 large employers and reaches more than 4.5 million covered lives.
      • Carisk, a specialty risk transfer and care coordination company, to provide transportation for injured workers in workers’ compensation cases. All patient scheduling for rides is handled through a web-based dashboard, and text messages alert the user to trip details. Carisk serves insurers, government entities, self-insured plan sponsors and other managed care organizations with solutions that include risk-transfer and care coordination of delayed recovery and complex, catastrophic cases
    • Lyft will focus on government programs, as evidenced by:
      • Becoming an enrolled Medicaid provider in Arizona this month as a non-emergency medical transportation provider. In the announcement, Lyft expressed a desire to partner with other state Medicaid programs.
      • Statements earlier this year about its impact with its first Medicare Advantage partner, CareMore, and its focus on Medicare Advantage as a major growth area.

Industry News

Payers And Providers

Accountable Care Organizations

Telehealth And Technology

Social Determinants Of Health (SDoH)

People On The Move


Government & Regulatory Pulse

Federal

States


Survey Says/Studies Show

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