Keeping up with the latest news in the virtual care space is challenging. Wheel's Virtual Care News is a monthly newsletter for stakeholders in the digital health industry. As a subscriber, you'll receive timely information on trending news, regulatory updates, engaging conversations, and key innovations emerging in the space
Explore the latest healthcare industry trends, insights, and innovations in September's Virtual Care News roundup.
Learn about the rise in new primary care models from nontraditional players, the growing importance of multi-user design for care experiences, and the environmental benefits of telehealth. Also, see how D2C retail health is expanding into new treatment areas and learn which healthcare AI companies you should watch.
Wishing you a wonderful start to fall! 🍂
Trends & Insights
Blue Shield of California Taps Amazon, Mark Cuban’s Cost Plus Drugs for Its Pharmacy Network
Blue Shield of California has partnered with Mark Cuban’s Cost Plus Drug Company and Amazon Pharmacy to save on drug costs for its 4.8 million members, moving away from CVS after a 15-year partnership. The shift is expected to save the company and its members $500 million annually and reinforce the payer's commitment to a value-based care model for pharmacy care.
Wegovy Shown To Cut Risk of Stroke and Heart Attacks
A late-stage clinical trial of more than 17,000 adults by drugmaker, Novo Nordisk, found the obesity drug cuts the risk of cardiovascular events by 20%. It’s thought the findings may encourage insurance companies to provide coverage for what’s been considered a cosmetic vanity drug. However, it’s unclear whether health benefits were a result of weight loss or another mechanism.
New Models of Primary Care Will Capture 30% of the US Market by 2030
A study by Bain & Company showed that new primary care models from nontraditional players — retailers, payer-owned providers, advanced primary care disruptors — could capture up to one-third of the US primary care market by 2030. A company spokesperson cited rising costs, physician shortages, consumerism, and digital disruption as factors driving the shift away from traditional providers and fee-for-service models to value-based reimbursement.
First Opinions & Engaging Conversations
Meet the 5th ‘C’ of Primary Care: Corporate America
Clinicians from Johns Hopkins, the American Board of Family Medicine, and the Association of Clinicians from the Underserved suggest a 5th C in primary care: Corporate. The authors dissect the pillars of great primary care — Contact, Coordination, Comprehensiveness, and Continuity — and unpack how corporate entities should appropriately manage the opportunity to disrupt how patients access and receive primary care in ways that help rather than harm.
“With nearly 50% of the American public within 1 mile of a community pharmacy and nearly 90% within 5 miles of a community pharmacy, the proximity of private players like Walgreens, Walmart, and CVS would appear on its face to be advantageous for providing first contact access to primary care. Will patients and families broaden beyond traditional pharmacy and pharmacist relationships and seek to establish their primary care medical home in these settings? It depends on what the new owners do.”
Designing for Multi-User Experiences: Digital Health Innovation for the Care Economy
Caregiving is a communal experience that involves a patient and the support system around them – yet most digital health products are designed for a single user: the patient. How can healthcare companies design products that engage, include, and enable everyone who plays a role in care experiences? This report from Rock Health and The Holding Co. answers that question and reveals three principles to guide a multi-user design approach for care experiences.
Policy & Regulatory Updates
Biden Administration Names 10 Prescription Drugs for First-Ever Medicare Price Negotiations
Last week, after years of pressure to lower healthcare costs, the Biden administration announced the first ten prescription drugs subject to price negotiations with Medicare. The list includes Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp/NovoLog insulin products – drugs that target heart failure, blood clots, diabetes, kidney disease, arthritis, blood cancers, and Crohn's disease.
Cigna Removes Prior Authorizations for 25% of Services
In light of congressional and regulatory interest in streamlining prior authorizations, Cigna became the latest payer to announce a significant rollback for prior authorizations – cutting the requirement for approvals for nearly 25% of medical services. This leaves fewer than 4% of procedures subject to prior authorization for all 16.5 million commercial policyholders and aims to reduce administrative bottlenecks in receiving care.
Growth & Innovation
Hims and Hers and Hearts – Cardiology Blurs Into DTC Retail Health
Hims and Hers announced a condition management program centered on heart health - Heart Health by Hims. This example highlights how retail health can branch out and expand their models with new treatment areas and personalized, preventive care.
Health Populi >
Virtual Healthcare Has Green Benefits
Beyond promoting greater access to care and lower costs, this article unpacks an interesting environmental benefit of telehealth that isn’t as frequently discussed — reduced carbon emissions. The healthcare industry is responsible for about 5% of global greenhouse gas emissions, of which the U.S. healthcare system alone accounts for a quarter. Learn how healthcare organizations like Kaiser Permanente have incorporated this into their digital strategy and reduced their carbon footprint by about 7,500 metric tons annually.
Providers Can Now See Patients’ Insurance Coverage in GoodRx’s Cost Comparison Tool
GoodRx has launched a new cost-saving feature, real-time benefit check (RTBC), that allows healthcare professionals to see the cost of a patient's prescription with their insurance. RTBC is embedded in GoodRx's Provider Mode, which over 550,000 healthcare professionals use. This new feature also includes cost comparison tools, GoodRx coupons, and other resources doctors can use to help their patients save on prescriptions.
58 AI Companies to Know
Tempus, Olive, and Viz.ai are a few of the healthcare companies highlighted in this roundup of artificial intelligence companies to watch. As global adoption of AI technology continues to rise quickly, we’re keeping an eye on these companies in the healthcare industry and beyond.
Visana Healthcare secures $10.1M in seed funding for their value-based, virtual women’s health platform
Thyme Care, a value-based oncology platform, raises $60M in series B funding to expand into new markets
Definitive Healthcare to acquire provider analytics startup, Populi, for $52M
Mahana Therapeutics signs multi-million-dollar distribution and marketing partnerships with Bayer’s consumer health division to commercialize digital therapeutics
Babylon Health files for bankruptcy in the U.S. after closing operations
At-home diagnostics startup Viome Life Sciences receives $86.5M in series C funding and will roll out gut microbiome testing kits into 200 CVS stores
Attending HLTH 2023 in Las Vegas?
Wheel is heading to HLTH in Las Vegas October 8-11th. We'll be at booth #2042. Stop by and learn how Wheel can power your business. You also won’t want to miss the opportunity to spin our Prize Wheel for a chance to win some awesome items (think Away luggage, AirPods, JBL speakers and more!)