Health tech startup Bold raises $7 million in seed funding for senior-focused fitness programs

Virtual health and wellness platforms have grown increasingly popular throughout the pandemic, but a new startup wants to focus that effort exclusively on senior citizens. Bold, a digital health and wellness service, plans to prevent chronic health problems in older adults through free and personalized exercise programs. Co-founded by Amanda Rees and her partner Hari Arul, Bold picked up $7 million this week in seed funding led by Julie Yoo of Silicon Valley-based Andreessen Horowitz.

Rees said in an interview that the idea for Bold came from time she spent caring for her grandmother, helping her through health challenges like falls. “I kept thinking about solutions we could build to keep someone healthier longer, rather than waiting for until they have a fall or something else goes off the rails to intervene,” she said. Rees started Bold to use what she’d learned from her own experience in dance and yoga to help her grandmother practice maintaining balance to prevent future falls. “My passion really was around ways to sort of widen the aperture, and make these solutions more accessible and built for older people.”

The member experience is pretty straightforward. Users fill out some brief fitness information on the web-based platform, outlining their goals and current baseline. From that information, Bold creates a personalized program that ranges from a short, seated Tai Chi class once a week, to cardio and strength classes meeting multiple times each week. “The idea is to really meet a member where they are, and then through our programming, help them along their journey of doing the types of exercises that are going to have the most immediate benefit for them,” said Rees.

Bold’s funding round comes at a time of concern around ballooning healthcare expenses for older populations, and a focus on how to reduce these costs for both current and future generations. While falls alone aren’t necessarily complex medical incidents, they have the potential to lead to fractures and other serious injuries. Bold’s preventative approach to falls is a more active solution than necklace or bracelet monitors that send a signal to emergency services when they detect a fall. And by offering virtual programs, they can help at-risk older populations engage in exercise while avoiding potential COVID-19 exposure at gyms.

Research shows that this works. Even simple, low-intensity exercise can improve balance and strength enough to reduce the incidence of falls, which is currently the leading cause of injury and injury death among older adults.

Fewer injuries would mean less need for medical care, which would lead to money saved for hospitals and health insurers alike. That’s why in addition to their seed funding, Bold has plans to start rolling out partnerships with Medicare Advantage organizations and risk-bearing providers, which will help make their exercise programs available to users for free.

#andreessen-horowitz, #articles, #balance, #exercise, #falling, #health, #julie-yoo, #medicare, #occupational-safety-and-health, #recent-funding, #silicon-valley, #startups, #tc


For Prosecutors, Trump’s Clemency Decisions Were a ‘Kick in the Teeth’

Commutations in high-profile Medicare fraud cases have elicited anger among those who spent years pursuing complex prosecutions.

#amnesties-commutations-and-pardons, #dershowitz-alan-m, #esformes-philip-1968, #federal-bureau-of-investigation, #frauds-and-swindling, #health-and-human-services-department, #johnson-alice-marie, #justice-department, #kardashian-kim, #medicare, #melgen-salomon-e, #negron-judith, #trump-donald-j, #united-states-politics-and-government


With New Majority, Here’s What Democrats Can (and Can’t) Do on Health Care

Senate control opens up new possibilities, but the party will still need to contend with arcane rules and the challenges of a narrow majority.

#health-insurance-and-managed-care, #law-and-legislation, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010, #united-states-politics-and-government


It’s Not Just You: Picking a Health Insurance Plan Is Really Hard

Most Americans make poor choices. So do most professional insurance brokers, a new study finds. But robots may help.

#consumer-behavior, #health-insurance-and-managed-care, #medicare, #patient-protection-and-affordable-care-act-2010, #research


Becerra Supports ‘Medicare for All,’ and Could Help States Get There

Waivers can expand health care offerings without need for congressional approval, but the challenge will be how to pay for them.

#becerra-xavier, #biden-joseph-r-jr, #health-insurance-and-managed-care, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010, #states-us


After 4 Years of Trump, Medicare and Medicaid Badly Need Attention

Science and objective analysis need to be revived.

#biden-joseph-r-jr, #centers-for-disease-control-and-prevention, #centers-for-medicare-and-medicaid-services, #drugs-pharmaceuticals, #elderly, #food-and-drug-administration, #health-insurance-and-managed-care, #medicaid, #medicare, #presidential-election-of-2020, #united-states


When Churches Rescue Americans From Crushing Covid

Churches are doing what politicians have been unable to do, rescuing Americans from crushing medical bills.

#biden-joseph-r-jr, #christians-and-christianity, #credit-and-debt, #debt-collection, #democratic-party, #health-insurance-and-managed-care, #medicare, #medicine-and-health, #patient-protection-and-affordable-care-act-2010, #personal-bankruptcies, #protestant-churches, #sanders-bernard, #warren-elizabeth


People Are Choosing Kidney Dialysis at H

A new Medicare program aims to increase the proportion of patients using home dialysis and receiving transplants.

#chapel-hill-nc, #dialysis, #elderly, #health-insurance-and-managed-care, #kidneys, #medicare, #transplants, #your-feed-health, #your-feed-healthcare


Medicare’s Choices Have Grown, but Many Americans Don’t Review Options

A new study shows that more than half of enrollees don’t review or compare their coverage options annually.

#content-type-service, #drugs-pharmaceuticals, #elderly, #health-insurance-and-managed-care, #kaiser-family-foundation, #medicare, #prices-fares-fees-and-rates, #retirement, #united-states


Obamacare Is Back in Court. The Stakes Couldn’t Be Higher.

This time, the issue is democracy, and the Supreme Court’s duty to leave political decisions to the elected branches of government.

#health-insurance-and-managed-care, #law-and-legislation, #medicaid, #medicare, #patient-protection-and-affordable-care-act-2010, #republican-party, #supreme-court-us, #trump-donald-j, #united-states


You’re Not Too Old to Talk to Someone

Studies have shown that older people do as well in psychotherapy as younger ones. But finding and affording therapy can prove difficult.

#anxiety-and-stress, #depression-mental, #elderly, #loneliness, #medicare, #mental-health-and-disorders, #psychiatry-and-psychiatrists, #quarantine-life-and-culture, #therapy-and-rehabilitation, #your-feed-health, #your-feed-science


CoreCare raises $3 million for managing billing and payments from public health benefit providers

CoreCare, a provider of revenue management services for healthcare companies dealing with public health benefit providers, has raised $3 million in a seed financing round.

The company, which uses machine learning, automates large swaths of billing and revenue cycle management to reduce the burden on hospitals, according to chief executive, Dennis Antonelos.

Already, companies like Creative Solutions in Healthcare, a nursing facility operator in Texas, which operates nearly 80 locations has signed up for the service.

Antonelos started the company in January, had the first product up by March and was accepted to Y Combinator in April. It now boasts over a dozen customers in Texas.

With the new $3 million in hand from investors including Primetime Partners, Goat Capital, Funders Club and Liquid2Ventures, Antonelos said the company would look to expand its sales and marketing and product capabilities.

CoreCare automates processing of billing and paperwork and clinical notes by linking electronic health records and medicare and medicaid information services and payers.

“We’re going through the organization and eliminating administrative waste so the organization can invest newly found resources into patient care,” Antonelos said.

The company uses a standard software as a service payment model and charges somewhere between $300 to $500 per-facility, per-month, according to Antonelos.

“These initial results are outstanding,” said Gary Blake, president, and co-founder of Creative Solutions in Healthcare, and one of CoreCare’s early customers. “In only a matter of months working with CoreCare’s CoreAccess software, we’ve seen a notable impact on our financial position. It has truly exceeded our expectations. CoreCare has changed the way we work with Managed Care, from top to bottom. We have been able to streamline our entire billing process, reduce admin costs, shorten the number of accounts receivable (AR) days and free up cash for growth. Every healthcare provider that works with managed care should work with CoreCare.”

#articles, #goat-capital, #health, #health-insurance, #healthcare, #machine-learning, #medicare, #tc, #texas, #y-combinator


UnitedHealth Ships Flu Kits to Medicare Recipients

Under MedAdvantage plans, the major insurer is sending packages including Tamiflu and coronavirus tests to those considered especially vulnerable to Covid and the flu.

#coronavirus-2019-ncov, #elderly, #health-insurance-and-managed-care, #influenza, #medicare, #medicare-advantage, #tamiflu-drug, #telemedicine, #unitedhealth-group-inc, #your-feed-healthcare


Trump Promised Seniors Drug Discount Cards. They May Be Illegal.

A proposal announced by President Trump last month was to send older Americans $200 discount cards to offset prescription costs. It’s not going to happen before the election, and maybe not ever.

#azar-alex-m-ii, #centers-for-medicare-and-medicaid-services, #drugs-pharmaceuticals, #elderly, #ethics-and-official-misconduct, #hatch-act-1939, #health-and-human-services-department, #medicare, #presidential-election-of-2020, #trump-donald-j, #united-states-politics-and-government, #verma-seema


Clover Health Is Acquired in a $3.7 Billion Deal

The health care company hopes to use the money, from an affiliate of the billionaire Chamath Palihapitiya, to fuel growth and achieve profitability.

#clover-health-llc, #health-insurance-and-managed-care, #medicare, #mergers-acquisitions-and-divestitures, #palihapitiya-chamath


Why a Hospital Might Shun a Black Patient

The way medical professionals are paid keeps structural racism alive. It’s unethical and it must change.

#black-people, #health-insurance-and-managed-care, #hospitals, #medicare, #patient-protection-and-affordable-care-act-2010


Bidencare Would Be a Big Deal

Don’t dismiss it because it isn’t Medicare for All.

#biden-joseph-r-jr, #health-insurance-and-managed-care, #medicare, #patient-protection-and-affordable-care-act-2010, #presidential-election-of-2020, #trump-donald-j, #united-states-politics-and-government


If the Supreme Court Ends Obamacare, Here’s What It Would Mean

The Affordable Care Act touches the lives of most Americans, and its abolition could have a significant effect on many millions more people than those who get their health coverage through it.

#content-type-service, #health-insurance-and-managed-care, #medicaid, #medicare, #medicine-and-health, #opioids-and-opiates, #patient-protection-and-affordable-care-act-2010, #states-us, #supreme-court-us, #trump-donald-j, #united-states-politics-and-government, #your-feed-healthcare


Many Hospitals Charge More Than Twice What Medicare Pays for the Same Care

The gap between rates set for private insurers and employers vs. those by the federal government stirs the debate over a government-run health plan.

#finances, #health-insurance-and-managed-care, #hospitals, #medicare, #patient-protection-and-affordable-care-act-2010, #prices-fares-fees-and-rates, #rand-corp, #regulation-and-deregulation-of-industry, #research, #united-states-politics-and-government, #your-feed-healthcare


Trump Issues Expansive Order Aimed at Lowering Drug Prices

The order expands on a presidential promise by trying to reduce the prices Medicare pays for prescription drugs, but experts said it was unclear whether the White House could carry out the directive.

#drugs-pharmaceuticals, #executive-orders-and-memorandums, #health-and-human-services-department, #health-insurance-and-managed-care, #medicare, #prices-fares-fees-and-rates, #trump-donald-j, #united-states-politics-and-government


Biden, Speaking to National Guard, Takes Aim at Republican Criticism on Crime

The Democratic presidential nominee hit back at attacks delivered at the Republican National Convention.

#biden-joseph-r-jr, #democratic-party, #health-insurance-and-managed-care, #medicare, #presidential-election-of-2020, #republican-national-convention, #republican-party, #sanders-bernard, #trump-donald-j


Ady Barkan, Activist and DNC Speaker, on Biden and ‘Medicare for All’

After learning in 2016 that he had a terminal neurodegenerative disease, Mr. Barkan became a champion of “Medicare for all.” He spoke with The Times ahead of his speech on Tuesday night at the Democratic National Convention.

#barkan-ady, #biden-joseph-r-jr, #democratic-party, #medicare, #presidential-election-of-2020, #united-states-politics-and-government


Despite Everything, Bernie Sanders Still Believes

The senator from Vermont explains why the left still has a fighting chance.

#biden-joseph-r-jr, #democratic-national-convention, #democratic-party, #harris-kamala-d, #medicare, #presidential-election-of-2016, #presidential-election-of-2020, #sanders-bernard, #socialism-theory-and-philosophy, #trump-donald-j, #youth


Trump Sends In the Economic Quacks

Now he’s prescribing hydroxychloroquine to fight recession.

#coronavirus-2019-ncov, #coronavirus-reopenings, #federal-taxes-us, #medicare, #moore-stephen-1960, #payroll-tax, #presidential-election-of-2020, #social-security, #taxation, #trump-donald-j


VenoStent has a new technology to improve outcomes for dialysis patients

Timothy Bouré and his co-founder Geoffrey Lucks were both near broke when they moved to Dallas to join the first accelerator they entered after forming VenoStent, a company that aims to improve outcomes for dialysis patients.

Failed dialysis surgeries occur in roughly 55% to 65% of patients with end-stage renal disease, according to the company. Caring for these patients can cost the Medicare and Medicaid Services system roughly $2 billion per year — and Bouré and Lucks believed that they’d come up with a solution.

So after years developing the technology at the core of VenoStent’s business at Vanderbilt University, the two men relocated from Nashville to South Texas to make their business work.

Bouré had first started working on the technology at the heart of VenoStent’s offering as part of his dissertation in 2012. Lucks, a graduate student at the business school was introduced to the material scientist and became convinced that VenoStent was on the verge of having a huge impact for the medical community. Five years later, the two were in Dallas where they met the chief of vascular surgery at Houston Medicine and were off to the races.

A small seed round in 2018 kept the company going and a successful animal trial near the end of the year gave it the momentum it needed to push forward. Now, as it graduates from the latest Y Combinator cohort, the company is finally ready for prime time.

In the interim, a series of grants and its award of a Kidney XPrize kept the company in business.

The success was hard won, as Bouré spent nearly three sleepless nights in the J-Labs, Johnson and Johnson’s  medical technology and innovation accelerator in Houston, synthesizing polymers and printing the sleeve stents that the company makes to keep replace the risky and failure-prone surgeries for end stage kidney disease patients.

The key discovery that Bouré made was around a new type of polymer that can be used to support cell growth as it heals from the dialysis surgery.

In 2012, Bouré stumbled upon the polymer that would be the foundation for the work. Then, in 2014, he did the National Science Foundation Core program and started thinking about the wrap for blood vessels. Through a series of discussions with vascular surgeons he realized that the problem was especially acute for end stage renal disease patients.

Already the company has raised $2.4 million in grant funding and small equity infusions. and the KidneyX Prize from the Department of Health and Human Services and the American Society of Nephrology. VenoStent was one of six winners.

“It’s part of this whole ongoing effort by the executive office to improve dialysis,” said Bouré. “[They are] some of the most expensive patients to treat in the world… Basically the government is highly incentivized to find technologies that improve patient’s lives.”

Now the company is heading into its next round of animal testing and will seek to conduct its first human trials outside of the United States in 2021.

And while the company is focused on renal failure first, the materials that Bouré has developed have applications for other conditions as well. “This can be a material for the large intestine,” says Bouré. “It has tunability in terms of all its properties. And we can modify it for a particular application.”


#chief, #co-founder, #core, #dallas, #houston, #medicare, #medicine, #national-science-foundation, #tc, #united-states, #y-combinator


In a sign of digital health’s rise, Livongo and Teladoc Health agree to $18.5 billion merger

In a sign of the growing importance and value of digital healthcare in the world of medicine, two of the industry’s publicly traded companies have agreed to a whopping $18.5 billion merger.

The union of Teladoc Health, a provider of virtual care services, and Livongo, which has made a name for itself by integrating hardware and software to monitor and manage chronic conditions like diabetes, will create a giant in the emerging field of telemedicine and virtual care.

“By expanding the reach of Livongo’s pioneering Applied Health Signals platform and building on Teladoc Health’s end-to-end virtual care platform, we’ll empower more people to live better and healthier lives,” said Glen Tullman, Livongo Founder and Executive Chairman. “This transaction recognizes Livongo’s significant progress and will enable Livongo shareholders to benefit from long-term upside as the combined company is positioned to serve an even larger addressable market with a truly unmatched offering.”

Under the terms of the agreement, each share of Livongo will be exchanged for 0.5920 shares of Teladoc health plus a cash payment of $11.33 for each share. The deal, based on Teladoc’s closing price on August 4, 2020, is roughly $18.5 billion. It’s an eye-popping figure for a company that was, at one point, trading below $16 per-share.

But the new reality of healthcare delivery in the era of COVID-19 rapidly accelerated the adoption of digital and remote care services like those Livongo was selling to its customers — and investor came calling as a result.

The combined company is expected to have pro forma revenue of $1.3 billion representing 85 percent year on year growth, on a pro forma basis. For 2020, the combined company expects adjusted EBITDA to reach $120 million.

“This merger firmly establishes Teladoc Health at the forefront of the next-generation of healthcare,” said Jason Gorevic, the chief executive officer of Teladoc Health, in a statement. “Livongo is a world-class innovator we deeply admire and has demonstrated success improving the lives of people living with chronic conditions. Together, we will further transform the healthcare experience from preventive care to the most complex cases, bringing ‘whole person’ health to consumers and greater value to our clients and shareholders as a result.”

The companies emphasized their combined ability to engage with patients and monitor and manage their conditions using technology. Teladoc Health’s flywheel approach to continued member engagement combined with Livongo’s proven track record of using data science to build consumer trust will accelerate the combined company’s development of longitudinal consumer and provider relationships, the companies said in a statement.

Teladoc currently counts 70 million customers in the United States with an access to Medicare and Medicaid patients that Livongo’s services could reach. The combined company also pitched the operational efficiencies that could be created through the merger. Teladoc estimated that there would be “revenue synergies” of $100 million two years from the close of the deal, reaching $500 million on a run rate basis by 2025, according to a statement. 

Gorevic will run the combined company and David Snow will serve as the chair of the new board — which will be comprised of eight current Teladoc board members and five members of the Livongo board.

The company expects the deal to close by the end of the fourth quarter, subject to regulatory approvals. Lazard advised Teladoc on the transaction while Morgan Stanley served as the financial advisor to Livongo. 

#articles, #chair, #chief-executive-officer, #diabetes, #digital-healthcare, #financial-advisor, #health, #healthcare, #lazard, #livongo, #medicare, #morgan-stanley, #tc, #technology, #telehealth, #telemedicine, #united-states


Is Telemedicine Here to Stay?

The answer largely depends on whether Medicare and private health insurers will adequately cover virtual doctor visits once coronavirus outbreaks subside.

#coronavirus-2019-ncov, #doctors, #elderly, #health-insurance-and-managed-care, #law-and-legislation, #medicare, #telemedicine, #united-states-politics-and-government, #verma-seema, #your-feed-healthcare


A Covid-19 Lesson: Some Seriously Ill Patients Can Be Treated at Home

To ease pressure on hospitals, Northwell Health brought medical workers, oxygen tanks and intravenous equipment into patients’ homes. Now Florida is taking cues.

#coronavirus-2019-ncov, #home-health-care, #hospitals, #medicare, #new-york-state, #northwell-health, #nursing-and-nurses, #telemedicine, #westbury-ny, #your-feed-science


A Conversation With Tammy Duckworth

The senator from Illinois joins the podcast to talk about Tucker Carlson, the vice presidency and parenting in a pandemic.

#coronavirus-reopenings, #duckworth-l-tammy, #illinois, #medicare, #monuments-and-memorials-structures, #quarantines, #russia, #russian-interference-in-2016-us-elections-and-ties-to-trump-associates, #trump-donald-j, #united-states-politics-and-government


Health Care Takes Center Stage in Battle for Congress During Pandemic

As the Trump administration pushes forward on dismantling the Affordable Care Act, Democrats are pressing their advantage on an issue that is becoming a chief focus of campaign advertising.

#bullock-steve, #coronavirus-2019-ncov, #daines-steve, #democratic-party, #elections-house-of-representatives, #elections-senate, #health-insurance-and-managed-care, #medicare, #patient-protection-and-affordable-care-act-2010, #political-advertising, #republican-party, #united-states-politics-and-government


Will We Be Hostages to Drug Makers’ Covid Vaccine Pricing?

The United States is the only developed nation unable to balance cost, efficacy and social good in setting prices.

#biomedical-advanced-research-and-development-authority, #coronavirus-2019-ncov, #drugs-pharmaceuticals, #food-and-drug-administration, #gilead-sciences-inc, #health-insurance-and-managed-care, #inventions-and-patents, #medicare, #national-institutes-of-health, #prices-fares-fees-and-rates, #vaccination-and-immunization


It Paid Doctors Kickbacks. Now, Novartis Will Pay a $678 Million Settlement.

The pharmaceutical company spent more than $100 million on lavish meals, fishing junkets, golf outings, sporting events and speaker fees to influence doctors to prescribe its drugs, federal prosecutors said.

#bribery-and-kickbacks, #diabetes, #doctors, #drugs-pharmaceuticals, #frauds-and-swindling, #medicare, #novartis-ag, #speeches-and-statements, #suits-and-litigation-civil


Fraudulent Covid Antibody Tests? FBI Warns of Scammers, Identity Theft

Scammers are out to get personal information that could lead to identity theft.

#centers-for-disease-control-and-prevention, #coronavirus-2019-ncov, #coronavirus-aid-relief-and-economic-security-act-2020, #federal-bureau-of-investigation, #federal-trade-commission, #food-and-drug-administration, #frauds-and-swindling, #health-insurance-and-managed-care, #identity-theft, #internal-revenue-service, #medicare, #national-institutes-of-health, #tests-medical


Hospitals Knew How to Make Money. Then Coronavirus Happened.

Surgeries are canceled. Business models are shifting. Some of the hardest-hit hospitals may close, leaving patients with fewer options for care.

#coronavirus-2019-ncov, #coronavirus-aid-relief-and-economic-security-act-2020, #hospitals, #layoffs-and-job-reductions, #mayo-clinic, #medicaid, #medicare, #new-york-presbyterian-hospital, #patient-protection-and-affordable-care-act-2010, #rural-areas


VC’s largest funds make big bets on vertical B2B marketplaces

During the waning days of the first dot-com boom, some of the biggest names in venture capital invested in marketplaces and directories whose sole function was to consolidate information and foster transparency in industries that had remained opaque for decades.

The thesis was that thousands of small businesses were making specialized products consumed by larger businesses in huge industries, but the reach of smaller players was limited by their dependence on a sales structure built on conferences and personal interactions.

Companies making pharmaceuticals, chemicals, construction materials and medical supplies represented trillions in sales, but those huge aggregate numbers hide how fragmented these supply chains are — and how difficult it is for buyers to see the breadth of sellers available.

Now, similar to the way business models popularized by and Webvan in decades past have since been reincarnated as Postmates and DoorDash, the B2B directory and marketplace rises from the investment graveyard.

The first sign of life for the directory model came with the success of GoodRX back in 2011. The company proved that when information about pricing in a previously opaque industry becomes available, it can unleash a torrent of new demand.

#amazon, #andreessen-horowitz, #bain-capital-ventures, #business-model, #doordash, #enterprise, #extra-crunch, #goodrx, #health, #julie-yoo, #market-analysis, #marketing, #material-bank, #medicare, #menlo-ventures, #merritt-hummer, #online-marketplaces, #pharmaceuticals, #postmates, #sequoia-capital, #startups, #tc, #venture-capital, #webvan, #y-combinator


How Small Physician Practices are Struggling to Survive During Coronavirus Pandemic

As visits plummet because of the coronavirus, small physician practices are struggling to survive.

#doctors, #elections-house-of-representatives, #health-insurance-and-managed-care, #medicare, #small-business, #telemedicine, #united-states-politics-and-government, #your-feed-healthcare


The New Great Depression Is Coming. Will There Be a New New Deal?

After the coronavirus, political transformation may be inevitable.

#biden-joseph-r-jr, #coronavirus-2019-ncov, #democratic-party, #great-depression-1930s, #green-new-deal, #health-insurance-and-managed-care, #khanna-ro, #labor-and-jobs, #layoffs-and-job-reductions, #liberalism-us-politics, #medicare, #new-deal-1930s, #organized-labor, #presidential-election-of-2020, #quarantines, #recession-and-depression, #united-states-economy, #warren-elizabeth, #yang-andrew-1975


Nursing Homes Were a Coronavirus Disaster Waiting to Happen

Long before Covid-19, poor care and lax standards were widespread and well known.

#centers-for-medicare-and-medicaid-services, #coronavirus-2019-ncov, #elder-care, #elderly, #epidemics, #lobbying-and-lobbyists, #long-term-care-community-coalition, #medicaid, #medicare, #nursing-homes, #regulation-and-deregulation-of-industry, #retirement-communities-and-assisted-living


Clever Care Health Plan launches with a holistic healing spin on Medicare Advantage programs

Angling for a slice of the multi-billion dollar Medicare Advantage market with a pitch to integrate holistic medical practitioners into its network of service providers has netted Clever Care Health Plan some big backers and a huge market opportunity, the company says.

The company has raised $23 million in a new round of funding from investors led by Norwest Partners for its unique take on how to create a new network of healthcare providers for potential Medicare Advantage beneficiaries.

Several healthcare startups have raised hundreds of millions of dollars to tackle the Medicare Advantage opportunity. These include companies like Bright Health, Clover Health, Devoted Health, and Oscar, but, to-date, none have tried to put an emphasis on cultural sensitivity and holistic healing that chief operating officer Myong Lee and his co-founders settled on.

Joining Lee in the launch of Clever Care’s services are chief executive David Firdaus and chief financial officer Hiep Pham. The three have a long history of working together at other health plans. 

We’re looking to have a really unique supplemental benefit on the Eastern Medicine side,” said Lee of the company’s pitch.

Of course, there’s one hitch. Whether the Centers for Medicare and Medicaid Services will approve the treatments for coverage. ““All of this is predicated on CMS approval,” Lee acknowledged.

Already, CMS has identified some holistic medical treatments — notably acupuncture — as eligible for coverage, and Lee and his team are hoping that more approvals could be forthcoming. 

Lee said that the problem was particularly acute for California’s aging immigrant population, which does not necessarily feel comfortable accessing the current healthcare system. Often, these populations are comprised of people who don’t speak English very well and whose needs are going unmet by current providers.

Using his own parents as an example, he said, “There wasn’t anything from their perspective. Nothing that spoke to them from an Eastern Medicine perspective.”

As Norwest general partner Casper de Clerq noted, Medicare Advantage has grown to encompass roughly 35% of all Medicare recipients. “There are 64 million Medicare members and 22 million are on Medicare Advnatage,” de Clerq said. “As this market matures it’s going to become more and more specialized and more niche with different populations that are not properly served. This hyperlocal phenomenon will be more and more important.”

The company said it would use the capital to establish its California Medicare Advantage health plan and hire staff for its two offices in Little Saigon in Orange County and Arcadia in Los Angeles County. 

“Medicare spending was 15 percent of total federal spending in 2018 and is projected to nearly double due to the retirement of the Baby Boom Generation and the rapid growth of per capita healthcare costs,” said Sean Doolan, healthcare partner at Global Founders Capital, which joined the round alongside Norwest. “We are excited to partner with the Clever Care Health Plan team and fully believe in their bold vision to create a progressive and affordable Medicare Advantage plan that will dramatically expand access to high quality care for diverse communities.”

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How Joe Biden Can Own Health Care

To achieve affordable health care for everyone, he should look closely at the plan of a particular former rival.

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How the Pandemic Can Improve America’s Health Care System

The coronavirus is forcing reforms that could change medicine forever if Congress requires it.

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As national COVID-19 cases top 1,000, insurers waive treatment fees and US preps stimulus

The number of COVID-19 cases in the U.S. crossed 1,000 on Tuesday as President Donald Trump met with the nation’s largest insurers and members of his cabinet to discuss how to pay for treatment and lessen the financial blow of the disease’s spread.

With the nation’s healthcare apparatus beginning to get a better understanding of the proliferation of the virus that causes COVID-19 within its borders, efforts have shifted fully from containing the disease’s spread to stopping the contagion from getting worse.

“What we would like the country to realize is that as a nation we can’t be doing the kinds of things we would be doing a few months ago,” said Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, during the daily briefing from the President’s Coronavirus Task Force. “It doesn’t matter if you’re in a state that has no cases or one case, you have to start taking seriously what you can do now, if and when the infections will come, and they will come.”

The government and private testing facilities Quest and LabCorp are quickly distributing new test kits, with the expectation that 5 million will be made available by the end of the week. The availability of testing means that more cases will be diagnosed and efforts will be made to limit the spread in the new clusters as they’re identified.

However, that rollout might be hampered by a potential shortage of a critical component of the tests — the “RNA extraction” kits, first reported by Politico earlier on Tuesday.

“RNA extraction is the first step in being able to perform” a COVID-19 test, Michael Mina, associate medical director of molecular diagnostics at Brigham and Women’s Hospital in Boston told Politico. “If we cannot perform this step, the [coronavirus] test cannot be performed.”

More roadblocks to testing could limit the identification of clusters of the virus that causes COVID-19 and stop governments from taking the kinds of dramatic action that medical professionals think could be necessary to mitigate the spread of the virus.

“When you have community spread you’re going to ratchet up the kinds of mitigations that you have,” said Fauci. “Everyone should be saying all hands on deck. This is what we need to be doing.”

In New York state that’s meant establishing a containment zone around New Rochelle, a city that has been the focal point for the disease’s spread in the region.

That mitigation strategy looks like an extreme version of the steps that Dr. Scott Gottlieb, the former Food and Drug Administration chief recommended over the weekend.

Meanwhile, more companies made calls for remote work for their employees and took steps to shield their workers from financial hardship caused by the disease — either through illness or because of the mitigation strategies imposed by the companies themselves. Their commitments come as President Trump and his economic advisors move forward with a stimulus package to boost the economy and provide a safety net for companies that are paying for workers’ time off.

Earlier in the day in a briefing at the White House, Vice President Mike Pence outlined the steps that insurance companies would be taking to ensure that patients receive the treatment they need.


“All the insurance companies here — either today or before today — have agreed to waive all copays on coronavirus testing and extend coverage for coronavirus treatment in all of their benefit plans,” Vice President Pence said. Last week the government said that Medicare and Medicaid beneficiaries would have their testing and treatment covered.

“They’ve also agreed to cover telemedicine so that anyone, particularly among the vulnerable senior population, would not feel it necessary to go to a hospital or go to their doctor,” said Pence. “They’ll know that telemedicine is covered.”

And for tech companies like Instacart, Postmates, Alphabet, Microsoft, Amazon, Salesforce, and Facebook, which have all committed to paying for hourly workers sickened by the virus or who have lost work due to office closures, the Federal government may provide some financial assistance (not that the tech companies need it).

Following up on the commitment made yesterday,  Director of the United States National Economic Council Larry Kudlow said at Tuesday’s briefing that the administration is putting together a proposal for a payroll tax cut and tax deferrals for small and medium-sized businesses who are impacted by the spread of COVID-19. 

Technology companies and the billionaires that own them are also chipping in to help local communities and finance initiatives looking for new diagnostics to identify the disease and treatments for the sick.

Earlier today, Amazon announced a $5 million initiative to help local businesses affected by the outbreak of COVID-19 in Seattle, while the Gates Foundation committed $50 million to a $125 million effort to develop treatments.

Still, executives at startups operating clinics in geographies affected by the virus that causes COVID-19 are saying that the infrastructure is not yet in place to adequately and effectively diagnose and treat the disease.

“Testing isn’t being done widely,” said one executive at a startup that runs a network of clinics and urgent care centers. “The supplies in the country are just very limited right now.” 

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WellSet is doing a limited launch in Los Angeles of its alternative medicine booking platform

Alternative and holistic healthcare seekers in the Los Angeles area have a new service they can turn to in WellSet, the listing platform that launched on Tuesday. 

Through the service, customers coming off the company’s existing waitlist can access its marketplace for finding acupuncturists, massage therapists, functional medicine practitioners, craniosacral therapists, nutritionists, life coaches and holistic therapists.

WellSet will serve up practitioners based on a users’ health concerns, as well as the price, location and type of practice on offer.

The company takes a 30% referral fee for its first booking and a 3% booking fee for future appointments booked through its platform. It also provides backend services like intake form management, insurance management and other logistical offerings, according to co-founder Tegan Bukowski.

Co-founder Sky Meltzer and Bukowski began working on the company two-and-a-half years ago, according to Bukowski. A former Yale-educated architect who worked for the starchitect Zaha Hadid, Bukowski founded the company because of her own experience with the healthcare industry. While in school she suffered through frequent trips to the hospital for what was an undiagnosed “mystery illness,” which she eventually treated holistically.

For the first 10,000 people to sign up for the company’s waitlist, WellSet is offering a $20 credit for the first session booked on the platform, once WellSet launches in their city.

So far the company has roughly 7,000 practitioners on the service and enough providers to launch in at least five major markets. Its deliberate rollout strategy will see the company opening its virtual doors in New York and San Francisco in the coming months.

The Los Angeles-based company was founded by Bukowski, who serves as co-founder and chief executive officer. Meltzer, the company’s executive chairman and co-founder, was the former chief executive of the yoga company Manduka. Rounding out the team is Hanna Madrigan, a former Pinterest employee who now serves as the chief operating officer.

The company is backed by investors including Kleiner Perkins, Broadway Angels (a female-focused Silicon Valley investment firm) and Kelly Noonan Gores, writer, producer and director of the documentary “Heal.”

There’s a small holistic healing community growing in Los Angeles. Gwyneth Paltrow’s Goop is by far the best funded of these new companies, but startups like Kensho Health are making their presence felt, as well.

Increasingly, holistic healing and functional medicine are seen as viable options for certain types of chronic conditions. The Centers for Medicare and Medicaid recently added acupuncture as a reimbursable treatment — opening the door to the possibility that other conditions may be covered by the government and private insurers.

#broadway-angels, #gwyneth-paltrow, #health, #kleiner-perkins, #massage, #medicare, #new-york, #pinterest, #san-francisco, #startups, #tc, #wellset