The Administration’s Drug Rebate Reforms: Four Implementation Questions That Will Influence Whether Drug Costs Fall

The Trump administration has outlined an ambitious agenda to reduce prices for prescription drugs, as outlined in its May 2018 Blueprint. Its policy agenda is centered on three premises with which most health care policy analysts and observers generally agree. First, high and rising prescription drug costs are caused by many interrelated factors; therefore, a multipronged policy approach is required. Second, fostering greater price competition in the purchasing of prescription drugs will reduce costs. And third, consumers and purchasers do not have full insight into the prices that are negotiated through the prescription drug distribution system. (Policy analysts debate, however, the extent to which greater price transparency will produce lower negotiated drug prices.) One area where there remains disagreement, at least on the political level, is the degree to which government purchasers specifically Medicare should enter into the direct negotiation of prices with manufacturers.

Spotlight

Lahey Health Behavioral Services

Non-profit agency providing outpatient mental health counseling, addiction treatment, emergency and inpatient psychiatric care and family behavioral health services. Clinics, inpatient hospitals and half-way houses on the North Shore, Merrimack Valley and greater Boston. 1,700 employees, including therapists, social workers, nurses, nurse practitioners and physicians...

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Health Technology

How Telehealth is Changing the Nursing Industry

Article | September 12, 2023

Before we discuss the importance of telehealth and how it is changing the nursing industry in general, it is important to understand what telehealth is all about. With the advent of new-age technologies and their impact on the fast-paced, growing population, medical health is an essential department that requires special attention. One’s health is of utmost importance, and to enhance the medical facilities, we as responsible citizens and experts in this particular field must come up with novel and quick solutions to provide optimum precaution and cure. Hence, one of such technological achievements is telecommunication,s and by utilizing such a useful resource, health-related services too can be offered. Telehealth promotes the distribution of various services related to medical health through electronic devices and telecommunication technologies. What can one possibly do if he or she lives in a different country and is pushed to an emergency situation where he requires medical advice from a physician who lives in another corner of the world? Of course, through telecommunication devices, the whole process of exchanging information becomes smoother and easier. Several health-related services such as medical advice, medical care, monitoring, education, remote admissions, and intervention can be extended to a long-distance patient with the help of telehealth facilities. Hence, the contemporary picture of health and medicine has been radically improved with the introduction of these electronic telecommunication systems.

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Health Technology, Digital Healthcare

Predictive Analytics: A Blessing for Healthcare Spaces

Article | August 21, 2023

Introduction Over the past couple of years, there has been a substantial rise in the burden of chronic conditions and treatment costs, along with the growing elderly population, which is transforming the healthcare sector at a rapid pace. As per a study, healthcare spending across the globe is anticipated to reach an unprecedented value to total US$ 18.3 trillion by 2030. In response to these trends, volume-based payment models are being replaced by outcome- or value-based models. Predictive analytics helps health organizations to get in line with these new models and improve patient care and outcomes. From predicting critical conditions such as heart failure and septic shock to preventing readmissions, the recent advancements in big data analytics are boosting the adoption of new predictive analytics solutions that aid clinicians improve outcomes and cut costs. Predictive analytics in healthcare is most helpful with clinical care, administrative tasks, and managing operations. More importantly, the technology is already making a difference in a wide range of healthcare settings, from small private doctor's offices and large academic hospitals to healthcare insurance companies. How is Growing Healthcare Data Favoring the Penetration of Predictive Analytics? The growing inclination toward digitalization in the healthcare industry has led to the creation of huge new data sets. These include radiology images, electronic medical record (EMR) systems, lab results, and health claims data. The amount of data is expected to reach new avenues with increasing genomics and cytogenesis research data in the near future. New data is being generated and collected by the novel medical devices at the edge, such as monitors and patient wearables. In addition, outside the healthcare setting, patients are generating quasi-health data through the use of health monitoring applications, fitness trackers, and personal wearable devices. By using data from these sources, health care providers can find new ways to use predictive modeling for health risks, predictive analytics for medical diagnosis, and prescriptive analytics for personalized medicine. Predictive analytics has become a crucial component of any strategy for health analytics. Today, it's an essential tool for measuring, combining, and making sense of biometric, psychosocial, and behavioral data that wasn't available or was very hard to get a hold of until recently. Here are some of the applications of predictive analytics for healthcare Identifying Patients at Risk Clinical Predictions Disease Progression and Comorbidities Predicting Length of Stay Speeding Treatment of Critical Conditions Reducing Readmissions The Future Story With the growing prominence of innovative technologies across the healthcare industry, a number of health IT providers are focusing on developing their own analytics software and engines to assist healthcare spaces deliver optimal patient care. For instance, in 2020, Eversana, a U.S.-based provider of innovative solutions to the life sciences industry, announced the introduction of its ACTICS predictive analytics solution, which enables clinical spaces to combine multiple data sources into a single comprehensive system. Also, some U.S. companies are partnering with healthcare institutions to develop proprietary algorithms designed to enhance organizational performance, improve clinical care, and increase operational efficiency. Such developments are projected to increase the popularity of predictive analytics solutions in the healthcare sector in the coming years.

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Health Technology, Digital Healthcare

The Internet of Medical Things and What Powers It?

Article | July 14, 2023

Technology in the 21st century is the fuel that drives innovation and ease in almost every industry today. The healthcare sector isn’t far behind. In fact, the medical industry has taken the concept of the Internet of Things and took it to a new level altogether to reimagine the use of medical technology. Imagine multiple devices like phones, cameras, GPS sensors, and computers interacting with each other through a seamless transfer of data. Now consider wearable medical devices. The exchange of critical medical information through a web of real-time data networks activates near instantaneous responses from doctors, nurses, and medical services. The aim is to anticipate the need for medical attention long before it is needed and remedy the concerns before they reach a critical stage. That is exactly how the future of the Internet of Medical Things (IoMT) is shaping out to be. How IoMT is Redefining Everyday Health? IoMT is a next-generation solution that embeds cutting-edge monitoring and analysis of individual healthcare journeys through medical devices. The smart watch is the most recognizable wearable medical device that is used by millions of people daily to keep tabs on their vitals. For instance, the Apple Watch series 6 maps blood oxygen levels, sleep patterns, ECG levels, and also reminds the user to wash their hands after returning home. The market for healthcare IoT products is vast and is constantly expanding. The Tango Belt is a leading example of smart wearable technology that is revolutionizing elderly and disability care. The belt is designed to sense falls and deploy airbags to soften the impact. In addition, it alerts caregivers in the event of a fall. The belt also uses data analytics by collecting mobility data that is then synced to a smartphone app for displaying metrics. Technologies that Empower IoMT With the diverse tasks that medical devices must perform, applications exist across a wide spectrum, from artificial intelligence to 5G networks to the cloud. Consider a pacemaker, for instance. Modern pacemakers are embedded with a multitude of technologies that communicate with each other to send critical patient data to physicians. A pacemaker is a bioelectronic implant that is placed in the chest to control the heartbeat. But a smart pacemaker goes a step further. It is equipped with wireless bluetooth technology that communicates with the patient’s wearable medical device. The smart device or phone will then transfer this data to physicians for check-ups and even alert doctors in the case of anomalies. To Round It Off IoMT will subsequently power all medical devices and usher in a future where technology forms the backbone of healthcare service delivery. Although wearable medical technology has been around for decades, the development of a streamlined communication channel between them has redefined their use. Smart medical devices are no longer just an aid but a source of vital individual medical data as well as a way to anticipate care and medical attention.

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Digital Healthcare

4 trends that are shaping product management in health care

Article | December 18, 2021

“Health care is different, the data here is emotional! If you tell me you were buying a fishing rod online and were emotional about it, I’d say you are lying. But I do frequently see people helpless and confused when it comes to receiving health care, managing its costs, making sense of its data.”  - Senior Product Leader inOptum Global Solutions Pvt. Ltd. Yes, health care is different, and so is product management in it. This piece highlights the top 4 product management trends that are specific to health care and serve beyond being just a list of technologies making their way into health care. Health care consumerism Lance broke his ankle in a bicycle accident and is now in hospital waiting for surgery. Which of these words would describe him more aptly— a ‘patient’ or a ‘health care consumer’? The fact that Lance holds a high-deductible health plan, manages an interactive relationship with his primary doctor, keenly monitors his fitness through his smartwatch, and learns about healthier diet plans and recipes online — I can say he isn’t just receiving health care, but making active choices on how to pay for and manage his health. This choice and responsibility that people demand, is ‘health care consumerism’. This trend has been growing since 2015 when value-based care started picking up in the US. What does this imply for products/PMs? These are challenging and exciting times to be a product manager (PM) in health tech. This is because people are now demanding an experience equivalent to what they’re used to from other products in their lives, such as e-commerce, streaming platforms, and digital payments, to name a few. Any consumer-facing product (a mobile app, a web-based patient portal, a tech-enabled service) needs to meet high expectations. Flexible employer-sponsored health plans options, health reimbursement arrangements, price transparency products for drugs and medical expenses, remote health care services, and government's push to strengthen data and privacy rights — all point to opportunities for building innovative products with ‘health care consumerism’ as a key product philosophy. Wellness COVID-19 has tested health care systems to their limits. In most countries, these systems failed disastrously in providing adequate, timely medical assistance to many infected people. Prevention is of course better than cure, but people were now forced to learn it the hard way when cure became both inaccessible and uncertain. With lockdowns and social isolation, prevention, fitness, diet, and mental wellbeing all took center stage. Wellness means taking a ‘whole-person approach’ to health care — one where people recognize the need to improve and sustain health, not only when they are unwell, but also when they’re making health care decisions that concern their long-term physical and mental health. A McKinsey study notes that consumers look at wellness from 6 dimensions beyond sick-care— health, fitness, nutrition, appearance, sleep, and mindfulness. Most countries in the study show that wellness has gained priority by at least 35% in the last 2–3 years. And wellness services like nutritionists, care managers, fitness training, psychotherapy consultants contribute 30% of the overall wellness spend. So, what do health-tech PMs need to remember about wellness? The first principle is, “Move to care out of the hospital, and into people’s homes”. A patient discharged after knee surgery has high chance of getting readmitted if he/she has high risk of falling in his/her house, or is unable to afford post-discharge at-home care with a physiotherapist. This leads us PMs to build products that recognize every person’s social determinants of health and create support systems that consider care at the hospital and care at home as a continuum. The second principle is, “Don’t be limited by a narrow view of ‘what business we are in’, as wellness is broad, and as a health tech company, we are in health-care, not sick-care”. Wellness products and services include — fitness and nutrition apps, medical devices, telemedicine, sleep trackers, wellness-oriented apparel, beauty products, and meditation-oriented offerings, to name just a few. Recent regulations in many countries require health care providers to treat behavioural health services at par with treating for physical conditions, and this is just a start. Equitable AI Last month, WHO released a report titled “Ethics and Governance of Artificial Intelligence for Health”. The report cautions researchers and health tech companies to never design AI algorithms with a single population in mind. One example I read was, “AI systems that are primarily trained on data collected from patients in high-income settings will not perform as effectively for individuals in low or middle-income communities.” During COVID-19, we came across countless studies that talked about the disproportionate impact on minorities in terms of infections, hospitalizations, and mortality. A student at MIT discovered that a popular out-of-the-box AI algorithm that projects patient mortality for those admitted in hospitals, makes significantly different predictions based on race — and this may have adversely moved hospital resources away from some patients who had higher risks of mortality. How should I think about health equity as an AI health-tech PM? Health equity means that everyone should have a fair chance at being healthy. As a PM, it’s my job to make sure that every AI-assisted feature in my product is crafted to be re-iterative and inclusive, to serve any community or subpopulation, and is validated across many geographies. To prevent any inequitable AI from getting shipped, it is important to ensure that the underlying AI model is transparent and intelligible. This means knowing what data goes into it, how it learns, which features does it weigh over others, and how does the model handles unique features that characterize minorities. Integrated and interoperable In every article that I read on topics such as digital platforms, SaaS, or connectivity with EMRs, I always find the words: ‘integrated’ and ‘interoperable’ therein. Most large and conventional health tech companies started by offering point-solutions that were often inextensible, monolithic, and worked with isolated on-prem servers and databases. To give a consistent user experience, leverage economies of scope, and scale products to meet other needs of their customers, started an exodus from fragmented point-solutions to interoperable, integrated solutions. The popularization of service-oriented architectures (SOAs) and cloud vendors like AWS, Azure, and GCP has also helped. The what and how of integrated-interoperable solutions for PMs: Integrated solutions (IS), as I see them, are of two kinds — one, in which as a health tech company, we help our customers (health systems, insurance companies, direct to consumers) accomplish not just one, but most/all tasks in a business process. For example, a B2B IS in value-based care contract management would mean that we help our customers and health systems by giving an end-to-end solution that helps them enter into, negotiate, plan for, manage, get payments for their value-based contracts with health plans. In the second type of IS, we offer products that can be easily customized to different types of customers. For example, a health management app that people can subscribe to for different programs such as obesity, diabetes, hypertension, cholesterol management, as needed. The app works with different datasets for these programs and uses different analyses and clinical repositories in its backend, but still delivers a consistent user experience across programs to a user who enrolled in multiple programs, say diabetes and weight management. ‘Interoperable’ simply means that one product should be able to talk to other products both in and out of the company. For example, if product-A can alert a doctor about any drug-drug interactions or allergies a patient might have, while she is writing prescriptions for the patient in product-B (an EMR), then product-A does talk to product-B, and hence, is interoperable. This trend is picking up further with the growth of IoT devices, and industry-wide participation in adopting common standards for data exchange. Conclusion Though the article derives much of its context from US health care, I have tried to keep a global lens while choosing these topics. For developing economies like India, digitization is the number one trend as much of the health system is still moving from manual records to digitally store patient and medical data in EMRs. The good news is that India is booming with health-tech innovation and that is where consumerism, wellness, and equitable AI make sense. Once companies develop enough point-solutions for different health system needs and use-cases, Indian health tech will see a move towards creating integrated, interoperable (IGIO) systems as well. There are some other trends such as — use of non-AI emerging tech such as Blockchain in health information management, cloud infrastructure for health tech innovation, big data and analytics to improve operational efficiency in areas such as claims management and compliance reporting, Agile product management for co-developing with and continuously delivering to clients etc. — but I see them either as too nascent, or too old to feature in this list. Finally, as a health tech product manager, you can use the following questions to assess your products against the above trends — (Consumerism) do the products that I manage, empower consumers with choice, information, and actionability? (Wellness) Does my product emphasize keeping them out-of-hospitals and healthy in the first place? (Equitable AI) Am I sure that my product doesn’t discriminate against individuals belonging to underserved populations? (IGIO) And finally, is my product scalable, integrated and interoperable to expand to a platform, in the true sense?

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Spotlight

Lahey Health Behavioral Services

Non-profit agency providing outpatient mental health counseling, addiction treatment, emergency and inpatient psychiatric care and family behavioral health services. Clinics, inpatient hospitals and half-way houses on the North Shore, Merrimack Valley and greater Boston. 1,700 employees, including therapists, social workers, nurses, nurse practitioners and physicians...

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Future of Healthcare

ClareMedica Health Partners, a Leading Provider of Value-Based Primary Care, Receives Investment from Revelstoke Capital Partners

Revelstoke | February 25, 2022

Revelstoke Capital Partners ("Revelstoke"), aDenver-based private equity firm focused on investing in healthcare services companies, today announced it has made a significant growth investment in ClareMedica Health Partners, LLC ("ClareMedica" or the "Company"), a leader in value-based primary care serving Medicare Advantage members inFlorida. This partnership will accelerate ClareMedica's growth and aid the Company in expanding itsBetterCare℠model into new markets. ClareMedica will continue to be led by CEORoberto Palenzuelaand the current management team, who will retain significant ownership in the business. BPOC, aChicago-based healthcare investor, which has been an investor in ClareMedica since 2019, will also retain equity ownership. "We have always believed in a value-based care model that places a priority on high-quality coordinated care designed to improve health outcomes," said Mr. Palenzuela, who reinvested alongside Revelstoke. "We are delighted to partner with Revelstoke, which has a proven track-record of building prominent healthcare services businesses with this patient centric philosophy. We are excited to use this investment to partner with other physician-led practices, expanding ourBetterCare℠model into new markets throughoutFloridaand into neighboring states." Russell Cassella, Managing Partner at Revelstoke, said, "Our investment in ClareMedica reflects Revelstoke's avid support of the industry's transition from fee-for-service to value-based healthcare, resulting in a greater emphasis on improving patient outcomes. ClareMedica's commitment to providing high-quality care has made it a partner of choice for physicians and payors throughoutFlorida. With our experience in physician practice management and value-based care, we look forward to helping management build a broader regional platform that will increase access to high-quality care." "We look forward to our continued partnership with Roberto and his team because of their patient-centered approach and focus on improving patient outcomes. As value-based care continues to expand, we see significant long-term growth potential as ClareMedica enters new markets and expands access to high-quality care." Peter Magas, Partner at BPOC "After a multi-year outbound search in the value-based primary care sector, we are very pleased to partner with ClareMedica's management team and providers who are dedicated to transforming healthcare," said Cy Barton-Dobenin, Principal at Revelstoke. "Throughout our targeted search process, we have built significant industry knowledge and strategic relationships that we are excited to integrate into ClareMedica's growth plans." SVB Leerinkacted as financial advisor and McGuireWoods LLP acted as legal counsel to Revelstoke.Houlihan Lokeyacted as financial advisor and Kirkland & Ellis LLP andMcDermott Will& Emery LLP acted as legal counsel to ClareMedica and BPOC. Terms of the transaction were not disclosed. About Revelstoke Revelstoke is a private equity firm formed by experienced investors who focus on building industry-leading companies in the healthcare services and healthcare technology sectors. Revelstoke partners with entrepreneurs and management teams to execute on a disciplined organic and acquisition growth strategy as it strives to build exceptional companies. Revelstoke is based inDenver, Coloradoand has approximately$4.3 billionof assets under management. Since the firm's inception in 2013, Revelstoke has completed 142 acquisitions, which includes 25 platform companies and 117 add-on acquisitions. About ClareMedica Health Partners ClareMedica is a growing health care company that provides and coordinates comprehensive health care services for Medicare Advantage members and other customers through a network of employed and affiliated physicians. We deliver accountable, value-based care for all health care stakeholders by employing a patient-centric care model that provides better care for our patients and a changing health care industry. About BPOC Founded in 1996, BPOC is aChicago-based private equity firm that invests exclusively in healthcare companies and is one of the nation's most experienced investors in the industry having raised five funds with total capital commitments of nearly$1.8 billion. BPOC has invested in numerous provider, manufacturing, outsourcing, distribution and information technology companies through growth equity, management buyouts and leveraged recapitalizations.

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Digital Healthcare

Brazilian Heath Tech Company Alice Partners With TytoCare to Expand Telehealth Offerings With At-Home Medical Examinations

TytoCare | February 23, 2022

TytoCare, the global health care industry's first all-in-one modular device and examination platform for AI-powered, on-demand, remote medical exams, and Alice,Brazil'sfirst primary care-driven health insurance plan, have announced today a partnership. Alice is the first company inBrazilto integrate with TytoCare, offering its members an easy-to-use, portable examination kit to conduct virtual physical examinations anywhere, anytime, putting healthcare in the hands of consumers. TytoCare will be distributed exclusively inBrazilby Tuinda Care. Alice, which inDecember 2021received the largest venture capital round ever reported inLatin Americaby a health tech company, began operations inJune 2020as an innovative tech-enabled health plan, built on the foundation of virtual-first, team-based primary care. Besides providing each of its members a 'Health Squad' ("Time de Saúde") – composed of a family doctor, a nurse, a nutritionist, and a physical trainer – the company also serves as a private health insurance provider with access to top-of-the-line hospitals, labs, and a network of medical specialists. Most hospitals in the network are contracted under a value-based healthcare (VBHC) payment model. With the TytoCare partnership, Alice will enable seamless digital diagnostics for its members, while enabling physicians to offer clinic-quality virtual care. TytoCare is the only all-in-one telehealth solution enabling physicians to remotely connect with patients for clinic-quality physical examinations. The handheld examination kit enables users to perform comprehensive exams of the heart, skin, ears, throat, abdomen, and lungs, as well as measure heartrate and body temperature, which are key for treating many acute and chronic conditions. This allows healthcare providers to gain the vital clinical data they require to monitor, diagnose, and treat patients and avoid unnecessary in-person visits. All the data is stored in Alice's app and becomes available to all health professionals who care for the member, allowing for seamless care coordination. "This data integration – the first of its kind inBrazil– enables the member's Health Squad to easily follow up on any chronic or acute condition, providing patients with long-term care while ensuring accuracy, speed, and convenience in both diagnoses and treatment plans. TytoCare also reduces costs and the need for travel to and from hospitals and clinics. In addition, it enables the health professional to share vital information with other physicians and specialists for a second opinion." André Florence, CEO of Alice TytoCare is easy to use and requires only an internet signal for members to conduct synchronous virtual consultations with their physician who can guide them through the exams and see the results in Alice's app. The physician can then better direct the member to the appropriate care pathway, either by referring them to an emergency room or by writing a digital prescription, when necessary. Currently, 15% of digital queries use TytoCare's support and with the integration, this number is expected to grow even further. With TytoCare, Alice can offer better assistance to a member who has, for example, an earache in the middle of the night and opts to use 'Alice Now' ("Alice Agora") – an in-app, text-based virtual primary care service that supports audio and video and is available 24/7 for members who need immediate medical assistance. Within one hour, the member will receive the TytoCare device at home and the physician will guide them through a physical exam to see in real-time what is happening in the ear canal. The TytoCare examination kit can be used to support the care of children and adults as well as for patients with more complex illnesses who need frequent monitoring. "Members with medical complexities use health services more frequently and can benefit from remote monitoring, reducing the frequency of in-person visits," saidAna Carolina Lucchese, Tuinda Care director. "Easier access to medical services can also prevent further complications and hospitalization." About TytoCare TytoCare is a telehealth company using AI to transform primary care by putting health in the hands of consumers. TytoCare seamlessly connects people to clinicians to provide the best virtual home examination and diagnosis solutions.Its solutions are designed to enable a comprehensive medical exam from any location and include a hand-held, all-in-one tool for examining the heart, lungs, skin, ears, throat, abdomen, and body temperature; a complete telehealth platform for sharing exam data, conducting live video exams, and scheduling visits; a cloud-based data repository with analytics; and built-in guidance technology and machine learning algorithms to ensure accuracy and ease of use for patients and insights for healthcare providers. Co-founded byDedi GiladandOfer Tzadikin 2012, TytoCare has FDA and CE clearances and has partnered with over 170 major health systems, health plans, and strategic partners in the U.S.,Europe,Asia,Latin America, andIsrael. About Alice Alice is currently considered the most promising health tech inLatin America. AsBrazil'sfirst primary care-driven health insurance plan, its mission is to make the world healthier. Launched inJune 2020, it already has nearly 7,000 members, more than 550 employees and has raised VC rounds at historically high levels for a health tech in the region. Founded by André Florence,Guilherme AzevedoandMatheus Moraes, the health tech has raised$174.8Mfrom the funds Allen & Company LLC, Canary, Endeavor Catalyst, Globo Ventures, G Squared, Kaszek, Maya Capital, StepStone Group, SoftBank Latin America Fund (SBLA) and ThornTree Capital Partners. About Tuinda Care Tuinda Care is a Healthtech startup focused on expanding access to high quality medical care inBrazilthrough telemedicine. It's the exclusive distributor of TytoCare technology inBrazil, with the purpose to connect clinicians and patients remotely, assuring medical excellence in every online visit. Tuinda Care is accelerated by Pequeno Príncipe Hospital and Sabará Pediatric Hospital, the two most prestigious pediatric hospitals inBrazil.

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Future of Healthcare

Avalon Healthcare Solutions Announces New Collaboration with N.Y.-Based Health Insurer CDPHP

Avalon Healthcare Solutions | February 19, 2022

Avalon Healthcare Solutions, LLC, DBA Avalon Healthcare Solutions, is pleased to announce a new collaboration to provide genetic testing management to Capital District Physicians' Health Plan, Inc. (CDPHP®). Lab testing is the gateway to appropriate diagnosis and treatment plans, and there are more than 13 billion lab tests performed annually in the U.S. Those results influence 70 percent of all medical decisions. Lab testing is highly complex and constantly evolving, creating challenges for health plans to navigate. Avalon, the world's first Lab Insights company, takes lab benefit and value management services to the next level, further removing waste and abuse from the system, while also improving clinical outcomes. Avalon helps its clients provide earlier disease detection for their members and drive treatment protocols to accelerate the Triple Aim of improving the patient experience, improving the health of populations, and reducing the per member cost of healthcare. Avalon and CDPHP are focused on using the latest technology, evidence-based medicine, and provider education to ensure high-quality, cost-effective laboratory services to drive appropriate care for CDPHP members. Avalon's innovative management services unlock the power of lab data, expanding the view to encompass the entire patient journey, optimizing treatment, improving outcomes, and driving down costs. "We are pleased to join together withCDPHP and bring our proven history of management, as well as our innovative approach to unlocking new possibilities. The CDPHP focus on improving the health and well-being of its members and communities is perfectly aligned with Avalon's mission to help our clients enable value-driven care in this dynamic and increasingly challenging environment." Bill Kerr, MD, Chief Executive Officer at Avalon "For nearly 40 years, CDPHP has been committed to lowering the total cost of care while preserving the high-quality service our members and the community at-large have come to expect," saidElizabeth Warner, MD, Senior Vice President of Member Health, CDPHP. "This new venture with Avalon Healthcare Solutions will further our mission of ensuring care is delivered at the right place, at the right time, and with the best outcome possible for each and every member we serve." About Avalon Healthcare Solutions Avalon Healthcare Solutions is the world's first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans across the country, the company covers more than 36 million lives and delivers 7-12% outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Platform that captures, digitizes, and analyzes lab results in real time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols, and driving down overall cost. About CDPHP® Established in 1984, CDPHP is a physician-founded, member-focused and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 29 counties throughoutNew York.

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Future of Healthcare

ClareMedica Health Partners, a Leading Provider of Value-Based Primary Care, Receives Investment from Revelstoke Capital Partners

Revelstoke | February 25, 2022

Revelstoke Capital Partners ("Revelstoke"), aDenver-based private equity firm focused on investing in healthcare services companies, today announced it has made a significant growth investment in ClareMedica Health Partners, LLC ("ClareMedica" or the "Company"), a leader in value-based primary care serving Medicare Advantage members inFlorida. This partnership will accelerate ClareMedica's growth and aid the Company in expanding itsBetterCare℠model into new markets. ClareMedica will continue to be led by CEORoberto Palenzuelaand the current management team, who will retain significant ownership in the business. BPOC, aChicago-based healthcare investor, which has been an investor in ClareMedica since 2019, will also retain equity ownership. "We have always believed in a value-based care model that places a priority on high-quality coordinated care designed to improve health outcomes," said Mr. Palenzuela, who reinvested alongside Revelstoke. "We are delighted to partner with Revelstoke, which has a proven track-record of building prominent healthcare services businesses with this patient centric philosophy. We are excited to use this investment to partner with other physician-led practices, expanding ourBetterCare℠model into new markets throughoutFloridaand into neighboring states." Russell Cassella, Managing Partner at Revelstoke, said, "Our investment in ClareMedica reflects Revelstoke's avid support of the industry's transition from fee-for-service to value-based healthcare, resulting in a greater emphasis on improving patient outcomes. ClareMedica's commitment to providing high-quality care has made it a partner of choice for physicians and payors throughoutFlorida. With our experience in physician practice management and value-based care, we look forward to helping management build a broader regional platform that will increase access to high-quality care." "We look forward to our continued partnership with Roberto and his team because of their patient-centered approach and focus on improving patient outcomes. As value-based care continues to expand, we see significant long-term growth potential as ClareMedica enters new markets and expands access to high-quality care." Peter Magas, Partner at BPOC "After a multi-year outbound search in the value-based primary care sector, we are very pleased to partner with ClareMedica's management team and providers who are dedicated to transforming healthcare," said Cy Barton-Dobenin, Principal at Revelstoke. "Throughout our targeted search process, we have built significant industry knowledge and strategic relationships that we are excited to integrate into ClareMedica's growth plans." SVB Leerinkacted as financial advisor and McGuireWoods LLP acted as legal counsel to Revelstoke.Houlihan Lokeyacted as financial advisor and Kirkland & Ellis LLP andMcDermott Will& Emery LLP acted as legal counsel to ClareMedica and BPOC. Terms of the transaction were not disclosed. About Revelstoke Revelstoke is a private equity firm formed by experienced investors who focus on building industry-leading companies in the healthcare services and healthcare technology sectors. Revelstoke partners with entrepreneurs and management teams to execute on a disciplined organic and acquisition growth strategy as it strives to build exceptional companies. Revelstoke is based inDenver, Coloradoand has approximately$4.3 billionof assets under management. Since the firm's inception in 2013, Revelstoke has completed 142 acquisitions, which includes 25 platform companies and 117 add-on acquisitions. About ClareMedica Health Partners ClareMedica is a growing health care company that provides and coordinates comprehensive health care services for Medicare Advantage members and other customers through a network of employed and affiliated physicians. We deliver accountable, value-based care for all health care stakeholders by employing a patient-centric care model that provides better care for our patients and a changing health care industry. About BPOC Founded in 1996, BPOC is aChicago-based private equity firm that invests exclusively in healthcare companies and is one of the nation's most experienced investors in the industry having raised five funds with total capital commitments of nearly$1.8 billion. BPOC has invested in numerous provider, manufacturing, outsourcing, distribution and information technology companies through growth equity, management buyouts and leveraged recapitalizations.

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Digital Healthcare

Brazilian Heath Tech Company Alice Partners With TytoCare to Expand Telehealth Offerings With At-Home Medical Examinations

TytoCare | February 23, 2022

TytoCare, the global health care industry's first all-in-one modular device and examination platform for AI-powered, on-demand, remote medical exams, and Alice,Brazil'sfirst primary care-driven health insurance plan, have announced today a partnership. Alice is the first company inBrazilto integrate with TytoCare, offering its members an easy-to-use, portable examination kit to conduct virtual physical examinations anywhere, anytime, putting healthcare in the hands of consumers. TytoCare will be distributed exclusively inBrazilby Tuinda Care. Alice, which inDecember 2021received the largest venture capital round ever reported inLatin Americaby a health tech company, began operations inJune 2020as an innovative tech-enabled health plan, built on the foundation of virtual-first, team-based primary care. Besides providing each of its members a 'Health Squad' ("Time de Saúde") – composed of a family doctor, a nurse, a nutritionist, and a physical trainer – the company also serves as a private health insurance provider with access to top-of-the-line hospitals, labs, and a network of medical specialists. Most hospitals in the network are contracted under a value-based healthcare (VBHC) payment model. With the TytoCare partnership, Alice will enable seamless digital diagnostics for its members, while enabling physicians to offer clinic-quality virtual care. TytoCare is the only all-in-one telehealth solution enabling physicians to remotely connect with patients for clinic-quality physical examinations. The handheld examination kit enables users to perform comprehensive exams of the heart, skin, ears, throat, abdomen, and lungs, as well as measure heartrate and body temperature, which are key for treating many acute and chronic conditions. This allows healthcare providers to gain the vital clinical data they require to monitor, diagnose, and treat patients and avoid unnecessary in-person visits. All the data is stored in Alice's app and becomes available to all health professionals who care for the member, allowing for seamless care coordination. "This data integration – the first of its kind inBrazil– enables the member's Health Squad to easily follow up on any chronic or acute condition, providing patients with long-term care while ensuring accuracy, speed, and convenience in both diagnoses and treatment plans. TytoCare also reduces costs and the need for travel to and from hospitals and clinics. In addition, it enables the health professional to share vital information with other physicians and specialists for a second opinion." André Florence, CEO of Alice TytoCare is easy to use and requires only an internet signal for members to conduct synchronous virtual consultations with their physician who can guide them through the exams and see the results in Alice's app. The physician can then better direct the member to the appropriate care pathway, either by referring them to an emergency room or by writing a digital prescription, when necessary. Currently, 15% of digital queries use TytoCare's support and with the integration, this number is expected to grow even further. With TytoCare, Alice can offer better assistance to a member who has, for example, an earache in the middle of the night and opts to use 'Alice Now' ("Alice Agora") – an in-app, text-based virtual primary care service that supports audio and video and is available 24/7 for members who need immediate medical assistance. Within one hour, the member will receive the TytoCare device at home and the physician will guide them through a physical exam to see in real-time what is happening in the ear canal. The TytoCare examination kit can be used to support the care of children and adults as well as for patients with more complex illnesses who need frequent monitoring. "Members with medical complexities use health services more frequently and can benefit from remote monitoring, reducing the frequency of in-person visits," saidAna Carolina Lucchese, Tuinda Care director. "Easier access to medical services can also prevent further complications and hospitalization." About TytoCare TytoCare is a telehealth company using AI to transform primary care by putting health in the hands of consumers. TytoCare seamlessly connects people to clinicians to provide the best virtual home examination and diagnosis solutions.Its solutions are designed to enable a comprehensive medical exam from any location and include a hand-held, all-in-one tool for examining the heart, lungs, skin, ears, throat, abdomen, and body temperature; a complete telehealth platform for sharing exam data, conducting live video exams, and scheduling visits; a cloud-based data repository with analytics; and built-in guidance technology and machine learning algorithms to ensure accuracy and ease of use for patients and insights for healthcare providers. Co-founded byDedi GiladandOfer Tzadikin 2012, TytoCare has FDA and CE clearances and has partnered with over 170 major health systems, health plans, and strategic partners in the U.S.,Europe,Asia,Latin America, andIsrael. About Alice Alice is currently considered the most promising health tech inLatin America. AsBrazil'sfirst primary care-driven health insurance plan, its mission is to make the world healthier. Launched inJune 2020, it already has nearly 7,000 members, more than 550 employees and has raised VC rounds at historically high levels for a health tech in the region. Founded by André Florence,Guilherme AzevedoandMatheus Moraes, the health tech has raised$174.8Mfrom the funds Allen & Company LLC, Canary, Endeavor Catalyst, Globo Ventures, G Squared, Kaszek, Maya Capital, StepStone Group, SoftBank Latin America Fund (SBLA) and ThornTree Capital Partners. About Tuinda Care Tuinda Care is a Healthtech startup focused on expanding access to high quality medical care inBrazilthrough telemedicine. It's the exclusive distributor of TytoCare technology inBrazil, with the purpose to connect clinicians and patients remotely, assuring medical excellence in every online visit. Tuinda Care is accelerated by Pequeno Príncipe Hospital and Sabará Pediatric Hospital, the two most prestigious pediatric hospitals inBrazil.

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Future of Healthcare

Avalon Healthcare Solutions Announces New Collaboration with N.Y.-Based Health Insurer CDPHP

Avalon Healthcare Solutions | February 19, 2022

Avalon Healthcare Solutions, LLC, DBA Avalon Healthcare Solutions, is pleased to announce a new collaboration to provide genetic testing management to Capital District Physicians' Health Plan, Inc. (CDPHP®). Lab testing is the gateway to appropriate diagnosis and treatment plans, and there are more than 13 billion lab tests performed annually in the U.S. Those results influence 70 percent of all medical decisions. Lab testing is highly complex and constantly evolving, creating challenges for health plans to navigate. Avalon, the world's first Lab Insights company, takes lab benefit and value management services to the next level, further removing waste and abuse from the system, while also improving clinical outcomes. Avalon helps its clients provide earlier disease detection for their members and drive treatment protocols to accelerate the Triple Aim of improving the patient experience, improving the health of populations, and reducing the per member cost of healthcare. Avalon and CDPHP are focused on using the latest technology, evidence-based medicine, and provider education to ensure high-quality, cost-effective laboratory services to drive appropriate care for CDPHP members. Avalon's innovative management services unlock the power of lab data, expanding the view to encompass the entire patient journey, optimizing treatment, improving outcomes, and driving down costs. "We are pleased to join together withCDPHP and bring our proven history of management, as well as our innovative approach to unlocking new possibilities. The CDPHP focus on improving the health and well-being of its members and communities is perfectly aligned with Avalon's mission to help our clients enable value-driven care in this dynamic and increasingly challenging environment." Bill Kerr, MD, Chief Executive Officer at Avalon "For nearly 40 years, CDPHP has been committed to lowering the total cost of care while preserving the high-quality service our members and the community at-large have come to expect," saidElizabeth Warner, MD, Senior Vice President of Member Health, CDPHP. "This new venture with Avalon Healthcare Solutions will further our mission of ensuring care is delivered at the right place, at the right time, and with the best outcome possible for each and every member we serve." About Avalon Healthcare Solutions Avalon Healthcare Solutions is the world's first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans across the country, the company covers more than 36 million lives and delivers 7-12% outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Platform that captures, digitizes, and analyzes lab results in real time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols, and driving down overall cost. About CDPHP® Established in 1984, CDPHP is a physician-founded, member-focused and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 29 counties throughoutNew York.

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