Child enrollment in public health programs fell by 600K last year

FierceHealthcare | March 08, 2019

The number of kids enrolled in Medicaid and the Children’s Health Insurance Program (CHIP)—two government health plans for the poor—fell by nearly 600,000 in the first 11 months of 2018, a precipitous drop that has puzzled and alarmed many health policy analysts, while several states say it reflects the good news of an improving economy. Enrollment in the two programs decreased by 599,000 children in the 48 states from which the U.S. Centers for Medicare and Medicaid Services (CMS) has data from December 2017 to November 2018, the last month for which numbers are available. At the beginning of that period, Medicaid and CHIP enrolled nearly 36 million children in those states. Missouri (8.1%), Idaho (6.7%) and Utah (6%) experienced the biggest percentage drops in kids enrolled.

Spotlight

This is the story of a nurse, who was treating my eighty year old father. He had suffered an incredible fall and was about to have his second back surgery in two weeks. My dad recognized the nurse caring for him and he joked that he was back after just a week. Upon hearing this, this nurse remarked, “Wow, I really don’t remember my patients.” At that point I noticed that she hadn’t introduced herself and she had her badge on backwards. I got her attention, and asked her name. She replied, "Well that depends, I will only tell you my name after you tell me if you think I am doing a good job." And she wasn’t joking. My trust level went to zero. I countered with, “My name is Barbara.” She eventually replied with, “My name is Cindy.” To this day, I wonder if Cindy was her real name. Her answer impacted my trust, but I also worried about what she might be experiencing. What was the culture like there and was that considered acceptable.


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HEALTH TECHNOLOGY

Alegeus and HealthSherpa Experience Significant Momentum for ICHRA

Alegeus and HealthSherpa | July 19, 2022

Alegeus, the market leader in healthcare payment solutions, and HealthSherpa, the leading enrollment platform for individual ACA health coverage, have outpaced the industry in individual coverage health reimbursement arrangements since announcing an integration partnership in the summer of 2020. With updates to their partnership in 2022, both companies are poised to increase their ICHRA enrollments even faster. HealthSherpa, which has seen more than 10X growth in ICHRA pipeline, has enrolled more than three million individuals on its platform in just the last year. ICHRAs, which were launched at the start of 2020, allow employers to reimburse employees for individual coverage insurance premiums in place of offering them a traditional group-sponsored health plan. ICHRAs can also be used by employees to pay for out-of-pocket healthcare expenses. Organizations administering consumer-directed health benefit programs can set up an ICHRA with Alegeus, and then HealthSherpa helps ICHRA-eligible employees search for and enroll in the best on-exchange and off-exchange individual health plans. This integration bolsters the health reimbursement arrangement (HRA) experience from Alegeus and gives third-party administrators and health plans a strategy for increasing employer and employee participation in health benefit accounts. “We’re excited about the growing demand our partners have seen for ICHRA since announcing our integration partnership with HealthSherpa,” said Mark Waterstraat, chief customer officer, Alegeus. “Our joint solution is helping employers to deliver quality and cost-effective benefits quickly and efficiently to their employees. While ICHRAs can offer these through employer-defined contribution and better-fit individual coverage plans, they are still new and require a considerable amount of education and awareness. Through this partnership, our efforts are resonating, as evidenced by growing market demand.” “ICHRAs are a great option for a large and growing number of employers and their employees, and we’ve seen many of our client organizations begin reaping their benefits,” said Ross Honig, president, OCA. “Working with Alegeus and HealthSherpa has allowed OCA to market our ICHRA solution as a “one-stop” product that is seamless and easy to use for brokers, employers, and their employees.” “Millions of consumers have enrolled in health insurance through HealthSherpa and experienced the increasing appeal of individual coverage. With our new off-exchange options, employers and brokers alike have more options for employees looking to make the transition away from group-sponsored health insurance. ICHRA is changing the dynamic of the relationship between employers and employees on the critical question of health insurance, and we’re thrilled to partner with Alegeus to help employers understand the benefits and communicate them with their employees.” George Kalogeropolous, CEO, HealthSherpa Alegeus and HealthSherpa recently presented a webinar, “The (Present and) Future of ICHRAs,” showcasing how to simplify the administration of ICHRA benefits and make it easier for consumers to find the care and coverage that meets their needs. About HealthSherpa HealthSherpa builds technology that increases access to health care. We provide end-to-end solutions for consumers, insurance carriers, and agents, delivering a superior ACA marketplace experience to fulfill our mission of connecting people to health coverage under the Affordable Care Act. The HealthSherpa Marketplace, our flagship health insurance enrollment platform, services more than 45,000 agents, 38 carriers, and 9 million consumers. About Alegeus With more than 25 years of growth and innovation, Alegeus is the market leader in SaaS-based benefit funding and payment solutions. Our highly flexible, white-label platform powers account-based benefit programs such as HSAs, FSAs, HRAs, COBRA, wellness incentives, lifestyle benefits and beyond. We deliver exceptional user experiences and differentiated capabilities that help our partners strengthen their product offerings, operate more efficiently, and unlock their full growth potential. Our partnerships with the industry’s leading health plans, third-party administrators, financial services and benefit solution providers give Alegeus unparalleled reach in the market, with access to more than 100 million commercially insured Americans. And our unique partnership model empowers our clients to achieve outsized results – growing their programs at a rate that is 3-4X the market, and with the highest NPS scores in the industry. We never compete with our clients in the market – we win when they win. Alegeus is headquartered in Waltham, Mass., with operations centers in Orlando and Bangalore, and a large remote workforce.

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HEALTH TECHNOLOGY

Harris Williams Advises The CM Group on its Pending Sale to OPEN Health

Harris Williams | August 01, 2022

Harris Williams, a global investment bank specializing in M&A advisory services, announces it is advising The CM Group, a portfolio company of NaviMed Capital (NaviMed), on its pending sale to OPEN Health, a portfolio company of Astorg. The CM Group is a leading medical communications platform offering a set of integrated solutions to the U.S. domestic biotech and pharma industries. The transaction is being led by Paul Hepper, Nick Owens, Lucas Scholl, Rob Crampton and Gabby Struckell of the Harris Williams Healthcare & Life Sciences Group. “Investor interest in outsourced pharma commercialization services is driven by complex therapies becoming an increasing portion of new drug launches, declining access to physicians, and the increasing importance of directly reaching patient populations. Differentiated platforms such as The CM Group are benefiting disproportionally from these trends,” said Paul Hepper, a managing director at Harris Williams. “The combination of OPEN Health and The CM Group brings together two best-in-class commercialization businesses, with stellar reputations in the industry and an exciting opportunity to service leading pharmaceutical companies globally,” said Nick Owens, a director at Harris Williams. “Harris Williams was a phenomenal partner and exceeded our expectations throughout the transaction. The team’s knowledge of the sector and extensive buyer relationships led to an optimal outcome. We look forward to the next phase of growth with the OPEN Health and Astorg teams and are excited about building a global leader in pharma commercialization,” Daniel Leonard, CEO of The CM Group Grounded in science—and powered by the patient voice—The CM Group is an integrated healthcare agency of innovative and imaginative subject-matter experts dedicated to providing scientific and commercialization strategies and services to the life sciences industry. NaviMed is a Washington, D.C.-based private capital firm with over $400 million of assets under management, focused exclusively on the healthcare industry. NaviMed invests in fast-growing lower-middle market healthcare businesses that it believes are poised to benefit from the reform and technology innovation reshaping the healthcare industry. The firm focuses on healthcare services, healthcare IT, hospital products and pharmaceutical services businesses. NaviMed targets profitable private companies with up to $10 million of EBITDA and double-digit revenue growth. NaviMed’s senior investment team has a track record of value creation spanning, in the aggregate, dozens of investments and more than $11 billion of enterprise value created over the course of their combined careers. OPEN Health brings together deep scientific knowledge, global understanding, and broad specialist expertise to support its clients in improving health outcomes and patient wellbeing. OPEN Health is united as one flexible organization, harnessing the power of the collective to solve complex challenges. Astorg is a European private equity firm with over €17 billion of assets under management. Astorg works with entrepreneurs and management teams to acquire market leading global companies headquartered in Europe or the U.S., providing them with the strategic guidance, governance and capital they need to achieve their growth plans. Enjoying a distinct entrepreneurial culture, a long-term shareholder perspective and a lean decision-making body, Astorg has valuable industry expertise in healthcare, software, technology, business services and technology-based industrial companies. Astorg has offices in London; Paris; New York; Frankfurt, Germany; Milan; and Luxembourg. Harris Williams, an investment bank specializing in M&A advisory services, advocates for sellers and buyers of companies worldwide through critical milestones and provides thoughtful advice during the lives of their businesses. By collaborating as one firm across Industry Groups and geographies, the firm helps its clients achieve outcomes that support their objectives and strategically create value. Harris Williams is committed to execution excellence and to building enduring, valued relationships that are based on mutual trust. Harris Williams is a subsidiary of the PNC Financial Services Group, Inc. The Harris Williams HCLS Group has experience across a broad range of sectors, including healthcare providers; payors and payor services; outsourced pharmaceutical services; medical device supply chain; healthcare IT; and pharmacy. Harris Williams LLC is a registered broker-dealer and member of FINRA and SIPC. Harris Williams & Co. Ltd is a private limited company incorporated under English law with its registered office at 8th Floor, 20 Farringdon Street, London EC4A 4AB, UK, registered with the Registrar of Companies for England and Wales (registration number 07078852). Harris Williams & Co. Ltd is authorized and regulated by the Financial Conduct Authority. Harris Williams & Co. Corporate Finance Advisors GmbH is registered in the commercial register of the local court of Frankfurt am Main, Germany, under HRB 107540. The registered address is Bockenheimer Landstrasse 33-35, 60325 Frankfurt am Main, Germany. Geschäftsführer/Directors: Jeffery H. Perkins, Paul Poggi.Harris Williams is a trade name under which Harris Williams LLC, Harris Williams & Co. Ltd and Harris Williams & Co. Corporate Finance Advisors GmbH conduct business.

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HEALTH TECHNOLOGY

Semantix Announces the Acquisition of Zetta Health Analytics

Semantix | September 01, 2022

Semantix, Inc. a leading Latin American end-to-end data platform provider announces the acquisition of Zetta Health Analytics S.A. a Brazilian health tech company focused on data analytics, with the strategic objective to further expand Semantix’s presence and capabilities in serving healthcare clients through proprietary SaaS data solutions. Founded in March 2019, Zetta has a robust variety of SaaS data solutions to enhance data-driven decision-making, leveraging client insights to improve care and costs and deepen value-based healthcare (VBHC) approach enriched by market analysis. In particular, Zetta provides to clients embedded dashboards utilizing artificial intelligence (AI) tools that help manage claims and improve assertiveness through the display of key indicators to optimize selection of providers and health outcomes. Currently, Zetta caters to a portfolio of more than 640 companies, including pharmaceutical companies, health insurers, health insurance brokers, hospitals and large companies in various sectors. In recognition of the powerful capabilities of Zetta’s data solutions, Zetta was named the number one tech company in the Brazilian healthcare market, according to the Ranking 100 Open Startups 2021. Semantix expects that the businesses combination with Zetta will complement the Semantix Data Platform offering and strengthen the healthcare business vertical, which caters to a sizeable and fast-growing market. According to market research produced by Grand View Research, the healthcare data analytics segment’s total addressable market globally is estimated at approximately US$35 billion in 2022 and is expected to reach US$ 167 billion by 2030. Zetta also brings a team of highly talented professionals, which, Semantix believes, combined with Semantix’s capital resources and robust sales capabilities, should accelerate new product development and enhance product cross-selling opportunities. “We are very excited about the new business capabilities that Zetta adds to our platform, both in terms of new markets and customers as well as new product development opportunities. We believe it is an important step towards the execution of our strategy to increase the share of proprietary products to our mix, with a recurring revenue stream and high growth potential,” Leonardo Santos, CEO of Semantix About Semantix Semantix is a leading Latin American end-to-end data platform provider. Semantix has more than 300 clients with operations in approximately 15 countries using Semantix’s software and services to enhance their businesses. The company was founded in 2010 by CEO Leonardo Santos.

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HEALTH TECHNOLOGY

Happify Health Weaves a New Path as Twill, the Intelligent Healing Company™

Happify Health | July 13, 2022

Happify Health has announced its transformation to become Twill. This change represents the culmination of a five-year journey to build in-house capabilities, which have enabled the company to transition from wellness apps to a clinical-grade platform that weaves together disparate strands of care to deliver a more connected care experience. As Twill, the company will shorten the distance between need and care to enable delivery of better care at a lower cost for the many, not the few. Twill offers Sequences™, which are configurable care experiences tailored to meet the needs of customers, specific medical conditions they cover, and the populations they serve. Sequences combine evidence-based digital therapeutics and well-being products, care communities, coaching, and third-party services on a clinical-grade platform designed to work seamlessly with the customer's existing digital solutions and resources. This enables a more precise, personalized and seamless care experience, at scale. “As we’ve grown to deliver care to more communities, the disconnectedness of our industry in addressing mental health along with physical health challenges has become abundantly clear. Instead of contributing to this problem, we saw an opportunity to take a different approach, one where we could make the meaningful connections between technology and humanity, body and mind, and need and care. As we’ve shifted our focus toward weaving together solutions that better support the whole person in the care journey, we wanted a name that better matched our mission: to make healing more intelligent.” Tomer Ben-Kiki, Chief Executive Officer at Twill Untangling the complexity of a fragmented healthcare system Today, there are over 350,000 consumer digital health apps, yet according to McKinsey, 90% of patients are looking for integrated healthcare journeys rather than single-point solutions. At the end of 2021, Twill conducted its own survey of large employers and health plans, to identify the largest barrier to executing a successful digital health strategy. Nearly half of all insurers and over a quarter of employers said that the biggest problem they faced was too many standalone point solutions. As Twill, the company is untangling the complexity of the healthcare system to deliver care that is more personal and connected. Twill's Intelligent Healing Platform™ integrates with, and augments, the customer’s existing offerings to give more people more choice in their care journey. This open-by-design architecture allows seamless integration with existing digital solutions, enhancing overall personalization and engagement to create a more personal, precise and connected experience. In doing so, Twill aims to usher in a new era of care built on a more human-centered, digital-first approach to guide each person to the care they need, when they need it, in the way they want. Weaving together a more connected approach to care through Sequences Sequences™ are the proprietary, configurable solution that enable Twill to provide simpler, more connected support for the care journey of a specific medical condition. Each Sequence is a bespoke configuration of evidence-based digital therapeutics and well-being products, care communities, coaching, third party services, and a customer’s own existing resources. They are open by design, in order to work seamlessly with a customer’s existing digital solutions, enhancing personalization and engagement to create a more personal, precise and connected journey. By the end of 2022, Twill will offer Sequences for four medical conditions: mental health, MS, pregnancy, and psoriasis. These have been developed with premier partners including Elevance Health Biogen, and Almirall, among others. Twill’s technology and science is designed to be scalable to a broad range of medical conditions. Intelligently guiding people through a more personalized and precise care journey Sequences are built on Twill’s Intelligent Healing Platform, which leverages deep understanding of each person’s unique clinical needs and personal preferences to guide people through a hyper-personalized and seamless care experience. About Twill Twill is The Intelligent Healing Company™, shortening the distance between need and care by intelligently guiding each person to the care they need, when they need it, in the way they want. The company delivers Sequences™, fully configurable, scientifically designed, digital-first solutions that support the care journey for specific medical conditions. Twill does this for pharmaceutical companies, health plans, jumbo employers, and those they serve. Available across 10 languages and covering more than 18 million lives, Twill creates a more precise, personal, engaging, and effective experience at scale for the many, not the few.

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Spotlight

This is the story of a nurse, who was treating my eighty year old father. He had suffered an incredible fall and was about to have his second back surgery in two weeks. My dad recognized the nurse caring for him and he joked that he was back after just a week. Upon hearing this, this nurse remarked, “Wow, I really don’t remember my patients.” At that point I noticed that she hadn’t introduced herself and she had her badge on backwards. I got her attention, and asked her name. She replied, "Well that depends, I will only tell you my name after you tell me if you think I am doing a good job." And she wasn’t joking. My trust level went to zero. I countered with, “My name is Barbara.” She eventually replied with, “My name is Cindy.” To this day, I wonder if Cindy was her real name. Her answer impacted my trust, but I also worried about what she might be experiencing. What was the culture like there and was that considered acceptable.

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