Missouri Firm With Silicon Valley Ties Faces Medicare Billing Scrutiny

khn.org | July 23, 2019

ST. LOUIS In many ways, Essence Group Holdings Corp. is a homegrown health care success story. Founded locally, it has grown into a broader company backed by a major Silicon Valley investor. Essence now boasts Medicare Advantage plans for seniors with some 60,000 members in Missouri and across the Mississippi River in Illinois. It ranks among the city’s top 35 privately held companies, according to the St. Louis Business Journal. And market research firm PitchBook Data values the company at over $1.64 billion. But a recent audit by the federal Health and Human Services inspector general, along with a whistleblower lawsuit, have put the St. Louis health care standout under scrutiny. Medicare officials also are conducting a separate audit of Essence. The same growth and use of big data that attracted venture capital cash are getting a renewed look from government officials who estimate that Medicare Advantage plans nationwide overcharge taxpayers nearly $10 billion annually. The April audit of Essence — the first in a series of upcoming audits scrutinizing some Medicare Advantage plans across the United States — revealed that the St. Louis company could not substantiate fees for dozens of patients diagnosed with stroke or depression.

Spotlight

Opportunities to Improve Care for Medicare Patients with Chronic Conditions A historic transformation is underway in healthcare as value-based reimbursement (VBR) gradually supersedes the fragmented and costly fee-for-service care model long employed in the United States.


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HEALTH TECHNOLOGY

Paradigm Oral Health Announces Acquisition by BlackRock Long Term Private Capital

Paradigm Oral Health | September 23, 2022

Paradigm Oral Health a leading oral surgery and digital dentistry platform announced that BlackRock Long Term Private Capital has entered into a definitive agreement to acquire a majority interest in the company from shareholders including InTandem Capital Partners. LTPC will partner with Paradigm’s executive leadership team, led by founder and CEO Dr. David Rallis, to support the company’s continued expansion and strategic growth plans. Founded in 2018, Paradigm has developed an industry-leading model designed to attract and retain best-in-class surgeons focused on delivering the highest quality of oral health care and dental implant surgery while fostering a medically-driven, patient-friendly culture of excellence. The company partners with leading oral surgery groups in markets across the United States, allowing them to maintain their unique brand identity while operating on the same platform. Paradigm’s proprietary practice management technology, Paragon, utilizes cutting-edge technology and data analytics to provide and store proprietary information and intelligence generated by the business, leading to enhanced performance as well as increased patient and provider satisfaction. Today, Paradigm and its team of over 100 surgeon partners provide patient care in 75 state-of-the-art facilities throughout the United States. “We are pleased to invest in Paradigm, which has established itself as an industry defining platform for the development and delivery of next-generation oral health solutions. Through its focus on providing superior clinical care, advanced technology, and continued training and education to its surgeon partners, the company is well positioned for long-term growth. We look forward to partnering with Dr. David Rallis and the entire Paradigm team.” Colm Lanigan, Head of BlackRock LTPC, Americas David Rallis, DDS, MD, and CEO of Paradigm Oral Health, commented, “Paradigm is advancing oral surgical outcomes and patient experience through a culture that places the needs of the patient first. At Paradigm, we validate our clinical performance through a proprietary data ecosystem and use data to reinforce our culture of excellence and accountability. Through innovation, and the rapid adoption of technology, we continue to set the standard for dental implant surgery. Aligning our company with world-class partners, first InTandem Capital and now BlackRock LTPC, has allowed Paradigm to emerge as a leader. We are humbled by the opportunity to partner with BlackRock LTPC, and excited to work with Colm Lanigan and his team as we continue to advance Paradigm as the global leader in oral surgery.” Elliot Cooperstone, Managing Partner of InTandem Capital Partners, Paradigm’s financial sponsor since 2019, commented, “InTandem Capital invests in healthcare companies that are local leaders with the ambition and potential to become a national powerhouse. Dr. David Rallis and the leadership team at Paradigm embraced our playbook for accelerated growth with amazing skill and dedication. Our deep trust in each other has allowed our partnership to flourish. My colleagues and I wish David and the Paradigm team the very best as they build on their well-deserved position as the country’s leading oral health company.” Paradigm is BlackRock LTPC’s sixth investment to date and its fourth investment in North America. Houlihan Lokey acted as financial advisor and Goodwin Procter acted as legal advisor to Paradigm. Simpson Thacher acted as legal advisor to Blackrock LTPC. About Paradigm Oral Health Paradigm Oral Health is the preeminent provider of oral surgery. Paradigm’s uniqueness comes from their ability to hire the most elite oral surgeons in the country and train them on their proprietary platform of excellence. Paradigm Oral Health continues to revolutionize and reinvent implant surgery through their ongoing technology and digital work-flow advancements. With a passion for excellence, Paradigm embraces every opportunity to meet the needs of their patients and referring dentists. About BlackRock LTPC BlackRock LTPC is an innovative private equity strategy focused on investing in high-quality businesses and value creation through active collaboration with management teams. The strategy's flexible duration and prudent approach to leverage preserve optionality for growth and help enable compounded capital appreciation. LTPC's team of 23 professionals are based in New York and London and invest across North America and Western Europe. LTPC is backed by BlackRock, Inc., which manages $320 billion in alternative investments and commitments on behalf of clients worldwide as of June 30, 2022. About InTandem Capital Partners InTandem Capital Partners is a private equity firm that invests in and helps accelerate the growth of select healthcare services companies. Its goal is to build excellent businesses of significant value working collaboratively with its management team partners. InTandem is comprised of former business executives and experienced investors, and is uniquely qualified to provide strategic, acquisition and operating expertise to help companies significantly increase their value over time. InTandem provides active support to the management of its portfolio companies directly and leverages its network of industry executives to augment its capabilities.

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HEALTHTECH SECURITY

Intuit to Acquire Financial Health Startup SeedFi

Intuit | December 02, 2022

Intuit the global financial technology platform that makes TurboTax, Credit Karma, QuickBooks, and Mailchimp, announced it has entered into an agreement to acquire SeedFi, the partner behind Credit Karma’s Credit Builder1, which helps low, or no-credit borrowers build credit while saving money, all for free. Credit Builder offers a line of credit and a secured savings account enabling members to build their credit while building up savings. By combining SeedFi’s Credit Builder technology with Credit Karma’s long standing relationships with credit bureaus and others in the credit ecosystem, Intuit will be able to move with greater speed and scale to help Credit Karma members make financial progress. Late last year, Credit Karma entered into a partnership with SeedFi to offer Credit Builder to its members, enabling them to make regular payments, starting with as little as $20 per month or $10 per paycheck. By reporting these payments to the credit bureaus, members took steps toward improving their financial health. Through this partnership, members increased their score by an average of 21 points in as little as 30 to 45 days2 and built up over $10 million in savings. This acquisition will enable Credit Karma Money to continue to build on that momentum and help put more members on a path to financial security. “Credit Karma Money was built to change consumers’ relationship with money and help them develop responsible financial habits, like staying on top of their bills and spending within their means. With Credit Builder, we are able to differentiate ourselves as one of the best accounts for building credit. We have long standing relationships with credit bureaus and others in the credit ecosystem, and SeedFi has built great technology, so when combined, we will move even faster and build products to help more members, including those who need it the most.” Poulomi Damany, SVP and GM for Credit Karma Money and Tax A recent study from the Consumer Financial Protection Bureau showed that nearly three-quarters of Americans with no emergency savings have credit scores below 660. The correlation between low credit scores and lack of emergency savings persists over time, and SeedFi takes that problem head-on. Similar to Credit Karma, SeedFi’s mission is to break the cycle of debt and help Americans realize their financial potential. “We have already been working with the Credit Karma Money team for over a year to help members build their credit score and have been impressed with how Credit Karma’s mission comes through in everything the company does. SeedFi has a similar mission to help consumers become financially fit, so joining forces just makes sense,” said SeedFi co-founder and CEO Jim McGinley. “Together, leveraging Credit Karma’s resources and scale, we will be able to accelerate the momentum of Credit Builder and SeedFi’s technology capabilities to help more consumers improve their financial health.” The transaction between Intuit and McBurberod Financial, Inc. which does business as SeedFi, is subject to closing conditions, and is expected to close in the coming months. Upon close, SeedFi will become part of Intuit’s Credit Karma business. The transaction is not expected to have a material impact on Intuit’s operating results for the full fiscal year 2023. Terms of the transaction have not been disclosed. Intuit Ventures was an investor in SeedFi’s last financing round. About Intuit Intuit is the global financial technology platform that powers prosperity for the people and communities we serve. With more than 100 million customers worldwide using TurboTax, Credit Karma, QuickBooks, and Mailchimp, we believe that everyone should have the opportunity to prosper. We never stop working to find new, innovative ways to make that possible. Please visit us for the latest information about Intuit, our products and services, and find us on social. About Credit Karma Founded in 2007 by Ken Lin, Credit Karma, an Intuit company is a consumer technology company with nearly 130 million members in the United States, U.K. and Canada, including almost half of all U.S. millennials. While best known for pioneering free credit scores, the company’s members turn to Credit Karma for everything related to their financial goals, including identity monitoring, applying for credit cards, shopping for loans auto insurance, savings accounts and now checking accounts through our bank partner, MVB Bank, Inc., Member FDIC — all for free.

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MEDICAL DEVICES

Asep Medical Holdings Inc. Announces Grant of Stock Options

ASEP Medical Holdings Inc | November 25, 2022

Asep Medical Holdings Inc. is pleased to announce that, for recruitment, incentivization, and retention purposes, it has granted to certain officers and advisors an aggregate of 1,080,000 stock options to purchase up to 1,080,000 common shares of the Company of which 200,000 are exercisable at a price of $0.30 per Share until September 29, 2032, 200,000 are exercisable at a price of $0.30 per share until October 1, 2032, and 680,000 are exercisable at a price of $0.30 per share until November 24, 2032. ABOUT ASEP MEDICAL HOLDINGS INC Asep Inc. is dedicated to addressing antibiotic failure by developing novel solutions for significant unmet medical needs. The Company is a consolidation of two existing private companies that are both in the advanced development of both proprietary diagnostic tools, enabling the early and timely identification of severe sepsis as well as broad-spectrum therapeutic agents to address multidrug-resistant biofilm infections. Sepset Biosciences Inc. is developing a diagnostic technology that involves a patient gene expression signature that predicts severe sepsis, one of the significant diseases leading to antibiotic failure since antibiotics are the primary treatment for sepsis. Despite this, sepsis is responsible for nearly 20% of all deaths on the planet. The semester test is a blood-based gene expression assay that is straightforward to implement, and results are obtained in about an hour in the emergency room or intensive care unit. This proprietary diagnostic technology differs from current diagnostic tests in enabling diagnosis of severe sepsis within 1-2 hours of first clinical presentation while other diagnostics only provide diagnosis after 24-36 hours. Asep Inc. believes this will enable critical early decisions to be made by physicians regarding appropriate therapies and reduce overall morbidity and mortality due to sepsis. ABT Innovations Inc.'s peptide technology covers a broad range of therapeutic applications, including bacterial biofilm infections anti-inflammatories, anti-infective immune modulators, and vaccine adjuvants.

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FUTURE OF HEALTHCARE

Tebra CTO Kyle Ryan Named to the Healthcare Technology Report’s List of Top Healthcare Technology CTOs of 2022

Tebra | November 22, 2022

Tebra, a leader in practice growth technology and cloud-based clinical and financial software, announced that its Chief Technology Officer Kyle Ryan was named in the Healthcare Technology Report’s list of Top 25 Healthcare Technology CTOs of 2022. The annual list recognizes the most accomplished executives in healthcare technology who are leading teams in delivering cutting edge products that boost operations and improve efficiency for their customers. The CTOs on this year’s list have a wide range of impressive backgrounds, but each is the driving force behind their company’s technology innovations, ensuring software functionality and effectiveness. Read the full report here. “Kyle has been an integral part of the executive leadership team at Tebra and has built a strong partnership between product management and the technology team within the organization. He has vast knowledge about healthcare IT and how it applies to solving business problems and is keenly customer focused and is always taking time to understand customer needs at a deeper level. Kyle’s an outstanding ambassador for the company and prides himself on developing a healthy and high-performance culture.” Dan Rodrigues, CEO of Tebra Kyle is responsible for all areas of technology with a focus on the vision and strategy for Tebra’s suite of products and services. He believes that great products are created through a keen customer focus, groundbreaking ideas, precise engineering, and efficient execution. “I am honored to be included in this list of prestigious technology leaders,” Kyle said. “This recognition also highlights the technology team’s passion for improving healthcare and the company’s mission of providing independent practices with digital tools and support to thrive in a new era of healthcare.” About Tebra In 2021, with a combined mission to unlock better healthcare, Kareo and PatientPop joined forces to form Tebra — the operating system for the connected practice of the future. With an all-in-one, purpose-built platform to drive practice success and modernize every step of the patient journey, Tebra provides digital tools and support to attract new patients, deliver modern care, get paid quickly, and operate efficiently.

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Spotlight

Opportunities to Improve Care for Medicare Patients with Chronic Conditions A historic transformation is underway in healthcare as value-based reimbursement (VBR) gradually supersedes the fragmented and costly fee-for-service care model long employed in the United States.

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