This Week Health

Contributors

September 26, 2022: Patty Hayward, Vice President, Strategy Healthcare and Life Sciences at Talkdesk joins Bill for the news. Following CVS Health-Signify Health and Amazon OneMedical, who will be the next digital health M&A target? Experts are not anticipating a slowdown in similar acquisitions. What will the Walmart, UnitedHealth Group, Optum collaboration bring for 2023? How will they endeavor to improve health outcomes and the patient experience? What is Trilliant Health’s evidence-based comparison tool all about? How will it supersede 'black box' top hospital lists?

Key Points:

  • You’re seeing Amazon and CVS really trying to look at how they can evolve the market and get ahead but they also have the assets to back it up and the time to wait to make it happen.
  • The way we acquire healthcare is fundamentally changing.
  • The Walmart, UnitedHealth, Optum collaboration puts the patient at the center of healthcare
  • Talkdesk

Stories:

Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Today on This Week Health.

Healthcare takes a long time to adopt new things. We all know that. So in order to really get through that cycle of adoption and looking at how we're gonna change things, which by the way, I do believe we are changing and evolving. It just goes at the healthcare speed. And unfortunately that doesn't always trend with wall streets speed to return. So you need to have that backing and that larger conglomerate, in order to really make some meaningful change.

It's Newsday. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a channel dedicated to keeping health IT staff current and engaged. Special thanks to CrowdStrike, Proofpoint, Clearsense, MEDITECH, Cedars-Sinai Accelerator, Talkdesk and DrFirst who are our Newsday show sponsors for investing in our mission to develop the next generation of health πŸ“ leaders.

All right. It's Newsday and we have a lot to talk about today. We're gonna talk about little M and a stuff. We're gonna talk. Walmart United health group Trilliant health is looking to replace the subjective best hospitals in the country stuff.

So we're gonna talk about that and we're gonna talk about it with Patty Hayward, the vice president of strategy for Talkdesk, Patty, welcome back to the show.

Hi Bill. How are ya? Always great to be here.

Yeah, I'm looking forward to it. That is still your title, right? It sure is. For those who don't know what talk desk is, just give the two minute update on what talk desk does.

Yeah. So talk desk is a C a solution, which is your contact center, but we've also added on top of that a entire purpose-built product for healthcare to really help to integrate into your EHRs and increase that patient experience. And also the agent experience.

Wow. That was, that was like the most crisp pitch I've ever heard in my life. I mean, there it is. Yeah, you guys, you guys get awards for being that platform that handles that experience level and contact center. definitely something to look at unless you just. Hellbent on spending a ton of money in which case there's other alternatives.

Exactly. If you wanna go in that direction sorry. I'm sure I just offended some somebody out there, but everyone out there in healthcare who has done this knows exactly who I'm talking about. So anyway let's see, where do I wanna start? Let's start with the. Modern healthcare story, who could be the next digital health M and a target.

So there's been a lot of stuff that's going on. Recently, you have Amazon one medical, you have CVS and signify health, and these are not small deals. These are 8 billion for signify health, 4 billion for one medical. And we're seeing these rollups. And it's interesting because you have modern healthcare goes out and interviews all these people.

And the thing that struck me on the people they've interviewed is they all make money from these kinds of transactions. So they're like, yeah, this is indicative of this is gonna continue. It's gonna continue and grow. So neither of us are gonna make a ton of money from the next major M and a activity. Do you think this is indicative of what we're going to see coming down the pike in the next year? I I do.

I do. I absolutely do. And I think if you look at not only just these last couple of acquisitions, but you look at the trends in sort of less money being spent out there and invested from the private sector.

So I think that you're gonna start to see. A lot of, I mean, first of all, healthcare takes a long time to adopt new things. We all know that. So in order to really get through that cycle of adoption and looking at how we're gonna change things, which by the way, I do believe we are changing and evolving. It just goes at the healthcare speed. And unfortunately that doesn't always trend with wall streets speed to return. So you need to have that backing and that larger conglomerate, I think in order to really make some meaningful change. So I think you're seeing like Amazon and you're seeing CVS really trying to look at how they can evolve the market and get ahead, but they also have the assets to back up and to wait and have that time to make it.

Yep. I agree. I mean, here's a quote here. We've seen a lot of IPOs in the healthcare space, Matt Wolfe, director of senior healthcare analysts at a consulting firm, RSM, many of these companies are viable. They might need to just be folded into a strategic buyer to be more economically viable or taken private.

It's interesting that they talk economically viable mm-hmm let's see, signify health posted a 490 million net loss in Q2. And I don't know if this article has the numbers, but one medicalized was not much better whatever it was. I, but I remember it being a significant net loss. The question in my mind, is, are these companies viable? I don't think they were built to be viable, to be honest with you. I think they were built to do exactly what's happening right now, which is to aggregate something. Essentially they're the R and D departments for CVS for United healthcare for Amazon, for Walmart, for anybody who's in this market, the big players.

Acquiring even even best buy we saw best buy, buy. Some we've seen, I mean, there's a lot of different players out there. There's private equity in this space and they're looking at it going, can we piece something together? But it's based on a, a concept and the concept is that the way we acquire healthcare is fundamentally changing.

Correct. That's that's the fundamental principle that, that one group believes and another group doesn't. So the one group believes that how I, how you and I receive care, maybe not acute care, but how we enter into the healthcare system is gonna fundamentally change. And another group is saying, nah, I don't think it's gonna change.

Or they're saying it changes so slowly. Yeah. We're not gonna worry. Yeah. Well, how much I worry about it? We, we have some time. Yeah. And. I don't know, these are, these are really big bets, 8 billion, 4 billion. These are organizations that are saying. Yeah, the consumer is going to get savvier They're gonna get more information.

We're gonna create a different experience, a different on ramp If you will, a more educated on ramp into the system, maybe a path where we can direct their care and identify the, the best outcomes for the lowest cost. Cuz essentially the healthcare consumer is completely disempowered. We have, I mean, we don't know what the costs are.

We don't know what it's gonna, I mean, we literally don't know what it's gonna cost us. And then when we ask the physician, they just look at us like, I dunno, I dunno either that's not my job. And so these, these companies were sort of rolling they're, they're rolling different things up, maybe going after the Medicare advantage space, maybe going after the primary care space maybe going after the home market and all of it is the same concept, which.

is How we acquire service is gonna fundamentally change. And it doesn't matter if they're making money or losing money, but now they're losing money in a very difficult market. And I think their investors came to 'em and said, Hey, look, if you can find it, it's now time to make this move. So they, they put out there, let's see 1, 2, 3 about five companies that this group of people.

Again, mostly investors legal, whatnot, who follow this market. They said, Hey there's five. You should keep an eye on Teledoc, Amwell, Oscar health, Babylon health, and Sharecare are the five. I don't know. I mean, when you look at these, when you look at these five, are there others that pop into your. head Or any of these five sort of pop off the page and you go, yeah, that, that would make sense for somebody

Yeah. I mean, I think that if you look at let's see, what's the one that's already working with CVS is, is Amwell, right? Usually when they're already starting to sort of be incorporated and working, there's obviously large bets there that are already being placed. So you know that that's the testing of the water to see if it's, it's part of something that they can and should. Fold into a larger piece. Teledoc we've been sort of seeing them boom and bust a little bit over the pandemic,

a little bit, $300 a share down to $32 a share, not a great, not a great investment in the,

not a great investment. If you bought it 300, obviously I think that when you looked at what happened in the pandemic, we had such a boom there and to base your entire business model around something that happened during an anomaly is gonna be fundamentally flawed going forward. There's still a lot of need, obviously for telemedicine.

I think the platform's a good platform. I think it'll be interesting to see what happens with it and how that moves forward, because there's so many other players in this space. That's the one, I, I sort of question, I don't know. What'll happen with that.

As I look at these things I don't like the technology. The tele technology play, I don't think is all that strong of a play. because as a CIO, you could break apart these components, you could put 'em back together and do telehealth, any number of. 50 different ways. And we saw that during the pandemic, people were creative and put 'em together.

Mm-hmm so, so that platform, now they did acquire Livongo. That's a, that's a different play all together. I'd have to think about that, but I think what people are looking for is. When you look at the Amazon one medical acquisition, they went from having a model and Amazon care that they couldn't scale to, you know what, let's just acquire scale.

Correct. That made sense. Yeah. It made sense. And it wasn't around the technology because Amazon care had put together some decent technology and the experience was pretty good from what I've heard. But they just, they couldn't figure out how to get from point a to point B. Well, how do you. Very rapidly is you spend $4 billion.

Yeah. And you get to scale. So the Teledoc, and by the way, Teledoc is stating they have no intentions to sell the company, which I think is what every company says. But correct. I think that, I think that might be true in this case. Yeah. I think they do see a play. Somewhere. So anyway, I think organizations that have scaled, they either scaled a patient community around Medicare advantage, around different payment models and that kind of stuff, or they've scaled providers.

Right. So Optima's buying up providers all over the place, right? If you've done a private equity where you scaled up providers or a certain capability, I think that bodes well, Teledoc not excited about Amwell. I don't think makes a lot of sense either for that same reason. I mean, it's a telehealth platform. CVS is using them and quite frankly, it's cheaper than buying them. So I, I I'm a little, I'm not so bullish on that. Oscar's an interesting one, though. And Oscar might not be one where you sell off the whole thing. It might be something where you split it up and sell it to healthcare providers.

Cuz healthcare providers are trying to figure out how to get into that space. How to be a payer provider in that whole ensure tech kind of space. They're not good at the experience. They're not good at the insurance part, potentially. There's a, a play here where you, you break it up and sell it to five major health systems or something to that effect.

I don't know if that, if that works and somebody who's listening to this, who's smarter than me can send me a note and tell me, tell me I'm nuts on that, but that's one of the ways I would look at that. And I don't even know if it's, if it's already pub, is it public? Yes, yes. And the price price fell by more than 80% year, year.

And I think these companies that are losing money, I think they're running out of options. I think they do have to find a safe Harbor Babylon health have to be honest with you. I'm not overly familiar with AI enabled virtual diagnosis and medical appointments said they were courting buyers. But then they put out a press release, said they weren't looking for buyers.

I'd have to look at that more closely. If they've ag again, if they've aggregated the delivery of care or if they've aggregated the patients in any way, I think there's value. And then the last one Sharecare consumer facing digital health platform company has struggled to appease wall street since it went public.

With many established companies investing in patient solutions, experts say share cares platform could offer intriguing integrations with pot. Again, I don't think the technology play makes sense because. Quite frankly,

most of these companies already have great tech platforms. So I don't know if they're going to grab something new, unless it incorporates something really unique and different that can open a space they don't currently have, or expand exponential. Like we saw with one medical and signify.

It's a lot cheaper to just hire some really great technologists and. Hey, we want something that looks like Sharecare. Yeah. And, and yeah, build it and go do that. What you wanna buy though, is the scale. If Sharecare had like aggregated a million patients or couple hundred thousand doctors or something to that effect, now you're looking at something going. Yeah, that's gonna take six or seven years to, to do let's go ahead and jump on that.

Not on this list that you think should be

I think there's gonna be the only one from a technology standpoint. I think there's gonna, there's an opportunity for roll up is in the security space. I think there are so many small security providers that it would make sense to come together and. Provide a, a holistic platform and preferably around a managed service provider in the security space. I think that's that's one that makes sense. I don't know. the thing in the technology space, you always have to be weary of.

And I already hit on epic once this week. I'm gonna hit on 'em again here. You gotta worry that Epic's just gonna all of a sudden turn the corner and say, I want that market. And they're just gonna wipe out if, as a startup or that kind of stuff. So I, I steer clear of those kinds of plays.

That you can see a path from where we're at today to where we're at in the future, where epic goes. Yeah. For all of our customers, we want you to go in this direction. They have a lot of sway over their clients. They do tremendous amount. Yeah. So that's, that would be my concern. Mm-hmm Where do you wanna go next? Walmart teams with United health. This is one of the major players. Actually, this is two of the major players coming together. So

yeah, I was gonna say, this is just one. This is, this is, I love this combination. I think it's a really intriguing one based on couple things you think about the reach that Walmart has into, especially the rural areas. I mean, there's Walmarts all over the country and the ability to co-brand Medicare ad advantage plans. I find really intriguing, I think, combining your traditional healthcare clinic with food. With the drugs with dentistry vision. I mean, imagine being able to provide all of that in some sort of a packaged way that allows people to stay healthier.

I find really intriguing because I've been waiting for someone to sort of bring in the whole health aspect to this because I. Of just imagine a newly diagnosed diabetic who doesn't know how to shop for food and being able to sort of package all of that together. Find really intriguing. I think you can add some really great value there as well as some great savings and just health .

c mm-hmm beginning, January,:

This is let's see, Walmart CEO, Doug McMillan said in a statement, this collaboration puts the patient at the center of healthcare. By leveraging the strength and complimentary skill sets of two companies to accelerate access to quality care. And Walmart health has 27 locations, Arkansas, Florida, Georgia, Illinois, offering primary and urgent care labs.

X-rays diagnosis, behavioral health, dental, optometry, and hearing services. It's important to note a lot of people, when I say Walmart health, they're like, oh, you mean that little thing when you walk in the front door. Right. And that's not what we're talking about in 27 other locations, actually not all 27 of those locations, but in a lot of those locations, They've cleared out parts of their parking lot and they've put a full blown.

Clinical office building there, which has the ability to do primary care, urgent care imaging diagnostic and I guess across the street, you have a pharmacy. I mean, it's, it's a pretty neat one stop shop. For the markets that they're serving I'm gonna make it a point. I'm going up to Orlando in the next couple of weeks. I'm gonna make it to a point to swing by one of these and take a look.

I think it's fascinating. I, I really think that they're Walmart's really trying to pull all the social determinants of health together and and look at how can they really impact the communities in which they serve. And I think, I think they really have an opportunity to make a big difference in those.

communities πŸ“ πŸ“ I wanted to take a moment and share our next two webinars. On September 29th, we are bringing you patient room next, improving care efficiency. The patient room is evolving inside and outside of the four walls with guests from Intermountain healthcare, monument health, and HCA healthcare. We will discuss machine vision, ambient listening, AI care companions, and much more. So you want to check that out September 29th. You find that on our. This week health.com in the top right hand corner. Next we have delivering better patient experiences with modern digital infrastructure. On October 13th, we will discuss multi-cloud three pillars to modernize health it and a blueprint for creating an agile digital infrastructure without impacting the quality of care. These webinars both have five episodes that proceed them. And you can view them before the webinar to learn more and to formulate your questions. When you register, you can put your questions right in there would love to hear them, and you can register for both webinars. As I said earlier at this week, health.com top right hand corner. You'll see our upcoming webinars click on those and sign up. Love to see you there. πŸ“ πŸ“

Well we're seeing a lot of health systems, especially in rural locations, struggling right now, we're seeing their budgets are tight and we're seeing some cuts that are how do I say this beyond what is normally considered a normal cut? So you're seeing positions get cut that you sort of scratch your head and go, wow.

That's that's that's to the bone. I mean, when you're cutting that position, that's that's pretty far Walmart. Traditionally has figured out how to scale in these rural locations incredibly well. Do you think they will be able to scale healthcare into those rural locations and provide the care that's gonna be necessary in those spots?

I think it'll be interesting to see if they can do that. It's a as we all know, it's a lot of expense. And they've all done a great job. Walmart's always typically done a great job at the cost and the buy side of things so that they can offer the prices that they need to offer in these rural communities.

You obviously have a much more difficult time to do. But can they do things like offer those, but then combine with telehealth to maybe offer some things more remotely, but have the phlebotomist there to pull the, the labs and to do some of those different things. It'll be interesting to see how they pull it all together, but there's definitely issues in those communities with access to health.

And again, I, I go back to loving the fact that they're also looking at the whole. Piece and not just the care delivery, but also all the things that impact care in between visits. Health with healthy foods and just different access like that. Not everybody has that access.

All right, Patty, but this is cynical bills, cynical bills coming out. Okay. I, I just wanna make sure, I mean, I see, I see providing access to fresh food and enhancing current initiatives to address social terms of health. I just wanna make sure that it's not just press release material. In theory, Walmart's already in that community. They're already offering access to fresh food.

The question becomes, how does a partnership with United healthcare and Walmart go beyond we have a store here that has fresh produce and, and quality items. It'll be interesting to see if, if I don't know if, if some sort of program is put together, That, that nets this all together. And I would like to see it knitted with technology as well, really understanding the demographics that they're serving and maybe personalizing solutions to different parts of that demographic,

maybe adding some gamification in there or different ways that they can get people to sort of think about the things that they need to do in a different.

Yeah, I, so I've always been bullish on gamification, cuz I, I love games. I'm a little competitive and even right now, I mean between my family. So my, my son, my daughter and myself all have a weight loss thing going on between us because when we do it on our own, we don't seem to get to where we want to get to.

Correct. And so we each threw a little bit of money in cuz my I've all adult kids, we each threw a little bit of money in, we're all doing this thing. And then we're tracking it and we could see how each other's doing and that kind of stuff, this whole gamification thing. Have we seen any companies really come forward on GA gamification yet and really move the needle?

See a few, like, okay. Apple watch. Right? You can compete. I've with my son multiple times. I always lose cuz he lives in San Francisco and walks everywhere. and I work at my house.

Yeah, exactly. For you to do that, you'd have to walk between the kitchen and your office, at least a thousand times. It's just not worth it.

It's knob hill down into the financial district and back, and he is already beating me. But you know there's definitely. Some things out there. I think there needs to be more I think was actually just reading an article about that over the weekend about the gamification in ways to kind of get yourself to do more activity is, and a lot of it was around competing and setting goals and trying to beat different things but. The ultimate piece was visibility to someone who you're competing with so that you had this accountability. So if someone can kind of pull some of those things together, I think it's interesting to look and see what Kroger's doing around scoring the baskets and different things like that around food.

Be interesting to see if they could kind of Walmart decides to roll all of that up with the partnership. But they haven't announced that obviously it's all in my head.

all right. All right. Here's our, here's our last story. Our last story is Trilliant health. And we've talked about some of the material that they've released before. It's really interesting stuff. Trilliant health in they're like a data. Aggregation and analytics company, unveils evidence based hospital comparison app. So let me give you a little bit of this. These top hospital lists are often based on subjective measures as a remedy, the analytics and market research firm develop benchmarking tools based on quantifiable data points, most relevant to hospitals following up on.

d They're gonna be looking at:

So what are they looking to do? The 800 plus top 100 hospital lists may be useful for marketing campaign. But they're useless for developing evidence based strategies, Trilliant health CEO, how Andrews said in a statement that's interesting evidence based strategies depend on accurate benchmarks. Against relevant peers.

The healthcare industry is both capital intensive and capital constrained and applying mathematical rigor to benchmarking and strategic planning reduces the risk of suboptimal capital allocation for healthcare provider suppliers and payers. The company is published a free public version of the benchmarking visualizer app online that allows users to select the hospital and review 10 most similar organizations in regard to care quality alone. And as an aggregate measure, meanwhile, customers will be able to dig deeper into the tool and customize their comparisons around specific measures. For instance, patient mix or market share training health. Chief research officer said. All right. So

am I with that yet? It's pretty fun. ,

it's pretty interesting. And by the way, this article's in fierce healthcare, it's called Trilliant health unveils evidence based hospital comparison app. I've often thought some of these lists are kind of silly you see the top 10, top 50, and then I pick up a magazine on an airplane and it'll say the top 10 surgeons and I'm like. Anytime I see that. I just sort of go, all right,

how

much do they pay to get in that?

Yeah. And, and the reality is on us news and world report. When you get into that or some of these others, they essentially then go to each health system and say, would you like to utilize our our emblem that we've made? And then they make a, a mint On on marketing, the fact that they've come up with this top 100 list and it's prestigious to be on that top 100 list and people don't recognize it before what it is. It's a marketing. Thing. So when somebody tells me, Hey, we we're the, we're the top 10 cardiac centers in the country.

There's, there's, there's validity to it. I'm not saying there's not validity to it. I'm just saying it was done by a really smart group of people who said, how can we make money from healthcare in marketing? Yeah. And they came up with this thing and now you are, you're helping them because you put it on every billboard across the country. So now we. That being the top 10, top 50 by ranking of X means something. I like this database.

I love being able to actually dig into the data, which I actually spent some time before we spoke to just, oh, what'd you find love data? I love data. So I was like, let me see what these are actually looking at. And it, it tells you every little piece of information and where they got it from, which I value because you can do anything you want with data. So I found it really, really interesting to see sort of how some of these folks rank and stack against each other. And if you look at like what Johns Hopkins and sort of looking at Vanderbilt and some of the other folks that are, that, that pop up on the the list, that are Similars it, it was one of those moments where you went well, of course, I've been worked with a lot of those organizations and, and they think about things very similarly.

They're obviously looked at differently depending on the specialties that they're talking to et cetera. But I felt like it was really cool to be able to, as a consumer. Look at something in my area, because not everybody's gonna fly to Minnesota to go to the Mayo clinic can what's similar to that in my area.

And it allows you to sort of look at the data and say, okay, these are the ones that are most similar in your area, and here's how they rank and stack against the best of the best. I loved that. I thought that was really great. And it gives you. The data behind it to, to sort of look at the patient satisfaction scores what the there's a lot of different data that they look at in here and benchmark.

And so you, as an organization can also go in and look at things like readmissions and emergency department readmissions as well as in they break. Emergency room inpatient versus outpatient mortality. It, it, I thought it was great. I loved,

oh my gosh, this is, yeah, this is a data nerds dream this is, oh my. Yeah, so I just, for them,

I thought it was great that they were able to put something really cool together to to look at rankings of hospitals

and they have a neat little visualizer down at the bottom.

Exactly. You can see it goes,

yeah. Emergency's readmissions, inpatient, readmissions, observation, readmissions, expiration, discharge, mortality. Wow.

And then they explain what they are too. Right. So if you scroll down, they even tell you exactly what it means, where they got it from. Yeah. So anyway, I, I love, I loved all the accountability, transparency of the data so that you could look at it and go, okay, well, this makes sense to me. I understand where it came from. So good for them.

yeah, this is they've essentially exposed their back end to for people to dig around in and look at it. Very interesting tool.

Think it'll think it'll have much impact though.

Do I think it'll have much impact?

It's hard to go after that. Us news world report last different.

I purposely didn't say their name, but since you said it no, I don't think it'll have much impact. And the reason I, the reason I say that is I've worked with enough marketing firm marketing teams within hospitals and health. they get their budget in the beginning of the year and go, we've gotta do these 10 things.

Oh, there's no money left. We're done. Instead of sitting back and going, I mean, the concept of having metrics around marketing, I'm not talking about firms like yours or partners. I'm talking about actual health systems. Yeah. The number of health to marketing firms. Our marketing departments that actually say, what are our objectives?

What are our strategies? And then identify the tactics, identify the measures, and then invest around those measures. And those tactics is very low. Yeah. It's like, well, we have to have a website. We have to sponsor the baseball team. We have to we have to be in the community. We're gonna sponsor the 10 K again, we're gonna do this. We're gonna do this. And they in fairness to some of 'em, they're just underfunded and they don't have enough resources.

That's I was gonna say, you don't have these huge marketing arms, like you have in, in a high tech firm or whatever they're going. They're not gonna spend the time to do a lot of these things. Although I think it. Phenomenal tool

Yeah. So Trilliant health take a look at it. It's it's definitely, it's definitely worth looking at, I, I think there's, this is probably one of their first applications for it. This is not the last we've heard of Trilliant health. I think we're gonna see them do do quite well. I mean, they've aggregated 320 million Americans claims records, so that's

There's gonna be some great use for the database that they've pulled together. It's it's I mean, just in the quick 10 minutes I took to play with it. I could have spent hours.

absolutely Patty. It is always great to catch up with you and thank you for coming on and talking about the news.

Thanks bill. Great to πŸ“ be here.

What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to show just like this one. It's conference level value every week. They can subscribe on our website thisweekhealth.com. They can also subscribe wherever they listen to podcasts. Apple, Google, Overcast. You get the picture. We are everywhere. Go ahead. Subscribe today. We want to thank our news day sponsors who are investing in our mission to develop the next generation of health leaders. Those are CrowdStrike, Proofpoint, πŸ“ Clearsense, MEDITECH, Cedars-Sinai Accelerator, Talkdesk and DrFirst. Thanks for listening. That's all for now.

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