Digital Content

We use cookies to enhance your browsing experience, serve personalized ads or content, and analyze our traffic. We’ll assume you’re ok with this, but you can opt out if you wish. See our 

Footer

Column Name Goes Here

Footer V2

2024 Event

Event Global

New HLTH Insights Programs

Become a Hosted Buyer

Become a Sponsor/Exhibitor

Apply for Media Pass

Promote Your Presence

2023 Event

Event Global Footer

Startup Opportunities

Hotel

2022 Event

LLC Global

2021 Event

LLC Menu Official

LLC Menu

In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates. Private Medical Founder &amp; Managing Partner <a href="https://www.linkedin.com/in/drjordanshlain/" target="_blank">Dr. Jordan Shlain</a> is a practicing primary care doctor, a digital health entrepreneur, a writer, and respected thought leader.

COVID-19 Discussion with Dr. Jordan Shlain

Blog - 0030

Director

&quot;I&#39;m excited about the science, but if we think about how to keep someone healthy, it takes a massive, multi-disciplinary effort and everyone must do their part. It&#39;s not only development and production, but also understanding who is going to use it and how it’s going to be used.&quot;  -Matthew Hepburn, White House Senior Advisor, Office of Science and Technology Policy at the 2022 BLUE KNIGHT™ Symposium  Global preparedness requires global cooperation. As a global community composed of regional innovation ecosystems, we must work together and lean on each other’s strengths to respond to emerging infectious diseases more readily. Progress continues as we support novel science and technology through our Blue Knight partnership, including the current Blue Knight <a href="https://jlabs.jnjinnovation.com/quickfire-challenges/blue-knight-tm-quickfire-challenge-next-generation-preparedness-solutions" target="_blank">QuickFire Challenge</a> which seeks solutions to leverage the microbiome, scale manufacturing of vaccines and/or therapeutics, and target the host response with the aim to enhance preparedness towards future known and unknown health security threats. There are still important gaps to fill towards health security preparedness solutions, especially as we look to accelerate solutions and invest in technologies that support the needs of diverse populations, including at-risk, immunocompromised, geriatric, and pediatric populations.  Supporting Innovators to “Leapfrog Progress”  In April 2020, our organizations—Johnson &amp; Johnson Innovation – JLABS and the Biomedical Advanced Research and Development Authority (<a href="https://www.medicalcountermeasures.gov/" target="_blank">BARDA</a>), part of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services— announced the global joint initiative now known as <a href="https://jlabs.jnjinnovation.com/blue-knight" target="_blank">Blue Knight</a>. The partnership is dedicated to anticipating potential health security threats, activating the global innovation community, and amplifying scientific and technological advancements with the aim to prepare for and respond to our rapidly evolving global health environment. Today, the program supports <a href="https://jnjinnovation.com/JLABSNavigator/search-results?isBlueKnight=true&amp;sort=Alphabetic" target="_blank">a portfolio of 23 companies</a> from around the world and accepts applications on a rolling basis.  In June 2022, we hosted the second <a href="https://blueknightsymposium2022.splashthat.com/" target="_blank">Blue Knight Symposium</a> to discuss the potential of partnerships to accelerate preparedness solutions. Throughout the Symposium, the speakers highlighted the importance of partnerships and support for regional innovation ecosystems to innovate and develop equitable solutions. We heard from both the early-stage companies and the organizations supporting them to bring innovative technologies to patients, such as the work of ENA Respiratory, a Blue Knight company based in Australia, with the Chronic Obstructive Pulmonary Disease (COPD) Foundation, to develop pan-antiviral nasal spray.  Thriving innovation ecosystems exist around the world, each region harnessing specific strengths. We have the potential to unlock a global force of preparedness by uncovering and accelerating our regional strengths to operate as one. As Kelly Chibale, Professor of Organic Chemistry at the University of Cape Town, noted during the Symposium, &quot;If we harness local innovators appropriately, those innovations are likely to leapfrog progress. This is not something that any region can do on their own. If we couple incentives to entrepreneurs, this is likely that we can co-create the innovation ecosystem.” Our Blue Knight partnership is working to do just that. Health Equity as a Driver for Preparedness for All  Equitable innovation may be key to shielding global communities from emerging disease threats and eliminating the disproportionate impact of pandemics and emerging infectious diseases on diverse and minority populations. Ensuring that all communities are protected and reaching people as far as the last mile, including rural communities and at-risk populations, is essential when developing potential solutions.  This sentiment flowed throughout the day as was highlighted by Lisha McCormick, the CEO of Last Mile Health, “Innovation without equity is inadequate. The orientation around collaboration really needs to be to scale impact, not an institution or individual innovation. Fall in love with solving the problem, not the specific tool with which you’re committed to solving it.” Through Blue Knight, we aim to support the early-stage companies that have done just that—companies solving a problem to address an unmet need.   Developing Next-Generation Solutions  Leveraging partnerships and collaborative opportunities are keys to moving forward towards global preparedness.  As we search to support the technologies that have the potential to create a more secure future from global health threats, BARDA has released their <a href="https://www.medicalcountermeasures.gov/barda/strategic-plan/" target="_blank">2022-2026 Strategic Plan</a>, which includes supporting an ecosystem of innovation programs, including Blue Knight. The current Blue Knight <a href="https://jlabs.jnjinnovation.com/quickfire-challenges/blue-knight-tm-quickfire-challenge-next-generation-preparedness-solutions" target="_blank">QuickFire Challenge</a> is one way to connect with our organizations and provides an opportunity to receive award funding, access to JLABS through a Blue Knight residency, and mentorship from The Johnson &amp; Johnson Family of Companies and BARDA.  As we look to the next generation of solutions to be accessible to all and help eliminate disparities that may be exacerbated by global health threats, we are seeking technologies that are easy to administer for the intended indications, including orally, nasally, or topically, if applicable; technologies that have the potential as multi-use solutions (indications as medical countermeasures for specific threat areas and for commercial use) or are threat-agnostic; and with a particular interest in technologies aiming to support the needs of diverse populations, including at-risk, immunocompromised, geriatric, and pediatric populations.  Join Blue Knight and the global discussion on how we can collectively come together to develop equitable solutions towards the known and unknown health security threats of the future. If you’re developing a potential solution to solve a problem, <a href="https://jji.jnjinnovation.com/meetwithblueknight" target="_blank">reach out to us</a> and watch the <a href="https://blueknightsymposium2022.splashthat.com/" target="_blank">2022 Blue Knight Symposium</a> on-demand today.

Spurring Global Connections at the BLUE KNIGHT™ Symposium to Develop Next Generation Preparedness Solutions

Blog - 0121

President, Health Innovation and Policy

In partnership with a broad coalition, City of Hope charted a path to support cancer patients enrolled in California&#39;s Medicaid program, who, in some cases, experience outcomes worse than patients with no insurance at all. The California Cancer Care Equity Act (CCCEA) was passed to ensure that patients with certain complex cancers have the right to seek care at academic centers if their network cannot provide the appropriate level of care. In this article, we’ll discuss how City of Hope and other community partners leaned in to identify and define a problem, and then drove to a solution that can serve as a model for future policy reform. Cancer Care is Different Cancer care is expensive, and mistreating patients adds to that expense, particularly in human costs. When patients with rare or complex cancers have access to care at a comprehensive cancer center, they often experience better outcomes at lower costs. Data show significant <a href="https://ent.box.com/s/6iql2fcg07n4uas8rfzok1cydl85zx22" target="_blank" style="background-color: transparent; color: rgb(0, 112, 192); font-family: Calibri, sans-serif; font-size: 11pt;">differences in outcomes</a>, including survival, when a patient is seen an NCI-designated comprehensive cancer center versus non-academic settings. The <a href="http://cancercarediff.org/" target="_blank" style="background-color: transparent; color: rgb(0, 114, 206); font-family: Calibri, sans-serif; font-size: 11pt;">Cancer Care Is Different</a> coalition, consisting of City of Hope, the American Cancer Society Cancer Action Network, the Leukemia &amp; Lymphoma Society, Susan G. Komen, Be the Match, the Latino Cancer Institute and California Black Health Network, among others, is driven by the belief that, because cancer care is complex, we must safeguard access to expertise when it’s needed, providing the best chance of cure for every patient.   In the last ten years, the field of oncology has undergone transformational change.  Advances in our understanding of genomics have spearheaded an overhaul in our approach to diagnosis, treatment and monitoring of cancer.  While many cancers are well managed in the community setting, it is important that patients have seamless access to academic centers when the patient is in need of cell-based therapies, emerging targeted treatment, complex surgery, multi-disciplinary or multi-modality treatments or a first-in-human clinical trial.  Today, our managed care programs often create barriers to such access, and this can lead to misdiagnoses and mistreatment that can often mean unnecessary exposure to toxic chemotherapy, suffering or avoidable death. These outcomes can be avoided with effective policy.  California Cancer Care Equity Act The <a href="https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB987" target="_blank" style="background-color: transparent; color: rgb(0, 114, 206); font-family: Calibri, sans-serif; font-size: 11pt;">California Cancer Care Equity Act (SB 987)</a> expands access to specialized cancer care for Medi-Cal patients who receive a complex cancer diagnosis. This important bill, which went into effect Jan. 1, 2023, will benefit and save countless lives. SB 987 represents a critical first step in delivering on the promise of the <a href="https://www.cancercarediff.org/cancer-patients-bill-of-rights/" target="_blank" style="background-color: transparent; color: rgb(0, 114, 206); font-family: Calibri, sans-serif; font-size: 11pt;">California Cancer Patients Bill of Rights</a> resolution, which recognizes that cancer patients should receive appropriate, timely and equitable access to expert cancer care.  The CCCEA helps remove one set of obstacles that prevent access to innovative care for Medi-Cal beneficiaries — who represent approximately <a href="https://www.dhcs.ca.gov/dataandstats/Pages/Medi-Cal-Eligibility-Statistics.aspx" target="_blank" style="background-color: transparent; color: rgb(0, 114, 206); font-family: Calibri, sans-serif; font-size: 11pt;">one-third of California’s population</a>. At present, many patients <a href="https://escholarship.org/uc/item/8xc078vj" target="_blank" style="background-color: transparent; color: rgb(0, 114, 206); font-family: Calibri, sans-serif; font-size: 11pt;">on Medi-Cal</a> experience inferior survival rates compared to patients on private insurance. In an age when new treatments such as CAR T cell therapies are <a href="https://ashpublications.org/blood/article/132/Supplement%201/322/263817/CAR-T-Therapy-Displays-Favorable-Gains-in-Health" target="_blank" style="color: rgb(0, 114, 206); font-family: Calibri, sans-serif; font-size: 11pt;">improving health outcomes while demonstrating cost-effectiveness</a>, CCCEA will increase access to the kind of cancer care any Californian would demand for a loved one fighting the disease.This is an important first step in creating a more equitable cancer ecosystem that works better for patients and expands access to lifesaving, groundbreaking treatments for those from historically underserved communities. Expanding Access to Optimal Cancer Care City of Hope looks forward to exploring opportunities to remove unnecessary barriers that keep additional populations of cancer patients from achieving improved cancer care outcomes, with an intent to elevate conversations surrounding narrow networks.  One opportunity is Medicare Advantage plans, which frequently have narrow provider networks that do not include the research medical centers that provide access to clinical trials and the most advanced treatments.  Sixty percent of Medicare Advantage plans do not include access to any of the 56 NCI-designated Comprehensive Cancer Centers. Medicare Advantage enrollees are only one fifth as likely to be treated for cancer at an NCI-designated center than people with traditional Medicare, and they are one third as likely to be treated at any academic medical center. The implications of this disparity are significant. For some complex procedures, Medicare Advantage cancer patients have <a href="https://protect-us.mimecast.com/s/abKWCPN898UoyZnECrqdkS?domain=ascopubs.org" target="_blank" style="background-color: transparent; color: rgb(0, 112, 192); font-family: Calibri, sans-serif; font-size: 11pt;">higher mortality rates</a> than patients with traditional Medicare. For example, Medicare Advantage patients who have surgery for pancreatic cancer are twice as likely to die in the month after surgery than those with traditional Medicare. Medicare Advantage patients with stomach and liver cancer are fifty percent <a href="https://protect-us.mimecast.com/s/abKWCPN898UoyZnECrqdkS?domain=ascopubs.org" target="_blank" style="background-color: transparent; color: rgb(0, 112, 192); font-family: Calibri, sans-serif; font-size: 11pt;">more likely to die</a> during the month after surgery. But the differences in outcomes are not limited to surgical rates alone. When a network does not have the expertise to deliver advance therapies, a patient will be less likely to be referred for such therapy. In the case of a therapy like CAR T cell therapy, it can mean the difference between life and death-- CART T cell therapies have increased the success rates of treatment for certain leukemias and lymphomas by <a href="https://protect-us.mimecast.com/s/wxM5CVO9k9S5OX8oSrMfsG?domain=shebaonline.org" target="_blank" style="background-color: transparent; color: rgb(0, 112, 192); font-family: Calibri, sans-serif; font-size: 11pt;">50 to 80 percent</a>. The same pattern is found in clinical trials, which can involve highly promising drugs that won’t be available to the general public for years. If you are in many Medicare Advantage plans, and don’t have access to an academic center, you are far <a href="https://ascopubs.org/doi/abs/10.1200/JCO.2020.39.28_suppl.74#:~:text=Enrollment%20to%20treatment%20trials%20was,%25%20and%203.6%25%2C%20respectively." target="_blank" style="background-color: transparent; color: rgb(0, 112, 192); font-family: Calibri, sans-serif; font-size: 11pt;">less likely to be enrolled into a clinical trial</a>. As part of its mission to expand access to optimal cancer care, City of Hope is advocating for policy changes to include Comprehensive Cancer Centers and other research centers in every Medicare Advantage provider network. The goal is not to lessen the role of the community oncologists, who remain a key pillar of cancer care, but to partner community oncology with academia,  establishing a modernized the definition of network adequacy. Through policy innovations and partnerships such as these, progress can be made toward a healthier, more equitable future for all.

Policy Innovations as a Lever for Health Equity

Blog - 0220

Managing Director, Life Science & Healthcare

This October, Silicon Valley Bank, a division of First Citizens Bank, published its annual<a href="https://www.svb.com/trends-insights/reports/healthtech-trends-report?utm_source=blog&amp;utm_medium=events&amp;utm_campaign=us-2023-10-lg-sp-na-na-lh-na&amp;utm_content=na" target="_blank" style="background-color: transparent; color: rgb(0, 0, 0); font-size: 12px;"> </a><a href="https://www.svb.com/trends-insights/reports/healthtech-trends-report?utm_source=blog&amp;utm_medium=events&amp;utm_campaign=us-2023-10-lg-sp-na-na-lh-na&amp;utm_content=na" target="_blank" style="background-color: transparent; color: rgb(11, 76, 180); font-size: 12px;">Future of Healthtech 2023 Report</a>, a comprehensive overview of the VC-backed healthtech innovation marketplace. The report contains a deep dive on the value-based care (VBC) space, including key trends, venture investment, opportunities and challenges in VBC. Mind the (care) gapThe US healthcare system has long struggled with steadily rising healthcare costs, overburdened providers and poorer relative outcomes. Even though the US spends much more of its GDP on healthcare than other countries, it has worse results. Compared with other high-income countries, the US has the highest rate of preventable deaths and infant deaths. The US has a history of inequality in access to care, with people of color and low-income individuals more likely to experience adverse health outcomes than the rest of the population. These issues stem in part from an inefficient fee-for-service (FFS) reimbursement model, which dictates how providers are paid. Under FFS, providers are paid for each service they provide and are rewarded for volume – they’re paid more if they deliver more care, even if they don’t achieve desired health outcomes. Because the FFS model focuses on volume rather than quality of care, it creates misaligned incentives for providers. VBC aims to change this dynamic by tying the reimbursement providers receive to the results they deliver to patients, rather than care volume. Providers are rewarded for hitting certain healthcare outcomes, quality and cost measures. Challenges Despite recent momentum, VBC’s adoption comes with challenges. One of the biggest hurdles is the financial risk providers must take on to participate in VBC contracts. Risk-based reimbursement models take time to achieve profitability, which is a risk that providers and investors are taking on at different levels. Most providers were built in a predominantly FFS system and must take on the operational and technical challenges that come with adapting to VBC, including care coordination, risk assessment and health outcomes measurement, all while navigating the limitations of the differing state CPOM (1) laws. Meaningful capital is also required to meet upfront capital reserves and there is a long delay in receiving cash shared savings payments. Undeniable pressure and momentum Though VBC adoption is still a work in progress, there is impressive recent momentum that is guiding the transformation. CMS is leaning further into VBC models, and in 2022 announced its aim to have all Medicare beneficiaries cared for by providers in VBC models by 2030. Payers, who are feeling the squeeze of rising medical costs, are doubling down on VBC models and growing partnerships with primary and specialty care VBC companies. VBC enablers, which offer technology-driven solutions to help providers and payers adopt VBC models, are seeing substantial growth and VC investment. Providers are realizing that while VBC comes with risk, it also allows for better outcomes, less administrative burden and more predictable revenue, with freedom to use those dollars more flexibly to meet patient needs. They can spend more time on preventive, holistic, equitable care that FFS models didn’t adequately support. Several recent strategic acquisitions by large payers and retailers in the VBC space have contributed to the positive momentum. This momentum is likely to accelerate as we see more incentives and government initiatives, better outcomes measurement data from early adopters and new innovative technology solutions. With the current strains on our system growing to unsustainable levels, the pressure has never been higher for VBC adoption and innovation in this space.Value-based care market map (2) <img src="https://lh7-us.googleusercontent.com/i8h-b0BoBycqKvJ7YHto2odvEtyWY-dvjG4kqXGUI5DKrBwCb6Od5fXnKTcqb0s3UGqIQK85P4dzJa7FnnzuHylDg9VBm2vTmtEGpXN5R34xVmKmbBVVeYnYX7wRUGrnz8wLo8nhHDvoBUbvJ6udDCg"></img>The spectrum of value-based careThe definition of VBC is subject to debate, but in the broadest sense, we consider it to include risk-taking entities, the companies caring for specific, high-cost populations (even if they do not take financial risk), as well as the technologies, products and services that enable the shift to VBC. Thus, the business models of VBC companies vary widely: Some derive 100% of their revenues from shared savings, some receive a combination of FFS revenue and shared savings, and others contract with risk-taking entities and are paid on a per-member-per-month (PMPM) basis. Full or global risk models involve two-sided risk, whereby providers share in both the upside of savings and the downside if care costs more than estimated. If costs come in lower than the benchmark, providers retain a predefined portion of the savings dollars. On the flip side, costs that are higher than the benchmark result in loss. Moderate risk models can involve one-sided risk or a capitated amount. Others take on no direct risk but offer tech powered solutions to enable providers and payers to adopt VBC models. As these tools evolve, we anticipate more payers and providers to dive deeper into VBC risk. Many companies have a combination of these various revenue models and risk levels, allowing providers and payers to dip their toes into VBC. We have also seen a recent burgeoning in specialty care VBC companies, which focus on patient populations that are both complex and high cost, such as kidney care, oncology and cardiology. Payers and primary care VBC companies are reducing risk by sub-contracting care to specialty care companies like Thyme Care and Strive Health.Mega-deals: VBC is a bright spotIt is not surprising that there has been a 116% decrease in mega-deal3 investments from 2021 to 2022 and 80% decrease from 2022 to 2023 given the bonus of cash companies raised in 2021 and 2022. Despite there being a lot of available investment dollars on the sidelines, investors are being disciplined on valuation. Many later-stage companies are revising growth projections and cutting costs to avoid fundraising this year to escape difficult valuation conversations. Valuations were very generous in 2021 and 2022, supported by strong public markets, which we do not have today. However, VBC is a bright spot, with half of this year’s mega-deals focused on VBC delivery or enablement: Carbon Health, Monogram Health, Strive Health, Aledade and Vytalize.  <img src="https://lh7-us.googleusercontent.com/OfqOnGRb7hJUzkdkfRdSARTuukNYEfGzPzWrTHsILGP0CBTgLjGsIyR6SSw6bKs4w0EPeJKK2zgJcuN5Or0j_ZZk4ko7KrrcjBHPaI6SvqYODdMvKN7-t65PhCPQiU1Z2xsySGA9p7uXTIKfIo7Rp1o"></img>Source: SVB’s Future of Healthtech report, Oct. 2023.  To view the full report, please visit<a href="https://www.svb.com/trends-insights/reports/healthtech-trends-report" target="_blank" style="background-color: transparent; color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 12px;"> </a><a href="https://www.svb.com/trends-insights/reports/healthtech-trends-report" target="_blank" style="background-color: transparent; color: rgb(11, 76, 180); font-family: Arial, sans-serif; font-size: 12px;">https://www.svb.com/trends-insights/reports/healthtech-trends-report</a>Notes:<ol><li>Corporate Practice of Medicine</li><li>List is not exhaustive, select healthtech companies represented</li><li>Mega-deals are venture-backed investments ≥ $100M</li></ol>This material, including without limitation to the statistical information herein, is provided for informational purposes only. The material is based in part on information from third-party sources that we believe to be reliable but which has not been independently verified by us, and, as such, we do not represent the information is accurate or complete. The information should not be viewed as tax, accounting, investment, legal or other advice, nor is it to be relied on in making an investment or other decision. You should obtain relevant and specific professional advice before making any investment decision. Nothing relating to the material should be construed as a solicitation, offer or recommendation to acquire or dispose of any investment, or to engage in any other transaction. All non-SVB named companies listed throughout this document, as represented with the various statistical, thoughts, analysis and insights shared in this document, are independent third parties and are not affiliated with Silicon Valley Bank or First Citizens Bank &amp; Trust Company. All third-party trademarks, logos, and brand names are the property of their respective owners and are herein used for informational purposes only. Any predictions are based on subjective assessments and assumptions. Accordingly, any predictions, projections or analysis should not be viewed as factual and should not be relied upon as an accurate prediction of future results.

The State of Value-Based Care

Blog - 0215