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Saturday, April 6, 2019

17 digital health mergers and acquisitions from the first quarter of 2019

The first quarter of 2019 started off strong with 17 digital health mergers and acquisitions, including five over the course of two days at the end of February. The quarter’s acquisitions included moves by ClassPass and Teladoc to bolster emerging international businesses with the acquisitions of GuavaPass and Médecin Direct, respectively, as well as a number of consolidation deals in niche digital health markets, such as AbleTo’s acquisition of Joyable. Still others represented novel synergies between similar but distinct companies, like Crossover Health’s purchase of Sherpaa. Finally, we saw another major private equity deal as Qualcomm divested itself of its Qualcomm Life business.
Read on for 17 digital health mergers and acquisitions from Q1 2019. And let us know if we missed one — we’ll update this article. As usual, they’re ordered first by price tag, with the undisclosed deals sorted chronologically.
Remote patient monitoring company BioTelemetry announced in January plans to acquire startup Geneva Healthcare, maker of remote monitoring for implantable cardiac devices, for $45 million in upfront cash with additional performance-based earn-out considerations of no less than $20 million.
Biotelemetry will gain access to Geneva’s cloud-based platform, which has the ability to aggregate data from device manufacturer systems. This gives physicians a platform to remotely keep track all of their patients that have implantable cardiac devices such as pacemakers, defibrillators and loop recorders, while also providing the doctors with the results of routine checks and monitoring.
New York-based startup AbleTo acquired fellow virtual mental health startup Joyable for an undisclosed sum in the tens of millions.
As part of the deal, AbleTo users will gain access Joyable’s mental health coaching app. AbleTo connects it users with a nationwide network of behavioral health providers, who use the company’s structured treatment protocols to treat the user’s condition. Currently it has 600 therapists and coaches in its network. The companies said that by combining its products, it will be able to expand its services.
Online fitness membership platform ClassPass acquired GuavaPass, a similar competing service active in Asia and the Middle East, for $4.2 million. Along with ClassPass assuming control of GuavaPass’s operations, GuavaPass CEO Jeffrey Liu, President Rob Pachter and a number of GuavaPass employees will be joining ClassPass. Both services allow users to pay a single subscription price for access to local classes for yoga, cycling, Pilates and other workouts using a mobile app.
Medical messaging company Medici announced the acquisition of Chiron Health, an Austin-based telehealth company.
Medici is a medical communication tool that lets patients communicate with multiple providers. The system was designed so that a user could not only have his or her providers on the system but also their loved ones physicians, for example their child’s pediatricians. This new acquisition will give Medici access to Chiron Health’s platform, which was designed to facilitate provider-patient video visits. Those visits can be uploaded to five compatible EHR systems. The HIPAA compliant system caters to physician-run practices. The plan is to integrate Chiron’s capabilities, as well as its full team into Medici’s current system.
Clinical information tool EBSCO Health announced the acquisition of HealthDecision, a clinical decision support and shared decision making tool for clinicians and patients. As part of the deal EBSCO Health will get HealthDecision’s educational resources, which includes a visual representation of medical outcomes. The tools were designed to help facilitate provider-patient conversations around treatment plans.
PerfectServe, a Tennessee-based medical communication and collaboration platform, announced two acquisitions in the digital health space. The first is CareWire, which is a mobile patient communication platform. The second is Lightning Bolt Solutions, an artificial intelligence-run physician shift scheduling technology designed for hospital and healthcare system. PerfectServe said that the new acquisitions will help “the company’s strategy to unify the entire care team across the continuum, from inpatient, to outpatient, to patients at home.”
Private equity firm Francisco Partners acquired Qualcomm Life, the Qualcomm subsidiary focused on medical device connectivity. The terms of the acquisition were not disclosed. Qualcomm Life will spin out as a new company under the name Capsule Technologies — the name of a clinical data management company that Qualcomm acquired in 2015. The new Capsule Technologies will continue to use the Capsule and 2net brands for its medical device connectivity offerings.
“FP’s acquisition will help Qualcomm Life (now CapsuleTech) continue to deliver market leading products and services to its world class customer base,” Rick Valencia, former president of Qualcomm Life, said in a statement.
Crossover Health, which provides medical services to large employers, Apple and Facebook among them, acquired Sherpaa, an asynchronous telehealth company that has also mostly focused on serving employer populations. The terms of the deal were not disclosed, but Sherpaa founder Dr. Jay Parkinson and his team will all become part of Crossover Health.
For Crossover Health, founded in 2010, the move to buy Sherpaa is an effort to address the changing nature of workforces, which are rarely anymore concentrated in one or even a handful of cities. With Sherpaa’s technology, Crossover Health will be able to offer a tiered system that provides in-person care to employees at a central site and comparable virtual care to remote employees.
CareLinx, a digital health company focused on in-home care, acquired Optimal Aging, a fledgling startup still being incubated at Providence St. Joseph Health. The terms of the deal were not disclosed.
Optimal Aging is a program that coordinates non-clinical services like home care, transportation and meal support for accountable care organizations and Medicare Advantage Plans. The program actually incorporates CareLinx’s technology, and has since its Seattle-area launch in 2016.
Guidewell Connect, a consumer engagement company that shares a parent company (Guidewell) with health insurer Florida Blue, acquired Onlife Health, a health and wellness technology platform, from Blue Cross Blue Shield of Tennessee and Cambia Health Solutions. The terms of the deal were not disclosed.
Onlife offers member engagement services that include wellness and chronic condition management programs, via both its My Journey app and other non-digital modalities. Post-acquisition, Onlife will be available to health plan and employer clients in 19 states, according to a statement from the companies. Guidewell intends to keep Onlife’s management intact. It will become a subsidiary of Guidewell Connect.
Healthcare software and services company WellSky (previously known as Mediware) announced yesterday the acquisition of Health Care Software (HCS), which specializes in clinical and financial software for long-term care settings. The terms of the deal were not disclosed. Although HCS will keep its New Jersey office and continue operations, the company will gradually transition into the WellSky brand.
According to WellSky, the acquisition provides the company with new analytics and care management tools, which will allow it to pursue new market opportunities as well as increase its offerings for existing clients.
Interoperable health IT company Medsphere Systems Corporation announced that it is set to acquire Wellsoft, a company that specializes in ED information systems. As part of the deal Medsphere will be acquiring Wellsoft’s signature product, the Emergency Department Information Systems (EDIS), which is targeted at improving workflow in EDs and urgent care centers.
Medsphere plans to create a comprehensive platform for urgent care centers that will employ the technology from Wellsoft as well as Medsphere’s RCM Cloud revenue cycle suite.
Senior-focused EHR and health software company PointClickCare Technologies acquired post-acute care management company QuickMar.
As part of the deal, PointClickCare will control QuickMar’s signature product, the CareSuite Manager. The system includes an EHR and electronic medication administration record (eMAR) that is targeted at post-acute care centers. The system has the ability to manage assessments, care plans, resident billing, behavioral management and charting notes.
Zoll Medical Corporation, the medical device and software company that makes the LifeVest wearable defibrillator acquired patient charting and revenue cycle management company Golden Hour.
The companies, which both offer charting and services related to the emergency medical services market, will now be able to combine their efforts. Zoll Medical has so far focused on working with larger operations, while Golden Hour has focused on a smaller organization. This acquisition will give the former the opportunity to work with EMS agencies of all sizes.
Earlier in the quarter, Zoll also acquired Payor Logic a patient receivable and insurance discovery company for providers. Both deals had undisclosed terms.
Teladoc Health has announced another acquisition that will bolster its growing international line of business. The US virtual care company will acquire Paris, France-based MédecinDirect, which provides confidential medical consultations via phone and internet. The terms of the acquisition were not disclosed, but Teladoc said “the acquisition will be immaterial to Teladoc Health’s financial results.”
MédecinDirect will become the French office of Teladoc, which now operates in the UK, Australia, Canada, Spain, Portugal, Hungary, China, Chile and Brazil in addition to the United States. What MédecinDirect offers Teladoc Health is a large existing client base that will give the company a comfortable foothold in a new country. Existing MédecinDirect customers will gain access to the full range of Teladoc services.
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CMS expands Medicare Advantage telehealth benefits

The CMS finalized a rule on Friday that would give Medicare Advantage plans more flexibility to offer additional telehealth services to seniors as part of their basic benefits package starting in 2020.
The rule, proposed in October 2018, allows seniors to use telehealth services in their homes, rather than being required to go to a healthcare facility.
While previously Medicare Advantage plans could include additional telehealth services only as a supplemental benefit to be paid for with rebate dollars or enrollee premiums, they will now be able to include telehealth as a basic government-funded benefit beyond what the original Medicare program offers. The change was called for by the Bipartisan Budget Act of 2018.
“Today’s policies represent a historic step in bringing innovative technology to Medicare beneficiaries,” CMS Administrator Seema Verma said in the announcement. “With these new telehealth benefits, Medicare Advantage enrollees will be able to access the latest technology and have greater access to telehealth.”
The CMS also said it is streamlining grievance and appeals process for patients enrolled in certain dual-eligible special needs plans and affiliated Medicaid managed care plans, as required by the Bipartisan Budget Act.
And to better integrate benefits for dual-eligible patients, the CMS is finalizing a new minimum criteria for Medicare and Medicaid integration in the so-called D-SNPs starting in 2021. It will require D-SNPs to either cover Medicaid long-term services and supports or behavioral health services through a capitated payment from a state Medicaid agency, or D-SNPs will have to notify a state Medicaid agency of its hospital and skilled nursing facility admissions for a group of high-risk, full-benefit dual-eligibles.
The CMS did not address in the final rule a dramatic change to the way it audits Medicare Advantage plans, given it extended the comment period to April 30. But it notes it will address the audits in later rulemaking.
In the October proposal, the agency also told insurers it wants to start recouping payments to Medicare Advantage plans based on a risk-adjustment data validation audit methodology proposed back in 2012. Under that methodology, the CMS would extrapolate the results of an audit of a sample of enrollees across the entire plan population, which could dramatically increase the recoupments of improper payments to plans.
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Healthcare sector saw highest job growth in March

Healthcare added more jobs than any other employment sector in March.
The sector added 49,100 jobs last month, continuing its pattern of unpredictable, month-to-month spikes and dips, according to the U.S. Bureau of Labor Statistics’ newest jobs report. March’s number represents a 136% jump from February’s weak hiring count, which was down 50% from January. Still, it was the biggest hiring month so far in 2019, even approaching December 2018’s historic high of 49,500.
Within healthcare, ambulatory healthcare services assumed its usual position as the top hirer, adding 27,000 jobs in March, up 27% from February. Home healthcare services reported the most job growth within the ambulatory sector, adding 8,000 jobs, a 70.2% spike from February. Physicians’ offices boosted their numbers by 7,000 jobs, up 126% over the prior month, and dentists’ offices added 5,100 jobs, up 96%.
Hospitals added 13,600 jobs in March, up more than 220% from February, a month in which hospital hiring was weak.
Nursing and residential care facilities added 8,500 jobs in March, up significantly from just 1,100 new jobs in February. Within that sector, community care facilities for the elderly added 3,800 jobs, a vast improvement from February in which it shed 500 jobs.
The overall U.S. unemployment rate remained at 3.8% in March, and total nonfarm payroll employment grew by 196,000 jobs.
Healthcare, which grew by 398,000 jobs over the past 12 months, added more jobs in March than professional and technical services, which added 34,000 jobs. Employment in food services and drinking places trended up last month, adding 27,000 jobs. Construction employment changed little in March, adding 16,000 jobs. Computer systems design added 12,000 jobs during the month.
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Pin-sized sensor could bring chemical ID to smartphone-sized devices

Imagine pointing your smartphone at a salty snack you found at the back of your pantry and immediately knowing if its ingredients had turned rancid.
Devices called spectrometers can detect dangerous chemicals based on a unique “fingerprint” of absorbed and emitted light. But these light-splitting instruments have long been both bulky and expensive, preventing their use outside the lab.
Until now. Engineers at the University of Wisconsin-Madison have developed a  that is so small and simple that it could integrate with the camera of a typical cell phone without sacrificing accuracy.
“This is a compact, single-shot spectrometer that offers  with low fabrication costs,” says Zhu Wang, who was among the team of electrical engineers that created the device.
The researchers published a description of the devices March 4, 2019, in the journal Nature Communications.
The team’s devices also have an advanced capability called hyperspectral imaging, which collects information about each individual pixel in an image order to identify materials or detect specific objects amidst a complicated background. Hyperspectral sensing, for example, could be used to detect seams of valuable minerals within rock faces or to identify specific plants in a highly vegetated area.
Every element’s spectral fingerprint includes unique emitted or absorbed —and the spectrometer’s ability to sense that light is what has enabled researchers to do everything from analyze the composition of unknown compounds to reveal the makeup of distant stars.
Spectrometers usually rely on prisms or gratings to split light emitted from an object into discrete bands—each corresponding to a different . A camera’s photodetector can capture and analyze those bands; for example, the spectral fingerprint of the element sodium consists of two bands with wavelengths of 589 and 590 nanometers.
Human eyes see 590-nanometer wavelength light as a yellowish-orange shade. Shorter wavelengths correspond to blues and purples, whereas longer wavelengths appear red. Sunlight contains a complete rainbow mixed together, which we see as white.
To resolve the difference among a mixture of different colors, spectrometers usually must be relatively large with a long path length for light beams to travel and separate.
Yet the team created tiny , measuring just 200 micrometers on each side (roughly one-20th the area of a ballpoint pen tip) and delicate enough to lie directly on a sensor from a typical digital camera.
That small size was possible because the researchers based their device on specially designed materials that forced incoming light to bounce back and forth several times before reaching the sensor. Those internal reflections elongated the path along which  traveled without adding bulk, boosting the devices’ resolution.
And the devices performed , resolving two distinct images (of the numbers five and nine) from a snapshot of an overlaid projection that combined the pair into something indistinguishable to the naked eye.
Now the team hopes to boost the ‘s spectral resolution as well as the clarity and crispness of the images it captures. Those improvements could pave the way for even more enhanced sensors.
Explore further
More information: Zhu Wang et al. Single-shot on-chip spectral sensors based on photonic crystal slabs, Nature Communications (2019). DOI: 10.1038/s41467-019-08994-5
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Investors should not buy into craze for hemp stocks, Barron’s says

Congress legalized hemp and its soothing extract cannabidiol, or CBD, and now the stock market cannot get enough of the stuff, Bill Alpert writes in this week’s edition of Barron’s. Cannabis producers like Canopy Growth (CGC), Aurora Cannabis (ACB) and Tilray (TLRY) quickly got into hemp and the stocks of companies that have long bet their business on CBD have doubled in recent months, including Charlotte’s Web (CWBHF) and GW Pharmaceuticals (GWPH), he notes. Unfortunately, there are no bargains among hemp or marijuana stocks these days, the author contends
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E. coli outbreak affecting 5 states

U.S. health officials say they are investigating an outbreak of E. coli gastrointestinal illness that’s already affected 72 people across five Eastern states.
The origin of the foodborne illnesses remains unknown, the U.S. Centers for Disease Control and Prevention said late Friday.
“The investigation is still ongoing and a specific food item, grocery store, or restaurant chain has not been identified as the source of infections,” the CDC said in a statement. States affected are Georgia, Kentucky, Ohio, Tennessee and Virginia.
Cases of illness first began to be reported March 2, and the last reported case occurred March 29. Although no deaths have been reported, “of 47 people with information available, eight have been hospitalized” because their cases have been so severe, the CDC said.
This outbreak has been linked to the E. coli O103 strain of bacterium, and the CDC says people typically get sick within three to five days of eating E. coli-contaminated food.
“Most people get diarrhea (often bloody), severe stomach cramps and vomiting,” the agency said. “Most people recover within a week, but some illnesses can last longer and be more severe.”
There are ways you can protect yourself, however. Be sure to wash hands while preparing food, and cook meats thoroughly.
“To kill harmful germs, cook beef steaks and roasts to an internal temperature of at least 145 degrees Fahrenheit and allow to rest for three minutes after you remove meat from the grill or stove,” the CDC advises. “Cook ground beef and pork to a minimum  of 160 degrees Fahrenheit.”
Also, “wash hands, counters, cutting boards, and utensils after they touch raw meat,” the agency said.
Explore further
More information: There’s more on E. coli at foodsafety.gov.
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NIOSH Seeks Firefighters for Data on Cancer Risk

Learning more about firefighters’ increased risk for certain cancers is the aim of a voluntary registry being created by the U.S. National Institute for Occupational Safety and Health (NIOSH).
It’s seeking more than 1.1 million firefighters to participate in the National Firefighter Registry.
“Firefighters put their lives on the line to ensure our safety in emergencies, but their jobs may also put them at risk for long-term health effects such as cancer,” Dr. John Howard, director of NIOSH, said in an agency news release.
Firefighters have higher odds for digestive, lung, throat and urinary cancers.
The registry will also highlight advances to safeguard firefighters, including improvements in the design and care of personal protective equipment, as well as practices to reduce exposure to hazardous substances.
“We look forward to receiving this formal input from our partners in the fire service on how we can make sure they are engaged in this process as we move forward. Their contributions will be important to the overall success of this registry,” said Kenny Fent, head of the National Firefighter Registry program.
Enrollment is expected to begin in 2020. The registry is especially seeking minorities and women, who have not been well-represented in past research.
A NIOSH study launched in 2010 included more than 30,000 career firefighters serving between 1950 and 2010, the largest study ever of U.S. firefighters.
It examined not only deaths from cancer, but also diagnoses of certain kinds of cancer, including testicular and prostate cancers, which have higher survival rates. It also looked at other causes of death to better understand firefighters’ risk compared to the general public.
Results of that study led to a call for a national registry with a focus on understudied groups of firefighters, according to NIOSH.
More information
The U.S. National Institute for Occupational Safety and Health has more on firefighters.
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