Oscar Health could get a boost with new funding and a spike in ACA enrollments

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The inside story of one of health care’s most valuable databases

The vast reach of MarketScan —  a family of databases that now includes the medical records of 270 million people in the U.S. — is unmistakable. So is its immense value. Last month, a private equity firm announced that it would pay $1 billion to buy the databases from IBM. It was by far the most valuable asset left for IBM as it cast off its foundering Watson Health business.

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“Because we had a 360-degree view of our patients, you could absolutely sell it and get a view that Amazon or Google might love,” MarketScan founder Ernie Ludy told Casey in an exclusive interview. “The industry wasn’t developed like that initially. I thought we were in sacred territory when we had this kind of data.”

In a new story, Casey traces the evolution and growth of MarketScan through multiple owners, illustrating how sensitive health data became an open secret in an industry that now treats their information as its hottest commodity. Read the story here, and his full conversation with Ludy here.

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Califf faces an uphill climb

Nearly a dozen Democratic senators aren’t yet willing to publicly support President Biden’s pick to run the Food and Drug AdministrationRobert Califf, our colleagues Nicholas Florko and Rachel Cohrs report. It’s a surprising level of uncertainty for Califf, who led the agency from 2016 to 2017 and later took a role at Verily. Califf’s financial ties with life science companies has proved a concern, as have his views on medical abortion. Read more.

Closing the loop in diabetes care

The FDA approved the first artificial pancreas, a device that pairs a glucose sensor with an insulin pump to automatically adjust doses of the drug, in 2016. As the devices inches closer to fully autonomous functioning — so far, they still require users to input things like food intake to help calculate dosing — they’re advancing in other ways: Last week, the FDA cleared the Omnipod 5 from Insulet, the first system that can deliver insulin through a patch and can be controlled by a smartphone rather than a standalone device. Built to work with Dexcom’s G6 continuous glucose monitor, it’s a meaningful shift in usability for the people with type 1 diabetes who use the systems day in and day out to avoid dangerous dips in glucose.

Open wide for dental data

As medicine turns to real-world data from electronic health records to answer questions about evidence-based practice, one field is largely left out in the cold: dentistry. Oral health, and its associated records, often live in silos that prevent dental data from being interpreted alongside information on chronic conditions or other important factors. Enter BigMouth: a dental data repository launched in 2012 that has grown to include records from 4.5 million U.S. patients at 11 academic dental institutions. In 2020 alone, the project grew by three organizations and 1.5 million patients, according to a paper in the Journal of the American Medical Informatics Association, driving investigations into dental care during pregnancy and for people with diabetes, and on the effects of sealants for children.

Affordable Care Act enrollment spikes 

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With open enrollment now closed in most states, the numbers are in, and ACA coverage is higher than it’s ever been. In a 21% increase since last year, 14.5 million people signed up — with increases led by Florida, Texas, and Georgia. Those were the same states Marketplace plan provider Oscar Health pointed to as drivers of its growth, as it last week announced projections to pull in $6 billion in premiums from more than 1 million members in 2022. That rosy picture, though, stands in contrast with the company’s preliminary 2021 figures, which show a roughly half-million-dollar net loss. What to do in times like these? Raise more money! The release was paired with the announcement of an additional $305 million led by Dragoneer Investment Group.

Rounds on rounds

  • In another six-figure round, Alto Pharmacy raised approximately $200 million in a Series E round led by SoftBank Vision Fund. The telehealth prescription provider is currently distributing Covid-19 antiviral pills in a free delivery partnership with New York City.
  • There’s no lack of investment flowing into telehealth, but now there’s a new venture fund devoted exclusively to virtual care from Swiftarc Ventures. The $75 million fund launched last week will initially focus on obesity, mental health, and pediatric care.
  • Reimagine Care, which provides home services for cancer care, raised $25 million from investors including Santé VenturesMartin Ventures, and LRVHealth.
  • Adding to the pile of companies deploying AI in an effort to speed and refine drug discovery, Gandeeva Therapeutics launched on Sunday with $40 million led by Lux Capital and Leaps by Bayer.

A proliferation of partnerships for platform plays

  • Diabetes data aggregator Glooko continues to push toward monetizing its reams of blood glucose data by acquiring a company called xbird. Based in Germany, the company develops AI-driven “just in time adaptive interventions” — the kind of clinical nudges that could be used to drive proactive care from providers ingesting streams of patient data.
  • Mayo Clinic has picked Oracle as the cloud provider for its business side, including supply chain management and HR. Oracle, you’ll remember, just announced plans to buy EHR giant Cerner — but Mayo’s medical side still runs on Epic and Google cloud.
  • Patient data aggregator Komodo Health will provide its software and analytics to 50 patient advocacy organizations that are part of the Chan Zuckerberg Initiative’s rare disease initiative, with a goal of identifying patient cohorts and connecting them to researchers.
  • Pfizer is getting into the digital therapeutics game, announcing a commercial partnership with Alex Therapeutics to support clinical validation of its smoking cessation app, with a goal of bringing it to market in Germany as a prescription device.
  • Cloud health software provider PointClickHealth announced plans to acquire health IT company Audacious Inquiry.

What we’re reading

Source: STAT