New Signify details, out-of-state telehealth use, and Fitbits to study brain exercise

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New details about the Signify bidding war

An SEC filing about CVS’s proposed $8 billion acquisition of Signify Health gives us a little more insight into the bidding war that unfolded over the summer — and how CVS ended up paying far more than it initially proposed. What we know so far from reports: UnitedHealth GroupAmazon, and Option Care Health all made bids on the business. According to the filing, there were five total parties involved in the final process. After receiving an unsolicited $20 per share bid in June, Signify contacted 15 parties to see if they might be interested.


When all the offers were collected a month later, CVS came out with the top bid of $24 a share. But CVS ended up paying over $30 per share — a shockingly higher price when you consider that at the beginning of the process in June, Signify’s shares were going for $12.

Why? The University of Michigan’s Erik Gordon explained to my colleague Katie one possibility is that leaks, chatter, and hype appear to drive up deal prices: “If you look at any acquisition, what you see is, there’s this inexplicable kind of creep up in the price before the acquisition is announced.” (Also thanks to Katie, who has been following this story, for trudging through the SEC docs!)


Why UHG-Change deal got the greenlight

newly unsealed opinion sheds light on why a federal judge shot down the Justice Department’s effort to block UnitedHealth Group‘s acquisition of the tech company Change Healthcare. The government had argued that the deal would threaten competition and that UHG could misuse the newfound wealth of health insurance claims data by sharing it with its health insurance arm, UnitedHealthcare. But while Judge Carl Nichols agreed the acquisition would give UHG and Change control of more than 90% of the market for a certain type of claims processing, he was satisfied with UHG’s plans to divest the Change unit that processes those claims. Nichols also rejected the government’s argument that the union would make other insurers less likely to innovate, noting that it provided “zero real-world evidence.”

How was out-of-state telehealth used?

Jama Health Forum

For a very good sense of how patients availed themselves of loosened licensure rules that let physicians practice out of state during the pandemic, look to Washington, D.C. From January through June 2021, 38% of residents’ telehealth visits were to doctors out of state, and over 90% of those were to clinicians in neighboring Maryland or Virginia, according to new research published in JAMA Health Forum looking at out-of-state use nationwide.

The findings highlight what co-author and Harvard professor Ateev Mehrotra calls the “bread-and-butter” nature of the use. “We all recognize that folks will use it for rarer conditions, but we emphasize that for folks who live in D.C. or near a state border, it is quite common to have a primary care doc outside your state,” he wrote me. Roughly two-thirds of out-of-state visits were preceded by an in-person visit to the same doctor. In the absence of national licensing reform, the authors suggest regional compacts could be useful. Important caveat: The analysis of Medicare claims may not be representative of, say, a younger commercially insured population.

Using Fitbits to explore the link between exercise and cognition

If you tell a doctor you’re anxious, they’re likely to recommend some exercise, but researchers in Jeremy Manning’s lab at Dartmouth are searching for a little more rigor behind those recommendations.

As a first step, Manning and colleagues found a clever low-cost way to explore links between exercise and memory: Using Amazon’s crowdsourced worker platform Mechanical Turk, the researchers recruited Fitbit users willing to submit their anonymized data and do a battery of memory tests. The researchers found links between low-intensity activity and episodic, or autobiographical, memory and high-intensity activity and spatial memory, or how you remember where you left your car keys. Manning cautions that these associations must now be studied to establish correlations.

One day, Manning suggests, you might be prescribed a set of exercises targeting specific brain changes. “If you’re training for a marathon, there’s a particular schedule of workouts that you might want to engage in,” he told me. “And we think we think that there might be a similar schedule we could suggest for brain health, whether it’s cognitive or mental health.”

Industry news

  • Well-funded startup Lyra Health announced an expansion into teen mental health, underscoring the ongoing demand for mental health services even in the face of a rocky economy.
  • Rockley Photonics announced it has developed a new, smaller version of its laser-based technology that it claims allows wearables to measure blood pressure, core body temperature, blood glucose and other metrics. The company has garnered a lot of attention for its deals with Apple and Medtronic, though you can’t presently buy any devices using its current generation technology. The new laser chip is expected to be available in 2024, and CEO Andrew Rickman told me it could permit vitals tracking in eyewear, earbuds, and clothing.
  • Carbon Health announced a deal to provide virtual primary care to eligible Blue Cross Blue Shield of Massachusetts members.
  • Health data company nference is launching its clinical data analytics platform nSights, which the press release states will allow “partners and customers across biopharma, medical devices and diagnostics can gain exclusive access to directly engage with the entirety of the Mayo Clinic healthcare data repository that nference has curated and de-identified.”
  • SyncThink, a company we last heard from in our investigation into the breakthrough devices program, has rebranded as NeuroSync. The company has FDA clearances for tech that analyzes eye movements for signs of brain injuries like concussions. Among other new efforts, it’s working on a “biomarker identification platform” for attention deficit hyperactivity disorder

What we’re reading

  • Employers’ coming health care crunch, Axios
  • Publicly insured and uninsured patients are more likely than other patients to be treated unfairly in healthcare settings because of their coverage type, Robert Wood Johnson Foundation
  • In a first, health panel calls for routine anxiety screening in adults, Washington Post
  • Meta quietly reduces staff in cost-cutting push, Wall Street Journal
  • Addressing the “elephant in the room” of AI clinical decision support through organization-level regulation, PLOS Digital Health
Source: STAT