In-home devices, week of 5/8
In a strange way, healthcare seems to be reverting back to a style that had gone out of fashion many years ago, with an increased amount of health taking place in the home. There are now around 12 million people who are now getting in-home care, from more than 33,000 providers, and last year the annual expenditures for home health care were projected to be over $72 billion.
This is thanks, in large part, to technology and, more specifically, to connected in-home devices that can easily collect and send data to a physician in real-time. This allows patients to be monitored remotely, without constant trips to the doctor, and for physicians to do more timely interventions based on patterns picked up by AI and machine learning.
In July, Vator, HP and UCSF Health Hub will be holding an event centered around these devices, and how they are affecting the healthtech space. Every week until then we will be doing a roundup of some of the news around in-home devices and what some of the major tech companies are up to in this space.
CareCentrix, a provider of home-based and post-acute care services, acquired Turn-Key Health, a community-based palliative care company serving health plans, hospitals and physicians. No financial terms were disclosed.
Founded in 1996, CareCentrix manages care for 26 million members through over 8,000 provider locations. Through advanced analytics, the company helps determine the appropriate site for post-acute care, and provides support and coordination for patients and their families throughout care transitions, including to and from Skilled Nursing Facilities (SNFs) and through Home Health, Home DME, Home Infusion, and Home Sleep services.
Going forward, Turn-Key’s Palliative Illness Management (PIM) program, which leverages data analytics and artificial intelligence to deliver personalized palliative care plans, will be fully integrated into CareCentrix’s platform.
“Health plans and patients are looking for home-based palliative care that honors the hard choices that patients and families need to make as well as gives them the opportunity to remain at home,” CareCentrix CEO John Driscoll said in a statement. “The acquisition of Turn-Key is the next step in CareCentrix’s commitment to provide more home-based services for all patients as delivering care at home becomes the new norm.”
According to a 2019 New England Journal of Medicine survey, 60 percent of patients who would benefit from palliative care services do not receive them. Unmanaged care for patients with advanced illnesses can lead to twice the number of unnecessary hospital readmissions compared to patients who receive palliative care.
A 2019 peer-reviewed study published in the Journal of Palliative Medicine highlights TurnKey’s community based palliative care program that successfully reduced the total cost of care by 20 percent and decreased ICU admissions and hospital admissions by 38 percent and 33 percent, respectively. The Company’s proprietary end-to-end PIM solution identified high-risk members for over-medicalization and supported providers in delivering a highly personalized palliative care plan.
“We share a mission with CareCentrix to care for the whole person, not just to treat the illness. That’s particularly important for people with a serious illness to ensure that care is aligned with their goals, values and preferences,” says Greer Myers, President at Turn-Key Health. “Together with CareCentrix we can bring a personalized and scalable approach to palliative care to more people.”
The acquisition follows a successful partnership with Turn-Key over the last year, and now CareCentrix will integrate the PIM solution into its overall suite of products, enabling CareCentrix to identify patients who could benefit from palliative care and those at risk of overmedicalization and provide them with community-based resources. CareCentrix will also be able to enhance communication and improve care coordination across all involved stakeholders, including the patient’s health plan, provider, and care team ultimately to drive down medical costs associated with palliative care.
Nelson Mullins Riley & Scarborough LLP acted as legal advisor to CareCentrix. Evercore Inc. acted as financial advisor and Latham & Watkins LLP acted as legal advisor to Turn-Key Health.
Formlabs, a 3D printing company, received emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA) to print bi-level positive airway pressure (BiPAP) adapters designed by Northwell Health. This makes Formlabs is the first 3D printing manufacturer to receive an EUA.
The company is now shipping these adapters to hospital systems throughout the U.S. to combat the shortage of ventilators and provide life-saving treatment to COVID-19 patients. The 3D printed adapters convert BiPAP machines, typically used for patients suffering from sleep apnea, into functional invasive mechanical ventilators.
Formlabs will produce small, plastic T-shape adapters which convert the BiPAP machines. The plan is to allocate 150 3D printers at its headquarters towards printing these adapters, allowing the company to eventually print up to 3,000 parts per day.
“Prior to the COVID-19 pandemic, the FDA had only authorized a handful of EUAs over a 30 year period,” Max Lobovsky, CEO and co-founder of Formlabs, said in a statement. “Formlabs’ EUA for BiPAP adapters signifies the need for these components and 3D printings’ unique ability to fill that need. 3D printing enables rapid iteration and prototyping of new, innovative medical equipment, while expediting the production process, shortening supply chains, and allowing for localized manufacturing. Hospitals around the country can also use Formlabs’ printers to create these adapters locally under their own practice of medicine, meaning printing the adapters at scale in the hardest-hit areas is as easy as uploading a design and pressing print.”
Formlabs has raised $103.7 million in venture funding from investors that include NEA, Pitango Venture Capital and DFJ Growth.
At-home health testing platform LetsGetChecked raised $71 million in its Series C round of financing co-led by Illumina Ventures and HLM Venture Partners, with new investors including Deerfield, CommonFund Capital, and Angeles Investments. Existing investors Transformation Capital, Optum Ventures, and Qiming Venture Partners USA also participated in this round. This brings its total funding to $113 million.
Along with the funding, Nick Naclerio, Founding Partner at Illumina Ventures and Steven Tolle, Partner at HLM Venture Partners, have joined as the Board at LetsGetChecked.
Founded in 2015, LetsGetChecked’s tests currently include wellness testing and chronic condition testing, such as diabetes, cholesterol, and thyroid testing; cancer screening, sexual health testing, fertility testing, and pharmacogenomic testing. Once a test is purchased, users collect samples at home and send it back to LetsGetChecked’s facility at no additional cost. Results are available online within a few days.
LetsGetChecked has also developed a “twin-track” Coronavirus test which includes a rapid (antibody) serology test for results within 15 minutes, followed by a PCR-based test which requires a swab sample to be collected from a patient and later processed within the LetsGetChecked high complexity CLIA lab.
The company will use this round of funding to increase manufacturing, supply and testing capacity for COVID-19, as well as scale-up activity at its CLIA certified high complexity laboratory in California. It will allow the company to expand supply and business operations and support personnel across the United States and Europe and to deepen its partnerships with leading insurers and employers.
“We have been developing our platform for more than five years and have helped hundreds of thousands of individuals by enabling access to high-quality testing and telehealth services in the home, across many health conditions. With the onset of COVID-19, we realigned resources with a view to helping with this global pandemic and are currently delivering tens of thousands of tests per day to critical and frontline healthcare workers,” LetsGetChecked founder and CEO Peter Foley said in a statement
PEAR Sports, a provider or smart digital coaching technology, acquired Performance Lab, an AI fitness coaching platform. No financial terms of the deal were disclosed. Going forward, members of Performance Lab will join the PEAR Sports Team, and the company will maintain offices in New Zealand, housing the Performance and Sports Science Platform.
Founded in 2010, the PEAR Health & Fitness Platform allow enterprises to build and deliver digital fitness and wellness programming. Its solution combines mobile and wearable technology with human-coach guidance, paired with music to optimize the training effect. Content ranges from running to spinning, strength, flexibility and more. It also has the PEAR Pro, which provides human touch tele-coaching so that trainers can customize individual and group workouts with smart guidance for proper sequencing, training load, and recovery balance.
Performance Lab, which was founded in 2003, analyzes and interprets performance data for thousands of athletes of all levels with ARDA, its patented AI-driven exercise recommendations engine.
Performance Lab’s science will now be informing PEAR’s Training Intelligence, analyzing and interpreting biometric performance data and contextual information to create workouts that balance training to optimize results. Post-activity recommendations will be delivered to reach personal goals and affect behavior change. Finally, the new performance data will be used by the AI fitness engine to update the individual’s training, therapy or health plan. Along the way, human-touch coaching, in-person or via tele-coaching, is also being supported.
“The mission at PEAR Sports is to leverage increasingly pervasive activity data from wearables, interpret it, and apply it in ways that can impact the effectiveness of digital coaching and even human touch coaching. Adding Performance Lab’s science and AI algorithms to PEAR’s real-time coaching technology means we will be able to offer the only truly intelligent, custom, adaptive training solution on the market. We are thrilled to welcome the experienced team at Performance Lab to PEAR and to work together to create a powerful player in the digital health and fitness arena,” Bob Allison, Founder of PEAR Sports, said in a statement.
(Image source: cloudinary.com)
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While COVID-19 is dominating headlines, another kind of emergency is threatening the lives of millions of people around the world—food insecurity.
The two are very much intertwined, however. By the end of 2020, authorities estimate that upwards of 265 million people could be on the brink of starvation globally, almost double the current rate of crisis-level food insecurity.
Today’s visualizations use data from the fourth annual Global Report on Food Crises (GRFC 2020) to demonstrate the growing scale of the current situation, as well as its intense concentration in just 55 countries around the globe.
The report looks at the prevalence of acute food insecurity, which has severe impacts on lives, livelihoods, or both. How does the Integrated Food Security Phase Classification (IPC) classify the different phases of acute food insecurity?
- Phase 1: Minimal/None
- Phase 2: Stressed
- Phase 3: Crisis
- Phase 4: Emergency
- Phase 5: Catastrophe/Famine
According to the IPC, urgent action must be taken to mitigate these effects from Phase 3 onwards. Already, 135 million people experience critical food insecurity (Phase 3 or higher). Here’s how that breaks down by country:
|Country/ Territory||Total Population Analyzed (Millions)||Population in Crisis (Phase 3+, Millions)||Share of Analyzed Population in Crisis|
(24 communes in 3 provinces)
(Cox’s Bazar and host populations)
|Central African Republic¹
|Democratic Republic of the Congo¹
(selected areas in 6 regions)
(Arid and Semi-Arid Lands)
(Southern, south-eastern and eastern areas)
(16 states and Federal Capital Territory)
(Balochistan and Sindh drought-affected areas)
(excluding West Darfur)
|Syrian Arab Republic||18.3||6.6||36%|
(Luhansk and Donetsk oblasts, and IDP)
|United Republic of Tanzania¹
|Total populations||825.1 million||134.99 million|
Source: GRFC 2020, Table 5 – Peak numbers of acutely food-insecure people in countries with food crises, 2019
¹ Include populations classified in Emergency (IPC/CH Phase 4)
² Include populations classified in Emergency (IPC/CH Phase 4) and in Catastrophe (IPC/CH Phase 5)
While starvation is a pressing global issue even at the best of times, the ongoing impact of the COVID-19 pandemic is projected to almost double these numbers by an additional 130 million people—a total of 265 million by the end of 2020.
To put that into perspective, that’s roughly equal to the population of every city and town in the United States combined.
A Continent in Crisis
Food insecurity impacts populations around the world, but Africa faces bigger hurdles than any other continent. The below map provides a deeper dive:
Over half of populations analyzed by the report – 73 million people – are found in Sub-Saharan Africa. Main drivers of acute food insecurity found all over the continent include:
Examples: Interstate conflicts, internal violence, regional/global instability, or political crises.
In many instances, these result in people being displaced as refugees.
- Weather extremes
Examples: Droughts and floods
- Economic shocks
Macroeconomic examples: Hyperinflation and currency depreciation
Microeconomic examples: Rising food prices, reduced purchasing power
Examples: Desert locusts, armyworms
- Health shocks
Examples: Disease outbreaks, which can be worsened by poor quality of water, sanitation, or air
A major side-effect of conflict, food insecurity, and weather shocks.
One severely impacted country is the Democratic Republic of Congo, where over 15 million people are experiencing acute food insecurity. DRC’s eastern region is experiencing intense armed conflict, and as of March 2020, the country is also at high risk of Ebola re-emergence.
Meanwhile, in Eastern Africa, a new generation of locusts has descended on croplands, wiping out vital food supplies for millions of people. Weather conditions have pushed this growing swarm of trillions of locusts into countries that aren’t normally accustomed to dealing with the pest. Swarms have the potential to grow exponentially in just a few months, so this could continue to cause big problems in the region in 2020.
Insecurity in Middle East and Asia
In the Middle East, 43 million more people are dealing with similar challenges. Yemen is the most food-insecure country in the world, with 15.9 million (53% of its analyzed population) in crisis. It’s also the only area where food insecurity is at a Catastrophe (IPC/CH Phase 5) level, a result of almost three years of civil war.
Another troubled spot in the Middle East is Afghanistan, where 11.3 million people find themselves in a critical state of acute food insecurity. Over 138,000 refugees returned to the country from Iran and Pakistan between January-March 2020, putting a strain on food resources.
Over half (51%) of the analyzed population of Pakistan also faces acute food insecurity, the highest in all of Asia. These numbers have been worsened by extreme weather conditions such as below-average monsoon rains.
An Incomplete Analysis
As COVID-19 deteriorates economic conditions, it could also result in funding cuts to major humanitarian organizations. Upwards of 300,000 people could die every day if this happens, according to the World Food Program’s executive director.
The GRFC report also warns that these projections are still inadequate, due to major data gaps and ongoing challenges. 16 countries, such as Iran or the Philippines have not been included in the analysis due to insufficient data available.
More work needs to be done to understand the true severity of global food insecurity, but what is clear is that an ongoing pandemic will not do these regions any favors. By the time the dust settles, the food insecurity problem could be compounded significantly.
How U.S. Consumers are Spending Differently During COVID-19
When times get tough, central banks typically act as the first line of defense.
However, modern economies are incredibly complex—and calamities like the 2008 financial crisis have already pushed traditional policy tools to their limits. In response, some central banks have turned to newer, more unconventional strategies such as quantitative easing and negative interest rates to do their work.
In response to the COVID-19 pandemic, central banks are once again taking decisive action. To help us understand what’s being done, today’s infographic uses data from the International Monetary Fund (IMF) to compare the policy responses of 29 systemically important economies.
The Central Bank Toolkit
To begin, here are brief descriptions of each policy, which the IMF sorts into four categories:
1. Monetary Policies
Policies designed to control the money supply and promote stable economic growth.
|Policy Name||Intended Effect|
|Policy rate cuts||Stimulates economic activity by decreasing the cost of borrowing|
|Central bank liquidity support||Provides distressed markets with additional liquidity, often in the form of loans|
|Central bank swap lines||Agreements between the U.S. Fed and foreign central banks to enhance the provision of U.S. dollar liquidity|
|Central bank asset purchase schemes||Uses newly-created currency to buy large quantities of financial assets, such as government bonds. This increases the money supply and decreases longer-term rates|
2. External Policies
Policies designed to mitigate the effects of external economic shocks.
|Policy Name||Intended Effect|
|Foreign currency intervention||Stabilizes the national currency by intervening in the foreign exchange market|
|Capital flow measures||Restrictions, such as tariffs and volume limits, on the flow of foreign capital in and out of a country|
3. Financial Policies for Banks
Policies designed to support the banking system in times of distress.
|Policy Name||Intended Effect|
|Easing of the countercyclical capital buffer||A reduction in the amount of liquid assets required to protect banks against cyclical risks|
|Easing of systemic risk or domestic capital buffer||A reduction in the amount of liquid assets required to protect banks against unforeseen risks|
|Use of capital buffers||Allows banks to use their capital buffers to enhance relief measures|
|Use of liquidity buffers||Allows banks to use their liquidity buffers to meet unexpected cash flow needs|
|Adjustments to loan loss provision requirements||The level of provisions required to protect banks against borrower defaults are eased|
4. Financial Policies for Borrowers
Policies designed to improve access to capital as well as provide relief for borrowers.
|Policy Name||Intended Effect|
|State loans or credit guarantees||Ensures businesses of all sizes have adequate access to capital|
|Restructuring of loan terms or moratorium on payments||Provides borrowers with financial assistance by altering terms or deferring payments|
Putting Policies Into Practice
Let’s take a closer look at how these policy tools are being applied in the real world, particularly in the context of how central banks are battling the effects of the COVID-19 pandemic.
1. Monetary Policies
So far, many central banks have enacted expansionary monetary policies to boost slowing economies throughout the pandemic.
One widely used tool has been policy rate cuts, or cuts to interest rates. The theory behind rate cuts is relatively straightforward—a central bank places downward pressure on short-term interest rates, decreasing the overall cost of borrowing. This ideally stimulates business investment and consumer spending.
If short-term rates are already near zero, reducing them further may have little to no effect. For this reason, central banks have leaned on asset purchase schemes (quantitative easing) to place downward pressure on longer-term rates. This policy has been a cornerstone of the U.S. Federal Reserve’s (Fed) COVID-19 response, in which newly-created currency is used to buy hundreds of billions of dollars of assets such as government bonds.
When the media says the Fed is “printing money”, this is what they’re actually referring to.
2. External Policies
External policies were less relied upon by the systemically important central banks covered in today’s graphic.
That’s because foreign currency interventions, central bank operations designed to influence exchange rates, are typically used by developing economies only. This is likely due to the higher exchange rate volatility experienced by these types of economies.
For example, as investors flee emerging markets, Brazil has seen its exchange rate (BRL/USD) tumble 30% this year.
In an attempt to prevent further depreciation, the Central Bank of Brazil has used its foreign currency reserves to increase the supply of USD in the open market. These measures include purchases of $8.8B in USD-denominated Brazilian government bonds.
3. Financial Policies for Banks
Central banks are often tasked with regulating the commercial banking industry, meaning they have the authority to ease restrictions during economic crises.
One option is to ease the countercyclical capital buffer. During periods of economic growth (and increased lending), banks must accumulate reserves as a safety net for when the economy eventually contracts. Easing this restriction can allow them to increase their lending capacity.
Banks need to be in a position to continue financing households and corporates experiencing temporary difficulties.
—Andrea Enria, Chair of the ECB Supervisory Board
The European Central Bank (ECB) is a large proponent of these policies. In March, it also allowed its supervised banks to make use of their liquidity buffers—liquid assets held by a bank to protect against unexpected cash flow needs.
4. Financial Policies for Borrowers
Borrowers have also received significant support. In the U.S., government-sponsored mortgage companies Fannie Mae and Freddie Mac have announced several COVID-19 relief measures:
- Deferred payments for 12 months
- Late fees waived
- Suspended foreclosures and evictions for 60 days
The U.S. Fed has also created a number of facilities to support the flow of credit, including:
- Primary Market Corporate Credit Facility: Purchasing bonds directly from highly-rated corporations to help them sustain their operations.
- Main Street Lending: Purchasing new or expanded loans from small and mid-sized businesses. Businesses with up to 15,000 employees or up to $5B in annual revenue are eligible.
- Municipal Liquidity Facility: Purchasing short-term debt directly from state and municipal governments. Counties with at least 500,000 residents and cities with at least 250,000 residents are eligible.
Central bank responses to COVID-19 have been wide-reaching, to say the least. Yet, some of these policies come at the cost of burgeoning debt-levels, and critics are alarmed.
In Europe, the ECB has come under scrutiny for its asset purchases since 2015. A ruling from Germany’s highest court labeled the program illegal, claiming it disadvantages German taxpayers (Germany makes larger contributions to the ECB than other member states). This ruling is not concerned with pandemic-related asset purchases, but it does present implications for future use.
The U.S. Fed, which runs a similar program, has seen its balance sheet swell to nearly $7 trillion since the outbreak. Implications include a growing reliance on the Fed to fund government programs, and the high difficulty associated with safely reducing these holdings.
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