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May 21, 2020
 
 
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OptumHealth, the healthcare services and delivery business of UnitedHealth Group's Optum, has acquired naviHealth, a post-acute care management platform for health plans and providers, for an undisclosed sum. The deal was first reported by the Nashville Business Journal, and confirmed to MobiHealthNews by an Optum representative.

While the terms of the transaction were not disclosed, Optum said that naviHealth will continue to work with its clients and members as a standalone entity that is aligned with OptumHealth. CEO Clay Richards – who cofounded the company in 2012 alongside former Centers for Medicare and Medicaid Services Administrator Tom Scully – will continue to head naviHealth's leadership team.

“For the past eight years, naviHealth has worked tirelessly combining data and clinical insights to improve the health care experience and help seniors live more fulfilling lives," Richards said in a statement. "Now, as part of the Optum organization, we can further deliver on this mission. Our leadership team remains committed to providing value to our customers, and excited about how we can serve patients even better.”

WHAT'S THE IMPACT?

naviHealth leverages a combination of analytics, clinical decision-support tools and clinical staff to monitor and guide recovery among post-acute patients. The company said that it is currently managing these services for 4.5 million Medicare Advantage members, and works with more than 140 hospitals in CMS' Bundled Payments for Care Improvement Advanced program.

From the outside, Optum has signaled that it wants to leave naviHealth's business mostly intact, but will be providing resources to help expand the platform to more patients.

“Bringing together naviHealth’s post-acute clinical model and data-driven insights with Optum’s community-based health care and clinical capabilities will help meet the growing demand for highly personalized, value-based care coordination for patients with complex health conditions across the entire care spectrum. Working together, Optum and naviHealth are strongly positioned to help patients get the highest possible quality of care so they can get and stay healthy.”

THE LARGER TREND

naviHealth is the latest in what is now looking to be a string of digital health acquisition plans for Optum.

Late last year it acquired remote-monitoring company Vivify Health in a deal that, similar to this week's news, has the Plano, Texas-based platform acting as a largely independent business unit.

More recently, Optum was also reported to be in late-stage talks with virtual behavioral-care company AbleTo regarding a roughly $470 million acquisition. Optum is already a stakeholder in the company as of January 2019.

Optum's parent company UnitedHealth Group also participated in some digital health M&A last summer when it acquired online patient community portal PatientsLikeMe. The startup became part of the company's research arm that investigates healthcare improvements and innovation.

 
One Medical office
 
 

One Medical, the tech enabled health startup that made headlines when it went public in January, is reporting a 25% year-over-year revenue growth. However, it still came up short of meeting earnings per share expectations.

The company, officially named 1Life Healthcare, uses a hybrid model, its members have access to 24-7 virtual health-services as well as the ability to visit brick-and-mortar clinics for care.

While, the coronavirus has posed several challenges for the company, its CEO Amir Dan Rubin said that it is looking toward digital means for the future.

“In late Q1, our digital platform expanded to offer remote visits. With remote visits, members can now schedule billable video appointments with their primary care providers, supporting continuity of care and social distancing. While still early, we have seen great initial uptake and plan on continuing these services into the future,” he said. 

TOP-LINE DATA 

The California-based company reported $78.8 million in net revenue, representing a 25% increase year-over-year. This also meant that it beat its goal by $3.75 million. It also reported a member increase of 25%. However, the earnings per share missed its goal by $0.23.

Membership revenue accounted for $15.2 million of revenue, patient services accounted for $34.1 million and partnerships accounted for $29.5 million. 

The Q1 adjusted EBITDA was a loss of $14.5 million, which the company attributes to the coronavirus crisis. 

LOOKING AHEAD 

The company is forecasting Q2 revenue at between $56 million and $66 million, attributing the large range to the uncertainty of the times. Noting that the company didn’t have plans to lay off employees, it said it expected an adjusted EBITDA to be between a loss of $36 million and a loss of $26 million. 

The company is also expecting a wave of patients seeking care that might have been put off during shelter-in-place orders. 

“We continue to expect an influx from deferred care at the appropriate time, although we cannot predict when and how sharply our in-office volumes will return,” Bjorn Thaler, Chief Financial Officer, said in the call. “This will include care for chronic disease management, cancer screening, reproductive health, behavioral health and wellness visits, to name a few. In the long term, COVID-19 may also drive an influx of demand for future vaccinations or other treatments.

The company said that, looking ahead, it is also planning on not hiring any more nonclinical staff for the time being, and has cut most discretionary spending. The company is also holding off on opening some of the new offices that were slated to open in 2020, and defer the opening until the second half of 2021.

As the coronavirus continues to limit patients access to in person care, the provider will be looking for digital revenue streams. However, virtual care has its own obstacles. 

“With the recent regulatory changes, remote visits are currently reimbursed at equivalent rates to similar in-office visits,” Thaler said. “That said, remote visits do not involve procedures or the administration of services like vaccines or reproductive care. For this reason, the average remote visits typically result in a lower average fee-for-service reimbursement. Finally, average reimbursement for COVID-19 testing is typically lower than average reimbursement for both remote visits and in-office visits."

LOOKING BACK 

Over the last few months One Medical has launched a number of initiatives to address the growing pandemic. One of its major expansion areas was COVID-19 testing. 

“In a matter of weeks, we stood up 18 mobile testing sites, along with in-office testing locations across our markets. In Q1, our testing services focused on symptomatic and high-risk individuals, in parallel with CDC guidelines,” Rubin said.  In Q2, as the CDC brought in testing guidelines, we expanded testing the frontline responders and essential workers.”

The company also made headway with a new program aimed at getting people back in the workforce. 

“During this extraordinary time, we launched our One Medical Healthy Together Worksite Reentry program to support employers as they began to transition workforces back into shared environments,” Rubin said. “Through our program, we can virtually screen employees for key symptoms and clinical risk-factors, offer testing services, and support ongoing digital screening, further testing, and follow-up care as needed.”

During this time the company has also partnered with hospitals and municipalities. 

 
 
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