Digital health firms that IPO’d in 2020.

One Medical: The health tech primary care platform backed by Google went public in January. (Link)

Ardent: Interestingly, privately-owned hospital operator Ardent Health Services called off its IPO plans in January. I can’t help but think the firm would have benefitted from such frothy market conditions, but of course hindsite is 2020, and I’m not a hospital operator. (Link)

Accolade: The firm associated with helping employers navigate health benefits, debuted on the public markets in early July. (Link)

GoodRx: Debuted to much success in late September, popping as high as $57 per share in its initial day of trading. Interestingly, since the Amazon Pharmacy announcement, GoodRx has traded down to $43. (Link)

GoHealth: The tech enabled insurance enrollment platform raised more than $913 million in its IPO in mid-July. (Link)

Oak Street Health: Went public in early August to – as expected – much success. The firm raised more than three times what it intended as the IPO market stayed red-hot in the back half of the year. (Link)

Outset Medical: successfully debuted on the public markets in late September. The portable dialysis firm is looking to capitalize on the recently finalized end-stage renal disease payment model that encourages at-home dialysis treatment.

SOC Telemed: As a part of another SPAC deal, SOC Telemed joined the public markets early November under the ticker $TLMD, valued initially at $720 million. The firm provides telemedicine and other tech services to hospitals in almost every state and is taking advantage of the boom in remote health care.

Amwell: skyrocketed in its IPO in late September. That same week, Teladoc hit Amwell with several intellectual property accusations, claiming that Amwell infringed on several of Teladoc’s patents.

Multiplan: Churchill Capital’s SPAC took Multiplan, a healthcare solutions provider that partners with managed care companies, public at an $11 billion valuation. (Link)

Hims & Hers: Is expected to go public via SPAC with Oaktree Acquisition Corp. The unicorn will hold a value of about $1.6 billion when the deal closes. (Link)

Clover Health: The health-tech managed care firm was acquired by Social Capital Hedosophia Holdings Corp III in October, valuing Clover at about $3.7 billion initially. (Link). Read this analysis of the Clover SPAC.

Other recently announced digital health IPOs.

Eargo: The hearing aids tech co. raised $141 million in its IPO in mid October. (Link)

UpHealth and Cloudbreak: In healthcare’s latest SPAC deal, UpHealth and Cloudbreak are merging with blank-check company GigCapital2 to become the latest digital health conglomerate unicorn on the public markets. The new combination is a fascinating PROFITABLE play into telemedicine, patient care management, medical interpretation, prescription drugs, and more. (Ticker: $UPH).

CareMax Medical Group and IMC Medical Group: Healthcare SPAC Deerfield is merging with the two in order to bring the firms to the public markets. The combination will create what I imagine to be similar to Oak Street Health – medical clinics for seniors under value-based contracts. (Link)

What to expect for digital health IPOs in 2021.

With frothy market valuations and the forced shift to virtual and digital health in 2020, we saw a number of digital health IPOs – and IPOs in general – along with the emergence of special purpose acquisition companies (SPACs) which also helped a few healthcare firms hit the public markets. Expect the same to continue in 2021.

On deck for 2021: Telehealth player MDLive, Highly touted unicorn Oscar Health, and more. The health tech IPO boom goes on! (Link)

In one of the most anticipated health tech moves, Oscar Health confidentially filed for IPO a week after raising $140 million in a pre-IPO funding round in late December 2020.

• As other digital health unicorns continue to raise money at astronomical valuations in the billions of dollars, expect other big digital health names to follow suit toward the IPO/SPAC play.

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How have recently IPO’d digital health firms performed during 2020 and since the beginning of their public debuts?

Of course, everyone has heard of Peloton before. The at-home fitness center skyrocketed for obvious reasons over the past years. But not-so-obvious?

Livongo Health.

• The connected, chronic health manager, digital health platform is up almost 300% on the year as of this writing, and over 150% since its IPO debut about a year ago.

Here’s how the rest of the recent digital health IPOs are faring in 2020. No surprise here, SmileDirectClub is at the bottom of the list after its dismal 2019 performance. Notably, it’s up so far in 2020.

We’ll be watching closely as Accolade shares continue to trade and expected IPOs from GoHealth and Oak Street Health take place.

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The public health crisis that formed in the first half of 2020 (“1H 2020”) affected various healthcare sectors quite differently.

• Overall, only a select few sectors – healthcare distributors like McKesson or Cardinal Health, and home health providers such as Amedisys or LHC Group – managed to eke out positive gains in 1H 2020.

While public healthcare companies as a whole during 1H 2020 outperformed the S&P 500, healthcare services companies were not treated as kindly.

• You can see this trend by comparing the S&P 500 Health Care Sector (^HCX) to the healthcare services ETF created by SPDR (XHS).

Broad healthcare company performance. ($XLV)

The broader S&P 500 Health Select Sector index contains outperformers in the pharmaceutical industry. Certain biotech firms were either (a) not affected by the pandemic given inelastic demand, or (b) benefited from higher demand for their stock due to the ongoing vaccine race.

• These factors allowed the index to perform well when compared to the more narrowly defined Health Care services ETF.

Healthcare services company performance. ($XHS)

Constituents in the Health Care Services ETF were arguably the most materially affected public sector when it comes to estimating COVID-19 impact.

• Companies such as HCA Healthcare (the largest public hospital operator), Encompass Healthcare (the largest operator of inpatient rehabilitation facilities), and all outpatient-focused firms sold off severely in the face of the pandemic.

When you look at a time-series graph, the vast underperformance by health care services becomes even more apparent.

As of the beginning of July, services underperformed the S&P 500 by a whopping 5.0%. Meanwhile, broader healthcare actually outperformed the S&P 500 over the same time horizon:

Interestingly, healthcare services were performing QUITE well prior to the onslaught of the global pandemic, outperforming broader healthcare and the S&P 500 by a wide margin even during the peak of the bull run. Of course, this changed quickly as panic gripped the public markets.

2020 (so far) is the year of the home health provider, distributor, and Big Pharma. Services continue to struggle.

Home health giants Amedisys and LHC Group continued their outperforming ways when compared to other traditional healthcare services.

• Meanwhile, sectors with less elastic demand (distributors) and vaccine hopes (pharmaceuticals) outperformed the S&P 500.

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Some friends at the Blue Cross Blue Shield media department have shared some very insightful data in a recent press release on both trends in pregnancy & childbirth as well as how COVID-19 is impacting pregnant women in the U.S.

Based on that BCBS report (which you can find here), their research team found the following eye-opening trends related to pregnancies during COVID-19:

• 25% of pregnant women said they missed a prenatal visit;
• 48% shifted their prenatal appointments to virtual visits;
• 53% reported that they could not have a loved one in the delivery room; and
• 15% delivered their baby at home.

The BCBS research report is chock full of interesting insights related to pregnancy and childbirth.

• The analysis found that pregnancy and childbirth complications have increased 16.4% and 14.2% respectively – 31.5% overall – as millennial women comprise 85% of all pregnancies in the U.S. and also hold more pre-existing conditions like hypertension that can lead to greater risk.

Resources and help for expecting mothers.

To help offset negative trends in pregnancy and childbirth, BCBS offers plenty of resources to expectant families, including a database of centers that are committed to quality, consistent maternity care.

• Noted as Blue Distinction Centers, these sites of care provide better outcomes for deliveries.

To help expectant mothers access quality and affordable care, payors like Blue Cross Blue Shield are providing support programs along with community-focused initiatives that help ensure the better health of America. Services include the following:

• Embedding health coaches and nutritionists in OBGYN offices to help women manage chronic diseases and lead healthier lives.
• Providing resources for pediatricians to screen new mothers for postpartum depression so they can quickly get the treatment they need.
• Offering expectant mothers with high-risk pregnancies confidential nursing support specific to their individual needs.

We hope this is a resource to you, and a big thank you to the Blue Cross Blue Shield media and data analytics team for finding insightful, actionable conclusions from their claims data.

If you want more insights like these, or if you want to stay on top of the latest healthcare news and trends in a once-weekly e-mail, please consider subscribing to our newsletter below.

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1. Acute care hospitals received the most funding support amid huge losses.

Of all the public healthcare services sectors, acute care hospital firms received by far the most funding as of Q1 2020.

• Almost 90% of CARES Act grant funding and Medicare accelerated payments went to hospital operators.

Hospitals are the biggest losers during the pandemic.

How much are hospitals losing without elective procedures in a pandemic environment?

• The American Hospital Association (AHA) published a report this week estimating that hospitals and health systems would lose about $202 billion over 4 months, mainly related to the cost of caring for COVID-19 patients and suspension of elective procedures.

Net that against the emergency healthcare funding of ~$175 billion, and you can spot the $27 billion difference hospitals might need just to break even over the coming months, according to the AHA.

To expand on hospital losses, publicly traded hospital operators reported interesting insights during their Q1 earnings releases.

• The highlights: most were seeing strong volumes until COVID lockdowns began (March 15). All hospital operators pulled their guidance for fiscal year 2020 and expect a big downturn in Q2.

It’s not just hospitals, either: Most outpatient healthcare settings experienced 30% to 75% patient volume declines during the Great Lockdown.

• This loss of volume is consistent across the board. You can see this effect in the April jobs report, too. Healthcare lost 1.4 million jobs almost entirely in outpatient settings.

2. Public healthcare companies received very little CARES Act grant $$ in Q1.

In Q1 2020, HHS distributed about $50 billion in grants to hospitals and providers struggling during COVID-19. Of that $50 billion, public healthcare companies received about $2,200, or 4.4% of total grant funding.

Notably, most public healthcare services firms received much more funding in the form of accelerated payments from CMS.

• Providers will have to start repaying these ‘advance loans’ in August, unless that deadline is pushed back.

3. More relief funding for public healthcare companies did not correlate to stronger stock performance.

While public hospital firms received the most relief funding, the sector as a whole (meaning an equally weighted index following the share price performance of HCA Healthcare, Universal Healthcare Services, Community Health Systems, and Tenet Healthcare) under performed the S&P 500 by a wide margin.

• Sectors that rely on outpatient healthcare services have performed the worst so far this year. This basket of companies includes Surgery Partners, hospital operators mentioned above, Mednax, and U.S. Physical Therapy.

4. The home health and hospice sector once again outperforms.

Similar to historical trends and the poster child for growth in the healthcare industry, home health and hospice – e.g., LHC Group, Amedisys, and Chemed – displayed resilience and strength when compared to other healthcare services sectors.

This performance is probably attributable to investor speculation. With payment changes underway through PDGM, many believe the pandemic will only exacerbate consolidation in the home health and hospice industry.

• Who wins in a consolidating industry? The biggest players – and these operators are at the top of that list.

5. There are ‘strings attached’ to CARES Act grant money.

Providers are growing increasingly concerned that the relief funds come with hidden strings attached – like quarterly reporting on where the money is going.

• Other concessions that providers may need to make if they take the money: no surprise (out of network) billing, disclosing reimbursement rates from private insurance (AKA price transparency), and more.

We’ve already seen providers speak cautiously about relief funds.

Encompass Healthcare mentioned on its earnings calls that it had no plans to use the relief funds until the firm better understands the implications from HHS. Now, the post-acute giant is returning its funds to HHS.

• Expanding on that, home health providers are shying away from the funding too, fearing a CMS, WWE-style smackdown.

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• It’s a once weekly e-mail updating you on all the major election news, broader trends, big stories, and policy updates. Learn more about our vision here.

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COVID-19 hit the American economy hard – that’s no secret. Despite its recession-resistant reputation, healthcare has been especially vulnerable as a result of canceled elective procedures, lower ER visits, and slashed outpatient visits.

While healthcare sub-sectors like acute care hospitals, diagnostic imaging (looking at you, RadNet), and physical therapy temporarily collapsed, other areas of healthcare have flourished.

Like we’ve discussed in our weekly newsletter, health insurance companies, or payors, are on track to meet their 2020 Wall Street financial guidance due to markedly lower medical costs in the front half of the year.

Payors aren’t the only winners, though.

People sheltering in place nationwide (and globally, for that matter) have turned to telehealth solutions during the pandemic.

• Telehealth has allowed individuals to meet with physicians during the COVID-19 crisis in order to discuss chronic conditions, receive prescription refills, and order tests.

So who’s the biggest public player in the telehealth market?

Teladoc.

As of May 18, 2020, Teladoc’s market capitalization has more than doubled this year to $13.7 billion despite only reporting net patient revenues of $606 million through Q1 2020.

What caused Teladoc’s rise during COVID-19?

Teladoc holds the biggest brand name in telehealth services. It’s flashy and easy to remember.

Just look at the exponential number of Google searches Teladoc received during 2020. I’ll give you three guesses as to when its stock price started ramping.

Alright, fine. Here’s Teladoc’s stock price chart over that same time period:

Prior to COVID-19, Teladoc struggled with the widespread adoption of telehealth. Many insurance providers didn’t see the same value in telehealth as they did in regular, old-fashioned physician office visits and reimbursed virtual visits significantly less.

• Others worried about the growth of fraud in telemedicine, especially among the elderly population. We’ve all seen grandma in front of the computer – she’s not the best at spotting scams, unfortunately.

As a result of the headwinds mentioned above, telehealth has seen steady, but unremarkable growth over the past several years.

Of course, this all changed drastically in the short-term, and Teladoc gave us some remarkable highlights in its Q1 earnings report.

Teladoc’s unprecedented Q1 growth.

Citing its critical role during the global pandemic, Teladoc experienced the strongest growth in company history during Q1:

“We are playing a critical role during the global outbreak of COVID-19 and have seen a significant increase in inquiries from both existing and new potential clients. Our clients are turning to us to expand our service offering to new populations and add new products during this time of need.

Requests from new potential clients are increasing as the outbreak of COVID-19 has highlighted the value of access to a comprehensive virtual health care solution.

During the first quarter alone, we onboarded over 6 million new paid members in the U.S. across government and commercial populations. And we anticipate onboarding an additional 6 million to 7 million new members during the second quarter, culminating in the strongest first half membership growth in company history.”

Teladoc Q1 2020 Earnings Call

Along with ‘significantly’ increasing its sales guidance by $100 million, we can easily see the rise of Teladoc during COVID-19 and why its stock price has performed so well:

• 60% of Teladoc’s visits in Q1 were from new users from mainly younger demographics.
• Patients using Teladoc don’t have any insurance co-pays right now, and this contributed to the adoption of Teladoc’s platform
• During the pandemic, Medicare adopted widespread use of telehealth for its beneficiaries and announced its intention to reimburse telehealth services at the same rates as in-office services. This action was a huge win for telehealth.
• If outcomes are good, Medicare could continue to reimburse telehealth at the same rates post-pandemic.

The largest question remaining is whether Teladoc can pivot this short-term growth and black swan event in healthcare into a long term, structural change in healthcare demand.

Challenges ahead for Teladoc.

Despite all of the good news, Teladoc still faces challenges ahead:

• Will health insurers continue to reimburse virtual visits at the same rates as in-office visits?
• Will patients still seek out telemedicine rather than in-office visits after the pandemic, and can Teladoc convert those first-time patients into recurring patients?
• Will the pandemic solidify telehealth as an integral part of the healthcare delivery system?

The rise of Teladoc during COVID-19 was no mistake. The telehealth giant benefited greatly from the global pandemic and the required responses from local, state, and federal governments.

• Whether this success continues in a post-COVID environment will be interesting to watch as the company continues to execute on its healthcare delivery strategy.

The post the meteoric rise of Teladoc during covid-19 appeared first on The Healthy Muse.

• The American Hospital Association (AHA) published a report this week estimating that hospitals and health systems would lose about $202 billion over 4 months, mainly related to the cost of caring for COVID-19 patients and suspension of elective procedures.

Net that against the emergency healthcare funding of ~$175 billion, and you can spot the $27 billion difference hospitals might need just to break even over the coming months, according to the AHA.

The biggest ways hospitals are losing money during the pandemic.

Over the four months from March 1, 2020 to June 30, 2020, the AHA estimates that hospitals could lose out on the following:

• Suspension of elective procedures: $161 billion loss
• COVID-19 hospitalizations: $37 billion loss
• PPE shortages and front-line employee support: $4 billion

The AHA analysis did not provide estimates for any losses beyond the four-month period described above.

• Furthermore, the AHA was unable to estimate certain other costs, like drug shortages, non-PPE equipment, and other capital costs.
  • It’s likely that hospital losses are even higher than what’s seen in the graphic above.
  • If COVID-19 continues beyond June 30, these losses will probably get worse as the $175 billion in emergency healthcare funding support dries up.

It’s not just hospitals, either: physician practices, like most other outpatient healthcare settings, experienced 30% to 75% patient volume declines during the Great Lockdown. This loss of volume is consistent across the board.

• You can see this effect in the April jobs report, too. Healthcare lost 1.4 million jobs almost entirely in outpatient settings.

In summary, even with the government reimbursing COVID-19 cases at 20% above normal rates and the $175 billion in extra funding, hospitals are losing out because of the suspension of elective procedures, which is a broad term to describe any medical procedure that isn’t emergent – AKA, immediately necessary.

• For instance, organ transplants were considered ‘elective’ under this definition. Wild.

“I think a lot of what’s being deferred are things like cardiac procedures, pens and pacemakers, cardiac cats, surgeries like oncology surgery, neurosurgery, heavy-duty orthopedics…And I think generally, I would have described those procedures as not very deferrable…I think our perspective is that most of those procedures will wind up getting done.”

UHS Q1 2020 Earnings Call

Here’s what the public hospital operators had to say about the current hospital environment:

Most public hospital operators reported strong volumes prior to COVID lockdowns (March 15).

• After lockdown began, all hospital operators pulled their guidance for the fiscal year 2020 and expect a big downturn in Q2 related to the pandemic and the suspension of elective procedures.

Now, all operators are in cost reduction and capital-preserving mode.

• Operators suspended buybacks and dividend payments and canceled any non-urgent capital projects like the construction of new facilities.
• Operators have received various amounts of CARES Act funding from the government’s emergency bailout pool. Here’s a breakdown.

Most of the operators reported 50% to 60% volume declines in admissions, patient days, ER visits, outpatient visits, and outpatient surgeries in April. A small silver lining: they noted that the declines ‘stabilized’ after Easter weekend.

With states reopening, hospital operators are optimistic that patient visits and the pent-up demand for elective surgeries will return. As Tenet noted below, some ‘elective’ surgeries are more urgent than others.

“If you look at which procedures are actually coming back more quickly, it’s actually probably the higher complexity cases in the area of spine, total joint, general surgery, some of those things that have been delayed but are certainly necessary to get done as soon as possible in order to avoid more complications later.

The types of procedures that are coming back a little bit more slowly are in the areas of GI and pain, ENT. That’s probably how I would differentiate between the specialties coming back more quickly than the ones that are a little bit slower to come back.

But generally speaking, as I alluded to earlier, we are seeing the demand kind of begin to improve significantly across all specialties but, of course, some are coming back a little faster than others.”

Tenet Q1 2020 Earnings Call

Questions left unanswered: will healthcare demand return?

With states beginning to lift the moratorium on elective procedures, Hospitals and health systems are hoping that patients feel comfortable in coming back to their facilities despite the current environment.

“We expect to bring on capacity in a conservative manner as markets allow and in the most efficient way possible during the reboot. At this point, we believe the reboot phase will be accomplished across most of the company by the end of the second quarter.”

HCA Q1 2020 Earnings Call

There’s no doubt that the pandemic caused a short-term shift in demand within the healthcare landscape.

• More people than ever are adopting telemedicine out of necessity.
• Nobody is getting surgery, using imaging services, or receiving physical therapy.
• Unemployment is rising. While furloughed individuals are still on the employer’s health insurance plans, we may eventually see a rise in the Medicaid and uninsured populations.
  • This would have a negative effect on provider reimbursement

So,will there be structural changes in healthcare?

The shift to outpatient care settings in the healthcare industry has mostly been a positive for both patients (cost and convenience) and health systems (revenue diversification).

While the current global pandemic has affected these operations drastically, in all likelihood these effects are short-term with limited structural changes in consumer behavior.

• Maybe some regulatory changes will stick.
• Perhaps more individuals will seek out telemedicine instead of seeing a physician in-office.
• The uninsured and Medicaid population may expand due to unemployment.

HCA isn’t so sure about structural demand changes, either:

“When we think about [structural changes to revenue], we’re thinking about the demand side of the equation and the supply side of the equation.

And on the demand side, we’re trying to judge, fundamentally, has there been a demand curve shift as a result of COVID-19. By that, we mean — have income levels dropped because of unemployment and uninsured that starts to influence buying patterns and health care services demand, do patient preferences with respect to concerns about COVID-19 caused patients to avoid the health system, has telemedicine structurally changed certain buying patterns.

We don’t have a sense of that yet, but those are variables that we’re trying to understand.”

HCA Q1 2020 Earnings Call

Overall, it would generally make sense for healthcare to return to normalcy once the pandemic gets under control.

The post how hospitals are losing billions during the pandemic appeared first on The Healthy Muse.

The most important stories to know in order to follow the coronavirus timeline.

It’s no surprise that there have been plenty of news headlines since the coronavirus timeline began.

Here at the Healthy Muse, we stick to the facts and spot the high-level trends happening rather than read all of the fearmongering and sensationalized stories out there.

If you want a healthcare newsletter that sticks to the facts, is non-partisan, and gives you healthcare news, trends, and analysis in a 5-minute read, then give us a try by subscribing here.

For that reason, I made this coronavirus timeline that follows most of the pandemic period – from the end of January to today (May 4).

Here are the coronavirus timeline’s biggest stories and things you should know:

January 27, 2020: we know where this is headed.

While last week the number of infected was sitting at 650 worldwide, the total reported cases was about 2,800. A majority of these infections occurred in Wuhan.

40 total cases have been spotted outside of China – 5 officially reported within the U.S.

The markets sold off Monday as fears spread about a potential epidemic. Companies like Disney, Starbucks, and McDonald’s are suspending their operations during what is normally a higher level of consumer spending activity in China with Lunar New Year celebrations. Here’s more info from Axios on the potential economic impact of the virus.

Officials have criticized China’s response to the outbreak, blaming the regime’s tendency for censorship while the virus spreads.

The virus is highly contagious and has a somewhat high mortality rate. Companies like J&J and Moderna are working on a vaccine, but it could take up to a year to bring it to market.

With all of this news coverage, I can’t help but think we’re all just playing the popular video game Pandemic – which, ironically, saw a spike in sales over the weekend.

WHO: The coronavirus is not yet a global emergency.

February 3, 2020: a public health emergency.

Airlines are halting flights to China, Chinese markets are selling off, and most companies and institutions in the U.S. are erring on the side of caution, the WSJ reports.

Axios is covering the number of infected with a live updating article. (over 17,000 infected, mainly in China). Earlier in the week, the U.S. didn’t think it was a big deal. The WHO disagreed, calling it a public health emergency. Then that Friday, the U.S. went ahead and declared the same.

There were 7,000 people stuck on a cruise in Italy because of it.

Johnson & Johnson says they’ve already started development on a coronavirus vaccine. After a rough couple of years in the spotlight for the wrong reasons, I’m sure J&J is looking for ways to make up some goodwill. Other biotechs like Gilead and GlaxoSmithKline are jumping on the coronavirus train too.

The virus might affect the global biopharma supply chain, since a lot of drugs and ingredients are produced in China.

Artificial Intelligence is actually being put to very practical use in predicting the global spread of the virus. In fact, an algorithm detected the outbreak a week before the CDC.

February 10, 2020: China’s healthcare system hits its breaking point.

As of February 10, the number of infected was ~41k and reported deaths at ~1k.

China built a hospital in 10 days. The first American died from the virus in Wuhan over this weekend. And here’s a feature piece from the WSJ on a Chinese healthcare system past the brink with the Coronavirus in full force.

Meanwhile, an AI simulation model is predicting that the Coronavirus will infect 2.5 billion people.

February 17, 2020: spreading to South Korea and Italy.

COVID-19 infections were confirmed in Italy and South Korea.

The DOW plunged 3.5%, its worst day in 2 years.

The White House asked Congress for billions in funding to combat COVID-19.

February 24, 2020: Chinese infections decline.

Chinese infections have started to decline, but experts think the cases are just hard to spot.

The WHO releases a statement that the ability to contain the coronavirus outbreak has decreased significantly.

March 2, 2020: Summer Olympics cancelled?

The White House is requesting more emergency funding.

The coronavirus might affect the summer Olympics in Japan. And the CDC is bracing for a U.S. outbreak that might lead to medical supply shortages.

March 9, 2020: cancellations everywhere

Conferences like HIMSS and SXSW are getting canceled. Airlines are cutting flights. South Korea is a coronavirus testing machine.

The U.S. funded an $8 billion emergency package, part of which lifts Medicare’s restrictions on telehealth. On that note, Teladoc’s stock is surging on the prospects of virtual care.

Biotech firms are tapping into (WSJ paywall) A.I. to speed up drug development. A mass-produced vaccine/drug will still take 18 months to get here. Meanwhile, stocks are tanking across the globe.

March 16, 2020: officially a pandemic.

Things have developed quickly. It’s officially a pandemic. Retail closures, restaurant closures, and a ban on events with over 50 people.

COVID-19 will push back the interoperability timeline.

Health insurers are expected to experience moderately elevated medical loss ratios.

March 23, 2020: a possible treatment?

The coronavirus officially enters all 50 states.

New York becomes the global epicenter of the pandemic.

Hydroxychloroquine and chloroquine, old drugs used for malaria treatment, have shown limited promise in treating coronavirus.

March 30: 2020: an unprecedented $2.3 trillion stimulus in the CARES Act.

Good news: Abbott Labs just developed a portable, 5-minute coronavirus test.

The coronavirus peak is expected in mid-April.

Learn more from the WSJ (should be free – no paywall) about how the coronavirus attacks the body.

The White House just extended its social distancing guidelines until April 30. Previously, Trump was considering an enforceable quarantine on the broader New York area, including parts of New Jersey and Connecticut.

Johnson & Johnson is looking to begin clinical trials on humans for its COVID vaccine as soon as September

Someone is always looking to make a quick buck: Trump had to sign an executive order preventing price gouging and hoarding of medical supplies.

The first federal inmate died from coronavirus.

Congress passed the CARES Act, the largest fiscal stimulus in the history of the U.S. Here’s what’s inside:

The FDA will allow doctors to treat critically ill coronavirus patients with blood from survivors.

A shortage of protective gear is stalling CVS’ drive thru testing rollouts.

A consortium of 15 medical and tech firms formed a COVID-19 alliance, aimed at #FlatteningtheCurve

Amid mounting shortage, 5 facts about the nation’s stockpile of emergency medical supplies

ICU Bed capacity, similar to acute care hospital bed capacity, varies widely nationwide.

Payors like Aetna are beginning to waive cost-sharing requirements for patients related to COVID-19 as a gesture of goodwill.

How health systems are responding as COVID-19 squeezes the medical supply chain

Fauci says US needs to be prepared for coronavirus to be cyclical

Shuttered hospitals are re-opening across the U.S. solely for coronavirus cases.

Medtronic is publishing its ventilator’s design specs to the public so that more production can ramp up quickly.

April 6, 2020: military measures.

As of April 6, 2020 – 1,290,896 confirmed cases and 70,653 deaths from the coronavirus

A live look at the U.S. COVID-19 situation – by county

Trump invoked the Defense Production Act to increase ventilator manufacturing. The administration is making sure the federal government is first in line to receive crucial medical supplies by invoking the act.

Hospitals are facing shortages of critical supplies, according to a watchdog report – to the point that states and counties are squabbling and outbidding each other over supply needs.

The CDC recommends face masks for everyone.

Molina Healthcare is expanding Teladoc services to all of its members. As we’ve mentioned, Teladoc has been a huge winner in all of this.

April 13, 2020: an end in sight?

Everyone is starting to wonder when the economy will re-open. With the improving condition in New York and the effective social distancing measures, state governors across the nation are discussing when to open things back up, something Trump says he only has the power to do.

In any scenario, the economy is expected to re-open slowly.

Officials are mulling over the idea of tracing people’s contact with one another via blue tooth in people’s cellphones in order to combat virus spread.

While proponents of privacy are sure to riot, a short term national surveillance system may end up being the best way to re-open economic activity.

Social distancing is working and is reducing deaths – by a LOT.

Thousands of tests are going unused in labs.

The best hopes for a coronavirus drug.

Government payments to healthcare providers are starting to flow, mainly with hospitals. HHS is using UnitedHealth, AKA health insurance giant Numero Uno, to distribute $30 billion in relief funding to hospitals.

April 20, 2020: a re-opening plan emerges.

We’re re-opening the economy – slowly – and states will get to choose how and when that’s done. They’ll use the White House’s 3-phase approach as a guide.

Antibody and other lab testing availability will be key. If you read anything healthcare related this week, read this piece from Stat. They’ve been at the forefront of reporting re: everything coronavirus. Second, read this piece from the WSJ.

More bailout $$$ is on the way for small businesses and hospitals.

The CDC is releasing a clinical reporting tool in May.

Gilead’s antiviral drug treatment Remdesivir is showing cautiously optimistic results.

Trump halted funding for the World Health Organization pending investigation.

New projected COVID-19 peaks by state.

Contamination at the main CDC lab in Atlanta delayed tests for weeks, according to the NY Times.

More bailout cash is coming for small businesses – $450 billion in total, $300 billion of which is slated for the paycheck protection program.

Notably for healthcare, another $75 billion in bailout $$$ is coming to hospitals on top of the $100 billion fund already approved in the CARES Act. The news comes days after the American Hospital Association asked Congress – specifically the House – for more hospital funding.

Total healthcare emergency funding now sits at $175 billion and is getting split up as follows:

About that CARES Act money… CMS is distributing another round of $30 billion to hospitals. $20 billion will be based on each hospitals’ proportion of total revenue received from private insurers and Medicaid. Then, the remaining $10 billion will be dispersed based on coronavirus need – i.e., addressing “hot spots,” or hospitals with large numbers of coronavirus patients.

In an interesting twist, private equity owned physician practices were shut out of the CARES Act bailout funds.

Remember: The first round of funding was distributed based on hospitals’ historical shares of Medicare revenue, which drew some backlash.

We might have to sacrifice some temporary privacy and personal freedom in order to track infections. Here’s one way to balance the two.

CMS just provided guidance for resuming elective procedures. It’ll depend on the availability of personal protective equipment and declines in COVID cases.

Antibody treatments may be the best hope against the virus until a vaccine.

Americans rally to protest social distancing

April 27, 2020: antibody testing rolls out, and Remdesivir the silver bullet?

As of April 27: 993,852 infected in the U.S. and 56,009 deaths (Live Tracker) (Global Tracker). The CDC just updated COVID-19’s list of possible symptoms with 6 more ailments.

Certain states like Georgia and Tennessee are easing coronavirus restrictions, opening up restaurants and retail stores – and notably for healthcare, elective procedures.

Testing, a crucial component of re-opening, is increasing. Slowly.

Antibody testing in places like New York indicate that a lot more people have had the coronavirus than previously thought (which implies a lower death rate).

Hydroxychloroquine probably doesn’t work. Remdesivir, an antiviral drug made by pharma giant Gilead, might work? Here are some other drugs and treatments that could help, too. And what about a common heartburn drug?

The WHO is warning that the pandemic is far from over and causing shortages in OTHER vaccines.

New York state’s health department is mapping the coronavirus genome.

There’s no end in sight to coronavirus-related stimulus spending.

Despite allegations that HHS secretary Alex Azar was getting the boot, Trump says Azar is staying.

A $46.5 billion plan pitched for COVID-19 tracing – with primary care physicians at the center of it.

A detailed guide for state and local governments to consult before re-opening anything.

May 4, 2020: infections level off while states re-open. Also, ‘Operation Warp Speed.’

This week, Quest, Labcorp, and other laboratory testing providers began rolling out direct-to-consumer antibody tests, which tell you whether or not you’ve had the ‘Rona.

In addition, CVS is continuing its swab-testing rollout to 1,000 locations. Walgreens has drive-thru testing in 49 states.

And Rite Aid is expanding its testing in a partnership with Verily, a healthcare startup backed by Google.

While current testing capacity sits at an estimated 2 million tests per week, public-health doctors are estimating that total testing must be around 4 million per week in order to appropriately capture all of the coronavirus cases and prevent further spread.

Fun fact: the government has renamed the vaccine development project to ‘Operation Warp Speed.‘ Their goal is to have 300 million vaccine dosages ready by January by combining both private (biotech companies) and public resources (military and government agencies).

How the coronavirus mutates and spreads. (NY Times)

The FDA is cracking down on fraudulent antibody testing (scumbags…) – (WSJ)

Medical diagnostic testing and cancer screenings have plummeted during the pandemic – leading many worried about future health outcomes

Apple and Google released a first look at the COVID-19 digital tracing API. Take a closer look at how it works here.

Thanks for reading my version of the coronavirus timeline. I’m out. @B_Madden4

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The Healthy Muse was created to educate people on the healthcare system. It’s a once-weekly e-mail updating you on all the major election news, broader trends, big stories, and policy updates. Learn more about our vision here.

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A summary of Joe Biden’s healthcare plan.

general healthcare ideas.

Institute a public option along with expanding the ACA. Provide a middle class premium tax credit. End surprise billing. Keep healthcare providers from consolidating market power. Use CMS to directly negotiate with drug companies on pricing. Implement a wide variety of other drug regulation to combat rising costs. Lower the Medicare eligibility age to 60.

health insurance reform: a public option, and expanding Obamacare.

Expand the ACA/Medicaid with more government funding. Make premium subsidies available to more families. Use the public option to offer premium-free healthcare to Medicaid recipients not covered under their respective state’s plan. Cap premium costs at 8.5% of income.

prescription drug prices.

Allow the federal government to directly negotiate with drug companies on how much they should pay. Limit launch prices for drugs that face no competition and peg prices to an international drug pricing model. Cap drug price inflation to the standard U.S. inflation rate. Allow drug importation. Improve the supply of generic drugs.

surprise billing.

Prevent providers from charging out-of-network rates for true emergencies, when a patient has no choice over which provider cares for them.

Get educated for the upcoming election.

Visit our healthcare 2020 election HUB to learn more about healthcare policy lingo, issues to know, and other candidates’ healthcare policies and viewpoints.

Save yourself some time by subscribing to our all-in-one newsletter. It’s a once-weekly e-mail that gets you caught up on everything healthcare – policy, election news, business, and more.

About the Healthy Muse.

The Healthy Muse was created to educate people on the healthcare system. It’s one weekly e-mail updating you on all the major election news, broader trends, big stories, and policy updates. Learn more about our vision here.

Get smarter and sign up today.

The post Understanding Joe Biden’s healthcare plan appeared first on The Healthy Muse.

Healthcare emergency funding distribution.

The latest round of stimulus funding includes $75 billion more in healthcare bailout money, which brings total funding to $175 billion.

Here’s where all the emergency healthcare funding has gone so far:

• Phase 1: $30 billion to hospitals based on historical Medicare fee-for-service revenue
• Phase 2: $20 billion to hospitals based on 2018 total net patient revenue. $10 billion for pandemic hot spots, $10 billion for rural health providers, and $400 million for the Indian Health Services
• Yet to be distributed: $105(ish) billion.

Other healthcare emergency funding things to know.

With this new $75 billion increase in bailout money, CMS is now suspending its accelerated payment program to providers.

• On another interesting note, rural hospitals are now eligible for small business loans after worries of being ‘crowded out’ of bailout funding.

More: Which hospitals have received bailout funds, and how much? Also, some of the CARES act funding went to closed hospitals, according to ModernHealthcare.

The post Visualizing the distribution of healthcare emergency funding during COVID-19 appeared first on The Healthy Muse.