Evolent Health LLC

Evolent Health is reportedly in talks with several private equity firms and a health insurer to buy the company after it received unsolicited takeover interest. Evolent Health, a company that offers software solutions to help providers and insurers transition to value-based care, is reportedly in talks for an acquisition after receiving takeover inquiries, Reuters reported on Thursday.The company assumes downside risk for providers and health plans and guarantees savings for the health plan. Evolent’s doctors, nurses and licensed clinical social workers help create clinical pathways and protocols for providers to improve care and optimize spend. Evolent has a market value of about $3.8 billion, the sources said, Reuters reported.Evolent shares jumped more than 18% Thursday after Reuters reported news of the sale interest by private equity firms TPG, KKR and Clayton, Dubilier & Rice (CD&R) and health insurer Elevance. Seeking Alpha predicts that the stock could sell for $35 per share if the sale goes through.Evolent declined to comment on the buyers’ interest or its willingness to sell the company.In 2021, Bloomberg reported that Walgreens Boots Alliance was considering a deal to acquire Evolent. In a note, analysts from Truist Securities highlighted that while Evolent Health has been familiar with M&A conversations, a leveraged buyout (LBO) might be more suitable than a strategic acquisition by a health insurer due to potential conflicts of interest, investing.com reported.Evolent’s Q2 2024 financial results show nearly 40% growth in revenue year over year, but the company lost $6.4 million in Q2, attributable to common shareholders, its earnings report says.The company decreased its full-year revenue outlook for 2024 in its Q2 earnings report.Evolent curates emerging medical literature to provide recommendations to partnering provider organizations about the optimal treatment pathway for conditions like cancer. Evolent also has an accountable care organization for independent primary care providers. Evolent takes on the financial and clinical responsibility for patients’ care, according to the company.If providers follow pre-approved care plans, based on the medical evidence collated by Evolent researchers, providers can get automatic authorization and not have to wait for a prior authorization request. If providers want to deviate from pre-approved plans, they can discuss the evidence with a physician at Evolent. 

Wellth, a digital health startup that offers small financial rewards for completing health-related tasks, is launching a suite of in-app personalized, predictive health features to help control the leading factors affecting chronic health conditions, such as increased blood pressure. Wellth works with insurers, providers and employers to offer an app that reminds users about daily health behaviors, such as taking medications or monitoring blood glucose. When patients take a photo confirming they've completed tasks, they receive small financial incentives. The company includes services for mental health concerns, cardiovascular disease, heart failure, diabetes, cancer, chronic kidney disease and COPD or asthma. Wellth's new features will employ the company's proprietary AI model to offer personalized health alerts when an individual's blood pressure is above the target range set in partnership by the patient and their provider. The California-based company trained its AI datasets on blood pressure readings it has amassed from users' images. The data was then input into the company's AI model, allowing Wellth to provide more personalized insights into a patient's health trends. "Now that we have this stream of millions of pictures of blood pressure readings and we can pull the data off that picture itself, we're starting to look at the trends and how to holistically help each individual member improve outcomes in general, but especially around blood pressure," Matt Loper, cofounder and CEO of Wellth, told MobiHealthNews. "We see what medications they're taking every day. We see how their blood pressures are trending over the course of time and are able to create more precision and personalized suggestions to that individual member based on all these data points that we're seeing across their whole health and care plan adherence." Wellth works closely within the Medicare Advantage and Medicaid spaces, serving both providers that service Medicare members at a stage of acuity where high monitoring is necessary and Medicare Advantage plans to improve cost and quality of care. "Quality scores and Medicare Star Ratings are the primary focus on quality. Blood pressure control is a key metric related to quality Star Ratings," Loper said. "The hope is that as you take these members that are currently at very high risk or have very high blood pressure – they have a higher incidence of heart attacks, edema and strokes and all these bad events that could put them in the hospital – that we're able to get them more adherent to taking their medications, more adherent to tracking their metrics, and therefore can cut down those very high-cost hospitalizations, while also improving the Stars scores and the quality scores." The company plans to expand its AI offerings by releasing blood sugar monitoring and enhanced pill detection features in the future. THE LARGER TREND The update in Wellth's offerings comes a year after the company secured $20 million in a Series B funding round led by SignalFire, with participation from former Evolent Health CEO Frank Williams and previous investors the Social Entrepreneurs’ Fund, CD Venture, Yabeo and the Partnership Fund for NYC. Over the past year, Wellth partnered with Western Massachusetts Health New England, a not-for-profit health plan with commercial, Medicare and Medicaid plans. Gold Coast Health Plan (GCHP), California's Medi-Cal health plan for Ventura County, also announced last year that it would offer its members access to Wellth's offerings. In 2020, Wellth closed a $10 million Series A funding round, and in 2018, the company scored $5.1 million in seed funding. CIO Connect, a HIMSS Professional Development program that aims to prepare aspiring health IT leaders, is accepting applications now through June 2024. Learn more.

Blackbird, a neuroscience-backed hybrid mental health provider for children and young adults, raised $17 million in February in a Series A funding round led by Define Ventures with participation from Frist Cressey Ventures and GreyMatter, bringing its total raise to $23 million. The company's CEO, Tom Peterson, sat down with MobiHealthNews to discuss why he went from initially being an investor to its CEO and how he's now helping scale the platform to impact individuals struggling with mental health issues. MobiHealthNews: Can you tell our readers a bit about Blackbird? Tom Peterson: So, I started a company called Evolent Health with two other people and ran that for ten years, and I left there right at the beginning of COVID, and I have five kids. I also had gone back before Evolent and got a Master's in mental health counseling. So, mental health has always been a big priority of mine. I used that mental health background to help build the clinical model for Evolent, which was really about wrapping care around primary care to move to value-based care arrangements. After leaving Evolent, I was home during COVID with five kids; now they're 23 down to six. Three of my kids had pretty significant issues with the mental health care system around that time and with mental health in general. My oldest, who is now 23, had pretty significant issues with depression, treatment-resistant depression, where she was on three different SSRIs, and, you know, nothing seemed to work. She had bad side effects with each of them. My now eight-year-old was kicked out of three different preschools, and we were worried about whether he would be able to stay in the fourth. We didn't really know what was going on, and later was diagnosed with some autism features, anxiety, some speech-language deficits, and a laundry list of issues. And so my experience with the healthcare system was just a lot of trial and error where we, you know, it just seemed like we weren't getting it right and we were just throwing stuff at the wall. I just felt like the standard of care wasn't really meeting my expectations, and I could afford to pay for the best care and access was not the problem that I was experiencing. So, I went looking for a model that was focused on this problem of long-time stabilization and trial and error and that's when I was introduced to the folks at Blackbird. MHN: Blackbird recently secured $17 million in Series A funding. What will the company do with the funds? Peterson: The money is going to be used in a couple of different ways. Our approach is to build community density with a hybrid clinical model. So we put what we call light local clinics into markets, and a certain amount of our care is delivered out of those clinics, but we do a lot of virtual care around that. Then, we build relationships with community referral sources, such as schools, doctors, and pediatricians in those markets. We're going to be expanding the markets that we're in, and there are dollars that go into the marketing and getting those clinics up and running. We'll be growing largely in the mid-Atlantic states and we use our payer relationships to go from state-to-state. We build strong relationships with payers, and then those payers will kind of take us into the next state. So, the first thing we'll be doing is really using that money to expand into new geographies. But again, doing that in a way that is disciplined and kind of growing in a way that's very based off of this community engagement model versus trying to be in 50 states all at once and running into a challenge with matching supply and demand, which I think a lot of digital health companies have experienced. It also helps us maintain low patient acquisition costs because we're getting a significant portion of our businesses coming from word of mouth in these local communities where we don't have to spend any money on marketing to get them. Secondary is to improve our infrastructure. So, new digital tools, the underlying technology backbone, that we'll be using to scale up our clinical model on workflow tools and enhance our EHR. There's a portion of what we do that is really focused on data because we take data points that we gather about the human across these eight different domains and we use that to identify what we call a biotype, which is sort of clusters of similar types of brain features, and then using that data to then build treatment plans around that biotype to make sure that we're treating that underlying root cause. And so, using that data, you can continue to get smarter about the correlation between the underlying symptoms, the biotypes, the treatment plans and the outcomes. That becomes a flywheel to continue to improve your treatment plans. And so that's an area that we're going to continue to invest in and get better use of that underlying data. Then expanding leadership and GNA [general and administrative expenses] to support our scale would be the third major category. MHN: Is there anything else you want to add? Peterson: The only other thing that I think is important is that we are really working to expand capacity in this space. So, we have residency programs...and it goes from psychiatry to prescribing nurse practitioners to therapists to speech-language pathologists, where we're taking them right out of school and we're putting them through a residency program in our model to build additional capacity. Because ultimately, you know, the shortage is something that has to be addressed, and you can't really address the problem without also addressing the supply issue. So, we think that's an important part as well.