New $100M fund to invest in pre-revenue medical device and digital health startups

New $100M fund to invest in pre-revenue medical device and digital health startups

Photo: Abscent84, Getty Images

Accelmed, a group of funds that invests in health tech companies, announced Monday that it is launching a new, nearly $100 million fund to invest in early-stage, pre-revenue medical devices and digital health startups in Israel and around the world.

This is the fourth fund launched by Accelmed, which currently manages more than $300 million. The new fund will be led by Dr. Irit Yaniv and Amir Blatt, both partners at Accelmed. Dr. Yaniv said that the fund will help to alleviate the problem that device entrepreneurs face in raising capital for their novel devices, in a news release. Blatt said that the fund will invest in device companies “in advanced clinical trials, nearing FDA approval, and after first-in-human trials” whereas in digital health, the fund will invest in “companies in initial commercialization stages in the US, be it with hospitals or insurers.”

The fund expects to make an average investment of $8 million to $10 million per startup, including follow-on investments.

Accelmed comprises of two entities:

  • Accelmed Partners – a U.S. -based private equity fund focused on health tech that does buyout and growth investments in commercial-stage companies.

  • Accelmed Ventures – an Israel based venture fund that invests in pre-commercialization health tech companies.

Since Aceelmed’s founding in 2009 by Dr. Uri Geiger, founder and managing partner and Mori Arkin, it has funded about 20 healthtech companies, of which several have been acquired.

These include Edge Medical Devices that was sold in 2011 to Claymount, which was then acquired by Varian Medical Systems; NLT Spine was sold to Seaspine Holdings in 2016; and MCS (Medical Compression Systems) was sold to Zimmer Biomet in 2017.

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Source: New $100M fund to invest in pre-revenue medical device and digital health startups

Grail validation data show highly accurate detection of cancers, tissues of origin

Grail validation data show highly accurate detection of cancers, tissues of origin

Photo: harmpeti, Getty Images

A test in development for early detection of cancers was able to pick up a dozen of the deadliest cancer types at stages I-IV with a high degree of accuracy while also determining where the tumor was located, according to validation data announced Monday.

Menlo Park, California-based Grail said an analysis from its Circulating Cell-Free Genome Atlas, or CCGA study, showed that its early detection test could pick up more than 20 total cancer types with a low false-positive rate. Data from the analysis will be presented at the American Society of Clinical Oncology Breakthrough conference, which takes place in Bangkok from Friday through Sunday.

“Today, cancer remains the second leading cause of death worldwide, and we believe an effective multi-cancer early detection technology has the potential to transform the cancer care landscape,” Grail CEO Hans Bishop said in a statement.

The data set included 927 participants from the CCGA, including 654 who had cancer and 273 who did not, as well as 337 participants without cancer from the STRIVE study. The data showed a high degree of specificity, 99.3 percent, meaning there was a low false-positive rate. When looking at 12 deadly cancer types – anal, bladder, colorectal, esophageal, head and neck, liver/bile duct, lung, lymphoma, ovarian, pancreatic, plasma cell neoplasm and gastric – the detection rate was 76 percent, with a 99.3 percent specificity. Detection rates between stages I and IV were 39-92 percent. For those cancers, the tissue of origin – which helps to accurately identify where in the body a cancer originates – was provided for 97 percent and correctly identified in 93 percent of cases.

Among the more than 20 cancer types, the detection rate was 55 percent, ranging from 18-93 percent depending on stage and with the tissue of origin correctly identified in 93 percent of cases.

Minimizing false positive rates is a crucial aspect of the kind of early cancer detection system Grail is developing, with even seemingly small false positive rates making a significant difference for patients. When it reported data on 2,508 participants in its study at the ASCO annual meeting in June, Grail reported a 99 percent sensitivity rate – corresponding with a 1 percent false positive rate that the company had forecast was likely to go down.

While a false positive rate of 1 percent in a 5,000-patient population is manageable, an interviewed expert at ASCO said, it could become more problematic when the population reaches hundreds of thousands or millions. The danger of a high rate is that it could create problems for the cost effectiveness of early detection, as patients who got false positive results would have to be subjected to several tests afterward.

Source: Grail validation data show highly accurate detection of cancers, tissues of origin

Uber and Lyft are playing larger roles for Medicaid

Uber and Lyft are playing larger roles for Medicaid

Image credit: Shutterstock.com

Arizona Medicaid Director Jami Snyder heard many complaints about enrollees missing medical appointments because the transportation provided by the state didn’t show or came too late.

So this summer she hatched a solution familiar to millions of Americans looking for an efficient ride: She turned to Uber and Lyft.

Arizona became the first state to revamp its Medicaid regulations to make it easier for ride-sharing companies to participate in its nonemergency transportation benefit. Under the changes, Arizona eliminated several safety rules, such as requiring all drivers to undergo drug testing and first aid training.

The strategy has added thousands of vehicles to the fleet serving Arizonans on Medicaid, nearly 24% of the state’s 7 million residents.

“It seemed like an obvious solution,” Snyder said. “So far, our anecdotal reports have been very positive.”

As they seek to lower costs and improve care, Medicaid and other insurers have begun to examine the transportation needs of patients — along with other so-called social determinants of health such as adequate food and housing. Whether states save money remains to be seen.

In 2017, more than 2 million Medicaid enrollees under age 65 ― about 4% of the program’s members — delayed care because they lacked transportation, according to a federal survey.

Lyft is working with about 35 state Medicaid programs or Medicaid managed care organizations, according to LogistiCare, one of the nation’s largest Medicaid transportation brokers. Uber works with Medicaid only in Arizona.

Lawmakers in Florida and Texas this year also relaxed state regulations to make it easier for Uber and Lyft to provide services for appropriate Medicaid patients. That service is expected to begin early next year.

Uber and Lyft can’t handle all Medicaid transportation demands because they generally don’t have enough drivers with cars fit to ferry people with serious disabilities, such as those who use a wheelchair. But Arizona’s Snyder said many Medicaid enrollees are healthy enough to use a typical ride-sharing service.

Van Means, executive director of a company that Arizona pays to arrange transportation for Medicaid enrollees, said the expanded options help even some patients who can’t use them.

“It gives us way more supply, it’s faster and frees up space [in specialized transportation] for people who need more substantial help such as those in wheelchairs,” he said.

In most traditional Medicaid transportation programs, patients need to reserve rides days ahead and then often must share a van. In contrast, the ride-sharing companies need little advance notice and can easily take solo passengers.

To ease the use of Uber and Lyft, states generally waive safety requirements that are standard for more traditional transportation. Those include mandates that drivers undergo drug testing and learn first aid and CPR. State officials said such mandates are not necessary since Uber and Lyft serve ambulatory enrollees who likely are in better health than those needing specialized transportation.

The ride-sharing companies already work with hospitals and health systems across the country, but participating in Medicaid could bring them millions of more riders.

Unlike typical Uber or Lyft riders, Medicaid enrollees don’t order rides on their smartphones. Instead, these patients will continue to request transportation services by phone or computer through their health plan or a Medicaid transportation broker.

The Medical Transportation Brokerage of Arizona said about 15% of rides taken by Medicaid recipients this summer relied on Uber and Lyft.

So far, though, Means said the brokerage hasn’t found the service substantially cheaper in most areas of the state.

Arizona officials did not have an estimate of cost savings.

Officials at Atlanta-based LogistiCare said working with Lyft in dozens of cities has added vehicles and helped speed service.

“The ride-sharing companies are cost-effective and for curb-to-curb, urban or suburban short-distance trips,” said Effie Carlson, a LogistiCare executive vice president.

But she cautioned that the companies are not the ideal option for enrollees who need extra time getting in and out of their house because drivers typically leave within five minutes of arriving.

Uber and Lyft are often cheaper than using taxis or other private transportation companies, but not always. She noted that when companies raise prices during peak-traffic hours, alternatives may be less expensive.

Carlson said her company decides whether ride-sharing services or more traditional transportation is most appropriate based on the health information provided about each Medicaid enrollee.

The Medicaid transportation benefit varies by state but typically includes rides by taxi services, wheelchair vans, private vehicles, and public transportation. Enrollees are eligible for the services if they do not have another means of transport.

Despite states’ growing interest in expanding transportation options, a University of Pennsylvania study, published last year in JAMA Internal Medicine, found providing ride-sharing services did not improve the no-show rate for primary care appointments among Medicaid patients in West Philadelphia. The no-show rate among patients offered free rides was 36.5%, compared with 36.7% for those who weren’t offered free rides.

Krisda Chaiyachati, co-author of the study and a University of Pennsylvania associate professor of medicine, said reliability of transportation is not the only factor determining whether Medicaid enrollees show for medical appointments. “People on Medicaid tend to live more chaotic lives, so they may be more OK with missing primary care appointments,” he said, referring to how low-income people often fear missing work, or have difficulties arranging childcare and other necessities.

Still, Chaiyachati envisions Uber and Lyft playing larger roles for Medicaid.

“Their cars can be everywhere, and having a dispatcher draw upon that network is a no-brainer,” he said. “It may not solve the transportation needs for everybody, but it’s certainly an answer for many.”

Megan Callahan, vice president of health care at Lyft, said she expects more states to adopt ride-sharing.

“I think what we are seeing is the beginning of a domino effect,” she said. “Our overall driver availability and speed are the big advantages that will have an impact on Medicaid members’ satisfaction.”

Uber officials said in about dozen cities they are developing a fleet of drivers trained to work with patients who must travel with fold-up wheelchairs, walkers and scooters.

“From a cost standpoint, we can save states significant dollars,” said Dan Trigub, head of Uber Health.

Phil Galewitz is a senior correspondent, Kaiser Health News.

Source: Uber and Lyft are playing larger roles for Medicaid

Printing Custom Flexible Electronics Directly Onto Skin, Bandages, Medical Devices

Printing Custom Flexible Electronics Directly Onto Skin, Bandages, Medical Devices

Flexible electronics have the potential to help monitor, and even modulate, a number of physiological parameters. While stick-on heart monitors can be manufactured as one-size-fits-all, in applications such as electronic bandages that can monitor and treat a wound, it’s best to be able to create custom devices that suit each patient’s needs.

Currently, making flexible electronics requires harsh processing, including chemical baths, hardening processes, and high temperature baking to purify the materials being used. Now, researchers at Duke University have come up with a way to directly print functional flexible electronics directly onto the skin, paper, bandages, and other flexible and moving devices. The capability may allow clinicians to print diagnostic and therapeutic devices right onto patients or onto bespoke medical tools.

“When people hear the term ‘printed electronics,’ the expectation is that a person loads a substrate and the designs for an electronic circuit into a printer and, some reasonable time later, removes a fully functional electronic circuit,” said Aaron Franklin, one of the lead researchers, in a Duke press release. “Over the years there have been a slew of research papers promising these kinds of ‘fully printed electronics,’ but the reality is that the process actually involves taking the sample out multiple times to bake it, wash it or spin-coat materials onto it,” Franklin said. “Ours is the first where the reality matches the public perception.”

The capability is possible thanks to two new advances. One is a new silver nanowire conductive ink. It can be printed at low temperatures and doesn’t need additional processing. It maintains conductivity even after it is bent back and forth thousands of times. The other advancement is to use the same ink along with carbon nanotubes to create electronic transistors directly on a surface, which also does not involve any harsh processing. The silver nanowire ink and new transistors provide the main components of an electronic system.

Related studies: Silver nanowire inks for direct-write electronic tattoo applications and Flexible, Print-in-Place 1D–2D Thin-Film Transistors Using Aerosol Jet Printing

Flashbacks: New Method for Integrating Flexible Electronics Into Skin Patches; New Type of Flexible Electronics Turns Soft When Implanted Into Body; Breathable, Flexible Electronics Allow Long Term On-Skin Health Monitoring; Building Flexible Electronics from Scratch Using 3D Printers

Via: Duke University

TrendMD v2.4.6

Source: Printing Custom Flexible Electronics Directly Onto Skin, Bandages, Medical Devices

Analysis: Impact of CVS, Walgreens, Walmart Retail Healthcare Expansion Strategies

Analysis: Impact of CVS, Walgreens, Walmart Retail Healthcare Expansion Strategies

– Recently, Walmart, CVS, and Walgreens have all announced their intent to invest in healthcare. Placer.ai, an advanced foot traffic analytics platform, analyzed their data to take the temperature of those efforts.

– Walgreens experiences an even greater reliance on evening hour visits than CVS. Analyzing the period from January 2017 through August 2019, Walgreens saw 27.6% of visits come between the hours of 6 pm to 12 am.

– While these moves may give a tremendous amount of hope to both brands, Walmart, the king of offline retail, is a significant threat looming on the horizon. 

– The move into health services could provide a major boon for CVS, Walgreens, and Walmart, adding new revenue streams and increasing core retail metrics like visit duration and repeat visits.

One of the critical themes that will determine offline retail success in the coming years will be the capacity to maximize physical locations. That will obviously place a huge emphasis on site selections, store formats, localized approaches to store stocking and more. But an important piece of this puzzle will center around the ability to take full advantage of each space with added services. Whether it be classes in a Lululemon or a meal at a Crate & Barrel, the change is coming.

And no sector is experiencing this shift with greater force and focus than Health. In recent months, Walmart, CVS, and Walgreens have all made significant announcements regarding their intention to dive more deeply into Health services.

We dove into the data to analyze the potential impact.

The Opportunity

When CVS announced the expansion of their Health Hubs, the first place to look was the potential value of pilot sites in Texas. Unsurprisingly, the locations showed a unique ability to extend visit durations, and to bring visitors during beneficial off-peak time periods. The result is a unique combination of a new revenue source, an ability to expand classic shopping with added visits, and visits that can be scheduled for off-peak hours to maximize the full day.

So to measure success, the locations would be looking to show ‘greater than average’ visit durations and visits during off-peak hours. And this is just what the CVS pilot showed. Two of the pilot sites have shown average visit durations of 42 (red) and 41 (green) minutes respectively. This is is 22.1% higher than the nationwide average for CVS, for the period since the launch of the pilot in February 2019. Looking at the graph below shows how much more dependant the CVS nationwide average is on shorter visits.

Even more, these visit durations amounted to an increase of 7.7% and 10.8% respectively for those specific locations when comparing the period between January 2017 through January 2019, to the time since the pilot was launched.

Why The Wider Trend?

There is always the concern that this is perhaps a CVS-centric benefit that has a unique capacity to support that chain. But, in this case, it looks like Walgreens may have even more to gain. Walgreens (red) sees an even greater reliance on evening hour visits that CVS (blue). Analyzing the period from January 2017 through August 2019, Walgreens saw 27.6% of visits come between the hours of 6 pm and 12 am. While the absolute number of visits may remain stagnant, the ability to drive more morning visits could help increase earning potential.

Beware The Giant

While these moves may give a tremendous amount of hope to both brands, there is a significant threat looming on the horizon – Walmart. Walmart, the king of offline retail, is obviously involved in the trend as well with a specific focus on leveraging its massive retail footprint to get involved in health services. Analyzing the location of one of their first Walmart Health sites shows a location that is already a strong and consistent performer.

Yet, there are already indications that the plan may indeed be working. Analyzing average daily traffic for September 2018 compared with the first 17 days of September 2019 shows an increase of 7.6%. This is a dramatic difference for a brand that already boasts huge daily visitor numbers. However, all this should be taken with needed caution as Walmart spikes can be related to a variety of factors, and not just the launch of a new service. In fact, even a minimal percentage increase could provide tremendous revenue improvements because of the audience size.

Moving Into Health

The move into health services could provide a major boon for CVS, Walgreens, and Walmart, adding new revenue streams and increasing core retail metrics like visit duration and repeat visits. Yet, the move must be seen within a wider context. Offline retailers have recognized that the full value of their physical footprint is not being met and are increasingly searching for new and innovative ways to fill this gap.

The experiential shopping perspective is spreading and more brands are going to ask how to better utilize the offline investment to maximize value.

The analysis originally appeared at  https://blog.placer.ai/2019/09/26/pushing-into-health/and is re-published with permission from Placer.ai, the world’s most advanced foot traffic analytics platform.

TrendMD v2.4.6

Source: Analysis: Impact of CVS, Walgreens, Walmart Retail Healthcare Expansion Strategies

12 myths about homelessness in America

12 myths about homelessness in America

Source: NYU

The realities of homelessness upend many common assumptions about its causes—and potential solutions—an expert argues.

On a single night in January 2018, the US Department of Housing and Urban Development collected nationwide data to determine there are now about 553,000 homeless people across the country—or nearly the same number as the entire the population of Albuquerque, New Mexico.

While that is an improvement on the estimated 647,000 homeless Americans in 2007, it also reflects a lingering inability to solve a four-decade-old national crisis.

What exactly caused the American homeless rate to reach and sustain such heights? Some have cited the shutting of mental hospitals in the 1970s. Others have pointed to the lack of safety nets for military veterans with post-traumatic stress disorder.

Still others have called out urban housing prices and cuts in government subsidies for affordable housing. Blaming the homeless, too, is not uncommon—bad choices, substance abuse, or a preference for life on the street are all popular explanations.

Two-thirds of all homeless are single adults, while families and unaccompanied youths make up the rest. Most “self-resolve,” or exit homelessness within a few days or weeks—in fact, only about 16% are chronically homeless. And while there are 190,000 visible homeless people each night on the street in the United States, many more live in shelters or are otherwise hidden from public view—sleeping in cars, for example.

Most often, people who are most visible, and how the media portray them, drive popular perceptions of why people are homeless.

While well-intended, New York City policies to stem street homelessness can increase rather than reduce alienation because they rarely take into account a homeless person’s individual needs—such as pet ownership, health issues, or difficulties obtaining identification documents, among other, says Deborah K. Padgett, professor at the Silver School of Social Work at New York University and co-principal author of recent study in Evaluation and Program Planning.

Much of Padgett’s work has explored the long-term cost benefit and effectiveness of providing housing and support to homeless individuals up front, without first requiring treatment compliance and drug and alcohol abstinence. This increasingly used approach, known as “Housing First,” originated in New York.

Here Padgett debunks some of the most common homelessness myths:

1. Most are mentally ill

Decades of epidemiological research reveals that one-third, at most, have a serious mental illness. Many initially believed de-institutionalization or closure of mental hospitals a prime cause of homelessness, but this occurred well before the sharp increase in the 1980s.

2. The majority abuse drugs and alcohol

Experts believe only about 20% to 40% of people who are homeless have a substance abuse issue. In fact, abuse is rarely the sole cause of homelessness and more often is a response to it because living on the street puts the person in frequent contact with users and dealers.

3. They’re dangerous and violent

Homeless people are far more likely to be the victims of violence than the perpetrators. Of course, some homeless individuals may commit acts of violence beyond self-defense but such acts rarely affect the non-homeless individuals they encounter. To put it another way, any violence by homeless persons is either self-defense or due to the rare violent perpetrator who preys on other homeless people. Non-homeless need to understand this.

4. They’re criminals

Homeless persons are more likely to have criminal justice intervention. However, this is primarily because many of their daily survival activities are criminalized—meaning they might be given a summons or arrested for minor offenses such as trespassing, littering, or loitering.

5. ‘Bad choices’ led to their homelessness

Everyone makes mistakes, but the descent into homelessness is not necessarily the direct result of “choices.” Far more often a sudden illness or an accident, losing a job, or falling into debt leads to eviction—or doubling up with family or friends becomes untenable.

6. They prefer the freedom of life on the street

There is no evidence to support this notion that homeless persons are “service resistant.” Since “Housing First” began in New York City in 1992 at the nonprofit Pathways to Housing, Inc., it became clear that most homeless people welcome and accept the offer of immediate access to independent housing with support services. People on the street often reject the option of crowded, unsafe shelters—not housing in general.

7. They spend all their money on drugs and alcohol

Interviews with street homeless persons show that most of their money goes to buying food and amenities such as socks, hygiene products, and bottled water. Although some do spend money on alcohol or drugs, the same can be said of anyone.

8. They just need to get a job

A significant portion of homeless people do have jobs—they just cannot afford to pay rent. Some receive disability income due to physical or mental problems but still cannot afford rent. For those wanting to work—a common refrain among those interviewed by my research team—the complications of applying for a job with no address, no clean clothes, no place to shower, and the stigma of being homeless (or having a criminal record), make such individuals far less competitive in the low-wage job market.

9. The homeless are not part of “our community”

Surveys have shown 70% to 80% of homeless persons are from the local area or lived there for a year or longer before becoming unhoused.

10. They live in unsanitary conditions because they don’t care

Living outdoors means having no regular place for bodily functions, to dispose of trash, to store food safely, or to bathe. A homeless person who “cares” has few alternatives. Our research shows that lacking access to a shower is one of the more humiliating aspects of being homeless.

11. The legal “right to shelter” is the best way to end homelessness

Currently, shelter construction and maintenance absorb the vast majority of the $3 billion spent yearly by the City of New York to address homelessness. Meanwhile, building affordable housing—the purview of state and local authorities that is left up to private developers—has not kept pace. Thus the “right to shelter” can, in practice, displace “the right to housing.”

12. In coastal cities with low rental-housing vacancy rates, it is impossible to find enough housing for homeless individuals and families

New York City has a vacancy rate of 3.6%. Of an estimated 2.2 million rental units in the city, this means 79,000 are vacant. This number is greater than the approximately 61,000 people labeled “homeless” in the city. It means that the argument that “we simply do not have enough existing housing” should be examined more closely.

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Source: 12 myths about homelessness in America