Taking stock in heart docs

The ideas and innovators shaping health care
May 25, 2023 View in browser
 
Future Pulse

By Erin Schumaker and Ben Leonard

FOLLOW THE MONEY

NEW YORK - SEPTEMBER 5:  A nurse prints out an EKG monitor reading in the emergency room at Coney Island Hospital September 5, 2002 in the Brooklyn borough of New York City. The public hospital serves a large multi-ethnic patient population including many Russians, Pakistanis and Central Americans residing in the South Brooklyn area. The emergency room receives approximately 60,000 patients each year. (Photo by Mario   Tama/Getty Images)

If you can read an EKG machine, private equity may be interested in you. | Getty Images

Private equity investors are bullish on cardiology, a new report from PitchBook, the Seattle firm that tracks market data, says.

That’s a change. While private equity firms have long invested in health care, with 1 in 10 investment dollars flowing into the sector, cardiology hasn’t been a big recipient.

Why now? Technological advancement has allowed surgeons to perform more cardiovascular procedures in outpatient settings instead of in hospitals.

In 2020, the Centers for Medicare and Medicaid Services added percutaneous coronary interventions — a nonsurgical procedure used to treat blocked arteries, or coronary artery blockages — to a list of covered procedures at ambulatory surgery centers.

The change enabled centers to perform enough procedures to cover overhead costs, which piqued investor interest.

By the numbers: Compared with other specialties like dermatology or dentistry, cardiology has relatively few independent practitioner groups.

That might seem like a downside for investors. But Rebecca Springer, the report’s author and PitchBook senior health care analyst, told Erin that scarcity can fuel investor interest. “There aren’t that many assets out there, so if you want to make a cardiology play, you have to move now and pay up in order to do so,” she said.

Why it matters: Heart problems are prevalent. Twenty million adults in the U.S. ages 20 and older have coronary artery disease, and at least 660,000 people die of heart disease each year, according to the Centers for Disease Control and Prevention.

Heart disease costs the country about $219 billion, the CDC says, and those costs are likely to rise as the population ages.

If you can’t beat ’em: Health systems, under financial strain from rising costs and the pandemic, worry about losing revenue, Springer said.

One potential model for health systems: A joint venture with an investor and a doctors’ group. “There’s a lot of discussion in that space around how to get out ahead of this,” she said.

 

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TECH MAZE

a bar graph showing a decline in venture capital investment in digital health companies

After heating up during the pandemic, funding for digital health firms focused on services like telemedicine and remote monitoring has plummeted.

And it hasn’t hit bottom yet.

A new report from market research firm CB Insights found that U.S. digital health funding dropped to its lowest level since the third quarter of 2019 at $2.3 billion in the first quarter of 2023.

After peaking at $9.3 billion in the final quarter of 2021, funding has taken a nosedive, declining every quarter. And the trend in the U.S. tracks the direction of global investment.

The 198 U.S. deals reached in the first quarter were also the fewest in the past four-plus years, as were the three deals of $100 million or more reached between Jan. 1 and March 31 globally. For context, 42 such deals were made in the second quarter of 2021.

What’s happening? Venture capitalists are pulling back because of recession fears and rising interest rates.

The fallout: Layoffs have plagued the sector, and startups are struggling to stay in business.

For the public, it could mean fewer innovative products and services coming to market.

Quick fix? There is none and there’s little Washington can do about it.

Congress’ extension of eased Medicare telehealth rules through 2024 has helped a bit, but the Covid public health emergency’s end this month has also brought regulations curtailing growth in remote patient monitoring.

The Federal Reserve has continued to raise interest rates to drive down inflation, meaning the hard times will likely continue.

 

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WASHINGTON WATCH

A drug user fills a syringe from a bottle cap.

The magnitude of the fentanyl problem is forging unlikely alliances on Capitol Hill. | Spencer Platt/Getty Images

Before the House voted Thursday on legislation to boost mandatory minimum sentences for distributors of street versions of fentanyl, Energy and Commerce ranking member Frank Pallone (D-N.J.) condemned the measure.

Pallone called it a “partisan distraction” from the hard work needed to combat opioid addiction, and said its increased mandatory penalties for fentanyl distributors would “disproportionately impact communities of color.”

But when the roll was called, 74 Democrats, including progressives and Hispanic and Black representatives joined Republicans in passing it.

Why it matters: The vote’s an indication of how the seriousness of the fentanyl problem – the Centers for Disease Control and Prevention says it was responsible for the majority of more-than-100,000 fatal drug overdoses in the U.S. last year – has made it difficult for members to vote against measures aimed at curtailing it.

Among the Democrats in favor were Rosa DeLauro of Connecticut, the ranking member of the House Appropriations Committee, Sanford Bishop and David Scott of Georgia, Steven Horsford of Nevada and Ruben Gallego of Arizona.

President Joe Biden cleared the way for them when he all but endorsed the legislation in a statement Monday.

What’s in the bill? In addition to increasing penalties for distributors, the HALT Fentanyl Act would make permanent the temporary scheduling of street versions of fentanyl under Schedule 1, which covers substances with no currently accepted medical use and high potential for abuse. It would also bolster research into the drug.

What’s next? A Senate version of the bill sponsored by HELP Committee ranking member Bill Cassidy (R-La.) is unlikely to pass the Democratic-controlled chamber since most Democrats oppose it.

 

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