As thousands of doctors’ offices shutter, telehealth becomes a way of life

Virtual healthcare has exploded during the pandemic, while traditional primary care offices have closed at an extraordinary rate. Can telehealth really replace primary care as our health system’s first line of defense?

Like many other physicians, Dr. Sandra Esparza and her husband Ramon closed their 17-year old primary care practice in December. It had always been a strain to both run the business and be the practice’s lead physicians, but the pressures of the pandemic made operating their company unsustainable. After closing their practice, Ramon, who is a pediatrician, started working full-time at a local clinic in Austin. Esparza started working for Doctor on Demand. She’s now licensed in 10 states caring for a stream of patients she’s never seen before and probably won’t see again.

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The 26 billion-dollar startups to watch that are revolutionizing healthcare in 2021

Summary List PlacementThe financial calamities predicted at the beginning of the coronavirus pandemic didn’t materialize for most healthcare startups. 
The industry’s up-and-coming private companies largely benefited from the one-two punch of financial concerns in other parts of the market and an increased focus on healthcare with all eyes on America’s wavering pandemic response.
2020 will likely go down as one of the single most pivotal years for the US healthcare industry in history. Even outside large hospitals and pharmaceutical companies, private startups raised a whopping $17 billion in 2020, a 57% increase over 2019’s record, according to a new report from Silicon Valley Bank.
That led to a new herd of healthcare unicorns, private companies valued at or above $1 billion. Some former unicorns, like GoodRx and Amwell, made public market debuts while others continued raising venture capital and private financings while the market was favorable. Some startups raised two separate funding rounds in the last year alone.
Read more: The 8 digital health startups to watch that are changing healthcare in 2021
Business Insider rounded up the 26 healthcare companies currently valued at more than $1 billion, according to Pitchbook and additional reporting.SEE ALSO: Investors think Amazon and Alphabet could set the pace for healthcare deals in 2021. Here’s what they are watching.
MDLive – $1 billion

MDLive is a long-standing telemedicine provider that has boomed during the pandemic. The 11-year-old company offers a suite of digital health and virtual care services to its patients in the United States and operates on a similar level to its competitor, telehealth giant Teladoc.
Teladoc in October completed its merger with Livongo, a company that helps patients manage chronic conditions like diabetes, spurring speculation that MDLive may pursue a similar blockbuster deal in 2021. 
MDLive indicated its plan to go public in 2021 instead when it announced $50 million in equity investment in September. According to Pitchbook data, the round valued MDLive at $1 billion and also included $25 million in debt financing as a separate transaction.
— Megan Hernbroth
Cityblock Health – $1 billion

Cityblock Health wants to improve healthcare outcomes for low-income patients through its social support services for what investors call social determinants of health in addition to its virtual care service.
These factors, which include access to public transportation, affordable and reliable housing, and nutritious food, operate outside the four walls of a clinic or doctor’s office but have massive implications on patients’ long-term health.
Cityblock Health raised $160 million in Series C funding on December 14, catapulting the three-year-old startup to the unicorn club.
Investors recently told Business Insider that startups like Cityblock could be poised to rise even further in 2021 as the pandemic continues and the inequities in care remain at the forefront of the nation’s response.
— Megan Hernbroth
Virta Health – $1.1 billion

Virta Health is a Silicon Valley startup that combines virtual care and the trendy ketogenic diet to help patients with diabetes. 
Virta encourages patients with type 2 diabetes to adopt a low-carb, high-fat diet and matches them with trained professionals to help track and manage their symptoms. In a peer-reviewed study Virta funded, researchers found that these changes to a patient’s diet could ultimately reduce or remove the need for medications like insulin.
Virta raised $93 million in Series C funding in January 2020 before raising another $65 million in Series D funding on December 2. The subsequent round valued the startup its $1.1 billion, Bloomberg reported.
— Megan Hernbroth
 
Lyra Health – $1.1 billion

Lyra is a mental health startup that works with companies to provide better benefits to employees. The startup has a network of therapists, coaches, and other care providers that provide virtual care visits to any employee with access to the software at little or no cost.
The service has been booming during the pandemic, according to investors, as remote employees struggle with work-life balance and employers seek to replace the enticing in-office perks with options that benefit more people.
Lyra raised $110 million in Series D funding on August 27, earning the five-year-old startup a $1.1 billion valuation, according to Pitchbook data.
Investors have been eager to back mental health startups in 2020, and many told Business Insider they foresee that trend only increasing in 2021. 
— Megan Hernbroth
 
Sema4 – $1.1 billion

Sema4 is a data analytics startup based in Stamford, Connecticut, that looks at data sets of large populations to gain insight into health outcomes. The company spun out of the Mount Sinai Health System in 2017, and was named for a system of sending messages using codes, which is the core function of its technology.
On July 29, the company said that it raised $121 million in Series C funding from BlackRock Innovation Capital Group, Mount Sinai Health System, The Blackstone Group, Moore Strategic Ventures, Deerfield Management, Oak HC/FT, Decheng Capital, Connecticut Innovations, and Section 32.
The round came about a year after a $120 million Series B funding round. In total the company has raised nearly $371 million, according to Pitchbook data.
— Megan Hernbroth
Freenome – $1.2 billion

Freenome is a liquid biopsy startup that seeks to detect cancer through a routine blood draw. 
“What we’re aiming to do is develop a test that healthy patients would take as part of their annual physical that tells you whether or not somebody’s going to have cancer,” cofounder and CEO Gabe Otte told Business Insider in 2016 following the company’s seed funding round.
Otte developed technology that can read the human genome for early markers of cancer by looking at a patient’s blood instead of more traditional biopsies that rely on sampling tumor cells. In the years since his first fundraising round, Otte and his team have also created software that creates a system for early disease detection and screenings.
The San Francisco-based company raised $270 million in Series C funding in July. Its investors include GV, Roche Venture Fund, Kaiser Permanente Ventures, Fidelity Investments, Novartis, American Cancer Society, Andreessen Horowitz, BrightEdge Ventures, Polaris Partners, Section 32, RA Capital Management, and Farallon Capital Management, among others. It has raised more than $508 million in total, according to Pitchbook data.
— Megan Hernbroth
 
 
Rakuten Medical – $1.2 billion

Headquartered in San Diego, Rakuten Medical develops precision-targeted cancer therapies designed to treat solid tumors. 
The biotech is led by the Japanese billionaire Hiroshi Mikitani, who is also founder and CEO of the large Japanese e-commerce firm Rakuten. Mikitani said he was inspired to fund the cancer research after his father was diagnosed with pancreatic cancer in 2012.
Rakuten Medical has raised about $471 million, according to PitchBook. Both Mikitani and Rakuten have invested in Rakuten Medical.
— Lydia Ramsey Pflanzer
Orca Bio – $1.2 billion

Biotech startup Orca Bio creates new cell therapies for procedures like bone marrow transplants that help strengthen patients’ immunity. The doses are personalized to each patient and are built cell-by-cell using another person’s blood.
According to the company, this treatment could help cure certain diseases and decrease side effects commonly experienced with current drugs. In November, the startup released a study of its therapy’s success on patients with graft-versus-host disease, a complication commonly associated with transplant recipients. 
The Silicon Valley company raised $192 million in Series D funding from Lightspeed Venture Partners and 8VC on June 17. According to Pitchbook data, it has raised $300 million since it was founded in 2016.
— Megan Hernbroth
Whoop – $1.2 billion

Whoop makes a health and fitness tracking strap that has won over everyone from Lebron James to Eli Manning to Kevin Durant.
The strap, which functions similar to existing watch fitness trackers, allegedly helped PGA Tour golfer Nick Watney detect early COVID-19 symptoms by picking up on his elevated respiratory rate, in addition to integrating with popular fitness app Strava. The strap itself costs nothing and is included with a membership for $30 a month or $288 for one year.
The 8-year-old startup was founded by 31-year-old founder and CEO Will Ahmed. On October 28, Whoop said it had raised $100 million in Series E funding at a $1.2 billion valuation. 
— Megan Hernbroth
Butterfly Network – $1.3 billion

Butterfly Network, a company that developed an iPhone-based ultrasound device, wants to make the technology more accessible to doctors and healthcare workers so they can make more precise diagnoses on the move. 
The device, called Butterfly iQ, plugs into the iPhone and isn’t much bigger than the phone itself. It’s been approved by the Food and Drug Administration for use in imaging the abdomen, bladder, and heart. 
In September 2018, Butterfly raised $250 million from investors such as Fidelity, Fosun Pharma, and the Bill and Melinda Gates Foundation. In total, the company raised $370 million. 
In November, the company said it plans to go public via a merger with the special purpose acquisition company Longview Acquisition Corp., a deal that would value the company at $1.5 billion. The deal, commonly referred to as a SPAC, was among a wave of similar reverse mergers that allowed startups to forgo the traditional IPO process while still taking advantage of public markets investors.
— Lydia Ramsey Pflanzer
Everlywell – $1.3 billion

Everlywell offers at-home testing kits for food sensitivity, fertility, hormones, STDs, and thyroid or metabolism issues, all compliant with federal standards. The startup sends samples to accredited labs, which perform the tests using patient-provided samples similar to what would occur at a routine doctor’s office visit. 
The tests are not currently covered by any insurance providers, but Everlywell says that it tries to keep its pricing simple and easy for consumers to understand. 
Everlywell patients receive results that have been reviewed by licensed physicians through a mobile app. They are then able to take those to a primary care or specialist provider without having to step foot in a traditional medical testing lab. The startup received national attention when founder Julia Cheek pitched the idea on Shark Tank.
In March, Everlywell announced it was also offering an at-home COVID-19 test as the coronavirus pandemic took hold in the United States. It partnered with independent labs to scale infrastructure to the point where it can handle up to 250,000 tests weekly, according to the company.
The company raised $25 million in Series C funding in February 2020. On December 3, the startup announced it raised $175 million in Series D funding from Goodwater Capital, Highland Capital Partners, and Next Coast Ventures in addition to several private equity firms. In total, the company has raised more than $250 million.
— Megan Hernbroth
Grand Rounds – $1.3 billion

Grand Rounds works with companies like Walmart and Home Depot to offer an on-demand healthcare virtual assistant to employees as an employer-provided benefit. The company previously focused on large self-insured companies like the aforementioned, but have recently started selling to medium-sized companies as the pandemic left many employers scrambling to offer relevant benefits while maintaining low costs.
In September, Grand Rounds raised $175 million from private equity firm Carlyle Group that launched its valuation to $1.3 billion, according to Pitchbook data.  
“As COVID hit and these employers, to take care of digital and work-from-home workforces across the country, they all had unique situations and needs pop up,” Carlyle Group investor and Grand Rounds board member Robert Schmidt told Business Insider in September.
— Megan Hernbroth
 
Ro – $1.5 billion

Ro is a direct-to-consumer provider that offers generic medications for conditions such as erectile dysfunction, hair loss, and weight management through the mail. Patients can consult a doctor through Ro’s telemedicine service throughout the course of treatment and are required to pay a cash fee for medication and the visit since Ro doesn’t accept insurance. 
The three-year-old company raised $200 million in venture funding on July 27, nabbing a $1.5 billion valuation as a result. It acquired Workpath, another startup that provides in-home care services, in December as it seeks to expand beyond digital health.
— Megan Hernbroth
Olive – $1.5 billion

Olive makes automation technology for healthcare workers. Its artificial intelligence software picks up on keystrokes to learn how a healthcare worker interacts with specific applications and provide suggestions for tasks like prior authorizations or patient verifications. It also has a tool to help automate processes in hospitals’ human resources, finance, and supply chain departments.
Olive raised $106 million in venture funding in September, just months after raising $51 million in March. It is currently valued at $1.5 billion, according to Pitchbook data. In December acquired Verata Health to further expand its services to insurance companies and hospitals.
— Megan Hernbroth
Hims – $1.6 billion

Be it depression, hair loss, or erectile dysfunction, Hims wants men to “take care of themselves” without fear of stigma via its suite of telemedicine and personal care offerings.
Besides online primary care visits and therapy, it sells hair, skin, and sex products directly to consumers. Its sister site, Hers, offers similar services for women. Hims says its total funding to date is $260 million.
On October 1, the company announced that it was going public through a reverse merger with blank-check company Oaktree, that valued Hims publicly at $1.6 billion.  
Its investors include Atomic, Maverick Ventures, Forerunner Ventures, Founders Fund, 8VC, and Redpoint Ventures.
— Lydia Ramsey Pflanzer & Megan Hernbroth
HeartFlow – $1.6 billion

HeartFlow is trying to make the process of finding blockages in the heart a lot less invasive. Using imaging from a CT scan, HeartFlow builds a 3D model that pinpoints the blockages associated with coronary-artery disease, a heart condition that affects millions of Americans and is the leading cause of death in the US. 
HeartFlow is based in Redwood City, California, and reached unicorn status in 2018 after raising $240 million. In total, the company has raised $532 million. 
— Lydia Ramsey Pflanzer
Zocdoc – $1.8 billion

Zocdoc helps patients book doctors’ appointments and check-in for them — everything from primary care to dental to optometry appointments.
Users can search based on procedures, conditions, and even a particular doctor they might want to book an appointment with.
In 2019, the company changed the way it pays its doctors in some states, moving from a subscription model to one that charges a per-booking fee. Some doctors weren’t been happy about the switch.
Zocdoc, which is based in New York, most recently raised $130 million in a Series D round in August 2015, bringing its total raised to $223 million. The company’s last reported valuation is from 2015, according to PitchBook.
During the pandemic, Zocdoc introduced video visits for the providers on its platform to use with patients. 
Zocdoc cofounder Cyrus Massoumi in September sued the company, claiming he was pushed out of his role as CEO in an illegal “coup.”
— Lydia Ramsey Pflanzer
Devoted Health – $1.8 billion

Devoted Health wants to reinvent how we care for aging Americans.
The company started selling Medicare Advantage plans in parts of Florida for 2019. In its second year, its enrollment jumped, in line with the company’s expectations. 
Read more: Oscar Health has confidentially filed to go public. Here’s a look at how the health insurer and rivals Clover and Bright have fared so far this year.
The company’s plans might look a bit different from traditional insurance in that Devoted plans to do more than pay for visits to doctors and hospitals. It also hires nurses and other employees directed at keeping seniors healthier and out of the hospital.
Devoted was founded in 2017 by brothers Ed and Todd Park. Before Devoted, Todd Park cofounded the health IT company Athenahealth and served as the chief technology officer of the US during the Obama administration. Ed Park, who serves as Devoted’s CEO, was formerly the chief technology officer and later chief operating officer at Athenahealth.
In October 2018, the Waltham, Massachusetts-based company raised $300 million in a Series B round led by Andreessen Horowitz, bringing its total funding to $369 million.
— Lydia Ramsey Pflanzer
Zymergen – $2.1 billion

Synthetic biology company Zymergen is a Silicon Valley company that turns living organisms into new materials. Synthetic biology involves harnessing the power of cells to make products like less-toxic sweeteners for food or drugs and biodegradable building materials and bags. It was a popular area of investment for cutting edge VC firms prior to the pandemic as the technology could help combat single-use plastic use.
On July 29, the eight-year-old startup raised $350 million in Series D funding led by private equity firm Baillie Gifford, according to Pitchbook data. Other investors include SoftBank Investment Advisers, SVF, Schiehallion Fund, SciFi VC, DCVC Bio, True Ventures, Perceptive Advisors, Baron Funds, Scottish Mortgage Investment Trust, and MicroVentures.
— Megan Hernbroth
Lyell – $2.5 billion

The San Francisco biotech company is focused on treating cancer with cell therapies. Lyell’s goal is to develop cell-based immunotherapies for cancer, with a focus on CAR-Ts and solid tumors.
In March 2020, the company raised a total $493 million in funding from undisclosed investors. The company has raised a total of $851 million, according to CB Insights, from investors including Foresite Capital Management, Arch Venture Partners, and Altitude Life Science Ventures.
— Lydia Ramsey Pflanzer
Sana Biotechnology – $2.8 billion

Sana Biotechnology is developing engineered cells that can be used as medication for patients. The goal, according to the company, is to engineer cells to repair and control genes or replace missing or damaged cells with an entirely new set of therapies for a range of conditions. It is currently focusing on immunology, stem cell biology, gene delivery, and gene modification.
The Seattle-based company said it has roughly 250 employees across three offices. In June, it raised $435 million in Series B funding from GV, Omega Fund, and Flagship Pioneering, according to Pitchbook data. The round was part of a larger initial financing, according to the company, which totaled $700 million after multiple separate rounds of fundraising.
Additional investors include ARCH Venture Partners, F-Prime Capital, Altitude Life Science Ventures, Canada Pension Plan Investment Board, City Hill Ventures, Baillie Gifford, Alaska Permanent Fund, Public Sector Pension Investment Board, and Bezos Expeditions.
— Megan Hernbroth
Radiology Partners – $4.3 billion

Southern California-based Radiology Partners owns and operates radiology clinics in 26 states across the US. According to the company, it employs roughly 1,500 radiologists and provides radiology services to more than 1200 hospitals on-site and virtually.
The eight-year-old company raised an undisclosed amount of private equity financing from Heritage Group in 2020, according to Pitchbook data, and subsequently raised two rounds of debt financing. Prior to 2020, it raised $750 million in growth financing from Starr Investment Holdings on July 19, 2019.
— Megan Hernbroth
Gingko Bioworks – $4.9 billion

Ginkgo Bioworks is a startup that designs microbes to produce substances like fragrances and medications. The Boston-based company sends the programmed bugs to partner companies that put them to use.
In September 2019, Ginkgo raised an additional $290 million. In total, the company has raised $719 million and a $350 million fund to invest in spinout companies that use its technology. 
In 2020 Ginkgo responded to the coronavirus pandemic by helping with testing, vaccines, and antibody therapeutics, according to its website. 
— Lydia Ramsey Pflanzer
Tempus Labs – $8.1 billion

Chicago-based Tempus got its start in 2015, and then rocketed into unicorn territory.
The startup, which was founded by Groupon founder Eric Lefkofsky, hopes to help doctors use data to find better cancer treatments for patients, using both clinical data — information about which medications patients have taken and how they responded to them — and data it sequences in its lab based on the tumors and hereditary genetics of cancer patients.
Tempus raised $100 million in March 2020 and another $200 million in December 2020, putting the company at an $8.1 billion valuation. So far, the company has raised about $1 billion. 
— Lydia Ramsey Pflanzer
Roivant Sciences – $9 billion

Roivant Sciences is a company known for developing drugs that other pharmaceutical companies have abandoned.
The company was founded by CEO Vivek Ramaswamy, who’s 35. Through its subsidiary companies, it identifies experimental drugs that other companies may have stopped developing for one reason or another that still have potential to get approved and go on the market.
So far, it has launched 17 subsidiary “-vant” companies, including a number that have gone public. Those include the neurodegenerative-disease-drug developer Axovant Sciences, the women’s health company Myovant Sciences, and the urology company Urovant Sciences.
In December 2019, the company entered a deal with Sumitomo Dainippon Pharma. The company raised $200 million from investors in 2018 a little more than a year after raising $1.1 billion in a monster round led by SoftBank’s Vision Fund. The $200 million round valued the company at $7 billion. 
— Lydia Ramsey Pflanzer
Samumed – $12.4 billion

Samumed is the highest-valued startup on this list.
The San Diego-based company has attracted a total of $764 million and a heady valuation thanks to a pipeline of what could be revolutionary treatments to regenerate hair, skin, bones, and joints.
The company’s science hinges on something called progenitor stem cells. Samumed hopes to manipulate the pathway that makes these progenitor stem cells spring into action so that they don’t cause conditions like hair loss or osteoarthritis. 
The company had previously raised funding from backers including high-net worth people and sovereign funds rather than venture capital. Samumed’s chief business officer, Erich Horsley, said in May 2018 that the company could go public in the next three to four years.
— Lydia Ramsey Pflanzer

The CEO of major health insurer Humana laid out why he's betting big on primary care

Summary List PlacementLong before Humana became the dominant health insurer it is today, its business revolved around operating hospitals.
Now, decades later, Humana is getting back to its roots of providing medical care.
This time, the company is hyper-focused on transforming primary care for older people.
The national health insurer is investing heavily in building clinics in underserved areas across the country. It’s also partnering with primary-care startups like Oak Street Health, ChenMed, and Iora Health to reach more seniors. And last year, Humana pumped $100 million into telehealth startup Heal to bring primary care into patient’s homes.
Humana’s quest, CEO Bruce Broussard told Insider, is to weave together health insurance with the delivery of healthcare. Integrating the two could lead to lower costs and better health outcomes, he said.
The insurer is focusing on primary care because that’s one type of clinical care that has shown to reduce costs in the long run. Various studies have demonstrated that investing more money into primary care is associated with fewer costly hospitalizations and emergency department visits.
“We’re big believers in primary care,” Broussard told Insider in an interview on Friday. “We see great results, high satisfaction scores, high quality scores, and in addition, from a cost point of view, some really great outcomes there.”
Over the next decade, as Humana continues to invest in primary-care clinics, along with home-based and virtual care, the company may start to look different, Broussard said. Soon, it could employ as many clinicians as it does other types of employees, he said.
“Over the longer run, a decade, you’ll see a very substantial healthcare service business within Humana,” Broussard said. “I think you’ll see considerably larger platform and a changing organization.
Humana got serious about primary care after its Aetna break-up
Humana began buying primary-care clinics about a decade ago, but it became “intentional” about its clinic strategy when it called off its planned merger with rival insurer Aetna in 2017 after a federal judge blocked the deal, Broussard said.
After the break-up, Humana did some soul-searching. It looked to big, integrated health systems like Kaiser Permanente in California and University of Pittsburgh Medical Center and Geisinger in Pennsylvania and concluded that delivering healthcare is most successful when integrated with insurance under one organization.
Primary care was one clinical area Humana decided to focus on. In 2018, Humana moved the various primary-care groups it had acquired under one brand called Conviva. Those clinics were largely concentrated in South Florida.
For a time, Broussard said Humana doubted that a clinic strategy would work outside of Florida, where the strategy had proven successful because people from Cuba and other Hispanic backgrounds who have a large presence in Florida were already used to getting care in clinics, he said.
Humana wanted to see where else a primary-care clinic strategy would work, but there weren’t a lot of senior-focused clinics out there. So it began investing in other primary-care startups like Oak Street, ChenMed and Iora. According to Oak Street’s latest earnings report, Humana comprised nearly half of the startup’s revenue for the first nine months of 2020.
“We wanted to fund a number of different companies, both to see who was going to be successful or not and also to get capacity in the marketplace,” Broussard said.
Humana then started building its own clinics under the brand Partners in Primary Care “both for defensive and offensive reasons,” Broussard said. It struck a deal last year with private equity company Welsh Carson to build out 50 more clinics over three years.

Read more: Humana just made $643 million on its bet on a new way to pay for doctor’s visits — and the CEO signaled that this is just the start
Humana owns 150 primary-care clinics and partners with about 100 more
Humana’s primary-care clinics cater to seniors enrolled in Medicare Advantage, which is a private alternative to the traditional government-run Medicare program that provides health coverage to older people. Humana serves about 4.7 million people in Medicare Advantage plans.
The clinics are paid in a nontraditional way. Insurers give them set monthly fees to care for each patient, so the clinics make money by keeping patients healthy and out of the expensive hospital or emergency room. Doctors see fewer patients than normal so they can give each patient more attention.
Broussard said the company would continue to open clinics in areas that are starved for primary care, both by building its own centers and partnering with startups.
Humana owns about 150 clinics that serve seniors enrolled in multiple health plans and boasts partnerships with 108 additional clinics operated by other companies. It aims to open about 50 to 60 more clinics with partners in 2021, a Humana spokeswoman confirmed.
About 8%, or 300,000, of Humana’s Advantage members, get care in owned and partnership clinics, and company executives have expressed plans to grow that figure.
Beyond primary care, Humana is also pushing deeper into delivering care in patients’ homes.
It bought a 40% stake in Kindred Healthcare’s home health business in 2018 for about $800 million, with a right to buy the whole business after a few years. In addition to its investment in Heal, Humana last year put money into DispatchHealth, which provides urgent medical care in the home.
Broussard said the insurer is testing a model in Atlanta that integrates the services of Kindred, DispatchHealth and Heal so that seniors can see a nurse or doctor, or even “visit” the emergency room, all without leaving the couch.
Read more: This pitch deck helped telehealth startup Heal raise $100 million and win a major partnership with healthcare giant Humana. Here’s how the deal came to be.
Humana’s transformation is emblematic of an industry-wide shift toward integrated healthcare companies
Humana’s focus on delivering healthcare is part of a broader movement among health insurers to become more that just intermediaries who pay medical bills.
This industry-wide shift has been happening for some time, but it seems to be speeding up as insurers look for ways to control runaway healthcare costs.
The poster child for this trend is UnitedHealth Group, the healthcare behemoth that houses insurance company UnitedHealthcare and Optum, a company that manages pharmacy benefits and provides care, under one roof. Optum generates about 45% of UnitedHealth’s total earnings from operations.
Optum includes 1,400 medical clinics and employs or partners with 50,000 doctors. It aims to add at least another 10,000 doctors to its roster in the next year, UnitedHealth CEO David Wichmann said in January.
Broussard told Insider that Optum is a more diverse business than Humana’s healthcare services division aims to be. Humana is focusing more narrowly on integrating clinical services to deliver holistic care to seniors.
Still, Broussard wants to grow the care-delivery side of Humana over the next decade. The insurer’s healthcare services segment collected $25.8 billion in revenue and $789 million in earnings in 2019, driven in large part by its pharmacy benefit management business. Humana’s total revenue that year was $64.9 billion and its net income was $2.7 billion.
He noted that when Humana acquires the rest of Kindred Healthcare’s home health business, Humana will employ as many clinicians as it does other workers. Kindred’s home health operation employs 50,000 clinicians.
The COVID-19 pandemic is accelerating the changes underway at Humana
Broussard said the coronavirus crisis has bolstered the case for offering care through multiple channels, whether in person in a patient’s home or virtually.
“There are many things that are done in the hospital that can be done in someone’s home,” he said. “I think the ability to serve the population in a broader way I think it was coming, but it just wasn’t coming fast enough, and the pandemic pushed that.”
The pandemic also highlighted the benefits of moving away from the traditional way of paying for care based on the volume of services provided, toward a model that pays doctors set amounts to keep patients healthy.
Doctors in such value-based arrangements continued to receive payments when patients stopped coming to the clinic for fear of contracting the coronavirus. Other healthcare providers saw their revenues plummet. Value-based clinics were also able to pivot quicker to telehealth and were more proactive about reaching out to patients, Broussard said.
As a result, Humana is pushing faster and faster into providing care in different settings. It’s also investing heavily in its technology, and launched a new internal Medicare company called Author, which will provide digitally-enabled health plans for seniors.
“I just feel that we’re at this cusp here,” Broussard said. “We still have a lot of development and organic build to do, but the energy level and the effort and the focus and the prioritization is much different.”

Read more:
Humana just launched its answer to the new crop of insurer startups in the red-hot health-plan market for older people
Humana just made $643 million on its bet on a new way to pay for doctor’s visits — and the CEO signaled that this is just the start
Clover Health laid out ambitious growth plans as part of its $3.7 billion deal, but they rely on an untested new Medicare experiment
Primary care startup Oak Street is going public. We pored over its 188-page filing, and it reveals 5 crucial details about the company as it looks to transform how seniors are cared for.
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