JPM23, Day 1: Humana not expecting high uptake of lecanemab; Centene CEO talks value-based care in individual market

It's that time of the year again.

This year's J.P. Morgan Healthcare Conference is back in person and officially kicked off today. It marks the first year that the big investor conference, where business leaders often announce major deals and collaborations, has returned to an in-person event amid the COVID-19 pandemic. The expensive hotels and crowded meeting spaces are back in action.

We've already jumpstarted the 2023 conference with a big funding deal and some news in the digital health space.

Fierce Healthcare will be covering the day's biggest news as it happens. Check back here for updates, and catch Fierce Biotech's reporting here and Fierce Pharma's reporting here.

UPDATED: Monday, Jan. 9 at 7:20 p.m. ET

While the Food and Drug Administration's decision to grant accelerated approval to lecanemab, a monoclonal antibody drug for Alzheimer's disease, grabbed headlines, Humana is not anticipating huge costs related to the drug despite its membership base being largely in Medicare Advantage.

Lecanemab, backed by Eisai and Biogen, comes on the heels of Aduhelm, which hit the market amid controversy about its effectiveness and high cost. A recent congressional report spotlighted "inappropriate" coordination between Biogen and the FDA to secure Aduhelm's approval.

The Centers for Medicare & Medicaid Services issued a national coverage decision for the entire class of drugs that severely limits Medicare coverage for these therapies. As such, Humana is not bracing for high costs when lecanemab hits the market, Chief Financial Officer Susan Diamond said during the conference.

Humana will adjust its expectations should the drugmakers request and secure a more expansive coverage decision, she said.

"Our belief is that you will see very low uptake and utilization," Diamond said. — Paige Minemyer

UPDATED: Monday, Jan. 9 at 2:24 p.m. ET

Last year, Humana fell on its face during the annual enrollment period for Medicare, and was forced to slash its projections for enrollment growth. That flop dominated the conversation among payers at 2022's conference, as skittish investors took a second look at Medicare Advantage, a hot market for the insurance industry.

It also forced Humana, which sees the bulk of its membership in MA, to look inward at what it could be doing differently to bolster its core Medicare product. So, over the course of the year, it embarked on a $1 billion value creation effort to invest in its Medicare Advantage business.

Those efforts appear to have paid off, according to a filing with the Securities and Exchange Commission issued Monday. Humana said that it added about 500,000 MA members during the enrollment window, and it will boost its growth estimate for 2023 Medicare Advantage membership to at least 625,000.

This estimate represents a net membership gain of 13.6% compared to 2022, Humana said in the filing.

Humana executives will speak at JPM later today, so keep an eye out for our full story on their remarks, as MA enrollment performance will no doubt be a key talking point. — Paige Minemyer

UPDATED: Monday, Jan. 9 at 11:27 a.m. ET

When asked how many members Centene would like to have in value-based contracts, CEO Sarah London had a simple answer: "More."

The government insurance giant kicked off JPM presentations for insurers early on Monday, and London told investors that while some markets are ahead of others in the transition to value-based care, overall progress has been felt.

The individual market, she said, poses a unique challenge due to the enrollment churn it tends to experience. However, with the increasing stability on the Affordable Care Act's exchanges, working with providers on value-based models in this space has gotten smoother.

"The stability of that market makes it easier to have conversations with providers," she said.

Hear more from London, who touched on Medicare Advantage, M&A and more, in our full story coming later today. — Paige Minemyer

UPDATED: Monday, Jan. 9 at 8 a.m. ET

Virtual psychiatry and therapy practice Array Behavioral Care picked up $25 million in fresh funding backed by CVS Health.

Array, a 20-year-old company, plans to use the capital to scale faster and provide further access to quality, timely behavioral care in new and existing markets. The funding round comes amid a mental health crisis in the U.S. and surging demand for behavioral health services. Array also plans o enhance its service offerings, invest in innovative technology and expand its practice team, according to a press release.

"Array has consistently been a strong mental health care provider within Aetna’s network,” said Cara McNulty, President of Behavioral Health and Mental Well-being for CVS Health in a statement. “As CVS Health drives more innovation into care delivery, we look forward to working with Array to enhance access that complements our existing services in new ways.” 

CVS Health joins other industry leaders and early investors in Array Behavioral Care, including Wells Fargo Strategic Capital, Health Velocity Capital, Harbour Point Capital, HLM Venture Partners, OCA Ventures and OSF Healthcare.

The financing builds upon a long history between Array and CVS Health and opens doors to new levels of collaboration to expand access to high-quality behavioral care, the companies said.

The Array clinical team started practicing telepsychiatry in 1999. In 2019,  InSight Telepsychiatry and Regroup Telehealth combined as one of the largest telepsychiatry service providers in the country. The company launched under a new name, Array Behavioral Care, in 2021. 

The company offers telepsychiatry solutions and services across the continuum of care from hospital to home and says it has partnered with hundreds of hospitals and health systems, community healthcare organizations and payers.

"The Array team's experience with telepsychiatry spans more than two decades, and during this time, we've been at the forefront of creating, implementing, and evolving virtualized mental health programs across the continuum of care. From our first telepsychiatry encounter in a rural hospital in 1999 to caring for patients online from their homes today, we've stayed true to our mission to meet patients where they are regardless of acuity level or setting to deliver the behavioral health care they deserve,” said Geoffrey Boyce, CEO and co-founder of Array in a statement. "As we continue to lead the charge in transforming access to modern behavioral health care, we’re proud to do it with our existing partners andCVS Health.”

An estimated 150 million Americans, or 40% of the population, live in federally designated mental health professional shortage areas.According to researchby the U.S. Department of Health & Human Services, only 27.7% of the national need for mental health professionals is actively being met. 

CVS Health's collaboration with Array and investment can help enhance access to virtual mental health services, which is "particularly important with demand for mental health services increasing significantly in recent years," said Vijay Patel, managing partner and co-founder of CVS Health Ventures, the company’s corporate venture capital arm. — Heather Landi

UPDATED: Sunday, Jan. 8 at 1 p.m. ET

LiveCare Corp, a provider of virtual practice management tools for primary and specialty care doctors, rolled out an artificial intelligence-enabled functionality that aims to streamline the work that goes into completing electronic medical records.

The company uses AI to interpret care team conversations in real-time in order to uncover insights that improve patient care, billing accuracy and clinician experiences, according to executives. The functionality was announced at the UC Davis Health Future and CEO Summit during the J.P. Morgan 41st Healthcare Summit.

The AI-enabled tool is available as an embedded feature in LiveCare’s platform. It enables healthcare organizations to leverage data to automate documentation and improve the accuracy of billing.

LiveCare also announced a partnership with UC Davis Health and its Digital Collaborative for Innovation and Validation (Digital CoLab) to work on digital health innovations that improve patient care and alleviate provider burnout.

"We are thrilled to partner with UC Davis Health and Digital CoLab to further our commitment to transforming how clinics manage their practices in the cloud and can’t wait for more healthcare organizations looking to drive value-based care initiatives and optimize billing to experience this game changing technology," said Peri Avitan, CEO and co-founder of LiveCare Corp., said in a statement.

“Documentation burden is one of the major drivers of provider burnout and historically technologies such as EHRs have led to increased burden and provider ‘pajama time’ on after-hours administrative work,” said Ashish Atreja, M.D., CIO and Chief Digital Health Officer at UC Davis Health in a statement.  “As part of the UC Davis Digital Collaborative for Innovation and Validation (Digital CoLab), we’re excited to explore how LiveCare’s technology can reduce this burden.” — Heather Landi