Even before a global pandemic upended the post-acute care continuum, transitions between settings represented one of the biggest pain points for operators and patients.
Fresh off a $60 million Series C funding round announced last week, PatientPing has its sights set on national coverage for its software network that connects hospitals, skilled nursing facilities, home health agencies, and other post-acute providers with the goal of eliminating problems during handoffs.
That most recent round — co-led by Andreessen Horowitz, F-Prime Capital, Google subsidiary GV, and Transformation Capital — brings the Boston-based company’s total funding haul to $100 million as it looks to expand its footprint of about 1,000 hospitals, mostly located in the eastern two-thirds of the country.
“It’s been exciting to watch PatientPing steadily expand its geographical reach and technology capabilities to positively impact millions of patients nationwide,” Andreessen Horowitz partner Julie Yoo said in a statement announcing the deal. “Their platform plays such a critical role in the transition of patients between sites of care, and eliminates one of the major blind spots in our fragmented health care system by longitudinally tracking a patient’s care journey across all encounters.”
Since its founding in 2013, the company has embedded its software in about 4,000 post-acute care facilities nationwide — starting with SNFs, but gradually folding in long-term acute care hospitals (LTACs), inpatient rehabilitation facilities (IRFs), home health agencies, and hospice providers, CEO Jay Desai told SNN last week.
The system works by sending out a “ping” to all the providers that have worked with a patient as soon as that person shows up to a site of care or receives a specific intervention. For instance, upon admission to the hospital, the software sends a notification to the patient’s skilled nursing facility, home health agency, and other clinicians that may have been a part of the original care team.
“We deliver the notifications to them so that they could coordinate with those providers that are seeing the patient in the ER, or the hospital, and just say: Hey, we’re the SNF that just recently was seeing that patient, and they’ve got these conditions, and you ought think about this for their care plan,” Desai said.
In a fragmented care landscape, skilled nursing facilities don’t always know what’s happening with a resident who’s been discharged home — even though the facility itself remains on the financial and regulatory hook for any future readmissions during a 30-day window under Medicare rules.
Under the SNF Value-Based Purchasing (VBP) program, operators can also lose up to 2% of their Medicare reimbursements if they do not meet certain readmission-reduction benchmarks, though VBP penalties have been temporarily suspended amid the ongoing COVID-19 pandemic.
And if the patient does indeed need to return to the hospital, the acute-care staff may not have any information about that person’s care history, thus keeping both emergency doctors and the skilled nursing facility in the dark at a time when clinicians should be working together to produce the best outcome.
What’s more, as the clinical capabilities of the average SNF have increased over the last decade, many facilities can provide a hospital-level of care for certain conditions without a transfer at all, avoiding the potential danger of hospital-acquired infections and other complications associated with moving a frail, elderly patient — but only if everyone is on the same page.
With the most recent cash injection, Desai and PatientPing have sights set on the Western U.S., with new hospital interoperability requirements from the Centers for Medicare & Medicaid Services (CMS) providing a potential carrot for new partners.
Starting next spring, hospitals must provide admission, discharge, and transfer (ADT) event notifications as part of their Conditions of Participation (CoPs), or baseline capabilities for receiving Medicare and Medicaid payments — similar to the Requirements of Participation (RoPs) for nursing homes.
“With the Medicare interoperability rules requiring hospitals to share ADT information, that creates a pretty, pretty powerful tailwind to our expansion,” Desai said.
PatientPing offers its software to skilled nursing facilities free of charge as part of building out its hospital networks, though it also allows SNFs to track their patients in subsequent settings for a fee.
That lack of cost for SNFs to join the network helped solve a persistent problem for any health care software platform designed to increase cross-continuum communication: Unless a large majority of health providers in a given area can use the software, it doesn’t have much value.
Back in 2018, Desai compared the company’s growth strategy to that of OpenTable, the online restaurant-reservation giant; in order for the service to take off, it required a critical mass of providers, prompting PatientPing to take the calculated risk of offering the service for free to start.
“It’s not easy to get everyone in a community on a common platform, but when you do that, it creates a disproportionate amount of value for everybody,” Desai said at the time. “So, for instance, OpenTable: You have to get all of the restaurants on, and that drives the diners, so that starts somewhere.”
The health tech landscape has changed significantly even in the two years since SNN first spoke with Desai, with the COVID-19 pandemic rapidly accelerating opportunities for vendors in the space. CMS has taken a hacksaw to its rules regarding telehealth interventions in an attempt to reduce in-person visits — particularly in nursing homes, where an asymptomatic doctor could unwittingly trigger a wave of coronavirus cases.
In the span of weeks, clinicians could suddenly receive reimbursements for providing services over virtual platforms, including non-HIPAA-compliant apps like Skype and FaceTime. While those flexibilities were only granted on an interim basis for the duration of the federal COVID-19 emergency, leaders from across the health care world predict that it will be impossible to roll back the progress to where things were.
“I can’t imagine going back,” CMS administrator Seema Verma, said during a virtual event hosted by STAT News this week. “People recognize the value of this, so it seems like it would not be a good thing to force our beneficiaries to go back to in-person visits.”
The shifting landscape has already prompted new entrants into the health tech marketplace: After being forced to shut down skilled nursing telehealth company Call9 last year, CEO Timothy Peck re-entered the space with a new data-sharing and software firm called Curve Health last month.
Desai echoed Verma’s perspective, comparing the rise of telehealth to the dominance of Amazon: Much like people found ordering books online more convenient than going to a store, people who take advantage of virtual visits during the crisis will see the value, and question why they needed to go for an in-person visit in the first place.
And for post-acute care in particular, Desai sees considerable opportunity for technology to further reduce the problems that patients and operators face when negotiating handoffs between settings.
“In the post-acute segment, I think that there’s a really neat opportunity for telehealth to apply grease to care transitions — where right now, you have to wait for an in-person interaction to happen,” he said.