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Our Take: Update on Darwin Research Group

Mar 27, 2023

Each week on Friday, I work with my long-time writer-editor collaborator, Lisa Wilhelm, to pick the top health care story of the week, along with several other important news items worth writing about. Given the diverse nature of our readership, we try to strike a balance of business news, health policy, research, and innovative new products.

The Our Take portion of the main story is our chance to editorialize about why we think the lead story is important.

It doesn’t happen often, but sometimes nothing from the week’s events warrants an extended treatment. This is where we found ourselves on Friday.

When this has happened in the past, I’ve written more general pieces on, say, Medicare ACO performance or health system trends. This week, I thought I’d take the opportunity to do something different and let you know what’s new and upcoming at Darwin. I’m guessing that there are many of you who have been reading Our Take for years and don’t have the foggiest idea of what we do.

Who Is Darwin Research Group?

I started Darwin Advisory Partners, LLC in 2010 as a vehicle for consulting services while I took a break from my Ph.D. program at Dartmouth. Today, we have about 25 employees and continue to grow at a healthy clip.

Our expertise is in health care systems, which we define very broadly to include integrated delivery networks (IDNs), physician groups, cancer centers, and other sites of care. Our roots, which I trace back to my Dartmouth days, are in accountable care organizations and value-based care models. Currently, we profile more than 500 organizations across the U.S.

In addition to our profile work, at any given time we’re likely to be working on a handful of strategic market research projects. Most of these projects are funded by manufacturers trying to better understand health system dynamics.

In 2023, we are launching several national syndicated research studies. While two of the studies are directed toward our market access partners, there will be broader implications that extend beyond the life sciences. The following are brief descriptions of a few studies we’re planning for this year. For more details, please contact me at jm@darwinresearch.com.

IDN Engagement Study

Our objective is to help market-access executives and key account teams continually refine best practices for customer engagement. Our research will focus on the current environment within health systems with regard to care management, patient engagement, digital health, and pharmacy operations.

To accomplish this dynamic and multifaceted task, we will conduct a semiannual tracking study of hospital and health system pharmacy directors, medical directors, and C-suite executives. Twice annually, we will conduct an online survey (n=150) and 25 to 30 personal interviews.

Key research questions include:
  1. What strategic steps are health systems taking to transform their operations and the care they provide?
  2. How are health systems working to improve their relationship with patients and increase engagement?
  3. What is the current state of digital health?
  4. What changes are pharmacy departments experiencing, either from external forces or internal initiatives?
  5. How are stakeholders engaging with the Life Sciences industry today, and how do stakeholders expect interactions with industry to change in the future?

Oncology Engagement Study
Our research will focus on the current environment within oncology service lines with regard to care management, patient engagement, precision medicine, and pharmacy operations. We will also be directly assessing the Life Science-IDN relationship.

While the methodology will be similar to the IDN Engagement Study, for this study we’ll be communicating with health system and cancer center key-opinion leader oncologists, pharmacists, and administrators in our online surveys and interviews.

Key research questions include:
  1. What strategic steps are institutions taking to transform their oncology service lines and the care they provide?
  2. How are institutions working to improve the oncology patient journey and increase engagement?
  3. What is the current state of precision medicine?
  4. What changes are pharmacy and infusion teams experiencing, either from external forces or internal initiatives?
  5. How are stakeholders engaging with the Life Sciences industry today, and how do stakeholders expect interactions with industry to change in the future?
The Emerging Dynamics of Primary Care

What are the implications of Amazon’s acquisition of One Medical on care delivery? What does CVS have in store for Oak Street Health and home health tech firm Signify Health? How much market power does UnitedHealth Group’s Optum unit wield, with more than 60,000 physicians and its recent acquisition of LHC Group — one of the largest home health providers in the U.S.? What’s ahead for VillageMD, after the recent cash infusion from Walgreens and Cigna? Will TeleDoc recover?

Several times we’ve taken a swing at some of these questions within the confines of Our Take. But we’re looking to take it a step further and go much deeper. Using our profiling skills, combined with in-depth executive interviews, we will do a deep-dive on organizations that are changing the face of primary care, from concierge medicine to virtual care. Some of these organizations, such as CVS, Walgreens, and Amazon, are large and complex; others are nascent but well-funded.

These are some of the firms we’re considering including in this study:
  • Agilon Health
  • Aledade
  • Cano Health
  • CareMax
  • CareMore
  • CenterWell
  • ChenMed
  • CityBlock Health
  • Evolent Health
  • Meritage Medical Network
  • Millennium Physician Group
  • Optum Care/Optum Health
  • P3 Health Partners
  • Pearl Health
  • Privia Health
  • VillageMD/Village Medical
  • Vytalize Health
We’re still working on the methodology for this study. As with all of our research, we welcome input as the project takes shape. If you have questions or suggestions, please reach out to me.

– John

What else you need to know
IBM and Cleveland Clinic unveiled the IBM Quantum System One, the first quantum computer dedicated solely to health care research, last Monday at Cleveland Clinic’s main campus in Cleveland, Ohio. The unveiling marks a milestone in a 10-year partnership the two organizations initiated in 2021. “This technology holds tremendous promise in revolutionizing health care and expediting progress toward new cares, cures, and solutions for patients,” said Dr. Tom Mihaljevic, CEO of Cleveland Clinic, in a news release. The IBM Quantum System One is the first private-sector, IBM-managed quantum computer in the U.S. Quantum computers can process multiple computations simultaneously rather than sequentially, making them exponentially faster than supercomputers. 

Legislation targeting pharmacy benefit management practices made progress last week, with the Senate Commerce Committee passing the PBM Transparency Act of 2023 by a 18-9 vote. The bipartisan bill, which would ban spread pricing and clawback fees, and would increase transparency of PBM operations, now advances to the full Senate. In the House, meanwhile, a bipartisan group of lawmakers reintroduced the Drug Transparency in Medicaid Act, which would ban spread pricing in Medicaid managed care plans. The bill did not advance in the last session of Congress. 

The Department of Justice and two state attorneys general will not pursue their legal challenge of UnitedHealth Group’s $13 billion acquisition of Change Healthcare. A federal district court gave UHG the green light in September to proceed with the deal despite the DOJ’s antitrust-related concerns. The acquisition was completed in October, with UHG merging Change Healthcare with Optum Insights. The DOJ then filed a notice in November regarding its intention fo appeal the district court’s decision. The recent court filing did not provide a reason for calling off the plans to appeal.

Lehi, Utah-based Civica Rx will manufacture insulin for the state of California under a 10-year agreement signed earlier this month. Through the CalRx Biosimilar Insulin Initiative, California will invest $50 million in the partnership with Civica Rx, and the state-branded insulin products, which will include biosimilar versions of Eli Lilly’s Humalog (insulin lispro), Novo Nordisk’s Novolog (insulin aspart), and Sanofi’s Lantus (insulin gargline), will be capped at a price of $30 for a 10-mL vial. Initially, Civica Rx will manufacture the products at a new facility being built in Petersburg, Virginia. Later, according to a press release, options will be assessed for manufacturing them at a site in California. The insulins will have to be approved by the FDA. Gov. Gavin Newsom said in a separate statement the products will be available to everyone, regardless of insurance coverage.

Oak Street Health and Interwell Health launched a joint venture called OakWell to offer primary care to patients with end-stage kidney disease in dialysis centers.  Patients undergoing in-center dialysis treatment spend approximately 12 hours a week in a dialysis center, Oak Street Health noted in the announcement, and that can make it difficult for them to schedule other medical appointments. With OakWell, patients will receive coordinated care from a primary care team and a nephrologist. Services such as video visits, behavioral health, and renal pharmacy support will be available. OakWell’s care services will start in the third quarter of this year and initially will be offered in Chicago, Houston, and Dallas-Ft. Worth. 

Reimagining public health programs to deliver equitable impact. McKinsey & Company, 3.20.23

What else we’re reading

A Walk in the Woods: Rediscovering America on the Appalachian Trail, by Bill Bryson. Up at our cabin in Prescott this weekend to recharge, this was the perfect re-read by one of my favorite writers. You will laugh out loud — really — as he describes his adventure on a hike that many of us have always wanted to do, but didn’t have the time or energy to do it.


Contact Darwin Research Group and we will get right back to you.