By Joe Ebberwein, Co-Founder and CFO
Here we are once again in January of a New Year reflecting on the previous year in healthcare and specifically at Corstrata. The Telehealth adoption trend led to the second year of significant growth in wound and ostomy consults for Corstrata; 2020’s 100% growth in virtual wound and ostomy consults was eclipsed by 200% growth in 2021.
Covid - While Corstrata experienced positive trends in 2021, there continued to be many struggles centered around the virus and the emergence of two new deadly and virulent strains - Delta and Omicron. Most people had held out hope that 2021 would provide much-needed relief from the turmoil and anguish caused by the worldwide Covid pandemic of 2020. However, 2021 did not produce the turn-around we longed for, despite the increased availability of vaccines to combat its spread. Cases of Covid to date have topped $56M in the U.S. with 825K attributed deaths.
Nursing Challenges - 2021 shined the spotlight on the significant shortages and access to nurses throughout the United States. The nursing shortage, as well as related work-related burnout, have been exacerbated by the pandemic. Some polls indicate that as much as 18% of U.S. healthcare workers quit their jobs during the pandemic, resulting in 62% of hospitals reporting a nurse vacancy rate higher than 7.5%. One glimmer of hope is the expansion of nursing license reciprocity through the Nurse Licensure Compact; to date, 39 states have enacted or have pending legislation allowing nurses to practice in multiple states.
Consumer-Driven Healthcare - In 2021, we witnessed a significant move by retail giants like Walgreens, CVS Health, Dollar General, and Amazon into the care delivery market. Walgreens invested $5.2 billion in VillageMD to integrate over 1,000 primary care practices next to Walgreens pharmacies. Additionally, Walgreens invested in the care management company, CareCentrix, to widen its reach in the post-acute care delivery space. At the center of these initiatives is the patient or consumer experience with the appropriate mix of in-person and virtual care. While the pandemic accelerated the use of technology, there will be a shift to this blended model of care, similar to what Amazon has achieved in its online retail experience.
M&A and Funding - Healthcare mergers and acquisitions surged in 2021, growing 56% in the 12 months through November 15th. Venture capital investment in global health tech companies was projected to reach $42 billion by the end of 2021, according to Silicon Valley Bank's(SVB) latest report, "The Future of HealthTech." The first three quarters of 2021 closed with what SVB called an astounding $34 billion invested globally across 1,040 deals. U.S.-based virtual and hybrid care companies raised more than $9.6 billion in 2021. On the startup front, “2021’s breakout funding is evidence of an unprecedented mandate for change, across all aspects of healthcare,” according to Rock Health’s report through Q3 2021. StartUp Health’s report, which focuses on the larger umbrella of “health innovation,” placed the 3rd quarter’s fundraising at $9.7 billion and the year-to-date tally at $31.3 billion. This is up from the $7 billion raised across 2020’s third quarter, the group wrote and put 2021 on pace to double the $21.9 billion raised in 2020.
Hospital at Home - We witnessed a proliferation of “hospital at home” care delivery solutions in 2021. The model provides hospital-level care to patients in the comfort and safety of their homes, resulting in improved clinical outcomes, lower costs of care, and higher patient/caregiver satisfaction. Validation of the model was evidenced by Mayo Clinic’s and Kaiser Permanente’s mid-year $100M investment in Medically Home Group, a Boston-based, national tech-enabled provider of hospital at home services. Additionally, the nation’s second-largest home health provider, Amedisys, acquired in-home care provider Contessa Health to expand its capability to provide acute level care in the home.
Wound and Ostomy Care - Covid continued to impact access to care in 2021. According to a report on WebMD, “During COVID-19 shutdowns, medical clinics temporarily closed their doors, and elective surgeries stopped, making it harder for patients to receive care.” Lee Kirksey, MD, vice chairman of vascular surgery at the Cleveland Clinic, describes what’s happened over the past year as a “pandemic superimposed on an epidemic.” A national survey of vascular surgeons found that 90% canceled elective surgeries during the pandemic. One study of 147 U.S. and Canadian sites found that preventive procedures fell by 71% and that hospital deaths increased by 500% for patients with urgent limb problems during COVID surges. WebMD reported data from Stanford Healthcare (March 2020 to February 2021) that shows the total number of amputations increasing 49%, compared to the prior year with the increase disproportionately borne by patients of color.
Although this highlights just one critical impact of Covide on the chronic wound patient population, Ostomy patients also experienced pandemic-related access issues with ostomy clinics, significantly reducing their hours of operation due to the scarcity of ostomy nurses.
Emerging Trends - 2022 and Beyond
Care Will Continue Moving Home - Fueled by changes in reimbursement, including CMS’s “Hospital without Walls Waiver” and the Acute Hospital Care at Home program, as well as regulatory changes, capital funding, growing staffing shortages, remote monitoring innovation, and consumer demand, the shift to care in the home will expand exponentially in 2022 and the coming years.
Telehealth Growth - The pandemic has shown us that telehealth and other digital health solutions change the way we view care delivery, from acute interactions to more longitudinal management of chronic conditions.
Artificial Intelligence in Healthcare- In an interview with TechTalks, Chief Innovation and Strategy Officer of Royal Philips, Shez Partovi, states “We need to dispel the myth that AI and ML are going to replace clinicians. In reality, they are simply new tools in the tool-belt of researchers and healthcare professionals that will enable them to do what they do best by providing them with actionable insights.” Andrew Kasarskis, Chief Data Officer at Sema4, predicts that innovations in health technology will help to improve medical diagnostics, leading to improved patient outcomes. Kasarskis states: “We continue to see great advances in machine learning (ML) and artificial intelligence (AI) applied to large information-rich data sources in fields such as image analysis and natural language processing, and I don’t expect that will slow down at all.”
Corstrata - 2021 and Beyond
As noted, the Telehealth adoption trend led to the second year of significant growth for Corstrata; 2020’s 100% growth in virtual wound and ostomy consults was eclipsed by 200% growth in 2021 for our customer segments of home health, hospice, skilled nursing facilities, rehab hospitals, Medicaid IDD waiver programs, wound and ostomy manufacturers, and consumers. This was punctuated by Corstrata recently executing a contract with a national hospital at home provider to provide specialized wound care consults for patients with complex wounds being cared for at home.
In Corstrata’s direct-to-consumer virtual ostomy support services, 99% of customers who responded to the customer satisfaction survey indicated they would recommend Corstrata to a friend or family member. Additionally, 22% of those indicated they would have gone to the Emergency Department for assistance if they had not had access to Corstata’s Ostomy certified nurses.
This year, Corstrata welcomed Yosef Nasseri, MD, a California-based Colorectal surgeon, to its clinical advisory board. According to Dr. Nasseri, “As a colorectal surgeon, I have deep respect for the expertise board-certified ostomy nurses provide my ostomy patients in optimizing their quality of life through education and clinical support. Finding access to an ostomy nurse is often a challenge for both providers and ostomy patients; Corstrata fills that unmet need and is poised to solve this problem through its technology platform coupled with a network of ostomy specialists.”
Corstrata’s investment in its compliant state Managed Service Organization / Professional Nursing Corporation infrastructure allows Corstrata’s board-certified nurses to practice at the “top of their licenses” in the delivery of wound and ostomy care, including in Direct to Patient models.
In a time when scarce wound and ostomy certified nurses are in demand nationally, Corstrata has attracted some of the nation’s most distinguished wound, and ostomy nurses with a curated list of over 180 board-certified wound and ostomy nurses available as Corstrata scales its operations throughout the U.S. and Puerto Rico with significant contracts expanding services in 2022.
Building a Wound Program of Excellence
Corstrata was featured in multiple publications this past year. In this Home Health News article, Corstrata CEO Kathy Piette discusses the importance of building a Wound Program of Excellence.
Wound care is a massive piece of the home health care business — about 30% of home health and hospice patients suffer from wounds. A wound program of excellence allows agencies to treat these patients properly, effectively, and compassionately.
Corstrata’s CFO, Joe Ebberwein, discussed how hospital at home and SNF at home models need access to clinical wound specialists to create a wound program of excellence in this episode of Home Health Care News Voices. Creating seamless and timely access to the best minds in wound care is possible through technology, and that has been Corstrata’s focus for the last five years. The clinician at the bedside presented with a complex non-healing wound needs access to wound experts who can recommend the best patient-centered care plan. Technology is key to the virtual consult world, as well as the ongoing wound monitoring for timely intervention.
Corstrata’s VP of Sales, Kathy Pruitt, spoke to emerging models of care, such as SNF at Home and Hospital at Home, that will require home health and hospice agencies to care for higher acuity wound patients in The Rowan Report article entitled Maximize Episode Management with Evidence-Based Wound Care Corstrata’s virtual wound management solution has helped clients to decrease wound supply costs by 30%, decrease the number of home visits by 50%, and decrease wound healing time by 30%. Pruitt added, "Most technology offerings in our industry lack the ability to provide direct access to a wound and ostomy certified nurse (WOCN). They offer great technology but not the consultation that home health and hospice nurses need to make good decisions around the care required to treat the wound effectively and efficiently."
Corstrata’s Mission is to enable wound and ostomy patients access to fuller, more enjoyable lives‒sustainably and at scale. To learn more about how we can support your care of wound and ostomy patients, contact us at info@Corstrata.com.