re: Cigna payment model/denials - this is not surprising at all. I had a client sue another large national payer…
Allscripts will sell its Hospitals and Large Physician Practices business segment to Canada-based Harris for up to $700 million in cash. The segment includes Sunrise, Paragon, TouchWorks, Opal, Star, HealthQuest,and DbMotion. It generated 2021 revenue of $928 million.
The deal is expected to close in Q2.
From the investor call:
- The company sold the business because it has shrunk for three straight years and will likely continue to do so; Veradigm is growing 6% to 7% organically; and managing unrelated businesses under a single corporate structure was becoming increasingly hard.
- Allscripts hopes to “unlock value” of its shares, whose price it feels is discounted compared to peers, by “separating pieces of the company.”
- The business had adjusted EBITDA of $145 million on revenue of $928 million. Management expects the unit’s revenue to drop 3-4% in 2022 and EBITDA to shrink 10-15% year over year.
- The unit being sold generates 60% of the company’s revenue and one-third of its free cash flow.
- Allscripts will use its expected after-tax proceeds of $600 million for share repurchase and potential M&A related to Veradigm.
- Interesting: the investor slides are copyrighted and footnoted as Veradigm, with the name Allscripts only appearing on the title slide.
From Former Eclipsii: “Re: Allscripts. So just under 12 years after buying Eclipsys for $1.3 billion, nine years after picking up DbMotion, and five years after acquiring Paragon from McKesson, Allscripts is selling its various parts for a loss? When I was at Eclipsys, we had looked at buying Allscripts and decided it wasn’t worth the effort.” Allscripts reportedly paid $235 million for DbMotion and $185 million for Paragon, so Allscripts spent $1.72 billion in acquisition costs alone for businesses that it is selling years later for $700 million, less than one year’s revenue. But wait, there’s more – it threw in former flagship TouchWorks as well. Last week’s earnings call made it clear that Allscripts was unhappy that its share price undervalues the company, a complaint that it makes just about every quarter, and that Veradigm is its future. I would be interested in hearing the reaction of Allscripts customers to the acquisition announcement. Also, what happened to the puffy 2019 announcement that Allscripts and Northwell would develop a next-generation EHR following the never-left-the-ground flop of Avenel?
From Mark Words: “Re: Allscripts. I predict that Harris / Constellation will acquire Meditech next since its business model is exactly what Constellation looks for – mission-critical software, high recurring revenue, and a somewhat stable market position in a mature market. Not to mention that Meditech is pretty strong in Canada and Harris already owns Iatric Systems, which has strong Meditech focus.” I agree it would be a good target. Constellation’s business model would support paying around $400 million for Meditech, which I doubt would entice its owners to sell.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Baker Tilly. Baker Tilly US, LLP is a leading advisory CPA firm, providing clients with a genuine coast-to-coast and global advantage in major regions of the US and in many of the world’s leading financial centers. On March 1, Baker Tilly merged in Orchestrate Healthcare, a multi-year Black Book and Best in KLAS awarded healthcare IT consulting firm. Combined with Baker Tilly’s legacy healthcare practice, their combined practice brings providers solutions for financial sustainability, integration and interoperability, EHR implementation and optimization, healthcare analytics, information security, and healthcare IT staffing. The company’s healthcare IT consultants are seasoned professionals with both a broad range of experiences and a deep understanding of how to listen, analyze, and innovate for process improvement. With over 1,400 healthcare IT engagements from Orchestrate and more than 3,100 healthcare clients from Baker Tilly, the company’s team of healthcare specialists excels at what they do, so your organization can excel at what you do. Baker Tilly is an independent member of Baker Tilly International, a worldwide network of independent accounting and business advisory firms in 148 territories, with 36,000 professionals and a combined worldwide revenue of $4 billion. Thanks to Baker Tilly for supporting HIStalk.
I’ve updated my guide to what HIStalk sponsors will be doing at ViVE next week. You can also download a PDF version. Want to make me look good? Let them know at the conference that you saw them listed.
Speaking of which, HIStalk sponsors who are participating in HIMSS22 should fill out my form by end of day Friday, March 4 to be included in my guide for that conference.
And speaking of HIMSS22, six exhibitors will staff booths of at least 4,000 square feet – EClinicalWorks, Epic, Microsoft, Cerner, IBM, and Athenahealth.
Don’t try this at HIMSS22: I’ve noticed several ViVE-related meetings and social events that will be held on boats. I’ve been on a couple of these in years past and they were fun, although choose your host carefully because you’ll be captive for hours.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Cognizant develops a remote patient monitoring solution using Microsoft Cloud for Healthcare.
Cancer risk assessment software vendor CancerIQ raises $14 million in a Series B funding round.
Israel-based research data discovery platform vendor MDClone raises $63 million in a Series C funding round.
- University of Rochester Medical Center selects Spok Care Connect to replace its operator console and support clinical communications at Strong Memorial Hospital.
- Behavioral health staffing and services provider EvolvedMD will implement NeuroFlow’s patient registry and mobile technology to enrich collaboration with HonorHealth’s 24 locations.
- Orbita and OnCall Health choose Lyniate to solve data-sharing challenges.
- Health Gorilla will incorporate clinically validated social determinants of health scores from LexisNexis Risk Solutions in its Health Interoperability Platform.
- Respiratory remote patient monitoring platform vendor Spire Health chooses Redox for EHR integration.
- Hospice of Wichita Falls will implement WellSky’s hospice and palliative care solution.
- Opioid use disorder virtual care provider Bicycle Health will use Bamboo Health’s Pings and Spotlights for real-time insights into ED and inpatient care utilization.
- Healthwise will integrate First Databank’s Meducation multilingual monographs into its digital point-of-care and patient education solutions.
John Chelico, MD, MA (Northwell Health) joins CommonSpirit Health as SVP/CMIO.
Harmony Healthcare IT hires Tamara Korbel, MBA (PDS) as SVP of operations and client experience.
Christine Yang (Stanford Health Care) joins Alameda Health System as VP/CTO.
Laurence Kessler, MPH (NThrive) joins Healthrise as SVP of growth and partnerships.
Announcements and Implementations
Styker-owned Vocera announces Minibadge, a hands-free, voice-driven communications device for mobile healthcare workers.
Diameter Health releases a technology and services solution for HIEs and data aggregators that are undertaking NCQA’s Data Aggregator Validation program.
CareMesh implements FHIR-based integration of its Navigate clinical program management system with Epic and Cerner.
VCU Health System went live on Epic on December 2021 with the assistance of CTG, which provided legacy system support, go-live preparation, data conversion, optimization, training, and at-the-elbow support.
CVS Health launches a Health Dashboard to allow people who received COVID-19 vaccination from CVS Pharmacy or MinuteClinic locations to access their record and print a QR code. The company says the dashboard will be expanded beyond vaccination and COVID test records.
Government and Politics
I missed this a couple of weeks ago: a federal jury convicts a Palm Beach, FL psychiatrist for billing private health insurers $110 million for drug urine screenings at a sober living living facility that was taking kickbacks to refer patients. The doctor, who was also the sober living facility’s medical director, wrote standing orders for the facility in exchange for a monthly fee and then had the patients sent to his office so he could bill several tests per week per patient at up to $9,000 per test. We hear a lot about insurers that are powerfully armed with big data capabilities, but how hard would this have been to detect given the dollar volume, the obviously frequently repeated tests, and the fact that it’s South Florida? Maybe this supports the argument that insurers have limited zeal for chasing fraud since it’s easier to raise premiums.
- Cerner President and CEO David Feinberg, MD joins Humana’s board.
- Bicycle Health, a virtual care company specializing in treatment for opioid use disorder, expands its use of Bamboo Health solutions to include Pings and Spotlights solutions for real-time insights into ED and acute inpatient care utilization.
- Impact Advisors celebrates its 15th anniversary.
- Jvion will exhibit at the Rise Summit on Social Determinants of Health March 20-22 in Nashville.
- Kyruus publishes a new infographic, “The Growing Role of Health Plans in the Search for Care.”
- Nordic Consulting has received certification from HITRUST via the risk-based, two-year validation process.
- Duty of Care for Business Travelers (Everbridge)
- 6 Components of a Vulnerability Threat Management Program (Fortified Health Security)
- A Renewed Appreciation for the Work Commute (HCTec)
- 9 Ways to Address Healthcare Staffing Challenges using Human Capital Management (Healthcare IT Leaders)
- The Importance of Epic Community Connect Service Level Agreements (Impact Advisors)
- The developer experience: how to nurture and retain existing tech talent (InterSystems)
- Managing HCCs for the right reimbursement (Intelligent Medical Objects)
- Will We See You at the ViVE Conference? (LexisNexis Risk Solutions)
- Leveraging AI Principles from Financial Fraud Detection to Identify Medication Errors (MedAware)
- Is Double Documentation Delaying the Delivery of Surgical Care? (Medhost)
- Privileged access management helps mitigate insider threats before they happen (Meditech)
- What is a SOAP Note in Physical Therapy? (MWTherapy)
- How Vanderbilt is improving the physician and patient experience with virtual assistant technology (Nuance)
- Why healthcare leaders should embrace the cloud (Nordic)
Mr. H, Lorre, Jenn, Dr. Jayne.
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1. I suppose it it possible that Harris would want to buy Meditech, but I do not believe it likely on planet Earth.
2. Allscripts: what’s left? https://www.northwell.edu/news/in-the-news/allscripts-microsoft-strike-5-year-cloud-partnership-to-enhance-ehr-software ??
Allscripts Pro? Because that’s a really… adequate(?) piece of ambulatory EHR?
Everything that Allscripts is known for has been carved out. It’s basically just Veradigm. Who’s taking bets on if they’re going to rebrand by next HIMSS and bury the Allscripts name for good?
I actually figured that the purchase would be the other way around, that veradigm would be sold, but moving Pro and Practice Fusion under the PLS umbrella made sense. Veradigm is run like a business, focused on revenue by providing value to its customers. I could never figure out what leadership was doing on the allscripts side of the house.
dbMotion was declining year over year in sites, their Population Health Analytics solution was finally put down after years of not being able to calculate the most basic of conditions or generate a cohort list. The dbMotion solution itself was extremely expensive to configure and maintain, and the resulting data was often — troubled. The Community Integration Agent (CIA) that fed it from the Allscripts product was written by the same team that wrote Avenel. Avenel was a bowl of spaghetti that couldn’t do basic EHR functions nor even Alexa level transcription.
Touchworks was a hot mess, being passed back and forth between continents, having outside contractors rewriting the middle tier only to have to rewrite it again, then to let the entire team that worked on the uplift were let go the week it was released.
There are a lot of great and dedicated people working for Allscripts, but leadership is challenged on too many levels to count. Harris will have an interesting time working through that dichotomy of senior leadership vs individual contributors. Given Allscripts barely knows what products it received from previous M&As, it will be an interesting task to map out what Harris receives.
Last publicly traded EHR company bites the dust.
5 years agoI would have bet Cerner would have outlasted Allscripts but that both would ultimately be acquired by 2025.
The 3-4% revenue projection drop for Allscripts doesn’t surprise me given several trends (e.g., nothing new to sell, exhausted cross-sell opportunities from previous M&A acquisitions, shift in health IT spend, shift in physician employment, etc).
The 10-15% drop in EBIDTA does though. It makes me wonder at how aggressive Allscripts has been on financial engineering around depreciation and amortization especially on legacy hardware they supplied.
In the end, I can’t say if this will be a good/bad thing for the large number of physicians who are still using a legacy Allscripts EHR. It isn’t a trivial number either. I just don’t know how Harris/Constellation will treat the acquisition. Cautiously optimistic?
I think this is plausibly a positive outcome. Allscripts didn’t put much effort into Sunrise or TouchWorks, instead focusing on acquisitions and the growth in Veradigm and other segments. They did no new features and they didn’t have the focus to run support and maintenance. With Constellation there will be an executive team that is actually tasked with only these products and they’ll make their money off support and maintenance. Nobody is ever going to add features to these products, but maybe Constellation is better at keeping the lights on than Allscripts.
Certainly it is a better outcome than being acquired by a different EHR or EHR adjacent vendor. I think the expectation there is to cannibalize the good customers onto their preferred platform with a small carrot and a big stick. Then if you won’t go, jack up the price within contractual limits and ignore your calls.
So I guess the optimism is that now Allscripts users will get the cheap corporate experience that comes from harvesting dated enterprise software investments. And they’ll avoid the unfocused, hostile, hot garbage experience that comes from being used as a component to complement another more strategic corporate investment.
I also wonder how much of current revenue comes from Northwell. I think it’s hard to overstate how much the real financials and profit of Sunrise depend on Northwell and how risky that makes the future. A certain amount of overhead is per customer. You’ve got to pay the account manager to handle X relationships and the lawyer to write X contracts where X is related to how many customers you have. That service is possible when you have one big customer paying the bills and you can service the little customers when the big one isn’t paying attention. But if all you have for customers is a bunch of systems with one to three hospitals, it’s hard to make it work at all and no one is able to get interested enough to take calls.
Ballpark guess – Northwell is 3-5% of total revenues for Allscripts.
I think the more relevant number to me is what percentage of the acquired company’s (Sunrise, TouchWorks) revenue will Northwell be after everyone whose announced leaving leaves (like UH must have at least a couple more years of contract but that doesn’t have much service cost and will be gone soon). I would have guessed 15 percent revenue, more of profit. But I have no real knowledge, just earnings calls and quarterly reports.
I’m stunned at the low price.
At the price Harris paid, they have a great opportunity to produce a lot of EBTA for the next 5-7 years. Slash all of the spending on products and marketing and skinny the company down to bare bones. It will take at least 5 years for most of the customers to switch platforms, and you will generate profit during the run down.
Just dumping the overhead of the Allscripts C-suite has to add $20m per year to the bottom line.
Allscripts stated use of the profits from the deal is yet another stock buyback that will create a great selling opportunity for the Allscripts executive team.
Allscripts disclosed largest customer (Northwell) as 12.5% of 2021 total revenue of $1.503B or approximately $188M.
“Leadership” at Allscripts in the last 10 years managed to spend billions buying something that was worth way less. Who r these morons who hire such CEOs. Crazy ppl who just played hooky with our careers.