Chartis Top Reads – Week of August 1 - August 7, 2021

Our research team breaks down this week’s top healthcare news.

Top Reads Overview

In an age of unprecedented change, staying current has never been more important. Our team at Chartis is curating news most relevant to the healthcare industry and tracking the topics that are trending on seven key issues: high reliability care, digital and advanced technology, financial sustainability, health disparities, the health ecosystem of the future, partnerships, and the provider enterprise. Each week, we break down what’s happening and why it matters.

The State of COVID-19

The Buzz This Week

Many thought COVID-19 was all but over in the United States this spring as cases rapidly declined, but in places with low vaccinations rates, the past few weeks have seen a devastating new wave of cases. Florida this week saw the highest single-day new case total and a seven-day average that increased 750 percent since July 1. The newest spike indicates that we do not yet have this virus under control, particularly the delta variant.

Although too late for many, in positive news, there has been a significant increase in vaccination rates in July. The growth has been the highest in states with the lowest vaccination rates as the delta variant has hit these areas especially hard. The national average is up to 650,000 shots per day — an increase of 26 percent from three weeks ago. But the rate is more pronounced in many Southern hot spots. Arkansas, Alabama, Missouri, and Louisiana have all doubled or nearly doubled their daily rates in the last three weeks.

Why It Matters

Many are worn down, and even angry, from continuing to contend with the ongoing pandemic, especially those who have long been vaccinated and do not understand the hesitation or refusal of those who remain unvaccinated. There is rightful concern and frustration that the return to normalcy of this spring may not last and fear that new variants will eventually evade the vaccines.

The vaccines are effective. They are the best means to prevent hospitalization and death from COVID-19. In the United States, vaccination rates are finally starting to increase again. It is vital that we understand what is working, who is still hesitant about receiving the vaccine, and why they are hesitant. That will allow us to address fears and issues, prevent further loss of life, and come closer to ending the pandemic. The data shows four demographic correlations amongst those who are vaccine-hesitant:

  • One link that has been widely reported is the tie to political affiliation — there is a positive association between counties with high vaccination rates and those that voted for President Biden in the 2020 presidential election. Just this month, some of the gap has started to narrow as prominent Republican officials have strongly encouraged their communities to get vaccinated.
  • Another correlation is race, though that gap is also closing. Black and Hispanic rates have lagged white vaccination from the beginning, though for many in Black and Hispanic communities, they noted they were willing to be vaccinated but wanted to wait and better understand the safety profile and efficacy first. As data has shown that the vaccine is both safe and effective, many have moved forward with their vaccination.
  • Income also appears to be a barrier to vaccination. Those in a lower income bracket have expressed anxiety or fear over taking time off and needing childcare both to get the vaccine and to recover from the doses, should they have side effects. Additionally, there have been reports of those erroneously billed for their vaccine as well as misinformation around the fact that the vaccine is no cost to anyone, regardless of insurance status.
  • Age is also correlated with vaccine status. As age decreases, likelihood of having received the vaccine also decreases. With the spike in the delta variant, many of the COVID hot spots are seeing significantly younger hospitalizations and deaths as nearly 80 percent of those over age 65 are vaccinated, while only 43 percent of those 18 to 24 years of age are vaccinated.

It is important to distinguish between the various unvaccinated parties and use targeted tactics that are most effective for each group. Someone who is apathetic and politically opposed will not be swayed by a paid day off or better understanding of the safety profile of a vaccine. For those who want more information, their legitimate questions should be addressed. For those who face financial barriers to access, companies or the government should consider offering time off or free transportation and safe childcare options.

For those who have said they would definitely not get vaccinated, it seems to be closely linked to political or religious beliefs. In those cases, mandates or endorsements from party or religious leaders may be the only way to make an impact. Based on the increasing vaccination rates this month, some Republican leaders likely already have had influence. As cases increase nearly everywhere, it serves everyone to do what we can to increase vaccination rates. Even if it is no longer possible to fully end the pandemic, we can drastically minimize surges and save lives.

Digital and Advanced Technologies

The Buzz This Week

Digital health continues to advance as a key component in the evolving healthcare ecosystem, with adoption by providers and consumers increasing. A recent CB Insights report found that 60 percent of healthcare organizations surveyed were starting new digital projects, and 42 percent are accelerating some or all of their digital transformation plans. Digital health start-ups are receiving attention from investors with record levels of investment. Rock Health recently released a report finding venture investment activity in digital health start-ups in the first half of 2021 — $14.7 billion — has already eclipsed the entire year of funding in 2020, and any prior year. In addition, the sector is undergoing significant merger and acquisition (M&A) activity. Mercom Capital Group recently released a report, as summarized in a piece in Modern Healthcare, stating that there have been 136 digital health M&A deals disclosed in 2021 so far, on pace to surpass the total of 184 deals in 2020 and 168 deals in 2019.

The growth in digital health solutions has been supported by advances in technology, a market necessity for digital healthcare with COVID-19 — and therefore coerced market adoption — and a recognition that all industries are undergoing some form of digital transformation, as is healthcare. Start-up companies have proliferated, and funding has been rich as investors seek to ride the trend. But with an introduction of many new but relatively similar products in any industry, the market becomes overcrowded, and M&A is a natural outcome. As Paddy Padmanabhan, host of The Big Unlock podcast, stated in a recent Modern Healthcare piece, “There's way too many digital health startups with way too many undifferentiated products." This inevitably leads to some start-ups failing, and others with like interests and/or complementary capabilities merging.

Why It Matters

For investors, the intense focus on digital health and growth momentum in the sector translates into some risk for both investors and start-up companies. As the recent Rock Health report states, “This speed and amount of investment will test the marketplace’s current and future capacity to design and deliver digital health solutions, and then scale them into sustainable companies.”

For healthcare providers, the rapid growth in digital health solutions presents many options for advancement in health system capabilities and efficiencies. However, it also introduces risk in vendor selection: A digital health company operating today, particularly the start-ups, is not guaranteed to be around in a year or so. With the amount of change, training, and provider and/or patient education with the launch of each new digital tool, a health system is put in a challenging position if a vendor goes out of business or merges with another company and renegotiates a contract or makes changes to its digital platform that require retraining.

For patients, the plethora of digital health platforms and mobile applications can be overwhelming. Deciding which to use with the knowledge that each of these platforms and applications may change, become something new, or disappear can cause consumer paralysis, or app over-subscription but under-utilization. Providers can help guide consumers to apps they recommend and that connect into their health system, acknowledging the risks mentioned above.

Because of the dynamics described, this market is likely to see continued consolidation, as some smaller start-ups become defunct; others are acquired; and larger, more established entities (e.g., Teladoc) build growth momentum, market share, and expand their breadth of services and solutions.


Roger A. Ray. MD
Chief Physician Executive
[email protected]

Alexandra Schumm
Principal, Vice President of Research
[email protected]

Abigail Arnold
Senior Research Manager
[email protected]

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Past Top Reads

Chartis Top Reads Week – of August 1 - August 7,… | The Chartis Group