Facing the inevitable deflationary pressures being put upon the healthcare system, innovation is critically needed. Having spoken with several innovation groups in health systems, most examples of “innovation” are decidedly uninspiring. Primarily, it is due to the fact that virtually all of their decisions have to go through the prism of how new ideas will fit with current businesses — a guarantee that will doom so-called innovation to be little more than incremental improvements. Consequently, increasing numbers of hospitals and health systems are smartly allocating money to venture funds that have free reign to find truly disruptive new businesses.
Health systems have taken various approaches such as becoming a Limited Partner in venture funds like Health Enterprise Partners. Some of the larger systems, such as HCA and Dignity Health, have their own venture arms. A new development is a much smaller organization establishing their own venture fund. Implicit in this approach is a much more hands-on approach than as an investor in a 3rd party venture fund. Rex Health Ventures is an early example of venture-capital investment funds in the country started by a community, nonprofit hospital (Rex Health Care). The fund is being launched with an initial $10 million investment from Rex Healthcare and will help finance the most promising innovations among new medical services, tools and technologies.
Rex carved out money from their investment portfolio previously in the “alternative investment” category. Given the capital efficiency of startup technology businesses, for a small fraction of the absurdly massive amounts they are paying legacy vendors for software built for the old reimbursement/care models that are rapidly being replaced, they have an opportunity to have a stake in businesses that could help reinvent their industry. Even if these businesses don’t succeed, the learning they will receive will outstrip other ways they could allocate money. For example, it’s not unusual for providers to pay large sums in consulting fees that might be better spent actually putting ideas into practice rather than simply talking about it.
For Rex, it was an 18 to 24 month process from concept to announcement of their fund. David Strong (President of Rex Healthcare) was the driver and one of his mentors had been Doug French, formerly CEO of Ascension Health and now managing director at Santé Ventures. Ascension has had success with their venture fund. It has proven to be effective at bringing about new ideas and companies into the Ascension fold. In addition to their venture fund, they have additional programs to encourage innovation:
- Rex Joint Ventures: a program to partner with thought leaders in the local and regional technology, research and entrepreneurial communities. The goal of such partnerships will be to team up to develop new products and services that can improve healthcare technology and delivery.
- Rex Impact Grants: a program to provide grants to a wide range of businesses and organizations that are working to help improve patient care or community health status.
- Rex Innovation Facilitator: a formalized way for Rex co-workers and thought leaders in the community to submit innovative ideas and receive technology commercialization and company-building services for promising concepts that could lead to new products or services.
Rex Health Ventures (RHV) believe they are uniquely positioned for venture compared to their traditional venture brethren. A core reason they state is they can conduct due diligence since they have staff who would be the ultimate users of a new medical device or healthIT tool. After the investment, they can help with product development and services that fit community hospitals. It isn’t unusual for products developed in academic medical centers to fall flat when moving out to a regular community hospital where dynamics and budgets are radically different.
Investment focus and goals
RHV expect their investments will be a mix of IT related services, pharma, and medical devices. Rex also indicated they would look at new care delivery models such as Direct Primary Care (DPC) as University of North Carolina (with whom they are affiliated) is looking at new models of care delivery. Purely coincidental is the fact that one of the pioneers in supporting the exploding DPC model (Physician Care Direct) is in the same locale.
RHV plans on being a seed and early stage investor. Most of the companies they invest in will be pre-revenue. They expect their deal size to initially be $250-500k in A rounds and they will allocate an additional $500k-$1.5M. While they aren’t purely driven by financial objectives, they are important. Rex’s most important objective is they want to create a more innovative culture. They realize change is coming, particularly in the provider space. The fund is intended to help culture look differently at the world and to cause people inside the organization to look up from their day jobs.
The Rex Health Venture leaders such as Bobby Helmedag recognize that healthcare is entering a period that is likely to be deflationary. Thus, they believe that a core part of being innovative is to provide the same level of care for less money. Rex’s leadership see that The Rise of Nimble Medicine may create challenges for their traditional business, however it creates even more opportunities for creative new startups. For example, telemedicine can cut healthcare costs 90% in some areas of care. Telemedicine is one example of how healthcare organizations are realizing that communication is the most important medical instrument of the future.
This is more good news for the rising healthtech startup community. Having smart money that knows the challenges and opportunities in healthcare can only help the ecosystem grow. One wonders whether future demo days of Blueprint Health, HealthBox, Rock Health and Startup Health will find as many strategic investors as pure financial investors. Gaining customer adoption is the biggest challenge for healthtech startups so this trend should help ignite their growth. This is a key reason by the New York Digital Health Accelerator (NYDHA) was formed. While the 22 healthcare providers part of the NYDHA haven’t put in investment dollars, they have committed significant executive resources. Rex is adding to the mix of different models meant to accelerate the reinvention of healthcare.
The following are hospital and health system based venture funds:
- CHV Capital – Indiana University Health System
- Cleveland Clinic Innovations
- Dignity Health
- Geisenger Ventures
- Kaiser Permanante Ventures
- Mayo Medical Ventures
- Mission Bay Capital spun out of UCSF
- Partners Innovation Fund (Brigham and Women’s Hospital and Massachusetts General) Rex Health Ventures (Rex Healthcare)
The following are venture funds with hospitals as their Limited Partners:
- Ascension Health Ventures
- Health Enterprise Partners
- Heritage Healthcare Innovation Fund
Health-related accelerators with active health system involvement
- New York Digital Health Accelerator
- Rock Health – Harvard Medical School, Kaiser, Mayo and UCSF are listed as sponsors
Another development at the regional level are regional Health Plans with venture arms. A couple examples include the following:
- Cambia Health (parent of Regence Blue Shield)
- Premera Blue Cross
Given the threat to the core health insurance business, Aetna and United Health have been very active in acquisitions, venture funding, etc. Please add in comments below which other regional health plans have venture arms.
Dave Chase is the CEO of Avado.com, a Patient Relationship Management company. Previously he was a management consultant for Accenture’s healthcare practice consulting to 25 hospitals and was the founder of Microsoft’s Health business. You can follow him on Twitter @chasedave.