Virtual-first primary care company Firefly Health is becoming a health plan! Backed by a $40M Series B, CEO Fay Rotenberg and Executive Chairman Jonathan Bush stop by to explain how they’re providing “half-price healthcare that’s twice as good.” (Or, as only Jonathan can put it: “we’re a bloat-less Kaiser.”) All kidding aside, some big-name health innovation investors are not only behind this raise (Andreessen Horowitz led, F-Prime Capital and Oak HC/FT dipped back in), but also this idea to wrap a benefit around Firefly’s digitally-driven comprehensive care model. Already in-market, the new benefit-plus-care product is aimed squarely at mid-sized/small, fully-insured employers – shops with 50-500 employees which, right now, have limited options for dramatically changing their healthcare spend or being able to build out their own benefits the same way large self-insured employers can.
Fay and Jonathan get into the details about how they’re extending their “Marie Kondo-ing” of healthcare delivery – which has thus far netted some pretty impressive health outcomes, cost savings, and a 92 Net Promoter Score – into healthcare financing.
BONUS: Tune in around 25:30 and stick around for a few minutes as Jonathan weighs in on the health tech funding boom, how it compares to the EMR arms race days of ole, and whether or not he thinks he can beat Glen Tullman’s $14.5B valuation if/when Firefly goes public. HA!
Anyone who follows me knows that I’ve been questioning whether digital therapeutics are real and more importantly whether the people building and trying to sell them are simply trying to replicate the American drug pricing model–patent, protect, prescribe & price gouge. So who better to have this conversation with than the person in charge of explaining and selling the notion of digital therapeutics to the world? Megan Coder is Executive Director of the Digital Therapeutics Alliance. She graciously and bravely agreed to talk to me. Who won the argument? You’ll have to watch to decide, but I found our discussion to be a lot of fun and very interesting and I hope you will too – Matthew Holt
The transcript is below
Matthew Holt:
Hi, it’s Matthew Holt with a THCB spotlight. I’m here with Megan Coder. Megan is the executive director of the Digital Therapeutics Alliance. And we’re here to talk about this thing called digital therapeutics, as to what they are, what the alliance does and whether they really exist and how we should treat them. Megan, thanks for coming on. I know we’ve done a little bit of sparring online and in-person, but I’ve never interviewed you. So I’m looking forward to this. So how are you doing?
Megan Coder:
Good. It’s more fun to spar in-person, but I miss the in-person aspect.
Happify Health is a online mental health company that is focused almost exclusively on scaling care by offering self-service tech solutions across the patient journey. After R&D starting in 2012, they’ve been scaling since 2017 and now are working with large employers and big health plans. What they don’t do is have their own therapists or psychiatrists. This is an interesting approach and probably much more scalable than many of their competitors. Today they raised $73m more to build out their solutions. I talked to Happify Health’s President, Ofer Leidner about how far they can go with automated self-service. He thinks it’s a long way.
Kelsey Mellard is CEO of Sitka, one of the emerging companies that’s providing specialty consults online to primary care docs. They’ve been building a specialty care network that can be accessed by asynchronous video, slightly different to some of their competition. Most of their customers are capitated medical groups, like ChenMed, trying to reduce their spend on specialty physician care (as Kelsey calls it the “unmanaged Part B spend bucket”). I asked her how it works, where the company is going (think virtual care integration), and whether it will be needed in the future. (You can guess her answer to the latter!)
On Episode 186, of Health in 2 Point 00 – I have bad jokes about Olive.ai-related Circulo raising $50m, online/offline clinic Eden Health grabbing $60m, cancer app Carevive getting $18m & provider engagement play Loyal getting $12m. Will Jess DaMassa think the jokes are funny? You’ll have to watch to find out but you can make a pretty good guess!—Matthew Holt
We are excited to announce that the campaign to pledge to the Participatory Medicine Manifesto is launching today — and we need your support!
Our Participatory Medicine Manifesto is a call to action for patients, caregivers and health care professionals to equally share decision-making and respect one another.
We want you and your organization to help us fix a broken healthcare system from the ground up. We want to put democracy back into the culture of healthcare by enabling patients, healthcare professionals and caregivers to all have an equal voice. We need your influence to inspire people. We will list individuals and organizations that support the Manifesto.
We have designed a promotional campaign encouraging people to pledge to the Participatory Medicine Manifesto. As part of this campaign, we created a pledge form and social media toolkit for people and organizations to use in spreading the work about Participatory Medicine.
And spread the word to your colleagues and friends to help us reach our goal. After you pledge you will find the easy to use social media toolkit.
We greatly appreciate your help and support!
Eric Bersh, Judy Danielson, Kevin Freiert, Matthew Holt, Dr. Danny Sands, Amber Soucy—all board members of SPM
David Medvedeff, CEO Aspen RxHealth, tells me about the new role of pharmacists in managing chronically ill patients. Aspen RxHealth has put together a network of independent pharmacists and a tool that allows them to select patients, call them and consult with them for their pharmacy issues. It’s kinda like the original Teladoc model but for pharmacists, while the clients are health plans keen for their patients to avoid problems with polypharmacy. They’ll be doing 200K+ consults this year and just raised $23m.
Attention digital health innovators! Do you have a health tech solution that can aid community-based care coordinators in COVID-19 vaccine screening and appointment scheduling for their underserved and vulnerable patients? Apply to the second Alliance for Better Health Rapid Response Open Call, hosted by Catalyst @ Health 2.0 & sponsored by the Robert Wood Johnson Foundation!
As the COVID-19 pandemic continues, the importance of ensuring health equity and access is vital. This RROC is looking for solutions to help community care coordinators and providers schedule appointments for COVID-19 vaccines for vulnerable and underserved patients who may be facing barriers to self-scheduling those vaccine appointments. The intended care providers are those working with patients who may lack resources, health literacy, or face other barriers to self-scheduling appointments. A select group of semi-finalists will have the opportunity to demo their technology. A grand prize winner will receive $15k and the opportunity to collaborate with Alliance for Better Health!
Do you have a solution that can fit this need? Apply HERE today! Applications close 2/2.
(This is the second of 2 COVID-19 RROC challenges from Alliance for Better Health. The first was for vaccine administration tracking announced on Tuesday 19th. Both are mentioned in the video from Jacob Reider, Alliance for Better Health’s CEO, which you can see below)
CEO Jacob Reider introduces the challenges
About Alliance For Better Health: Alliance For Better Health engages medical and social service providers in developing innovative solutions to promote people’s health, with a goal of transforming the care delivery system into one that incentivizes health and prevention. Established in 2015 as a Performing Provider System in the New York State Delivery System Reform Incentive Payment program (DSRIP), Alliance partners with more than 2,000 providers and organizations across a six-county area in New York’s Tech Valley and Capital Region.
Elizabeth Brown is a Program Manager at Catalyst @ Health 2.0
Attention digital health innovators! Do you have a tracking tool that can assist public health care providers in managing the two-phased COVID-19 vaccination administration? Apply to the Alliance For Better Health Rapid Response Open Call for Vaccination Administration Tracking!
As the COVID-19 pandemic continues, the importance of ensuring health equity in #COVID19 vaccination administration for vulnerable and underserved populations is increasingly critical. Catalyst @ Health 2.0 is proud to host a Rapid Response Open Call (RROC) in collaboration with Alliance For Better Health. A select group of semi-finalists will have the opportunity to demo their technology. A grand prize winner will receive $15k and the opportunity to collaborate with Alliance For Better Health!
Do you have a solution that can fit this need? Apply HERE today! Applications close 1/31.
(This is the first of 2 COVID-19 RROC challenges from Alliance for Better Health. The second will be announced on Thursday 21st but is mentioned in the video from Jacob Reider below)
CEO Jacob Reider introduces the challenges
About Alliance For Better Health: Alliance For Better Health engages medical and social service providers in developing innovative solutions to promote people’s health, with a goal of transforming the care delivery system into one that incentivizes health and prevention. Established in 2015 as a Performing Provider System in the New York State Delivery System Reform Incentive Payment program (DSRIP), Alliance partners with more than 2,000 providers and organizations across a six-county area in New York’s Tech Valley and Capital Region.
Elizabeth Brown is a Program Manager at Catalyst @ Health 2.0
Andreesen Horowitz’s digital heath investor Julie Yoo has been building quite the theory of the present and future of health tech. I am going to try to write up a longer response to her but first, please view her presentation on the New Tech Stack for Virtual-First Care — a compelling 8 minute watch. And then have a quick read about how I am (trying to) put her in context.
Her first argument is that the digital services that you need to run health care (things like accounting/revenue management, network management, credentialing, pharmacy, etc, etc.) are getting really good. That means that startup digital heath companies can build services really quickly. No argument there. The second part of her argument is that incumbent organizations will also use these tools (actually already are using these tools) to improve their offerings.
Her argument is somewhere in the middle of three themes I’ve been banging on for a while.
My first argument is that too much VC money has been spent on new tech companies intending to prop up the incumbents and the incumbents by definition can’t change to become the type of virtual-primary care first chronic care management consumer friendly organizations that we need. I called this the Lynne Chou O’Keefe fallacy (which is why Julie wants one of her own!) and wrote it up on THCB about a year ago.
The second is the rather longer theme that I (with Indu Subaiya) have been banging on about called “Flipping the Stack”. The basic idea is that health care services now have the potential to go from an event-driven, encounter-driven acute-care delivery model to one where technology is able to measure, manage, message and monitor patients wherever they are, and that virtual services and physical interventions are layered over the top.
The third is my idea about the “continuous clinic” which is an attempt to describe the activities that an organization needs to run a 24/7 patient management organization. (I’ve presented on this many times but haven’t totally written it up–a version of how it might work for COVID patients is here).
Somewhere in what Julie is doing and in my fumbling towards new models is the idea of what a new health system will do and what it will look like.
Of course the related question is who will be the players? While we have United Healthgroup buying anything that moves and the incumbent hospital systems collectively sitting on an Apple/Google sized mountain of cash reserves, it’s hard to see the current system being changed dramatically by the people running it now.
