Today on THCB Spotlights, Matthew talks to Jacob Reider. Jacob is the CEO of Alliance for Better Health, one of New York State’s 25 Performing Provider Systems which work to reduce unnecessary or preventable acute care utilization for Medicaid members by improving the health of communities. Alliance for Better Health has a new approach to this—they’ve created an Independent Practice Association (IPA) called Healthy Alliance IPA to pull together community based organizations focused on improving health and addressing the social and behavioral aspects of health. Their approach helps the 29 organizations within the IPA negotiate funding and creates an infrastructure for integrating social determinants of health into health care. Watch the interview to find out how this is going to work in practice.
On Episode 3 of HardCore Health, Jess & I start off by discussing all of the health tech companies IPOing (Livongo, Phreesia, Health Catalyst) and talk about what that means for the industry as a whole. Zoya Khan discusses the newest series on THCB called, “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?”, which follows & discuss the legislation being passed on data privacy and protection in Congress today. We also have a great interview with Paul Johnson, CEO of Lemonaid Health, an up-and-coming telehealth platform that works as a one-stop-shop for a virtual doctor’s office, a virtual pharmacy, and lab testing for patients accessing their platform. In her WTF Health segment, Jess speaks to Jen Horonjeff, Founder & CEO of Savvy Cooperative, the first patient-owned public benefit co-op that provides an online marketplace for patient insights. And last but not least, Dr. Saurabh Jha directly address AI vendors in health care, stating that their predictive tools are useless and they will not replace doctors just yet- Matthew Holt
Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site.
Today on Health in 2 Point 00, Jess is reporting back to us from the future… On Episode 91, Jess asks Matthew about Babylon and MetaMe’s recent raises and CVS rolling out their new CarePass service. It’s been weeks and we haven’t had any more IPO’s, but Babylon’s $550 million raise—the largest ever in digital health, bringing its valuation to $2 billion—comes pretty close. Babylon is big and complex in what it offers, but at its core, it is an AI-based symptom checker. In the UK, they’re working with primary care doctors and in China, they’re working with insurance companies, but this latest round of funding points to where they’ll be focusing in the US. In other news, MetaMe raised $3.8 million to create a hypnosis-based digital therapeutic for IBS treatment and there’s been a lot going on in this space. Finally, now that CVS has finished its pilot, it will be rolling out CarePass nationwide. Do they have a shot at competing with Amazon Prime? —Matthew Holt
Today on Health in 2 Point 00, we’re wishing Matthew a happy birthday!
On Episode 90, Jess and I talk about the drama around Amazon PillPack and Surescripts, HelloHeart’s $12 million raise, and Cerner selling its health data. In the end, the data is going to have to flow after this battle between Surescripts and PillPack. For HelloHeart’s blood pressure and cardiovascular health management platform, have they found their niche or is it too little too late with others like Livongo, Omada and Vivify in the space already? Finally, Cerner has put in their earnings call that they’re going to develop a business model around selling their data, sending ePatient Dave on a Tweet storm, but how big of a deal is this really? —Matthew Holt
Today on Health in 2 Point 00, it’s IPO day! On Episode 89, Jess asks me about the recent IPOs, Oscar Health getting into Medicare Advantage, and Fitbit accuracy in people of color. Jess asks me to weigh in on whether Livongo’s IPO was better than we expected and it’s safe to say that they are growing fast. On the flip side, the “silent” IPO that no one seems to be talking about is Health Catalyst, which is also doing quite well with a $1.6 billion valuation although they are not growing as fast as Livongo is. Next, Oscar Health decided to enter into Medicare Advantage, which is not surprising because that’s where the real money is in the insurance side. Finally, Fitbits and other wearables may not be tracking heart rates accurately in people of color, so what does this mean for the wearables industry—and their potential use for medical purposes? —Matthew Holt
By MATTHEW HOLT
I’ve been driven steadily nuts by a series of recent articles that are sort of describing what’s happening in health tech or (because the term won’t die) digital health, so I thought it was time for the definitive explanation. Yeah, yeah, humility ain’t my strong suit.
It won’t have escaped your attention that, after five years during which Castlight Health more or less single-handedly killed the IPO market for new health tech companies, suddenly in the middle of July 2019 we have three digital health companies going public. While Livongo, (FD-a THCB sponsor) Phreesia and Health Catalyst are all a little bit different, I’m going to use them to explain what the last decade of health tech evolution has meant.
Don’t get carried away by the precise details of the IPOs. Phressia is already out with a market cap of $845m. Yes, it’s true that none of the three are profitable yet, but they are all showing decent revenue growth at an annual run rate of $100m+ and Livongo in particular has been on a client acquisition and annual triple digit revenue growth tear. It’s also the newest of these companies, founded only in 2014, albeit by buying another company (EosHealth) founded in 2008 that had some of the tech they launched with. Going public doesn’t really mean that the health care market will swoon for them, nor that they are guaranteed to change the world. After all, as I pointed out in my recent somewhat (ok, very) cynical 12 rules for health tech startups, UnitedHealth Group has $250 Billion in revenue and doesn’t seem to be able to change the system. And anyone who remembers the eHealth bust of 2000-2002 knows that just because you get to the IPO, it’s no guarantee of success or even survival.
But just by virtue of making it this far and being around the 1/10th of 1% of health tech startups to make it to IPO, we can call all three a success. But what do they do?
They are all using new technologies to tackle longstanding health care problems.
By MATTHEW HOLT
Last week Mark Cuban tweeted out 12 rules for tech startups and Jessica DaMassa challenged a bunch of people to respond for health care. VC and general health care wit Lisa Suennen came out with quite the list (she got to 13) but I thought someone ought to write the real rules…
1. Never start a health tech company if you can sucker someone into giving you a real job
2. When VCs at conferences say raising money isn’t a problem, throw a milkshake at them
3. Never work with a technical co-founder who won’t give you the last M&M in the packet
4. When a clinician wants to quit their job and co-found with you, remember that the good ones could be making $500K a year reading X-rays and be on the golf course at 4pm
5. Do the 50/2 diet. Starve for 50 weeks of the year then eat and drink as much as you possibly can at HIMSS & JP Morgan parties when someone else is paying
6. When the incubator/accelerator/matchmaker says that they “chose you from 700 applicants” remember that there are roughly 700 of them and every company applies to each one
7. When you get the elusive partnership deal with the big hospital system, tech company or corporate, you’re going to expect to work at the speed of the startup and the scale of the corporate. It’ll be the reverse . (I stole this from Michael Ferguson at Ayogo)
8. After your first few clients and funding rounds you’ll be losing money at a exponential rate that matches what you had for revenue on the hockey stick chart in your pitch deck
9. Hopefully you’ll eventually be able to start making the money the health care way, by establishing a monopoly that can arbitrarily raise prices to the moon and stick it to your customers. If not, start prepping for the really big Oscar/Collective/Clover type round.
10. Pray to whatever God you follow that Softbank is still in business when #9 happens.
11. If after a decade or so of slog, you finally get the IPO, or semi decent exit, try to ignore the fact that the Instagram guys sold for $1 billion 11 months after they founded the company
12. Hope that you can disrupt health care, but remember that UnitedHealth Group’s revenue is $220 billion and CMS spends $900 billion a year and they both appear mostly powerless to make anything better.
Matthew Holt is publisher of The Health Care Blog and advises startups at SMACK.health using these principles and a few others too!
Today on THCB Spotlights, Matthew talks to Brooke LeVasseur, who is the CEO of AristaMD. AristaMD provides eConsults to empower providers to get patients faster access to care. The average wait time to see a specialist is one to two months, and the proportion of referrals to specialists that never happen can be incredibly high, at 40% in Medicare populations for instance. AristaMD aims to provide an efficient way for primary care providers to tap into the expertise of specialists to immediately start executing on a treatment plan without the patient having to wait or travel. Tune in to find out how AristaMD is actually rolling this out and get a demo of the platform.
Today on Health in 2 Point 00, Jess and I are getting in the spirit of things with this week’s Democratic debate. In Episode 87, Jess asks me about Omada Health’s $73 million raise, bringing its total to $200 million, and about what happened with nursing home telehealth startup Call9 shutting down. We turn to politics with Trump telling HHS to have hospitals publish their price list—and it’s unclear that this is even going to make a difference—and to health care coverage in the Democratic debate. —Matthew Holt
Today on Health in 2 Point 00, Jess and I are back from Europe and there is a LOT going on in health tech right now. In Episode 86, Jess asks me about United Health’s big moves, between acquiring PatientsLikeMe and their acquisition of DaVita Medical going through; integrated mental health company Quartet Health raising $60 million; Xealth closing a $14 million round (maybe now they’ll make Epic relevant); Collective Health’s $205 million raise led by SoftBank,; Vida’s $30 million round led by Teladoc (who knows why Teladoc didn’t just acquire Vida); European telehealth company Zava raising $32 million; and finally, Phreesia going IPO (wasn’t Livongo the one to watch?). —Matthew Holt