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BREAKING: Thirty Madison and Nurx Merge, CEO Steve Gutentag Takes Us Inside

By JESSICA DaMASSA, WTF HEALTH

Thirty Madison and Nurx are merging and here’s what Steve Gutentag, CEO of Thirty Madison and the soon-to-be-combined entity, is saying about the deal!

This is a merger of two well-funded, direct-to-consumer, virtual-care-plus-pharmacy startups that deliver specialty and expert care and prescription drugs to a combined 750,000 active patients, with or without insurance. To-date, Nurx has raised a total $110 million, and Thirty Madison closed a Series C in June 2021 that brought their total funding to $210 million with a then-valuation of over $1 billion.

Thirty Madison currently deals with migraines, allergies, GI issues, and men’s hair loss, while Nurx (once referred to as “the Uber of birth control”) brings a predominantly women’s health-focused portfolio of chronic condition care focusing on sexual health, contraception, STIs, and dermatology.

So, what makes sense about this combination? And, what’s the big-picture plan for differentiation against rivals like Hims&Hers or Ro’s Rory or Roman brands – OR, the myriad virtual-first primary care clinics that have popped up in-person and online and offer more traditional routes to care for these same such conditions?

Steve talks extensively about the chronic care focus of both businesses, how each is providing access to specialists and experts patients wouldn’t otherwise be able to see, and how both companies’ tech platforms are built to scale along with the addition of new conditions. Still…why bring together care for this assortment of conditions instead of, say, either Thirty Madison or Nurx looking to find a merger partner who could expand their platform into high-demand chronic care areas like diabetes management, heart health, or mental health care? Is that what’s next, after the paperwork on this merger is signed? Tune in for more on Steve’s plans for the future of the NEW Thirty Madison and how “longitudinal care models” factor into its strategy to win over more patients AND their employers and payers.

THCB Gang Episode 81, Thursday Feb 3

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Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be: Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune);  the double trouble of vaunted futurists Ian Morrison (@seccurve) & Jeff Goldsmith, WTF Health host & Health IT girl Jessica DaMassa (@jessdamassa). Today’s special guest returning to #THCBGang is the “I make unicorns” King Bill Taranto from Merck GHIF (@BillTaranto).

You can surmise that there will be some discussion around #DigitalHealth valuations!

The video will be below. If you’d rather listen to the episode, the audio is preserved from Friday as a weekly podcast available on our iTunes & Spotify channels

New Cancer Care Navigator Thyme Care Starts Out with $22M Series A & Big Name Backing

By JESSICA DaMASSA, WTF HEALTH

Thyme Care is a cancer navigation platform that is looking to use technology to make the kind of high-touch care coordination usually only found at Centers of Excellence available to oncology practices across the country. The navigation we’re talking about is typically quarterbacked by experienced oncology nurse navigators, and is known to have a direct impact on a patient’s experience and their health outcomes. Thyme Care’s platform not only scale-ups this expertise, but also augments it with analysis of claims data and EMR data to help those navigators quickly detect which patients might be at higher risk for poor outcomes and which interventions might help mitigate those risks – whether that be addressing social determinants of health issues like transportation to appointments, or just more quickly spotting gaps in care.

Thyme Care’s President & Chief Medical Officer Bobby Green (an oncologist himself) introduces us to the tech platform and explains how, among a competitive field of tech-enabled care navigators, it’s managed to stand apart enough to win Medicare Advantage plan Clover Health as an early client and to gain a $22 million dollar Series A investment from platform-savvy investors like Andreessen Horowitz and AlleyCorp. (Frist Cressey Ventures, Casdin Capital and Bessemer also participated in the round, which was announced in October 2021.)

As the business looks to scale, what’s to make of all its connections to Flatiron Health, arguably health tech’s best-known cancer care platform? Lots of alumni on the cap table and in the biz, including Bobby himself! Find out more about expansion plans and points of differentiation in this quick get-to-know-you chat.

Matthew’s health care tidbits: #What is insurance again?

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Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

For my health care tidbits this week, I was reminded on Twitter that many Americans really don’t understand health insurance. A spine surgeon no less in this thread (no jokes about arrogance please) was telling me that he was paying ~$8,000 a year ($4,000 in insurance and $4,000 in deductible) before he got to “use” his insurance–which, as his medical costs were low, he never did. Others were complaining that the cost of employee premiums were over $20K. They all said they should keep the money and (presumably) pay cash when they do use the system. It’s true that most people don’t use their insurance. That’s the whole point. When you buy house insurance, you don’t expect your house to burn down. You are paying into a pool for the people whose house does burn down.

In the US we are on average spending $12k per person on health care each year. But spending on most people is way under that and for a few it’s way, way over. If you take the rough rule that 50% of the spending is on 10% of the people then 35 million people account for $2 trillion in spending–that’s ballpark $60,000 each. They are the ones with cancer, heart disease, complex trauma, etc, etc. The rest of us are “paying” our $4,000, $8,000 whatever, into the pool to cover that $60,000.

There are only two ways to lower that cost for the healthy who aren’t “using” their insurance. One is to exclude unhealthy people from that insurance pool, which makes the costs for everyone else much less. We did that for years with medical underwriting and it was nuts because it screws over the unhealthy. Fixing the pre-existing condition exclusions was the only bit of Obamacare everyone agrees on–even Trump. But now we are ten plus years into this new reality, some people have forgotten how bad it was before.

The other way is to reduce the costs in the system and lower that $4 trillion overall. How to do that is a much longer question. But it isn’t much connected to the concept of insurance.

THCB Gang Episode 80, Thursday Jan 27

Joining Matthew Holt (@boltyboy) on #THCBGang for an hour of conversation on the happenings in health care and beyond were regulars medical historian Mike Magee  (@drmikemagee) and writer Kim Bellard (@kimbbellard), and TWO special guests.

Shantanu Nundy @DrNundy  is Chief Medical Officer of Accolade and last year we had him on to talk about his book Care After Covid. This week, with Lisa Cooper and Kedar Mate he wrote in Jama adding “advancing health equity” as a new part of the “quintuple aim.”

Our second guest was Janae Sharp @CoherenceMed from the Sharp Index, which is dedicated to increasing awareness of and reducing physician suicide and burnout through support and data science

Were we ever going to be able to cover everything about physician burnout and health equity in just one hour? Yes, it was unlikely but we gave it our best shot!

The video is preserved below. If you’d rather listen to the episode, the audio is available from Friday as a weekly podcast available on our  iTunes & Spotify channels. 

Big Health’s Softbank Money, FDA Board Member Send Strong Signals About Digital Therapeutics Market

By JESSICA DaMASSA, WTF HEALTH

With a $75 million investment from Softbank last week, and the addition of former FDA Deputy Commissioner Dr. Anand Shah to its Board of Directors this week, Big Health has sure kicked 2022 off with some noise! But, this is more than just big news for Big Health as CEO Peter Hames is here to tell us. This is a story about the market potential for an all-tech approach to mental health care, AND an important endorsement for digital therapeutics – specifically, those that do NOT require a prescription.

Big Health sits at the intersection of two of the hottest health-tech markets: digital mental health care and digital therapeutics. Its approach, via apps Daylight (for anxiety) and Sleepio (for insomnia), has been flagged as unique because 1) unlike other leading digital mental health companies like Headspace Health or Lyra Health, Big Health’s approach to care is tech-driven and does not depend on coach or clinician intervention, and 2) unlike its digital therapeutics rivals, Pear Therapeutics or Click Therapeutics, Big Health’s business model isn’t relying on prescriptions to get paid.

Big Health is, in other words, proving the market potential for a different “breed” of tech-first, PBM-backed digital therapeutics, and I ask Peter about it head-on as we discuss Softbank’s investment. The mega-fund has placed bets on all sides now, having invested in Cerebral, which delivers clinician-first mental health care and prescription medication, and prescription DTx company Pear, which went public in December 2021. So, what should the market make of the fact that Softbank sees room for Big Health alongside Cerebral and Pear? How have high-profile deals with CVS Health and the NHS in Scotland proven out the model? And, what does the addition of Anand Shah (and his insider perspective on the FDA’s sentiment toward digital therapeutics) indicate about what’s ahead when it comes to the regulatory environment for DTx in the future? So many market dynamics at play, so much to talk about!

Writing the Book on Digital Health: Roberto Ascione on “The Future of Health”

By JESSICA DaMASSA, WTF HEALTH

In Milan, just outside the Frontiers Health conference, I caught up with Roberto Ascione, conference Chairman and CEO of Healthware Group, about his newly released book, “The Future of Health: How Digital Technology Will Make Care Accessible, Sustainable, and Human.”

A primer on digital health and its role in shaping care and well-being, the book is intended to provide an overview of the digital health market and what it means for the way healthcare will be delivered and consumed in the future.

Loaded with real-world examples and guest perspectives from a number of Roberto’s fabulous friends from across the healthcare and life sciences industries, the book aims to tell the story of health-and-tech in a way that is fun and fast – and doesn’t require healthcare expertise to understand!

Roberto and I quickly cover the main themes of the book, and why it’s so important RIGHT NOW for patients, clinicians, and healthcare entrepreneurs, investors, and innovators to read about where health tech came from, where it’s at, and where it’s headed. You know your market category is coming-of-age when it hits the bookshelves!

Vida Health Hires New Chief Medical Officer from Hims & Hers: A Sign ‘Scripts’ Are Coming Soon?

By JESSICA DaMASSA, WTF Health

Vida Health’s new Chief Medical Officer, Dr. Patrick Carroll is bringing a very unique expertise to the chronic condition management startup’s C-suite: pharmacy. Pat just left virtual pharmacy co, Hims & Hers, where he helped take the company public as CMO after building-out their virtual primary care practice. Before that, he was CMO at Walgreens…

We get to know Pat – brand-new in his role as Vida Health’s first-ever CMO – and catch glimpses of how his years of experience as a primary care doc and executive leader at leading consumer-focused pharmacy businesses will likely be shaping Vida’s future delivering care to poly-chronic patients.

Vida Health’s current approach to diabetes management and mental health care has stood apart for being fully-integrated from the get-go, tackling the mind-body connection through digitally-based coaching and counseling. While Pat acknowledges that this approach has thus far yielded “remarkable outcomes,” he definitely seems interested in finding out if those outcomes could be even better if a virtual prescriber group were involved as well.

Will this be a partnership with a medical group? Or something Pat sees Vida Health building out itself to fully support its 100% at-risk-on-outcomes model? A compelling set of questions, particularly when you consider Vida Health’s investor-and-client relationship with the largest managed Medicaid plan in the U.S. (Centene participated in their $110 million Series D round in May 2021), the prevalence of complex diabetes cases (30% are multi-chronic), and the interesting data point Pat shares about Vida’s ability to get more people to see their primary care docs, increasing PCP visit rates by 10%. Interesting opportunity for Vida Health to further compete with Teladoc-Livongo and other virtual-first primary care providers aiming to deliver on the chronic condition care spectrum.

Headspace Health Merger Update: First Look at How Ginger-Headspace Combo is Really Going to Market

By JESSICA DaMASSA, WTF HEALTH

Headspace Health CEO Russell Glass says the merger-of-equals between on-demand mental health care provider, Ginger, and consumer meditation app, Headspace, is starting its upward trajectory on the “merger J-curve” and this monster 30-minute chat gets into the how-and-why.

We start out talking about the company’s recent acquisition of chatbot-based self-care app Sayana, but quickly turn to the integration of Headspace and Ginger and where things stand in terms of bringing those offerings together after three months of operationalizing. A combined vision and set of values have been launched with all 900 employees, and Russ says its enterprise clients (there are now 3,500 of those) are just weeks away from getting a fully-integrated platform that proves reporting for both Headspace and Ginger, allows launch from a single eligibility file, and offers communication that spans both service lines.

What’s “extra” in all this – and gives us a real glimpse of where Headspace Health is headed in terms of positioning itself to health plans and employers as standout from the Lyra Health / Quartet Health / Modern Health pack – comes out when Russ is describing the company’s partnership with Blue Shield of California at the 15:25-minute mark. The plan’s members can now access Headspace Health’s full-spectrum of services (meditation to therapy) via Blue Shield of California’s Wellvolution platform, which provides intelligent intake, smart patient routing, ongoing measurement and adjustment of services, and the ultimate ability to help prove-out mental health care’s connection to the reduction of downstream healthcare costs over time. As Russ says, “All of this is part of a long-term vision for what this could mean to a broader population, not just those who may need acute care, but to think about the entire population and how you pull the cost out of healthcare by managing behavioral health in a smart way.”

The big finish to this BIG conversation is Russ’s take on what’s ahead for both Headspace Health AND the digital mental health care market in 2022. Tune-in around the 20-minute mark to start this segment off with the IPO question that I never get answered, then lots of detail on where Headspace Health is looking to acquire and expand, what he thinks the headline story will be when it comes to the business of mental healthcare this year, and which patient population will rise to the top in terms of mental healthcare need.

THCB Gang Episode 79, Thursday Jan 20 — 1pm PT- 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be: Queen of all employer benefits Jennifer Benz (@Jenbenz);  fierce patient activist Casey Quinlan (@MightyCasey); Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune); and, making a rare but welcome appearance, digital health guru Fard Johnmar (@fardj).

Video will be live (and then preserved) below. If you’d rather listen to the episode, the audio is available from Friday as a weekly podcast available on our iTunes & Spotify channels. 

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