You know all that “magic” that machine learning is meant to bring to seemingly lackluster healthcare data and our limited understanding of it? Komodo Health’s co-founder & CEO Arif Nathoo demystifies the wizardry of one of our favorite buzz phrases, “The Algorithm,” and gives us a colorful overview of how his startup is making data useful to the way payers, health systems, and pharma co’s study populations at-scale. Komodo’s raised $314M to-date, closing a MASSIVE $220M Series E backed by Tiger Global Management, Casdin Capital, ICONIQ Growth, Andreessen Horowitz, and SVB Capital in April, and after hearing this enthusiastic explanation of what they’re working on – and the market potential for it – we understand why.
At its most simplistic, Komodo is using de-identified healthcare claims data as a base from which to learn how patients flow through the healthcare system. Other data sets are brought in and layered onto that “patient-flow, dollar-flow” claims trail in effort create a new vantage point for seeing what’s happening within the system, at a population level. That insight can then be used to predict patient behavior and provide evidenced analysis for how the system can be improved. Don’t worry: Arif provides lots of detailed examples and talks through exactly what kind of data can (and currently can’t) be pulled into the mix. If you want to get smart on the “Big Data” opportunity in healthcare and how it’s going to be impacting the future of care delivery and virtual care delivery, this is one chat you won’t want to miss!
It’s another mega-round for a digital health chronic condition management startup, as Vida Health closes its $110M Series D – AND adds a pair of big-name insurers to their cap table. Vida’s Founder & CEO, Stephanie Tilenius, gets into the good news about the funding round, which was led by growth equity fund, General Atlantic, and brought managed care giant Centene (a Vida customer) and multinational insurer AXA into the mix.
Beyond the funding – and the extra “insurance side” endorsement it gives to the virtual chronic condition care space – what’s interesting about Vida now is how its “whole person” approach, which integrates physical health care and mental health care, is very much tilting to mental health these days.
While overall revenue has tripled since last year, Stephanie talks about how the 6000% year-over-year growth for her mental health services has played into that rise, and how the new funding will be used to further expand those offerings.
Does this mean we need to start naming Vida as a competitor to digital mental health companies like Ginger, Modern Health, and Talkspace? And, how does this impact their positioning among the field of other health tech chronic care co’s? For those who may have forgotten, Vida went out the gate with a platform that was designed to treat both the mental-and-physical aspects of chronic disease, while others like Omada and Livongo-now-Teladoc acquired-and-integrated behavioral health providers to augment their physical-first offerings and satisfy customer demands. Will it now prove easier for Vida to scale-up and scale-out, having been built for both “mind and body” from the very beginning? Stephanie’s got her opinion, big plans, and now a treasury to rival those key competitors across both fields of care. Tune in for all the details!
Cigna is making digital mental health services available to its entire nationwide network of 14 million members, and it’s selected health tech startup, Ginger to deliver the new benefit. Cigna’s Chief Medical Officer for Behavioral Health, Doug Nemecek, and Ginger’s CEO, Russ Glass, stop by to discuss the deal and why Cigna is making such a commitment to expanding its behavioral health offering.
This is about more than just dealing with mental health in the aftermath of Covid; Cigna is actually looking at Ginger’s behavioral health coaching model as preventative. Will other health plans follow suit? Could expanded coverage for lower-acuity mental health services become commonplace? Doug talks about what’s ahead for mental health care from a population health standpoint, and how services like Ginger’s give primary care docs a standard, trusted provider to which they can refer patients when it comes to increasingly common concerns like depression and anxiety. For Russ and Ginger, who talk about using virtual care to right the “supply-and-demand imbalance” in mental health care, what will more than doubling their current client base (from 10 million to 24 million) do to their own ability to provide supply? It’s a moment-of-truth for the business of digital mental health and we’ve got the details!
Sharecare, the population-health-slash-care-navigator of the stars (literally, celebrity doc Dr. Oz is a co-founder, and Oprah’s Harpo Productions, Sony Pictures Television, and Discovery Communications are partners) is about to hit the public market via a $4-Billion SPAC IPO with Falcon Capital. Jeff Arnold, co-founder, CEO, and Chairman drops in to talk about how he plans to make Sharecare even more successful than the first healthcare business he founded-and-exited, WebMD.
The Sharecare ecosystem is sprawling. The company’s been around for more than a decade, acquired about a dozen digital health point solutions and health tech businesses, and built a population health analytics platform that’s interwoven consumer, employer, provider, and health plan data for years. Now, the business is even getting into providing Health Security verifications for hotels, restaurants, and the like to prove that their facilities meet guidelines for health and hygiene protocols, cleaning standards, physical distancing and other health requirements implemented in the Covid-19 era.
So, how does Jeff anticipate meeting shareholder expectations for growth? The investor deck touts a future of recurring revenue driving sustainable 20% year-over-year growth; Jeff talks through each of Sharecare’s verticals in detail so we can learn how.
Healthcare SPAC-trackers interested in placing bets on value-based primary care for the lucrative Medicare Advantage market will love hearing Cano Health’s CEO Marlow Hernandez dive into the details behind his company’s $4.4B valuation and 7,000% three-year growth rate. Cano Health’s clinics provide “primary care plus” for 100,000 seniors, targeting the particular needs of underserved Latino senior markets in Florida, Texas, Nevada, and Puerto Rico. With $1.4B in revenue, Cano’s business looks similar to publicly-traded Oak Street Health – which boasts a market cap of $14B.
Hoping to replicate what they’ve started in Florida (where Cano Health boasts a long-standing relationship serving Humana’s Medicare Advantage members) the company is building partnerships with major national MA plan providers like UnitedHealthcare, Anthem, Centene and Devoted and scaling up its network of more than 550 primary care physicians. A surprising component of the business plan? Cano Health’s health tech stack! Marlow explains how the care delivery co developed its own practice management software for care navigation, billing, and back-office admin and is already licensing it to more than 1,000 independently owned medical centers.
Tune in for more on the scale-up and scale-out plans for Cano Health before it starts trading at $CANO. The planned merger with Jaws Acquisition Corp (the SPAC led by Barry Sternlicht of Starwood Capital fame) is “imminent.”
What’s the move for Crossover Health? Looking past the virtual-first primary care co’s $168M Series D, CEO Scott Shreeve gets grilled on the long-game. Is their future private? Or public? As “THE” primary care clinic for Amazon employees, rumors have swirled about a potential acquisition for the better part of a year. But now, with the launch of Amazon Care, does Crossover stand a better chance of being acquired – or being axed? Scott’s explanation of a model that uses small, in-person facilities as “confirmatory centers” to compliment virtual care does sound awfully “Amazon-y,” but it also sounds like a very fundable model for public market investors. A Crossover IPO has also been a long-standing rumor as well, perpetuated by the public market filings of OneMedical, Oak Street Health, and, now, VillageMD. A little extra fuel has been added to the fire by big-money raises among still-private competitors Iora Health and Forward. Does the fact that Crossover’s Series D includes a fresh crop of funders – a group of “crossover investors” no less – that back a wider spectrum of startups and industries foreshadow anything? How about the fact that Crossover is launching a product with a PAYER? What does this new offering, that unites payment model and care model into one market-friendly bundle, foretell about the types of clients Crossover is aiming to serve? Pick this interview apart, health tech friends! All guesses are fair game!
What’s better than being the CEO of one blazing-hot disruptive health tech company that’s raised $450M to build “the internet of healthcare”? How about becoming the CEO of a second company – a new managed Medicaid health plan company – that’s to be built on top of your first company’s machine learning platform, which is chock-full of hospital data and learning how to automate healthcare admin expertise? So is the fate of Sean Lane, CEO of Olive and now, also CEO of Circulo.
What does a built-from-scratch, tech-first Medicaid plan look like? Sean talks through the strategy behind the new health insurance co, which is aiming to use Olive’s tech to automate every aspect of the way a payer functions in effort to 1) strip away health plan admin costs and 2) create a never-before-seen relationship between patient, payer, and provider. On this latter point, it’s the fresh approach to payer-provider relations that seems to really have Sean excited. With Olive already built into hundreds of health systems, and conveniently located on the desktops of those providers, Sean says Circulo will be poised to take advantage of that network’s data and distribution to forever alter the healthcare payment model. Submitting claims goes away. Denials go away. Costs drop. Care improves.
Backed by a fresh $50M from Olive’s investors (Drive Capital and General Catalyst led Circulo’s Series A with participation from Oak HC/FT and SVB Capital) the new plan is currently building team and tech and aiming “to cover one life, bring on one provider, and earn one dollar of revenue by the end of the year.” It’s early days, but we dive into the details behind the strategy and also explore how this fits into the “health assurance thesis” that’s lurking behind General Catalyst’s latest investments, particularly those spearheaded by Hemant Taneja, who literally co-wrote the book on the subject with Jefferson Health’s Steve Klasko, and is the CEO of the Health Assurance Acquisition Corporation ($HAACU) SPAC that’s just out there waiting to take a health tech business public.
Despite nearly 900 employer clients (including big brands like Burger King, Kroger, and DoorDash), a net promoter score of 84, and a new pharmacy benefits management (PBM) program launched mid-pandemic, healthcare navigator startup, Rightway, seems to have come out of left field with its $100M Series C fundraise and $1.1B valuation. CEO Jordan Feldman introduces us to the company he’s built and its pretty impressive ability to achieve double-digit decreases in the cost of healthcare for mid- and large self-insured employers.
We walk through the business model, talk about the well-funded competition in both the care navigation and PBM spaces, and get acquainted with Rightway’s plans for scaling up and attracting new clients. An added little point of intrigue? As Rightway looks to gain a foothold working with health plans, Jordan mentions some interesting ties via its Series C investors. While the round was led by Khosla Ventures, with participation by Tiger Global and existing investors, it’s Thrive Capital, also an investor in the health insurance startup Oscar Health, that sounds like it might help Rightway make its way into the payer market.
Digital mental health startup Ginger just closed a $100M funding round on the heels of its biggest growth year yet: tripling revenue in 2020, bringing its employer-client count to 500, and expanding to offer its services to more than 30 integrated health systems and health plans. CEO Russ Glass updates us on what’s next for the company now that it, too, has joined the $1-Billion-Plus club of digital mental health startups.
In a space where competitors are well-capitalized and poised to scale (Don’t forget: Talkspace awaits it’s SPAC IPO, Lyra Health has raised a whopping $475M, and others like Happify Health and Modern Health have just soared past $100M in total funding) Ginger plans to stand apart with a value-based care approach that offers employers a single-priced, fixed fee that gives employees access to Ginger’s entire spectrum of care. Launched during the pandemic, more than 60% of Ginger’s new employer clients have opted for this approach in effort to improve both the quality and cost of care offered to their employees. We dig in to hear more about this model and hear Russ’s predictions for how the supply-and-demand imbalance in mental health will continue to impact us (and the digital mental health market) as the pandemic wans.
As if one consumer digital health company with an $18.5B exit wasn’t enough, Livongo founder Glen Tullman has decided to give the transformation of healthcare another go – this time as Executive Chairman & CEO of Transcarent. Matthew Holt and I sit down with Glen to hear about the “new kind of experience” that Transcarent is offering self-insured employers and their employees: one focused on providing unbiased information, guidance for accessing high-value healthcare, and an at-risk model that promises to share back the financial benefits associated with better healthcare decision-making.
Could you consider Transcarent an aggregator, a healthcare navigator-PLUS, or is it more like a next-gen health plan that does everything but process claims? Glen talks about how his team was “asked” to jump into providing a better experience for this kind of healthcare service, details what the company needs next, and explains the role of Bridge Health, which merged with Transcarent in October 2020 when the company closed its $44M Series A. Familiar investors, General Catalyst and Glen’s own 7Wire Ventures, have led the funding for Transcarent and we find out if there will be any additional support from the Health Assurance Acquisition Corporation (the SPAC that Glen launched in partnership with General Catalyst’s Hemant Taneja and others) that could potentially provide a vehicle for taking the business public. And, what about Teladoc Health? With a seat on TDOC’s Board, does Transcarent’s commitment to offering “unbiased” direction to the best possible healthcare put Glen into a conflict of interest? This is one catch-up chat you’re not going to want to miss!