Today on Health in 2 Point 00, we have a no-nonsense April 1st episode—with deals this time! On Episode 115, Jess asks me about Olive raising $51 million for its AI-enabled revenue cycle management solution, Bright.md raising an $8 million Series C for its asynchronous telemedicine platform, and AristaMD raising $18 million for a different sort of telemedicine, eConsults, which allow primary care physicians to consult with specialists virtually. —Matthew Holt
Health in 2 Point 00, Episode 110b | Maven, IntelyCare, and New Acquisitions!
Today on Health in 2 Point 00, we resume our two-part series with part B and bring our promised special guest! Continuing from the first part of Episode 110, Jess and I discuss the women and family health startup Maven raising $45 million in its Series C round with celebrity investment. 1UpHealth, the MassChallenge HealthTech Finalist, raises $8 million; IntelyCare raises $45 million bringing the gig-economy approach to nurse staffing raises, and HealthJoy raises $30 million in Series C funding. The hospital owned ACO umbrella services company Caravan Health acquires Wellpepper, and Sharecare acquires Visualize Health; are these good acquisitions? -Matthew Holt
Can Startups Save Primary Care?
By ANDY MYCHKOVSKY
Today, primary care is considered the bee’s knees of value-based care delivery. Instead of being viewed as the punter of the football team, the primary care physician (PCP) has become the quarterback of the patient’s care team, calling plays for both clinical and social services. The entire concept of the accountable care organization (ACO) or patient-centered medical home (PCMH) crumbles without financially- and clinically-aligned PCPs. This sea change has resulted in rapid employment or alignment to health systems, as well as a surge in venture capital being invested into the primary care space.
Before we get too far in the weeds, let’s first begin with the definition of primary care. The American Academy of Family Physicians (AAFP) defines a primary care physician as a specialist typically trained in Family Medicine, Internal Medicine, or Pediatrics. Some women do use their OB/GYN as their PCP, but these specialists are not traditionally considered PCPs. Now if you’ve gone to your local PCP and noticed that your care provider is not wearing a white coat with the “MD” or “DO” credentials, you are either receiving treatment from a hipster physician, nurse practitioner (NP), or physician assistant (PA). Two of the three professionals are trained in family medicine and can provide primary care services under the responsibility of an associated PCP. At least one of the three has a beard.
The crazy thing is, despite the industries heightened focus on the importance of PCPs, we’re still expecting a shortage of primary care providers. In April 2019, the Association of American Medical Colleges (AAMC) released a report estimating a shortage of between 21,100 and 55,200 PCPs by 2032. Given we just passed 2020, this not that far off. The primary reason for the shortage is the growing and aging population. Thanks mom and dad. Digging into the numbers will really knock your socks off, with the U.S. Census estimating that individuals over the age of 65 will increase 48% over that same time period. Like a double-edged sword, the issue is not just on the patient demand side though. One-third of all currently active doctors will be older than 65 in the next decade and could begin to retire. Many of these individuals are independent PCPs who have resisted employment by large health systems.
Continue reading…How Hospital Systems Invest in Digital Health | Brent Stackhouse, Mount Sinai Ventures
By JESSICA DaMASSA, WTF HEALTH
Savvy health tech startups can learn how the differing investment priorities of venture capital funds and strategic investors (those tied to large healthcare organizations like health plans, pharma companies, and health systems) can impact everything from their capital raise to their ability to gain new clients. Brent Stackhouse, Managing Director at Mount Sinai Ventures, talks about the nuances of investing as a strategic, trying to balance a health system’s inherent aversion to risk with the gusto it takes to place good bets on the future of health. Where does a hospital system find investments? Are they looking for clinical solutions or consumer solutions? Brent shares the details behind Mount Sinai’s investment thesis and talks ‘big picture’ about trends he’s seeing in healthcare investing worldwide.
Filmed at Frontiers Health Conference in Berlin, November 2019.
Consulting for Health Tech Startup CEOs From the Guy Who Knows | Matthew Holt, SMACK Health
By JESSICA DaMASSA, WTF HEALTH
To hear Matthew Holt tear apart a pitch deck—or worse, a demo—one thinks of another Brit with a penchant for criticism and tell-it-like-it-is tough love. Could Matthew Holt be the Simon Cowell of health tech? Or maybe he’s got a point underneath all that gruff? Having co-founded Health 2.0, Matthew helped bring digital health and health tech startups into the mainstream by providing a friendly forum for entrepreneurs and established healthcare incumbents. Along the way, he’s suffered through his fair share of demos and pitches, and watched all corners of the healthcare market as it reacted to (and invested in) tech health solutions. Now bringing that 30 years of wisdom to startups seeking coaching, help with strategy, business model design, fundraising, and, of course, demoing and pitching, Matthew explains how he hopes to help the current class of up-and-coming health startups via his consulting biz, SMACK Health.
Filmed at HLTH 2019 in Las Vegas, October 2019.
Health in 2 Point 00, Episode 106 | More Post-JPM Deals, & a Google/Cerner catfight?
Today on Health in 2 Point 00, everybody’s getting 20 million dollars! There are so many deals to cover. AI chatbot symptom checker Buoy gets $20 million, Clew gets $20 million, diabetes management company Oviva gets $21 million, Covera gets $23.5 million for diagnostic improvement in radiology, Zipari gets $22.5 million working on engagement in health plans. Another $20 million for Kaizen (yet another nonemergency medical transportation company), and Color raises $75 million for personal genetics testing. In other news, Google and Cerner—the catfight begins just in time so we don’t have to talk too much about interoperability at HIMSS. And if you were also waiting with bated breath for where Mona Siddiqui ended up, tune in for the gossip on this episode of Health in 2 Point 00. —Matthew Holt
9 Things Every Healthcare Startup Should Know About Business Development
By ANDY MYCHKOVSKY
In this post, I write down all my strategy and business development knowledge in healthcare and organize it into the top 9 commandments for selling as a healthcare startup. I think everyone from the founder to the most junior person on the team should know these pillars because all startups must grow. I should also note these tenets are most applicable for selling into large enterprise healthcare incumbents (e.g., payers, providers, medical device, drug companies). Although I appreciate the direct-to-consumer game, these slices are less applicable for that domain. If your startup needs help developing or implementing your business development strategy, shoot me an email and we can discuss a potential partnership. Enjoy!
1. Understand Everything About the Product and Market
You must also understand the competitive landscape, who else is in the marketplace and how they appear differentiated? What has been their preferred go-to-market approach and is your startup capable of replicating a similar strategy with your current team members? Also, do you understand the federal and state policy that most affects your vertical, whether that be pharmaceutical or medical device (e.g., FDA), health plans (e.g., state insurance commissioners), or providers (e.g., CMS)? For example, if your company is focused on “value-based care” and shifting payment structures of physicians to downside risk, do you intimately understand The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the requisite CMS Demonstration Models from the Innovation Center (e.g., MSSP, BPCI-A, etc.)? Make sure you do or at least hire someone to explain what is important now and in the future.
Continue reading…9 Healthcare Companies Who Changed the 2010s
By ANDY MYCHKOVSKY
In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit!
1. Epic Systems Corporation
The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Population of 13,166. The privately held company created by Judith “Judy” Faulkner in 1979 holds 28% of the 5,447 total hospital market in America. Drill down into hospitals with over 500-beds and Epic reigns supreme with 58% share. Thanks to the Office of the National Coordinator for Health Information Technology (ONC) and movement away from paper records (Meaningful Use), Epic has amassed annualized revenue of $2.7 billion. That was enough to hire the architects of Disneyland to design their Google-like Midwestern campus. The other amazing fact is that Epic has grown an average of 14% per year, despite never raising venture capital or using M&A to acquire smaller companies.
Over the years, Epic has been criticized for being expensive, non-interoperable with other EMR vendors, and the partial cause for physician burnout. Expensive is probably an understatement. For example, Partners HealthCare (to be renamed Mass General Brigham) alone spent $1.2 billion to install Epic, which included hiring 600 employees and consultants just to build and implement the system and onboard staff. With many across healthcare calling for medical record portability that actually works (unlike health information exchanges), you best believe America’s 3rd richest woman will have ideas how the country moves forward with digital medical records.
Continue reading…Health in 2 Point 00, Episode 103 | ACA Ruling, Sutter Health Settlement, & Bright Health
Today, I’m closing out the year of Health in 2 Point 00 from the ski slopes. In Episode 103, Jess asks me about the ACA ruling that the individual mandate is unconstitutional, whether Sutter Health got what they deserved after the $575 million settlement, health insurer Bright Health raising a huge $635 million round, and a rumor about a $250M Softbank investment coming next week. Wishing you all a very happy 2020! —Matthew Holt
Angels are Taking our Data
A response to Michael Millenson’s holiday song
Angels seeking Clouds to buy
But healthcare’s not like Spotify
My health data’s here and yon
Monetized by Amazon
Gloria, in excessive profits
Gloria, it’s excessive net cash flow
Investors, why this jubilee?
You’ve done naught to soothe our pain
No care’s improved nor costs controlled
My data just fuels cap’tal gains
Gloria, in excessive profits
Gloria, it’s excessive net cash flow
Silicon Valley come and see
Start-up births thy VCs sing
Come invest on bended knee
But health care’s not yet transforming
Gloria, such excessive profits
Gloria, just excessive net cash flow
