In this episode of Health Tech Deals, Jess thinks the music has stopped as Rock Health reports Q1’s funding total being below Q4 2022! No $100m rounds today! But still $37m for Real; $40m for Iris Telehealth; only $16m for 9am Health but lots of Livongo connections; $30m for Eko and $15m for Papa-lookalike Duos
-Matthew Holt
Today on Health in 2 Point 00, Jess and I run through a lot of telehealth investments including Doctor Anywhere raising $27 million, 98point6 raising $43 million, Tyto Care raising $50 million, SilverCloud Health raising $16 million, SteadyMD raising $6 million, and Aktiia raising $6 million. In addition, there’s a company called Air Doctor which matches people when they’re traveling to doctors on the ground which raised $7.8 million despite the inauspicious timing. On the flip side, there have been a slew of layoffs in the space, and Jess and I give our $.02 on Rock Health’s Q1 fundraising report which was just released. Don’t miss our tag-team interview of Livongo’s Glen Tullman, and check out these episodes in podcast form on Spotify and iTunes. —Matthew Holt
Today on the 52nd episode of Health in 2 Point 00, Jess reports from InsurTechConnect 2018! In this episode, Jess asks Matthew about RockHealth’s $6.8 billion fundraise to date & its $3 Billion raise in Q3, Weight Watcher’s rebranding itself and pushing into the wellness space, and (just in time we might add) Maven, a women’s digital health clinic, series B round of $27 million from Oak HC/FT
In this episode Jessica DaMassa asks about the thunder from Down Under, well the noise about the My Health Record program in Australia, the latest on women in health IT from Rock Health, and nearly gets to Click Therapeutics $17m round…all under the watchful gaze of Buddha–Matthew Holt
Back in the US of A to celebrate the nation’s birthday, Jessica DaMassa asks about Amazon buying Pill Pack, GE spinning off its health division, and what Rock Health and Startup Health’s numbers say about health tech investment–Matthew Holt
Jessica DaMassa asks me about digital health funding, Walmart and PillPack, Blockchain and my sweater — not in that order, but all in less than 2 minutes. Bonus–Farzad Mostashari’s bow tie makes a twitter appearance! — Matthew Holt
Last year I got in a modest Twitter spat with Anand Sanwal the CEO of investor analytics company CB Insights. Anand writes a very amusing newsletter, has built a wildly successful business tracking venture investing (at $20-50K a client) and has recently taken on $10m in VC himself to build out his business which was already profitable. The spat was because in August 2015 (5 months ago) CB insights said that “Digital Health” investments totalled $3.5 billion in 2014. You can go read the article Stephanie Baum concocted from the Tweetstream but my point was that when CB Insights, a generalist analyst company, said that the investment in digital SMAC health was $3.5bn in 2014 they were wrong because 4 specialists (Health 2.0, Mercom, Rock Health and Startup Health) all said it was over $4.5bn.
What’s a billion between friends? Not much, but what I left unsaid until now is that if they’re 25% off the average in one sector, where are they in the other sectors they cover? But other than a few amused readers of MedCity News no one much cared and the world moved on.
Then everyone stared putting out their Q4 2015 numbers. Amusingly, but probably only to me, both Rock Health & Startup Health put out their Q4 numbers 2 weeks before the quarter/year ended, and missed a bunch of late deals! But by the time the revised numbers came in everyone was again in that middle $4 billion range and there was general agreement that funding was about flat in 2015 compared to 2014–albeit at a high level compared to what the Cinderella sector had been recently.
Health 2.0’s numbers in our report were $4.8 billion for the year, as shown on the left. (You can see more on these and some other data in our Q4 report here. In case you don’t know I co-run Health 2.0 as my day job and yes I own THCB). OK. All so far so ho-hum.
Then as the other numbers started coming out I noticed something a little odd. CB insights came out with its numbers for 2015, but something was different.
You’ll recall that I had poo-poohed their 2014 number shown as $3.477 Bn in their blog post here and displayed in the chart below. These are 2014 numbers shown in a post about investment in 2015, published in August 2015. 
And that was the number I’d started the original spat about. But when I looked at the post they released in January 2016, not only was the number for 2015 at $5.7 billion (remember Rock Health, Mercom & Health 2.0 all put it in the mid-high $4s) but the 2014 number had somehow climbed from about $3.5 billion to $5.1 billion. 
Again check the January post and check the chart I’ve lifted from it below. You’d think this was a curious jump and you’d be right. But nowhere in the post does it say why the total for 2014 in August 2015 was so different from the total for 2014 in January 2016.
Of course being the troublemaker I am, I asked about this on Twitter and got a classic no reply from Anand at CB insights. 
So then I sent all this info off to Stephanie Baum at Medcity News thinking that she might like to write more about it.
And a funny thing happened. Instead of writing the article I wanted her to write (i.e. this one!) She found yet another number for 2015 from CB Insights, and wrote about how they were now back in the pack with everyone else.
Rock Health has been around since 2011 first as an accelerator and now as an early stage venture fund. Matthew Holt had a chance to sit down with Rock Health’s Managing Director Malay Gandhi ahead of his appearance at WinterTech to discuss how Rock Health looks at the consumer side of digital health, and what developments Rock Health thinks we’ll see in the near future.
Matthew Holt: It’s Matthew Holt with Malay Gandhi. He is the managing director of Rock Health, and has been officially for what, nearly a year or so now, Malay? Is that right?
Malay Gandhi: Since June, June of this year.
MH: So about six months. Most of us know that Rock Health was founded by Halle Tecco and Nate Gross a few years back, 2011, and probably was the first and most influential of the incubators and accelerators that target health care specifically. Perhaps you can explain a little bit about how Rock Health works. Most people know that Rock Health is a nonprofit, and that you guys do a lot in terms of stimulating the ecosystem with small events, big events, and your reports on financing and so on. But you are mainly a fund and the amount of money that you invest in your companies has been increasing from I think $20,000 in the early days to $100,000 plus recently? Could you explain how that actually works compared to other accelerators or incubators?
MG: Yeah. Essentially, the way Rock Health works is there are three big things that we do, all under our mission to support and fund entrepreneurs. We have our venture arm, which does seed investments in the companies now. We’ll write checks up to $250,000 per company, really at the seed-stage. We conduct research which we release publicly. Let’s say about four reports or so a year, as you mentioned, tracking funding, but also doing deep diving in various topical areas.
Then our third area, we host a couple of events each year. Our signature events are the Health Innovation Summit, which is for everybody; the CEO Summit, which is an event for founders and CEOs of digital health companies; and then finally, the XX Retreat, which is a women’s professional leadership group for women who work in health care.Continue reading…
Rock Health recently released a decidedly mixed report on the current state of Digital Health investing, as the data suggest many investors continue to tentatively explore the sector, but most have yet to make a serious commitment.
Overall, VC funding for digital health increased significantly over the past year, from just under $1B in 2011 to about $1.4B in 2012; 20% of this total was associated with just five deals: two raises for transparency companies, Castlight (targeting employees with high deductible plans looking to manage their costs) and GoHealth (targeting consumers contemplating purchase of health insurance); two raises for referral companies, Care.com (helps consumers find the right caregiver – defined broadly, as needs addressed include eldercare, child tutoring, babysitting, and pet care) and BestDoctors (helps employees find the right doctor), and one deal for 23andMe (a pioneering consumer genetics company).
Not surprisingly, the largest thematic area of investment ($237M) was “health consumer engagement,” comprised of companies that – like the first four above – help consumers or employees with healthcare purchases. “Personal health tools and tracking,” the second leading category, captured $143M in funding last year. “EMR/EHR” ($108M) and “hospital administration” ($78M) rounded out the list; the last two numbers seem shockingly low given the apparent size of these markets, and suggest both areas may be perceived as firmly owned by incumbent players, and prohibitively difficult for new participants to enter.
Athenahealth’s just-announced acquisition of Epocrates highlights the competitive pressures even existing EMR companies face as they struggle for traction in an environment that seems to be increasingly dominated by a few large players, most notably Epic. “Our biggest obstacle,” Athenahealth CEO Jonathan Bush told Bloomberg Businessweek, “is that 70% of doctors don’t even know we exist.” In contrast, I’ve suggested that a category I’d broadly define as EMR adjacencies may be primed for growth, as VC’s Stephen Kraus and Ambar Bhattacharyya have also discussed recently in this intelligent post. The related area of care transitions is also attracting considerable entrepreneurial interest, including current Rock Health portfolio companies WellFrame and OpenPlacement, and TechStars alum Careport; it remains to be seen whether a robust business model will emerge here.
Healthcare providers are finding their “play it safe” culture isn’t conducive to breakthrough innovation.
Facing the inevitable deflationary pressures being put upon the healthcare system, innovation is critically needed. Having spoken with several innovation groups in health systems, most examples of “innovation” are decidedly uninspiring. Primarily, it is due to the fact that virtually all of their decisions have to go through the prism of how new ideas will fit with current businesses — a guarantee that will doom so-called innovation to be little more than incremental improvements. Consequently, increasing numbers of hospitals and health systems are smartly allocating money to venture funds that have free reign to find truly disruptive new businesses.
Health systems have taken various approaches such as becoming a Limited Partner in venture funds like Health Enterprise Partners. Some of the larger systems, such as HCA and Dignity Health, have their own venture arms. A new development is a much smaller organization establishing their own venture fund. Implicit in this approach is a much more hands-on approach than as an investor in a 3rd party venture fund. Rex Health Ventures is an early example of venture-capital investment funds in the country started by a community, nonprofit hospital (Rex Health Care). The fund is being launched with an initial $10 million investment from Rex Healthcare and will help finance the most promising innovations among new medical services, tools and technologies.
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