Kevin's Weekly Health Tech Reads 2/14

A couple more SPACs (ShareCare and Sema4), lots of funding rounds (ZocDoc, RapidSOS, Modern Health, Alma, Sitka & more), confusion around the Geographic Direct Contracting model & more

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SPACs of the Week:

Because how could a week go by these days without SPAC news:

  • ShareCare formally announced its SPAC on Friday. ShareCare is a confusing conglomerate of healthcare businesses that have been acquired over the past few years, which they break down into enterprise, provider, and consumer segments. Their enterprise business consists of a dizzying number of offerings ranging from the Blue Zones project to digital vaccine scheduling for employers. The provider business ranges from remote monitoring to value based care to payment integrity. The consumer business includes a whole bunch of content that life sciences pays for marketing purposes. They claim to be the only company in the B2B2P space (slide 44), which makes sense because I’m not sure anyone else knew the B2B2P space was a thing before this presentation.
  • The core of the business stems from ShareCare’s acquisition of Healthway’s Population Health division back in 2016, which represents almost 60% of revenue for ShareCare. This makes up $190 million of revenue in 2020, which is down from $241 million in 2017 (slide 37). It appears ShareCare has gone through some rightsizing to get that division to profitability over the past few years (slides 37, 38). I’m not quite sure I follow the story of how a business that’s been doing a normalized CAGR of 8.8% over the past four years (slide 38) is going to hit a CAGR of 24% over the next four years, while also doubling its EBITDA margin over that period (slide 34). It would appear that ShareCare is cozying up to Anthem / Blues plans as a core part of its growth strategy as Anthem is featured prominently throughout the SPAC announcement as a strategic partner of ShareCare. The doc.ai acquisition makes sense in this light given the Anthem deal they struck - which is highlighted on slide 30. It will be interesting to watch if ShareCare can keep up the land / expand approach of signing up big clients and expanding those relationships to drive the growth they’re expecting. I’m personally a bit skeptical of the growth story - at least organically, perhaps they can keep acquiring companies to continue driving growth. Link.
  • In another SPAC that confuses the heck out of me, Sema4 announced this week it is going public via SPAC. My understanding is that Sema4 helps health systems leverage patient health data to treat patients and enable drug development using their AI platform, Centrellis. It certainly sounds like a good enough idea. But… their investor presentation shines basically no light on what it actually means for their business. It appears that most of Sema4’s revenue is generated from doing genetic testing in the women’s health space (slides 15 + 16). But, growth in that space appears to be slowing (slide 15) and Sema4 sees it’s future growth in pharma and oncology. Somewhat confusingly, they highlight what appears to be a patient facing pregnancy app (slide 25)… which… looks a lot like a generic pregnancy app. Add in the fact that they don’t include any historical financials anywhere (they include estimates for 2020 data) and it’s hard not to be a bit skeptical of this SPAC. I’d be quite curious to know what percent of their revenue comes from the Mount Sinai relationship, which is the health system that Sema4 spun out of. Link.

News:

  • PE investor Deerfield has merged portfolio company ConcertoHealth with Perfect Health into a new entity called ConcertoCare. ConcertoCare will be building on both companies capabilities in the risk-based in-home care delivery space for seniors. Link.
  • A group of leading health systems got tired of watching everyone else monetize real world data and have decided to join together to create a new company, Truveta. The group includes 14 health systems that have a very wide reach, serving tens of millions of patients across 40 states. Will be curious to watch if anything materializes out of this. Link.
  • Online booking platform ZocDoc raised $150 million as it has pivoted its business slightly to focusing on enabling telehealth visits. Pre-pandemic, only 1% of their visits scheduled were telehealth, a number that is up 20% since according to this article. Which - still doesn’t seem like a huge portion of their business? They’ve seen that when patients have the option of selecting a virtual visit without knowing their provider versus scheduling a virtual appointment with a known provider, they prefer the latter at a 10:1 ratio. Interesting. Link.
  • RapidSOS, a data platform for EMS organizations, formally announced its recent $85 million funding round this week covered here a few weeks back. RapidSOS supported EMS teams handling 150 million emergencies in 2020, working across 4,800 emergency communications centers across the country. They’ve expanded the service into Mexico and the UK. Link.
  • Mental health for employers startup Modern Health raised another $74 million and hit unicorn status at a valuation of $1.17 billion. Link.
  • Alma, a startup that provides practice support for mental health providers, raised $28 million. Alma has a membership model that costs providers $125/mo to sign up for, and it provides marketing support, digital tools, and streamlined insurance management. Alma then appears to go and contract with insurers with all of mental health providers in its network, aggregating the supply to negotiate better rates. Seems like a smart play. It’s an interesting slight pivot away from where they started which appeared more focused on physical co-working spaces for mental health providers, although it appears to still operate the original co-working space in Brooklyn. Link.
  • Theator raised $15.5 million for it’s AI surgical intelligence platform. Link.
  • Equip raised $13 million for its digital platform for treating eating disorders. Seems like a no brainer for a model like this to succeed particularly in the COVID-19 world. It is pretty wild to me that they have been able to raise $17 million total having only treated dozens of patients at this point - indicative of how the VC community is viewing the risk (or lack thereof) associated with these models. Take a clinically validated model, prove you can adapt it to your digital protocol, and then pour money in to scale it to that specific population before anyone else does. Link.
  • Sitka, a startup building a virtual specialty care network, raised $14 million. Sitka announced a partnership with ChenMed as part of the deal, which provides a nice proof point for how Sitka can integrate with innovative primary care models. Link.
  • Insightin Health raised $12 million to scale it’s member engagement platform for payors. Link.
  • Gentem Health, a startup helping independent providers manage their practice finances, raised $10 million. Link.
  • Mate Fertility launched with a $2.8 million seed round to launch fertility clinics. They’re initially launching in Oklahoma City, where they intend to undercut the price of legacy fertility clinics by 50% - 60%. They claim incumbent clinics can make 1,000% margin on every procedure. Between that and the general population fertility trends this seems like a rather large potential opportunity here. Link.
  • Nuance acquired Saykara, an AI-voice assistant for clinicians. The Saykara team will join Nuance’s R&D group, which would seem to say something about how Nuance views the product offering. Seems like an acquisition that makes sense on both sides - Nuance gets new technology for its roadmap and Saykara gets a clearer go-to-market pathway. Link.
  • Mercy and Anthem BCBS Missouri entered into a collaborative care agreement. Hard to know how meaningful something like this is without any more details. Link.
  • Dexcom announced it is launching a VC fund, focused on investments in sensing technologies, data analytics, remote patient monitoring, and population health. Link.

Opinions:

  • Apparently I’m not the only person confused by CMS’s Geographic Direct Contracting Model proposal, as this Modern Healthcare piece highlights some potential operational issues with the program. A number of experts quoted in the article think the program is too complicated to implement as currently laid out, recommending it be delayed until the operational kinks get worked out. The issues with providers struggling to understand where a patient is attributed in real time seems like a major challenge for providers to implement these programs successfully. Link.
  • This is a good read from Christina Farr on the intersection of virtual care and in person care delivery models and the roles each may play moving forward. It provides a balanced perspective in the world of hyped virtual care delivery plays. I found particularly interesting the point raised about health equity in the era of virtual care delivery - noting that “telemedicine tends to appeal to patients who are ‘English-speaking, educated… with working phones and access to the internet.’” I for one am excited to get through this phase of virtual-only models and get to a future state where virtual and in-person care delivery are blended into one model. Link.
  • This is a really interesting set of briefs from a group of health economists on how to reduce healthcare costs in this country. The economists outline a series of 16 initiatives that could collectively reduce healthcare spend in this country by ~9%. The briefs cover a wide range of topics, including eliminating surprise billing, capping commercial insurance prices, and addressing hospital consolidation among other things. Worth checking out. Link.
  • SeekMedicare, the insurance brokerage startup that was mentioned in the Clover short selling report last week, published a blog about what they’re up to. The blog shares that Seek was initially incubated inside of Clover, and it would appear from this post that Walgreens is the other partner in Seek. It’s hard to argue with the vision behind Seek - a Medicare brokerage with the consumers best interest in mind - hopefully they’re able to successfully build that. Link.

Data:

  • This is an interesting Deloitte report looking at how we can bend the cost curve in this country by 2040. Deloitte’s actuaries think that by 2040, 60% of health spending is going to go towards health and wellbeing, versus today when 80% of spending goes to care and treatment. This shift will reduce health spending by $3.5 trillion dollars, and a new health economy will emerge with hospitals being replaced and a shift in how healthcare is financed. I’d be quite thrilled if this prediction turns out to be accurate, although it reminds me a bit of the time I predicted I’d be an NBA player one day when I was in 2nd grade. Link.
  • This study looks at whether patients act as consumers and shop based on price when getting MRI scans. Of course it found that patients basically go where their providers refer them, and on average ignore 6 lower cost MRI options closer to home than where they end up going. I can’t say I blame them given how hard it is to actually get clarity on pricing and ensure that the data will get back to your doc. Link.

Jobs:

  • Cityblock, a primary care startup for Medicaid and dual-eligible populations, is hiring a network strategy lead. Link.
  • Collective Health, an employer health benefits manager, is hiring a principal product manager. Link.
  • Garner Health, a data analytics platform helping employers identify high quality / low cost providers, is hiring a data scientist. Link.
  • HEALTH[at]SCALE, a data analytics platform helping employers identify high quality / low cost providers, is hiring for a number of roles including a growth leader. Link.
  • Hospital for Special Surgery, a leading orthopedic hospital based in NYC, is hiring an integration specialist / MuleSoft developer. Link.
  • Meridian Street Capital, an early-stage healthcare-focused VC, is hiring a principal. Link.
  • Nemedio, a platform for medical device startups, is hiring for a number of roles. Link.
  • Salesforce is hiring a Sr. Product Marketing Manager for its MuleSoft group. Link.
  • Vatica Health, a platform that helps providers / insurers capture quality data for risk adjustment and the like, is hiring a product manager. Link.
  • Wittington Ventures; a VC firm investing in retail, healthcare, and food; is hiring an associate. Link.
  • Zaya, a maternity care platform, is hiring a chief of staff and director of engineering. Link.