Kevin's Weekly Health Tech Reads 4/11

Lots of news for the past few weeks: Bright & VillageMD preparing for IPOs; Cityblock, Crossover, and Rightway raised $100m+; good reads on pharma, the passion economy, dialysis, and more!

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News:

  • Some interesting reported upcoming IPO news in the digital health space:
  • Minneapolis-based(!!!) health insurer Bright Health is preparing for an IPO in Q2, with this article reporting it could be valued between $10 - $20 billion. Will be quite curious to see how Oscar’s public experience impacts the valuation here - hopefully Bright is managing cash burn a bit better than Oscar has done over the past few years. Bright’s strategy of membership growth via acquisition appears to be working out well for them if they indeed end up in the $10 - $20 billion valuation range. I’m guessing we’ll see more of the other startup insurers start to follow suit. Link.
  • Primary care startup VillageMD is also preparing for an IPO that could happen in Q3. VillageMD was recently valued at $6 billion, and this IPO could value it at up to $10 billion. Link.
  • Bright Health also was in the news as it acquired Minneapolis(!!!)-based telehealth startup Zipnosis, which offers a white-labeled platform for health systems. Zip seems to fit well into Bright’s strategy of partnering with local care providers, presumably it’ll be offered into the suite of services that Bright is offering its partners. Zipnosis has attracted some quality health system clients for it’s telehealth offering, will be curious to watch if any of them get flipped to Bright insurance partners over time. Will also be interesting to see if this is the beginning of Bright moving down an Optum-like path, tucking in services acquisitions. Link.
  • CMMI released its Direct Contracting entities participating in the implementation period. The momentum around this program appears to have completely stalled, as CMMI notes in the update on their site that they are not planning to accept any future applications from any new organizations. Startups including Clover, Oak Street, Iora, and VillageMD are all participating, although it appears that Agilon and Cityblock, which were participating in implementation period, are not participating in performance year 1. Will be interesting to watch how VillageMD, Clover, and Oak Street continue to explain their view of the Direct Contracting opportunity to Wall Street. Link.
  • Women’s health startup Tia partnered with Commonspirit, and the two are launching a clinic together in Phoenix. This is a really interesting strategy on Tia’s part - start by nailing the D2C experience and then leverage that expertise to partner with health systems. I think many of the brand-focused digital clinics will be well served getting out in front of partnerships like this moving forward. I’m a fan. Link.
  • Rubicon Founders, a joint effort between Adam Boehler, Oak HC/FT, and Welsh Carson, launched this week. It’s hard to tell what they’re actually up to from the press release, but based on the website it looks like Rubicon will be leveraging a fund to both building and investing in companies. Interesting to see them note they’re looking at investing in large companies and spin outs in particular. Given the players involved, I’m guessing we’ll see some relatively large bets from this group over time. Link.
  • General Catalyst raised a new $600 million fund off the back of its recent success in Livongo. It looks as though it is primarily health systems that are LPs in the new fund. Somewhat similar to Rubicon, General Catalyst will be looking to both incubate / start early stage companies as well as providing growth capital for companies like Cityblock. This seems like the trend in investing these days - everyone is moving towards an incubation model at an early stage, and then everyone wants to put growth capital into companies already on the success track. It seems like a natural byproduct of a market where everyone is chasing the same handful of ideas and a large portion of success or failure can be attributed to the network of individuals around the idea. Link.
  • SOC Telemed acquired Access Physicians for $194 million. Link.
  • Bank of America acquired healthcare payments company AxiaMed. Link.

Funding:

  • Cityblock, a primary care model for dual eligible populations, raised $192 million from none other than Tiger Global. Link.
  • Crossover Health, a primary care model for employers, raised $168 million to support its national expansion. Link.
  • Rightway, an employee benefits navigation platform focused on Rx benefit navigation, raised $100 million at a $1.1 billion valuation. Link.
  • Firefly Health, a virtual primary care startup, raised $40 million. Link.
  • Cleo, a platform supporting working parents, raised $40 million. Link.
  • SteadyMD, a telehealth platform, raised $25 million. Link.
  • CirrusMD, a text based telehealth platform, $20 million. Link.
  • Canvas Medical, an EMR for primary care, raised $17 million and announced a partnership with Anthem. Link.
  • Inbox Health, a medical payments platform, raised $15 million. Link.
  • Real, a mental health platform, raised $10 million. Link.
  • Lifelink, a chatbot platform for health systems and life sciences companies, raised $9.75 million. Link.
  • Mantra Health, a college mental health platform, raised $2 million. Link.

Opinions:

  • The Healthcare Substack Writer’s Guild continues to pump out excellent content:
  • Maitreyee Joshi wrote a piece on the pharmacy supply chain. It’s as good of an explanation of the pharmacy supply chain as I’ve seen - does a really nice job explaining one of the most insane parts of the healthcare system. The graphics describing the payment flows are excellent. Link.
  • Ben Lee penned a three part series on the how the rise of the passion economy could impact healthcare. This is going to be one of the more interesting areas of healthcare delivery over the coming years - i.e. how do we empower individual providers as creators? What if an individual PCP could rethink their business and create an online following of 5k people paying $10 a month and make $600,000 a year for themselves? Link.
  • Sherman Leung wrote about care coordination and specifically looking at some learnings from CMS’s Accountable Health Communities model. Link.
  • Freakonomics does a excellent job taking on another insane part of healthcare - the amount of money we spend on dialysis. This statement really puts it into perspective: “it’s almost 1 percent of the entire federal budget, which to me is just a staggering statistic. Every $100 I send in taxes, one of it’s going to pay for dialysis.” Absolutely wild. You can see why there is so much startup activity going after Davita and Fresenius after reading / listening to something like this. Link.
  • Jane Sarasohn-Kahn provided some solid perspective on a recent McKinsey report focusing on the rise of healthcare in the home and how behaviors we developed during COVID-19 are likely to persist post-COVID-19. The chart below is particularly interesting, on the difference between virtual mental health and other virtual care utilization during COVID-19. Link.
  • This is a solid report on mental health by the 7wire Ventures team, breaking down the digital health market into various company types - virtual mental health, mental wellness, care coordination / enablement, remote monitoring, SUD treatment, and digital therapeutics. I get a bit overwhelmed looking at how many mental health startups are out there at the moment. Link.
  • Forbes featured a deep dive on Judy Faulkner and Epic. There’s lots to be said about Epic’s role in the industry, but Faulkner’s entrepreneurial story building Epic is pretty incredible. Link.

Data:

  • HCCI released an excellent analysis looking at price variation across hospitals based on hospital price transparency data. Check out the chart below looking at the price of a c-section at 18 Sutter hospitals. It costs anywhere from $7k to $80k depending on the hospital and insurance you have. Wild. Link.
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  • Chartis released a report on MA enrollment, doing a nice job breaking down the growth in MA enrollees across various insurance plan types (for profit, not-for-profit, Blues, startups, etc). The bar chart showing that venture-backed MA plans have enrolled 0.9% of the market provides a good reminder of their relative size to the rest of the industry at the moment. Link.
  • Health Affairs looked at the costs of urgent care centers versus emergency departments and found that “thirty-seven additional urgent care center visits were associated with a reduction of a single lower-acuity ED visit. In addition, each $1,646 lower-acuity ED visit prevented was offset by a $6,327 increase in urgent care center costs.” Link.

Jobs:

  • Cityblock, a primary care model for dual eligible populations, is hiring a market growth lead. Link.
  • Dreambound, a company helping people become CNAs, is hiring a senior software engineer. Link.
  • Included Health, a virtual clinic for the LGBTQ+ community, is hiring a number of jobs including member services manager and talent acquisition lead. Link.
  • Kensho, a platform for holistic medicine, is hiring a number of roles in product and engineering. Link.
  • Maven, a virtual clinic for women’s health, is hiring a compliance director. Link.
  • SCAN, a Medicare Advantage insurer, is hiring a director and manager of corporate development. Link.
  • Season, a food-as-medicine startup, is hiring a data scientist. Link.
  • Sidebench, a software development studio, is hiring for product roles, among others. Link.
  • Transcarent, a navigation platform for employers, is hiring a product lead. Link.
  • Vim, a platform for payers and providers to coordinate care, is hiring a provider success manager. Link.
  • Virtusense, a data analytics platform helping hospitals prevent falls, is hiring sales people. Link.
  • Zeke Emanuel is hiring two research positions at University of Pennsylvania. Link.