Renuka Agarwal

Platforms are in, point solutions are out as the healthcare AI category leaders come into focus this year. In conversation with Shelby Livingston at Endpoints News, I shared: 1. Why AI-first companies have the greatest platform potential and heuristics for identifying these opportunities at the earliest stages, 2. How companies are differentiating through co-development and distribution partnerships with leading healthcare institutions, and 3. Strategies for navigating anemic budgets and constrained market sizes through business model innovation such as AI-enabled services and pay for performance models Read more here: https://lnkd.in/dJWqv_zC Bessemer Venture Partners Abridge #healthcare #lifesciences #AI #generativeAI

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Awesome report from Rock Health (in the comments) about H124 digital health funding. ?? Despite broader economic challenges, the digital health sector, including mental health, has shown resilience, raising $5.7B across 266 deals. There is a strong Series A pipeline, tapering off of unlabeled funding rounds and 3 public exits in Q2 2024 indicating a revival in the exit market and a return to more sustainable funding patterns?. Key insights about the mental health market: ?? Mental health continues to be the leading clinical indication in digital health funding, securing $682 million in H1 2024. This consistent top ranking highlights the ongoing investor interest and the market's recognition of the critical need for mental health solutions. ?? The focus on mental health is driven by a combination of increased awareness, the rising demand for accessible mental health services, and the integration of tech solutions...?? In fact, AI has become a significant factor in digital health investments, with 34% of the total sector funding going to AI-startups. This trend is also reflected in mental health, where AI is being utilised to enhance diagnosis, personalise treatment plans, and provide scalable, efficient care solutions. Let's go!

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Some VC investors believe that brick and mortar - referring to a physical presence of some kind - should be avoided at all costs. Yet, the track record of clinic and hybrid care businesses in health care indicates otherwise. ==> One Medical (sold for $3.9 billion to Amazon), Oak Street (bought by CVS for $10.6 billion), Lifestance (IPO at $7.5 billion market cap), and PE-backed Premise Health (acquired by OMERS Private Equity for $1.1 billion) If a clinic is indicated as the optimal way to deliver care for that patient population, there are creative ways to build and operate them. Full article below with advice and strategies on how to build and operate hybrid clinics from my teammate Anarghya Vardhana from Maveron, Amir Dan Rubin from OneMedical Group, Steven Eidelman from Modern Animal and more!

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I’m a lucky man - I get to talk about stuff I care about with people that feel the same way, but know how to approach it in fresh ways. This chat with Josh Au Yeung goes into another area I think needs much more attention - leadership. NHS providers recently published data showing only around a third of NHS CEOs have a clinical background: https://lnkd.in/givrbU_p . When evidence suggests that expert leadership is strongly associated with better outcomes, happier staff, and greater productivity, we need to work harder to identify, train, and support current and future clinical leaders. The burning question is this: when it comes to #HealthTech , who is the expert leader? A technologist? A clinician? A hybrid? Would love to hear your thoughts on this (and the podcast, naturally)

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After $400M of capital invested and 30 portfolio companies in health and pharma tech, we are excited to publish our SignalFire health and pharma tech sector thesis, 2024 edition and beyond! ?? Here are 5 major trends that we're focused on ?? If you are a founder building in any of these categories below, we'd love to hear from you! 1) Explosion of healthcare data creates both opportunities & risks in the GPT-4 era 2) PharmaTech is accelerating R&D, manufacturing & distribution to tackle inefficiencies 3) The labor shortage crisis and the need for AI to improve productivity 4) Aging population and the shift to hybrid, value-based care models in patients’ homes? 5) Scaling access to lifesaving therapeutic breakthroughs: GLP-1s & CGTs Grateful to work closely with an incredible team focused on this sector including our legendary Eric Larsen, and partners in crime Sooah Cho, Tony Pezzullo, Sahir Raoof, Adele English ?? What gets me up every morning is our incredible portfolio, each of which making their own dent in our healthcare system for the better — Grow Therapy, Color, Ro, CodaMetrix, Health Gorilla, Verse, Wellth, PayZen, Recora, all.health, Bicycle Health, Form Health, Health Note, Osso VR, Praia Health, Freshpaint, Auxilius, Ovation, OrthoFX, Moxie and many others coming out of stealth soon ?? #healthtech #pharmatech #sectorthesis #innovation https://lnkd.in/gDE3nQqK

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Had a blast diving into Amir Dan Rubin's extensive healthcare career on Vital Signs. Amir previously served as the CEO of One Medical and Stanford Health Care, was an EVP at United/Optum and is now the Founding Managing Partner at Healthier Capital. Our conversation spanned payer-provider integrations, lessons learned from leading One Medical, applications of generative AI, and more. Some highlights: ?Combining care models We talked a lot about the One Medical/Iora combination. Amir argues that just because two care delivery approaches may occupy the same physical location (e.g., a clinic), that doesn’t mean they necessarily need to conform to the same economic model. For instance, One Medical and Iora were able to combine effectively despite the former being a membership model and the latter being global capitation. Amir emphasizes that much of the overhead resources (e.g., front desk staff, phlebotomy) can be shared across models. ?How One Medical uses generative AI to improve efficiency One Medical allows members to message the care team, and then uses NLP to read the message, figure out its content, and triage it to the appropriate team member. Amir is excited about leveraging internal knowledge graphs to get around hallucinations. This approach can point to relevant internal data in helping compose responses, creating more trust and accuracy in the outputs. ?Behind the Amazon acquisition One Medical was interested in expanding its direct to consumer offering. However, they recognized that customer acquisition was costly, which is why partnering with Amazon Prime’s existing membership base made sense for them. Amir explains how at their core, both Amazon and One Medical are all about using technology and logistics to create an excellent customer experience. An awesome conversation ranging from health system innovation to startup strategy to health tech investing! Listen to our full episode below: Spotify: https://spoti.fi/3Wrbnol Apple: https://apple.co/3XWOomb

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I’m optimistic about the potential of generative AI to reduce provider burnout and improve provider-patient interactions. However, that optimism is tempered by the data that indicates the technology is not quite ready yet. Bright Ventures is interested in digital health founders who understand the realities of provider-patient interactions, and the role technology can play in strengthening clinical outcomes. Which founders and teams are getting this right? Tag them in the comments below.

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According to the latest report from Rock Health, digital health funding in Q1 2024 totaled $2.7B across 133 deals, with an average deal size of $20.6M. It doesn’t break out device-related investments, but most medtech founders I meet these days are being forced to chase tiny rounds made up of endless little checks, consuming valuable energy and slowing their progress. The benign neglect of this next generation of diagnostic and therapeutic devices is counterproductive and surprising. Given the crowded virtual care market, for example, I’d expect more such companies would be exploring medtech partnerships, investments or acquisitions that'd enable them to back integrate into delivering sharper, and more differentiated, care and treatment. This is exactly what Maverix Medical is doing from the other direction: Reshaping the entire spectrum of lung cancer care by integrating more advanced + effective approaches to screening and diagnosis, treatment and therapeutics, and even palliative care…And putting it all to work through an innovative provider network. One notable investor exception is Y Combinator partner Surbhi Sarna who’s been backing great teams like Selera Medical (YC W24) doing foundational work on ambitious medical devices. Without more support from investors like her, we’re going to increasingly find ourselves stuck with the incremental portfolio improvements from the incumbents, and that’s just not nearly enough.

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Digital Health Acquisitions # 107 - # 108: Week of July 14th - 20th, 2024 Digital health M&A cooled off slightly last week with just two deals announced. 108: Commure acquired Augmedix in an all-cash deal valued at $139M. Augmedix, a company that previously went public through a SPAC transaction, was initially listed through a reverse merger with Malo Holdings Corp. in 2020 before listing through a traditional IPO on NASDAQ in 2021. This acquisition marks a significant move for Commure, as it aims to enhance its healthcare technology offerings by integrating Augmedix's capabilities in medical documentation and workflow automation. 107: The German/Dutch company Apothera GmbH / MYA Health acquires Disapo.de Apotheke B.V. from Europe's omnichannel premium beauty chain Douglas Group. Apothera has its main office in Berlin, Germany but operates its online pharmacy through Mya Health B.V. in Amsterdam, Netherlands. This acquisition is a strategic play to strengthen Mya Health's online pharmacy presence and reach a wider customer base. While deal activity slowed down, the digital health industry continues to evolve rapidly. What are your thoughts on the current M&A landscape? Did I miss a deal last week? Galen Growth | Insights You Can Trust #DigitalHealth #Mergers #acquisitions

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Exciting news from Monica Chopra, Jeffrey De Flavio, MD, Samantha Adelberg, and the rest of the Auxa Health team as they officially announce their $5.2M Seed round. The team's deep industry expertise and drive for change have led them to solve critical infrastructural friction to providing quality healthcare and adoption of value-based care. Auxa's AI benefit navigation platform is simplifying the complexities of healthcare by streamlining all of the fragmented and siloed data and information to make it actionable in real-time for healthcare organizations. For the 70% of Americans who aren't getting access to the health and social care benefits they deserve, Auxa's solution will be pivotal in enabling equitable care. We're thrilled to partner with co-investors Zeal Capital Partners, AlleyCorp, Laconia, and Chaac Ventures on this journey and look to share many more milestones ahead. Cc K50 Ventures, Ryan Bloomer, Daniel Vásquez, Nick Talwar, Stefanie Ng https://lnkd.in/dPDY7-Db

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As physicians, we are committed to improving patient care through clinical excellence. However, there's an often-overlooked avenue where our expertise can significantly impact healthcare innovation: serving as medical advisors for startups. Here are a few reasons why I believe we should engage with the entrepreneurial community ?? 1?? Driving Innovation Forward: Startups are at the forefront of medical technology and services. By contributing our clinical expertise, we can guide these companies to develop solutions that are not only innovative but also practical and patient-centered. 2?? Broadening Impact: While our primary influence is within the confines of our practices or hospitals, working with startups allows us to extend our impact globally. Technologies we help develop could benefit patients worldwide, many of whom could never visit us in person. 3?? Learning and Growth: Engaging with startups exposes us to the latest technologies and business strategies, enriching our understanding beyond the medical field. This cross-disciplinary knowledge can enhance our own practices and the way we approach patient care. 4?? Professional Networking: Collaborating with entrepreneurs and other tech innovators can open new doors. These connections can lead to other advisory roles, speaking opportunities, and even advancements in our own careers. 5?? Financial Opportunities: Often, advising roles come with financial compensation, including equity options. These can provide significant financial benefits, particularly if the startup succeeds. 6?? I urge my fellow clinicians to consider stepping into the role of a medical advisor. Our insights are invaluable, and our participation can be the key differentiator in the success of health-focused innovations. ---- Join our vibrant community of 2,000+ healthtech experts and thought leaders. Comment below or DM me, and I’ll provide you with an invitation to our fast-growing network. ??

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"Digital health is no longer the future; it is the present, reshaping our healthcare landscape in real-time." Excited to be part of the UCSF Digital Health Hub Foundation's Quarterfinalist Party! As a past board member, I'm honored to celebrate the outstanding quarterfinalists. As we reflect on the state of digital health in 2024, it's evident that the COVID-19 pandemic has fundamentally transformed healthcare delivery. The rapid adoption of telemedicine during the crisis has become a permanent fixture, with over 60% of physicians continuing to utilize this technology. The sprint towards smarter healthcare, catalyzed by necessity, has shattered preconceptions about digital-first health experiences. Virtual care is no longer a stopgap but an integral part of a seamless, anytime, anywhere health ecosystem. ?? We're witnessing the rise of B2B2C models in remote consultations, with companies like Teladoc Health and Amwell partnering with insurance providers to integrate their services into health plans. Public sector collaborations, like eConsult Health 's partnership with the NHS in the #UK, underscore the potential for remote consultations to enhance efficiency and accessibility at a national level. The digital health landscape is evolving rapidly, with advancements in remote consultations, mental health support, at-home diagnostics, and patient monitoring. AI and generative AI transform care delivery, making it more efficient, personalized, and patient-centric. ?? Yet, challenges remain. While venture capital funding for digital health has stabilized after the pandemic boom, it remains below its 2021 peak. Sectors like digital therapeutics face reimbursement hurdles, and we've seen major players like Walmart and Optum close telehealth businesses. Looking ahead, we anticipate further consolidation in digital health, driven by acquisitions to create broader ecosystems encompass telemedicine, mental health, and other specialized services. As healthcare leaders, we must leverage these digital advancements to improve access, enhance patient outcomes, and drive efficiency in our healthcare systems. The future of healthcare is digital, and the time to embrace this transformation is now. Congratulations to all the finalists! ?? Looking forward to the grand finale at #HLTH2024 in #LasVegas! ?? By the way, the pink drink that we were holding was delicious—and nonalcoholic! The Digital Health Hub Foundation - Digital Health Awards #HealthcareInnovation #DigitalHealth #UCSFHealthHub #Networking #HealthTech #Entrepreneurship #LasVegasFinale Walter Greenleaf, PhD Daniel Kraft, MD Unity Stoakes StartUp Health University of California, San Francisco UCSF Innovation Ventures American Association for Precision Medicine (AAPM) WISE World Investors & Entrepreneurs Society #AAPMhealth #aapm_health

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Should you sell your practice to a VC-Backed MSO Startup? tldr: - new VC-backed startups are forming MSOs to roll up independent practices - The pitch is physicians receive early liquidity from the roll up and are granted ESOP shares that can be used for retirement - Problem is the use of ESOPs with independent practices is not a new concept and has been used with large group practices since the 70's - ESOPs do not grant full ownership and in order for the shares to be valuable for retirement, the practice needs to run the same if not better post roll up - With VC-backed startups being primarily operated by non-physicians with zero clinical or medical practice experience, the likelihood of this happening is extremely low making the entire concept high risk However, there is a viable path for continued ownership + liquidity for independent practices. Check out the article to learn more. ? https://lnkd.in/gmGvTYwP

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Today, Two Chairs announces $72M of new funding to continue building a world where everyone has access to exceptional mental health care. Since late 2017, when Maveron led the Two Chairs Series A, the need for mental health services has grown considerably as our society has become lonelier and more isolated than ever. At the same time, our culture’s willingness to openly acknowledge these challenges is greater than ever. Sadly, the rapid growth of Two Chairs affirms the fact that our society is in desperate need of better mental health support. Two Chairs has built a business that believes clinical quality is the defining characteristic of success. Alex Katz has always emphasized the paramountcy of measurement-based clinical outcomes, which the team works tirelessly to achieve. In the process, Two Chairs has illustrated that embracing the ‘move fast and break things’ mentality doesn’t always work. Instead, Two Chairs opted for a different approach: they went slow to go fast. They built a proprietary algorithm that matches patients with the perfect therapist at the onset and hired a team of W2 clinicians oriented toward providing the highest quality care available. Even as the Two Chairs team has grown, their culture has remained small. This has enabled more intimate relationships within the team and between clients and clinicians. Reflecting on this milestone brings me back to the founding of Maveron and the values we hold dear. In 1998, my friend Howard Schultz and I founded Maveron to help entrepreneurs build companies that improve the lives of everyday people—their employees and their customers. There is perhaps no better example of this than Two Chairs. *** Thank you to TechCrunch's Marina Temkin, CFA for the great write-up. https://tcrn.ch/4aMt7yG

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Someone broke down the estimated costs of a $15 Sweetgreen salad. We need these cost graphics for digital health to help future founders. Especially for tech enabled cos, the greatest cost is labor. Much of the "value created" is in curation and matching, which means the gross margins are reliant on labor arbitrage. Pay someone $X, but get paid $X+Y% per visit. The challenge with healthcare is that you often have to pick one of two business models: 1. specialized, low volume, high cost, low gross margin % 2. generalized, high volume, low cost, high gross margin % I'd argue founders should focus on gross dollars over the lifetime of the customer (like Jeff Bezos said) instead of gross margin %'s, but we'll leave that for another time. The challenge is that many tech enabled digital health cos have high cost of goods sold (labor) and moderately high product, design, and engineering budgets. We must build differentiated solutions for patients, clinicians, and clients to be out incumbents, however, we're realizing that companies are ultimately valued on the discounted value of future cash flows. And the high SG&A costs at most organizations might be inbalanced to the unit economics of the business. I'm not sure the math pencils out for everyone unfortunately. But I'm just a guy on the internet, would love to hear the thoughts from those smarter than I (you!). Comment below. --- p.s. I have no idea the accuracy of the graphic and not an investor in Sweetgreen. Cheers. Credit: David Crowther

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This week Mikal Ventures brings you a 4-week breakdown of the US capital market with an emphasis on the Mikal verticals. Over the 4-week period ending April 15, just over 900 new companies were added, with 94,109 companies included in the US Health Tech, Med Tech, Fin Tech, AI Tech, and Ed Tech verticals. AI Tech again saw the greatest percentage of growth in new companies and transactions, weighing in at over double the vertical averages for the period. The US Fin Tech vertical again led the way in SEC Filings and news articles. Mikal Ventures publishes these stats on a rolling 4-week basis to provide a perspective on how the verticals and new startups move through time.?We hope you find them informative?and thought-provoking. VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark?https://mikalventures.com/?for additional insights and information.

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Another large funding round in the virtual behavioral health space. It's interesting to note Talkiatry's focus on a physician-centric care model with W-2 providers, as opposed to most of the other players who are delivering care with 1099 mid-level therapists. However, it's still not clear to me how they are measuring care quality and outcomes, which is the foundation of true value-based care.

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Still feeling energized from last week's roundtable on building successful relationships with hospitals. We invited 7 portfolio companies and health system leaders from Mayo Clinic, Cedars-Sinai and UCLA Health. The founders shared their questions ranging from the strategic to the nuts and bolts of closing partnerships. For example, how do you determine what measures of effectiveness help drive alignment? And how do you get all the stakeholders together to actually drive a decision. Answer: put them all in a room for half a day! “I think we're in a pivotal moment regarding how we assess AI. There are numerous risks currently dominating AI discussions, particularly those concerning bias and other associated risks. However, there's a notable absence of focus on evaluating the proactive value of AI. We need to consider what AI actually offers and what we want it to offer. It's not solely about determining whether it will cause harm; people are apprehensive about how this technology will be implemented. One perspective gaining traction involves ensuring the product's validation process is robust enough to prevent risks to various populations.” -Vladimir Manuel, Medical Director at UCLA Health From Vlad's comments above to perspectives others shared, we heard a sense of excitement for the promise of #AI and other new technologies. But we're also in a unique moment where the risks are not well understood. Still much to do here.

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To my amazing network - I am thrilled to announce the launch of Pave Health Ventures, an early-stage venture fund dedicated to broadening access to healthcare and improving the overall well-being of our communities. I’ve been very fortunate in my healthcare career. As the Founder & CEO of MedPilot, we capped off a seven-year journey with a successful exit when we were acquired by Vytalize Health. For the last three years, serving as Chief Innovation Officer, I’ve had the honor to contribute to the remarkable growth at Vytalize, impacting the lives of hundreds of thousands of patients by enhancing the quality of care they receive. I am immensely grateful to Matt Buder Shapiro, not only for being the perfect partner and co-founder but also for being an incredible friend. Additionally, I extend my heartfelt appreciation to Faris Ghawi, Amer Alnajar, and Jordan Brown for their outstanding leadership and for broadening my perspective on the significance of value-based care. This journey has not only provided me with industry expertise but has allowed me to cultivate invaluable relationships and an incredible network. As I embark on this new chapter, I am profoundly grateful to be supported by top executives and thought leaders in the investment, wellness, and healthcare industries. Within the healthcare ecosystem, we are represented by key stakeholders from health systems, insurers, governmental organizations, retail health businesses, provider groups, and value-based care organizations. At Pave Health Ventures, we believe the timing couldn't be more opportune to help support health-focused startups. With the growing prevalence of illness and chronic health conditions impacting our communities, consumers and key Healthcare Stakeholders are increasingly prioritizing proactive and preventative care. This shift in focus is fueling demand for technology, products, and services aimed at improving health outcomes, unlocking trillions of dollars in growth potential within the healthcare landscape. Pave Health Ventures is all-in. We are actively seeking solutions that tackle the root causes of illness, manage chronic conditions, and optimize care and care teams. Please support us in our mission by opening your networks and introducing us to amazing founders and entrepreneurs. Together, let's help pave the way to a healthier tomorrow. Jacob Myers

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