Sesame Secures $27M for Healthcare Marketplace

Direct-to-consumer healthcare has attracted a lot of investor attention over the past few months, and Sesame recently continued the trend by raising $27M in Series B funding to help it become the “Expedia for medical care.”

Sesame is a two-sided marketplace for providers and patients. It allows users to quickly compare physicians with an interface that’s fine-tuned to make booking an appointment as frictionless as possible. Here’s a look at the layout.

  • There are over 2.5k providers on the marketplace offering primary care, chronic condition management, and over 40 specialties – with an average visit cost of under $40. Sesame claims that it is able to lower the cost of care by cutting out the bureaucracy that comes with working with payors.
  • Providers can leverage the platform to offer dynamic pricing based on peak windows, then patients can filter the list to match their needs. Since launching in mid-2020, more than 150k patients have used the platform, and Sesame reports that its revenue has grown nearly 500% year-over-year.

The Series B round brings Sesame’s total raise to $75M and will fund the commercial launch of its Sesame Plus membership product, which has been in beta since November 2021.

  • For $99 per year, Sesame Plus members get $20 off all telehealth / primary care visits and $30 off in-person specialist appointments, as well as other benefits geared toward supporting the 40% of Sesame patients not covered by a health plan.
  • Unlike most other subscription telehealth services, Sesame does not require a membership to book appointments, but the Sesame Plus incentives led to beta members booking 33% more appointments than other patients.

The Takeaway
Sesame isn’t the only company offering affordable direct-to-consumer healthcare (K Health and Teladoc both play in this space), but the marketplace’s dynamic pricing and wide variety of specialists are important differentiators that will only help more as the company scales. Transparency, affordability, and usability also seem like solid pillars to build a marketplace around, and Sesame’s recent growth suggests that the strategy is resonating with users.

Digital Health Primed for Consolidation

The market hasn’t been kind to digital health companies this year. The stock charts of most of these companies look like red lines in a race to the bottom-right corner, and at this point it’s safe to say that many founders are buckling down for a bumpy second half of the year.

The public market struggles are quickly carrying over to the private markets. Woodside Capital Partners counted 44 health tech funding rounds above $10M in Q1 2022, nearly half the total recorded during Q4 2021 (86). The investment bank’s latest market report calls out several main drivers for the slowdown, but the biggest one probably sounds familiar: 

  • Investors are looking for companies generating a profit, and staying far away from those piling on losses to reach meaningful scale.

On the flip side of the coin, the same public market volatility that’s hammering many high-flyers is creating bargains for M&A teams. 

  • The first quarter saw 63 health tech M&A transactions combine for a total value of $48B (an increase over the $41B seen in Q4 2021), which seems to indicate that the declining valuations have already begun translating to more M&A activity.
  • Many public companies have become solid M&A targets due to declines in their shares (Vera Whole Health’s acquisition of Castlight, Oracle’s acquisition of Cerner), while private companies have started rounding out their services by acquiring the missing pieces (Aledade’s acquisition of Iris Telehealth, Lightbeam’s acquisition of Jvion).

The companies most poised for consolidation are those offering point solutions or catering to a specific end market.

  • So many of these have popped up since the beginning of the pandemic that it’s made funding scarce at a time when other exit options are drying up.
  • This likely makes an acquisition look like one of the best paths forward, particularly as larger companies look to capitalize on the moment by expanding their platforms and pushing into new markets.

The Takeaway

It’s usually easier to acquire an established solution than to build one from scratch, and the ongoing market selloff has narrowed the exit options for many startups while also making their valuations more attractive to potential acquirers. These same conditions have made other startups begin looking for ways to bolster their strategies by merging into more comprehensive solutions, which could mean that the real consolidation is just getting started.

Oracle Announces Plans for a Unified National Health Record

Fresh off the close of its $28.3B acquisition of Cerner, Oracle hosted a virtual event to outline its healthcare roadmap, which ended up being more ambitious than most analysts expected after the company announced plans to build a “unified national health records database.”

Oracle co-founder and CTO Larry Ellison said that the national database aims to replace the hospital-centric approach of current EHRs with a more patient-centric model, pulling data from thousands of separate hospital databases to create a unified view of patient health.

  • The goal of the database is to ensure that providers have access to a patient’s up-to-date medical data regardless of their location or past points of care. It will also incorporate real-time updates from provider EHRs to let public health officials monitor trends as they unfold.
  • Ellison stressed that data privacy will be a top priority for the buildout. Providers will only be able to access identifiable information with patient authorization, while other researchers and public health officials will be limited to a de-identified view.

While a unified patient record looks like a worthwhile pursuit on the surface, the health IT community was quick to express skepticism towards Oracle’s announcement, citing concerns over everything from data security to a complicated regulatory landscape.

  • Successfully building the database would also presumably involve cooperation from Cerner’s EHR competitors, but details were vague on its strategy to accomplish this. Epic’s Cosmos solution houses over 122M patient records and could easily be viewed as a competing product, which makes information sharing seem like an uphill battle.
  • Oracle’s presentation was light on information regarding the database’s timeline, cost, and outside access, but Ellison did acknowledge that it’s a “lofty vision” that will likely take a while to execute.

The Takeaway

Establishing a unified national health record has the potential to be a gold mine for Oracle, which mentioned the data’s ability to greatly accelerate life science research and new product development. That said, having the nation’s health data consolidated in a single database operated by a public company is understandably raising some concern, and Oracle has a long road ahead to gain the trust of both the patients it intends to serve and the competitors that will need to cooperate to make its vision a reality.

Innovation for Underserved Groups

Venture firm Rock Health recently published an interesting deep dive on the digital health adoption patterns of marginalized user groups that have carried a disproportionate amount of access disparities. The analysis was based on survey results from Rock Health’s latest Digital Health Consumer Adoption Survey of 7,980 US adults, which shed light on where digital health solutions are gaining traction, and where gaps still remain.

Rural households have one of the most persistent adoption gaps among all demographics, with rural respondents reporting lower rates of live video telemedicine use, wearable ownership, and digital tracking of health metrics… and not by a small margin. Rock Health found that rural residents trust health information from a doctor (88%) far more than from a website (52%), highlighting a need to invest in tools that empower rural providers.

  • Startups working to solve these problems include Main Street Health, which pairs rural MA beneficiaries with local health navigators to coordinate chronic care needs, and Homeward Health, which designed its RPM platform to function on cellular networks to bypass the need for a broadband connection.

Medicaid’s 80M beneficiaries account for over $650B in annual health expenditure, and the fact that they use digital health tools at similar levels to the survey average seems to bust the myth that people with low incomes or disabilities won’t use health technologies. 

  • Recent raises from startups like Waymark ($45M) and Clinify Health ($3.1M) have helped support Medicaid care hubs like Federally Qualified Health Centers, and Rock Health expects more innovation to be targeted at these community-based networks.

Women of color reported significantly lower satisfaction with digital health tools than women who identified as white, despite their strong adoption across all modalities. Although the survey didn’t explore the “why” behind the satisfaction levels, Rock Health believes that they may relate to disconnects between product design and the communities using the solutions.

  • Several startups have begun co-designing solutions with their communities to mitigate these satisfaction breakdowns, including Radical Health (online peer support for navigating healthcare journeys) and Grapevine Health (community-created health content that’s then distributed at scale).

LGBQA+ and transgender patients report some of the highest levels of discrimination in health settings, and their sky-high digital health utilization serves as a proxy for lack of trust in traditional care. Rock Health found that 85% of transgender respondents and 33% of LGBQA+ respondents delayed medical care in 2021, and several solutions are entering the market to ensure that care gap doesn’t persist.

  • Startups supporting queer and transgender patients raised a record $311M in 2021, including Folx, which raised $25M to expand its virtual clinical services, and Plume, which raised $14M to help deliver holistic gender-affirming care to anyone who needs it.

Turquoise Health Closes $20M to Bring Transparency to Healthcare

New CMS price transparency rules have created a massive headache for hospitals looking to publish data often hidden in archaic systems and fragile spreadsheets, which is why Turquoise Health raised a $20M Series A round to help ease the pain and increase compliance. 

The Turquoise platform allows provider organizations and payors to digitize their service catalogs and pricing information, creating what it calls a “pre-revenue cycle” where patients know costs upfront and providers receive quicker compensation.

  • Although most of this data reaches care navigation platforms through an API, patients can also use a search engine on the Turquoise Health website to compare hospitals across all 50 states.
  • Turquoise’s recent investment will be put to work developing the software needed to aggregate the wide range of inputs contributing to a procedure’s final cost, as well as determining health plan coverage at each step.

In anticipation of new payor rate disclosure requirements arriving in July, Turquoise also announced the launch of its Clear Contracts platform, which streamlines the direct contracting process with premade agreements generated from its pricing data.

  • At launch, Clear Contracts will support single case agreements, retrospective out-of-network agreements, and group health agreements, with the boilerplate contracts allowing for a quicker back-and-forth during negotiations.
  • a16z’s Julie Yoo called payor-provider contracts “the tail that wags the dog for most healthcare navigation decisions,” and Turquoise’s mission to modernize them was a key driver behind her decision to lead the Series A.

The Takeaway

Leveraging data from the Turquoise platform to support contract negotiations seems like a smart move for a company looking to build a business model around a valuable data asset. CMS transparency rules, the No Surprises Act, and the upcoming payor rate disclosure requirements have created a sea of regulations that’s extremely favorable for startups that can help navigate these waters, especially if they can translate their data into supporting services like Clear Contracts.

Digital Health, Bubble or No Bubble?

Pandemic-fueled digital health adoption and regulatory changes have brought a wave of new entrants and climbing valuations, but a cloudy macroeconomic outlook has caused many to wonder when the music will stop playing. Digital health venture firm Rock Health recently published its thoughts on whether digital health is in an investment bubble, providing a framework for innovators to assess their individual bubble risk to help navigate a downturn.

Is digital health in an investment bubble? Rock Health assesses “bubbliness” with a six point rubric based on analysis of past bubbles. The rubric currently indicates that digital health is not in an investment bubble, but has more valuation risk than in the past.

To assess the bubble risk of an individual segment, Rock Health maps the segment’s market infrastructure (tech stack, regulatory framework, business models) to its market traction (adoption, outcomes, integration). The resulting framework (pictured here) lets companies plan different bubble strategies depending on their quadrant.

  • “Early days” startups have emerging market infrastructures and limited market adoption, giving them long growth runways but only if they can put in place mission-critical infrastructure pieces (scalable tech, sustainable business models). Example: VR therapeutics
  • “Disequilibrium” companies have high market traction that outpaces the maturity of the market infrastructure, creating the need to partner with companies that fortify this infrastructure with complementary assets (regulatory expertise, foothold in adjacent markets). Example: Consumer genetic testing
  • “Niche” companies have limited traction despite a mature market infrastructure, and Rock Health suggests that they should expand the types of customers they target in order to secure more stable (bubble-proof) revenue. Example: Personal health records
  • “Established” companies have a high degree of market traction and a mature market infrastructure, so continued growth hinges on expanding into novel use cases and investing in technology that reduces the chance of commoditization (cloud/AI, reimbursement mechanisms). Example: Telemedicine

The Takeaway

Rock Health’s current stance is that “digital health is not in an investment bubble, but it is frothy.”  That said, the report’s true call-to-action applies regardless of whether or not we’re in a bubble: now is the time for companies to evaluate their bubble risk and put a plan into place to prepare for whatever the market brings in the future.

Notable’s State of Automation 2022 Report

Burnout and staffing shortages are two of the biggest challenges currently facing the healthcare system, and at this point it doesn’t take another survey to prove that point. The more pressing issue is finding a solution to this well-documented problem, which is what healthcare automation company Notable set out to do with its latest research.

Notable’s State of Automation 2022 Report was based on a survey of over 1,000 US healthcare professionals, and a clear theme emerged in the responses: as workloads continue to increase due to the staffing shortages, health systems looking to grow need to unlock capacity for existing workers to refocus their time on patients.

The key findings echo the sentiment of most medical workforce polls from the last few years:

  • 57% of respondents said they are worried they will burn out due to the number of repetitive tasks required in their role.
  • 45% of respondents are frustrated with how little time is spent on patient care.
  • An average of 58% of staff time is currently spent on repetitive tasks such as data entry and documentation.

The responses also revealed a disconnect in the perception of time spent on repetitive tasks depending on the role, which as likely contributed to the slow relief of this issue:

  • 16% of patient-facing staff agree that “90%+ of staff time is spent on repetitive tasks,” while less than 10% of executives believe the same. 
  • Under 40% of patient-facing staff strongly agree that “their organization is using digital technology effectively,” while 63% of executives agree with the statement.

The Takeaway

The report recommends automating away cumbersome administrative tasks like patient intake and registration to help eliminate downstream work. Although this might be an obvious takeaway from a report conducted by an automation company, it’s hard to argue against streamlining repetitive tasks to support overworked employees.

Health systems today are up against some major obstacles to achieving growth, with patient expectations climbing at a time when expenses are inflating just as quickly. Until we see the supply of healthcare workers begin to rise to meet this demand, freeing up the bandwidth of existing staff to let them spend more time with patients seems like a solid step in the right direction.

Biofourmis Secures $300M for Personalized Care

Biofourmis is taking a two-pronged approach to the healthcare market, leveraging its FDA-cleared data platform to fuel insights for both remote patient monitoring and the development of digital therapeutics. The completion of a $300M Series D funding round will now advance the company’s progress on both fronts, while also minting a new digital health unicorn with a valuation of $1.3B. 

The Biovitals Analytics Engine serves as the foundation of Biofourmis’ services. It employs artificial intelligence to transform biometric data into personalized baselines for each patient, allowing providers to take action as conditions begin to escalate.

Biofourmis’ Care@Home solution uses Biovitals in combination with remote monitoring devices to detect early clinical deterioration and offer dynamic care pathways.

  • These insights are supported by a staff of licensed health professionals that can respond to alerts and update treatments while coordinating with primary care teams.
  • The new financing will be used to scale up these offerings, including the expansion of the recently announced Biofourmis Care service, focused on managing patients with chronic conditions like heart failure and diabetes. 

The other half of Biofourmis’ strategy involves developing digital therapeutics by pairing Biovitals with different medications to optimize dosages as patient health begins to deviate from their baselines. 

  • Biofourmis has a full pipeline of digital therapies, and its BiovitalsHF solution for congestive heart failure is poised to be the first to reach commercialization after receiving FDA Breakthrough Device Designation in July.
  • The influx of capital will be put towards clinical trials to develop new digital therapeutics while growing the product pipeline.

The Takeaway

Remote patient monitoring solutions often live up to their name by focusing more on “monitoring” than “management.” Biofourmis is aiming to change that through a Biovitals platform that enables not only proactive home care, but also individualized insights into the efficacy of digital therapeutics.

It’s the synergies between these service lines that Biofourmis is building around. As the company begins to commercialize its own digital therapeutics, its remote care operations could serve as the perfect distribution channel.

Reuters Digital Health 2022 Takeaways

Fresh off a busy March for health tech conferences, Reuters recently hosted its Digital Health 2022 event in the sunny city of San Diego, with an agenda hyper-focused on sharing the technology and practices that are enabling providers to deliver high quality care.

One of the keynotes that stood out was a conversation featuring Bon Secours Mercy Health CDO Jason Szczuka and Providence Health’s newly appointed CDO Sara Veazy, who each shared pearls of wisdom surrounding streamlining clinical workflows and reaching key executives at large health systems.

BSMH’s Jason Szczuka explored strategies that vendors can use to influence decision makers when presenting their solutions, and how this usually involves taking a different approach with each stakeholder.

  • Szczuka stressed the importance of knowing the entire landscape of individuals at each organization, then communicating the value of solutions appropriately for each one. The way to sway a data ops team looks much different than convincing a clinical team.
  • He also shared his “jobs-to-be-done approach” to assessing potential solutions. Given that patients need to complete a series of “jobs” from intake to discharge while simultaneously facing difficult health challenges, it’s the responsibility of health systems to make these tasks as easy as possible. New technologies get looked at through this lense.

Providence’s Sara Vaezy, who was appointed to the CDO role just earlier this month, fielded a handful of questions about the types of solutions that are a priority for adoption, including technologies that help flexibly match supply and demand for care.

  • Vaezy shared how the solutions that streamline workflows for clinicians are often disguised as patient-facing changes, such as enabling self service for patients in order to open up provider bandwidth.
  • She also discussed how new solutions must align with all three dimensions of Providence’s services: 1) the business model; 2) the operating model from a network perspective; 3) the technology layer.

The Takeaway

While many of the themes at Reuters Digital Health 2022 had a familiar ring to them, one overarching message rang louder than the rest. Whether you’re a provider looking to deliver the best care possible or a vendor introducing a new solution to make that happen, technology is just a tool to help whoever is wielding it. Healthcare is still all about the people.

NexHealth Raises $125M for Universal API

At a time when patients are expecting more from their healthcare experiences and providers are looking for new ways to rise to the challenge, NexHealth announced the close of $125M in Series C funding to help create the infrastructure needed for frictionless care interactions.

The funding arrives less than a year after the company’s $31M Series B round, pushing its total valuation to an even $1 billion. 

NexHealth’s 29-year-old CEO Alamin Uddin first caught a glimpse of the technical barriers preventing seamless patient management while working as a medical receptionist during his time as a pre-med undergrad.

  • The experience led Uddin to found NexHealth in 2017 with the ambitious mission of accelerating innovation in healthcare through the creation of a “Universal API” that enables developers to quickly build useful services.
  • NexHealth’s Universal API integrates data from EHR systems to break down the silos that have traditionally slowed the pace of healthtech innovation, eliminating the need for developers to integrate with individual EHRs and reducing the time required to deploy new products.
  • Uddin compares the service to fintech company Stripe’s back-end credit processing platform, which allows companies to easily plug-in and start interacting with different vendors.

The fresh financing will be used to drive strategic talent acquisitions and develop new doctor-facing features for NexHealth’s patient experience platform that leverages the Universal API to streamline practice management with features like online scheduling, automatic reminders, and two-way messaging.

  • The platform currently manages over 68M patient records, and the recent capital raise should help bring on more large enterprises by adding functionality for one-click booking and integrated forms.

The Takeaway

NexHealth is looking to establish itself as a way to provide frictionless patient experiences during a period when that’s exactly what the market is calling for. As the healthcare industry continues to lumber its way through the adoption of standards like HL7 and FHIR, NexHealth’s Universal API promises a simpler alternative that’s easier to implement, and the investor attention that it’s attracting appears to be validation that the approach has merit.

Get the top digital health stories right in your inbox

You might also like..

Select All

You're signed up!

It's great to have you as a reader. Check your inbox for a welcome email.

-- The Digital Health Wire team

You're all set!