Category: Digital Health

Akili Interactive Goes Public in $1B SPAC Merger

Posted on by Jason Barry

It’s less than a month into the new year and the first major digital health SPAC merger of 2022 has arrived. Digital therapeutic company Akili Interactive announced plans to go public in a merger with Social Capital Suvretta Holdings Corp, a SPAC run by high profile venture capitalist Chamath Palihapitiya. 

The transaction values Akili at approximately $1B and is structured to provide over $400M in new capital after it closes in mid-2022, after which the company will be listed on the Nasdaq under the ticker symbol AKLI.

  • Akili develops video games designed to address cognitive impairments in patients. The games actively adapt to each player’s abilities to deliver individualized regimens for building attention control.
  • EndeavorRx is the company’s flagship product targeted at treating ADHD in children by requiring them to manage multiple tasks simultaneously while navigating a character through complex levels. It became the first FDA approved video game in June 2020.
  • The proceeds from the merger will support the commercial launch of EndeavorRx later this year and help to expand Akili’s digital therapeutic pipeline to other cognitive impairments such as depression, autism spectrum disorder, and multiple sclerosis.

Industry Impact

SPAC enthusiasm is clearly alive and well, often chosen for the structure’s ability to take companies public quickly while avoiding much of the volatility associated with traditional IPOs. Last year saw a record 23 digital health companies go public, 8 through IPOs and 15 through SPAC mergers, including another DTx-developer Pear Therapeutics.

Prior to its public listing, Akili raised $301M in funding while projecting that the US market for its ADHD solution could generate $500M by 2030, a potentially rosy forecast given that EndeavorRx has yet to be made commercially available.

The public markets have not been very kind to pre-revenue healthcare companies so far this year, but the FDA and investors both seem to agree that Akili’s fresh approach to video game-styled therapeutics offers significant potential.

UnitedHealth’s Business is Booming Heading Into 2022

Posted on by Jason Barry

Last week, UnitedHealth Group (UHG) reported its full-year financial results for 2021, defending its title as the most profitable US healthcare company while serving as the earnings season bellwether for the broader industry.

Between its UnitedHealthcare payor operations and its Optum hybrid care service lines, UnitedHealth Group pulled in $287.6B in revenue for the year (up 11.8%), beating their initial projections by about $10B.

UnitedHealthcare is the nation’s largest commercial payor, and the company spent a lot of time in its conference call highlighting its success in Medicare Advantage (MA).

  • UHG leads the MA space with 7.9M members, adding 800M in 2021 alone. Over the past year, total MA plan enrollment grew 8.8% to 28.5M beneficiaries, meaning that UHG accounted for nearly 1 in 3 new members – a huge revenue boost from the government at $1,000/patient/month.

Optum’s fast-growing health services business was no less impressive, serving 100M people at year end 2021 while growing revenue per consumer by 33% as it expanded the reach of its value-based care arrangements.

  • UHG spent $100M in 2021 helping partners prepare for value-based contracts. This investment was divided between three primary work streams (clinician training, tech enhancements, network coordination), with similar investments expected this year.

The Forecast for 2022

Looking ahead to the rest of 2022, it’s difficult to forecast a scenario where UHG doesn’t continue its momentum. In the past few months the company’s expansion has only accelerated, with UnitedHealthcare debuting a virtual-first health plan NavigateNOW and Optum moving into the direct-to-consumer pharmacy arena.

UNG expects its 2022 revenue to grow roughly 10%, falling between $317B and $320B, and there’s even a kicker. That projection doesn’t include any gains from the pending acquisition of Change Healthcare for $8B, which has its April approval deadline quickly approaching.

Lyra Health Raises $235M, Acquires ICAS World

Posted on by Jason Barry

Mental health benefits provider Lyra Health is making a habit out of starting the new year with a ton of momentum.

In January 2021, Lyra closed $187M in Series E funding and entered a partnership with ICAS World to bring its benefits overseas. This week, the company raised another $235M at a $5.58B valuation, while announcing the acquisition of ICAS World as it begins to make international expansion a top priority.

  • Lyra provides a suite of in-person and virtual behavioral health benefits to over 75 large employers, offering accessible treatments for conditions such as depression and anxiety that are often stigmatized in the workplace.
  • The latest raise pushes Lyra’s private funding total to $916M and ranks it among the most well-funded companies in one of the hottest corners of the digital health market. The timing follows Lyra’s September announcement of a trio of new solutions designed to address complex conditions such as alcohol use disorder and suicidality. 
  • ICAS World is a global employee assistance provider with a specialist network that offers “culturally responsive care” and localized support in more than 155 countries and 66 languages. 
  • The acquisition greatly expands Lyra’s worldwide reach, allowing it to provide mental health coaching, therapy, and medication within a single platform to over 10M global members. That’s a big jump from the 2.2M members covered by Lyra prior to the acquisition.

The Takeaway

Lyra’s employer-facing model has quickly gained traction in the US, but mental health challenges are hardly isolated to US-based employees. The WHO estimates that productivity losses due to depression and anxiety cost the global economy $1T annually. Mental healthcare is a global challenge, and the ICAS acquisition is a large step towards making Lyra a global solution.

Headspace Health Acquires App-Maker Sayana

Posted on by Jason Barry

Headspace Health isn’t skipping a beat in its mission to create a comprehensive behavioral health platform, acquiring AI-enabled wellness app developer Sayana less than six months after forming through the merger of Headspace and Ginger.

Sayana emerged from the Y Combinator incubator in 2020 with $125K in Seed funding and a goal of introducing as many people as possible to self-care exercises rooted in cognitive behavioral therapy, acceptance commitment therapy, and dialectical behavioral therapy.

The company’s solutions leverage a chat-based AI avatar named Sayana to encourage users to track their moods, allowing it to personalize content delivered through its three primary apps:

  • The Sayana App provides mood tracking and journaling tools coupled with mindfulness exercises to provide insights into how users are feeling over long periods of time.
  • Sayana Sleep aims to match user moods to sleep patterns in order to help those struggling with insomnia fall asleep through custom relaxation sessions.
  • Sayana Workplace uses the same approach but targets it towards employers by helping their employees manage workplace stressors.

The acquisition brings Sayana’s AI expertise and team to the Headspace Health platform to improve its own recommendation algorithms and coaching offerings. The employer-facing component is also interesting given Headspace Health’s enterprise operations, which are a key growth driver for the company and are distributed by over 3,500 employers looking to increase productivity by improving employee wellbeing. 

Data, AI, and Accessible Care

Although Sayana’s 300k+ user base is fairly substantial, it’s tiny in comparison to the 70M+ members commanded by Headspace Health. More user sessions training the AI models should improve the recommendations and ultimately lead to better outcomes for users (and a large competitive advantage for Headspace Health if well executed).

Mental healthcare is a complicated challenge, and requires a scalable solution beyond hiring more therapists and putting them in front of a screen. With the acquisition of Sayana and its AI-enabled chatbot, we’re beginning to get a good idea of what Headspace Health’s solution might look like.

Rock Health Funding Trends for 2021

Posted on by Jason Barry

Regular Digital Health Wire readers could probably guess that 2021 was a spectacular year for digital health funding, and Rock Health’s latest full-year report confirms that investment in the space topped even the most bullish expectations.

  • Total funding for US digital health startups climbed to $29.1B across 729 investments, nearly doubling 2020’s former record of $14.9B. The growth was shaped by 88 different $100M+ rounds combining for $16.6B, including four of the largest digital health raises of the decade: Noom ($540M), Ro ($500M), Mindbody ($500M), and Commure ($500M). [Chart 1]
  • M&A activity grew at a similarly breakneck pace, with 272 M&A moves easily eclipsing 2020’s total of 146. Last year also saw a record 23 companies go public through either SPAC mergers (15) or IPOs (8), shattering the previous record of 8 exits set in 2020. [Chart 2]
  • The most funded value propositions of the year included R&D catalysts such as decentralized trials ($5.8B) and on-demand healthcare ($4.5B). Healthcare marketplaces were among the fastest growing segments, with 3.2x funding growth driven by D2C marketplaces like Mindbody and caregiver marketplaces like Honor. [Chart 3]
  • Mental healthcare was the most popular clinical indication among investors ($5.1B), raising $3.3B more than any other clinical focus. Outside of the pandemic’s less-than-stellar impact on many people’s mental health, this area has seen a funding frenzy due to the rise of virtual behavioral health platforms such as Lyra Health and NOCD. [Chart 4]

Bubble Watch

Despite last year’s record breaking digital health funding, Rock Health’s view on the market was that it “wasn’t an across-the-board bubble, but it wasn’t placid water either.” Many companies are exceeding pre-pandemic projections by wide margins, and it’s possible that historical digital health benchmarks are too low, as opposed to today’s valuations being too high. If these companies can find a way to sustain their momentum beyond the pandemic, there’s a chance we could see a repeat performance in 2022.

Digital Health Trends to Watch in 2022

Posted on by Jason Barry

Happy New Year, and welcome to the first Digital Health Wire of 2022. The past year was anything but boring for those working in digital health, with the pandemic continuing to expose the strengths and weaknesses of our healthcare system.

As with any new year, 2022 brings its own set of challenges for digital health companies to address, and a new roundup of the trends connecting them together.

  • Data Dominance – EHRs, wearables, and telehealth solutions are among the long list of technologies ushering in a new era of healthcare data collection, and leveraging this data to improve outcomes will be a centerpiece of digital health strategies in 2022 and beyond. As more data is able to be collected, more impactful insights will be able to be distilled, and Oracle’s recent acquisition of Cerner is likely a sign of more action to come in the pursuit of patient data.
  • Hospital at Home – Over the past year, the remote care space has gained a lot of momentum, with organizations like Moving Health Home beginning to advocate for policies that enable home-based clinical care. At the same time, remote care providers like DispatchHealth and Current Health have seen a surge in utilization, which will help to generate data demonstrating the effectiveness of home-care models and could accelerate regulatory support.
  • Less Tuck-In Acquisitions – Last year saw record digital health M&A activity by nearly every metric, but the rising valuations of private startups could start to have a negative impact on the total number of acquisitions. Tuck-in acquisitions, where larger businesses acquire companies for their talent or technology, might begin to see a slowdown if younger startups continue to command higher multiples earlier in their life cycles.
  • More Mergers – Although it’s possible that investor enthusiasm is making smaller companies less attractive as acquisition targets, it is also creating a landscape of well-funded startups that will be looking at consolidation as a way to combine strengths, such as with the recent merger of Ginger and Headspace.
  • Behavioral Health Spotlight – Behavioral health is among the fastest growing segments of digital health, with a stress-inducing pandemic simultaneously lowering the stigma surrounding mental illness while increasing mental health literacy. These circumstances have created a large disconnect between the supply of mental health providers and the demand from patients, and the companies tackling this problem will continue to attract a lot of attention from consumers and investors alike.

It’s hard to say which, if any, of these trends will be the top story of the next 12 months, but it seems likely that we’re heading into another year with more innovation than can fit into a five-bullet roundup. Wishing you the best in 2022, Digital Health Wire readers!

Oracle Acquires Cerner for $28.3B

Posted on by Jason Barry

Sometimes when there’s smoke, there’s fire, and that was definitely the case with last week’s rumor that Oracle was in talks to acquire Cerner in one of the largest healthcare M&A moves of the year.

Database and cloud infrastructure provider Oracle is acquiring Cerner for $28.3B in a transaction expected to close in early 2022. Upon closing, Cerner will be organized as its own dedicated business unit, serving as Oracle’s “anchor asset” to expand deeper into the healthcare sector.

What does Oracle gain from the merger?

Cerner marks Oracle’s largest acquisition ever, with several key benefits justifying the move.

  • Oracle and Cerner share a large overlap in end users. Cerner has access to an existing customer base in a giant market, potentially expediting Oracle’s pivot toward the cloud by leveraging these established relationships.
  • Cerner is expected to be a source of durable revenue growth, with Oracle anticipating a positive earnings impact in the first year that is likely to accelerate as it expands Cerner’s services into new regions.
  • As Oracle looks to push into healthcare, access to patient data will be a deciding factor of success, and Cerner’s EHR data helps eliminate its reliance on third party data providers.

What does Cerner gain from the merger?

Cerner was valued at close to $23B heading into the merger (vs. Oracle’s $280B valuation), and it will be looking to pursue ways to use its newfound scale to help it move past the EHR business that’s been slowly losing ground to competitors like Epic.

  • Oracle’s resources, infrastructure, and cloud capabilities will accelerate Cerner’s pace of technology development, while its global footprint could also allow Cerner to reach new geographies faster than if it was a standalone company.
  • Oracle’s hands-free Voice Digital Assistant will become the primary interface for Cerner’s clinical systems, reducing time spent typing and creating more time to care for patients.
  • Cerner will move to Oracle’s Gen2 cloud with the goal of achieving “zero unplanned downtime in the medical environment,” a migration that should happen quickly because of previous integrations between the two companies. 

Industry Impact

If this strategy sounds familiar, it’s right from Microsoft’s playbook, with the tech giant acquiring Nuance for nearly $20B to add more clinical speech recognition tools while gaining a foothold in healthcare.

Cerner has been in the process of shifting its focus beyond its core EHR business, under the helm of David Feinberg, who left Google to become the company’s chief executive in October. 

Feinberg has stated that improving usability and data analytics would be a critical component of Cerner’s strategy going forward, and the combination of Oracle’s Voice Digital Assistant and cloud computing capabilities could go a long way toward making this strategy a reality.

Cerebral Raises $300M for Digital Mental Health

Posted on by Jason Barry

Online mental healthcare provider Cerebral announced the close of its $300M Series C round, raising the company’s valuation to $4.8B within two years of its launch.

  • Cerebral is a “one-stop shop” for comprehensive digital mental healthcare and wellness, offering support for depression, anxiety, and post-traumatic stress disorder among other illnesses.
  • Monthly subscription plans give members access to Cerebral’s team of over 2,000 clinicians, lowering barriers to care through its virtual platform combining therapy and medication management for full-service support in the home setting.
  • The funding will be invested in new services such as schizophrenia management expected to launch in 2022, as well as strategic partnerships and international expansion.
  • Advancing partnerships with employers and payors is another priority for the funds, with Cerebral’s new Chief Impact Officer, Simone Biles, enrolling to help on this front after withdrawing from the Tokyo Olympics to focus on her own mental health.

Industry Impact

In-person mental health facilities were heavily impacted by the pandemic, experiencing capacity constraints that frequently led to month-long wait times to see a provider. This created a window for digital providers to address the care gap, with Cerebral reporting that the wait times for its  “instant live” visits are now just over five minutes.

Large amounts of capital continue to be directed towards the mental health space, and more M&A announcements from its well-funded startups are likely to follow as companies like Cerebral aggressively compete for contracts with employers.

CVS and Microsoft Partner on Digital-First Care

Posted on by Jason Barry

CVS Health is wasting little time with its transformation into an “integrated health solutions company.” Less than a month after unveiling its omnichannel strategy, CVS announced a new five-year strategic partnership with Microsoft focused on digital health and personalized care.

The partnership is centered on leveraging Microsoft’s computing capabilities to unlock value from CVS’ treasure trove of patient and consumer data. CVS is in a unique position to know a patient’s provider choices (through its Aetna payor arm), medication history (through CVS pharmacy), and even shopping habits (through its retail stores).

Now, the company has enlisted Microsoft to tie it all together, with key goals of:

  • Customizing care by combining information from across the company to deliver customized health recommendations while scaling loyalty and personalization programs.
  • Enabling front line workers through the use of Microsoft Teams and Office products, allowing retail employees to quickly consume information and solve customer needs.
  • Digitizing operations through Azure’s cognitive services like computer vision and text analytics to automate tasks such as pharmacy intake.
  • Expanding cloud services by migrating applications currently running on on-site servers to Azure, giving CVS access to over 1,500 new business apps.

The Takeaway

The partnership announcement adds color to the picture of what CVS’ transformation from a local pharmacy to a healthcare destination might look like.

Microsoft’s cloud infrastructure enables CVS to take a more proactive approach to its services, including preventative health recommendations, like when a patient is due for a screening, or automated reminders to pick up sunscreen if a customer has an increased risk of melanoma.

CVS has millions of customers between its retail operations and health plan enrollees, and this partnership allows it to use this data to reach people ”with the right services, through the right channels, at the right time.”

SWORD Raises $163M for Virtual MSK Platform

Posted on by Jason Barry

Digital musculoskeletal (MSK) care provider SWORD Health raised a $189m Series D round, making the startup the latest digital health “unicorn” by lifting its valuation to $1.8b.

Based on SWORD’s fundraising pace, it’s safe to say the pandemic has been a boom for virtual MSK solutions. The company closed a $25m Series B in January, followed by an $85m Series C in June, and the recent funding pushed its outside capital total to over $324m.

SWORD offers a suite of personalized MSK solutions that includes:

  • ASK a PT – 24/7 remote access to physical therapists for general questions
  • Digital Guardian – Applies wearables and video monitors to guide safe workouts
  • The Academy – Customized educational content

The virtual-first approach is designed to reduce preventable surgeries for patients while driving value for risk-taking customers such as payors, employers, and health systems.

SWORD CEO Virgilio Bento founded the company in 2015 after seeing first-hand the “challenges that families face when they have to recover a loved one.” The WHO estimates that close to 2 billion people suffer from MSK conditions globally, creating a lot of room for multiple companies to emerge as leaders.

Digital MSK startups have attracted significant investor attention in recent months, with Hinge Health securing $600m to expand its online MSK platform, and Kaia Health raising $75m for its no-hardware-needed rehabilitation programs.

The Takeaway

SWORD prides itself on being “the industry’s only end-to-end digital MSK solution” (but then again, so does Hinge), and it will need to demonstrate that its hybrid approach offers a superior return on investment than competing strategies. If it can accomplish this, then the new funding should give it strong positioning within an MSK market that is quickly establishing itself as one of the top telehealth use cases.

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