Oshi Lands $60M Series C for Virtual GI Care

Oshi Health just found 60 million reasons why becoming the first virtual gastrointestinal center of excellence in the U.S. was a great decision.

Since launching in 2020, Oshi has raised nearly $120M (half from its just-closed $60M Series C) to help the ~70M Americans suffering from GI conditions control their symptoms while decreasing their total cost of care.

  • It accomplishes this by supporting patients with a gastroenterologist-led care team of advanced practice providers, dietitians, behavioral health specialists, and care coordinators.
  • These multidisciplinary teams collaborate with local PCPs and GI clinics to treat conditions ranging from acid reflux to Crohn’s Disease, enabling a high-touch point approach that would be difficult to achieve without the extra bandwidth.

The fact that Oshi is already available in all 50 states and to 40M+ people as an in-network benefit is a testament to both the size of the market as well as its model, which differentiates itself with its deep behavioral health integration.

  • Many symptoms can be caused by the connection between the patient’s gut and brain, with trauma often marking the onset of new GI issues, and can be corrected through CBT or gut-directed hypnotherapy. Oshi has the research to back that up.

A study done in conjunction with a large national health plan found that Oshi generated $10,292 per patient in avoidable testing, procedures, and ED visits, with 92% of patients reporting symptom improvement within six months.

  • Publishing this data was instrumental to Oshi securing health plan coverage, which made it easier for the employers they work with to integrate that care into their benefits offerings, and in turn helped drive awareness among employees with access to the service.

Although payors and employers continue to shift away from specialty point solutions toward broader digital health platforms, the GI market is large enough to justify standalone companies like we see in cardiology or MSK.

The Takeaway

Oshi has quickly emerged as a leader in the virtual GI space, and it’s now armed with $60M to push its lead even further by expanding its payor coverage, provider group partnerships, and employer programs – not to mention a push into Medicare slated for 2025.

IT Leaders Are Ready For New Solutions

The future’s looking bright for digital health after the Peterson Health Technology Institute’s 2024 State of Digital Health Purchasing Survey found that decision-makers across the industry are ramping up their tech investments.

  • The headlining stat: 97% of employers, 86% of health systems, and 84% of health plans intend to maintain or increase digital health spending in the coming year.

Three quarters of purchasers have already grown their budget for new solutions, motivated primarily by consumer demand (83%) and improved outcomes (62%).

  • Cost advantages were cited as a top investment driver for 60% of health plans and 49% of health systems, versus just 34% of employers.
  • Across all three groups, 43% have acquired enough solutions to address 6+ conditions, and it was interesting to see how their clinical priorities varied.

Purchasers are more hawk-eyed than ever when it comes to their contracts and vetting processes.

  • 59% of contracts have a duration under two years, leaving a short window for solutions to demonstrate clinical improvements and illustrate their value.
  • When comparing vendors, a proven track record was usually the deciding factor, beating out both ROI and ease-of-use for every group.

Looking ahead to next year, value-based care is top of mind, with 100% of employers expressing interest in risk-based contracts for new solutions, as well as 60% of health plans and 50% of health systems. Other top goals include:

  • 72% of health plans are looking to reduce costs and improve member experience
  • 74% of employers are looking to improve productivity
  • 80% of health systems are looking to improve patient experience

The Takeaway

Health plans, employers, and health systems all seem to be embracing the transformative magic of digital health, and this report gave vendors a way stack their decks with data on the unique priorities of each group.

Maven Clinic, Suki, Glooko Start Q4 in Style

It isn’t every week we see digital health startups score a hat trick of massive funding rounds – let alone one that rakes in a combined $295M – but Maven Clinic, Suki, and Glooko clearly came to play.

Maven Clinic kicked off the action by closing $125M of Series F funding and vaulting its valuation to $1.7B. The women’s and family health startup also gave us a behind-the-scenes peek at its 10-year roadmap:

  • Fertility Benefits – Maven’s fertility benefits administration product has brought millions of lives under management since launching last year, and it’s leaning in on forming more clinic partnerships to create a seamless experience between Maven’s virtual care model, financial platform, and in-person treatments. 
  • VBC – The maternity program that serves as the bedrock of Maven’s platform is moving past “phase one” by using real-time data to engage members with a broader ecosystem of services, enabling Maven to take on full-risk and align incentives with outcomes.
  • Engagement – Soon-to-be-announced AI capabilities will bolster Maven’s engagement engine with more insights into fertility, maternity, and family building, as well as often-overlooked areas like return-to-work, parenting, and menopause.

Next up we saw ambient AI startup Suki land $70M of Series D financing on the heels of  adding over a dozen new health systems in the past few months.

  • The release highlighted an expanded partnership with MedStar Health that’ll make Suki Assistant available to thousands of clinicians across specialties including primary care, cardiology, and gastroenterology.
  • Suki also teased plans to expand beyond its existing Suki Assistant and Suki Platform offerings, although details were sparse on what that might entail.

Glooko rounded out last week’s top scorers with a $100M Series F round and the appointment of a new CEO to guide the digital diabetes developer through its next chapter.

  • Freshly appointed chief Mike Alvarez will accelerate the global expansion of Glooko’s solution suite that helps diabetics take control of their condition and equips care teams with a unified platform for managing devices, data, and engagement.

The Takeaway

Digital health startups are off to a hot start in Q4, and Maven Clinic, Suki, and Glooko are the ones cranking up the heat. All signs are pointing to more late-stage mega-rounds as companies look to shore up their balance sheets and bridge the gap to a quickly thawing IPO market, unless of course they’re already eager to diveright in.

Rock Health Q3 Update: Tapestry Weaving

Rock Health’s Q3 Digital Health Market Update showed that investors have found comfort strolling down a path of “focused funding,” with last quarter’s innovation story shifting from transaction volume to market positioning.

The U.S. digital health sector logged $2.4B in venture funding across 110 rounds in Q3 2024, bringing year-to-date funding to $8.2B. 

  • While Q3’s 110 rounds marked a slowdown from 136 in Q1 and 133 in Q2, average investment size held steady at $22M quarter-over-quarter, indicating that investors are honing their focus while continuing to make sharp plays.
  • The analysis also noted that investments are overlapping with partnerships, with companies keen to support startups they’ve already worked with in crowded spaces like healthcare AI – as seen with NVIDIA and Hippocratic AI.

The real narrative behind last quarter’s activity was what Rock Health referred to as “tapestry weaving,” or digital health players building up their offerings to compete with legacy leaders and market incumbents. The related graphic was easy on the eyes.

  • While Q3 mergers and acquisitions were also low at just 21 moves – versus a quarterly average of 37 last year – companies like Dario and Fabric are using M&A to integrate new capabilities and expand their footprint.
  • Like weaving a tapestry, both Dario’s addition of Twill and Fabric’s acquisition of TeamHealth VirtualCare stitched together different solutions to create a more robust platform and address a broader range of customer needs. 

Tapestry weaving isn’t exactly an easy hobby. It involves integrating different products, teams, and go-to-market strategies that all have a chance of backfiring along the way.

  • Big acquisitions help compete for big contracts, but they can also strain the acquirer’s balance sheet.
  • CVS is an easy example. In the last six years, CVS used $88B to add a major payor, a clinic operator, and a home-care provider to its flagship pharmacies. The entire company is now valued at less than the cost of those three moves ($83B current market cap).

The Takeaway

Although the raw count of digital health investments continues to drop off, activity volume isn’t the same as activity quality. The tapestry weaving trend is a reminder that the “true impact of digital health innovation is shaped in the details,” through its investment structures, targeted partnerships, and post-M&A playbooks.

Huma Acquires eConsult, Launches Huma Workspace for Health Systems

Huma isn’t wasting any time putting its $60M of Series D funding to work, acquiring digital triage and consultation platform eConsult less than a few months after closing the round.

The move aligns with Huma’s vision of becoming the “Shopify for Digital Health” by equipping provider orgs and pharma companies with modular platforms / software development kits for a wide range of use cases.

  • The Huma Cloud Platform is a no-code app builder that enables companies to spin up their own solutions using a combination of GenAI prompts and pre-built templates.
  • The platform includes a library of modules and device connectivity tools for any therapeutic area, APIs and integration capabilities, and a marketplace that creates a flywheel of new features from existing users.

eConsult’s intelligent triage platform adds an entrypoint to Huma’s ecosystem by guiding patients through a series of medical questions before determining an appropriate pathway.

  • From there, eConsult gives physicians a summary of any flags or considerations to review, then connects them to a “comprehensive array of digital health solutions” such as appointment booking, screening tools, or virtual consults.

Those capabilities strengthen the foundation of Huma Workspace for Health Systems, which was announced alongside the acquisition to provide seamless access to Huma’s library of pre-built modules and solution marketplace. Those support:

  • Check-in and Triage: Captures patient symptoms and clinical history to prioritize patients with immediate needs and optimize intake.
  • Communication Suite: Equips clinicians with tools to manage patients remotely, such as a full messaging suite, video, scheduling, and EHR integration.
  • Remote Patient Monitoring: Allows hospitals to quickly scale applications for diabetes, hypertension, CKD, and other conditions.
  • Proactive Engagement: Automates direct patient communication for screening, education, and engagement campaigns across entire populations.

Put it all together, and Huma is assembling the pieces to an end-to-end platform for delivering virtual care at scale, with over 3,000 hospitals and clinics already using it to power projects for nearly two million active users.

The Takeaway

End-to-end digital health platforms aren’t built in a day, and the acquisition of eConsult confirms that Huma isn’t afraid of using M&A to speed up the process. Huma is full-speed-ahead with adding new capabilities and growing its footprint, so it wouldn’t be surprising if more acquisitions were right around the corner.

2024 Trends Shaping the Health Economy

Trilliant Health just released its 2024 Trends Shaping the Health Economy Report, delivering a unique perspective on the healthcare market through the lens of supply and demand.

The fourth edition of the report builds on the core findings from the previous three:

  • 2021: Healthcare is a negative-sum game.
  • 2022: Every part of the health economy will be impacted by reduced yield.
  • 2023: The victors in healthcare’s negative-sum game will be those who deliver value.

This year’s 164 page analysis is organized into eight sections, each examining a significant macro trend and supported by a wide collection of data-driven stories:

  • 1) The healthcare system is disproportionately expensive. Despite spending nearly 2X more on healthcare than peer countries, utilization has remained largely unchanged, while increasing 7% in peer countries since 2000. U.S. outcomes are also far worse. (Page 11 Chart)
  • 2) Health status continues to decline. We’re seeing higher volumes of early onset cancers in patients under age 45 for breast (+6.6%), colon (+10.0%), and kidney (+2.1%) between 2018 and 2023. (Page 22 Chart)
  • 3) Government regulation is failing to produce value. This one’s a mixed bag. Regulating cigarettes decreased usage by 30%, but mandated reporting of quality measures hasn’t yielded enough improvement to offset the cost of reporting. (Page 46 Chart)
  • 4) The value of tech advancements is uncertain. Since 2018, multiple AI CPT codes have been introduced, but utilization remains infrequent and concentrated among cardiac conditions such as coronary artery disease and ECG cardiac dysfunction. (Page 77 Chart)
  • 5) Supply constraints are correlated with inadequate yield. The decrease in practicing physicians from 2019 to 2023 resulted in a -0.9% workforce reduction. Notably, 31.3% of physicians changed practice location over that time period. (Page 89 Chart)
  • 6) Forced consumerism has fostered fragmentation. Over 14% of patients with commercial coverage go out-of-network for behavioral health services, versus just 2% for physical care. (Page 111 Chart)
  • 7) Lower-cost care settings can offer better value. New treatment paradigms often start in the hospital but shift to new settings over time (due to new tools, reimbursement reform). How long will that continue? (Page 125 Chart)
  • 8) Employers are better equipped to demand value. Employers have historically been relatively passive in managing healthcare costs., but new transparency requirements compel them to change that. (Page 148 Chart)

The Takeaway

Trilliant’s report showcases the fact that the inputs of the U.S. healthcare system, as measured by cost, exceed the outputs, as measured by the actual value received by Americans. As Trilliant’s Head of Research Sanjula Jain puts it, “every stakeholder can – and must – deliver more value to their customers.”

Providence Spin-Out Praia Brings Flywheels to Healthcare

The ink is officially dry on Providence-spinout Praia Health’s $20M Series A fundraise, and we couldn’t have asked for a better frame up of the startup’s potential impact than SignalFire’s investment memo on why it co-led the round.

Praia Health is helping hospitals avoid the commoditized care caravan by enabling the creation of consumer profiles that extend beyond the medical record, allowing them to recreate the “digital flywheels” enjoyed by other industries.

  • These flywheels have been hindered by healthcare’s reliance on the legacy architectures and closed-system constraints of the EHR, which fails to incorporate the behaviors happening outside of medical encounters that drive a lion’s share of health outcomes. 

Here’s how Praia enters the picture:

  • The first step is a “lift and shift” to Praia’s Secure Patient Identity Service that enables a single sign-on for all of a system’s digital experiences (branded apps, portals, etc.).
  • Praia’s PersonStore then marries those patient profiles with consumer data, synchronizing the EHR to connect-the-dots between outside data and outcomes. 
  • The SPI and PersonStore capabilities lay the groundwork to link Praia’s growing partner ecosystem into ecommerce-like experiences that emphasize patient satisfaction and loyalty – critical priorities for C-suites grappling with margin pressure and patient attrition.

SignalFire’s history on the patient engagement evolution highlights the leap in Praia’s approach:

  • Gen 1: Unidirectional patient notifications primarily focused on scheduling marked the first step in delivering healthcare info through more accessible channels like SMS.
  • Gen 2: Bidirectional communication transformed medical interactions by giving patients the ability to respond to provider messages.
  • Gen 3: Omnichannel engagement with tech-enabled interactions and seamless integrations let patients perform tasks like rescheduling appointments with options pulled from the provider’s practice management software.
  • Gen 4: Praia Health’s breakthrough – an AI-powered patient engagement suite and automated actions driven by deep EHR integration to connect all data sources and orchestrate the end-to-end patient experience.

The Takeaway

The healthcare industry is at a well-traveled crossroads, facing the same challenges as the banking sector encountered with the rise of online services. Just as fintech companies disrupted banking with fine tuned experiences and lower costs, digital health startups are going after health systems’ lowest hanging service lines with the same promises. Praia gives providers a way to fight back with the tried-and-true digital flywheels that have so-far been out of reach.

Sync Fast and Solve Things

The “move fast and break things” motto might work wonders with consumer products, but a new editorial in npj Digital Medicine makes a compelling case that healthcare needs to flip that paradigm on its head and co-create with clinicians to “sync fast and solve things.”

The editorial argues that healthcare practitioners (HCPs) should play an active role in driving digital health innovation, as opposed to being passively “consulted” so that developers can tout the fact that their product is backed by clinicians.

  • The breakneck pace of digital innovation in the wake of the pandemic has outpaced the inclusion of HCPs in the co-creation of new solutions, leading to a fight-or-flight response where clinicians are reluctant to adopt said solutions to defend their traditional responsibilities. Separate research seems to back that up.
  • If new tools lack product insight and buy-in from HCPs, they’re significantly more likely to be doomed to clinical irrelevance, as showcased by a recent analysis that found 44% of digital health companies have a clinical robustness score of 0 out of 10.

Although it isn’t an earth-shattering revelation that HCPs have a solid grasp on the exact workflows needed to inform clinically relevant solutions, the authors offer three considerations for shifting from “passive” to “active” co-creation.

  • First, financial incentives alone aren’t enough to ensure busy clinicians can engage in meaningful co-creation. The most important incentive that companies can offer clinicians is time, particularly by delivering a product that can optimize workflow efficiency or help deliver quicker treatments.
  • Second, the article stresses a need to embed digital health technologies in clinical curricula so that HCPs can learn about not just using these new tools, but also translating their experience into better-informed products.
  • Lastly, the authors lay out why there’s a role for regulators to mandate that HCPs participate in digital health innovation, and suggest that payors and legislators consider augmenting their approval processes by requiring HCPs be involved in the development of new solutions to serve as a proxy for their clinical safety and efficacy.

The Takeaway

Healthcare clearly isn’t the best sandbox to “move fast and break things,” but this article is an important reminder that “sync fast and solve things” shouldn’t mean trading clinician input for speed. While passive co-creation might help with the marketing materials, giving clinicians an active role in product development is the only way to ensure their experience is reflected in digital innovation.

MedArrive Shifts Gears to ClinOps Orchestration

The best path forward isn’t always the same one you started down, which is why MedArrive is pivoting from delivering in-home care to “ClinOps orchestration for healthcare@home.”

MedArrive got its start at Redesign Health in 2020, powering care-at-home programs for payors and managed care groups by integrating physician-led telemedicine with in-home care from EMS professionals.

  • Although MedArrive saw great results reducing ED usage and hospitalizations among the Medicaid populations that it worked with, the lackluster reimbursement meant that it would be a rough road to building a sustainable business.
  • Instead of ignoring that economic reality and fueling visits with its $40M of VC funding, MedArrive decided to chart a new course where it could leverage its lived experience to enable other in-home providers to deliver better care.

To meet the needs of its own providers, MedArrive developed a comprehensive platform that handles:

  • Patient and Labor Capacity Planning – models patient engagement and staffing needs
  • Resource and Shift Management – ensures optimal labor use for anticipated visit volume
  • Scheduling and Routing Optimization – maximizes utilization by minimizing driving
  • Care Coordination – EHR-integration informs care planning and supports documentation
  • Monitoring and Analytics – highlights critical efficiency, ROI, and clinical outcome levers

MedArrive is now focused on fine-tuning the tech infrastructure that it built for its own providers to meet the needs of other organizations looking to deliver high-quality in-home care.

  • That’ll start by teaming up with other providers to co-develop new features and integrations to translate MedArrive’s own success to more partners, with full commercialization planned at some point over the next year.

The Takeaway

One of the best ways to get close to the problems of your end users is to spend time in their shoes, and it’s hard to get closer than MedArrive has by actually delivering in-home care. That experience should give MedArrive a leg up on competing platforms if it can help replicate its results with new partners.

Fabric Leans In On Virtual Care With TeamHealth

Fabric is back at it again with another acquisition, this time scooping up the virtual care business of physician practice juggernaut TeamHealth.

Here’s the updated timeline leading up to Fabric’s fourth acquisition in 18 months:

  • March 2023 – Florence launches with $20M to tackle ER capacity constraints
  • May 2023 – Florence nabs Zipnosis from Bright Health 
  • Jan 2024 – Fabric rebranding and GYANT acquisition
  • Feb 2024 – Fabric closes $20M Series A led by General Catalyst
  • June 2024 – Fabric acquires MeMD from Walmart
  • Sept 2024 – Fabric picks up TeamHealth VirtualCare

That’s an unusually hot start for a startup still looking forward to its second birthday, but Fabric CEO Aniq Rahman walked Business Insider through the method behind the madness.

  • After bringing a consumer mobile experience to the ER, Fabric acquired Zipnosis to add asynchronous telehealth capabilities and accelerate its roadmap to new sites of care.
  • That apparently worked like a charm, so Fabric picked up GYANT’s conversational AI to serve as a patient entry point to its other offerings, then followed that up by grabbing MeMD and its 30k corporate/payor partners.

The latest move with TeamHealth VirtualCare officially gives Fabric access to over 100M lives in managed care contracts with payers, as well as a 50-state network of clinicians.

  • TeamHealth also broadened Fabric’s medical group with multi-specialty experience, including cardiology, sports medicine, OB/GYN, and family medicine.
  • On top of that, the health systems working with TeamHealth VirtualCare will transition to Fabric, providing plenty of surface area to start cross-promoting other services.

Put it all together, and Fabric’s strategy of acquiring both capabilities and customers has led to it having a rare amount of each for such a young company – not to mention an eight-figure ARR (reported during the GYANT acquisition) that’s probably well on its way to adding another digit.

The Takeaway

Fabric is leaning in on virtual care at a time when massive players are bowing out completely, creating an ecosystem of solutions that pushes the telehealth economics in a positive direction that’s hard to achieve with narrower strategies. That M&A playbook isn’t a secret, and given where we’re at in the investment cycle, Fabric probably has quite a few companies knocking on its door looking to be the next solution in its portfolio.

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