LeanTaas Acquires Hospital IQ

It didn’t take long for 2023 to mint its first digital health unicorn, and LeanTaas is now a billion dollar company after scooping up workforce management startup Hospital IQ.

The combined entity is now one of the largest providers of hospital efficiency solutions, as health systems scramble for new ways to address both labor shortages and mounting financial pressures.

If you’re unfamiliar with LeanTaas, it provides a cloud-based SaaS platform to optimize capacity for operating rooms, infusion centers, and inpatient beds.

  • While LeanTaas focuses primarily on assets such as equipment and rooms, Hospital IQ is focused on staff optimization and workforce management.
  • By combining these services, LeanTaas is aiming to become the “air traffic control center” for health systems, allowing them to take advantage of predictive AI to improve resource utilization and deliver better care.

The transaction arrives just six months after Bain Capital acquired a majority stake in LeanTaas, which included a “significant” growth investment to accelerate hiring and expand its customer base.

  • LeanTaaS currently serves more than 150 health systems, and it just gained ~40 more from Hospital IQ, bringing its total customer base to over 600 hospitals.
  • The combined company will also benefit from Hospital IQ’s distribution partnerships with various healthcare technology providers, including Oracle Cerner, Siemens Healthineers, and Altera Digital Health (formerly part of Allscripts).

The Takeaway

At a time when everyone is trying to do more with less, LeanTaas’ promise of resource optimization and staffing efficiency has to be one of the easier pitches to try and make to health system execs. Matching supply and demand in an industry where the demand is volatile and the supply is unpredictable is a tough challenge to crack, but bringing staffing and asset optimization solutions under one roof seems like a solid way to go about it.

Rock Health 2022 Full-Year Funding Recap

Every quarter, Rock Health gives us the gift of tallying, analyzing, and adding a bit of spin to the biggest trends in digital health funding – and their 2022 recap might be their best gift yet.

As Rock Health describes it, 2022 was a “downhill ride,” with $15.3B in total US digital health funding signaling the tail end of a three year cycle centered around a pandemic investment frenzy that peaked in 2021 ($29.1B total raise).

That $15.3B figure breaks down to 572 investments at an average of $27M, and we weren’t exactly picking up steam toward the end of the year. (Chart: 10-year trend)

  • Q4’s $2.7B total was less than half of Q4 2021’s $7.4B raise, and it now looks like the market is winding down from its mania to find a more sustainable long term growth rate. (Chart: quarterly totals)
  • Investors’ reluctance to go after late-stage companies and founders’ fears of raising a down round led to only 35 startups raising $100M or more throughout the year. By all means a lot of capital, but well shy of the mega-rounds seen in 2021 (88) and 2020 (43). (Chart: mega-rounds)
  • As investors battled over early-stage prospects, median Series A rounds climbed to an all-time high of $15M in 2022, while check sizes shrunk across all later stages. (Chart: round sizes)
  • Although “on-demand” care companies led the pack with $2.4B in funding (props to DispatchHealth and Homeward), providers’ front-and-center focus on efficiency kept nonclinical workflow startups close behind with $2.2B raised. (Chart: top value props)
  • One of the best charts of the report was tucked away toward the end, highlighting how D2C startups took the biggest hit of any cohort due to rising customer acquisition costs, capital lifelines drying up, and a weakening consumer. (Chart: customer segment focus)

The Takeaway

It’s hard to tell whether we’ve reached the end of this cycle, or if we’re now entering the recession that’ll bring the real pain. Rock Health points to a couple of signals that suggest we might have already seen the worst of it: investors have dry powder stockpiled, and a difficult exit climate could bring late-stage companies back to the fundraising table.

Regardless of when investment starts ramping back up, Rock Health predicts that it’ll be “built up on slow, steady, and maybe even boring strategies.” Sounds like a reasonable prediction, and if 2023 is anywhere near as hectic as many analysts think it will be, “boring” might not be such a bad thing.

Digital Health Trends to Watch in 2023

Happy holidays, and welcome to the last Digital Health Wire of 2022! For our final issue of the year, we’re polishing off our crystal ball (crowdsourcing predictions from digital health leaders) to bring you some of the top trends likely to make a big impact in 2023.

Without further ado…

  • Show, Don’t TellDiMe CEO Jennifer Goldsack – Digital health innovators with practical solutions for real problems have enormous potential to thrive in the coming year, but only if they have clinical evidence to demonstrate their value. Even better, full-stack digital solution providers will identify pathways to reimbursement that don’t involve throwing themselves at the feet of healthcare systems and carving away at their margins.
  • Deeper Patient SegmentationSCAN Health Plan CEO Sachin Jain – The idea that all patients should receive the same clinical model is being fundamentally questioned, and more companies will look at further segmenting their offerings to differentially serve diverse populations. See: Clever Care (MA startup with Asian-focused benefit offerings), Included Health (Affirm product focused on LGBTQ+ population), and Zocalo Health (clinical care “by Latinos for Latinos”).
  • More ConsolidationCentura Health CEO Peter Banko – Traditional health care competition will intensify as consolidation continues and new entrants bring disruptive value propositions. Private equity firms’ $700B+ in dry powder is set to surge even higher in 2022, and national health plans are deploying their pandemic-driven financial gains to fuel consolidation and diversification.
  • Quality Funding Rounds7wireVentures Partner Alyssa Jaffee – With fewer IPOs for exits, many high quality startups will return to the private markets for another funding round. Fewer investors are running around with loose capital, making it likely that investment decision cycles will take longer but have more discipline. For context, there were 23 public digital health market exits in 2021, vs. 7 in 2022.
  • D2C Pivot to B2BAlyssa Jaffee again since her Twitter thread was best-in-class – As inflation continues pressuring the global economy, half of consumers can’t cover a $1K medical expense within 30 days. As consumer purse strings tighten, we could see an increasing number of D2C companies pivot to B2B models to survive.
  • AI-Driven EngagementMD Anderson Cancer Center CIO Rebecca Kaul – AI will start to enable omni-modal communications that are personalized, predictive, and empathetic to the patient. Communications platforms will need to be able to seamlessly connect patients to integrated end-to-end solutions, and more sentiment analysis is needed to build emotional intelligence into digital tools.
  • Mission Critical TechOMERS Ventures Principal Christina Farr – Hospitals are bleeding revenue, so 2023 will be about “must have” vs.“nice to have.” What’ll do well is anything mission critical (addressing labor shortages, burnout, revenue cycle). Companies that can be wiped out by Epic’s next feature update will be in a tough spot.

The Takeaway

It’s tough to predict which of these trends will become the top story of 2023, but it’s pretty safe to say that we’re in for another action-packed year for digital health. While the record shattering funding days of 2021 are behind us, we still have overworked providers, rising healthcare costs, and patients in need of innovative solutions. Cheers to making those solutions a reality in the new year.

Sonde Raises $19M for Voice-Based Screening

Sonde Health puts a few unique spins on the hard problem of early disease detection, but its core tech is built around doing one thing extremely well: flagging patients at risk for health conditions using short voice clips.

Now, after landing a string of new partnerships and $19.25M in Series B funding, Sonde is turning its sights to global expansion.

Sonde’s AI-enabled platform analyzes vocal biomarkers like smoothness, pitch, and clarity to gain insight into a patient’s mental state. It also measures breath cadence and vocal capacity to gauge their respiratory health.

  • This data isn’t positioned as a standalone solution for diagnosing medical conditions, but as a way to improve the clinical workflows of physicians / therapists, the patient stratification of RPM programs, and the value of call center audio.
  • Sonde’s platform can be embedded directly onto device chipsets for passive health monitoring, a feature that’s already being explored within Qualcomm’s smartphone chips and GN Group’s hearing products.
  • This technology also produces a treasure trove of every healthcare startup’s favorite asset – data. Sonde claims to have the largest and most diverse health-labeled voice dataset, with over 1.2M voice clips from 85k users across four continents.

The latest funding will help Sonde expand into Asia, where it’s reportedly seen high demand for its existing solutions, and support the addition of more health conditions to its platform.

  • A validation study of Sonde’s mental health tools is underway at McMaster University, and research on new focus areas is in development at Cambridge University (cystic fibrosis) and the Albert Einstein College of Medicine (dementia).
  • A partnership with Korean telecom giant KT corporation should also streamline the international expansion by bringing Sonde into its call centers and telehealth solutions.

The Takeaway

Although voice-tech is a relatively new healthcare arena, the prospect of passively diagnosing conditions has attracted plenty of competition from startups like Kintsugi ($20M Series A in March) and Eleos ($20M Series A in April), and it’s definitely on the radar of larger players like Microsoft (Nuance) and Amazon (Alexa).

As these companies begin to refine the AI models supporting voice diagnosis, access to proprietary data sets for training the algorithms will become increasingly important for gaining an edge, and Sonde’s funding announcement makes it clear that it plans on turning its dataset into its biggest competitive advantage as quickly as possible.

care.ai Raises $27M for Ambient Monitoring

“Non-clinical workflow” companies continue to lead the pack in terms of digital health funding, and ambient monitoring startup care.ai just added $27M to the segment’s Q4 total following its latest raise.

care.ai’s Smart Care Facility Platform uses ambient sensors spread within care facilities to monitor patients and their caregivers, informing real-time clinical and operational insights.

  • The platform records data such as patient bed exits and falls, while also reducing manual tracking in EHRs by enabling contactless check-ins and screenings.
  • The ambient nature of the solution means that patients aren’t required to wear any RPM device for it to be effective, removing a big source of friction for many virtual nursing or virtual sitting programs.

The fresh funding will help care.ai expand to more hospitals, skilled nursing facilities, and assisted living facilities, building on the 1,500 locations already using its technology.

  • care.ai points to the continued prevalence of staff shortages and burnout as key demand drivers for its solutions, which aims to improve the lives of overworked staff by automating away manual workflows.
  • Other products from GE, ADT Health, or even Amazon’s Alexa fall detection feature compete at least somewhat within the same arena, but care.ai is focused on creating the first truly care site-agnostic solution to the problem of ambient patient monitoring.

The Takeaway
care.ai is setting out to automate away the manual processes causing higher burnout and operational costs for the organizations attempting to deliver optimal care. It’s a tough promise to live up to, but the company’s leadership has done it before. care.ai founder and CEO Chakri Toleti sold his previous patient engagement startup HealthGrid to Allscripts for $60M, and prior to that was putting his motion sensor expertise to work while filming what look to be some pretty epic Bollywood action movies.

The Biggest Company in the World

Venture capital giant Andreessen Horowitz (a16z) got right to the point in a recent blog post that made a huge splash across health tech social media: “We think the biggest company in the world will be a consumer health tech company.”

a16z lays out two paths that could let a healthcare company leapfrog over massive consumer icons like Google, Apple, Facebook, and Amazon to become the world’s most valuable company (Fun fact: the $4T US healthcare market is 5x the size of the global advertising industry).

Path 1 involves creating a vertically integrated “payvidor” that grows to own most care. Picture a company that looks something like if “UnitedHealth Group and Apple had a baby,” with the business model of UHG but the sleek consumer experience of Apple.

  • a16z believes that these companies will need to become big enough to cover most specialties, and also own a health plan that encourages patients to stay within the same care ecosystem (similar to Apple’s tech lineup).
  • Combining both components is essential so that the reimbursement arm can serve as a distribution channel for the care delivery services.

Path 2 centers around building a horizontal marketplace similar to Amazon where healthcare services are aggregated alongside trusted reviews and comparison data. 

  • According to a16z, the key to success for healthcare marketplaces is to serve as an acquisition channel for established players, in addition to being their own acquisition channel.
  • These companies will need to crack the code on how to direct patients to relevant services, while also leveraging the traditional healthcare system for both provider listings and patients.

The Takeaway

Some of the biggest companies in the world are consumer companies that were built in relatively small industries, and the US healthcare market is so big that it can support plenty of success stories with both vertical and horizontal models. That said, packaging something as complicated as healthcare into a consumer experience as simple as Amazon isn’t exactly an easy task, which is why a16z believes that the biggest company in the world will be the one that pulls it off.

HLTH 2022 Recap and Major Announcements

HLTH 2022 is officially a wrap, and we’re sending lots of good energy to the vendors currently breaking down their booths after spending a full week in Vegas.

Hats off to HLTH for putting together a stellar 9,000 person event with awesome attendees, a great speaking track, and the best lunch menu in the industry.

If you weren’t able to make it in person, we’ve got you covered with a roundup of some of the biggest announcements that were showcased in the exhibit hall.

  • 98point6’s new OEM platform tailored for health systems signed Tacoma-based MultiCare Health System as its first partner, licensing the virtual care solution within its hybrid ambulatory care platform, Indigo Health.
  • Awell and Healthie are partnering to enable care organizations to build clinical workflows in Awell’s low-code platform and easily integrate them into Healthie’s API to automate routine clinical tasks and synchronize data between systems.
  • Carenostics joined Bayer G4A’s portfolio of Digital Health Partnerships, providing the AI startup with a €200k convertible loan and coaching from industry experts to help enable earlier clinical intervention through machine learning on EHR data.
  • Google and Epic are partnering to create a new offering that’ll allow Epic hospitals to run their EHR on Google Cloud, with New Jersey-based Hackensack Meridian Health set to be among the first users.
  • General Catalyst tripled its health system partner roster with 10 new logos that it will work with to co-build startups: Banner Health, Cincinnati Children’s, Hackensack Meridian Health, Health First, MetroHealth, OhioHealth, MUSC, UC Davis Health, UC Irvine Health, and Universal Health Services.
  • Health Gorilla was selected by MEDITECH as the technology platform for Traverse Exchange Canada, a new interoperability network designed to enable the seamless flow of health information between participating organizations across Canada.
  • Hello Heart added Dot-to-Dot capabilities to its digital heart health program, leveraging AI to help people draw connections between their lifestyle choices, such as minutes walked or medication adherence, and their heart health.
  • Included Health, the digital health powerhouse formed by the merger of Doctor on Demand and Grand Rounds, launched an All-Included Health hybrid care service to provide primary, specialty, and behavioral care with personalized care teams.
  • Maven Clinic entered the unicorn club with a $90M Series E raise that’ll help the virtual maternity and family health clinic expand its parenting, pediatrics, and menopause platform beyond the 175 countries it already serves.
  • Nomi Health unveiled its Connect fintech platform to power real-time healthcare payments, enabling health plans and third-party administrators to drastically speed up their processes while cutting down on administrative waste.
  • Roche unified its digital health portfolio under the navify brand, providing a range of solutions that help provide evidence about optimizing operational processes and clinical decision making.
  • SonderMind acquired neuroscience company Total Brain to enable patients to better understand their mental state outside of therapy while helping therapists implement measurement-based care techniques.

Welcome to all of our new readers that we met at HLTH, and stay tuned for deeper dives into many of these announcements in next week’s Digital Health Wire.

2022 Digital Health M&A Trends

One of the best reads of last week was Rock Health’s deep dive into the digital health M&A trends that have defined 2022 as the funding bubble lets some air out.

While big ticket acquisitions have taken up most of the spotlight, Rock Health makes the case that declining valuations, customer overwhelm, and an unfriendly IPO market are setting us up for a widespread upswing in M&A activity.

This year’s 144 M&A moves have been shaped in part by supply-side dynamics (harsh fundraising conditions make M&A look more appealing than a down round or shaky IPO), but the report lays out four acquirer archetypes that are likely to drive the next wave.

  • Consolidation for inorganic growth – Lets startups grow their customer base while building confidence from investors looking for growth. This approach is particularly useful as purse strings tighten and customer acquisition costs climb.
  • Enhancing core operations – These acquisitions ideally offset their cost with the internal efficiencies gained in areas such as data integration or analytics. Provider orgs are leaning into this approach, logging 11 transactions Q1-Q3 2022 (3x 2021’s total).
  • Buy-and-build – Acquiring complementary features that enable the acquirer to move along the care delivery value chain or into adjacent categories. Examples include Quest Diagnostics’ acquisition of Pack Health (pushed Quest beyond lab testing into patient engagement / condition management) and Advocate Aurora’s acquisition of MobileHelp (propelled the health system into in-home care).
  • Disruptive innovation – Transforms an acquirer’s existing services and positions them to create a new business model or drastically differentiate in the market (Ex. Amazon acquiring One Medical). Rock Health predicts that the most likely targets will have strong clinical evidence and user bases, but may be struggling with their business model.

The Takeaway

Rock Health makes a pretty convincing argument that digital health M&A is poised for an active year ahead, but also wraps up the report with a warning that acquisition announcements are rarely the end of the story.

“Successful M&A approaches are determined by important choices (e.g. how best to integrate tech stacks as well as cultures and operations, what to keep and where to cut bait, workforce strategy, etc.)… but assessing these frameworks alongside financial, cultural, and operational aspects of M&A is necessary to help organizations—both acquirer and target—maximize impact.”

Headspace Launches Unified Mental Health Platform

Headspace Health just took a massive step forward in delivering on the promise of last year’s $3B merger with Ginger, rolling out a new unified product experience that combines the services of both companies into a comprehensive mental health platform.

The integrated experience brings together Headspace’s meditation and mindfulness offerings with Ginger’s on-demand coaching, therapy, and psychiatry solutions – all within the Headspace app.

The Headspace Health overhaul is set to debut in January 2023, which should be welcome news to the employers and employees that have been calling for more mental health support as the pandemic drags on.

For employees, the new experience provides seamless navigation between Headpace’s wellness content and Ginger’s clinical services.

  • An onboarding survey helps Headspace get to know its members and create personalized care plans, then ongoing check-ins help scale the level of support to individual needs.
  • A sample program might include meditation, a mindfulness walk, and a Sleepcast, with easy escalation to text-based behavioral health coaching or therapy if warranted.

For employers, the single platform approach is designed to eliminate administrative burden, while providing high-level insights for understanding their employees’ mental health needs.

  • Employers can access joint enrollment and engagement trends, such as the percent of members using both Headspace and Ginger simultaneously, as well as aggregate outcomes data for each product.
  • An included Employee Assistance Program bolts on work-life services, critical incident support, workplace training, and manager consultations.

The Takeaway
As we enter the fourth year of the pandemic, most employers are making mental healthcare a top strategic priority, but they’re also trying to avoid cobbling together point solutions to make it happen. The new Headspace Health experience sets out to be the end-to-end solution employers are calling for, although their biggest competitor seems to have gotten the same memo. Headspace will be up against Calm’s new clinical mental health product that was announced last month.

Providers Double Down on Software Investment

A new 2022 Healthcare Provider IT Report from Bain & Company and KLAS Research drew a lot of coverage this week with a headline takeaway that served as a nice break from recent bleak healthcare forecasts:

  • Providers are doubling down on software investments, even in the face of macroeconomic turbulence.

The research includes plenty of interesting data that’s worth checking out if you have half an hour to absorb it all, but here are the highlights for the visual learners with 3 minutes to spare.

  • Over 75% of providers expect to make new software investments next year, and one-third plan to invest more than usual (Figure 1). This signals a turning point in the provider IT market as many orgs who have stayed on the sidelines are now looking to retool software roadmaps for a “new normal.”
  • Of those investing heavily, nearly 80% cite labor shortages, inflation concerns, or restructuring (M&A, change in leadership) as the top catalysts (Figure 2).
  • Providers are particularly interested in revenue cycle management, security, and patient intake solutions as they look to address rising margin pressure and improve the productivity of limited staff (Figure 3).

The other main point that the report drives home is that providers are feeling increasingly overwhelmed by their expanding tech stacks and the proliferation of new vendors.

  • Over half are struggling with the flood of offerings and 24% believe that their existing tech stack keeps them too busy to stay current on new solutions (Figure 4). 
  • As a result, providers are actively trying to streamline their bloated tech stacks, with 72% attempting to expand with existing vendors before considering new ones and 63% looking to cut back on third-party software solutions over the next year (Figure 5).

The Takeaway

The consensus among providers appears to be that falling behind on software investment isn’t the way to turn around struggling performance, and neither is overloading their staff with disjointed products. That seems like a telltale sign that we’re in for more consolidation, especially with the report concluding that software vendors should pursue bolt-on acquisitions and strategic partnerships to create sticky platform offerings in a crowded field.

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