Florence Acquires Zipnosis From Bright Health

Florence isn’t wasting any time putting its $20M seed round to good use, picking up asynchronous telehealth platform Zipnosis off of struggling insurtech Bright Health less than two months after closing the funding.

Florence was founded to unlock clinical capacity by giving patients mobile-first experiences that rival consumer industries, allowing them to update their clinical information, fill prescriptions, initiate self-discharge, and book follow-ups. Here’s our full overview.

  • Although Florence initially set its sights on the ED, acquiring Zipnosis broadens its product suite with device-agnostic asynchronous telehealth and immediately allows it to accelerate its roadmap to new sites of care – particularly the home.
  • The cherry on top of the acquisition is that Zipnosis also brings 50+ health system customers, giving Florence a solid foot in the door to start offering its core ED services.

For its part, Bright Health acquired Zipnosis for roughly $50M just two years ago as it looked to bulk up its capabilities ahead of an IPO that ended up valuing the company at $11.2 billion.

  • As with most high-flying public debuts around that time, Bright… struggled to grow into its valuation. The company has since exited ACA exchanges, begun looking to cut its last two MA markets, and overdrawn a $300M+ line of credit.
  • That combo forced Bright to offload business lines like Zipnosis to avoid bankruptcy, and although the financial terms of the acquisition weren’t disclosed, Florence’s entire seed round doesn’t seem like it would put much of a dent in Bright’s problems.

The Takeaway

All-in-all, this looks like textbook execution by Florence. The company had just 70 employees prior to doubling its head count with Zipnosis team members, and acquiring complementary capabilities and an existing customer base was probably a lot more efficient than building them in-house. It’s also safe to say that Bright isn’t the only distressed business looking to trim units, and it’s likely that we’ll see more stories like this one as strategic acquirers scoop them up.

Memora Lands $30M for Care Automation

Among last week’s wave of HIMSS announcements was Memora Health landing $30M in fresh funding from General Catalyst and a group of strategic health system partners.

The investors included big names like Northwell and NorthShore/Edward-Elmhurst, which makes sense given the two major goals of Memora’s care automation platform:

  • Unburden care teams to allow them to practice at the top of their license
  • Proactively guide and engage patients throughout their care journeys 

The themes are familiar, but Memora’s platform tackles them in some unique ways.

  • An SMS-based asynchronous communication platform (vs. app based)
  • Tight integration with human providers for triage and navigation
  • Automation to push data to patients + pull new data via questionnaires and devices
  • AI-enabled care journeys that evolve with the behavior of patients

Memora works with its partners to understand how they manage their most complex patients, then takes their existing workflows and automates as much as possible into a text messaging protocol with reminders, check-ins, and scheduling.

  • Although companies like Conversa and Twistle also play in the automated engagement sandbox, Memora points to its enterprise scalability as a differentiator.
  • The platform includes a wide breadth of programs for areas like surgical care, chronic condition management, and maternal care, and Memora’s investor roster speaks to the fact that systems are actively looking for ways to consolidate solutions.

It was interesting to see Memora CEO Manav Sevak note that the round was “not something we intended to raise,” but as a way to “work more collaboratively with these sites.”

  • Sevak also mentioned that Memora is “exploring opportunities” to market its solution to more payors and digital health companies.
  • Memora already works with a few digital health startups like Luma Health and Reimagine Care, but its bread and butter still looks like the care delivery orgs after adding Virtua Health and Moffitt Cancer Center earlier this year.

The Takeaway

Memora’s value proposition reads like a Mad Lib of ways to address today’s biggest provider pain points, and $30M of strategic funding should definitely help it deliver. That said, it sounds like Memora is widening its focus to new customers, making execution even more important as the strategy shifts gears.

Florence Debuts With $20M to Unlock Capacity

Patient experience startup Florence emerged from stealth with $20M in seed funding to address what it views as the most significant constraint in care delivery: clinical capacity.

Backed by venture teams from Google, Salesforce, and Thrive Capital, Florence is developing solutions to help patients track and accelerate their care journeys using their smartphones.

The first stop for Florence, as with a growing number of patients, is the emergency department. 

  • Using Florence’s mobile platform, patients in the ED can complete intake forms, update clinical information, initiate self-discharge, and schedule follow-ups.
  • The mobile-first self service solution is designed to eliminate operational overhead while cutting down on ED wait times and patients leaving before seeing a provider. 
  • The entire system is integrated into existing workflows to deliver an experience that rivals what consumers are used to in other industries. The idea is that patients get real-time updates, providers get better ED throughput, and everyone goes home happy.

Florence’s strategy leads with product, and the seed funding will be used to hire design and engineering talent to help advance that goal.

  • The “optimize capacity, streamline admin” value proposition is reaching providers at the right time. Since kicking off operations in 2021, Florence has added 40 health systems to its client roster, including its marquee partnership with Maryland-based Luminis Health.
  • “Non-clinical workflow” companies began topping Rock Health’s digital health funding charts back in Q3 2022, and between Florence, Vital, and LeanTaas’ activity within just the last week, that trend looks like it’s here to stay.

The Takeaway

Florence plays at the intersection of healthcare consumerization and workflow optimization, two themes that were definitely standouts at ViVE Nashville last week. If Florence can keep drawing a straight line between its solution and higher provider revenues, it should have no problem finding more health systems looking to streamline their EDs.

Healthjoy Lands $60M for Benefits Navigation

Employees love health benefits almost as much as they hate navigating them, which is why Healthjoy closed $60M in Series D funding to simplify the process. 

The new investment brings the company’s total funding to $108M as it looks to build its platform into the leading user experience for both employees and HR departments. 

Simplicity and engagement are how Healthjoy plans to accomplish this. Its app is designed to serve as a unified front door to employee benefits, and includes all the good stuff you’d assume would make that happen: 

  • An AI-assistant named JOY that helps triage users to relevant services 
  • A 24/7 concierge team to answer any questions
  • An “automated steerage” feature that guides members to lower cost solutions

Healthjoy’s stance is that a serious lack of awareness is what causes underutilization. Many HR departments have a robust network of services, but employees can’t use what they don’t know about.

  • By housing every benefit in an employer’s package under one roof (medical, dental, vision, wellness initiatives, etc.), then serving as the engagement layer, Healthjoy is aiming to make the entire experience more seamless for everyone involved.
  • Healthjoy combines its own user metrics with partner data to create comprehensive profiles of its members, allowing it to present them with relevant benefits and nudge them towards efficient options.
  • The company also partners with virtual care providers like Teladoc and other benefit administrators to expand the solutions available to its members. It counts the ability to integrate with, as opposed to compete with, outside platforms as a key differentiator.

The Takeaway
As the health benefits space becomes more complex at the same time as many employers are growing overwhelmed with point solutions, HealthJoy’s strategy of simplifying the experience as much as possible seems to make a lot of sense. If Healthjoy can execute on its plan to drive higher engagement by connecting all utilization data within a single ecosystem, then plenty of employers would probably welcome the help in the battle for talent.

Why Healthcare Needs a Flywheel

Big tech took a week off from major healthcare acquisitions, giving us a rare chance to highlight some of the thought leadership coming out of Providence’s Digital Innovation Group.

A new blog post co-authored by Sara Vaezy and Doug Grapski – DIG THIS: Why HealthCare Needs a Flywheel – lays out how incorporating business flywheels into health system strategies can lead to lower churn, higher capacity, and a better patient experience.

Vaezy is Providence’s newly appointed CDO (she also spices things up with an awesome craft hot sauce side gig), and Grapski is the Director of Digital Strategy within the innovation group (unclear whether he likes hot sauce).

For those unfamiliar with the flywheel concept, it’s a business mechanism that pulls consumers to a platform and drives continued use, thereby adding stability and increasing momentum much like a mechanical flywheel. Notable examples include Amazon’s Prime membership and Starbucks’ loyalty program.

Despite their success in other industries, flywheels are seldomly implemented in healthcare, and most patients rarely interact with their providers outside of moments of individual need.

  • Vaezy and Grapski emphasize that a portfolio of modalities (3rd party apps, care navigation, personalized experiences) is needed to create flywheels that are effective at providing proactive healthcare experiences.
  • By integrating these tools in a single platform, health systems can begin eliminating the gap between “sick care” and “healthy care” – especially important for those in value-based arrangements.

Providence’s flywheel revolves around leveraging various data sources to deeply understand its patients as consumers with identities outside of their clinical data, allowing it to create highly personalized engagement programs.

  • This 360-degree view of its consumers lets Providence operate more like a D2C startup than a giant health system, with strong direct relationships that draw people to its services and keep it top of mind between visits.
  • Only once this flywheel is in place would the authors suggest augmenting it with non-traditional offerings such as a durable medical equipment business or concierge-level care.

The Takeaway

The consumerization of healthcare is one of the biggest trends in digital health, and it makes sense that forward-looking health systems will be borrowing plenty of plays from the consumer-tech playbook. Flywheels are the foundation of some of the most successful consumer businesses, and Providence’s digital health leaders make a strong case that it’s time for healthcare to start putting them to use.

Optum: Patient Expectations vs Reality

It’s difficult to quantify exactly what a perfect healthcare consumer experience looks like. That’s why most coverage of rising patient expectations involves pointing out differences between broken care experiences and Amazon Prime, and why it’s worth taking a closer look when a company like Optum puts out an in-depth report on the topic.

Optum surveyed over 1,000 consumers to explore how payors and providers can adapt their digital on-ramps to healthcare (online portals, websites, mobile apps) to optimize for patient satisfaction.

Highlights from the report centered around the expectation vs. reality gaps for these digital front doors, with the largest rifts found between: finding information about providers (i.e. ethnicity, gender, and licenses), ability to schedule an appointment online, and booking telehealth visits.

  • Scheduling disconnects were most acute for consumers ages 25 to 34, with 45% preferring online scheduling, but only 28% doing so today.
  • The cross-generational divide for engagement preferences has shrunk, with 44% of 55-64 year olds preferring text messages for post-appointment provider communication – just a few percentage points behind phone calls (47%) and email (49%). 
  • 52% of respondents missed a scheduled appointment in the past year, suggesting that there’s plenty of room for payors and providers to improve engagement. The most cited reason for missing an appointment was that they simply forgot (33%).

The Takeaway
The consumerization of care has been one of the biggest themes of digital health for years, and the past few weeks were no exception. Although the core idea is no longer a surprise, Optum did a great job wrapping numbers around areas where healthcare experiences are falling short, and drove home the point that removing friction for those seeking care is one of the best ways to attract and retain new patients.

Happify Health Weaves a New Path as Twill

Happify Health recently re-introduced itself to the world as Twill, the Intelligent Health Company.

While a name change and a shiny new logo probably wouldn’t warrant a full feature story, Twill’s fresh identity was tied to a complete overhaul of its business, and reflects the culmination of its five-year journey from a wellness app to a clinical-grade connected care platform.

Twill’s transformation centers around its three core pillars of a connected care experience. 

  • Untangling the complex digital health ecosystem to make the process of finding the right care more personalized and engaging
  • Weaving together evidence-based digital therapeutics, wellness coaching, and third party solutions into Sequences that help patients navigate their care journey
  • No fabric pun was stitched into the press release for this bullet, but the final pillar is about leveraging AI to intelligently guide patients to appropriate care based on their clinical needs and personal preferences

To accomplish these goals, Twill provides fully-configurable Sequences that combine its digital therapeutics with existing partner solutions to address specific clinical needs. The Sequences employ AI and behavior change techniques to steer patients towards positive outcomes at each step of their journey.

  • To give an example, a patient that joins Twill’s psoriasis Sequence would be onboarded with a questionnaire and given access to a content library for their condition. If their responses indicate that their condition is still being managed by their PCP, Twill might direct them to a dermatologist before presenting them with Almirall’s psoriasis treatment after other milestones have been reached.
  • By the end of 2022, Twill and its partners will offer Sequences for four conditions: mental health (Happify), pregnancy (Elevance), multiple sclerosis (Biogen), and psoriasis (Almirall).

The Takeaway 

Even in its past life as Happify Health, Twill’s biggest strength was its ability to blend AI and intelligent design to create real behavior change. Now, with a new brand and configurable Sequences that can weave together outside solutions as needed, Twill has a much more scalable platform that should let it quickly expand into more clinical areas as it grows beyond its wellness app roots.

Memora Raises $40M to Simplify Care Delivery

Although sky-high private valuations made a slowdown in healthcare venture activity a popular prediction for 2022, it sure doesn’t feel like that’s the case six weeks into the new year. Care automation platform Memora Health recently raised a $40M growth round to help more health systems provide proactive care from any setting.

  • Memora Health builds the technology infrastructure behind “learning health systems,” with an AI-enabled platform that automates complex care workflows and improves them over time by learning from the ongoing behavior of patients and providers.
  • The platform includes SMS-based patient messaging, reminders, and scheduling to create continuous patient touchpoints that allow providers to collaboratively manage care journeys and monitor progress.
  • Data from questionnaires and EHR integrations help triage concerns to appropriate care team members while providing patients with proactive communication about their conditions, ideally improving the efficiency of all parties involved.
  • The funding will help Memora meet commercial demand and drive new partnerships with health systems beyond the organizations it already works with, which include Mayo Clinic, Edward Elmhurst Health, and Penn Medicine.

The Takeaway

Memora is solving one of the most pressing challenges facing health systems by automating components of the care journey and allowing time-constrained providers to practice at the top of their license. In doing so, the company is simultaneously pushing the transition from episodic to continuous and always-on care, which seems like a pretty solid combination of goals to build around in the current healthcare landscape.

Babylon Acquires Patient Engagement Platform DayToDay

Value-based care enabler Babylon is wasting no time making M&A moves in 2022, announcing patient engagement platform DayToDay as its second acquisition in as many weeks. 

Just days after kicking off its US expansion by acquiring health kiosk manufacturer Higi, Babylon is bolstering its remote care capabilities with DayToDay’s digital-first programs supporting patients through major health events such as surgeries, childbirth, and the diagnosis of chronic conditions.

  • DayToDay supports patients during crucial recovery periods that often extend beyond a hospital stay. It provides targeted education resources and clinical support from a personal care team, a strategy that it reports is able to keep rehospitalization rates below 4% (vs. a 15% industry average).
  • Babylon works with providers, employers, and payors to offer members digital-first healthcare through the devices they already own. Its AI platform powers its Babylon 360 value-based solution as well its Babylon Cloud Services data analytics suite.
  • The combination of DayToDay’s patient engagement services with Babylon’s existing offerings should enable better care delivery for both the hospital setting and the home, widening the impact that Babylon can have across the care continuum.

The Takeaway

Babylon’s goal is to “make high-quality healthcare accessible and affordable for every person on Earth,” a mission that’s as big as the company’s appetite for acquisitions that could help make it happen. The Higi acquisition was a strong entry point into US healthcare, and DayToDay’s patient engagement services strengthen Babylon’s value-based care portfolio as it establishes itself internationally.

Phreesia Acquires Insignia Health

Patient engagement company Phreesia recently announced its acquisition of Insignia Health to help patients become more active participants in their care journeys.

  • Phreesia provides services focused on “putting tools in the hands of patients to take on tasks,” ranging from scheduling to self-reporting social determinants of health. Each service is designed to make care more efficient through patient activation.
  • Insignia Health holds the worldwide license for the PAM patient activation measure, which allows clinicians to quickly understand a patient’s ability to self-manage their healthcare. PAM is backed by over 700 peer-review studies and is the only measure of patient activation used by the NHS and CMS.
  • PAM levels include “disengaged and overwhelmed,” “becoming aware but still struggling,” “taking action and gaining control,” and “maintaining behaviors and pushing forward.” Knowing a patient’s level allows care teams to cater treatment plans to individual needs.
  • The acquisition expands PAM’s reach through Phreesia’s existing partner network. Insignia Health founder Chris Delaney stated that “the number of patients we can reach in a single week through Phreesia’s platform would otherwise take us months.”  

The Takeaway

Improving outcomes through individualized care is a top priority for any patient engagement company, and the Insignia Health acquisition gives Phreesia the license to the “gold-standard” of patient activation measures.

Owning PAM could generate additional revenue for Phreesia through licensing, but might also lead to Phreesia cutting back on the number of competitors that have access to PAM in order to strengthen its competitive positioning.

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