Zus Health CEO Jonathan Bush

Digital Health

Digital Health Primed for Consolidation

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

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

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

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

• The first quarter saw 63 health tech M&A transactions combine for a total value of $48B (an increase over the $41B seen in Q4 2021), which seems to indicate that the declining valuations have already begun translating to more M&A activity.

• Many public companies have become solid M&A targets due to declines in their shares (Vera Whole Health’s acquisition of Castlight, Oracle’s acquisition of Cerner), while private companies have started rounding out their services by acquiring the missing pieces (Aledade’s acquisition of Iris Telehealth, Lightbeam’s acquisition of Jvion).

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

• So many of these have popped up since the beginning of the pandemic that it’s made funding scarce at a time when other exit options are drying up.

• This likely makes an acquisition look like one of the best paths forward, particularly as larger companies look to capitalize on the moment by expanding their platforms and pushing into new markets.

The Takeaway

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

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The Wire

• Healthcare Hiring Boost: The healthcare sector recently saw a bump in hiring according to the May Jobs Report, adding 28k jobs throughout last month, including 16k hospital workers. Following hospitals, the subsectors with the largest workforce gains were ambulatory services, physician offices, and nursing care facilities, each adding ~6k employees. Despite the improvement, the healthcare workforce remains 1.3% (223k jobs) below pre-pandemic levels, compared to a 0.5% decline across all industries

• CareBridge Raises $140M: Value-based care startup CareBridge secured $140M of financing to expand its at-home and community-based services for Medicaid patients and dual eligibles. The investment brings CareBridge’s valuation to over $1B as it works to expand the coverage of its virtual care teams while adding services for people with intellectual and developmental disabilities. The round was led by Oak HC/FT alongside four of the nation’s five largest Managed Medicaid plans, which seems like a pretty big competitive advantage considering those organizations collectively serve nearly 60% of all Americans receiving care outside of the medical setting.

• Telehealth Popularity by Specialty: A recent study of over 400k New England healthcare visits between August and September 2021 found that telehealth use varies widely by specialty. Mental health providers used video more than any other modality (40.3% for established patients, 35.9% for new patients). Primary care providers did the most appointments by phone (22%, 8.3%), while specialists opted to do the most appointments in-person (84.4%, 86.9%).

• Withings + athenahealth: Withings Health Solutions is adding its remote patient monitoring solution to the athenahealth marketplace, enabling physicians to ship RPM devices such as the Withings Body Pro scale and the Withings BPM Connect Pro blood pressure monitor directly to patients from within the EHR. The connected devices then transmit data straight to athenahealth patient charts, a feature right in line with Withings’ plan to position its RPM solution as the easiest platform to setup and manage.

• An AI Education Lesson: A team from the University of British Columbia shared valuable insights into how best to teach future doctors about AI. After training 350 med students in a 5-week workshop, the authors identified a series of educational challenges (knowledge disparities, curricular depth vs. breadth, knowledge retention) and successes (addressing AI concerns, open-access resources, and multidisciplinary collaboration) that they encountered. Based on their experience, they recommend that future AI educators: (1) standardize their curricular structure, (2) create AI case studies, (3) use experiential learning, and (4) involve a diverse group of trainees.

• YNHH Home Hospital: Yale New Haven Health is partnering with Medically Home to launch a Home Hospital Program for Medicare patients within 25 miles of Yale New Haven and Bridgeport hospitals. Patients that would otherwise need to be hospitalized will be enrolled in the program for an average of two to six days, receiving a daily telehealth visit with a physician through a provided tablet, twice-daily in-person visits from a nurse, plus additional services as needed (occupational therapy, phlebotomy, mobile imaging).

• Physician Sentiment Survey: athenahealth’s annual Physician Sentiment Survey of 743 physicians found that 66% believe that exchanging patient data with another provider with the same EHR is easy, yet only 24% said the same for exchanging data with a different EHR. When asked about interoperability hurdles, respondents cited a lack of coordination among different health systems (65%) and poor data standardization (57%). Although not related to interoperability, another interesting takeaway was the fact that 54% of respondents said technology has diminished their ability to make emotional connections with patients.

• Walgreens & Jasper Partnership: The Walgreens Find Care platform is adding virtual oncology care to its online digital health marketplace in a new collaboration with Jasper Health, expanding access to psychosocial support through chat, telemedicine, and coaching services for cancer patients. Walgreens Find Care allows users to find appointments with more than 45 national and local healthcare providers for services ranging from COVID testing to mental healthcare.

• Included Health Expansion: Included Health launched a connected partner system that helps employers navigate digital health offerings by integrating data across partner vendors, enabling better coordination of member care. The first companies to join are Carrum Health, Employer Direct Healthcare, Hinge Health, SWORD Health, and Virta Health, with plans to expand to more vendors as Included looks to support employers with aggregating the different point solutions they’re offering to employees.

• AI Model Imbalances: When AI models are trained on datasets weighted towards patients with the condition they’re trying to predict, they often struggle to identify patients without the condition. A new study published in JAMIA found that efforts to correct these imbalances frequently do more harm than good. In a case study on ovarian cancer, the authors found that adding more examples of the minority outcome to fix the model led to a strong overestimation of patients in the minority group, further adding to the miscalibration and reducing the model’s clinical viability.