OMERS Ventures’ Michael Yang on the state of the digital health market.

Digital Health

Rock Health: Funding Cools Off in H1 2022

The numbers are in. After a record shattering year for digital health funding in 2021, the latest Rock Health venture recap shows that the sector’s frothiness has officially turned to a fade, which might actually be good news for opportunistic startups.

First things first, digital health funding totaled $10.3B across 329 rounds in H1 2022, placing it on a trajectory to end the year significantly lower than 2021’s $29.1B. As the broader market plummeted in response to recession worries and global conflict, digital health companies weren’t immune, resulting in a full year funding projection of $21B.

• Rock Health is quick to point out that “there are two sides to every (market) story.”  While this year’s funding will likely fall far short of last year, it’s still on track to outpace 2020’s $14.7B, representing an important return to long-term growth and supporting the view that digital health is a sustainable investment sector.

The slowdown impacted nearly every corner of the digital health market. Series B round sizes declined by an average of 25% in the first half of the year, while Series C and D+ rounds fell by 22% and 12%, respectively. The one bright spot was early-stage startups unburdened by an outdated sky-high valuation, with the average Series A size of $18M staying on par with 2021.

• We’ve covered this often but it’s worth restating here: companies prioritizing growth-at-all-costs over a sustainably profitable business model are struggling in the current funding environment. As investors re-evaluate future revenue with a less favorable outlook, not a single digital health company decided the timing was right to go public in H1 2022, down from 23 in 2021.

The most-funded clinical area defended its title once again, with mental health startups bringing in $1.3B during H1 2022 on the back of a huge round from Lyra Health ($235M). This chart gives a full breakdown of the top clinical indications.

• The value propositions that attracted the most investment were research and development at $1.6B, followed-by on-demand healthcare and disease monitoring each bringing in $1.4B. Administrative / clinical workflow automation also saw large totals as health systems continue to build back up their worn down workforces.

The Takeaway

Although the first half of the year brought a pullback in digital health funding, the return to a multi-year growth trend is a healthy sign for a sector that was overheating throughout 2021. This particular market moment gives companies a chance to tighten their belts and reorient towards a more fundamentals-driven direction, and we should start to see more differentiation and clinical rigor from the businesses that successfully navigate the transition.

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The Wire

• RVO Health Launch: UnitedHealth Group’s Optum has been quietly combining assets with online media company Red Ventures to form a new joint venture dubbed RVO Health, which includes consumer-facing health websites (Healthline, Healthgrades, and many others) along with Optum Store and virtual coaching platforms. The joint venture represents an interesting strategy shift that introduces future consumers to UHG through new channels (Healthline had an estimated 229M visitors last month) outside of the company’s health plans, while also presumably giving better visibility to Optum Store through the sites in the RVO network.

• Phantom Providers: An interesting Oregon Health study investigated “phantom” provider listings in Medicaid provider directories in Oregon, finding that 58% of network directory listings didn’t actually see Medicaid patients (including 67% of psychiatrists!). Researchers compared provider listings in network directories against administrative claims data for members of Oregon’s Medicaid managed care organizations in 2018, concluding that provider directories are overstating true availability, which suggests that private health plans may be padding networks with physicians unwilling to treat program beneficiaries.

• Moving Analytics Series A: Remote cardiac rehab company Moving Analytics closed a $20M Series A round (total funding now $30M) to expand its coverage and implement bilingual services to better serve marginalized communities. The Movn platform provides patients with a cellular-enabled smart scale, an AHA handbook, exercise bands, a blood pressure cuff, and a fitness tracker to improve cardiac rehab outside of the hospital. If you’re interested in cardiology and want an easier way to stay informed on more stories like this one, make sure to check out our latest publication – Cardiac Wire.

• RPM for COVID: A JAMA study of 9,378 COVID patients found that using remote patient monitoring might result in lower hospitalizations and length of stay. The two-week RPM program enabled patients to track their symptoms through an app, while also providing access to COVID educational info and stress management programs. Of the 5,364 RPM participants, only 2.4% were hospitalized (vs. 3.9% for non-participants) and had an average length of stay of 4 days (vs. 7 days).

• Minuteful Approval: Healthy.io recently received FDA 510(k) clearance for home use of its Minuteful kidney-damage test, making it the first smartphone-powered test for albumin to gain approval. The Minuteful Kidney test includes a testing strip and a urine sample cup to let patients scan a photo of their strip using the company’s app to determine their albumin-to-creatinine ratio and check for early signs of chronic kidney disease.

• Fold Funding: Primary care-focused tech developer Fold Health raised $6M in seed funding to provide private practices with tools to manage patient onboarding, marketing, and engagement for a per-member per-month fee. Fold is positioning itself as the most modular operating system in the primary care enablement space, and can be layered on top of existing EHRs and member management systems to reportedly reduce admin time by 60%.

• Telemental Healthcare: A recent cohort study of more than 118k patients with severe mental illness found that those residing in high telehealth use counties were 1.2 percentage points more likely to participate in a minimum number of specialty mental health service visits and had a 13.7 percentage point higher likelihood of outpatient follow-up after hospitalization. Although the telehealth group also had a greater chance of hospitalization, the researchers cautioned that does not mean the telehealth visits resulted in worse care, but that the virtual visits may have helped to identify and stabilize patients having an acute crisis.

• Brightline Expansion: Northwell Health recently invested an additional $10M in pediatric behavioral health provider Brightline, bringing the company’s total Series C raise to $115M. In our full breakdown of the initial raise, we cover Brightline’s approach to supporting children with unique needs such as cyberbullying or wearing masks in the classroom, as well as its plans to use its new funding to expand its services for children with autism and those who identify as LGBTQ+.

• HF Care for English Learners: In a JACC study, researchers asked 20 medical interpreters how providers could improve heart failure care for patients with limited English proficiency. Interpreters emphasized these five practical steps: (1) briefly describe the patient’s condition to interpreters before discussing discharge instructions, (2) ensure a family member is present during discharge, (3) tailor nutrition referrals to the patient’s native cuisine, (4) include an interpreter service phone number on the discharge paperwork, and (5) integrate interpreters in the inpatient and outpatient heart failure care team.

• A Case for Dementia Precision Medicine: A new Journal of Alzheimer’s Disease study detailed an MRI-guided precision medicine approach that could help avoid or limit Alzheimer’s disease. The researchers evaluated 25 patients with dementia or mild cognitive impairment for potential contributors (e.g. inflammation, nutrients, hormones, microbiomes, genetics, etc.) and then developed personalized treatment plans for each patient. After nine months of treatment, the patients showed significant improvements across most key metrics, including cognitive improvements among 84% of the patients.

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