SeamlessMD CEO Joshua Liu

Startups

DarioHealth Acquires Digital Therapeutics Startup Twill

The flash flood of ViVE news is officially here, and one of the biggest stories from the first wave was DarioHealth’s acquisition of mental health digital therapeutics startup Twill for $10M plus another $20M in stock.

Dario got its start in 2011 with a direct-to-consumer diabetes app before expanding to cardiometabolic, musculoskeletal, and behavioral conditions. Although Dario still operates its D2C business, it’s since shifted its primary market to employers and health plans to reach larger patient populations.

• Dario hasn’t shied away from fueling its expansion through M&A, most recently acquiring a trio of companies in 2021 that included wayForward (behavioral health), Upright (MSK), and Physimax Technologies (also MSK).

• Despite the momentum, Dario hasn’t notched a profitable year since going public in 2016, and it’s looking to Twill to help expedite that journey.

Twill provides configurable Sequences that combine its digital therapeutics with partner solutions to address specific clinical needs such as mental health (Happify) and pregnancy (Elevance).

• These Sequences are used by three of the five largest US health plans, over half of the top 20 global pharmaceutical companies, and reportedly cover 18 million lives.

• Twill raised $153M through 2021, so while some quick napkin math probably suggests this wasn’t exactly a glowing exit for investors, the stock-based transaction at least means that there’s some upside if the combined company succeeds.

Outside of the immediate scale achieved through Twill’s customer-base, Dario is banking on its newly consolidated offering striking a chord with employers that are grappling with point solution fatigue and workers in need of mental health support.

• During Dario’s last investor call, it said that it expects to reach breakeven at ~$80M in revenue (about 4x what it currently generates in a year), but Twill should help in this department.

• Since Twill and Dario share minimal customer overlap, joining forces should allow them to cross promote their services, and Dario expects the acquisition to double its revenue this year as a result.

The Takeaway

At a time when the market is demanding more value from fewer vendors, Dario’s acquisition of Twill is promising to deliver just that. All eyes will be on the integration of Twill’s platform to see if the expected revenue gains will be realized, but Dario has a track record of successfully folding in acquired companies, so this could end up being one of the first dominoes to fall in a long-awaited chain of consolidation.

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The Wire

• Abridge Lands $150M: Right when you think the clinical documentation space couldn’t get any hotter, Abridge cranked up the heat with $150M in Series C funding just four months after closing its previous round. The raise marks one of the largest funding totals to date for healthcare generative AI, and will be used to scale Abridge’s team and accelerate R&D. The announcement included a new partnership with Yale New Haven Health System, giving thousands of clinicians in Connecticut access to Abridge. Not to let a good brand overhaul go unnoticed, there’s also some slick new design work throughout the website.

• Information As a Determinant of Health: The Google Health team penned a Nature article laying out why “information” should be thought of as its own determinant of health, separate from social determinants. Think health literacy (IDOH) vs. education level (SDOH). The piece argues that ensuring access to high quality health information – and preventing the spread of misinformation – should be a key priority for all healthcare stakeholders, including governments. Hard to disagree.

• Care.ai + Virtua: Ambient monitoring platform care.ai announced an enterprise-wide partnership with New Jersey-based academic system Virtua Health. The news follows a successful virtual nursing pilot that went live in December, and Virtua was clearly impressed enough with the outcomes to deploy care.ai’s Smart Care Facility Platform and ambient sensors throughout all of its acute care settings.

• The Case Against an Annual Physical: An article in The Wall Street Journal rocked the boat by suggesting that annual wellness exams aren’t necessarily the best course of action for all patients. While annual checkups are obviously important for managing chronic conditions and driving preventative screenings, they haven’t been shown to reduce mortality or cardiovascular events in asymptomatic patients. The author makes the case that evolving these visits to be less frequent or virtual first could better serve some patients while simultaneously addressing the provider shortage.

• Standards-Based API Uptake: A UCSF survey published in JAMIA found that 73% of digital health vendors are now using standards-based APIs (FHIR) for EHR integrations. The ONC gave itself a pat on the back with a blog post highlighting the progress made on the interoperability front since the Cures Act was finalized in 2020, although it also pointed out there’s still work to be done considering that a majority of vendors (68%) still use proprietary APIs in some capacity.

• Fabric Series A: Fabric added to its recent hot streak with $60M in Series A funding less than a month after closing its acquisition of conversational AI startup GYANT. Since launching last March, Fabric has ramped up to 70+ enterprise customers (courtesy of a Zipnosis acquisition that brought along 50 health systems) as it grows into an “end-to-end healthcare operations enablement platform.” For a deep dive on what that entails, head over to our full coverage of the GYANT acquisition.

• WellSpan Teams Up With Biofourmis: WellSpan Health is looking to scale its hospital-at-home capabilities by teaming up with Biofourmis to transition its legacy system to Biofourmis’ RPM platform, specifically highlighting its ability to drive proactive care and optimize nurse-to-patient ratios. The New York-based health system already boasts one of the largest hospital-at-home programs in the country, but it anticipates a 75% increase in post-acute care-at-home patient volume over the next three years and wants to get out in front of the trend.

• MA vs. Medicare Experiences: A Commonwealth Fund report comparing the experiences of Medicare and Medicare Advantage enrollees found high satisfaction across both groups, with nearly two-thirds of each satisfied with their plans. More than a third of enrollees in both buckets also said they’ve had to wait over a month to see a doctor. Key differences included MA beneficiaries reporting both more care delays while waiting for approvals (22% vs. 13% for Medicare) and more requests to undergo health assessments that “rarely led to changes in care plans or availability of more services” (62% vs. 27%).

• Change Hack: Healthcare cybersecurity dominated the headlines again last week after a cyberattack – allegedly perpetrated by a nation-state – forced Change Healthcare to shut down many of its services. Change Healthcare, which is part of UnitedHealth’s Optum business, identified the breach on Wednesday and quickly disconnected its services related to prescription processing, medical imaging, and payments. The AHA urged healthcare facilities to similarly disconnect from Optum until it is deemed safe to reconnect, and check their systems for vulnerabilities. 

• Health Execs Ready for More AI: AI bullishness is reaching a new level, with Accenture’s Technology Vision 2024 report showing that 90% of healthcare executives believe that AI advances are just getting started and that they’ll improve their organizations. Consumers were a bit more wary, with 69% wanting healthcare organizations to develop stricter standards for AI ethics and privacy. On the flip side of that stat, it’s surprising to see that the other 31% of consumers are confident in existing AI standards.

• VillageMD Exits Florida: Walgreens is closing its remaining VillageMD primary care clinics in Florida, with the total count of shuttered clinics slated to reach 52 by March. The announcement isn’t entirely unexpected given that Walgreens’ $1B cost reduction strategy included closing 60 VillageMD clinics and exiting five markets throughout this year. The pullback now includes the Sunshine State and Indiana, but Walgreens says it’s still committed to finding a sustainable care delivery model after investing $5B in VillageMD in 2021 and acquiring Summit Health for $9B a year later.

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