Hinge Health

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Sources: Hinge Health has raised $310M Series D at a $3B valuation

Hinge Health, the San Francisco-based company that offers a digital solution to treat chronic musculoskeletal (MSK) conditions — such as back and joint pain — has closed a $310 million in Series D funding, according to sources.

The round is led by Coatue and Tiger Global, and values 2015-founded Hinge at $3 billion post-money, people familiar with the investment tell me. It comes off the back of a 300% increase in revenue in 2020, with investors told to expect revenue to nearly triple again in 2021 based on the company’s booked pipeline.

I also understand that Hinge’s founders — Daniel Perez and Gabriel Mecklenburg — retain voting control of the board. I’ve reached out to CEO Perez for comment and will update this post should I hear back.

Hinge’s existing investors include Bessemer Venture Partners, which backed the company’s $90 million Series C round in February, along with Lead Edge Capital, Insight Partners (which led the Series B), Atomico (which led the Series A), 11.2 Capital, Quadrille Capital and Heuristic Capital.

Originally based in London, Hinge Health primarily sells into U.S. employers and health plans, billing itself as a digital healthcare solution for chronic MSK conditions. The platform combines wearable sensors, an app and health coaching to remotely deliver physical therapy and behavioral health.

The basic premise is that there is plenty of existing research to show how best to treat chronic MSK disorders, but existing healthcare systems aren’t up to the task due to funding pressures and for other systematic reasons. The result is an over tendency to use opioid-based painkillers or surgery, with poor results and often at even greater cost. Hinge wants to reverse this through the use of technology and better data, with a focus on improving treatment adherence.

Meanwhile, Hinge’s jump in valuation is significant. According to sources, the company’s February round produced a valuation of around $420 million, so the new valuation is more than a 6x increase.

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Caroline Brochado and Sophia Bendz on the boom in Europe’s early and growth-stage startups

As part of Disrupt 2020 we wanted to look at the contrasting positions of both early and later-stage investing in Europe. Who better to unpack this subject than two highly experienced operators in these fields?

After a career at Spotify and then as a VC at Atomico, Sophia Bendz has rapidly gained a reputation in Europe as a keen early-stage investor. She recently left Atomico to pursue her early and seed-stage passion with Cherry Ventures. Bendz is a prolific angel investor, with a total of more than 44 deals in the last nine years. Her angel investments include AidenAI, Tictail, Joints Academy, Omnius, LifeX, Eastnine, Manual, Headvig, Simple Feast and Sana Labs. She is known for being a champion of the femtech space, and her angel investments in that space include Clue, Grace Health, Daye, O School and Boost Thyroid.

Carolina Brochado, the former Atomico partner and most recently a partner at SoftBank Vision Fund’s London office, recently joined EQT Ventures to help launch EQT’s Growth fund, which is positioned between ventures and private equity. Brochado led investments in a number of promising companies at Atomico,  including logistics company OnTruck, health tech company Hinge Health and restaurant supply chain app Rekki.

After establishing that these two knew each other while at Atomico, I asked Bendz why she headed back into the seed-stage arena.

“I’m a trained marketeer and storyteller by heart… What makes me excited is new markets opportunities, people, culture, teams. So with that, in combination with my angel investing, I think I’m better suited to be in the earlier stages of investing. When I was investing before joining Atomico, I said to myself, I want to learn from the best, I want to see how it’s done, how you structure the process and how you think about the bigger investments.”

Brochado says the European “cat is out of the bag,” as it were:

When I first moved to Europe in 2012 and first joined Atomico, after having been at a very small startup, there was still a massive gap in funding and Europe versus the U.S. I think you know the European secret is no longer a secret, and you have incredible funds being started at that early-stage seed and Series A, and because I was here in 2012, I’ve seen the amazing pipeline of growth companies that are coming up the curve, how the momentum of those companies is accelerating and how the market cap of those businesses are growing. And so I just became super excited about helping those businesses scale… I just now felt like bridging that gap in between was really exciting.

One of the perennial topics that come up time and time again is whether or not founders should go with VC partners who have previously been operators, versus those with a finance background.

“Looking back, my years at Spotify, we had great investors, but there were not many of them that had the experience of scaling a big company,” Bendz said. “So, I’m happy to give [a startup] more than just the check in a way that I would have wished I had a sounding board when I was 25 and tackling that challenge at Spotify.”

Brochado concurred: “Having operators in the room is just is an incredible gift I think to a fund and at certain levels, having people that understand you know different forms of financing and different structures can also be incredibly helpful to founders who may not necessarily have that background. So I think that the funds that do it best have that diversity.”

Bendz is passionate about investing in female founders and femtech: “It’s such a massive business opportunity that is completely untapped. We’ve seen it many times when you have a female investment partner [that] the pipeline opens up and you get more deal flow from female founders…. So I think we have a lot of work to do. I think it’s definitely improved a lot in the last couple of years but not enough… That is one of the drivers for why I put my money where my mouth is and invest in lifting the founders, but also because there are incredibly interesting business opportunities… There are so many opportunities and products or services that we will see being developed. When we have a more equal society, and more women, both building their own companies, coding and also investing… I can’t wait to see what that world will look like.”

Brochado’s view is that “even beyond founders… the best managers today are putting a lot of focus on this and I think what’s exciting is, I think we’re past the point where you have to explain to people why diversity matters.”

Is there a post-Series A chasm?

Bendz thinks: “We have more big funds in Europe [now]. We have a really solid ground here in Europe of A, B and C investors.”

Brochado said: “It’s definitely getting better. You don’t hear as many founders say that to do my Series B or my Series C I have to move to the Valley as you used to. But there’s a lot of room still for growth investors in Europe. I think Series B is the hardest round actually because, at seed or Series A, you can raise on very early traction or the quality of the management team. At Series B the price goes up but the risk doesn’t necessarily go down as much. And so I think that’s where you really need investors who are sector or thematic focused, who can come with conviction and also some knowledge around the company to really propel that company forward.”

Did they both see European entrepreneurs still making silly mistakes, or has the ecosystem mastered?

Brochado thinks 10 years ago it was hard for European founders as a lot of the talent to scale companies was still in the U.S. “What you’ve seen is a lot of big companies grow up in Europe, a lot of people come back from the U.S., and so I think that pool of talent now is larger, which is very helpful. I don’t think it’s yet at the scale of where the U.S. is. But it gives us, you know as investors, a great window of opportunity to help get some of that talent for our portfolio companies.”

The impact of COVID-19

Bendz thinks we will “see a much slower spring, but… I think it has been overall a good exercise for some companies, and I have not seen a slower deal flow. I’ve actually done more angel deals this spring than I normally do… Some businesses have definitely accelerated their whole business concept because of COVID. Investments are being made even though we haven’t met the founders. We’re able to do everything remotely so I think the system is kind of adjusting.”

Brochado’s view is that at the growth stage “there’s been a flight to quality. So actually, the really great companies or the companies that are seeing great tailwinds or companies that will still be category-leading once [have] seen a lot of interest. It’s been a very busy summer, which usually it isn’t, particularly at the growth stage… I think a lot of money is still in the system, and has flown into technology. And so if you look at how tech in the public markets has performed it’s performed extremely well. And that includes European public companies and within tech.”

Watch the full panel below.

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Hinge Health raises $26M Series B to tackle musculoskeletal pain

Hinge Health, the San Francisco-based startup that offers a tech-enabled platform to treat musculoskeletal (MSK) disorders — things like knee pain, shoulder pain, or back pain — has raised $26 million in Series B funding.

Leading the round is Insight Venture Partners, with participation from the company’s Series A backer Atomico. In fact, I understand that the London VC firm has doubled down on its investment and has actually increased its stake in Hinge.

The new round of funding brings total raised by the company to $36 million since being founded in 2015 (and originally based in London). Hinge Health founders Daniel Perez and Gabriel Mecklenburg still maintain majority control of the board.

Billing itself as digitising healthcare, Hinge Health combines wearable sensors, an app, and health coaching to remotely deliver physical therapy and behavioural health for chronic conditions. The basic premise is that there is plenty of existing research to show how best to treat MSK disorders, but existing healthcare systems don’t do a very good job at delivering best practice, either because of cost and the way it is funded or for other systematic reasons. The result is an over tendency to fall back on the use of opioid-based painkillers or surgery, with sub-optimal results.

The startup’s initial target customers are self-insured employers and health plans, with the pitch being that its platform can significantly reduce medical costs associated with chronic MSK conditions.

To that end, Perez tells me Hinge Health now has 40 enterprise customers in the U.S. and has partnered with 10 of the largest health plans. This is off the back of improved results, with 2 in 3 patients who go through the program avoiding the need for surgery, up from 1 in 2 at the time of the startup’s Series A. “[We’re] aiming to bump that to 80 percent soon,” he says.

Just don’t call Hinge a “software as a drug” or so-called digital therapeutic. Perez isn’t a fan of either term, and certainly not when applied to the work Hinge Health is doing.

“Both seem to imply you just pop one easy pill and that’s it,” he says. “While software, connected hardware, and behavioural health support (e.g. education, coaching, targeted notifications, gamification/rewards) can help scale the labor intensive processes involved in chronic care, it’s not akin to just popping a pill and you’re done. That’s why I really dislike the term “digital therapeutic” when applied to chronic conditions, and I wish it was retired”.

Instead, Perez considers Hinge Health to be a “Digital Care Pathway” as patients are still required to carry out a lot of work in order to tackle their chronic condition. In other words, it goes well beyond just passively popping a “digital pill”.

I ask the Hinge Health founder if perhaps it is access to a one-to-one health coach via the app that makes all the difference, especially related to adherence, rather than technology. That depends, he says, revealing that some patients rely very heavily on having access to a coach, while others need very little or zero coaching support, and instead rely on Hinge’s wearable motion sensors to guide them through their exercises and to track progress.

Adds Perez: “The clinical literature is very compelling; when you have a relationship with a real person on the care team, it boosts adherence to the care plan. Critically that person doesn’t have to be a doctor or even a nurse, but it must be someone you trust”.

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