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Five success factors for behavioral health startups

Courtney Chow
Contributor

Courtney Chow is an associate with Battery Ventures in San Francisco who focuses on early and growth-stage internet, software and services companies.

Justin Da Rosa
Contributor

Justin Da Rosa is a vice president with Battery Ventures in San Francisco. He focuses on consumer internet, online marketplace and software investments.

Telehealth, or remote, tech-enabled healthcare, has existed for years in primary medical care through companies like Teladoc (NYSE: TDOC)Doctors on Demand and MDLIVE.

In recent years, the application of telehealth had rapidly expanded to address specific chronic and behavioral health issues like mental health, weight loss and nutrition, addiction, diabetes and hypertension, etc. These are real and oftentimes very severe issues faced by people all over the world, yet until now have seen little to no use of technology in providing care.

We believe behavioral health is particularly suited to benefit from the digitization trends COVID-19 has accelerated. Previously, we’ve written about the pandemic’s impact on online learning and education, both for K-12 students and adult learners. But behavioral health is another area impacted by the fundamental change in consumers’ behavior today. Below are four reasons we think the time is now for behavioral health startups — followed by five key factors we think characterize successful companies in this area.

Telehealth can significantly lower the cost of care

Traditional behavioral healthcare is cost-prohibitive for most people. In-person therapy costs $100+ per session in the U.S., and many mental health and substance-use providers don’t accept insurance because they don’t get paid enough by insurers.

By contrast, telehealth reduces overhead costs and scales more effectively. Leveraging technology, providers can treat more patients in less time with almost zero marginal costs. Mobile-based communications enable asynchronous care that further helps providers scale. Access to digital content gives patients on-going support without the need for a human on the other side. This is particularly useful in treating behavioral health issues where ongoing support and motivation may be necessary.

Technology unlocks supply in “shadow markets” of providers

Globally, we face an extreme shortage of behavioral health providers. For example, the United States has fewer than 30,000 licensed psychiatrists (translating to <1 for every 10,000 people). Outside of big cities, the problem gets worse: ~50-60% of nonmetro counties have no psychologists or psychiatrists at all.

Even when providers are available, wait times for appointments are notoriously long. This is a huge issue when behavioral health conditions often require timely intervention.

We are seeing new platforms build large networks of certified coaches, licensed psychologists and psychiatrists, and other providers, aggregating supply in what has historically been a scarce and a highly fragmented provider population.

Behavioral/mental health issues are losing their stigma

We believe the stigma associated with mental illness and other behavioral health conditions is dissipating. More and more public figures are speaking out about their struggle with anxiety, depression, addiction and other behavioral health issues. Our zeitgeist is shifting fast, and there’s an all-time high in people seeking help as the Google Trends data below demonstrates.

google trends search: "therapist near me," 2015- 2010

Image Credits: Google

Note: The anomalous dip in March/April ’20 was driven by mandatory shelter-in-place due to COVID-19.

Policy and regulations are changing quickly

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A full-time VC & part-time ER doctor shares his thoughts on COVID-19

An emergency room physician for the past 12 years, Dr. Robert Mittendorff joined Norwest Venture Partners eight years ago as a healthcare investor; the firm invests in a number of healthcare startups, including Talkspace, which raised a $50 million Series D last year, and TigerConnect.

As the COVID-19 pandemic spreads, Mittendorff is spending his weekdays with portfolio companies and weekends working with Kaiser Permanente in San Francisco. While he notes that his medical colleagues are “bearing the brunt” of the pandemic by working full time, we wanted to hear from someone who has a foot in both the investing and the healthcare world right now.

In this interview, he discusses what he’s learned from both roles, how it has influenced his healthcare investments, and offers his predictions regarding which companies will fare the best in the future.

This interview has been edited for length and clarity.

TechCrunch: How did you get to where you are today?

Dr. Robert Mittendorff: So, my journey to being a venture capitalist at Norwest and investing in healthcare companies as well as an emergency physician was really a parallel set of paths that overlapped and that cross every once in a while and now usually on a daily basis.

I started off life as a biomedical engineer really focused on wanting to be on the side of innovation and on the development of technologies to help human health. I knew early on that I wanted to be on the business side [of that], but it was important for me to understand and really be deeply in touch with what it was like to be a provider.

The journey started out going to engineering school, medical school, and then business school in the middle of medical school. I trained at Stanford, which really exposed me to county hospitals, which are probably going to be the more challenging situations as the weeks go on here, and then to Kaiser Permanente. And then, of course, Stanford, I was exposed to San Francisco General and then the Santa Clara Valley Hospital. I always practice part-time following up so it’s been 12 years as an attending, practicing part-time as an emergency physician.

In the venture space I saw an opportunity to really help select entrepreneurs and markets to grow them to a higher impact state.

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Talkspace picks up $50 million Series D

Talkspace, the platform that lets patients and therapists communicate online, has today announced the close of a $50 million financing round led by Revolution Growth. Existing investors, such as Norwest Venture Partners, Omura Capital, Spark Capital and Compound Ventures, are also participating in the round.

As part of the deal, Revolution Growth’s Patrick Conroy will join the Talkspace board of directors.

Talkspace launched back in 2012 with a mission to make therapy accessible to as many people as possible. The platform allows users to pay a subscription fee for unlimited messaging with one of the company’s 5,000 healthcare professionals. Since launch, Talkspace has rolled out products specific to certain users, such as teenagers or couples.

The company also partners with insurance providers and employers to offer Talkspace services to their members/employees as part of a commercial business. Today, Talkspace has announced a partnership with Optum Health. This expands Talkspace’s commercial reach to 5 million people.

According to the release, Talkspace will use the funding to accelerate the growth of its commercial business.

Here’s what Talkspace CEO and co-founder Oren Frank had to say in a prepared statement:

Our advanced capabilities in data science enable us to not only open access to therapy, but also identify the attributes of successful therapeutic relationships and apply that knowledge throughout the predictive products we build, to the therapists that use our platform, and in the content we provide.

This brings Talkspace’s total funding to $110 million.

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