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Singapore-based caregiving startup Homage raises $30M Series C
Homage, the caregiving-focused startup, has raised a $30 million Series C led by Sheares Healthcare Group, which is wholly-owned by investment firm Temasek. Other participants included new investors DG Daiwa Ventures and Sagana Capital, and returning backers East Ventures (Growth), HealthXCapital, SeedPlus, Trihill Capital and Alternate Ventures.
The new funding will be used to develop Homage’s technology, continue integrating with aged and disability care payer and provider infrastructure and speed-up its regional expansion through partnerships with hospitals and care providers. Homage currently operates in Singapore, Malaysia and Australia.
The Singapore-based company’s services include home visits from caregivers, nurses, therapists and doctors; telemedicine; and services for chronic illnesses. One of the reasons Homage’s platform is able to scale up is its matching engine, which helps clients, like older adults and people living with chronic conditions, find providers who are best suited to their needs (the final matches are made by Homage’s team).
The startup says the round was oversubscribed and one of the largest fundings raised by an on-demand care platform in Southeast Asia and Oceania so far. It brings Homage’s total raised to more than $45 million.
As part of Series C, Sheares Healthcare Group chief corporate development officer Khoo Ee Ping will join Homage’s board of directors.
Homage now has a regional network of more than 6,000 pre-screened and trained care professionals. It claims that its business outside of Singapore has grown more than 600% year-over-year in 2021, and it has more than tripled revenue over the past year.
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Back to the suture: The future of healthcare is in the home
The pandemic has highlighted some of the brightest spots — and greatest areas of need — in America’s healthcare system. On one hand, we’ve witnessed the vibrancy of America’s innovation engine, with notable contributions by U.S.-based scientists and companies for vaccines and treatments.
On the other hand, the pandemic has highlighted both the distribution challenges and cost inefficiencies of the healthcare system, which now accounts for nearly a fifth of our GDP — far more than any other country — yet lags many other developed nations in clinical outcomes.
Many of these challenges stem from a lack of alignment between payment and incentive models, as well as an overreliance on hospitals as centers for care delivery. A third of healthcare costs are incurred at hospitals, though at-home models can be more effective and affordable. Furthermore, most providers rely on fee for service instead of preventive care arrangements.
These factors combine to make care in this country reactive, transactional and inefficient. We can improve both outcomes and costs by moving care from the hospital back to the place it started — at home.
Right now in-home care accounts for only 3% of the healthcare market. We predict that it will grow to 10% or more within the next decade.
In-home care is nothing new. In the 1930s, over 40% of physician-patient encounters took place in the home, but by the 1980s, that figure dropped to under 1%, driven by changes in health economics and technologies that led to today’s hospital-dominant model of care.
That 50-year shift consolidated costs, centralized access to specialized diagnostics and treatments, and created centers of excellence. It also created a transition from proactive to reactive care, eliminating the longitudinal relationship between patient and provider. In today’s system, patients are often diagnosed by and receive treatment from individual doctors who do not consult one another. These highly siloed treatments often take place only after the patient needs emergency care. This creates higher costs — and worse outcomes.
That’s where in-home care can help. Right now in-home care accounts for only 3% of the healthcare market. We predict that it will grow to 10% or more within the next decade. This growth will improve the patient experience, achieve better clinical outcomes and reduce healthcare costs.
To make these improvements, in-home healthcare strategies will need to leverage next-generation technology and value-based care strategies. Fortunately, the window of opportunity for change is open right now.
Five factors driving the opportunity for change
Over the last few years, five significant innovations have created new incentives to drive dramatic changes in the way care is delivered.
- Technologies like remote patient monitoring (RPM) and telemedicine have matured to a point that can be deployed at scale. These technologies enable providers to remotely manage patients in a proactive, long-term relationship from the comfort of their homes and at a reduced cost.
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NewView Capital leads $22.3M Series B in Australian telehealth platform Eucalyptus
Telehealth platform Eucalyptus raised a $22.3 million Series B round of funding to build a digital health portfolio for primary care in Australia.
NewView Capital led the round with participation from existing investors Blackbird Ventures and W23, and new investor AirTree Ventures. As part of the investment, Ravi Viswanathan, NewView founder and managing partner, will be joining the Eucalyptus board.
The new round gives the Sydney-based company a total of $32.8 million raised since it was founded in 2019 by Tim Doyle, Benny Kleist, Alexey Mitko and Charlie Gearside.
Australia’s healthcare system is a two-payer model, where most of the care is paid for by the government, and there is a smaller insurance coverage that is owned by individuals. Eucalyptus fits into these models as a private-pay option selling directly to consumers. In some cases, the company is able to charge lower copays for care than the average $25 per doctor visit, Doyle told TechCrunch.
He touts the company as the “largest vertically integrated telehealth platform in Australia,” serving more than 200,000 patients across four demographic-focused brands: contraception and fertility, skincare, men’s health and sexual wellness. Each brand has its own core platform of healthcare providers, patient data repository, remote monitoring tools and partnerships with pathology labs and pharmacies.
All of that results in a higher touch and higher quality relationship between doctor and patient, Doyle said.
“We are seeing an opportunity to shorten the amount of time between identification of a condition and diagnosis,” he added. “We also want to go more in-depth into diabetes, heart conditions and mental health. People are dropping out of diabetes and mental care because there are not enough touch points that are easy to use. If we can build a hub, it will make it easier to treat those conditions.”
In addition to product development, the new funding enables Eucalyptus to build toward being a major player in the telehealth industry. The company will introduce new brands in the next year around chronic care like behavioral health, weight management and diabetes.
Eucalyptus grew its revenue between 200% to 300% year over year since 2019, Doyle said. This is not unlike other startups in the digital health sector, where 2020 saw another record year for venture capital investment. He expects similar growth in 2021, including adding about 20 employees to be over 100 by the end of the year.
Meanwhile, Doyle said he is excited to work with NewView, especially with Viswanathan and principal Christina Fa, who said Eucalyptus is proving that Australia can lead in digital healthcare.
“The team is impressive in terms of clarity of vision and execution, especially in the way they brought in people to manage the brands,” she told TechCrunch. “It is unique being based in Australia where they don’t have Teledoc and other digital health companies. Instead, Eucalyptus had to build all of that in-house and do the hard work upfront. In addition, they curated a network of health providers and four brands, each with their own personalities. This allows them to be fully vertically integrated and own the customer journey.”
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Extra Crunch roundup: Jam City SPAC, startup PR, telemedicine market map, more
For this morning’s edition of The Exchange, Alex Wilhelm studied information recently released by mobile gaming studio Jam City as it prepares to go public in a $1.2 billion blank-check deal with DPCM Capital.
“Jam City is a bit like Zynga, but unless you are a mobile-gaming aficionado, you might not have heard of it,” he writes.
Since its launch, Jam City has raised upwards of $300 million, including a $145 million round in 2019. At the time, the company was riding high after signing a deal with Disney to adapt some of the media giant’s intellectual property, which includes brands like Marvel, Fox and Pixar.
Almost half of all Americans play mobile games, so Alex reviewed Jam City’s investor deck, a transcript of the investor presentation call and a press release to see how it stacks up against Zynga, which “has done great in recent quarters, including posting record revenue and bookings in the first three months of 2021.”
(Full disclosure: the second time I worked at a startup founded by Mark Pincus, Zinga slept behind my desk and I was one of her favorite dog-sitters.)
Thanks for reading Extra Crunch; I hope you have an excellent weekend!
Walter Thompson
Senior Editor, TechCrunch
@yourprotagonist
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5 ways to raise your startup’s PR game
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The ability to effectively communicate can make or break your launch. It will play a role in determining who wins a new space — you or a competitor.
So how do you make a splash? How do you stay relevant?
For one, you have to stop thinking that what you are up to is interesting.
Every early-stage startup must identify and evaluate a strategic advantage
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Whether you’re building a company or thinking about investing, it’s important to understand your strategic advantage.
In order to determine one, you should ask fundamental questions: What’s the long-term, sustainable reason that the company will stay in business?
As M&A accelerates, deal-makers are leveraging AI and ML to keep pace
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The global pandemic has changed the way we work, including how and where we work. For those involved in the mergers and acquisitions (M&A) industry, a notoriously relationship-driven business, this has meant in-person boardroom handshakes have been replaced by video conference calls, remote collaboration and potentially less travel in the future.
The pandemic has also accelerated digital transformation, and deal-makers have embraced digital tools to help them execute effectively.
The quickening pace of digital transformation is no longer about ensuring a competitive edge. Today, it’s also about business resilience. But what’s on the horizon, and how else will technology evolve to meet the needs of companies and deal-makers?
There are still many inefficiencies in managing M&A, but technologies such as artificial intelligence, especially machine learning, are helping to make the process faster and easier.
New Relic’s business remodel will leave new CEO with work to do
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Lew Cirne, New Relic’s founder and CEO, is stepping into the executive chairman role. He will be replaced by Bill Staples on July 1.
Cirne spent the last several years rebuilding the company’s platform and changing its revenue model, aiming for what he hopes is long-term success.
TechCrunch decided to dig into the company’s financials to see just what challenges Staples may face as he moves into the corner office. The resulting picture is one that shows a company doing hard work for a more future-aligned product map and business model, albeit one that may not generate the sort of near-term growth that gives Staples ample breathing room with public investors.
Fast growth pushes an unprofitable no-code startup into the public markets: Inside Monday.com’s IPO filing
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At long last, the Monday.com crew dropped an F-1 filing to go public in the United States. TechCrunch has long known that the company, which sells corporate productivity and communications software, has scaled north of $100 million in annual recurring revenue (ARR).
The countdown to its IPO filing — an F-1, because the company is based in Israel, rather than the S-1s filed by domestic companies — has been ticking for several quarters.
The Exchange has been riffling through the document since it came out, and we’ve picked up on a few things to explore.
The battle for voice recognition inside vehicles is heating up
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Until recently, integrating affordable voice-recognition software into an automobile was something from science fiction.
But last year, the percentage of vehicles offering in-car connected services reached 45%. By 2024, analysts predict cars with voice recognition will comprise 60% of the market.
Considering how much time many of us spend behind the wheel, there’s an infinite number of applications for the technology. For our latest Extra Crunch market map, we sized up the general market opportunity before creating a roster of major players and reaching out to investors to see where they’re placing bets.
Industrial automation startup Bright Machines hauls in $435M by going public via SPAC
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Bright Machines is going public via a SPAC-led combination that will see the 3-year-old company merge with SCVX, raising gross cash proceeds of $435 million in the process.
After the transaction is consummated, the startup will sport an anticipated equity valuation of $1.6 billion.
The Bright Machines news indicates that the great SPAC chill was not a deep freeze. And the transaction itself, in conjunction with the previously announced Desktop Metal blank-check deal, implies that there is space in the market for hardware startup liquidity via SPACs. Perhaps that will unlock more late-stage capital for hardware-focused upstarts.
We took a look at what Bright Machines does, and then the financial details that it shared as part of its news.
Want to double your rate of return? Seek counsel from experienced executives
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As a rule of thumb, it takes 7-8 years for a successful startup to achieve an exit. But there’s a simple way to speed up the clock: Bring in one or more founders who have previous executive experience.
According to data gathered by Rob Olson, partner and head of data strategy at venture engine M13, startups that have two or more experienced founders tend to exit 33% faster and raise 34% less capital.
“Combined, these two improvements can nearly double an investor’s rate of return,” says Olson.
Should startups build or buy telehealth infrastructure?
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Digital health in the U.S. got a huge boost from COVID-19 as more people started consulting physicians and urgent care providers remotely in the midst of lockdowns. So much so that McKinsey estimates that up to $250 billion of the current healthcare expenditure in the U.S. has the potential to be spent virtually.
The prominence of digital health is undoubtedly here to stay, but how it looks and feels from provider to provider is still a debate among sector startups.
But for providers who want to deliver care virtually across the country, it’s not as simple as adding a Zoom invite to an annual check-up. The process requires intention every step of the way — right from the clinicians delivering remote care to the choice of payment processor.
Help TechCrunch find the best email marketers for startups
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Email marketing has been with us for decades, but today it has been refined to a science and an art form.
If you’re an early-stage founder, it is one of the best ways to build and grow your direct relationship with your customer. You know how fickle the platforms can be. You can’t afford to mess this up.
So when and how should you think about doing email marketing, versus all of your other frantic priorities?
Here at Extra Crunch, we’re helping you find the answers. We launched a survey of founders who want to recommend a great email marketer or agency they have worked with to the rest of the startup world.
For companies that use ML, labeled data is the key differentiator
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When a company chooses supervised learning, it needs to have a strategy that allows it to label data as quickly as it acquires it.
Supervised learning is currently the most practical approach for most ML challenges, but it requires the crucial additional step of making raw data smart by labeling it.
How Expensify got to $100M in revenue by hiring ‘stem cells’ and not ‘cogs in a wheel’
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The influence of a founder on their company’s culture cannot be overstated. Everything from their views on the product and business to how they think about people affects how their company’s employees will behave, and since behavior, in turn, informs culture, the consequences of a founder’s early decisions can be far-reaching.
So it’s not surprising that Expensify has its own take on almost everything it does when you consider what its founder and CEO David Barrett learned early in his life: “Basically everyone is wrong about basically everything.”
As we saw in part 1 of this EC-1, this led him to the revelation that it’s easier to figure things out for yourself than finding advice that applies to you. Eventually, these insights would inform how he would go about shaping Expensify.
Inside Marqeta’s fascinating fintech IPO
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Marqeta, long a darling of the fintech market though less well known than some companies in its sector due to its infrastructure nature, filed to go public late last week
If you are not familiar with Marqeta, it powers the payment card tech behind products that you use, like Square, a key customer and driver of the unicorn’s growth. Marqeta exhibits a number of fascinating fintech characteristics (majority revenue from interchange, a rabidly competitive market) that make it very interesting to unspool.
May Mobility’s Edwin Olson and Nina Grooms Lee and Toyota AI Ventures’ Jim Adler on validating your startup idea
When a founder has a work history that includes the name of the parent company of one of their key investors, you probably assume that was one of the first deals to come together. Not so with May Mobility and Toyota AI Ventures, which connected for the company’s second seed round after May went out and raised its original seed purely on the strength of its own ideas and proposed solutions.
That’s one of the many interesting things we learned from speaking to May Mobility co-founder and CEO Edwin Olson, as well as Chief Product Officer Nina Grooms Lee and Toyota AI Ventures founding partner Jim Adler on an episode of Extra Crunch Live.
Extra Crunch Live goes down every Wednesday at 3 p.m. EDT/noon PDT. Our next episode is with Sequoia’s Shaun Maguire and Vise’s Samir Vasavada, and you can check out the upcoming schedule right here.
Meanwhile, read on for highlights from our chat with Olson, Grooms Lee and Adler, and then stay tuned at the end for a recording of the full session, including our live pitch-off.
WalkMe is going public: Let’s stroll through its numbers
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WalkMe is the second Israel-based technology company to file to go public this week: No-code startup Monday.com is also pursuing an American IPO.
WalkMe’s software provides visual overlays on websites that help users navigate the product in question. Per the company’s F-1 filing, other elements of its service that matter include its onboarding system, Workstation, or its “single interface to the applications within an enterprise and simplifies task completion through a natural language conversational interface and automation.” We’re including that last feature because it says “automation,” which, in the wake of the UiPath IPO, is a word worth watching. Investors are.
At a high level, WalkMe is a SaaS business, which means that when we digest its results we are digging into a modern software company. Let’s do just that.
Can Squarespace dodge the direct-listing value trap?
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Squarespace’s reference price has been set at $50 per share.
We went over Squarespace’s recently disclosed Q2 and full-2021 guidance and asked how its expectations compare to its reference-price-defined pre-trading valuation. Then, we set some stakes in the ground regarding historical direct-listing results and what we might expect from the company as it adds a third set of data to our quiver.
Let’s get into the numbers!
Mapping out one edtech company’s $200M bet on lifelong learning
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Mumbai-based Emeritus, an edtech company that works with universities to create online upskilling courses for employed folks, just spent a big chunk of cash to break into K-12.
Emeritus, which is part of the Eruditus group, announced this week that it plans to acquire iD Tech, a STEM education service for children. The acquisition, which has not yet closed, is estimated to be around $200 million and leaves iD Tech operating as an independent brand for now.
ID Tech brings a whole different set of customers to its umbrella: The startup offers courses for elementary through high-school students across the globe taught by college students in the U.S.
5 innovative fundraising methods for emerging VCs and PEs
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According to Versatile VC founder David Teten, five new strategies are gaining traction among fund managers looking to raise capital from family offices and high-net-worth individuals:
- Online communities and virtual events.
- Platforms that help other investors access your fund.
- Soliciting under the 506(c) designation.
- Launching a rolling fund.
- Crowdfunding from retail investors into a general partnership.
In a summary of a class he taught for the Oper8r VC fund accelerator, Teten offers actionable advice for anyone who wants to connect with pre-qualified investors.
Dear Sophie: What’s happening with visa application receipt notices?
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Dear Sophie,
Our startup employs several individuals who are on work visas or have employment authorization. Many of them have been waiting for quite a while for the government to tell them their applications have been received.
Why? When will things be back on track? We have a few employees who are waiting for green cards, and a few F-1 visa holders who will be extending their OPT to STEM OPT.
Is there anything we can do?
— Patient in Pasadena
Arrival’s Denis Sverdlov on the new era of car manufacturing
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Electric vehicle company Arrival wants to break the current auto manufacturing model. Instead of one giant factory and an assembly line, Arrival’s commercial electric vans, buses and cars are robotically built in small, regional microfactories, of which the company wants to open 31 by the end of 2025.
If you want to achieve something radically more efficient, you have to go deeper, into complex, high-level computational algorithms that are not normally used in consumer-facing products.
The London-based company, founded in 2015, joined the ranks of EV companies going public via SPAC, merging with blank-check company CIIG Merger Corp. in March. UPS has already ordered 10,000 of Arrival’s robotically engineered vans, and the company recently signed a deal with Uber to create purpose-built EVs for ride-hail drivers.
Arrival founder Denis Sverdlov has been at the intersection of technological advancement and societal change before.
Chasing hype is human nature: The tyranny of startup trends
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The fear of missing out (FOMO) spreads faster than wildfire and often overwhelms rational decision-making.
In the VC community, investors look for lessons from disruptive startups they can use to identify other potential winners. But hype leads to bad decision-making, rushed due diligence and wishful thinking.
When and if those startups actually do well, “irrational FOMO takes over” because the initial assessment was based on bad information, says Victor Echevarria, a partner at Jackson Square Ventures. “Trends are addictive; to remain disciplined and avoid hype is to deny our innate instincts.”
It’s natural for investors to follow the crowd, but in the race to the bottom, FOMO can be high-octane fuel.
Robinhood’s epic Q1 growth explains its fundraising boom
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The Exchange explores Robinhood’s financial results using the lens of payment for order flow (PFOF) income, which the company said during a congressional hearing constitutes the majority of its revenues.
This particular revenue growth — or the lack thereof — is a good way to understand not only Robinhood’s own results but also its larger market. If Robinhood is seeing rapid growth and strong trading volumes, we can infer with some confidence that others in its space are enjoying a related, if not similar, level of interest.
For Public.com, eToro and others like Freetrade (as well as our own understanding), how Robinhood performed recently is key. So, let’s explore the data.
How to ensure data quality in the era of Big Data
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A little over a decade has passed since The Economist warned us that we would soon be drowning in data. The modern data stack has emerged as a proposed life-jacket for this data flood — spearheaded by Silicon Valley startups such as Snowflake, Databricks and Confluent.
Today, any entrepreneur can sign up for BigQuery or Snowflake and have a data solution that can scale with their business in a matter of hours. The emergence of cheap, flexible and scalable data storage solutions was largely a response to changing needs spurred by the massive explosion of data.
Currently, the world produces 2.5 quintillion bytes of data daily (there are 18 zeros in a quintillion). The explosion of data continues in the roaring ‘20s, both in terms of generation and storage — the amount of stored data is expected to continue to double at least every four years. However, one integral part of modern data infrastructure still lacks solutions suitable for the Big Data era and its challenges: Monitoring of data quality and data validation.
Investors help Procore build a decacorn valuation in public debut
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Watching construction tech software company Procore go public Thursday after pricing above its range makes the IPO slowdown look like the deceleration that wasn’t.
Investors quickly bid up the company’s value in trading, giving Procore a higher valuation than it might have anticipated, along with a boost of confidence for the IPO market in general.
Construction tech may not be as glamorous as space travel, but it’s a massive industry that’s fraught with inefficiencies.
Procore initially set an IPO range of $60 to $65 per share before pricing at $67 per share Wednesday night. Its debut was worth gross proceeds north of $600 million and a fully diluted valuation of $9.6 billion. As of early afternoon Thursday, shares were trading at a solid $85.25.
In light of Procore’s debut, TechCrunch is digging quickly into the company’s new valuation and its resulting revenue multiples.
Telemedicine startups are positioning themselves for a post-pandemic world
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It’s impossible to predict how healthcare institutions will operate post-pandemic, but with so many people now accustomed to telemedicine, startups that provide services around virtual care continue to be poised for success.
Telemedicine has faced an uphill battle to become more relevant in the U.S., with challenges such as meeting HIPAA compliance requirements and insurance companies unwilling to pay for virtual visits. But when COVID-19 began raging across the globe and people had to stay home, both the insurance and healthcare industries were forced to adapt.
Now that people see the benefits and conveniences of “dialing a doc” from the kitchen table, healthcare has changed forever.
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Telemedicine startups are positioning themselves for a post-pandemic world
Telemedicine, in its original form of the phone call, has been around for decades. For people in remote or rural areas without easy access to in-person care, consulting a doctor over the phone has often been the go-to approach. But for a large swath of the world used to taking half a day off work just for a 15-30 minute doctor’s appointment, it may seem like telemedicine was invented only last year. That’s mostly because it wasn’t until 2020 that telemedicine, in its myriad forms, debuted into the mainstream consciousness.
It’s impossible to predict how healthcare institutions will operate post-pandemic, but with so many people now accustomed to telemedicine, startups that provide services around virtual care continue to be poised for success.
Telemedicine has faced an uphill battle to become more relevant in the U.S., with challenges such as meeting HIPPA compliance requirements and insurance companies unwilling to pay for virtual visits. But when COVID-19 began raging across the globe and people had to stay home, both the insurance and healthcare industries were forced to adapt.
“It’s been said that there are decades where nothing happens, and then there are weeks when decades happen,” said StartUp Health co-founders Steven Krein and Unity Stoakes in the company’s 2020 year-end report. That statement couldn’t be truer for telemedicine: Around $3.1 billion in funding flowed into the sector in 2020 — about three times what we saw in 2019, according to the report. A health tech fund and insights company, StartUp Health counts Alphabet, Sequoia and Andreessen Horowitz as some of its co-investors.
Now that people see the benefits and conveniences of “dialing a doc” from the kitchen table, healthcare has changed forever. It’s impossible to predict how healthcare institutions will operate post-pandemic, but with so many people now accustomed to telemedicine, startups that provide services around virtual care continue to be poised for success.
The state of telemedicine
Major players in the field now look at the state of healthcare as, “before COVID and after COVID,” Stoakes told Extra Crunch. “In the post-pandemic world, there’s a significant transformation that’s occurred,” he said. “It’s all accelerated; the customers have shown up. There’s more capital than ever and consumers and physicians have adapted quickly,” he added.
In the U.S., healthcare is first and foremost a business, so while there are treatment approaches that have long been proven to improve patient outcomes, if they didn’t make sense financially, they weren’t instituted at scale. Telemedicine is a great example of this.
A 2017 study by the American Journal of Accountable Care showed that telemedicine can be quite useful for managing healthcare. “The use of telemedicine has been shown to allow for better long-term care management and patient satisfaction; it also offers a new means to locate health information and communicate with practitioners (e.g., via e-mail and interactive chats or video conferences), thereby increasing convenience for the patient and reducing the amount of potential travel required for both physician and patient,” the study reads.
But as we’ve seen, it took a global healthcare emergency to drive widespread adoption of virtual healthcare in the U.S. Now that investors recognize the potential, they are increasingly pouring money into startups that promise to take telemedicine to the next level. Some of the investors backing these newer companies include StartUp Health, Andreessen Horowitz, Sequoia, Alphabet, Kaiser Permanente Ventures, U.S. Venture Partners, Maveron, First Round Capital, DreamIt Ventures, Human Ventures and Tusk Venture Partners.
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Microsoft goes all in on healthcare with $19.7B Nuance acquisition
When Microsoft announced it was acquiring Nuance Communications this morning for $19.7 billion, you could be excused for doing a Monday morning double take at the hefty price tag.
That’s surely a lot of money for a company on a $1.4 billion run rate, but Microsoft, which has already partnered with the speech-to-text market leader on several products over the last couple of years, saw a company firmly embedded in healthcare and decided to go all in.
And $20 billion is certainly all in, even for a company the size of Microsoft. But 2020 forced us to change the way we do business, from restaurants to retailers to doctors. In fact, the pandemic in particular changed the way we interact with our medical providers. We learned very quickly that you don’t have to drive to an office, wait in waiting room, then in an exam room, all to see the doctor for a few minutes.
Instead, we can get on the line, have a quick chat and be on our way. It won’t work for every condition, of course — there will always be times the physician needs to see you — but for many meetings such as reviewing test results or for talk therapy, telehealth could suffice.
Microsoft CEO Satya Nadella says that Nuance is at the center of this shift, especially with its use of cloud and artificial intelligence, and that’s why the company was willing to pay the amount it did to get it.
“AI is technology’s most important priority, and healthcare is its most urgent application. Together, with our partner ecosystem, we will put advanced AI solutions into the hands of professionals everywhere to drive better decision-making and create more meaningful connections, as we accelerate growth of Microsoft Cloud in Healthcare and Nuance,” Nadella said in a post announcing the deal.
Holger Mueller, an analyst at Constellation Research, says that may be so, but he believes that Microsoft missed the boat with Cortana and this is about helping the company catch up on a crucial technology. “Nuance will be not only give Microsoft technology help in regards to neural network-based speech recognition, but also a massive improvement from vertical capabilities, call center functionality and the MSFT IP position in speech,” he said.
Microsoft sees this deal doubling what was already a considerable total addressable market to nearly $500 billion. While TAMs always tend to run high, that is still a substantial number.
It also fits with Gartner data, which found that by 2022, 75% of healthcare organizations will have a formal cloud strategy in place. The AI component only adds to that number and Nuance brings 10,000 existing customers to Microsoft, including some of the biggest healthcare organizations in the world.
Brent Leary, founder and principal analyst at CRM Essentials, says the deal could provide Microsoft with a ton of health data to help feed the underlying machine learning models and make them more accurate over time.
“There is going be a ton of health data being captured by the interactions coming through telemedicine interactions, and this could create a whole new level of health intelligence,” Leary told me.
That of course could drive a lot of privacy concerns where health data is involved, and it will be up to Microsoft, which just experienced a major breach on its Exchange email server products last month, to assure the public that their sensitive health data is being protected.
Leary says that ensuring data privacy is going to be absolutely key to the success of the deal. “The potential this move has is pretty powerful, but it will only be realized if the data and insights that could come from it are protected and secure — not only protected from hackers but also from unethical use. Either could derail what could be a game-changing move,” he said.
Microsoft also seemed to recognize that when it wrote, “Nuance and Microsoft will deepen their existing commitments to the extended partner ecosystem, as well as the highest standards of data privacy, security and compliance.”
Kate Leggett, an analyst at Forrester Research, thinks healthcare could be just the first step and once Nuance is in the fold, it could go much deeper than that.
“However, the benefit of this acquisition does not stop [with healthcare]. Nuance also offers market-leading customer engagement technologies, with deep expertise and focus in verticals such as financial services. As MSFT evolves their industry editions into other verticals, this acquisition will pay off for other industries. MSFT may also choose to fill in the gaps within their Dynamics solution with Nuance’s customer engagement technologies,” Leggett said.
We are clearly on the edge of a sea change when it comes to how we interact with our medical providers in the future. COVID pushed medicine deeper into the digital realm in 2020 out of simple necessity. It wasn’t safe to go into the office unless absolutely necessary.
The Nuance acquisition, which is expected to close some time later this year, could help Microsoft shift deeper into the market. It could even bring Teams into it as a meeting tool, but it’s all going to depend on the trust level people have with this approach, and it will be up to the company to make sure that both healthcare providers and the people they serve have that.
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Ro makes the weight loss product Plenity commercially available to everyone in the US
In what could be the first step in the development of a significant new line of business for the telemedicine prescription provider Ro, the company is finally announcing the general commercial availability of weight loss product, Plenity.
Developed by Gelesis, a biotech company that makes treatments for gastro-intestinal disorders, Plenity is a weight loss treatment that uses citric acid and cellulose to create a non-toxic paste that makes people feel more full after they ingest it. Taken before meals, the pill becomes a substance that expands to take up about 25% of the stomach, so people eat less.
The product has been approved by the U.S. Food and Drug Administration and is available for a much broader segment of the population than other weight loss products. While most prescription medicines are intended for people who are obese, the Gelesis product is made for people who are overweight, too.
“That’s adults who have a BMI from 25 up to 40. That’s 150 million Americans,” according to Gelesis chief commercial and operating officer, David Pass.
Plenity received FDA approval last April, and Gelesis started working with Ro soon after, according to Pass. The idea was to craft a strategy that could get the treatment, which is classified as a medical device and not a drug, in the hands of as many patients as quickly as possible.
For Ro, the agreement with Gelesis is a sign of potential things to come. The company is the exclusive online provider of the Plenity treatment and Ro founder Zachariah Reitano said that there’s an incredible potential to engage in more of these types of deals.
“We would love to be able to partner with pharmaceutical companies to decrease the cost of distribution,” said Reitano. “We were excited to build an exciting treatment solution for weight management. Our high-level mission is to be the patient’s first call.”
With the Gelesis partnership Ro can add another highly desirable treatment to its roster of therapies — and one that can be a contributing factor to increasing the severity of other conditions that the company already provides treatment for, Reitano said.
“There are a few conditions that we currently treat that are exacerbated by a patient being overweight or obese. People who struggle with weight management will also experience ED. Obesity can lead to heart failure, stroke, coronary heart disease, hypertension, depression,” Reitano said. “The breadth of the label is interesting. Only FDA approved with a BMI from 25 to 40. FDA approved treatment have been between 30 and 40. [It] makes the treatment more accessible to a wider variety of people.”
As the only online provider of the treatment, Ro has developed an onboarding process to ensure that the Plenity therapy isn’t abused by people who suffer from eating disorders.
“During our onboarding we not only ask questions to patients about their weight management. There’s a consecutive set of images that need to be uploaded and taken with the provider. That’s something we’ve taken a lot of time and energy to make sure about,” said Reitano.
Like the other treatments Ro offers, Plenity is a cash-pay prescription, because the weight loss treatments aren’t typically covered by insurance, he said.
The benefit of working with an online pharmacy like Ro to provide distribution for a new therapy was obvious to both startups.
“We turned this market on its head by putting the consumer at the heart of everything we do,” said Pass. The treatment costs $98 per month, compared to other therapies or branded medications that could be as much $300 and $350 per month, according to Pass.
One reason that Gelesis is able to reduce the price of the drug is that it won’t have to hire a massive sales force to pitch it. The company has Ro for that.
“Normally you have a pharmaceutical company that would have to hire a sales force and go door to door and it increases the cost of a new drug. [Ro] can make a new, innovative treatment, like Plenity, available nationwide,” Reitano said.
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Carbon Health to launch 100 pop-up COVID-19 testing clinics across the US
Primary care health tech startup Carbon Health has added a new element to its “omnichannel” healthcare approach with the launch of a new pop-up clinic model that is already live in San Francisco, LA, Seattle, Brooklyn and Manhattan, with Detroit to follow soon – and that will be rolling out over the next weeks and months across a variety of major markets in the U.S., ultimately resulting in 100 new COVID-19 testing sites that will add testing capacity on the order of around an additional 100,000 patients per month across the country.
So far, Carbon Health has focused its COVID-19 efforts around its existing facilities in the Bay Area, and also around pop-up testing sites set up in and around San Francisco through collaboration with genomics startup Color, and municipal authorities. Now, Carbon Health CEO and co-founder Even Bali tells me in an interview that the company believes the time is right for it to take what it has learned and apply that on a more national scale, with a model that allows for flexible and rapid deployment. In fact, Bali says the they realized and began working towards this goal as early as March.
“We started working on COVID response as early as February, because we were seeing patients who are literally coming from Wuhan, China to our clinics,” Bali said. “We expected the pandemic to hit any time. And partially because of the failure of federal government control, we decided to do everything we can to be able to help out with certain things.”
That began with things that Carbon could do locally, more close to home in its existing footprint. But it was obvious early on to Bali and his team that there would be a need to scale efforts more broadly. To do that, Carbon was able to draw on its early experience.
“We have been doing on-site, we have been going to nursing homes, we have been working with companies to help them reopen,” he told me. “At this point, I think we’ve done more than 200,000 COVID tests by ourselves. And I think I do more than half of all the Bay Area, if you include that the San Francisco City initiative is also partly powered by Carbon Health, so we’re already trying to scale as much as possible, but at some point we were hitting some physical space limits, and had the idea back in March to scale with more pop-up, more mobile clinics that you can actually put up like faster than a physical location.”
Interior of one of Carbon Health’s COVID-19 testing pop-up clinics in Brooklyn.
To this end, Carbon Health also began using a mobile trailer that would travel from town to town in order to provide testing to communities that weren’t typically well-served. That ended up being a kind of prototype of this model, which employs construction trailers like you’d see at a new condo under development acting as a foreman’s office, but refurbished and equipped with everything needed for on-site COVID testing run by medical professionals. These, too, are a more temporary solution, as Carbon Health is working with a manufacturing company to create a more fit-for-purpose custom design that can be manufactured at scale to help them ramp deployment of these even faster.
Carbon Health is partnering with Reef Technologies, a SoftBank -backed startup that turns parking garage spots into locations for businesses, including foodservice, fulfilment, and now Carbon’s medical clinics. This has helped immensely with the complications of local permitting and real estate regulations, Bali says. That means that Carbon Health’s pop-up clinics can bypass a lot of the red tape that slows the process of opening more traditional, permanent locations.
While cost is one advantage of using this model, Bali says that actually it’s not nearly as inexpensive as you might think relative to opening a more traditional clinic – at least until their custom manufacturing and economies of scale kick in. But speed is the big advantage, and that’s what is helping Carbon Health look ahead from this particular moment, to how these might be used either post-pandemic, or during the eventual vaccine distribution phase of the COVID crisis. Bali points out that any approved vaccine will need administration to patients, which will require as much, if not more infrastructure than testing.
Exterior of one of Carbon Health’s COVID-19 testing pop-up clinics in Brooklyn.
Meanwhile, Carbon Health’s pop-up model could bridge the gap between traditional primary care and telehealth, for ongoing care needs unrelated to COVID.
“A lot of the problems that telemedicine is not a good solution for, are the things where a video check-in with a doctor is nearly enough, but you do need some diagnostic tests – maybe you might you may need some administration, or you may need like a really simple physical examination that nursing staff can do with the instructions of the doctor. So if you think about those cases, pretty much 90% of all visits can actually be done with a doctor on video, and nursing staff in person.”
COVID testing is an imminent, important need nationwide – and COVID vaccine administration will hopefully soon replace it, with just as much urgency. But even after the pandemic has passed, healthcare in general will change dramatically, and Carbon Health’s model could be a more permanent and scalable way to address the needs of distributed care everywhere.
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Our 12 favorite startups from Y Combinator’s S20 Demo Day: Part 2
Figma for filmmakers, TikTok for English learners and a cryptocurrency twist that actually makes sense?
After 197 pitches, Y Combinator’s Demo Day for its Summer 2020 cohort has concluded. While the fanfare, run-ins and fortune cookies were missing in this virtual session, it was still exciting to see and hear founders from 26 countries pitch their passions. Of course, some opted for a more quiet route, raising millions before the two-day pitch session even kicked off.
Members of the Summer 2020 class drew attention from nearly 2,400 investors across the world. For those who didn’t tune in, no worries: here’s our write-up of the companies that presented yesterday.
Participating startups spanned a number of sectors: we saw companies in the future of work, sustainability, no-code, consumer, edtech and delivery solutions. Several entrepreneurs aimed big at e-mail, small at socks and straight at Shopify’s recent success.
While TechCrunch reporters aren’t in the business of cutting checks or predicting success, read on to learn about the 12 startups that stuck out to us for a variety of reasons (apart from their Zoom backgrounds).
CarbonChain
CarbonChain may be the company that times the carbon market correctly. Now that the European Union and other regions are taking a serious look at penalizing businesses that fail to reduce carbon emissions, a service that provides accurate accounting for a company’s carbon footprint will be increasingly valuable.
And if the company can add marketplace and offsetting services on the back of its assessments, then its proposition becomes even more valuable. But what really makes CarbonChain stand out is the rigor with which it approaches its measurements.
The company uses independent software tools to make a digital twin of the carbon-emitting assets in a company’s business and claims that it can determine the emissions footprint of operations down to a cup of coffee (it also has models for the carbon footprint of heavy industrial equipment in the world’s most polluting industries).
For the world to address its carbon emissions, companies must understand their contribution to the problem. CarbonChain could be an invaluable tool in that effort.
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Thirty Madison raises $47 million for its direct to consumer treatments of hair loss, migraines and indigestion
Thirty Madison, the New York-based startup developing a range of direct to consumer treatments for hair loss, migraines and chronic indigestion, has raised $47 million in new financing.
After last week’s nearly $19 billion merger between Teladoc and Livongo, remote therapies and virtual care companies are all the rage among the healthcare industry, and Thirty Madison’s business is no exception.
An indicator of just how important these companies are to the future of the healthcare business can be seen in the presence of Johnson & Johnson Innovation – JJDC, Inc. (JJDC) in the latest round for Thirty Madison.
Existing investors Maveron and Northzone also returned to back the company in a deal led by Polaris Partners. Thirty Madison has raised a total of $70 million so far.
Founded just three years ago by Steven Gutentag and Demetri Karagas, Thirty Madison expanded from treating hair loss with its Keeps brand in 2018 to migraine treatments in early 2019 with Cove, and launched Evens (the company’s acid reflux treatment service) later that year.
Thirty Madison has just begun offering urgent care consultations for users on a pay-what-you-will model.
And the company’s founders differentiate Thirty Madison’s business from their better-funded competitors like Hims and Ro by emphasizing that their company provides continuing care after a diagnosis and offers a range of treatment options for the conditions that the company treats. That, coupled with the more narrow focus on a few specific conditions, distinguish Thirty Madison from its peers in the industry.
“Over 59% of Americans suffer from at least one chronic condition, but few resources exist to help them connect the dots of their care,” said Amy Schulman, a partner with Polaris Partners and new director on the Thirty Madison board.
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