Amid violent threats, lawmaker ditches bill to make unvaxxed pay hospital bills

Intensive Care Unit nurse monitors patients in the ICU ward at Roseland Community Hospital on December 14, 2020, in Chicago, Illinois.

Enlarge / Intensive Care Unit nurse monitors patients in the ICU ward at Roseland Community Hospital on December 14, 2020, in Chicago, Illinois. (credit: Getty | Scott Olson)

Illinois Representative Jonathan Carroll is scrapping his proposed legislation to make willfully unvaccinated people pay COVID-19 hospital bills out of pocket after he received violent threats that also targeted his family, staff and synagogue.

The Democrat from the Chicago suburb of Northbrook introduced legislation earlier this week that would have amended the state’s codes for health and accident insurance. The proposed bill aimed to prevent insurance policies from covering COVID-19 hospital bills for people who choose to remain unvaccinated without a medical reason.

The bill was quickly politically divisive—and legally dubious. Federal law prevents health insurance providers from denying or reducing coverage based on a change in a person’s health status, including a diagnosis of COVID-19.

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#covid-19, #health-insurance, #hospital, #illinois, #infectious-disease, #public-health, #science, #unvaccinated

Dubious $56,000 Alzheimer’s drug spurs largest Medicare price hike ever

Multistory glass building on a tree-lined campus.

Enlarge / Biogen Inc. headquarters in Cambridge, Massachusetts. Biogen Inc. shares soared after its controversial Alzheimer’s disease therapy was approved by US regulators. (credit: Getty | Bloomberg)

Seniors throughout the US will see a hefty increase to their health care premiums next year thanks in large part to Biogen’s Alzheimer’s drug, Aduhelm, which is priced at $56,000 per year and is not proven to be clearly effective at treating Alzheimer’s.

The Centers for Medicare & Medicaid Services (CMS) announced Friday that the standard monthly premium for Medicare Part B will rise from $148.50 in 2021 to $170.10 in 2022, an increase of $21.60 or roughly 14.5 percent. It is the largest increase ever in terms of dollars and among the largest percentage increases in recent years.

CMS officials said Friday that Aduhelm was responsible for about half of the rise in Part B premiums, according to the Associated Press. Though the CMS is still determining how it will cover Aduhelm under Part B, the agency said the prospect of paying for Aduhelm at all required “additional contingency reserves.”

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#aduhelm, #alzheimers-disease, #biogen, #cms, #coverage, #fda, #health-care, #health-insurance, #medicare, #premiums, #science

Ascend raises $5.5M to provide a BNPL option for commercial insurance

Ascend on Wednesday announced a $5.5 million seed round to further its insurance payments platform that combines financing, collections and payables.

First Round Capital led the round and was joined by Susa Ventures, FirstMark Capital, Box Group and a group of angel investors, including Coalition CEO Joshua Motta, Newfront Insurance executives Spike Lipkin and Gordon Wintrob, Vouch Insurance CEO Sam Hodges, Layr Insurance CEO Phillip Hodges, Anzen Insurance CEO Max Bruner, Counterpart Insurance CEO Tanner Hackett, former Bunker Insurance CEO Chad Nitschke, SageSure executive Paul VanderMarck, Instacart co-founders Max Mullen and Brandon Leonardo and Houseparty co-founder Ben Rubin.

This is the first funding for the company that is live in 20 states. It developed payments APIs to automate end-to-end insurance payments and to offer a buy now, pay later financing option for distribution of commissions and carrier payables, something co-founder and co-CEO Andrew Wynn, said was rather unique to commercial insurance.

Wynn started the company in January 2021 with his co-founder Praveen Chekuri after working together at Instacart. They originally started Sheltr, which connected customers with trained maintenance professionals and was acquired by Hippo in 2019. While working with insurance companies they recognized how fast the insurance industry was modernizing, yet insurance sellers still struggled with customer experiences due to outdated payments processes. They started Ascend to solve that payments pain point.

The insurance industry is largely still operating on pen-and-paper — some 600 million paper checks are processed each year, Wynn said. He referred to insurance as a “spaghetti web of money movement” where payments can take up to 100 days to get to the insurance carrier from the customer as it makes its way through intermediaries. In addition, one of the only ways insurance companies can make a profit is by taking those hundreds of millions of dollars in payments and investing it.

Home and auto insurance can be broken up into payments, but the commercial side is not as customer friendly, Wynn said. Insurance is often paid in one lump sum annually, though, paying tens of thousands of dollars in one payment is not something every business customer can manage. Ascend is offering point-of-sale financing to enable insurance brokers to break up those commercial payments into monthly installments.

“Insurance carries continue to focus on annual payments because they don’t have a choice,” he added. “They want all of their money up front so they can invest it. Our platform not only reduces the friction with payments by enabling customers to pay how they want to pay, but also helps carriers sell more insurance.”

Ascend app

Startups like Ascend aiming to disrupt the insurance industry are also attracting venture capital, with recent examples including Vouch and Marshmallow, which raised close to $100 million, while Insurify raised $100 million.

Wynn sees other companies doing verticalized payment software for other industries, like healthcare insurance, which he says is a “good sign for where the market is going.” This is where Wynn believes Ascend is competing, though some incumbents are offering premium financing, but not in the digital way Ascend is.

He intends to deploy the new funds into product development, go-to-market initiatives and new hires for its locations in New York and Palo Alto. He said the raise attracted a group of angel investors in the industry, who were looking for a product like this to help them sell more insurance versus building it from scratch.

Having only been around eight months, it is a bit early for Ascend to have some growth to discuss, but Wynn said the company signed its first customer in July and six more in the past month. The customers are big digital insurance brokerages and represent, together, $2.5 billion in premiums. He also expects to get licensed to operate as a full payment in processors in all states so the company can be in all 50 states by the end of the year.

The ultimate goal of the company is not to replace brokers, but to offer them the technology to be more efficient with their operations, Wynn said.

“Brokers are here to stay,” he added. “What will happen is that brokers who are tech-enabled will be able to serve customers nationally and run their business, collect payments, finance premiums and reduce backend operation friction.”

Bill Trenchard, partner at First Round Capital, met Wynn while he was still with Sheltr. He believes insurtech and fintech are following a similar story arc where disruptive companies are going to market with lower friction and better products and, being digital-first, are able to meet customers where they are.

By moving digital payments over to insurance, Ascend and others will lead the market, which is so big that there will be many opportunities for companies to be successful. The global commercial insurance market was valued at $692.33 billion in 2020, and expected to top $1 trillion by 2028.

Like other firms, First Round looks for team, product and market when it evaluates a potential investment and Trenchard said Ascend checked off those boxes. Not only did he like how quickly the team was moving to create momentum around themselves in terms of securing early pilots with customers, but also getting well known digital-first companies on board.

“The magic is in how to automate the underwriting, how to create a data moat and be a first mover — if you can do all three, that is great,” Trenchard said. “Instant approvals and using data to do a better job than others is a key advantage and is going to change how insurance is bought and sold.”

#andrew-wynn, #artificial-intelligence, #auto-insurance, #bill-trenchard, #box-group, #cloud, #commercial-insurance, #enterprise, #first-round-capital, #firstmark-capital, #funding, #health-insurance, #hippo, #insurance, #payments, #praveen-chekuri, #recent-funding, #saas, #startups, #susa-ventures, #tc, #vouch-insurance

Indonesia-based Rey Assurance launches its holistic approach to insurance with $1M in funding

Rey Assurance co-founders Bobby Siagian and Evan Tanotogono

Rey Assurance co-founders Bobby Siagian and Evan Tanotogono

Health insurance is the kind of thing people usually only think about only when they need it. Otherwise, their policies are just paperwork in their files or cards in their wallet. Indonesian insurtech Rey Assurance is taking a new approach. Once someone becomes a member, they also get access to a platform of health services, including AI-based self-assessment tools, 24/7 telemedicine consultations for no added fee and pharmacy deliveries. The startup is launching out of stealth today, having already raised $1 million in pre-seed funding from the Trans-Pacific Technology Fund (TPTF). 

Rey was founded this year by Evan Tanotogono, former head of digital channel at Sequis, one of Indonesia largest insurers, and Bobby Siagian, who held lead engineering roles at companies including Tokopedia and Sea Group. They are joined by insurance industry veteran David Nugrho as their chief business officer. 

They created Rey to address the low penetration of life and health insurance in Indonesia. “When you look at the root causes and pain points, you are looking at problems that are systemic here,” Tanotogono said. These include low awareness, expensive distribution channels like agents and telemarketing, high premiums and complicated policies.

“People feel like the product is really complex, the process is difficult and they don’t get the best value for the money. It’s been that way for many, many years,” he told TechCrunch. “We believe that we cannot just go into the market and digitize part of the value chain.”

Plans start from about $4 USD per month and are available for individual or groups, like families, and small businesses. Rey’s wellness ecosystem was created to give customers more value for their money, and help differentiate it from other companies in Indonesia’s growing insurtech industry. Some other startups that have recently raised funding include Lifepal, PasarPolis and Qoala.

“Right now, if you look at insurance in Indonesia, if the premium is high, maybe 80% or 90% of that is used for the distribution channel. Now if we optimize something for digital distribution, then we can reduce the price and use the rest for the wellness features,” Tanotogono added. 

TPTF managing partner Glenn Kline told TechCrunch that Rey’s founding team was “really the driver” for its investment. “We felt these people really know where the pain points are and they understand clearly how not to try to change the legacy system, but create a whole new platform from the very beginning, where the core value proposition is an integrated solution that is simple and hassle-free.” 

Instead of doing the underwriting themselves, Rey works with insurance partners to design proprietary policies. The goal is to have an onboarding process that is completely online and only takes about five minutes, and a mostly cashless claim and reimbursement system through Rey’s payment cards. If its payment card can’t be used at healthcare provider, claims can be submitted by uploading receipt photos to the app. 

Tanotogono said this is much faster than traditional insurance providers, which can take up to 14 working days to reimburse a claim, and made possible with Rey’s proprietary claim adjudication technology. 

Rey’s wellness ecosystem currently covers primary care services, including chats and video calls with medical providers. In the future, it plans to add specialists to the platforms.

Customers can also link their health wearables for incentives. For example, if they hit certain step or activity goals, they get rewards like discounts or shopping vouchers. Rey’s long-term plan is to link wearables more deeply to its insurance policies, using data to personalize policies and premiums.

#asia, #fundings-exits, #health-insurance, #indonesia, #insurance, #insurtech, #southeast-asia, #startups, #tc

SimpliFed serves up $500,000 pre-seed toward infant nutrition support

Feeding babies can take many different forms, and is also an area where parents can feel less supported as they navigate this new milestone in their lives.

Enter SimpliFed, an Ithaca, New York-based company providing virtual lactation and a baby feeding support platform. The startup announced Friday that it raised $500,000 in pre-seed funding led by Third Culture Capital.

Andrea Ippolito, founder and CEO of SimpliFed. Image Credits: SimpliFed

CEO Andrea Ippolito, a biomedical engineer and mother of two young children, had the idea for SimpliFed three years ago. She struggled with breastfeeding after having her first child and, realizing that she was not alone in this area, set out to figure out a way to get anyone access to information and support for infant feeding.

“Post discharge is when the rubber meets the goal for us,” she told TechCrunch. “This is a huge pain point for Medicaid, and it is not just about increasing access, but providing ongoing support for feeding and the quagmire that is health insurance. We want to help moms reach their infant feeding goals, no matter how they choose to feed, and to figure out what feeding looks like for them.”

The American Academy of Pediatrics recommends that mothers nurse for up to six months. However, the Centers for Disease Control and Prevention estimates that 60% of mothers don’t breastfeed for as long as they intend due to reasons like difficulty lactating or the baby latching, sickness or an unsupportive work environment.

SimpliFed’s platform is a judgement-free zone providing evidence-based information on nutritional health for babies. It isn’t meant to replace typical care that mother and baby will receive before and after delivery, but to provide support when issues arise, Ippolito said. Parents can book a free, initial 15-minute virtual consultation with a lactation expert and then subsequent 60-minute sessions for $100 each. There is also a future membership option for those seeking continuing care.

The new funds will be used to hire additional employees to further develop the telelactation platform and grow the company’s footprint, Ippolito said. The platform is gearing up to go through a clinical study to co-design the program with 1,000 mothers. She also wants to build out relationships with payers and providers toward a longer-term goal of becoming in-network and paid through reimbursement from health plans.

Julien Pham, managing partner at Third Culture Capital, said he met Ippolito at MIT Hacking Medicine a decade ago. A physician by training, he saw first-hand how big of an opportunity it is to demystify providing the best nutrition for babies.

“The U.S. culture has evolved over the years, and millennials are the next-generation moms who have a different ask, and SimpliFed is here at the right time,” Pham said. “Andrea is just a dynamo. We love her energy and how she is at the front line of this as a mother herself — she is most qualified to do this, and we support her.

 

#andrea-ippolito, #apps, #breastfeeding, #centers-for-disease-control-and-prevention, #funding, #health, #health-insurance, #julien-pham, #recent-funding, #simplifed, #startups, #tc, #third-culture-capital

Oviva grabs $80M for app-delivered healthy eating programs

UK startup Oviva, which sells a digital support offering, including for Type 2 diabetes treatment, dispensing personalized diet and lifestyle advice via apps to allow more people to be able to access support, has closed $80 million in Series C funding — bringing its total raised to date to $115M.

The raise, which Oviva says will be used to scale up after a “fantastic year” of growth for the health tech business, is co-led by Sofina and Temasek, alongside existing investors AlbionVC, Earlybird, Eight Roads Ventures, F-Prime Capital, MTIP, plus several angels.

Underpinning that growth is the fact wealthy Western nations continue to see rising rates of obesity and other health conditions like Type 2 diabetes (which can be linked to poor diet and lack of exercise). While more attention is generally being paid to the notion of preventative — rather than reactive — healthcare, to manage the rising costs of service delivery.

Lifestyle management to help control weight and linked health conditions (like diabetes) is where Oviva comes in: It’s built a blended support offering that combines personalized care (provided by healthcare professionals) with digital tools for patients that help them do things like track what they’re eating, access support and chart their progress towards individual health goals.

It can point to 23 peer-reviewed publications to back up its approach — saying key results show an average of 6.8% weight loss at 6 months for those living with obesity; while, in its specialist programs, it says 53% of patients achieve remission of their type 2 diabetes at 12 months.

Oviva typically sells its digitally delivered support programs direct to health insurance companies (or publicly funded health services) — who then provide (or refer) the service to their customers/patients. Its programs are currently available in the UK, Germany, Switzerland and France — but expanding access is one of the goals for the Series C.

“We will expand to European markets where the health system reimburses the diet and lifestyle change we offer, especially those with specific pathways for digital reimbursement,” Oviva tells TechCrunch. “Encouragingly, more healthcare systems have been opening up specific routes for such digital reimbursement, e.g., Germany for DiGAs or Belgium just in the last months.”

So far, the startup has treated 200,000 people but the addressable market is clearly huge — not least as European populations age — with Oviva suggesting more than 300 million people live with “health challenges” that are either triggered by poor diet or can be optimised through personalised dietary changes. Moreover, it suggests, only “a small fraction” is currently being offered digital care.

To date, Oviva has built up 5,000+ partnerships with health systems, insurers and doctors as it looks to push for further scale by making its technology more accessible to a wider range of people. In the past year it says it’s “more than doubled” both people treated and revenue earned.

Its goal is for the Series C funding is to reach “millions” of people across Europe who need support because they’re suffering from poor health linked to diet and lifestyle.

As part of the scale up plan it will also be growing its team to 800 by the end of 2022, it adds.

On digital vs face-to-face care — setting aside the potential cost savings associated with digital delivery — it says studies show the “most striking outcome benefits” are around uptake and completion rates, noting: “We have consistently shown uptake rates above 70% and high completion rates of around 80%, even in groups considered harder to reach such as working age populations or minority ethnic groups. This compares to uptake and completion rates of less than 50% for most face-to-face services.”

Asked about competition, Oviva names Liva Healthcare and Second Nature as its closest competitors in the region.

“WW (formally Weight Watchers) also competes with a digital solution in some markets where they can access reimbursement,” it adds. “There are many others that try to access this group with new methods, but are not reimbursed or are wellness solutions. Noom competes as a solution for self-paying consumers in Europe, as many other apps. But, in our view, that is a separate market from the reimbursed medical one.”

As well as using the Series C funding to bolster its presence in existing markets and target and scale into new ones, Oviva says it may look to further grow the business via M&A opportunities.

“In expanding to new countries, we are open to both building new organisations from the ground up or acquiring existing businesses with a strong medical network where we see that our technology can be leveraged for better patient care and value creation,” it told us on that.

 

#diabetes, #digital-therapeutics, #eight-roads-ventures, #europe, #f-prime-capital, #france, #fundings-exits, #germany, #health, #health-insurance, #health-systems, #obesity, #oviva, #sofina, #switzerland, #tc, #temasek, #united-kingdom, #zoe

After raising $10M, Breeze breathes fresh air into a stagnant disability insurance market

Working in the world of disability insurance for a decade, Colin Nabity felt not everyone could access this type of insurance due to its nature of it being difficult to understand and underwrite.

Disability and critical illness insurance is typically income protection should someone be too sick or hurt to work. An average of 5.6% of working Americans each year will experience a short-term disability during a period of six months or less due to illness, injury or pregnancy. At the same time, 1 in 4 Americans currently live with a disability that impacts their major life activities.

Similar to other insurance products, disability insurance was sold the same way for more than 20 years: using outdated technology, data science and underwriting that didn’t provide consumers an appropriate policy based on their occupation and health. In addition, there was not a digital platform to sell this type of insurance directly to consumers, Nabity said.

Enter Omaha, Nebraska-based Breeze, the company Nabity started in 2019 with Cody Leach to enable individuals to go online and complete in 10 minutes the application process to receive a personalized quote for either disability insurance or critical illness insurance.

There are large incumbents in the space — for example Aflac, but Nabity said Breeze’s platform offers a digital approach to disability and critical illness applications, quotes and policy-making that offers consumers protection during events like cancer, heart attacks, strokes and other medical conditions that can lead to a loss of income if someone is unable to work.

The U.S. market for disability insurance was valued at $19.1 billion as of this year and was declining slightly since 2016, IBIS World reported. Breeze is reimagining these products to make them more affordable — a policy for several thousand dollars costs, on average, around $20 a month — and to provide consumer education so that purchasing this type of insurance is less intimidating, he added.

“We want a way for people to understand this type of insurance, make it more affordable and be bought completely online,” Nabity told TechCrunch. “These illnesses and injuries wreck families because they can be so financially devastating.”

Breeze raised $10 million in Series A funding in a round led by Link Ventures that Nabity boasts is the “largest first round of institutional capital ever invested in a Nebraska-based software startup.” Northwestern Mutual Ventures, Silicon Valley Bank, M25, Fiat Ventures and Invest Nebraska also participated in the financing.

Lisa Dolan, managing director at Link Ventures, said she found the company while examining web traffic data, where Breeze was listed among industry incumbents among consumers searching for disability.

Dolan admits that even she was not familiar, at the time, with disability insurance and has since learned that the market is larger than originally thought. She believes that by using technology to route the appropriate customer to the approach insurance, Breeze is able to reach customers that incumbent insurance carriers can’t get to.

Nabity did not disclose any growth metrics, but said he intends to use the new funding — the company’s first round of institutional capital — to grow its core products and add new products, carriers and agents to the platform. He will also increase Breeze’s headcount in the areas of software development, customer service and marketing.

“We are in the process of opening up our platform to agents that have not sold these products before, and we will need product and support teams to handle that increased volume,” he added.

 

#breeze, #colin-nability, #disability-insurance, #funding, #health, #health-insurance, #link-ventures, #lisa-dolan, #northwestern-mutual-ventures, #recent-funding, #software-development, #startups, #tc

Catch takes hold of $12M to provide benefits that aren’t tied to employers

Catch is working to make sure that every gig worker has the health and retirement benefits they need.

The company, which is in the midst of moving its headquarters to New York, sells health insurance, retirement savings plans and tax withholding directly to freelancers, contractors or anyone uncovered.

It is now armed with a fresh round of $12 million in Series A funding, led by Crosslink, with participation from earlier investors Khosla Ventures, NYCA Partners, Kindred Ventures and Urban Innovation Fund, to support more distribution partnerships and its relocation from Boston.

Co-founders Kristen Anderson and Andrew Ambrosino started Catch in 2019 and raised $6.1 million previously, giving it a total of $18.1 million in funding.

It took the Catch team of 15 nearly two years to get approvals to sell its platform in 38 states on the federal marketplace. Anderson boasts that only eight companies have been able to do this, and three of them — Catch included — are approved to sell benefits to consumers. The other side of the business is payroll, and the company has gathered thousands of sources based on biller.

“More companies are not offering healthcare, while more people are joining the creator and gig economies, which means more people are not following an employer-led model,” Anderson told TechCrunch.

The age of an average Catch customer is 32 years old, and in addition to current offerings, were asking the company to help them set up income sources, like setting aside money for taxes, retirement, as well as medical leave without having to actively save.

When the global pandemic hit, many of Catch’s customers saw their income collapse, 40% overall across industries, as workers like hairstylists and cooks had income go down to zero in some cases.

It was then that Anderson and Ambrosino began looking at partnership distribution and developed a network of platforms, business facilitation tools, gig marketplaces and payroll companies that were interested in offering Catch. The company intends to use some of the funding to increase its headcount to service those partnerships and go after more, Anderson said.

Catch is one startup providing insurance products, and many of the competitors either do a single offering and do it well, like Starship does with health savings accounts, Anderson said. Catch is taking a different approach by offering a platform experience, but going deep on the process, she added. She likens it to Gusto, which provides cloud-based payroll, benefits and human resource management for businesses, in that Catch is an end-to-end experience, but with a focus on an individual person.

Over the past year, the company’s user base tripled, driven by people taking on second jobs and through a partnership with DoorDash. Platform users are also holding onto 5 times their usual balances, a result of setting more goals and needing to save more, Anderson said. Retirement investments and health insurance have grown similarly.

Going forward, Anderson is already thinking about a Series B, but that won’t come for another couple of years, she said. The company is looking into its own HSA product as well as disability insurance and other products to further differentiate itself from other startups, for example, Spot, Super.mx and Even that all raised venture capital this month to provide benefits.

Catch would also like to serve a broader audience than just those on the federal marketplace. The co-founders are working on how to do this — Anderson mentioned there are some “nefarious companies out there” offering medical benefits at rates that can seem too good to be true, but when the customer reads the fine print, finds out that certain medical conditions are not covered.

“We are looking at how to put the right thing in there because it does get confusing,” Anderson added. “Young people have cheaper options, which means they need to make sure they know what they are getting.”

 

#andrew-ambrosino, #crosslink, #doordash, #ecommerce, #employee-benefits, #funding, #gig-economy, #gig-workers, #health, #health-insurance, #khosla-ventures, #kindred-ventures, #kristen-anderson, #labor, #nyca-partners, #recent-funding, #startups, #tc, #urban-innovation-fund

Insurtech startup Spot brings in $17.5M equity, debt to fill insurance gaps for accidental injuries

Affordable healthcare continues to be a major problem in the U.S., with roughly 30 million people without comprehensive healthcare and high medical costs causing many to go into debt. Spot is tackling this issue with a digital, on-demand injury insurance product that can be as-is or as a complement to traditional health insurance.

Headquartered in Austin, the company raised $15 million in equity and $2.5 million in debt in a round of seed funding led by GreatPoint Ventures, with participation from Montage Ventures, Mutual of Omaha, MS&AD and Silverton Partners.

The idea for the company came from a conversation founder Maria Goy and Matt Randall had back in 2018. Randall is married to Goy’s best friend, and one night, they started talking about Goy’s job at the time, in insurance at New York Life, and how there needed to be a product that provided affordable insurance. That led to a discussion about how to also have healthcare that was accessible.

“Every major market was disrupted by some change of distribution, like Netflix and Airbnb,” Goy told TechCrunch. “We are setting the foundation to drive change and the distribution of insurance.”

Spot’s business model takes a holistic approach by providing customized injury insurance policies through both direct-to-consumer and strategic partnerships with companies and organizations. For example, one of the company’s first partners was the Austin Marathon, selling one-time injury policies to the participants. Randall wasn‘t sure if people would buy them, but they ended up selling over 1,100 policies.

That led to applying the same idea across youth sports, ski resorts and cycling organizations. It now has over a dozen partners, including USA Cycling, Powder Mountain, USA BMX, National Ski Patrol and athleteReg, and covers tens of thousands of people.

The policies start at $25 and work like a monthly subscription. Family plans are also available. Spot covers up to $20,000 each time the customer is injured. The company will also coordinate with any existing healthcare insurance. Customers can use any licensed physician, hospital or urgent care clinic.

Spot has grown 800% in policies from last year and 300% in partnerships, including bringing on Mutual of Omaha. Spot is the first startup the insurance giant has invested in, and “having them alongside Maria is beyond a powerhouse team to say the least,” Randall said.

The company’s policies are available in 42 states via the DTC model and nationwide on group coverage, Goy said. The new funding round will be used to triple Spot’s team of 25, go after new partnerships and develop a go-to-market strategy. Randall also plans to raise a Series A round in the next nine months.

“We are focusing on bringing additional products that fill in holes and gaps in insurance and provide more education to the market,” Goy added. “We are getting requests for alternative coverage. For example, people would rather have acupuncture instead of surgery, which is not easy for a typical policy. Ultimately, our big mission is how to create a community within our customers and drive engagement.”

As part of the investment, Mike McCormick, principal at GreatPoint Ventures, will join Spot’s board of directors. He said in an interview that his firm is on the lookout for things that make healthcare better, including companies rooted in rethinking how to keep people well.

Spending much of his time in both healthcare and insurtech, McCormick wanted to find an answer to the problem of how the U.S. is spending so much money, on a per capita basis, and getting what he called “meh results.”

There are also the issues of most care being fee-for-service, and insurance for most people being attached to employment, while high deductibles have become a big feature, he said. He likes Spot because it is offering a product, for example, to someone young who is unlikely to get diabetes or cancer soon, but could incur $10,000 in medical costs breaking a leg skiing.

“What Spot is doing for the underinsured and uninsured makes sense,” McCormick added. “Maria and Matt are incredible people building an incredible company with growth and product-market fit. In terms of the partnership and direct-to-consumer models, they could build either one into a $10 billion company and both will work.”

 

#funding, #greatpoint-ventures, #health, #health-insurance, #maria-goy, #matt-randall, #montage-ventures, #msad, #mutual-of-omaha, #recent-funding, #silverton-partners, #spot, #startups, #tc

Former Iora Health execs raise $13M to guide seniors through Medicare enrollment

Employers typically offer three options for healthcare insurance. When it’s time to switch to Medicare, particularly Medicare Advantage, there are over 3,500 plans available nationwide, and an average of 30 plans someone can choose from in their particular area. Connie Health is leading seniors through the Medicare maze, helping whittle down those 3,000 plans into a handful of best choices based on care requirements.

The company’s three co-founders, Oded Eran, CEO, David Luna, chief revenue officer, and Michael Scopa, chief growth officer, saw this problem firsthand as executives at primary care company Iora Health, which is being acquired by OneMedical for $2.1 billion.

They started their company in 2019 to develop a Medicare concierge service to assist seniors in easily navigating through those 30 plans to find the right one for them.

“We were coming from the provider side and understood that though healthcare is local, people don’t know the difference in hospitals or the ins and outs of local networks,” Eran told TechCrunch. “Seniors need trust there, and when there are local advisers to meet over the phone or at home, you gain that trust.”

The Boston-based company announced Wednesday it raised $13 million in Series A funding led by Khosla Ventures and Pittango Healthtech to give it a total of $16 million in funding. The company raised $3 million in a seed round back in January 2020, also led by Khosla. The seed and Series A rounds also saw participation by AbstractVentures, Dynamic Loop Capital, Arkitekt Ventures, as well as a group of angel investors, including Hippo Insurance CEO Assaf Wand and Flatiron Health founders Zach Weinberg and Nat Turner.

Image Credits: Connie Health

With 55 million Medicare consumers benefiting from major innovation in Medicare Advantage and value-based care, Kaul saw a large market that was being disrupted by Connie Health. He was especially impressed with the team Eran built and how the company was able to launch during the pandemic and stay nimble.

“The Medicare Advantage space is rich and will continue to grow,” Kaul added. “Technology has not played a big role here, and Oded is going to bring technology in to make the market more efficient.”

Medicare Advantage is the private market part of the insurance program. Eran said the government is trying to drive competition and innovation, so there are a lot of new players coming in to create more plan options, more nuances and to help manage costs better. On the consumer level, this creates a lot of confusion, he added. Potential customers have a hard time making decisions on the latest and greatest options, so they tend to stick with the status quo.

That’s where Connie Health comes in. The company’s technology takes into account the providers someone sees, the medications they are on and the benefits they would like to have, feed those into its model, and based on that, sifts through the thousands of plans available and recommends the best fits.

Four months ago, Connie Health kicked off its consumer platform in Arizona, and with the new investment, also began operating in Texas. Over the next year, Eran expects to move into Illinois, where he is seeing big demographic changes as a lot of people are moving into Medicare and other states. The new funding will also enable the company to branch off to other insurance products.

Within those states, the company’s footprint grew to seven markets, and its local agent base grew 15 times.

“We are going to democratize access to the local agents to help people make these often tough decisions and find healthcare that they deserve and have paid for all of their working life,” Eran said. “We are taking this market-by-market approach because healthcare is in the community.”

 

#artificial-intelligence, #assaf-wand, #connie-health, #flatiron-health, #health, #health-insurance, #hippo-insurance, #khosla-ventures, #medicare, #oded-eran, #recent-funding, #startups, #tc

Khosla Ventures leads Even’s $5M seed to give India the kind of healthcare their insurance doesn’t

The global pandemic highlighted inefficiencies and inconsistencies in healthcare systems around the world. Even co-founders Mayank Banerjee, Matilde Giglio and Alessandro Ialongo say nowhere is this more evident than in India, especially after the COVID death toll reached 4 million this week.

The Bangalore-based company received a fresh cash infusion of $5 million in seed funding in a round led by Khosla Ventures, with participation from Founders Fund, Lachy Groom and a group of individuals including Palo Alto Networks CEO Nikesh Arora, CRED CEO Kunal Shah, Zerodha founder Nithin Kamath and DST Global partner Tom Stafford.

Even, a healthcare membership company, aims to cover what most insurance companies in the country don’t, including making going to a primary care doctor as easy and accessible as it is in other countries.

Banerjee grew up in India and said the country is similar to the United States in that it has government-run and private hospitals. Where the two differ is that private health insurance is a relatively new concept for India, he told TechCrunch. He estimates that less than 5% of people have it, and even though people are paying for the insurance, it mainly covers accidents and emergencies.

This means that routine primary care consultations, testings and scans outside of that are not covered. And, the policies are so confusing that many people don’t realize they are not covered until it is too late. That has led to people asking doctors to admit them into the hospital so their bills will be covered, Ialongo added.

Banerjee and Giglio were running another startup together when they began to see how complicated health insurance policies were. About 50 million Indians fall below the poverty line each year, and many become unable to pay their healthcare bills, Banerjee said.

They began researching the insurance industry and talking with hospital executives about claims. They found that one of the biggest issues was incentive misalignment — hospitals overcharged and overtreated patients. Instead, Even is taking a similar approach to Kaiser Permanente in that the company will act as a service provider, and therefore, can drive down the cost of care.

Even became operational in February and launched in June. It is gearing up to launch in the fourth quarter of this year with more than 5,000 people on the waitlist so far. Its health membership product will cost around $200 per year for a person aged 18 to 35 and covers everything: unlimited consultations with primary care doctors, diagnostics and scans. The membership will also follow as the person ages, Ialongo said.

The founders intend to use the new funding to build out their operational team, product and integration with hospitals. They are already working with 100 hospitals and secured a partnership with Narayana Hospital to deliver more than 2,000 COVID vaccinations so far, and more in a second round.

“It is going to take a while to scale,” Banerjee said. “For us, in theory, as we get better pricing, we will end up being cheaper than others. We have goals to cover the people the government cannot and find ways to reduce the statistics.”

 

#allessandro-ialongo, #even, #founders-fund, #funding, #health, #health-insurance, #hospitals, #india, #kaiser-permanente, #khosla-ventures, #lachy-groom, #matilde-giglio, #mayank-banerjee, #recent-funding, #startups, #tc, #venture-capital

Opioid addiction treatment apps found sharing sensitive data with third parties

Several widely used opioid treatment recovery apps are accessing and sharing sensitive user data with third parties, a new investigation has found.

As a result of the COVID-19 pandemic and efforts to reduce transmission in the U.S, telehealth services and apps offering opioid addiction treatment have surged in popularity. This rise of app-based services comes as addiction treatment facilities face budget cuts and closures, which has seen both investor and government interest turn to telehealth as a tool to combat the growing addiction crisis.

While people accessing these services may have a reasonable expectation of privacy of their healthcare data, a new report from ExpressVPN’s Digital Security Lab, compiled in conjunction with the Opioid Policy Institute and the Defensive Lab Agency, found that some of these apps collect and share sensitive information with third parties, raising questions about their privacy and security practices.

The report studied 10 opioid treatment apps available on Android: Bicycle Health, Boulder Care, Confidant Health. DynamiCare Health, Kaden Health, Loosid, Pear Reset-O, PursueCare, Sober Grid, and Workit Health. These apps have been installed at least 180,000 times, and have received more than $300 million in funding from investment groups and the federal government.

Despite the vast reach and sensitive nature of these services, the research found that the majority of the apps accessed unique identifiers about the user’s device and, in some cases, shared that data with third parties.

Of the 10 apps studied, seven access the Android Advertising ID (AAID), a user-generated identifier that can be linked to other information to provide insights into identifiable individuals. Five of the apps also access the devices’ phone number; three access the device’s unique IMEI and IMSI numbers, which can also be used to uniquely identify a person’s device; and two access a users’ list of installed apps, which the researchers say can be used to build a “fingerprint” of a user to track their activities.

Many of the apps examined are also obtaining location information in some form, which when correlated with these unique identifiers, strengthens the capability for surveilling an individual person, as well as their daily habits, behaviors, and who they interact with. One of the methods the apps are doing this is through Bluetooth; seven of the apps request permission to make Bluetooth connections, which the researchers say is particularly worrying due to the fact this can be used to track users in real-world locations.

“Bluetooth can do what I call proximity tracking, so if you’re in the grocery store, it knows how long you’re in a certain aisle, or how close you are to someone else,” Sean O’Brien, principal researcher at ExpressVPN’s Digital Security Lab who led the investigation, told TechCrunch. “Bluetooth is an area that I’m pretty concerned about.”

Another major area of concern is the use of tracker SDKs in these apps, which O’Brien previously warned about in a recent investigation that revealed that hundreds of Android apps were sending granular user location data to X-Mode, a data broker known to sell location data to U.S. military contractors, and now banned from both Apple and Google’s app stores. SDKs, or software development kits, are bundles of code that are included with apps to make them work properly, such as collecting location data. Often, SDKs are provided for free in exchange for sending back the data that the apps collect.

“Confidentiality continues to be one of the major concerns that people cite for not entering treatment… existing privacy laws are totally not up to speed.” Jacqueline Seitz, Legal Action Center

While the researchers keen to point out that it does not categorize all usage of trackers as malicious, particularly as many developers may not even be aware of their existence within their apps, they discovered a high prevalence of tracker SDKs in seven out of the 10 apps that revealed potential data-sharing activity. Some SDKs are designed specifically to collect and aggregate user data; this is true even where the SDK’s core functionality is concerned.

But the researchers explain that an app, which provides navigation to a recovery center, for example, may also be tracking a user’s movements throughout the day and sending that data back to the app’s developers and third parties.

In the case of Kaden Health, Stripe — which is used for payment services within the app — can read the list of installed apps on a user’s phone, their location, phone number, and carrier name, as well as their AAID, IP address, IMEI, IMSI, and SIM serial number.

“An entity as large as Stripe having an app share that information directly is pretty alarming. It’s worrisome to me because I know that information could be very useful for law enforcement,” O’Brien tells TechCrunch. “I also worry that people having information about who has been in treatment will eventually make its way into decisions about health insurance and people getting jobs.”

The data-sharing practices of these apps are likely a consequence of these services being developed in an environment of unclear U.S. federal guidance regarding the handling and disclosure of patient information, the researchers say, though O’Brien tells TechCrunch that the actions could be in breach of 42 CFR Part 2, a law that outlines strong controls over disclosure of patient information related to treatment for addiction.

Jacqueline Seitz, a senior staff attorney for health privacy at Legal Action Center, however, said this 40-year-old law hasn’t yet been updated to recognize apps.

“Confidentiality continues to be one of the major concerns that people cite for not entering treatment,” Seitz told TechCrunch. “While 42 CFR Part 2 recognizes the very sensitive nature of substance use disorder treatment, it doesn’t mention apps at all. Existing privacy laws are totally not up to speed.

“It would be great to see some leadership from the tech community to establish some basic standards and recognize that they’re collecting super-sensitive information so that patients aren’t left in the middle of a health crisis trying to navigate privacy policies,” said Seitz.

Another likely reason for these practices is a lack of security and data privacy staff, according to Jonathan Stoltman, director at Opioid Policy Institute, which contributed to the research. “If you look at a hospital’s website, you’ll see a chief information officer, a chief privacy officer, or a chief security officer that’s in charge of physical security and data security,” he tells TechCrunch. “None of these startups have that.”

“There’s no way you’re thinking about privacy if you’re collecting the AAID, and almost all of these apps are doing that from the get-go,” Stoltman added.

Google is aware of ExpressVPN’s findings but has yet to comment. However, the report has been released as the tech giant prepares to start limiting developer access to the Android Advertising ID, mirroring Apple’s recent efforts to enable users to opt out of ad tracking.

While ExpressVPN is keen to make patients aware that these apps may violate expectations of privacy, it also stresses the central role that addiction treatment and recovery apps may play in the lives of those with opioid addiction. It recommends that if you or a family member used one of these services and find the disclosure of this data to be problematic, contact the Office of Civil Rights through Health and Human Services to file a formal complaint.

“The bottom line is this is a general problem with the app economy, and we’re watching telehealth become part of that, so we need to be very careful and cautious,” said O’Brien. “There needs to be disclosure, users need to be aware, and they need to demand better.”

Recovery from addiction is possible. For help, please call the free and confidential treatment referral hotline (1-800-662-HELP) or visit findtreatment.gov.

Read more:

#android, #app-developers, #app-store, #apple, #apps, #artificial-intelligence, #bluetooth, #broker, #computing, #director, #federal-government, #google, #google-play, #governor, #health, #health-insurance, #healthcare-data, #imessage, #law-enforcement, #mobile-app, #operating-systems, #privacy, #read, #security, #software, #stripe, #terms-of-service, #united-states

Meet Super.mx, the Mexico City-based insurtech that raised $7.2M from VCs and unicorn CEOs

Super.mx, an insurtech startup based in Mexico City, has raised $7.2 million in a Series A round led by ALLVP.

Co-founded in 2019 by a trio of former insurance industry executives, Super.mx’s self-proclaimed mission is to design insurance for “the emerging Latin American middle class,” according to CEO Sebastian Villarreal.

“That means insurance that is easy to buy – it can be bought on a cell phone in minutes – and that pays quickly with no adjusters,” he said. The company has built its offering with proprietary models that are used both on the underwriting side to predict risk and on the claims side to make payments automatically. 

Goodwater Capital, Kairos Angels and Bridge Partners also participated in the Series A round in addition to angels such as Joe Schmidt IV, vice president of business development at insurtech Ethos and former investor at Accel and Kyle Nakatsuji, founder and CEO of auto insurance startup Clearcover (and also a former VC). Better Tomorrow Ventures led Super.mx’s $2.4 million seed round, which also saw capital from 500 Startups Mexico, Village Global, Anthemis and Broadhaven Ventures, among others.

Unlike most insurtech startups in Latin America, Villarreal emphasizes that Super.mx is neither an aggregator nor a carrier. Instead, it’s an MGA, or managing general agent.

“This lets us have a ‘best of both worlds’ approach,” Villarreal said. “We handle the entire user experience just like a direct to consumer carrier, but with the breadth of product choice offered by an aggregator.”

That product choice includes property, natural disasters and life insurance. The company soon plans to expand to also offer health insurance. 

The founding team brings a variety of insurance experience to the table. Villarreal previously co-founded Chicago-based Kin Insurance (which raised over $150 million in funding from the likes of Flourish Ventures, Commerce Ventures and QED Investors). He was also once head of auto product at Avant, a growth-stage company funded by General Atlantic and Tiger Global, among others.

With over two decades of insurance industry experience, Dario Luna once served as Mexico’s insurance regulator and helped develop Mexico’s disaster risk management strategy. Marco Ahedo has designed parametric insurance products for 19 Caribbean countries. He was also once a solvency expert for life and health insurance lines at MetLife, and has developed financial models for several P&C carriers.

Villarreal lived in the U.S. for a while before deciding to move back to Mexico, which he recognized was home to an “underinsurance problem.”

“That’s actually a very acute problem,” he said. “People in Latin America buy a lot less insurance than they do in the U.S., and people in Mexico, in particular, buy a lot less insurance than they do in other Latin countries.”

Some have blamed the lack of insurance coverage on the country’s culture but Super.mx operates under the belief that this notion is “total BS.”

“It’s not a cultural problem,” Villarreal said. “The problem is that the insurance products that exist in the market just suck. They’re super expensive. They’re really hard to buy, and they pay very little.”

Image Credits: Super.mx

So far, Super.mx has sold “thousands of policies” but is more focused now on increasing the number of products that it’s selling. The company started out by selling earthquake insurance before adding COVID insurance, and more recently, in April, it launched life insurance. Next, it’s going to offer property, renter’s and health insurance.

“It’s really a different strategy than what you would find in the U.S.,” Villarreal said. “In the U.S, when you look at insurtechs, it’s like everyone just does one thing, but here, it’s very different because when someone says ‘I want insurance,’ really what they’re saying is ‘Hey, something happened that makes me nervous that didn’t make me nervous before.’”

That something could be a new child, for example, that prompts a need for life insurance.

“What we’re trying to do is like Lemonade, Roots and Hippo or Kin all rolled into one,” he added. It’s a big, big play.”

Digital adoption in Mexico, and Latin America in general, has increased exponentially in recent years. The bigger hurdle for Super.mx, according to Villarreal, has less to do with technology and more to do with Mexicans getting over what he describes a “deep mistrust” based on bad experiences in the past.

“People are really distrustful and that’s a huge hurdle, but once you show them that you actually are different,” Villarreal told TechCrunch, “that you actually do things in a different way, you get this incredible emotional response.”

Eventually, Super.mx plans to outside of Mexico to other countries in Latin America.

ALLVP’s Federico Antoni said his Mexico City-based firm had been looking for a team building in this space “for years” before investing in Super.mx. The venture firm was impressed with the company’s technical knowledge and industry expertise. It was also drawn to their multi-product approach and “capacity to ship highly complex products to the market quickly” — both of which he believes are “unique” in the region.

Citing statistics from MAPFRE Economics, Antoni pointed out that globally, the insurance market has been growing over the last 10 years. During that time, Latin America expanded faster on average (4.4% vs. 2.4% worldwide), albeit with more volatility. Life insurance has been driving this growth, at 6.1%, over the period. 

“Insurtech may be even bigger than fintech. Also, harder,” he told TechCrunch via email. “We knew the team to unlock the market potential would need to be highly competent and highly disruptive.”

Antoni said he is also convinced that Insurtech is the “next frontier” in financial inclusion in Latin America especially as digitization continues to increase.

“Providing risk coverage to individuals and businesses in the region, brings financial stability to families and unlocks economic potential for SMEs,” he said. “Moreover, the insurance incumbents have been unable to address a growing and underserved market.”

 

#anthemis, #clearcover, #federico-antoni, #funding, #fundings-exits, #health-insurance, #insurance, #latin-america, #life-insurance, #mexico, #mexico-city, #recent-funding, #startups, #super-mx, #venture-capital, #village-global

If you pay an emotional labor fee, Postdates will get your stuff from your ex

Yesterday, the team behind the parody Amazon Dating delivered us Postdates. It’s like Postmates, but for getting your stuff back from your ex.

Postdates looks like the actual Postmates website – you can select a type of relationship (“casually dated,” “lived together,” “one night stand,” etc.) like it’s a type of restaurant. Then, you can choose from preset items to retrieve (concert tickets if you were friendzoned, family heirlooms if you were divorced) or add a custom item. Delivery starts at $25 in LA and $30 in NY, along with an additional emotional labor fee of $3.99. Yes, you can actually use this service if you’re in one of these two cities, but Postdates isn’t here to stay — it’s a pop-up business. Or, as Postdates “founder” Ani Acopian puts it, “It’s kind of like watching a ‘Black Mirror’ episode, but it’s your real life.”

You might remember Elon Musk’s failed comedy start-up/”intergalactic media empire” Thud, which aimed to create immersive digital experiences that blurred the lines between what’s real and fake. Or, you might not remember Thud, since it failed spectacularly and wasn’t very funny. Postdates struck the satire gold that Elon Musk dreamed of with Thud, only they did it without $2 million dollars in funding from one of the richest men in the world.

TechCrunch talked to conceptual artist Ani Acopian, producer Suzy Shinn, and product developer Brian Wagner to get the low-down on just how legit Postdates is.

TechCrunch: Why Postdates? How did the idea come about?

Suzy Shinn: At the start of quarantine when everything was falling apart, Ani and I made ScrubHub, like PornHub for hand washing. We raised $50,000 for charity.

Ani Acopian: I think we had this creative juice inside of us that we wanted to find an outlet for.

SS: Then, we had the Postdates idea, and we actually tried to get investors and artists to fund it, because we were like… This is going to cost something, we want to make it real and actually function. No one wanted anything to do with it, because they were like, “What’s the return?”

AA: And we were like, “Well, the return is that it’s a vibe.”

SS: No one wanted anything to do with us funding-wise, so we built it ourselves.

TC: So, you can actually use this?

AA: Yeah, we partnered with two local courier companies, Gourmet Runner in LA and Airpals in New York. We wanted to make sure we work with people that treat their workers right.

SS: You can put in a request, and the ex has to consent obviously and be like, “Yeah, I have this stuff for you, I’ll put it outside,” and our couriers have Postdates bags that we give to them. But legitimately, you can use it in both of those cities as long as you’re not sending a cat, or a child, or alcohol, or drugs, or something that won’t fit in a bag.

AA: We spent a lot of time on the workflow to make sure no addresses are shared, that everyone’s consenting to be involved, and we’re trying to keep it no-contact, so we’re asking people to put stuff on their door handle. You’re not charged until your ex accepts the order.

TC: You just launched yesterday, but have people actually been using the service so far?

Brian Wagner: We had some people who would post a screenshot in response to Ani’s tweet and be like, “Oh snap, I actually got Postdated by my ex!”

SS: There’s about 30 to 40 pending requests, and we’ve gotten a handful that just as of this morning have been delivered successfully.

TC: Do you think this could be a viable business?

AA: Not everything needs to be a viable business. I would actually be… not surprised, but upset if this actually became a thing, because I don’t think the world needs that level of stuff, but I think we’re pretty much already there. All you can do is hold the mirror up.

TC: As satire, what are you trying to say with Postdates?

SS: I think in the tech world, it seems like all of these tech startups get crazy amounts of funding, and they spend so much money, and they take themselves so seriously. The three of us, with the help of our friends, were able to do this, and we didn’t need $13 million in funding or five years. But we were staying up until like 5 AM, and we were like, “Can we hire someone to help us?” but we were like, “No, we can’t pay.”

BW: Especially with the rise of the gig economy, we’ve seen some positives and some pretty serious negatives, especially during quarantine. It helps people get the things that they need, but also, a lot of workers aren’t being paid fairly and don’t have health insurance. So there’s a sentiment a lot more often now that a lot of tech is redistributing labor, and you’re just paying for people to be moved around. So in a way, we’re sort of like… We’ve redistributed emotional labor here.

TC: There’s an emotional labor tax on the site, yeah.

BW: There’s a bit of poking fun of that, saying how far will we go in terms of actually moving labor along for money. Will people pay for someone else to deal with the emotional handling of a situation?

TC: How did Postdates build upon Amazon Dating?

AA: We’ve made two parody sites now, and we wanted to take that to the next level and make it experiential. It’s kind of like watching a Black Mirror episode, but it’s your real life.

SS: What is the literal price you will pay not to see someone? This is a real thing that happens all the time — my friends will be like, “I broke up with my girlfriend, I need you to go get my stuff,” and I’m like, “I don’t want to go get your stuff.”

AA: I don’t think we should outsource it, though.

TC: So you don’t think we should outsource it, but also, you made Postdates.

AA: I think that’s the whole…

TC: That’s the joke.

AA: Yeah.

TC: What does it say about startup culture to make a product that you don’t think should exist?

SS: Startups are so, so serious, there’s no humor in it, and they think it’s going to last forever. Well, we’re doing the opposite.  We’re going to make this last a couple of weeks for a limited time only, and then we’re gonna take it away. But we would love to keep doing these, making something where art meets tech meets entertainment.

BW: Companies and experiences can just be fun. They don’t have to be a billion dollar idea, they don’t have to be something that’s going to go on Shark Tank. Imagine us entering Shark Tank…

#amazon, #ani-acopian, #apps, #elon-musk, #films, #health-insurance, #new-york, #postmates, #producer

Health care CEOs raked in $3.2 billion as pandemic raged

Health care CEOs raked in $3.2 billion as pandemic raged

Enlarge (credit: Getty Images | Jonathan Kitchen)

As the COVID-19 pandemic ravaged the country last year, the chief executive officers of 178 US healthcare companies saw their already lofty pay soar to even higher heights.

Collectively, the 178 CEOs took home $3.2 billion in 2020, according to a new analysis by Axios. Their median pay rose to $9 million, up from about $7.7 million in 2018 and $8 million in 2019. The 2019 US median household income was $68,703, according to the US Census Bureau. The Department of Housing and Urban Development estimates that the 2020 national median income for families was $78,500.

Thirty health care CEOs made over $30 million each. That list includes the CEOs of Regeneron ($174 million), Eli Lilly ($68 million), Teladoc ($45 million), UnitedHealth Group ($42 million), and Quest Diagnostics ($34 million).

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#ceo, #compensation, #covid-19, #for-profit, #health-insurance, #healthcare, #hospitals, #policy, #science

Biggest health insurer plans to deny ER bills if it doubts you had an emergency

Multistory glass-and-brick building with UnitedHealthcare logo on exterior.

Enlarge / UnitedHealth Group Inc. headquarters stands in Minnetonka, Minnesota, U.S., on Wednesday, March 9, 2016. (credit: Getty | Bloomberg)

Doctors and hospitals are condemning plans by UnitedHealthcare—the country’s largest health insurance company—to retroactively deny emergency medical care coverage to members if UHC decides the reason for the emergency medical care wasn’t actually an emergency.

In the future, if one of UHC’s 70 million members submits a claim for an emergency department visit, UHC will carefully review what health problems led to the visit, the “intensity of diagnostic services performed” at the emergency department (ED), and some context for the visit, like the member’s underlying health conditions and outside circumstances. If UHC decides the medical situation didn’t constitute an emergency, it will provide “no coverage or limited coverage,” depending on the member’s specific insurance plan.

Emergency medical doctors and hospitals were quick to rebuke the plan. They say it sets a dangerous precedent of requiring patients to assess their own medical problems before seeking emergency care, which could end up delaying or preventing critical and even life-saving treatment.

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#acep, #american-hospital-association, #emergency-medical-care, #health-insurance, #hospitals, #policy, #science, #unitedhealthcare

Substack acquires team from community consulting startup People & Company

New media poster child Substack announced today that they’ve added a small community-building consultancy team to its ranks, acquiring the Brooklyn-based startup People & Company.

The small firm has been working with clients to build up their community efforts and its team will now be tasked with building up some of the newsletter company’s upstart efforts for writers in its network.

In a blog post, Substack co-founder Hamish McKenzie said that the company had previously used the People & Co. team to consult on their fellowship and mentorship programs and that members of the team would now be working on a variety of new efforts from scaling programs to help writers with legal support and health insurance to community-guided projects like workshops and meetups to help crowdsource insights.

“These people are the best in the world at what they do, and now they’re not only working for Substack, but they’re also working for you,” McKenzie wrote.

Beyond Substack, previous partners with People & Company include Porsche AG, Nike and Surfrider.

Substack has been blazing ahead in recent months, adding new partners and raising cash as it aims to bring on more and more subscribers to its network. The firm shared back in late March that it had raised a $65 million round at a reported valuation around $650 million according earlier reporting by Axios.

#axios, #brooklyn, #co-founder, #crowdsource, #digital-media, #hamish-mckenzie, #health-insurance, #nike, #porsche-ag, #substack, #tc, #websites, #world-wide-web

Risk startup LogicGate confirms data breach

Risk and compliance startup LogicGate has confirmed a data breach. But unless you’re a customer, you probably didn’t hear about it.

An email sent by LogicGate to customers earlier this month said on February 23 an unauthorized third-party obtained credentials to its Amazon Web Services-hosted cloud storage servers storing customer backup files for its flagship platform Risk Cloud, which helps companies to identify and manage their risk and compliance with data protection and security standards. LogicGate says its Risk Cloud can also help find security vulnerabilities before they are exploited by malicious hackers.

The credentials “appear to have been used by an unauthorized third party to decrypt particular files stored in AWS S3 buckets in the LogicGate Risk Cloud backup environment,” the email read.

“Only data uploaded to your Risk Cloud environment on or prior to February 23, 2021, would have been included in that backup file. Further, to the extent you have stored attachments in the Risk Cloud, we did not identify decrypt events associated with such attachments,” it added.

LogicGate did not say how the AWS credentials were compromised. An email update sent by LogicGate last Friday said the company anticipates finding the root cause of the incident by this week.

But LogicGate has not made any public statement about the breach. It’s also not clear if the company contacted all of its customers or only those whose data was accessed. LogicGate counts Capco, SoFi, and Blue Cross Blue Shield of Kansas City as customers.

We sent a list of questions, including how many customers were affected and if the company has alerted U.S. state authorities as required by state data breach notification laws. When reached, LogicGate chief executive Matt Kunkel confirmed the breach but declined to comment citing an ongoing investigation. “We believe it’s best to communicate developments directly to our customers,” he said.

Kunkel would not say, when asked, if the attacker also exfiltrated the decrypted customer data from its servers.

Data breach notification laws vary by state, but companies that fail to report security incidents can face heavy fines. Under Europe’s GDPR rules, companies can face fines of up to 4% of their annual turnover for violations.

In December, LogicGate secured $8.75 million in fresh funding, totaling more than $40 million since it launched in 2015.


Are you a LogicGate customer? Send tips securely over Signal and WhatsApp to +1 646-755-8849. You can also send files or documents using our SecureDrop. Learn more

#amazon, #amazon-web-services, #blue-cross-blue-shield, #capco, #cloud, #cloud-computing, #cloud-storage, #computer-security, #computing, #data-breach, #data-security, #europe, #health-insurance, #securedrop, #security, #security-breaches, #sofi, #united-states

As working out goes virtual, Moxie raises $6.3M Seed+ round led by Resolute Ventures

With the pandemic sending the planet indoors to workout, the at-home fitness market has boomed. It was only in October last year that three-year-old Future closed $24 million in Series B and Playbook (streaming for personal trainers) raised $9.3 million in a Series A. Into this market launched Moxie, a platform that allowed fitness instructors to broadcast live and recorded classes, access licensed music playlists and deploy a CRM and payment tools. Classes range from $5-$25 and various subscriptions and packages are offered.

Moxie has now raised a $6.3M ‘Seed+’ funding round led by Resolute Ventures with participation from Bessemer Ventures, Greycroft Ventures, Gokul Rajaram, and additional investors. With the $2.1M Seed round from last October, that means Moxie has now raised a total of $8.4M.

With the funding, Moxie now plans to better optimize the user experience with a curated selection of top Moxie classes; new tools that help connect users to instructors; and the ability to preview classes before attending.

The company claims to have experienced “exponential growth” because of its convenience in the pandemic era, with 8,000 classes and 1 million class-minutes completed in March. Moxie’s independent instructors set their own schedules and prices, and get to keep 85% of what they earn on the platform.

The company will also now launch ‘Moxie Benefits’ in partnership with Stride Health, provide instructors with access to health insurance, dental and vision plans, life insurance, and other benefits.

Also planned is ‘Moxie Teams’, enabling groups of instructors to join together to form small businesses on the platform, not unlike the way some Uber drivers form teams.

Jason Goldberg, CEO and founder said in a statement: “Moxie was born during the pandemic alongside thousands of independent fitness instructors who were forced out of gyms and studios and suddenly had to become entrepreneurs and navigate the new frontier of virtual fitness. Now we are seeing widespread adoption of online fitness into people’s lives, and Moxie’s growth proves that these shifts in consumer behavior have staying power. We know that 89% of Moxie users plan to continue virtual workouts post COVID — they love the convenience.”

Resolute Ventures Partner & Co-Founder Raanan Bar-Cohen said: “Our investment theory has always been to identify entrepreneurial founders solving for today’s problems. With Moxie, we saw an experienced operator in Jason, with a product that solved for the issues that instructors and consumers had experienced in the shift to online fitness, as well as a clear roadmap for continued success.”

So why has Moxie managed to cleave to the new virtual workout culture? Goldberg tells me it’s down to a range of factors.

For starters, it’s a two-sided fitness marketplace that has live interactive group fitness classes, unlike VOD apps, and, crucially, unlike Peloton. Additionally, any instructor can teach on Moxie, rather than wait to be picked as a ‘star’ by Peloton. Since 90% of classes are live group fitness classes, they are effectively replacing yoga studios and HIIT classes, rather than personal training. He says many top instructors are now earning $6-figures on the platform.

Certainly, Moxie has managed to capitalize on the fact that while gyms are closed, it’s easy to do virtual classes. Will they still stick around when the pandemic is over? Presumably many will find it more convenient than schlepping to the gym and less intimidating than joining classes in person. Additionally, users can switch classes as easily as switching TV channels.

As Goldberg told me via email: “Covid forced everyone to try virtual fitness for the first time. Guess what? People found it more convenient and more connected than going to offline gyms. And guess what? Peloton is not for everyone.”

#3m, #bessemer-ventures, #ceo, #co-founder, #companies, #crm, #drinks, #education, #future, #gokul-rajaram, #health-insurance, #jason-goldberg, #life-insurance, #moxie, #online-fitness, #peloton, #playbook, #resolute-ventures, #tc, #uber

Ro raises $500M to grow its remote and in-home primary care platform

Healthcare tech startup Ro has raised $500 million to help fuel continued growth of its hybrid telehealth/in-home primary care platform, which also includes a growing pharmacy business as the company pursues a strategy of vertical integration to optimize delivery and reduce costs for clients. The company’s latest raise is a Series D round, and means it has now raised over $876 million since its 2017 founding.

That may seem like a lot of money, but as Ro fo-founder and CEO Zachariah Reitano told me in an interview, it’s actually “peanuts” when it comes to the healthcare industry – which is part of why they founded the company in the first place.

“Sometimes people talk about how great it is to be in the healthcare arena, in tech circles,” Reitano said. “They say, ‘Oh, healthcare is a $4 trillion market – it’s so massive.’  But that’s the worst thing in the entire world; it’s awful how large it is. And I think what we have the opportunity to cut it in half with technology.”

That’s what Reitano says will be the primary focus of this round of funding: Fueling its efforts around vertical integration of healthcare services and technology, to further the eventual end goal of reducing costs to patients through the efficiencies realized in that process.

“To me, what I’m really excited about is being able to continue to invest in that infrastructure and add even more,” Reitano told me. “We’ll continue to invest in telemedicine, we’ll continue to invest in our logistics and pharmacy, and continue to invest in in-home care, as well as the connection between the three, and then we’ll also invest in additional diagnostics, remote patient monitoring – so collecting and distributing devices to patients to go from reactive to proactive care.”

Ro’s model focuses on primary care delivered direct to consumer, without involving any payer or employer-funded and guided care programs. The idea is to reduce costs through vertical integration and other efficiency engineering efforts in order to get them to the point where they’re effectively on par with your out-of-pocket expense with co-pays anyway. Reitano explained that the insurance system as it exists in the U.S. now only effectively masks individual costs, making it less clear that much of what a person pays out in healthcare costs comes out of their pocket anyway, whether it’s through taxation, or employers allocating more of the funds they have available for compensation to healthcare, vs. take-home pay.

Image Credits: Ro

That’s what’s behind Ro’s recent push into operating its own pharmacies, and growing that footprint to include more all the time. Reitano told me that the company will have 10 pharmacies by the end o this year, and 15 by the end of next, all placed strategically around the country to ensure that it can provide next-day shipping to patients at ground shipping rates pretty much anywhere in the U.S.

Doing that kind of vertical optimization has enabled Ro to offer 500 common drugs at $5 per month, including treatments for heart disease, anxiety, depression and diabetes — with a plan to ramp it to 1,000 drugs available at that price by year’s end. That’s roughly equal to the co-pay required for many insurers for the same treatments.

Meanwhile, Reitano says Ro has seen big changes in the healthcare system generally that favor its model and accelerate its hybrid care plans owing to the COVID-19 pandemic.

“I would say that there are two most profound impacts of the pandemic on the healthcare system,” he said. “One is that it simultaneously shed light on all of the inequities for the entire country to see, right at the same time where we all cared about it. So those things were sort of known for the people impacted day to day — the geographic inequity, the financial inequity, the racial inequity. If someone felt that that inequity, then they would talk about it, but it wasn’t something everyone cared about at the same time. So this massive spotlight was shed on the healthcare system. And the second was that everyone’s healthcare journey now starts online, even if it is going to end in person, it will still start online.”

Ro’s model all along has espoused this time of healthcare delivery, with remote care and telehealth appointments handling most day-to-day needs, and follow-up in person care delivered to the home when required. That obviously generate a lot of efficiencies, while ensuring that older patients and those with mobility issues also don’t need to leave the house and make a regular trip into their physician’s office for what amounts to a 15-minute visit that could’ve been handled over video.

Ro co-founders Rob Schutz, Zachariah Reitano and Saman Rahmanian (left to right)

Ro co-founders Rob Schutz, Zachariah Reitano and Saman Rahmanian (left to right)

According to most industry observers, Reitano is likely right that healthcare probably won’t go back to the old, inefficient model of favoring primarily in-person care after the pandemic ends. One of the positive outcomes of the COVID-19 situation has been proving that telehealth is more than capable of handling a lot of the primary care needs of a lot of people, particularly when supplemented with remote monitoring and ongoing proactive health measures, too.

While Ro doesn’t work with insurance currently, Reitano points out that he’s not against the concept entirely – he just says that health insurance as it exists now doesn’t actual work as intended, since it’s meant to pool risk against an, expensive, uncertain and rare outcome. Eventually, he believes there’s a place for insurance in the overall healthcare mix, but first the industry needs to face a reckoning wherein its incentive structure is realigned to its actual core customer – patients themselves.

#articles, #ceo, #depression, #diabetes, #funding, #health, #health-insurance, #healthcare, #healthcare-industry, #pharmacy, #physician, #ro, #tc, #technology, #telehealth, #telemedicine, #united-states

Oscar Health’s IPO filing will test the venture-backed insurance model

Late Friday, Oscar Health filed to go public, adding another company to today’s burgeoning IPO market. The New York-based health insurance unicorn has raised well north of $1 billion during its life, making its public debut a critical event for a host of investors.

Oscar Health lists a placeholder raise value of $100 million in its IPO filing, providing only directional guidance that its public offering will raise nine figures of capital.

Both Oscar and the high-profile SPAC for Clover Medical will prove to be a test for the venture capital industry’s faith in their ability to disrupt traditional healthcare companies.

The eight-year-old company, launched to capitalize on the sweeping health insurance reforms passed under the administration of President Barack Obama offers insurance products to individuals, families and small businesses. The company claimed 529,000 “members” as of January 31, 2021. Oscar Health touts that number as indicative of its success, with its growth since January 31 2017 “representing a compound annual growth rate, or CAGR, of 59%.”

However, while Oscar has shown a strong ability to raise private funds and scale the revenues of its neoinsurance business, like many insurance-focused startups that TechCrunch has covered in recent years, it’s a deeply unprofitable enterprise.

Inside Oscar Health

To understand Oscar Health we have to dig a bit into insurance terminology, but it’ll be as painless as we can manage. So, how did the company perform in 2020? Here are its 2020 metrics, and their 2019 comps:

  • Total premiums earned: $1.67 billion (+61% from $1.04 billion).
  • Premiums ceded to reinsurers: $1.22 billion (+113%, from $572.3 million).
  • Net premium earned: $455 million (-3% from $468.9 million).
  • Total revenue: $462.8 million (-5% from $488.2 million).
  • Total insurance costs: $525.9 million (-8.7% from $576.1 million).
  • Total operating expenses: $865.1 million (+16% from $747.6 million).
  • Operating loss: $402.3 million (+56% from $259.4 million).

Let’s walk through the numbers together. Oscar Health did a great job raising its total premium volume in 2020, or, in simpler terms, it sold way more insurance last year than it did in 2019. But it also ceded a lot more premium to reinsurance companies in 2020 than it did in 2019. So what? Ceding premiums is contra-revenue, but can serve to boost overall insurance margins.

As we can see in the net premium earned line, Oscar’s totals fell in 2020 compared to 2019 thanks to greatly expanded premium ceding. Indeed, its total revenue fell in 2020 compared to 2019 thanks to that effort. But the premium ceding seems to be working for the company, as its total insurance costs (our addition of its claims line item and “other insurance costs” category) fell from 2020 to 2019, despite selling far more insurance last year.

Sadly, all that work did not mean that the company’s total operating expenses fell. They did not, rising 16% or so in 2020 compared to 2019. And as we all know, more operating costs and fewer revenues mean that operating losses rose, and they did.

Oscar Health’s net losses track closely to its operating losses, so we spared you more data. Now to better understand the basic economics of Oscar Health’s insurance business, let’s get our hands dirty.

#ec-consumer-health, #fundings-exits, #health-insurance, #insurance, #oscar-health, #startups, #tc

LA-based Sidecar Health’s low-cost, cash-pay health insurance service is now valued at $1 billion

Meet Sidecar Health, the newest member of the tech industry’s billion dollar healthcare startup club.

The valuation comes thanks to $125 million in new funding that the company will use to expand its new model for health insurance. Sidecar Health’s insurance plans give consumers the ability to pay directly for care — often at steep discounts to the prices that patients would be charged through traditional insurance plans.

A typical Sidecar Health plan costs $240 per-member, per-month and its flexibility has made it a popular choice for the nation’s 20 million to 30 million uninsured individuals, according to chief executive officer Patrick Quigley.

The core of Sidecar’s plan is an ability to offer its policy holders the ability to pay directly for their medical care — and shop around to find the best provider using pricing information that the company provides through its mobile app.

Sidecar’s app provides real-time, geo-located information on the costs of any number of medical procedures, consultations, or drugs — and allows its users to shop at the places that offer them the best deal — in some cases the company will even pay money back if a price-savvy healthcare shopper finds a better deal.

If this all sounds kind of dystopian and nightmarish — well, welcome to the world of American healthcare!

In an ideal world, low-cost medical care would be a right, not a privilege and a baseline level of healthcare access would be available to everyone — including an ability to pay a set price for drugs, consultations and treatment. But if you live in America, bargain hunting for care may be the best bet to curb skyrocketing healthcare costs — at least for now.

While Sidecar pitches its service for everyone, the average age of the company’s current patient population is 33 years-old, Quigley said.  “It’s typically people that earn more than $45,000 a year and less than $75,000,” said Quigley of the company’s demographics.

The way it works is that Sidecar issues its insured members what’s basically a debit card that they use to pay for care, prescriptions, and consultations directly. The money comes from Sidecar’s claims accounts and is paid directly to doctors. By avoiding the middleman (traditional insurance companies), Sidecar can reduce overhead for care providers who like to get paid directly and will offer discounts in exchange for receiving cash in hand.

“It is 40% cheaper than the traditional commercial insurance companies would pay,” said Quigley.

Sidecar covers around 170,000 medical conditions and procedures, according to Quigley — including things from horse therapy (it’s a thing) for anxiety relief to heart transplants and chemotherapy, Quigley said.

Sidecar is currently available in 16 states and hopes to expand to most of the country on the back of its latest round of funding.

And while the company is working with uninsured patient populations now, it’s hoping to also expand its footprint with government-backed healthcare plans and into employer-sponsored health insurance as well.

It’s still early days for the service, which has only been around through two open enrollment periods for would-be plan members to sign up. And while the company doesn’t disclose its membership figures, Quigley said it would end the year above 30,000 members.

“It’s still super early,” Quigley said. 

Despite the stage of the business, investors are convinced that the business model has an opportunity to transform health insurance in the US. 

“The extraordinary level of transparency Sidecar Health brings to the marketplace has the  potential to fundamentally change how millions of Americans shop for healthcare,” said Molly  Bonakdarpour, a partner at the Drive Capital, which provided early backing for the company. “We think Sidecar Health’s team of consumer,  technology and healthcare veterans is well positioned to capitalize on the large healthcare  insurtech opportunity.” 

For the latest round, Drive Capital was joined by new investors including BOND, Tiger Global and Menlo Ventures, according to a statement.

Sidecar Health will use the investment to expand its geographic footprint, grow its team and  invest in new insurance products that build on its success in the uninsured market. The first of  these will be an ACA or “Obamacare” offering for 2022, followed by a product for the self funded employer market. 

“We believe we can take $1 trillion in waste out of the U.S. healthcare system,” Quigley said. 

#affordable-care-act, #america, #articles, #chief-executive-officer, #drive-capital, #health, #health-insurance, #healthcare, #insurance, #menlo-ventures, #partner, #sidecar, #tc, #tiger-global, #united-states

Omnipresent raises $15.8M Series A for its platform to employ remote-workers globally

Omnipresent, which helps companies employ remote-working local teams worldwide, has closed a $15.8M Series A funding round. The fundraise was led by an undisclosed investor with participation from existing investors, Episode 1, Playfair Capital and Truesight Ventures. The company said it closed the round five months after it’s July 2020 $2m in seed round.

Founders Matthew Wilson and Guenther Eisinger started the company as part of Entrepreneur First’s London cohort in 2019.

Omnipresent says it ensures the process of remote-hiring costs a fraction of what it would if the company did it on their own, by using Omnipresent’s platform to onboard employees compliantly in 150 countries. It provides employees with local contracts, tax contributions, and local and international benefits such as health insurance, pensions and equity options. 

In a joint statement, Guenther Eisinger and Matthew Wilson, Co-CEOs of Omnipresent said: “Even before the pandemic we recognized the revolutionary potential of breaking down legal and administrative barriers of international employment. As former business owners, we had first-hand experience of what a headache it is to navigate the complexity and bureaucracy of building global teams. Now with the pandemic and the global shift towards remote working it’s confirmed that we are on the right track.”

Wilson told me in an interview: “For instance, in Canada, we have a Canadian entity and we enter into an employment relationship with that person in Canada, on behalf of our client, so they don’t have to set up any of the legal infrastructure themselves in Canada, or any of the 149 countries that we operate in. We then manage all the ongoing administration of the employment relationship, whether that’s from an HR perspective, from an employee benefits perspective, or if they want to get health care for instance.”

The company competes with other firms like Remote.com and Boundless HQ.

Carina Namih, General Partner at Episode 1 Ventures commented: “While talent is evenly distributed around the world, for too long, opportunities have not been. I have experienced first hand the challenge of hiring globally. Omnipresent has already become a crucial piece of infrastructure for global teams working across different countries.”

Joe Thornton, General Partner at Playfair Capital commented: “Remote work undoubtedly represents the future of the modern workforce. The sooner companies adapt, the sooner they will reap the massive competitive advantage associated with a globally distributed workforce, including increased workforce productivity and satisfaction and a larger and more diverse pool of talent from which to recruit workers.”

Omnipresent said its own employer surveys show that over 85% of employers will be employing remote or international employees in 2021.

#canada, #employment, #entrepreneur, #episode-1-ventures, #europe, #general-partner, #health-insurance, #london, #playfair-capital, #remote-com, #tc, #telecommuting, #truesight-ventures, #workforce

CoreCare raises $3 million for managing billing and payments from public health benefit providers

CoreCare, a provider of revenue management services for healthcare companies dealing with public health benefit providers, has raised $3 million in a seed financing round.

The company, which uses machine learning, automates large swaths of billing and revenue cycle management to reduce the burden on hospitals, according to chief executive, Dennis Antonelos.

Already, companies like Creative Solutions in Healthcare, a nursing facility operator in Texas, which operates nearly 80 locations has signed up for the service.

Antonelos started the company in January, had the first product up by March and was accepted to Y Combinator in April. It now boasts over a dozen customers in Texas.

With the new $3 million in hand from investors including Primetime Partners, Goat Capital, Funders Club and Liquid2Ventures, Antonelos said the company would look to expand its sales and marketing and product capabilities.

CoreCare automates processing of billing and paperwork and clinical notes by linking electronic health records and medicare and medicaid information services and payers.

“We’re going through the organization and eliminating administrative waste so the organization can invest newly found resources into patient care,” Antonelos said.

The company uses a standard software as a service payment model and charges somewhere between $300 to $500 per-facility, per-month, according to Antonelos.

“These initial results are outstanding,” said Gary Blake, president, and co-founder of Creative Solutions in Healthcare, and one of CoreCare’s early customers. “In only a matter of months working with CoreCare’s CoreAccess software, we’ve seen a notable impact on our financial position. It has truly exceeded our expectations. CoreCare has changed the way we work with Managed Care, from top to bottom. We have been able to streamline our entire billing process, reduce admin costs, shorten the number of accounts receivable (AR) days and free up cash for growth. Every healthcare provider that works with managed care should work with CoreCare.”

#articles, #goat-capital, #health, #health-insurance, #healthcare, #machine-learning, #medicare, #tc, #texas, #y-combinator

Twentyeight Health is a telemedicine company expanding access to women’s health and reproductive care

New York’s Twentyeight Health is taking the wildly telemedicine services for women’s health popularized by companies like Nurx and bringing them to a patient population that previously hadn’t had access. 

The mission to provide women who are Medicaid or underinsured should not be deprived of the same kinds of care that patients who have more income security or better healthcare coverage enjoy, according to the company’s founder, Amy Fan.

The mission, and the company’s technology, have managed to convince a slew of investors who have poured $5.1 million in seed funding into the new startup. Third Prime led the round, which included investments from Town Hall Ventures, SteelSky Ventures, Aglaé Ventures, GingerBread Capital, Rucker Park Capital, Predictive VC, and angel investors like Stu Libby, Zoe Barry, and Wan Li Zhu.

“Women who are on Medicaid, who are underinsured or without health insurance often struggle to find access to reproductive health services, and these struggles have only increased with COVID-19 pandemic limiting access to in-person appointments,” said Amy Fan, co-founder of Twentyeight Health, in a statement. “We are fighting for healthcare equity, ensuring that all women, particularly BIPOC women and women from low-income backgrounds, can access high quality, dignified and convenient care.”

To ensure that its catering to underserved communities, the company works with Bottomless Closet, a workforce entry program for women, and the 8 colleges in the City University of New York ecosystem including LaGuardia College, which has 45,000 students with 70% coming from families making less than $30,000 in annual income.

The company’s services are currently available across Florida, Maryland, New York, New Jersey, North Carolina and Pennsylvania and it’s the only telemedicine company focused on contraception services to accept Medicaid.

In another example of how awesome this company is, it’s also working to provide free birth control for women who aren’t able to pay out of pocket and are uninsured through a partnership with Bedsider’s Contraceptive Access Fund. The company also donates 2% of its revenue to Bedsider and the National Institute for Reproductive Health. (Y’all, this company is amaze.)

To sign up for the service, new customers fill out a medical questionnaire online. Once the questionnaire is reviewed by a US board-certified doctor within 24 hours customers can access over 100 FDA-approved brands of birth control pills, patches, rings, shots, and emergency contraception and receive a shipment within three days.

Twentyeight Health provides ongoing care through online audio consultations and doctor follow up messages to discuss issues around updating prescriptions or addressing side effects, the company said.

“Today, low-income women are three times more likely to have an unintended pregnancy than the average woman in the U.S., and nearly one-third of physicians nationwide aren’t accepting new Medicaid patients,” said Bruno Van Tuykom, co-founder of Twentyeight Health, in a statement. “This underscores why offering high-quality reproductive care that is inclusive of people across race, income bracket, or health insurance status is more important than ever.”

Launched in 2018, Twentyeight Health said it would use the new cash to continue to expand its services across the U.S.

 

#articles, #birth-control, #co-founder, #contraception, #fda, #florida, #health, #health-insurance, #health-services, #maryland, #medicaid, #new-jersey, #new-york, #north-carolina, #pennsylvania, #tc, #telehealth, #telemedicine, #town-hall-ventures, #united-states

Papa raises $18 million to expand its business connecting older adults with virtual and in-person companions

The Miami-based startup Papa has raised an additional $18 million as it looks to expand its business connecting elderly Americans and families with physical and virtual companions, which the company calls “pals.”

The company’s services are already available in 17 states and Papa is going to expand to another four states in the next few months, according to chief executive Andrew Parker.

Parker launched the business after reaching out on Facebook to find someone who could serve as a pal for his own grandfather in Florida.

After realizing that there was a need among elderly residents across the state for companionship and assistance that differed from the kind of in-person care that would typically be provided by a caregiver, Parker launched the service. The kinds of companionship Papa’s employees offer range from helping with everyday tasks — including transportation, light household chores, advising with health benefits and doctor’s appointments, and grocery delivery — to just conversation.

With the social isolation brought on by responses to the COVID-19 pandemic there are even more reasons for the company’s service, Parker said. Roughly half of adults consider themselves lonely, and social isolation increases the risk of death by 29%, according to statistics provided by the company.

“We created Papa with the singular goal of supporting older adults and their families throughout the aging journey,” said Parker, in a statement. “The COVID-19 pandemic has unfortunately only intensified circumstances leading to loneliness and isolation, and we’re honored to be able to offer solutions to help families during this difficult time.” 

Papa’s pals go through a stringent vetting process, according to Parker, and only about 8% of all applicants become pals.

These pals get paid an hourly rate of around $15 per hour and have the opportunity to receive bonuses and other incentives, and are now available for virtual and in-person sessions with the older adults they’re matched with.

“We have about 20,000 potential Papa pals apply a month,” said Parker. In the company’s early days it only accepted college students to work as pals, but now the company is accepting a broader range of potential employees, with assistants ranging from 18 to 45 years old. The average age, Parker said, is 29.

Papa monitors and manages all virtual interactions between the company’s employees and their charges, flagging issues that may be raised in discussions, like depression and potential problems getting access to food or medications. The monitoring is designed to ensure that meal plans, therapists or medication can be made available to the company’s charges, said Parker.

Now that there’s $18 million more in financing for the company to work with, thanks to new lead investor Comcast Ventures and other backers — including Canaan, Initialized Capital, Sound Ventures, Pivotal Ventures, the founders of Flatiron Health and their investment group Operator Partners, along with Behance founder, Scott Belsky — Papa is focused on developing new products and expanding the scope of its services.

The company has raised $31 million to date and expects to be operating in all 50 states by January 2021. The company’s companion services are available to members through health plans and as an employer benefit.

“Papa is enabling a growing number of older Americans to age at home, while reducing the cost of care for health plans and creating meaningful jobs for companion care professionals,” said Fatima Husain, principal at Comcast Ventures, in a statement. “

#comcast-ventures, #fatima-husain, #flatiron-health, #florida, #health-insurance, #initialized-capital, #investment, #miami, #operator-partners, #recent-funding, #scott-belsky, #sound-ventures, #startups, #tc, #video-on-demand

BIMA nabs $30M more for micro- health and life insurance aimed at emerging markets

The coronavirus global health pandemic — and the new emphasis on social distancing to slow down the spread of COVID-19 — has put healthcare and tech services used to enable healthcare remotely under the spotlight. Today a startup that’s building microinsurance and healthcare services specifically targeting emerging markets is announcing a round of funding to meet a surge in demand for its services.

BIMA, a startup that provides life and health insurance policies, along with telemedicine to support the latter, all via a mobile-first platform targeting consumers in emerging markets whose primary entry point to online services is via phones, not computers, is today announcing that it has raised $30 million in funding, a growth round that the Stockholm/London-based startup plans to use to double down on its health services in the wake increased demand around COVID-19.

The company currently provides telemedicine as a service connected to its health insurance, and it has expanded to include health programs for managing illnesses and offering discounts for pharmacies, and the plan seems to be to bring more services into the mix.

This is the same approach we’re seeing from other insurance startups targeting emerging economies, including China’s Waterdrop, which recently raised $230 million. Looking at the network of services Waterdrop is building, including crowdfunding, gives you an idea of what else BIMA might potentially look to add in, too.

The round is being led by a new investor — China’s CreditEase Fintech Investment Fund (CEFIF) — with previous backers LeapFrog Investments and insurance giant Allianz (who were in BIMA’s previous, $97 million round) also participating.

The startup is not disclosing its valuation this time around, but in its previous round the company was valued at $300 million, and it has grown considerably since then.

BIMA has now clocked up 2 million tele-doctor consultations and has some 35 million insurance and health policies on its books, growing its customer base by some 11 million people in the last two years. It’s now active in 10 countries — Ghana, Tanzania and Senegal in Africa; and Bangladesh, Cambodia, Indonesia, Malaysia, Pakistan, Philippines and Sri Lanka across Asia.

At a time when we have seen a number of insure tech startups emerge in the US and Europe — with some, like Lemonade, growing into publicly-listed companies — BIMA is very notable in part because of who it targets.

It’s not higher economic brackets, or necessarily segments with disposable income, or those in developed markets with stable economies. Rather, its focus is, in its words, underserved families that typically live on less than $10 per day and are at high risk of illness or injury, with 75% of its customers accessing insurance services for the very first time, BIMA notes.

“Telemedicine and insurance are needed more than ever and COVID accelerated awareness and acceptance for these types of products amongst emerging consumers and government. They’ve gone from ‘nice to have’ to a necessity,” said Mathilda Strom, who co-founded the company with CEO Gustaf Agartson, in an interview. “Utilisation nearly doubled in our telemedicine services.” BIMA covers COVID and pandemics in general in its policies, she added. “We have paid out COVID-related claims to families of people who suffered or passed away from the illness.”

It’s also working with health authorities that have been overwhelmed in the pandemic. Pakistani government and Indonesian government now use BIMA to off-load their health services by providing teledoctor consultations or doctors chats to customers.

Aiming at developing economies where middle classes are still only materialising, currencies are potentially unstable, and there is still a lack of infrastructure means that BIMA is contending with a combination of factors that makes the bar high for entry, but it’s also potentially more rewarding because of the lack of competition and tapping a demand that is still rapidly growing.

“The onset of COVID-19 has brought home the value of telemedicine, to help prevent the spread of disease, and the importance of insurance, for peace of mind,” said Agartson in a statement.

“Through digital solutions, and a human touch, we’ve been able to serve hard to reach communities with tools and services that bring them a sense of security at such a challenging time. The funds we have raised will allow us to expand our operations and further invest in our product offering that will help us scale quickly to meet the unprecedented demand for our services.”

It’s interesting to see CreditEase, a Chinese investor, as part of this round: the idea of all-in, full service health services companies banked around the insurance proposition has been one cultivated in the Chinese market. But even with the development of HMOs in the US, it’s interesting that there have been relatively few startups around the world trying to develop similar models. BIMA stands out in part because of that.

“We are very impressed by BIMA’s innovative integration of micro insurance and tele-doctor services, which provide critical coverage to meet large unmet demand in emerging markets, and whose value is accentuated further by the current pandemic,” said Dennis Cong, managing partner at CEFIF, in a statement. “We are very happy to have the opportunity to join this meaningful journey, along with the established leading shareholders, and support the company to grow its business and expand its leadership position in its served markets.”

“The market that BIMA is serving is vast and demand for health services is tremendous,” added Stewart Langdon, a partner at LeapFrog Investments. “BIMA’s unique digital capabilities empower emerging market consumers to access many health and insurance services on a single, easy to use platform. That includes protection for millions of first-time buyers of insurance who would otherwise remain unprotected and at risk.”

“We are happy to continue our partnership with BIMA and jointly deliver telemedicine and remote healthcare services in developing markets,” said Nazim Cetin, CEO at Allianz X, in a statement. “We believe the demand for these services will continue to increase and want to manifest BIMA’s leading position in the market by providing support with our experience and network.”

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