Momentum is gathering for telemedicine, which could alleviate a longstanding problem: wait times.
Arturo Sanchez and his co-founders have spent the past two years developing the telemedicine and insurance platform, Sofia, as a way to give customers across Mexico better access to quality healthcare through their insurance plan.
Along with his co-founders, Sebastian Jimenez, a former Google employee who serves as the company’s chief product officer, and Manuel Andere an ex-Patreon employee who’s now Sofia’s chief technology officer, Sanchez (a former Index Ventures employee) is on a path to provide low-cost insurance for middle class consumers across Latin America, starting in Mexico City.
Backing that vision are a clutch of regional and international investors including Kaszek Ventures, Ribbit Capital, and Index Ventures. When Index Ventures came in to lead the company’s $19 million round earlier this year, it was the first commitment that the venture firm had made in Latin America, but given the strength of the market, it likely won’t be their last.
In Sofia, Index has found a good foothold from which to expand its activity. The company which initially started as a telemedicine platform recently received approvals to operate as an insurer as well — part of a long-term vision for growth where it provides a full service health platform for customers.
Founded by three college friends who graduated from the Instituto Tecnológico Autónomo de México (Mexico’s version of MIT), the company initially launched with COVID-19 related telemedicine service as the pandemic took hold in Mexico.
That service was a placeholder for what Sanchez said was the broader company vision. And while that product alone had 10,000 users signed up for it, the new vision is broader.
“We registered as an insurance company because we want to go deeper into people’s health. We have built a telemedicine solution, which is a core component of the product. The goal is to be an integrated provider that provide primary care and handles more significant types of illnesses,” said Sanchez.
The company already has a core group of 100 physicians in Mexico City and initially will be serving the city with 70 different specialist areas.
All the virtual consultations are covered without an additional payment and in-person or specialty consultations come at a 30% reduced rate to an out-of-pocket payment, according to Sanchez.
Fees depend on age and gender, but Sanchez said a customer would typically pay around $500 per-year or roughly between $40 and $50 per-month.
The company covers 70% of the cost of most treatments that’s capped at $2,000 per-year and coverage maxes out at $75,000. “In Mexico that covers north of 98% of all illnesses or treatment episodes,” said Sanchez.
In Mexico, insurance is even less common than in the US.
“90% of private health spend happens out of pocket. The problem that we’re trying to solve is for these people that are already spending money on healthcare but doing it in an unpredictable and risky way,” said Sanchez. “They buy [our service] and they have access to great quality healthcare that they buy it and it’s a significant step up from what they’ve been living with.”
The clinical trial management software developer Medable has raised $91 million in a new round of financing as life sciences companies struggle with how to conduct the necessary validation studies of new drugs and devices in a pandemically challenged environment.
Digital and decentralized clinical trials are becoming a necessity given the health and safety guidelines that have been adopted to respond to the COVID-19 pandemic, the company said. And those changes are driving a shift to services like Medable’s as companies move through the approval process, the company said in a statement.
Medable’s software manages recruitment, remote screening, electronic consent, clinical outcomes assessment (eCOA), eSource, telemedicine, and connected devices, the company said.
Its software is already being used to work on vaccines and therapeutics targeting COVID-19 specifically in addition to facilitating the development of other potentially life-saving therapies and treatments.
“The pandemic has made the world aware of the importance of clinical drug development,” said Dr. Michelle Longmire, CEO and co-founder of Medable, in a statement. “We need transformative technologies that break down critical barriers to improve patient access, experience and outcomes. This new funding will enable Medable to continue our aggressive pursuit of new technologies that improve clinical trials to benefit all patients.”
Trials underway in more than 60 countries are using the service and Medable has inked partnerships with companies like Datavant, to integrate multiple data sources for decentralized trials; MRN, to handle home and remote visits, and AliveCor, to track in-home health with electrocardiograms.
Telehealth has taken off.
Spurred by the pandemic, many doctors in the U.S. now offer online appointments, and many patients are familiar with getting live medical advice over the internet. Given the obvious benefits, many experts have concluded that telehealth is here to stay. “It’s taken this crisis to push us to a new frontier,” said Seema Verma, administrator of the Center for Medicare and Medicaid Services. “But there’s absolutely no going back.”
Now the question is, where are we going? Telehealth has played an essential role during the pandemic, and it could do even more good in the years to come. But we are still in the very early days of its development. And if we are to realize telehealth’s full potential, then we must first reckon with the fact that there are serious flaws in the predominant way it is delivered today — flaws that endanger patients themselves.
Legacy telehealth services like Teladoc and others were built for a time when telehealth was a fringe phenomenon, mostly used to support acute needs like a bad cold or a troubling rash. They largely offer, in effect, randomized triage care. Patients go online, wait in a queue and see the first doctor who happens to be available. These companies market this as a virtual house call, but for patients, the experience may feel more like being stuck on a conveyor belt. Too often, they get funneled through the system with little to no choice along the way.
Insurance companies love this model because it is cheap to operate. But patients bear the cost. Doctors, in this arrangement, get paid to work the assembly line. Every minute they spend listening to patients — learning about their lives, building a personal relationship — is a minute they’re not moving them down the line, seeing the next patient and earning their next fee. The system doesn’t reward doctors for providing care; it rewards them for churning through patients.
As we build telehealth’s future, doubling down on this model would be a worrisome mistake since it is antithetical to how our healthcare system should operate. Healthcare has long been premised on the idea that you should have an ongoing relationship with a local care provider — someone with a holistic, longitudinal view of your health, who you trust to help navigate difficult or sensitive medical issues.
The randomized triage model breaks this bond and replaces it with a series of impersonal interactions that feel more like ones you have with an Uber driver — polite but transactional, brief and ephemeral. Healthcare, however, should not be treated in the same way as the gig economy.
As a physician, I am troubled by the prospect of what happens when you scale this model up. Every time a patient gets passed from one doctor to the next, there is a chance that critical information is lost. They won’t understand your baseline mood, your family context or living situation — all critical “intangibles” for informed treatment. That lack of longitudinal data leads to worse outcomes. This is why the healthcare system has long been designed to minimize patient handoffs — and why it would be a mistake for us to choose a telehealth infrastructure that increases them.
What, then, does a better approach look like?
We are at the very dawn of telehealth’s integration into our country’s healthcare system, and I won’t claim to know the full answer. But I do know that patients are far better stewards of their own health than a random doctor generator. A more effective approach to telehealth puts the power in patients’ hands. Because when we give them choices and then listen to them, patients tell us what they prefer.
Data gathered by my company makes clear that by a substantial margin, people want to make this decision themselves: Nine out of 10 telehealth patients prefer to schedule an appointment with a provider of their choosing rather than see a randomly assigned doctor after waiting in a digital queue.
Not only that: When given this choice, most patients — about seven in 10 — make an appointment with a nearby doctor when booking a virtual visit. Patients instinctively know that at some point, they’ll want or need to physically be in the same room with their doctor. And they know that choosing a local provider makes it possible to pick up the conversation in-person right where it left off online. They don’t want to be forced to choose between telehealth and an ongoing relationship with a trusted provider. And they’re right — they shouldn’t have to.
None of the legacy telehealth companies focus on this imperative. Instead, while the pandemic rages on, they are rushing to scale while their randomized triage model is still viable. And the markets may reward them in the near term for being in the right place at the right time. But long-term value will be derived from listening to, responding to and iterating on what patients want.
Experience suggests patients will reward whoever can give them the most control over their healthcare. That’s where I’m placing my bet, too.
Thousands of medical practices are closing, as doctors and nurses decide to retire early or shift to less intense jobs.
Under MedAdvantage plans, the major insurer is sending packages including Tamiflu and coronavirus tests to those considered especially vulnerable to Covid and the flu.
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.
In what could be the first step in the development of a significant new line of business for the telemedicine prescription provider Ro, the company is finally announcing the general commercial availability of weight loss product, Plenity.
Developed by Gelesis, a biotech company that makes treatments for gastro-intestinal disorders, Plentiy is a weight loss treatment that uses citric acid and cellulose to create a non-toxic paste that makes people feel more full after they ingest it. Taken before meals, the pill becomes a substance that expands to take up about 25% of the stomach, so people eat less.
The product has been approved by the U.S. Food and Drug Administration and is available for a much broader segment of the population than other weight loss products. While most prescription medicines are intended for people who are obese, the Gelesis product is made for people who are overweight, too.
“That’s adults who have a BMI from 25 up to 40. That’s 150 million Americans,” according to Gelesis chief commercial and operating officer, David Pass.
Plenity received FDA approval last April and Gelesis started working with Ro soon after, according to Pass. The idea was to craft a strategy that could get the treatment, which is classified as a medical device and not a drug, in the hands of as many patients as quickly as possible.
For Ro, the agreement with Gelesis is a sign of potential things to come. The company is the exclusive online provider of the Plenity treatment and Ro founder Zachariah Reitano said that there’s an incredible potential to engage in more of these types of deals.
“We would love to be able to partner with pharmaceutical companies to decrease the cost of distribution,” said Reitano. “We were excited to build an exciting treatment solution for weight management. Our high-level mission is to be the patient’s first call.”
With the Gelesis partnership Ro can add another highly desirable treatment to its roster of therapies — and one that can be a contributing factor to increasing the severity of other conditions that the company already provides treatment for, Reitano said.
“There are a few conditions that we currently treat that are exacerbated by a patient being overweight or obese. People who struggle with weight management will also experience ED. Obesity can lead to heart failure stroke, coronary heart disease, hypetension, depression,” Reitano said. “The breadth of the label is interesting. Only FDA approved with a BMI from 25 to 40. FDA approved treatment have been between 30 and 40. [It] makes the treatment more accessible to a wider variety of people.”
As the only online provider of the treatment, Ro has developed an onboarding process to ensure that the Plenity therapy isn’t abused by people who suffer from eating disorders.
“During our onboarding we not only ask questions to patients about their weight management. There’s a consecutive set of images that need to be uploaded and taken with the provider. That’s something we’ve taken a lot of time and energy to make sure about,” said Reitano.
Like the other treatments Ro offers, Plenity is a cash pay prescription, because the weight loss treatments aren’t typically covered by insurance, he said.
The benefit of working with an online pharmacy like Ro to provide distribution for a new therapy was obvious to both startups.
“We turned this market on its head by putting the consumer at the heart of everything we do,” said Pass. The treatment costs $98 per month, compared to other therapies or branded medications that could be as much $300 and $350 per month, according to Pass.
One reason that Gelesis is able to reduce the price of the drug is that it won’t have to hire a massive sales force to pitch it. The company has Ro for that.
“Normally you have a pharmaceutical company that would have to hire a sales force and go door to door and it increases the cost of a new drug. [Ro] can make a new, innovative treatment available, like Plenity, available nationwide,” Reitano said.
While many industries are taking a major hit due to the ongoing pandemic, the healthcare technology market continues to grow. In fact, total healthcare-related innovation funding for H1 2020 hit $9.1 billion, up nearly 19% compared to the same period in 2019, according to StartUp Health’s 2020 Midyear Funding Report.
As the virus continues to pose new challenges for the industry, investors are rushing to pump money into startups addressing healthcare sub-sectors ranging from telemedicine to patient financial engagement.
The inefficiencies and frustrations of the U.S. healthcare system make it a tempting target for disruption-oriented VCs. But here’s the hard truth: Healthcare is unlike any other industry. It has a morass of regulations that a “move-fast-and-break-things” startup can’t handle over the long term.
Healthcare is also a sensitive, personal issue. As such, patients are inherently reluctant to adapt to new technologies, even when they’re dissatisfied with the status quo. Consequently, it’s crucial that startup technology leaders in this space understand how to wade through these unpredictable waters in order to thrive and deliver a strong ROI for investors.
But here’s the hard truth: Healthcare is unlike any other industry. It has a morass of regulations that a “move-fast-and-break-things” startup can’t handle over the long term.
Entering health technology
VCs are seeing all the latest headlines about COVID-19 and spying a potential money-making opportunity to invest capital into innovative startups. However, they must overcome barriers to entry when offering patient-focused, technology-centric solutions before they can compete with legacy players. As the saying goes, “Luck is what happens when preparation meets opportunity,” and, within the healthcare startup space, COVID-19 presents an opportunity for those who stood ready to offer a solution to the market before the situation became a crisis.
Therefore, VC and PE investors should focus on the problem the potential startup is trying to solve as recent times have rapidly refashioned the need for certain solutions. Are there other key players leading the market, or is the startup a duplicative offering that is currently available? If the value proposition is unique, it may be interesting. If it’s not, investors may want to think twice.
At an online event today, Daniel Ek, the founder of Spotify, said he would invest 1 billion euros ($1.2 billion) of his personal fortune in deeptech “moonshot projects”, spread across the next 10 years.
Ek indicated that he was referring to machine learning, biotechnology, materials sciences and energy as the sectors he’d like to invest in.
“I want to do my part; we all know that one of the greatest challenges is access to capital,” Ek said, adding he wanted to achieve a “new European dream”.
“I get really frustrated when I see European entrepreneurs giving up on their amazing visions selling early on to non-European companies, or when some of the most promising tech talent in Europe leaves because they don’t feel valued here,” Ek said. “We need more super companies that raise the bar and can act as an inspiration.”
According to Forbes, Ek is worth $3.6 billion, which would suggest he’s putting aside roughly a third of his own wealth for the investments.
And it would appear his personal cash will be deployed with the help of a close confidant of Ek’s. He retweeted a post by Shakhil Khan, one of the first investors in Spotify, who said “it’s time to come out of retirement then.”
During a fireside chat held by the Slush conference, he said: “We all know that one of the greatest challenges is access to capital. And that is why I’m sharing today that I will devote €1bn of my personal resources to enable the ecosystem of builders.” He said he would do this by “funding so-called moonshots focusing on the deep technology necessary to make a significant positive dent, and work with scientists, entrepreneurs, investors and governments to do so.”
He expressed his desire to level-up Europe against the US I terms of tech unicorns: “Europe needs more super companies, both for the ecosystem to develop and thrive. But I think more importantly if we’re going to have any chance to tackle the infinitely complex problems that our societies are dealing with at the moment, we need different stakeholders, including companies, governments, academic institutions, non-profits and investors of all kinds to work together.”
He also expressed his frustration at seeing “European entrepreneurs, giving up on their amazing visions by selling very early in the process… We need more super companies to raise the bar and can act as an inspiration… There’s lots and lots of really exciting areas where there are tons of scientists and entrepreneurs right now around Europe.”
Ek said he will work with scientists, investors, and governments to deploy his funds. A $1.2 billion fund would see him competing with other large European VCs such as Atomico, Balderton Capital, Accel, Index Ventures and Northzone.
Ek has been previously known for his interest in deeptech. He has invested in €16m in Swedish telemedicine startup Kry. He’s also put €3m into HJN Sverige, an artificial intelligence company in the health tech arena.
As medical providers across the world turn to digital delivery of consultations and services, OnCall Health a Toronto-based provider of back-end services for telemedicine is having a moment.
The company, which competes with services like Truepill to offer physicians, pharmacies and other potential point of care services a way to consult online, has grown exceptionally quickly since the onset of the COVID-19 pandemic.
OnCall Health’s services include the ability to schedule a video or text appointment with a physician, hosting those video consultations on its secured servers, and the integration of back end billing systems so physicians can get paid.
Services like OnCall and TruePill’s have increased exponentially since the advent of lockdown orders put in place to combat the COVID-19 pandemic. In a sign of how hungry investors are for these kinds of deals, Truepill just raised $75 million to expand its own health services offerings.
“Since COVID-19, telemedicine has shifted from a nice-to-have revenue source for primary care, mental health, and home care and chronic conditions to a need-to-have,” said Base10 Partners principal Chris Zeoli, who led the investment into OnCall.
Joining Base10 in its $6 million investment into OnCall were several existing investors from the company’s $2 million seed round, including Ripple Ventures, Panache Ventures, and Stout Street Capital.
The bulk of the company’s customers come from small and medium-sized physician’s practices, according to Zeoli. Roughly 500 of the company’s existing customers consist of offices with less than ten practicing doctors.
Capturing this long tail is important because it actually represents a huge proportion of healthcare providers.
“OnCall provides everything that healthcare brands like pharmaceutical companies, insurers, and direct to consumer digital health startups need to get into the space and launch their own virtual care programs, often for the first time,” said Nicholas Chepesiuk, founder and CEO of OnCall Health. “Meanwhile, we are well positioned to help conventional healthcare clinics and systems adopt virtual care technology in the context of their operational processes. In the past year we have been able to roll out our technology with two global insurance companies, several leading pharmaceutical brands, and many rapidly growing digital health startups.”
OnCall now has over 30 employees and supports 7,000 primary care, mental health, and paramedical service providers across North America.
Primary care health tech startup Carbon Health has added a new element to its “omnichannel” healthcare approach with the launch of a new pop-up clinic model that is already live in San Francisco, LA, Seattle, Brooklyn and Manhattan, with Detroit to follow soon – and that will be rolling out over the next weeks and months across a variety of major markets in the U.S., ultimately resulting in 100 new COVID-19 testing sites that will add testing capacity on the order of around an additional 100,000 patients per month across the country.
So far, Carbon Health has focused its COVID-19 efforts around its existing facilities in the Bay Area, and also around pop-up testing sites set up in and around San Francisco through collaboration with genomics startup Color, and municipal authorities. Now, Carbon Health CEO and co-founder Even Bali tells me in an interview that the company believes the time is right for it to take what it has learned and apply that on a more national scale, with a model that allows for flexible and rapid deployment. In fact, Bali says the they realized and began working towards this goal as early as March.
“We started working on COVID response as early as February, because we were seeing patients who are literally coming from Wuhan, China to our clinics,” Bali said. “We expected the pandemic to hit any time. And partially because of the failure of federal government control, we decided to do everything we can to be able to help out with certain things.”
That began with things that Carbon could do locally, more close to home in its existing footprint. But it was obvious early on to Bali and his team that there would be a need to scale efforts more broadly. To do that, Carbon was able to draw on its early experience.
“We have been doing on-site, we have been going to nursing homes, we have been working with companies to help them reopen,” he told me. “At this point, I think we’ve done more than 200,000 COVID tests by ourselves. And I think I do more than half of all the Bay Area, if you include that the San Francisco City initiative is also partly powered by Carbon Health, so we’re already trying to scale as much as possible, but at some point we were hitting some physical space limits, and had the idea back in March to scale with more pop-up, more mobile clinics that you can actually put up like faster than a physical location.”
To this end, Carbon Health also began using a mobile trailer that would travel from town to town in order to provide testing to communities that weren’t typically well-served. That ended up being a kind of prototype of this model, which employs construction trailers like you’d see at a new condo under development acting as a foreman’s office, but refurbished and equipped with everything needed for on-site COVID testing run by medical professionals. These, too, are a more temporary solution, as Carbon Health is working with a manufacturing company to create a more fit-for-purpose custom design that can be manufactured at scale to help them ramp deployment of these even faster.
Carbon Health is partnering with Reef Technologies, a SoftBank -backed startup that turns parking garage spots into locations for businesses, including foodservice, fulfilment, and now Carbon’s medical clinics. This has helped immensely with the complications of local permitting and real estate regulations, Bali says. That means that Carbon Health’s pop-up clinics can bypass a lot of the red tape that slows the process of opening more traditional, permanent locations.
While cost is one advantage of using this model, Bali says that actually it’s not nearly as inexpensive as you might think relative to opening a more traditional clinic – at least until their custom manufacturing and economies of scale kick in. But speed is the big advantage, and that’s what is helping Carbon Health look ahead from this particular moment, to how these might be used either post-pandemic, or during the eventual vaccine distribution phase of the COVID crisis. Bali points out that any approved vaccine will need administration to patients, which will require as much, if not more infrastructure than testing.
Meanwhile, Carbon Health’s pop-up model could bridge the gap between traditional primary care and telehealth, for ongoing care needs unrelated to COVID.
“A lot of the problems that telemedicine is not a good solution for, are the things where a video check-in with a doctor is nearly enough, but you do need some diagnostic tests – maybe you might you may need some administration, or you may need like a really simple physical examination that nursing staff can do with the instructions of the doctor. So if you think about those cases, pretty much 90% of all visits can actually be done with a doctor on video, and nursing staff in person.”
COVID testing is an imminent, important need nationwide – and COVID vaccine administration will hopefully soon replace it, with just as much urgency. But even after the pandemic has passed, healthcare in general will change dramatically, and Carbon Health’s model could be a more permanent and scalable way to address the needs of distributed care everywhere.
Sana Benefits, a manager of self-funded insurance plans for small businesses, said it has raised $20.8 million in a recent round of funding as it looks to roll up all of the latest startup health benefit providers into a convenient package for small businesses.
Self-financed insurance plans are set up by companies to pay out of pocket for their employees’ health care and are typically cheaper, because employers can pick and choose which services they offer.
According to Sana Health co-founder Will Young, most companies wind up spending too much because they buy off-the-shelf plans from the big insurance companies like United Healthcare, Anthem Blue Cross Blue Shield, Aetna, Cigna or Humana.
The company touts partnerships with startups like Beam Dental for dental coverage, PlushCare for telemedicine, Calm and Ginger.io for mental wellness, ClassPass for physical fitness, and Maven Clinic for maternity care.
Its pitch attracted the attention of Gigafund, Trust Ventures and mark vc, which came in to back the company’s $20.8 million series A round.
“Sana’s disruptive model for health insurance empowers small businesses to both cut costs and improve employee benefits,” said Stephen Oskoui, Managing Partner of Gigafund, in a statement. “We believe that only a win-win solution like Sana can make a real dent in the healthcare crisis.”
What do employees get? Sana’s plans range from health insurance offerings with a $4,000 deductible and $6,650 in out of pocket maximum payments of $6,650 to a $0 deductible plan with a $1,250 out of pocket maximum expense for individuals.
“We save our customers 20 percent on what they would get on a traditional plan,” according to Young. “From the perspective of our client company. Self insured means technically the company is offering insurance and buying insurance itself.”
The company makes money by managing the health insurance plans for customers and direct and distribute the plans. It currently operates in Texas and Kentucky with plans to bring its services to Illinois later this year.
Truepill, the white-label healthcare services company that provides telehealth and pharmacy fulfillment services, is adding at-home medical testing as the third branch of its services powering the offerings of companies like Hims and Hers, Ro, and other direct-to-consumer healthcare companies.
Financing this expansion of services is a new $75 million round of financing from investors led by Oak HC/FT, with participation from Optum Ventures, TI Platform Management, Sound Ventures and Y Combinator.
“With the change in reimbursement for telemedicine, it changed the trajectory of the direct to consumer companies,” said Annie Lamot, the co-founder and managing director of new lead investors Oak HC/FT. “When we talked to every one of them they all seemed to be using Truepill .”
With its expansion into lab testing, Truepill can provide a full suite of services that used to be confined to the doctor’s office remotely. As more patients adjust to remote delivery of care, these kinds of options will become more attractive.
The move to telemedicine isn’t just something for new entrants either. Incumbents are also finding that they need to provide the same care as their direct to consumer competition, especially as the priority shifts to value-based care rather than fees for services on the reimbursement side — and consumers start demanding lower cost options on the direct pay side.
“I think it enables health plans to provide better care in targeted programs,” said Lamont, a longtime investor in healthcare.
Truepill’s executives certainly hope so.
The two co-founders, Umar Afridi and Sid Viswanathan met over LinkedIn where Viswanathan cold-emailed Afridi. At the time, Afridi was working as a pharmacist filling prescriptions at a Fred Meyer near Seattle).
Initially, Truepill’s growth came from acting as the pharmacist to companies like Hims, Ro, Nurx, and other direct-to-consumer healthcare companies focused on serving the elective health needs of people who wanted hair loss treatments, erectile dysfunction medication, and birth control.
As the company has grown, so have its ambitions. By the end of the year, Truepill expects to book up to $175 million in revenue, according to Viswanathan, and that revenue will come from a more evenly distributed mix of customers among direct to consumer companies, insurance companies, and healthcare providers.
“Everything we do is white labeled from our pharmacy to the lab testing component. You can go to teladoc and use that service. What we like to think early. 80 percent of healthcare is going to happen on a digital channel.. We’re in a perfect position to build the platform company in that space,” Viswanathan said.
At-home testing is a critical component of that platform. Expected to launch before the end of the year, Truepill is working with lab testing providers to offer hundreds of at-home tests. The company said it will focus on tests to manage chronic conditions like diabetes, heart disease, chronic kidney disease. Incidentally these are areas which have attracted a lot of interest from investors who are backing companies that provide direct to consumer or digital therapeutic solutions to treat or help address these conditions.
“To create a comprehensive, effective digital healthcare experience, there are three essential pillars: pharmacy with extensive insurance coverage, at-home lab testing and telehealth,” said Viswanathan, in a statement. “By adding diagnostics to our suite of solutions, we’ll be able to deliver direct-to-patient healthcare at scale through one platform – Truepill. We envision a future where 80% of healthcare is digital. With diagnostics, telehealth and pharmacy built on our foundation of API-connected infrastructure, Truepill will power that reality.”
New technology is allowing homeowners who can afford it to outfit their bedrooms, kitchens and bathrooms with tools to monitor their health.
When I reopened my dental practice in early June, the tooth fractures started coming in: at least one a day, every single day that I’ve been in the office.
How parents can distinguish between hand-washing that is a reasonable reaction to a real threat and something more concerning.
Hazel Health was founded five years ago to provide telemedicine services to children in public schools. Launched by a former Apple software engineer and serial entrepreneur, Nick Woods, and named after one of Woods’ children, Hazel Health has grown to work with school districts responsible for 1.5 million children, and has raised $33.5 million to expand its footprint even further across the United States.
The company’s services are even more sorely needed as children are forced into distance learning classrooms by the global COVID-19 pandemic.
Denied the network of services that in-person schooling provides for basic healthcare and nutrition, remote services like Hazel Health become, in some cases the only window into children’s health that some communities have.
When the first lockdown orders came through, the company began working with school districts to develop remote telemedicine services distributed via applications to continue serving the children it provided basic telemedicine services for.
So far, ninety percent of eligible families have enrolled in the company’s telemedicine program and 70 percent have engaged with the company’s services. These numbers are even more significant when viewed through the lens of the nearly forty percent of the company’s users who indicate they don’t have a primary care physician.
“We built this incredibly powerful model that partnered with schools and brought access to healthcare to families,” said Hazel chief executive, Josh Golomb. “At the schools we had an iPad on a stand. You hit a button and in a few minutes you would be talking to a doctor.”
After the onset of the COVID-19 epidemic in the U.S., the company’s Hazel at Home service continues to provide care to kids.
“As soon as covid happened there was a lot of recognition by districts that we have to have a solution around student health and wellness,” said Golomb. “Pre-COVID we went from 300,000 in our network of districts to now, when we just passed 1.5 million. [The] rate of engagement went down but our overall expansion has increased dramatically.”
With those kinds of numbers it was no wonder that Owl Ventures and Bain Capital Ventures came in to back the company. Additional financing came from Uprising, the UCSF Foundation Investment Company and Centene Corp.
And the demand just keeps increasing, according to Golomb.
“Our pipeline has exploded,” he said. “A lot of the states have made expansion for telehealth and increasing access a priority. We were going to have eight or nine states that we were going to prioritize.. That’s priority number one… another big chunk is really making sure that we can invest in expanding the product to support that volume of states and finding ways to support our families and district partners.”
Experts have long predicted that psychotherapy was poised to go virtual. The pandemic may prove them right.
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After 197 pitches, Y Combinator’s Demo Day for its Summer 2020 cohort has concluded. While the fanfare, run-ins and fortune cookies were missing in this virtual session, it was still exciting to see and hear founders from 26 countries pitch their passions. Of course, some opted for a more quiet route, raising millions before the two-day pitch session even kicked off.
Members of the Summer 2020 class drew attention from nearly 2,400 investors across the world. For those who didn’t tune in, no worries: here’s our write-up of the companies that presented yesterday.
Participating startups spanned a number of sectors: we saw companies in the future of work, sustainability, no-code, consumer, edtech and delivery solutions. Several entrepreneurs aimed big at e-mail, small at socks and straight at Shopify’s recent success.
While TechCrunch reporters aren’t in the business of cutting checks or predicting success, read on to learn about the 12 startups that stuck out to us for a variety of reasons (apart from their Zoom backgrounds).
CarbonChain may be the company that times the carbon market correctly. Now that the European Union and other regions are taking a serious look at penalizing businesses that fail to reduce carbon emissions, a service that provides accurate accounting for a company’s carbon footprint will be increasingly valuable.
And if the company can add marketplace and offsetting services on the back of its assessments, then its proposition becomes even more valuable. But what really makes CarbonChain stand out is the rigor with which it approaches its measurements.
The company uses independent software tools to make a digital twin of the carbon-emitting assets in a company’s business and claims that it can determine the emissions footprint of operations down to a cup of coffee (it also has models for the carbon footprint of heavy industrial equipment in the world’s most polluting industries).
For the world to address its carbon emissions, companies must understand their contribution to the problem. CarbonChain could be an invaluable tool in that effort.
Occupational therapy is not just for kids with disabilities, it can benefit a wide variety of children.
Concierge care has grown fast as patients no longer want to sit in a waiting room with strangers. But it comes at a high price.
The Canadian Pension Plan Investment Board, an asset manager controlling around $311 billion in assets for the Canada’s pensioners and retirees, has identified four key industries that are set to experience massive changes as a result of the global economic response to the COVID-19 pandemic.
The firm expects the massive changes in e-commerce, healthcare, logistics, and urban infrastructure to remain in place for an extended period of time and is urging investors to rethink their approaches to each as a result.
“It really ties into the mandate that we have in thematic investing,” said Leon Pedersen, the head of Thematic Investments at CPPIB.
There was a realization at the firm that structural changes were happening and that there was value for the fund manager in ensuring that the changes were being addressed across its broad investment portfolio. “We have a long term mandate and we have a long term investment horizon so we can afford to think long term in our investment outlook,” Pedersen said.
The Thematic Investments group within CPPIB will make mid-cap, small-cap and private investments in companies that reflect the firm’s long term theses, according to Pedersen. So not only does this survey indicate where the firm sees certain industries going, but it’s also a sign of where CPPIB might commit some investment capital.
The research, culled from international surveys with over 3,500 respondents as well as intensive conversations with the firm’s investment professionals and portfolio companies, indicates that there’s likely a new baseline in e-commerce usage that will continue to drive growth among companies that offer blended retail offerings and that offices are likely never going to return to full-time occupancy by every corporate employee.
Already CPPIB has made investments in companies like Fabric, a warehouse management and automation company.
The e-commerce wave has crested, but the tide may turn
Amid the good news for e-commerce companies is a word of warning for companies in the online grocery space. While usage surged to 31 percent of U.S. households, up from 13 percent in August, consumers gave the service poor marks and many grocers are actually losing money on online orders. The move online also favored bigger omni-channel vendors like Amazon and Walmart, the study found.
The CPPIB also found that there may be opportunities for brick and mortar vendors in the aftermath of the epidemic. As younger consumers return to shopping center they’re going to find fewer retailers available, since bankruptcies are coming in both the US and Europe. That could open the door for new brands to emerge. Meanwhile, in China, more consumers are moving offline with malls growing and customers returning to shopping centers.
Some of the biggest winners will actually be online entertainment and cashless payments — since fewer stores are accepting cash and music and video streaming represent low-risk, easier options than live events or movie theaters.
Healthcare goes digital and privacy matters more than ever
Consumers in the West, already reluctant to hand over personal information, have become even more sensitive to government handling of their information despite the public health benefits of tracking and tracing, according to the CPPIB. In Germany and the U.S. half of consumers said they had concerns about sharing their data with government or corporations, compared with less than 20 percent of Chinese survey respondents.
However, even as people are more reluctant to share personal information with governments or corporations, they’re becoming more willing to share personal information over technology platforms. One-third of the patients who used tele-medical services in the U.S. during the pandemic did so for the first time. And roughly twenty percent of the nation had a telemedicine consultation over the course of the year, according to CPPIB data.
Technologies that improve the experience are likely to do well, because of the people who did try telemedicine, satisfaction levels in the service went down.
Cities and infrastructure will change
“From mass transit to public gatherings, few areas of urban life will be left unmarked by COVID-19,” write the CPPIB report authors.
Remote work will accelerate dramatically changing the complexion of downtown environments as the breadth of amenities on offer will spread to suburban communities where residents flock. According to CPPIB’s data roughly half of workers in China, the UK and the US worked from home during the pandemic, up from 5 percent or less in 2019. In Canada, four-in-ten Canadian were telecommuting.
To that end, the CPPIB sees opportunities for companies enabling remote work (including security, collaboration and productivity technologies) and automating business practices. On the flip side, for those workers who remain wedded to the office by necessity or natural inclination, there’s going to need to be cleaning and sanitation services and someone’s going to have to provide some COVID-19 specific tools.
With personal space at a premium, public transit and ride hailing is expected to take a hit as well, according to the CPPIB report.
Supply chains become the ties that bind in a distributed, virtual world
As more aspects of daily life become socially distanced and digital, supply chains will assume an even more central position in the economy.
“Amid rising labor costs and heightened geopolitical risk, companies today are focused on resilience,” write the CPPIB authors.
Companies are reassessing their reliance on Chinese manufacturing since political pressure is coming from more regions on Chinese suppliers thanks to the internment of the Uighur population in Xinjiang and the crackdown on Hong Kong’s democratic and open society. According to CPPIB, India, Southeast Asia, and regional players like Mexico and Poland are best positioned to benefit from this supply chain diversification. Supply chain management software providers, and robotics and automation services stand to benefit.
“Confined to their homes for months and subjected to a rapid reordering of their perceived health risks and economic prospects, consumers are emerging from a shared trauma that will change their priorities and concerns for years to come,” the CPPIB study’s authors write.
One of the most consistent pieces of advice from health organizations about COVID-19 has been that everyone do their utmost to limit contact with people who may have been exposed to the novel coronavirus that causes the disease. That’s difficult in a hospital setting, where medical professionals regularly have to take patient vital sign measurements in order to provide proper care. But a new collaborative effort by MIT, Brigham and Women’s Hospital, Boston Dynamics and others might provide a way to get those measurements without putting frontline healthcare workers directly in harms’ way.
In a new academic paper, MIT researchers describe how they developed and used ‘Dr. Spot,’ a customized version of Boston Dynamics’ four-legged, dog-like robot, to be able to make use of contactless vital sign monitoring equipment for taking measurements. Dr. Spot is also outfitted with a tablet to make it possible for doctors and nurses to have ‘face-to-face’ interviews with patients while they conduct exams. This hyperlocal version of telemedicine has the potential to not only reduce the risk of exposure for medical personnel, but also drastically reduce use of personal protective equipment, conserving resources for when they’re needed most.
Dr. Spot is able to measure vital signs including skin temperature, respiratory rate, heart rate, and blood oxygen saturation all at once. These are all key metrics that healthcare professionals track when determining the progress of COVID-19 in a patient. For the purposes of this study, Dr. Spot was deployed in a hospital setting, but only took measurements from health volunteer research subjects in order to validate the accuracy of its measurement and sensor equipment.
This is just a study to provide some proof as to the potential of actually deploying Dr. Spot or a similar system in an actual clinical study, but the results are promising. Remote vital monitoring isn’t a new concept, but many other systems for accomplishing this require adapting the physical locations where patients are treated to accommodate that kind of distanced measurement, whereas this one could be deployed much more flexibly in existing hospitals and clinics.
Helping young adults with the skills they need to transition to health care independence — with a bonus script for canceling appointments.
Thirty Madison, the New York-based startup developing a range of direct to consumer treatments for hair loss, migraines, and chronic indigestion, has raised $47 million in new financing.
After last week’s nearly $19 billion merger between Teladoc and Livongo, remote therapies and virtual care companies are all the rage among the healthcare industry and Thirty Madison’s business is no exception.
An indicator of just how important these companies are to the future of the healthcare business can be seen in the presence of Johnson & Johnson Innovation – JJDC, Inc. (JJDC) in the latest round for Thirty Madison.
Founded just three years ago by Steven Gutentag and Demetir Karagas, Thirty Madison expanded from treating hair loss with its Keeps brand in 2018 to migraine treatments in early 2019 with Cove, and launched Evens (the company’s acid reflux treatment service) later that year.
Thirty Madison has just begun offering urgent care consultations for users on a pay what you will model.
And the company’s founders differentiate Thirty Madison’s business from their better-funded competitors like Hims and Ro by emphasizing that their company provides continuing care after a diagnosis and offers a range of treatment options for the conditions that the company treats. That, coupled with the more narrow focus on a few specific conditions, distinguish Thirty Madison from its peers in the industry.
“Over 59% of Americans suffer from at least one chronic condition, but few resources exist to help them connect the dots of their care,” said Amy Schulman, a partner with Polaris Partners and new director on the Thirty Madison board.
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In a sign of the growing importance and value of digital healthcare in the world of medicine, two of the industry’s publicly traded companies have agreed to a whopping $18.5 billion merger.
The union of Teladoc Health, a provider of virtual care services, and Livongo, which has made a name for itself by integrating hardware and software to monitor and manage chronic conditions like diabetes, will create a giant in the emerging field of telemedicine and virtual care.
“By expanding the reach of Livongo’s pioneering Applied Health Signals platform and building on Teladoc Health’s end-to-end virtual care platform, we’ll empower more people to live better and healthier lives,” said Glen Tullman, Livongo Founder and Executive Chairman. “This transaction recognizes Livongo’s significant progress and will enable Livongo shareholders to benefit from long-term upside as the combined company is positioned to serve an even larger addressable market with a truly unmatched offering.”
Under the terms of the agreement, each share of Livongo will be exchanged for 0.5920 shares of Teladoc health plus a cash payment of $11.33 for each share. The deal, based on Teladoc’s closing price on August 4, 2020, is roughly $18.5 billion. It’s an eye-popping figure for a company that was, at one point, trading below $16 per-share.
But the new reality of healthcare delivery in the era of COVID-19 rapidly accelerated the adoption of digital and remote care services like those Livongo was selling to its customers — and investor came calling as a result.
The combined company is expected to have pro forma revenue of $1.3 billion representing 85 percent year on year growth, on a pro forma basis. For 2020, the combined company expects adjusted EBITDA to reach $120 million.
“This merger firmly establishes Teladoc Health at the forefront of the next-generation of healthcare,” said Jason Gorevic, the chief executive officer of Teladoc Health, in a statement. “Livongo is a world-class innovator we deeply admire and has demonstrated success improving the lives of people living with chronic conditions. Together, we will further transform the healthcare experience from preventive care to the most complex cases, bringing ‘whole person’ health to consumers and greater value to our clients and shareholders as a result.”
The companies emphasized their combined ability to engage with patients and monitor and manage their conditions using technology. Teladoc Health’s flywheel approach to continued member engagement combined with Livongo’s proven track record of using data science to build consumer trust will accelerate the combined company’s development of longitudinal consumer and provider relationships, the companies said in a statement.
Teladoc currently counts 70 million customers in the United States with an access to Medicare and Medicaid patients that Livongo’s services could reach. The combined company also pitched the operational efficiencies that could be created through the merger. Teladoc estimated that there would be “revenue synergies” of $100 million two years from the close of the deal, reaching $500 million on a run rate basis by 2025, according to a statement.
Gorevic will run the combined company and David Snow will serve as the chair of the new board — which will be comprised of eight current Teladoc board members and five members of the Livongo board.
The company expects the deal to close by the end of the fourth quarter, subject to regulatory approvals. Lazard advised Teladoc on the transaction while Morgan Stanley served as the financial advisor to Livongo.
Getting medication long meant seeing a licensed provider. Now a strategy for evading Covid-19 makes treatment available via the web.
The answer largely depends on whether Medicare and private health insurers will adequately cover virtual doctor visits once coronavirus outbreaks subside.
“The doctor’s office is dead.”
That’s the way Nick Desai, the co-founder and chief executive of the Los Angeles-based startup Heal describes the future of traditional healthcare delivery.
While Desai’s bluster may be wishful thinking, the doctor’s office is certainly changing, and that’s thanks in part to companies like Heal, which offer in-home and telemedical consultations — and health insurance providers like Humana that are backing them.
The two companies have announced a new partnership that will see Humana pushing Heal’s in-home and virtual care delivery services to the patients it covers and committing $100 million to spur the Los Angeles-based startup’s growth.
“Humana has a more strategic view of home-based care,” said Desai. “We want all payers to be this strategic. Most insurance partners offer Heal now but we want them to view it more strategically.”
For Desai, the home is the best place to get care because doctors can see the environment that may influence (and in some cases complicate or worsen) a patient’s condition. Heal, Desai says, also works with the digital technologies to provide more remote and persistent patient monitoring, so that doctors can have a better sense of a patient’s health over time, rather than at an acute moment of care.
“You want to talk to the doctor and get continuity of care,” said Desai. “We think we are… an accelerant for the adoption of those services.”
Things like iPhone-based EKG machines, remote diagnostics to determine diabetic retinopathy, digital hubs to provide remote monitoring of body mass and movement are all hardware offerings within Heal’s panoply of care and diagnostic solutions. “We want to be able to gather more and more of those diagnostics remotely,” Desai said. “Anything that makes care more accurate, more data driven, more timely we want to use and ask our patients to utilize so that they can get better care, more quickly and more affordably.”
The new financing from Humana will go to support Heal’s geographic expansion, product development, and sales and marketing, Desai said. Already, the company has expanded into new treatment areas, including teletherapy for mental health.
Discussion between Heal and the Louisville-based Humana began back in December and the two businesses only inked the final terms of their deal last week.
Heal telemedicine, telepsychology (CA only), and digital monitoring services are currently available in New York, New Jersey, Washington, California, Georgia, Virginia, Maryland, and Washington D.C. To date, the company has linked patients with over 200,000 home visits from doctors since its launch in 2015.
Under the terms of the agreement with Humana, will expand to geographies in Chicago, Charlotte and Houston as part of Humana’s “Bold Goal” program focusing on addressing and creating healthcare services that address social determinants and social needs for its population of insured patients.
“The partnership with Heal is part of Humana’s efforts to build a broader set of offerings across the spectrum of home based care, with high quality, value-based primary care being a key foundational element,” said Susan Diamond, Humana’s Segment President, Home Business, who is joining Heal’s Board of Directors as part of the partnership and investment. “We continue to see high levels of customer satisfaction and improved health outcomes when care is delivered in the home. Our goal is to make the healthcare experience easier, more personalized and caring for the people we serve—and is the hallmark of how Humana delivers human care.”
For Desai, the deal is also an indicator of not just his company’s growth, but the growth of the entire Los Angeles technology ecosystem.
“Heal’s funding just proves that LA is as much an epicenter of venture backed ecosystem as any in the country including Silicon Valley,” he said.
In three years Zachariah Reitano’s startup, Ro, has managed to hit a reported $1.5 billion valuation for its transformation from a company focused on treating erectile disfunction to a telemedicine service for a range of elective and urgent care-focused treatments.
Through Rory for women’s health, Roman for men’s health, and Zero for smoking cessation, Reitano’s company now treats 20 conditions including sexual health, weight loss, dermatology, allergies and more, according to a statement from the company.
Ro also has a new pharmacy business, Ro Pharmacy, which is an online cash pay pharmacy offering over 500 generic medications for just $5 per month per drug. And the company is getting into the weight loss business through a partnership with the private equity-backed health care company, Gelesis.
Ro’s also becoming a gateway into patient acquisition for primary care providers through Ribbon Health, and a test-case for the use of Pfizer’s Greenstone service, which provides certification that a generic drug is validated by one of the major pharmaceuticals.
The company’s $1.5 billion valuation is courtesy of a new $200 million investment from existing investors led by General Catalyst and including FirstMark Capital, Torch, SignalFire, TQ Ventures, Initialized Capital, 3L, and BoxGroup. New first time investor The Chernin Group also participated. In all, Ro has raised $376 million since it launched in 2017.
“This new investment will further our mission to become every patient’s first call. We’ll continue to invest in our vertically-integrated healthcare ecosystem, from our Collaborative Care Center to our national pharmacy operating system. This is just the beginning of Ro’s patient-centered healthcare platform.”
It’s all part of the company’s mission to provide a point of entry into the healthcare system independent of insurance qualifications.
“Telehealth companies like Ro are using technology to address long-standing healthcare disparities that have been exacerbated by Covid-19,” said Dr. Joycelyn Elders, MD, Ro Medical Advisor and Former US Surgeon General. “By empowering providers to leverage their skills as efficiently and effectively as possible, Ro delivers affordable, high-quality care regardless of a patient’s location, insurance status, or physical access to physicians and pharmacies.”
Ro’s new financing is one of several forays by tech investors into reshaping the healthcare system at a time when patient care has been severely disrupted by attempts to mitigate the spread of COVID-19.
Digital medicine is assuming a central position in the healthcare world with most consultations now occurring online. Reimbursement schemes for telemedicine have changed dramatically and investors see an opportunity to capitalize on these changes by aggressively backing the expansion plans of companies looking to bring digital healthcare directly to consumers.
That’s one of the reasons why Ro’s major competitor, Hims, is reported to be seeking access to public markets through its sale to a Special Purpose Acquisition Company for roughly $1 billion, according to Reuters.
Technology doesn’t have to cure the coronavirus to be an enabler for good.
To ease pressure on hospitals, Northwell Health brought medical workers, oxygen tanks and intravenous equipment into patients’ homes. Now Florida is taking cues.
Boston-based startup Activ Surgical has raised a $15 million round of venture funding led by ARTIS ventures, and including LRVHealth, DNS Capital, GreatPoint Ventures, Tao Capital Partners and Rising Tide VC. The round will help Activ continue to develop and expand availability of its software platform, which it launched to market in May.
Activ Surgical’s ActivEdge platform uses data collected from surgical implements, outfitted with sensors created by the company to collect real-time data during the actual surgical process. That data is then used to inform the development of machine learning and AI-based visualizations that can provide guidances to surgeons and surgical systems to help them reduce the occurrence of potential errors, and ultimately improve outcomes for patients.
The company’s primary aim is to bring technological innovation to the sphere of surgical vision, which still relies primarily on methods like using fluorescent dyes that date back more than 70 years. Activ wants to use computer vision to provide real-time visual insight into things that surgeons wouldn’t be able to see on their own – and ultimately to use those insights to power the next generation of both collaborative surgical robots, and eventually even fully autonomous robotic surgical procedures.
ActivSight is the company’s first product in its ActivEdge platform offering, and is a small, connected imaging coddle that can be attached to existing laparoscopic and arthroscopic surgical instruments. The company is currently tracking towards getting their hardware cleared by the FDA for use by Q4 this year, and are working with eight hospital partners for pilot projects in the U.S.
The company has raised a total of $32 million in funding to date.
The Cusp, a newly launched startup offering telemedicine services for women in perimenopause and menopause, is launching an at-home hormone test service that slashes the cost of in-office visits and lab tests.
Women in California can order the test at a cost of $159 for a telemedical consultation and test, versus roughly $500 for having the same test and lab work administered in a clinic, according to the company.
Unlike other, commonly-prescribed hormone tests The Cusp bases its still-to-be-clinically-validated test on new research that a key hormone measurement can help predict the time to menopause. The company is currently working with researchers to help the broader medical community validate these findings.
Although the test may not be clinically validated, the company said that its use of “menopause specialists” with specific training in issues surrounding perimenopause and menopause can provide a more complete diagnosis of a woman’s current state and what is likely to come next based on both clinical and laboratory data.
“Menopause is very stigmatized and midlife care is a highly underserved market. We launched The Cusp to provide women with a new model of care during this stage of life so women can optimize their health,” said The Cusp, chief executive, Taylor Sittler. “Our focus begins with perimenopause treatment as early care can lead to healthier outcomes.”
The company said that the test is best for women experiencing early signs of perimenopause, typically between the ages of 42 and 50.
“Throughout my career I’ve been focused on the intersection of women’s health, menopause, and breast cancer. It was shocking to me how little information is out there for women, so I worked with national committees helping establish guidelines for managing menopause symptoms and sexual functioning in cancer survivors,” said Dr. Mindy Goldman, Director of the Gynecology Center for Cancer Survivors and At-Risk Women Program at UCSF, and a physician working with The Cusp. “I’m thrilled to be a part of The Cusp, as we are on the front lines providing women with comprehensive diagnostic tools and personalized care so that menopause can be faced head-on and managed with a multi-pronged approach that can include medical interventions, naturopathic solutions, and/or hormone replacement therapies.”
The company is already providing care to roughly 75 patients already and is growing its membership rapidly. With its recent launch, The Cusp has joined startups like CurieMD, Elektra Health, and Geneve, which are all focused on providing medical services to women in perimenopause and menopause.
To date, the company has raised $4 million from investors including HomeBrew, Village Global and individual investors like Katie Stanton and Megan Pai.
Sittler, a co-founder of Color Genomics, sees an opportunity in applying new diagnostics tests and technology to treating women as they enter menopause.
The Cusp charges an initial $210 for tests and the first three months of care and then an additional monthly fee of $72 per month.
“Being able to provide these personalized solutions that involve proprietary technologies. We would love to get into newer treatments… once we get a few zeros to our member number… there’s an initial advantage that we have in terms of the integration we’ve already done and the advantages that we have,” said Sittler.
Some therapists find that remote therapy is so convenient to their patients that they will continue with it.
People who put off care as Covid-19 surged are easing back into the medical system. Here are some tips to help keep it safe.
Issues include limited access to community support and counseling and, in some cases, quarantining with unsupportive family members.
Dentists are donning head-to-toe protective equipment, switching to laser instruments and taking other steps to reassure patients that it’s safe to get back in the chair.