James Li

Should you sell your practice to a VC-Backed MSO Startup? tldr: - new VC-backed startups are forming MSOs to roll up independent practices - The pitch is physicians receive early liquidity from the roll up and are granted ESOP shares that can be used for retirement - Problem is the use of ESOPs with independent practices is not a new concept and has been used with large group practices since the 70's - ESOPs do not grant full ownership and in order for the shares to be valuable for retirement, the practice needs to run the same if not better post roll up - With VC-backed startups being primarily operated by non-physicians with zero clinical or medical practice experience, the likelihood of this happening is extremely low making the entire concept high risk However, there is a viable path for continued ownership + liquidity for independent practices. Check out the article to learn more. ⤵ https://lnkd.in/gmGvTYwP

7

3 Comments

Awesome report from Rock Health (in the comments) about H124 digital health funding. 📈 Despite broader economic challenges, the digital health sector, including mental health, has shown resilience, raising $5.7B across 266 deals. There is a strong Series A pipeline, tapering off of unlabeled funding rounds and 3 public exits in Q2 2024 indicating a revival in the exit market and a return to more sustainable funding patterns​. Key insights about the mental health market: 🧠 Mental health continues to be the leading clinical indication in digital health funding, securing $682 million in H1 2024. This consistent top ranking highlights the ongoing investor interest and the market's recognition of the critical need for mental health solutions. 🤖 The focus on mental health is driven by a combination of increased awareness, the rising demand for accessible mental health services, and the integration of tech solutions...🙄 In fact, AI has become a significant factor in digital health investments, with 34% of the total sector funding going to AI-startups. This trend is also reflected in mental health, where AI is being utilised to enhance diagnosis, personalise treatment plans, and provide scalable, efficient care solutions. Let's go!

22

1 Comment

Someone broke down the estimated costs of a $15 Sweetgreen salad. We need these cost graphics for digital health to help future founders. Especially for tech enabled cos, the greatest cost is labor. Much of the "value created" is in curation and matching, which means the gross margins are reliant on labor arbitrage. Pay someone $X, but get paid $X+Y% per visit. The challenge with healthcare is that you often have to pick one of two business models: 1. specialized, low volume, high cost, low gross margin % 2. generalized, high volume, low cost, high gross margin % I'd argue founders should focus on gross dollars over the lifetime of the customer (like Jeff Bezos said) instead of gross margin %'s, but we'll leave that for another time. The challenge is that many tech enabled digital health cos have high cost of goods sold (labor) and moderately high product, design, and engineering budgets. We must build differentiated solutions for patients, clinicians, and clients to be out incumbents, however, we're realizing that companies are ultimately valued on the discounted value of future cash flows. And the high SG&A costs at most organizations might be inbalanced to the unit economics of the business. I'm not sure the math pencils out for everyone unfortunately. But I'm just a guy on the internet, would love to hear the thoughts from those smarter than I (you!). Comment below. --- p.s. I have no idea the accuracy of the graphic and not an investor in Sweetgreen. Cheers. Credit: David Crowther

112

27 Comments

To my amazing network - I am thrilled to announce the launch of Pave Health Ventures, an early-stage venture fund dedicated to broadening access to healthcare and improving the overall well-being of our communities. I’ve been very fortunate in my healthcare career. As the Founder & CEO of MedPilot, we capped off a seven-year journey with a successful exit when we were acquired by Vytalize Health. For the last three years, serving as Chief Innovation Officer, I’ve had the honor to contribute to the remarkable growth at Vytalize, impacting the lives of hundreds of thousands of patients by enhancing the quality of care they receive. I am immensely grateful to Matt Buder Shapiro, not only for being the perfect partner and co-founder but also for being an incredible friend. Additionally, I extend my heartfelt appreciation to Faris Ghawi, Amer Alnajar, and Jordan Brown for their outstanding leadership and for broadening my perspective on the significance of value-based care. This journey has not only provided me with industry expertise but has allowed me to cultivate invaluable relationships and an incredible network. As I embark on this new chapter, I am profoundly grateful to be supported by top executives and thought leaders in the investment, wellness, and healthcare industries. Within the healthcare ecosystem, we are represented by key stakeholders from health systems, insurers, governmental organizations, retail health businesses, provider groups, and value-based care organizations. At Pave Health Ventures, we believe the timing couldn't be more opportune to help support health-focused startups. With the growing prevalence of illness and chronic health conditions impacting our communities, consumers and key Healthcare Stakeholders are increasingly prioritizing proactive and preventative care. This shift in focus is fueling demand for technology, products, and services aimed at improving health outcomes, unlocking trillions of dollars in growth potential within the healthcare landscape. Pave Health Ventures is all-in. We are actively seeking solutions that tackle the root causes of illness, manage chronic conditions, and optimize care and care teams. Please support us in our mission by opening your networks and introducing us to amazing founders and entrepreneurs. Together, let's help pave the way to a healthier tomorrow. Jacob Myers

140

34 Comments

I recently sat down with Michael Batko, CEO at Startmate and Founder of Puddle Pod for Episode 11 of Insane Ambition. Startmate has invested in 230+ startups, much of it under Michael's leadership, and now has $3.5b in value across its portfolio companies. In this episode, we discussed: - Michael's journey from consulting, then living in the Amazon rainforest, to leading Australia's biggest startup accelerator - The future of Australia's startup ecosystem - The labour government's very stupid plan to make it harder for people to qualify as sophisticated investors (now thankfully shelved) - Startmate City! Startmate's plan to build Australia's first startup city. Probably the most ambitious idea I've ever heard from a startup accelerator. - The balance between visionary thinking and traditional startup advice (think Elon Musk's plan to colonise Mars, vs Y Combinator's problem/customer obsession) - "The Courage to Be Disliked", and its influence on Michael's approach to life and business. Links in the description below 👇

61

4 Comments

Some VC investors believe that brick and mortar - referring to a physical presence of some kind - should be avoided at all costs. Yet, the track record of clinic and hybrid care businesses in health care indicates otherwise. ==> One Medical (sold for $3.9 billion to Amazon), Oak Street (bought by CVS for $10.6 billion), Lifestance (IPO at $7.5 billion market cap), and PE-backed Premise Health (acquired by OMERS Private Equity for $1.1 billion) If a clinic is indicated as the optimal way to deliver care for that patient population, there are creative ways to build and operate them. Full article below with advice and strategies on how to build and operate hybrid clinics from my teammate Anarghya Vardhana from Maveron, Amir Dan Rubin from OneMedical Group, Steven Eidelman from Modern Animal and more!

13

1 Comment

Exciting news from Monica Chopra, Jeffrey De Flavio, MD, Samantha Adelberg, and the rest of the Auxa Health team as they officially announce their $5.2M Seed round. The team's deep industry expertise and drive for change have led them to solve critical infrastructural friction to providing quality healthcare and adoption of value-based care. Auxa's AI benefit navigation platform is simplifying the complexities of healthcare by streamlining all of the fragmented and siloed data and information to make it actionable in real-time for healthcare organizations. For the 70% of Americans who aren't getting access to the health and social care benefits they deserve, Auxa's solution will be pivotal in enabling equitable care. We're thrilled to partner with co-investors Zeal Capital Partners, AlleyCorp, Laconia, and Chaac Ventures on this journey and look to share many more milestones ahead. Cc K50 Ventures, Ryan Bloomer, Daniel Vásquez, Nick Talwar, Stefanie Ng https://lnkd.in/dPDY7-Db

44

4 Comments

The obesity crisis in the U.S. has become unsustainable. We are broken, and we have to change... The prevalence of obesity in adults has grown from 14.5% in 1975 to 41.9% in 2020, and childhood obesity has more than TRIPPLED since the 1970s. The total annual cost of obesity is at a staggering $1.4 trillion. Treatment options range but the emergence of GLP-1's has taken on a national debate. It is our view at 7wireVentures that the growing obesity crisis requires innovative and personalized solutions and digital health companies are rising to meet this challenge. Our team took a deep dive into the market landscape and came up with key predictions on how the market will evolve. ✨ PREDICTION 1: The emergence of high-cost anti-obesity medications and their growing consumer demand will push employers and payers to seek increasingly creative plan design structures that tackle weight management as a discrete disease category.​ 💉 PREDICTION 2: Greater emphasis will be placed on proactive identification and management of patients with an obesity diagnosis 🔬 PREDICTION 3: Key differentiators of successful solutions will include long-term engagement and the ability to address multiple chronic conditions. 🤝 Innovative companies such as 9amHealth, Parsley Health, Transcarent, Everly Health, Foodsmart, Livongo, Season Health, Iron Health, Cylinder, and more. See our full analysis and perspectives on enabling positive change in weight management. 👇 #digitalhealth #obesity #GLP1 #disease #healthcare https://lnkd.in/gUCttSZj

74

10 Comments

If you want to learn anything Ops, Senam is the person! From best hiring practices to raising VC funding, Senam will teach you the tricks of the trade. Senam not only simplifies Ops but makes it enjoyable, and she's an absolute pleasure to work with. I can not recommend this Ops Series for Startups enough! #startups #entrepreneurship #operations #OKRs #fundraising #operations

11

1 Comment

A little late, even though this process started in July.... Excited to share our latest investment in Heads Together Health!! We met Steve DeVrieze in October last year, and we think they are poised for impressive growth! Read more here: https://lnkd.in/ecYcqqkn #earlystagestartup #earlystageinvesting #VCinvestment #ncstartups #nctechstartups

22

We're absolutely thrilled to announce a monumental milestone for Flo Health Inc.! After years of dedication to women's health, Flo, a long-standing member of the Target Global family, has secured over $200 million in Series C funding led by General Atlantic.This incredible investment propels Flo's valuation beyond $1 billion, officially making it a unicorn – a rare and remarkable feat in the femtech space. This accomplishment isn't just about numbers. It's a testament to the power of prioritizing women's health. Flo has seen phenomenal growth over eight years, becoming the #1 downloaded app in the Health & Fitness category. Today, Flo empowers nearly 70 million monthly active users (MAUs) and boasts close to 5 million paid subscribers. Notably, 1 in 4 US women trust Flo, solidifying its position as a leader in the global movement for women's health. But this is just the beginning! This investment fuels Flo's mission to revolutionize female healthcare experiences worldwide. By directing resources towards areas of critical yet unmet needs (which, let's be honest, encompasses a vast majority of women's health!), Flo will continue to be a driving force for positive change. Congratulations Dmitry Gurski,Yuri Gurski, and the entire Flo Health Inc. team! More in the Financial Times here ---->https://lnkd.in/dJZdajM4

109

9 Comments

Let's finally get rid off the "VC alphabet song" and redo the system to become more founder friendly. "The benchmarks set by funding stages are often arbitrary and not necessarily aligned with the actual development needs of individual startups." #vc #venturecapital #founder #fundraising #startups #fundingstages #funding #fundingrounds #pitchbook

5

The most talked about AI x Medical startup Abridge is working to rescue doctors from the never-ending admin grind (which causes burnout and less patient face-time). Abridge's AI listens to patient visits and generates precise medical notes, slashing the clerical workload. Now, doctors can focus on what truly matters: patient care. Major health systems like Yale and Emory are already on board and raving, calling it "life-changing" and "magical." 🔷 A big reason --> Payback of the scribe tool is easy to measure. It supports 14 languages including Haitian Creole, Brazilian Portuguese, and Punjabi. An ongoing criticism of generative AI is that it still has few substantive business applications. This seems to quash that. Question: is a dedicated medical LLM needed to be successful in the space? Or will the huge foundational models (GPT-4o, Google, and Meta) ingest a plethora of medical notes and kill the competition with performance? We're dealing with a fast and furious pace, and today's edge may not be relevant tomorrow. Competitors include Microsoft-owned Nuance Healthcare , Ambience Healthcare, Nabla and Suki. I'm excited to continue to see this field revolutionized. 🌟 #AI #MedTech #Abridge #HealthTech

12

5 Comments

Great article from PitchBook on why domain expertise amongst VCs matters. TL;DR -- in verticals like healthcare, having investors with high amount of domain expertise can result in up to 40% higher odds of achieving an IPO, 20% higher chance of being acquired and 30% higher chance of an overall successful exit. Importantly, the marginal value of having investors with domain expertise varies by sector and stage, and is not uniform, so your mileage may vary, and generalist investors still have a very important role to play in the venture ecosystem. https://lnkd.in/dXpi8gzm Curious to hear from founders: Do you have examples of seeing specialist investors be helpful in unique ways that you can share? Or alternatively, do you have an experience with a generalist investor who has been more helpful than the specialists?

160

4 Comments

One of my proudest moments as an investor occurred today as Alaffia Health announced its series A because it shows how the Aperture® Venture Capital vision of multi-level, multi-generational #impactinvesting is succeeding in the marketplace. Here’s the model in its most basic form : ✅As diverse fund managers with meaningful capital to allocate, we are changing the VC landscape every day just by doing our day jobs. ✅As Black/Brown investors with ~40 years experience collectively, Aperture GPs have access to talent /excellence that others do not, so our portfolio *organically* is more inclusive by race, gender and geography even while optimizing for financial outcomes (all about the alpha). ✅Our most successful portco’s are using financial #innovation to solve market problems that impact underrepresented demographics and underserved communities. Alaffia Health is a shining example of the impact portion of our overall fund thesis, and we couldn’t be prouder of TJ Ademiluyi and Adun Akanni, MPH, PMP - the dynamic brother-sister founder duo whose vision we have steadfastly supported on their journey. Congratulations to TJ and Adun from William Crowder and myself, as well as the whole Aperture team- Marjorie King Philip McKenzie Yves Louis-Jacques Tanvi Lal Michelle Dhansinghani Lisha Bell Katie Kelly Amy Chung Cindy Chong, CFA Brian Fernandes-Halloran Monroe France Jayden Pantel Darren Herman Evan Wladis Neal Triplett Thomas Scriven Peter Ammon Irina Bit-Babik Tim Milanich Rob Rahbari

38

18 Comments

In 2023, only 13.2% of all startup founders were women. Startups with all-women founders raised less than 2% of all venture capital funding. Only 15% of unicorns that went public in 2021 had at least one female founder. April Koh is one of the rare founders who has made it through the gauntlet to get to this point. While companies are struggling to raise more capital in this environment because the hurdles are higher, imagine how much harder it is for a woman founder. It is a triumph and credit to how she has built Spring Health into a $3.3 billion valuation. We are all pulling for you April, because the more Spring Health's there are in the world, the more likely we are to see women unicorn founders in the future.

114

4 Comments

Maternal mortality in the U.S. is shockingly higher than in other high-income countries, despite global improvements. It's time to rethink how we approach maternal care—tech innovations like remote monitoring could be the game-changer closing the gap and saving lives. Our visiting analyst Aleksandra Manolcheva wrote about it in a recent blog post! 🚀 #MaternalHealth #HealthTech #Innovation #wearenina #healthequity

10