Aimun Malik

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

The (Healthcare) Ground Beneath Our Feet… This year it is likely that over $10 billion will be invested in the digital health sector – a robust amount, no doubt, but inconsequential when compared to the amount of capital tied up in healthcare real estate assets, which is estimated to be $1.2 trillion by Jones Lang Lasalle. Of that amount, approximately $790 billion is in the hospital sector while the remaining $490 billion is in medical office assets. It is estimated that there are 48.6k facilities with 3.4 billion square feet of healthcare real estate, 42% of which are owned by REITs and another 33% held by other private investment vehicles. Much of the digital health investment is meant to make the physical healthcare infrastructure more productive: greater operating efficiencies, greater patient throughput, more relevant personalized care models with better outcomes. As the healthcare system is being pushed to be more distributed to lower cost sites of care, accelerated now by the rapid proliferation of automation and AI capabilities, the potential impact on healthcare infrastructure assets will be profound. Thoughts on what that might look like... https://lnkd.in/eTfAdUbS #digitalhealth Flare Capital Partners

97

5 Comments

This week Mikal Ventures brings you a 4-week breakdown of the US capital market with an emphasis on the Mikal verticals. Over the 4-week period ending September 16, 1,245 new companies were added, resulting in just under 98,450 companies included in the US Health Tech, Med Tech, Fin Tech, AI Tech, and Ed Tech verticals. US AI Tech again saw the greatest percentage growth in new companies at 30%, vs. the vertical average of 13% for the period. AI Tech also led the group in transactions and news articles. US Med Tech led in SEC Filings. Mikal Ventures publishes these stats on a rolling 4-week basis to provide a perspective on how the verticals and new startups move through time. We hope you find them informative and thought-provoking. VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark https://mikalventures.com/ for additional insights and information.

1

🧬 This week's Austin Bio & Health Roundup highlights new funding, intriguing data, and major commercial & scientific milestones 🧬 💰 Funding Hello Patient, building Gen-AI phone agents for healthcare providers, came out of stealth with a $6.3M seed raise. Congrats Alex Cohen! And it’s Austin funding Austin, with 8VC a key part of the round. Aspira Women's Health, focused on non-invasive AI-powered diagnostics, was awarded a $10M grant from ARPA-H to advance their blood test for endometriosis. Well done, Nicole Sandford, Sandy Milligan, MD JD & team. Maxwell Biosciences, a synthetic small molecule drug platform, received ~$3M from the Medical Technology Enterprise Consortium (MTEC) to find assets that will prevent wound infection on the battlefield. Fantastic work, Joshua McClure & team. Reminder: I don’t cover SEC filings. When the builders themselves announce, I’ll shout it from the rooftops! 📊 Data Clutch VC released its Texas Seed Funding Update (YTD Q3): YTD 387 seed rounds raised for a total $636M. Though deal counts are down QoQ, capital invested has trended upward, making this the highest quarter since Q1 2023. Health was the second largest sector with 27% of all capital raised so far this year, up from 16% during the same time frame last year. Great data & insights Rajiv Bala, Steve Coffey, and Caitlin McHugh. 🤝 M&A and Partnerships Lumos Pharma entered a merger agreement with Double Point Ventures, going private at a $38M valuation. 🚀 Launches, Expansions, Milestones, and Wins Oracle Health announced updates to its Data Intelligence platform, with enhancements to Clinical, Analytics, and Care Coordination products. 🤠 Texas Bio Triangle Houston-based Coya Therapeutics, Inc. shared positive results from a double-blind study of low-dose interleukin-2 (LD-IL-2) in Alzheimer’s, showing the therapy is safe and well tolerated with promising trends toward cognitive improvement. Amazing Howard Berman, PhD, Arun Swaminathan, and the rest of the team. Dallas-based Stone Mountain Ventures closed a $5M Fund II focused on health & AI. Fund I included Austin Bio & Health startups Legion Health and MDisrupt. Congratulations, John Diaz and keep looking at Austin for new opportunities! Quick Note: Some items this week actually happened last week, apologies if I missed them! Please tag or message me for future announcements so I can make sure to include them. What’s Next?

43

6 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

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

🍂 Falling for Digital Health Trends! 🍂 Q4 is knocking, and I'm diving headfirst into the digital health pool! At Visible Hands, we're cultivating a fresh perspective on Empowering the Health sector. Here are three game-changing trends capturing my time and attention: Streamlining nonclinical work: AI has created a seismic shift in digital health, one of the improvements being shedding antiquated and broken workflows. Did you know: the health sector still uses fax machines? AI is transforming antiquated workflows, with some solutions slashing admin time by a staggering 70%. From intelligent scheduling to automated paperwork and streamlined revenue cycles, we're freeing up critical resources for what truly matters: patient care. Reimagining weight loss beyond GLP-1: 1 in 4 Americans by 2030 may face “severe obesity,” which equates to being overweight by at least 100lbs. (Link 1: Chan School, Harvard Study) With GLP-1s changing the game, digital platforms are shifting focus to holistic health coaching and long-term behavior change. While the market for GLP-1 drugs could surpass $1 trillion by 2035, my prediction is the market to support weight loss from a comprehensive and multimodal approach to obesity care will need to keep pace - an equally massive opportunity. In order to sustain weight loss, you have to do much more than move the number on a scale. (Link 2) Revolutionizing remote care: From AI-enabled diagnostics to VR therapy sessions in your native language, the line between clinic and home is blurring. Patients and providers face difficulty following up and monitoring remote patient care after being discharged. Understandably, simple follow-up can fall through the cracks when many physicians report being bogged down with data, and 87% of primary care physicians surveyed in the VA reported that they receive an “excessive” amount of alerts each day. The next frontier? Intelligent systems that cut through the noise, enabling meaningful remote patient management beyond basic telemedicine. What's your digital health obsession? Let's talk trends in the comments!  #HealthTechFuture #FallIntoInnovation #DigitalHealthTrends #HealthTechFuture #FallIntoInnovation Link 1: https://lnkd.in/euy5PmGX Link 2: https://lnkd.in/ed9-AJsp

17

The opioid crisis was a sad hallmark of my years working for the Baker Administration. In a time of extreme partisanship at the federal level, this was one area where public policy, civil discourse, and private enterprise seemed aligned and sufficiently motivated to find a solution. What we learned, however, is that dollars and access only go so far in combatting a disease that knows no so specific demographic. Instead, it's apparent that a battery of tools is needed to combat and prevent addiction--ranging from strong safety nets, to novel non-addictive pain therapies, and better technology. Introducing Marigold Health. Shrenik Jain, Ravi Shah, Tracey Cohen, MD, FASAM and team have built a proprietary NLP-based platform that--most significantly--improves the lives of those suffering from SUD/SMI. One customer we spoke with noted, "We needed a unique treatment intervention that had supportive research, fit into a CMS established model with a recognized service code, and that would provide positive clinical outcomes in an efficacious and fiscally responsible manner”. Another plainly said: "Marigold is our best hope to reach into the lives and help those who many have already given up on." Honored to join Bill Evans, Sean Day, and the entire syndicate in doing our part to scale a tool we believe will become essential in the fight against addiction. Marigold Health Innospark Ventures Rock Health KdT Ventures Matt Fates Lily Zarrella Venkat Srinivasan

50

1 Comment

"Digital health is no longer the future; it is the present, reshaping our healthcare landscape in real-time." Excited to be part of the UCSF Digital Health Hub Foundation's Quarterfinalist Party! As a past board member, I'm honored to celebrate the outstanding quarterfinalists. As we reflect on the state of digital health in 2024, it's evident that the COVID-19 pandemic has fundamentally transformed healthcare delivery. The rapid adoption of telemedicine during the crisis has become a permanent fixture, with over 60% of physicians continuing to utilize this technology. The sprint towards smarter healthcare, catalyzed by necessity, has shattered preconceptions about digital-first health experiences. Virtual care is no longer a stopgap but an integral part of a seamless, anytime, anywhere health ecosystem. 🌍 We're witnessing the rise of B2B2C models in remote consultations, with companies like Teladoc Health and Amwell partnering with insurance providers to integrate their services into health plans. Public sector collaborations, like eConsult Health 's partnership with the NHS in the #UK, underscore the potential for remote consultations to enhance efficiency and accessibility at a national level. The digital health landscape is evolving rapidly, with advancements in remote consultations, mental health support, at-home diagnostics, and patient monitoring. AI and generative AI transform care delivery, making it more efficient, personalized, and patient-centric. 🤖 Yet, challenges remain. While venture capital funding for digital health has stabilized after the pandemic boom, it remains below its 2021 peak. Sectors like digital therapeutics face reimbursement hurdles, and we've seen major players like Walmart and Optum close telehealth businesses. Looking ahead, we anticipate further consolidation in digital health, driven by acquisitions to create broader ecosystems encompass telemedicine, mental health, and other specialized services. As healthcare leaders, we must leverage these digital advancements to improve access, enhance patient outcomes, and drive efficiency in our healthcare systems. The future of healthcare is digital, and the time to embrace this transformation is now. Congratulations to all the finalists! 🎉 Looking forward to the grand finale at #HLTH2024 in #LasVegas! 🙌 By the way, the pink drink that we were holding was delicious—and nonalcoholic! The Digital Health Hub Foundation - Digital Health Awards #HealthcareInnovation #DigitalHealth #UCSFHealthHub #Networking #HealthTech #Entrepreneurship #LasVegasFinale Walter Greenleaf, PhD Daniel Kraft, MD Unity Stoakes StartUp Health University of California, San Francisco UCSF Innovation Ventures American Association for Precision Medicine (AAPM) WISE World Investors & Entrepreneurs Society #AAPMhealth #aapm_health

94

7 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

Hot take on a lot of early-stage digital health companies out there: You're not a tech company. Most tech-enabled care companies I've seen over the past two years are only tech-enabled in the sense that they use telehealth as their delivery mechanism for care. There are exceptions to this, of course - companies who build computer vision and applied AI tools to better the doctor-patient experience, companies who build tooling around risk scoring and stratification to enable more personalized medicine, companies who build truly novel intakes to better route patients to the appropriate care, etc. These companies have real technology chops and, if they sell it right to the market, can get credit for this from investors. But if you're truly a telehealth provider, you need to realize now that the goal post has shifted dramatically from 2021 and you're going to be valued at maturity at something like 3x EBITDA. That's profit. Not revenue. Throw a revenue multiple out the window. That's not the world we live in if you're a virtual doctor's office. Think of how that impacts venture math. If you're raising a seed round at $15M post-money (or $12M pre-money), it means you'll have to generate something like $150-200M in annual EBITDA to be a fund returner for your seed investors. Maybe even more with dilution, since telehealth businesses are not traditionally capital efficient and will likely need to raise material additional capital to reach that scale. You need to be ridiculously profitable (probably on $800M-$1B in annual revenue since you're likely going to be a 40% gross margin business). Here's the good news: you can set yourself up well (and probably be a contrarian founder relative to your peers), by talking about EBITDA growth and how you can grow into a fund-returning outcome based on realistic mature market comps. This will stand out for the investors you're pitching, even at the early stage. This is how you can beat the malaise of the tech-enabled care market. Focus on the right metrics and the right type of growth. You don't have to have all the answers (no founder does), but you need to make sure the ship is headed in the right direction. A focus on profitability for "tech-enabled care" (*ahem* telehealth) businesses is a good first step.

26

3 Comments

Interesting report from PitchBook on first quarter Digital Health VC activity. - $1.1 billion in funding. Key late-stage deals were led by Transcarent ($126M) and Rightway ($108.8M). - The top investment categories were general & primary care ($213.4M) and health benefits navigation ($140.7M). Challenges & Trends: Valuations: Less than 20% of startups reported a priced round in the last 18 months, with an increase in extension/bridge rounds. Digital Therapeutics: Facing significant challenges due to elusive reimbursement and cautious investors. Better Therapeutics is winding down operations, and Akili is being taken private for $34M, a sharp decline from its peak valuation of nearly $450M. Telehealth: Setbacks include the shutdown of Optum's virtual care and Walmart's telehealth services. The pandemic saw over $15B in VC funding since 2020, but some platforms struggled with unsustainable business models and strategic missteps (e.g., Teladoc's costly Livongo acquisition and Amwell's delisting from Nasdaq). Looking Ahead: While digital therapeutics and telehealth face hurdles, there's potential in: Platforms integrating various treatments for conditions like diabetes, metabolic health, and mental health. Specialty telemedicine, B2B platforms, and hybrid-care models, which offer a promising investment outlook. Despite current challenges, strategic investments and a focus on sustainable models can drive the next wave of innovation in digital health. As a former digital health founder, I encourage founders in this space to keep going...there is light at the end of the tunnel! If you are a digital health founder with impressive traction based in Virginia, feel free to reach out! #digitalhealth #venturecapital #virginiaipc #virginiainvests

28

2 Comments

This week Mikal Ventures brings you a 4-week breakdown of the US capital market with an emphasis on the Mikal verticals. Over the 4-week period ending August 19, about 960 new companies were added, resulting in just under 97,702 companies included in the US Health Tech, Med Tech, Fin Tech, AI Tech, and Ed Tech verticals. AI Tech maintained its most active status, seeing the greatest percentage of growth in both new companies and transactions. The US Fin Tech vertical led the way in SEC Filings and US Med Tech led in news articles. Mikal Ventures publishes these stats to provide a perspective on how the verticals and new startups move through time. We hope you find them informative and thought-provoking. VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark https://mikalventures.com/ for additional insights and information.

6

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

Platforms are in, point solutions are out as the healthcare AI category leaders come into focus this year. In conversation with Shelby Livingston at Endpoints News, I shared: 1. Why AI-first companies have the greatest platform potential and heuristics for identifying these opportunities at the earliest stages, 2. How companies are differentiating through co-development and distribution partnerships with leading healthcare institutions, and 3. Strategies for navigating anemic budgets and constrained market sizes through business model innovation such as AI-enabled services and pay for performance models Read more here: https://lnkd.in/dJWqv_zC Bessemer Venture Partners Abridge #healthcare #lifesciences #AI #generativeAI

258

14 Comments

Last month, founders and funders convened at Founder Collective's: Future Collective Boston 2024 Summit to discuss the evolving digital health landscape. It was a joy to have a candid conversation with many including co-facilitators: Giuseppe Stuto and Steven Lee. The conversation spanned key challenges and opportunities in the sector, with a focus on value-based care, AI integration, and market dynamics. VBC: A Long Complex Transition The shift towards value-based care (VBC) emerged as a central theme. Participants highlighted the difficulties in defining metrics for innovative care models. The lack of established benchmarks and slow adoption rates too often hinder progress. Many comments emphasized the misalignment of incentives in VBC and the gnarly complexities of attribution. We covered the impact of lengthy sales cycles, often spanning years, add another layer of challenge for startups in this space. AI It didn’t take too long for us to use our favorite vowels:AI. We discussed Thatch’s recent Series A funding round as an example of a company that is detangling some of the broken incentives in healthcare. Thatch is leveraging AI-powered tools, fintech infrastructure, and deep integrations to make shopping for healthcare as easy as possible. Investment Strategies in Digital Health The discussion also touched on investment dynamics in the sector. Healthcare is largely a service-based business, which correlates to missing out on the higher margins of a typical SaaS business. Given how challenging this space is, we discussed a tactic that is counter to most VC investing: back companies focusing on incremental improvements in healthcare delivery, not revolutionary paradigm-shifting plays. For the near term, the group recognized significant ROI potential in models that enable existing practices and known technology, rather than creating new standalone entities selling into difficult-to-scale and expensive customer bases. Looking Ahead: Policy Outlook Shifts The summit concluded with a debate on the future of healthcare systems. This conversation happened before we understood which White House Administration to plan for. While acknowledging that the current system fails to effectively incentivize long-term health outcomes, opinions were divided on whether policy changes or new business models would drive future improvements. There was a consensus on the need for innovation within existing reimbursement frameworks to catalyze meaningful change. The digital health landscape continues to evolve, it's clear that collaboration between founders, funders, and policymakers will be crucial as the regulatory environment shifts under the next administration. Drop links, reports, or predictions below on any early thoughts on how you think the sector will shift. Source: https://lnkd.in/ePfsv9iT

24

3 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

This week Mikal Ventures brings you a 4-week breakdown of the US capital market with an emphasis on the Mikal verticals. Over the 4-week period ending September 16, 1,245 new companies were added, resulting in just under 98,450 companies included in the US Health Tech, Med Tech, Fin Tech, AI Tech, and Ed Tech verticals. US AI Tech again saw the greatest percentage growth in new companies at 30%, vs. the vertical average of 13% for the period. AI Tech also led the group in transactions and news articles. US Med Tech led in SEC Filings. Mikal Ventures publishes these stats on a rolling 4-week basis to provide a perspective on how the verticals and new startups move through time. We hope you find them informative and thought-provoking. VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark https://mikalventures.com/ for additional insights and information.

2

2 Comments