Adam Jackson

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!

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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

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Exciting news for startups! California accounts for about 50% of all venture investments. The not-so-secret reason is that non-competes are illegal in California, so engineers at FAANGs can build competitors without fear. Today, the US Federal Trade Commission declared non-compete agreements illegal nationwide. This means that engineers at big tech companies can now leave and build their own companies without fear of violating a non-competes (legacy agreements for executives are still enforceable - talk to your lawyer), this is a step in the right direction for fostering innovation and competition across the country. A variety of big-business groups have vowed to sue to bring non-competes back, but at least for now, they're gone! #startups #innovation #competition #noncompete Official Announcement: https://lnkd.in/gRXUpgDy Impending lawsuit: https://lnkd.in/gqSiVuTd

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🌟Innovative VC Firm Overcomes Exits Drought with Secondary Sales🌟 ⛵Navigating a challenging landscape where exits are scarce, Santa Barbara Venture Partners (SBVP) has pioneered a novel approach to sustain its growth and attract investors for its second fund: secondary sales. Instead of waiting for traditional exits like IPOs or acquisitions, SBVP opted to sell shares of its portfolio companies, demonstrating its ability to generate returns for investors and stand out in a competitive market. 🎤According to Dan Engel, founder and managing partner of SBVP, these secondary transactions have been a game-changer, sparking investor interest and bolstering the firm's credibility. By leveraging its recent successes, including a lucrative stake in sports-betting company DraftKings Inc.' acquisition of digital lottery app Jackpocket, SBVP seized the opportunity to return profits to its limited partners (LPs) and pave the way for its second fund. 💡Engel highlighted the challenges faced by young VC firms in raising subsequent funds, particularly amid a downturn in exit activity and heightened investor scrutiny. With traditional exit routes becoming increasingly elusive, the pressure is on for firms to demonstrate tangible returns and establish a track record of success. ✨"For us, secondary sales have been a game-changer. They've helped us return profits to our LPs and attract investors for our second fund," said Dan Engel. 💰For SBVP, the decision to pursue secondary sales was driven by the need to provide liquidity to LPs and validate its investment thesis in the eyes of prospective investors. By strategically offloading portions of its holdings in high-performing portfolio companies like Bark Technologies and Rad AI, SBVP not only generated substantial returns but also bolstered investor confidence in its ability to deliver results. ⚠Despite the complexities and potential stigma associated with early share sales, Engel emphasized the importance of prioritizing investor returns and seizing opportunities to unlock value for stakeholders. With a focus on profitability and transparency, SBVP remains committed to its mission of delivering sustainable growth and maximizing returns for its LPs. 🔍 "Returning profits to our investors is our top priority. By strategically selling shares, we're proving our commitment to delivering results and driving value for our stakeholders," added Engel. As SBVP continues to explore secondary transactions and expand its investor base, the firm stands as a testament to innovation and resilience in the face of market challenges. 🚀 ✅ Looking to raise capital for your #fund and increase the international pool of your LP #investors?   🤝 Need warm #LP introductions?   📝 Selling #secondaries to increase liquidity?   🧐 Looking for co-investments?   ▶ G+QUANT's link for inquiries and fund decks: https://lnkd.in/gjC_EuTE #VCInnovation #SecondarySalesSuccess #InvestorReturns #ValueCreation 

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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.

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Still feeling energized from last week's roundtable on building successful relationships with hospitals. We invited 7 portfolio companies and health system leaders from Mayo Clinic, Cedars-Sinai and UCLA Health. The founders shared their questions ranging from the strategic to the nuts and bolts of closing partnerships. For example, how do you determine what measures of effectiveness help drive alignment? And how do you get all the stakeholders together to actually drive a decision. Answer: put them all in a room for half a day! “I think we're in a pivotal moment regarding how we assess AI. There are numerous risks currently dominating AI discussions, particularly those concerning bias and other associated risks. However, there's a notable absence of focus on evaluating the proactive value of AI. We need to consider what AI actually offers and what we want it to offer. It's not solely about determining whether it will cause harm; people are apprehensive about how this technology will be implemented. One perspective gaining traction involves ensuring the product's validation process is robust enough to prevent risks to various populations.” -Vladimir Manuel, Medical Director at UCLA Health From Vlad's comments above to perspectives others shared, we heard a sense of excitement for the promise of #AI and other new technologies. But we're also in a unique moment where the risks are not well understood. Still much to do here.

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Had a blast diving into Amir Dan Rubin's extensive healthcare career on Vital Signs. Amir previously served as the CEO of One Medical and Stanford Health Care, was an EVP at United/Optum and is now the Founding Managing Partner at Healthier Capital. Our conversation spanned payer-provider integrations, lessons learned from leading One Medical, applications of generative AI, and more. Some highlights: ⚡Combining care models We talked a lot about the One Medical/Iora combination. Amir argues that just because two care delivery approaches may occupy the same physical location (e.g., a clinic), that doesn’t mean they necessarily need to conform to the same economic model. For instance, One Medical and Iora were able to combine effectively despite the former being a membership model and the latter being global capitation. Amir emphasizes that much of the overhead resources (e.g., front desk staff, phlebotomy) can be shared across models. ⚡How One Medical uses generative AI to improve efficiency One Medical allows members to message the care team, and then uses NLP to read the message, figure out its content, and triage it to the appropriate team member. Amir is excited about leveraging internal knowledge graphs to get around hallucinations. This approach can point to relevant internal data in helping compose responses, creating more trust and accuracy in the outputs. ⚡Behind the Amazon acquisition One Medical was interested in expanding its direct to consumer offering. However, they recognized that customer acquisition was costly, which is why partnering with Amazon Prime’s existing membership base made sense for them. Amir explains how at their core, both Amazon and One Medical are all about using technology and logistics to create an excellent customer experience. An awesome conversation ranging from health system innovation to startup strategy to health tech investing! Listen to our full episode below: Spotify: https://spoti.fi/3Wrbnol Apple: https://apple.co/3XWOomb

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With Americans over 65 projected to grow from 58 million to 82 million by 2050, AI solutions like Foundation Capital portco SafelyYou are becoming increasingly crucial. They’re also a powerful answer to the industry’s persistent staffing shortages, acting as a force multiplier for caregivers. The benefits extend beyond individual residents and their families. For senior living homes, SafelyYou’s AI-powered fall prevention and response system translates to longer lengths of stay and higher net operating income (NOI). With AI, we are working towards a future where every individual—regardless of age or health status—receives the highest quality care, tailored to their unique needs and circumstances. Companies like SafelyYou are leading the charge in making this future a reality, and I’m immensely proud to work alongside them as they use AI to build a better world.

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🧬 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?

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💡Benchmarks in the investment industry serve as a standard for measuring the performance of securities, mutual funds, or investment managers. They provide a reference point for analyzing allocation, risk, and return of a portfolio, enabling investors to make informed decisions. Thanks Peter Walker for keeping us all informed!! Can’t wait for this!! Follow and get on the waitlist for this one! #benchmarks #fundraising #Capitalraise #founders #womenshealth #femhealth #medtech #wellness

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🧬 This week's Austin Bio + Health Roundup highlights significant data trends, my stance on covering funding announcements, new partnerships, and action across the Texas Bio Triangle. 🧬 💰 Funding: The Way I Plan to Cover Funding Announcements You may have seen reports of a local Bio & Health startup’s funding round through an SEC report filing. While some outlets have covered this, my position is not to. I prefer to support our builders directly rather than trolling the filings for scoops. There is plenty of real investigative journalism that our city would be well served by if that is where they focused. Remember I am not a journalist and I am not the media. When the company is ready to announce their round officially, I’ll gladly shout it to the rooftops. 📊 Data Peter Walker at Carta reports that in 2017, Biopharma and Medical Devices captured just under 10% of all VC dollars. By 2023, this figure rose to 17.7%, and in Q1 2024, it reached 24%. The overarching tailwinds favor our sector and region with trends towards Bio & Health and the physical & digital intersection. Energy and hardware, two other sector blossoming in Central Texas, also saw similar share gains. 🤝 M&A and Partnerships Sensi.AI, a 24/7 senior care intelligence agent, is partnering with Caring Senior Service to deploy SensiAI’s platform in Caring’s 50 locations across the US. This partnership allows seniors a better opportunity to age gracefully in their homes. 🚩 Texas Bio Triangle BioMedSA is hosting an event called Women in Bioscience, Thursday June 20th. It’s designed to connect and empower women in the bioscience industry across Central Texas, and features Randi Brosterman Hutchens discussing "Building your Personal Board." Find the link to the event in the comments. Houston-based Lokum, a staffing solution to connect clinicians and clinical staff to health care facilities, has raised a $700K pre-seed round. Congrats Ayoade (Joy) Ademuyewo on the raise. What’s Next? #AustinNext #LifeSciences #Healthcare #Biotechnology

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At SignalFire, it's long been our thesis that the next decade of healthcare will follow the trends of how the ecommerce industry evolved in the past decade - increasingly using big data to hyper personalize and target its audience. Isn't it crazy that our healthcare industry is reactive? If you are reading this post, then you are likely one of us - privileged and educated to be proactive about our health. Most Americans aren't. They show up at a doctor's office only when they need help. And that's where things start breaking down - months of wait times, big out of pocket costs, and a frustrating experience all around. Companies like One Medical and Praia Health are fundamentally redefining what proactive healthcare means - engaging patients exactly the way each person wants for the best outcomes. Excited to have been featured on Healthcare Rap Podcast with Jared Johnson to jam about the future of consumer healthcare at length! #healthcare #healthcaretech #innovation https://lnkd.in/gFpmmu6y

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A recent monumental milestone for the femtech industry: Flo Health secured $200M in funding, achieving a valuation of over $1 billion as the world's first femtech unicorn. It’s important to acknowledge both the progress and the paradoxes within this achievement. Flo Health, a platform empowering women with vital health insights, was founded by two male cofounders. 🤔 This brings to light a critical discussion about representation and inclusivity in the femtech space. While their contribution is commendable, it underscores the necessity for more female founders and leaders in industries that primarily serve women. As the founder of BAD BITCH EMPIRE dedicated to breaking down barriers for women in business and investing, I see this as a call to action. We need more women at the helm of innovative solutions addressing our unique health needs. It's not just about creating products for women; it's about ensuring these products are driven by the voices and experiences of women themselves. This historic funding round proves that femtech is not only vital but also a lucrative market. Now, let's channel this momentum to elevate more female entrepreneurs, investors, and leaders who can drive the next wave of femtech innovations. #Femtech #WomenInTech #FemaleFounders #InvestInWomen https://lnkd.in/euwbhqVB

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The consolidation play by Private Equity has both pros and cons, and it cannot be denied that sometimes the consumer may suffer, but the quality of the provision may become higher. It's a trade-off that needs to be managed well in order for it not to become "vampire economics" #PrivateEquity #VentureCapital #ImpactInvesting #Economy #USEconomy #Investing https://lnkd.in/gtdk6d5v

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My amazing cousin, Cleven Ticeson (https://lnkd.in/gWis4xX6) , a 14 time Emmy award winning producer for KCTS9 in Seattle, is a hero of mine. I grew up watching the educational shows like Bill Nye and the performing arts they would showcase. He was following the work I have been doing de-siloing the Black professional class working in venture scale entrepreneurship in the Pacific Northwest and composed a news reel covering Dreamward Group that moved me not only because he is my hyper-talented and dear cousin but because it voiced and gave me the perspective of the decades that what we’re building has been missing from the mass culture and my culture. Lewis Rudd once told me that the hardest target to hit is an invisible one and my dear cousin hit me right in the heart by speaking in his video about the unseen, but nonetheless felt, absence of inclusive capitalization of startups. Felt by the generation of Black people that watched the tech industry grow not only painting Black technologists and Black founders out of the heroic saga of tech, but Black funders as well. I am so glad that Dreamward Group is able to paint the target and make it visible through our work. Venture Capital, the financial backing of the tech industry, just like tech itself, had an evolution with foundational moments in the 70s on Sand Hill Road in Silicon Valley yet it’s mechanics, drama, and operation are largely unknown to the public that isn’t working in tech entrepreneurship. It’s trajectory and heights of accomplishment with Andreessen Horowitz and Madrona Ventures are parallel and analogous to Google and Amazon…But only the later two brands are household names to people outside of the industry. The world knows the story of Black people being excluded from Tech, It knows the story of Black people being excluded from executive leadership. It experienced the Obama administration and the depravity of the Trump backlash and had to ask itself why it had actively or passively participated in writing off Black professionals. Some of the world hears of Black founders getting less than 2% of invested capital, but even on hearing that, they don’t know the story of Black people being excluded from the role of deciding which startups get funded using a yet third party’s (often their own government’s) money…That is the story of Venture Capital today, and that’s what Dreamward is changing for the future.

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"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

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Please don't waste food. AMPLE update : Juniper Ventures Signs up to AMPLE Marketplace AMPLE : B2B Marketplace for Fresh Food. Impact Investment. See https://buff.ly/3W32D7p Steve Thomas - CEO/Co-Founder of AMPLE provides an update on a most recent business partnership: "...Juniper Ventures, which supplies over 23,000 meals daily to students in the London Borough of Newham, has become a keen buyer on the Ample Marketplace. Incorporated in April 2018 from the council’s catering and cleaning service, Juniper aims to operate with the social aspects of the local authority but with the business acumen and autonomy of the limited company that it is. Michael Hales, chief executive of Juniper Ventures and vice-chair-elect of LACA, said: “It is shocking that in the UK we waste 13m tonnes of food every year. As a hospitality business we are determined to do all we are able to help reduce this figure....".   Read the full update. https://buff.ly/3WnGEar REMINDER Ample Marketplace is a new B2B channel for unsold fresh food integrating e-commerce, logistics, and digital marketing. Ample is the UK’s first smart marketplace for wholesale food (with expansion plans for the US, EMEA and APAC). Ample creates value by shortening the supply chain, giving more control to sellers and value for buyers.  AMPLE is a portfolio company of XSS Capital. Join us on this investment journey? DM me for more info. #e-commerce #logistics #Impact Investing Join our mailing list at buff.ly/4cd2OCo

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