Greg Waldstreicher

I’m worried about the state of venture capital and direct-to-consumer (DTC) healthcare startups. Hims & Hers is the poster child for DTC healthcare at $1.2B proj 2024 revenue and a $3.6B valuation. By most accounts, they have been an outlier success for DTC since bottoming out in May 2022. So why is this bad news for DTC healthcare? Because the market leader (Hims) trades at a 3x forward revenue multiple. And the category leader typically gets a higher valuation multiple than smaller startups. We see this phenomenon in private equity. They “roll up” smaller companies within the same category at a lower multiples just to create one larger platform that trades at higher multiples. Now back to DTC healthcare startups. If Hims commands a 3x revenue multiple, it’s not unrealistic that smaller, unprofitable startups may be valued 1-2x revenue at exit. At 2x revenue, a startup must generate $500M to produce a $1B exit in today’s market (depending on growth and profitability). Series A/B venture capitalists must see a pathway to $1B outcomes. And if the growth-stage investors with billions under management are less interested in DTC healthcare, the future funding rounds necessary for fueling growth are not guaranteed. Juxtapose this against 2017-2022 where DTC could raise Series B-E funding. Let’s take a DTC startup doing $25M after 3-4 years of operations and has already raised a Series A. By most accounts, it would be a phenomenal accomplishment. But today, investors will question the chances of that same company scaling from $25M to $500M revenue in the next 3-4 years with unknown future funding sources from Series B and beyond. You're stuck in VC-funding purgatory. Some of these companies will shut down. Some may sell for 1-3x revenue. And some may try to transition to profitable, cash-flowing businesses. All of which are certainly not the venture-backed goal the founders, investors, and employees often had in mind when first taking capital. I say this all with friends working at or starting DTC healthcare companies, I feel bad for them. I also feel bad for the patients who enjoy those products or services. To caveat (b/c I know people will object), there will be other DTC brands that exit for $1B+ (i.e., Ro). However, they were forged and scaled during a different time period where seemingly endless venture capital was available for DTC healthcare. Now we're in a different time with no end in sight. Thoughts?

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We need to highlight more bootstrapped healthcare companies. I rarely see founders of these small businesses profiled at conferences or in the media. The chances of building a $100M+ revenue healthcare company are very slim. But that’s the expectation once you accept VC funding (especially Series A and beyond). Let me remind you, most healthcare companies do lower revenue than total capital raised. And you can build a wonderful life and help your community with much lower revenue / growth, if you take minimal or no funding. And believe it or not, most VC-backed founders are fascinated by founders and business models that didn’t require external capital. Do you agree? Or would you prefer media and “influencers” to focus on venture-backed and publicly traded companies? Sometimes I feel like I’m shouting out into the void. Because majority of content is focused on the unicorn chasers. Would love to hear from founders of bootstrapped companies in the comments?

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What you won’t find: Wheel powering any of the sketchy DTC GLP-1 compounding companies. What you will find: This market exists because companies like Wheel, who prioritize clinical quality and regulatory compliance in every process and product, refuse to take shortcuts. We're committed to ensuring that patients receive high-quality care—not just drive quick profits. Sometimes, choosing ethics over revenue means we don't see a short-term windfall during a "Gold Rush." But as CEO, I can assure you that it also means that patients, customers, and clinicians can trust that Wheel is always on the right side of history. I believe GLP-1s will transform healthcare as profoundly as AI, and Wheel is dedicated to being at the forefront—delivering compliant, accessible, and responsible care.

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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

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An overlooked benefit of AI scribes: standardizing and enriching clinical documentation for research purposes. Today, patient stories are filtered heavily through the lens of the physician and are further warped by billing codes. Depending on the medical specialty, pertinent positive or negative findings may not be documented, especially if they are insignificant for billing purposes. Omitting this information has tremendous downstream implications for research on disease phenotyping, progression, and treatment, as well as clinical trial recruiting. If architected thoughtfully, AI scribes can preserve the integrity of the patient journey, producing standardized and consistent documentation to support breakthrough research across disease classification, diagnostics, natural history, and therapeutic development.

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Here's another fundraising roundup spotted in the healthcare wilds 👀 🍃 ✅ Sword Health raised $130M (new valuation: $3B). ✅ Better Health raised $14M to deploy expanded payer partnerships. ✅ Alzheon, Inc. | Preserving Future Memories raised $100M Series E to advance development & commercialization of its Alzheimer’s treatment. ✅ CinRx Pharma raised $73M to continue its ‘Hub and Spoke’ model of startup formation. ✅ Eko Health raised $41M to scale AI-driven heart and lung disease detection. ✅ Anterior (formerly Co:Helm) secured a $20M Series A to unlock admin efficiencies for healthcare payers. ✅ SamaCare raised a $17M Series B to scale specialty drug prior authorization platform. ✅ Plenful secured a $17M Series A to streamline pharmacy operations with AI-powered workflow automation. ✅ Grayce raised a $10.4M Series A led by Maveron amid a caregiving crisis. ✅ Stitch Employment Services Inc PEO raised $8.75M in seed to support independent medical practices. ✅ Posterity Health secured $6M to fund expansion and technology acceleration. ✅ Sware raised $6M to accelerate life sciences innovation by automating FDA-mandated software validation. ✅ Keragon raised $3M, as announced in @Conno Christou’s LinkedIn post. As always, if I missed you, let me know! Each week I'm spotlighting an innovative healthcare startup. I just ask for a bit more transparency. All submissions are confidential; submit yours here 👇 https://lnkd.in/gF4DrAvJ Looking for more fundraising roundups, alongside healthcare industry news and analysis? Subscribe to Hospitalogy, my 2x/week newsletter. Join 33K+ other investors, executives, and healthcare professionals: https://lnkd.in/g-nfRqW6

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The median patient adoption for our Digital Health tool is 75%. Our best health systems achieve 90% adoption. Here’s what those getting 90% patient adoption are doing differently👇 1. Go true multichannel: make it available beyond just their patient portal and digital front door. Some patients prefer a native mobile app, an SMS or email + web app experience. 2. Entire interprofessional care team (physicians, nurses, pharmacists, OT/PT, allied health, etc.) all involved in the customization and implementation process. That’s how you build a sense of team-wide ownership of the Digital Health tool. 3. Clinicians actively promote it to patients as standard of care. It’s not an afterthought that just the office staff barely mention. 4. The leadership team is bought in and cares. When everyone knows it’s a real organizational priority, magically the numbers go up. Who would’ve guessed? 5. If possible, actually monitor patient health data (e.g. symptoms) and act on it when patients fall off track (e.g. early signs of deterioration). When patients have log a symptom and a care team member calls them about it, it has a magical effect: patients stay engaged. 6. Automate patient enrollment via an EHR integration BUT still educating patients on the tool. You can’t just “set it and forget it”. Patients still have to know WHY they should use this tool they get an electronic notification about. 7. Reinforce use of the Digital Health tool at multiple points in the patient journey - at the clinic, in the hospital, at follow up, etc. 8. Support multiple languages based on the local demographics. No AI isn’t safe enough to real-time translate clinical information with no oversight. But, LLMs are now often good enough to do a “first draft” of the translation which lowers time and cost to review. 9. Review your patient adoption and engagement data regularly (at minimum quarterly, but ideally monthly). Share it with your executives and key champions. Dig into the data where it’s weak and ask WHY. Use the tips in this post to improve the dta. 10. Provide actual scripts and train staff on best practice talk tracks for how to introduce the Digital Health tool to patients and families. Don’t just leave it up to staff to make up what to say. Systematize the communication. 11. Design for health literacy: all clinical content at the Gr. 6 reading level, in plain language, using adult learning principles. 12. Meet digital accessibility guidelines, such as WCAG 2.0 level AA. E.g. make sure it’s colorblind and contrast-tested, screen reader friendly, etc. 13. Allow caregivers and family members to be enrolled in the Digital Health tool so they can monitor the patient’s progress and nudge them to stay on track. Motivation from family members is HUGE. P.S. SeamlessMD enables health systems to digitize patient care journeys with reminders, education and symptom monitoring. If you’re looking for help on how to make 90%+ adoption happen for you… give us a shout!

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This partnership will help you know how food affects your health 🥗 ŌURA (wearable ring that tracks health data) and Dexcom (continuous glucose monitoring device maker) are working together and integrating their data and biosensors so users can adjust behaviors to positively impact their #biometrics and long term health. Dexcom has also invested $75 million into Oura Series D funding round - increasing their valuation to $5 billion. Oura had stated they sold 2.5 million rings earlier this year and is predicting their annual sales to double end of this year. This partnership can help people understand the link between activity 💪, sleep 💤 , nutrition 🍲, and glucose 🍭. Our society continues to care more about our bodies and health, and I believe this will move the needle for the #holistichealth industry. Looking forward to trying out the new technology once released in 2025. #healthtech #wellness #startupjourney

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Famed investor Marc Andreesen tweeted, trust in doctors and hospital dropped from 70% in 2020 to 31% now, and on its way to zero. Seriously! Benjamin Schwartz, MD, MBA at The Surgeon’s Record writes on ‘What Silicon Valley Gets Wrong about Trust in Healthcare.’ Patient trust is a complex issue, one that’s critical to effective care delivery. Technology and AI can be powerful tools, but they should support, not replace, humanism in care. Here, here! https://lnkd.in/ec4at7ue

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How much is your health worth? Wait for it... $10,566 Anyways, that's what investors in Clover Health think 80,261 members $848M market cap Clover, by the way, is profitable for the first quarter ever It has shed a significant amount of business in order to get leaner and focused on nearer term (and theoretically longer term) profitability Some statty-stats for Q2 2024: $356M rev $100M SG&A $248M claims paid $349M op expenses $7.2M operating income 71% MCR (medical cost ratio) $80M cash from continued ops (six months) Seems the focus on Medicare Advantage is paying off Meanwhile hospitals are dropping MA plans left and right How are patients doing? They're obviously worth it, but by what means? P.S. If you liked this little breakdown interlude, you'll love The Healthcare Breakdown, where we look at the business of healthcare and ask, does this make any sense? Like, at all?? Check it out here: https://lnkd.in/gVRtQGZN See you out there!

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🚀 Three Startup CEOs walk into the Techstars Boston Accelerator to Redefine Surgery I truly believe innovation thrives when passion meets experience and our founding team isn’t just any team. We are three former startup CEOs, united by one bold vision: to transform surgery through cutting-edge AI. 🔥 We’ve built companies. We’ve overcome challenges. Now, we’re channeling that drive into revolutionizing the operating room with our AI-powered Vision System. We capture surgeries in real-time and turn them into immersive 3D experiences to empower world-class surgeons to drive the mastery and adoption of the latest medical devices. 🌍 With the world’s top surgeons as our partners, we’re not just building tech – we’re redefining the future of surgery. The stakes are high, but so is our passion. I met Ignacio Tzoumas right after college. He was one of the most successful people our age as he was able to leverage his biomedical engineering degree with a deep understanding of business and operational excellence. Later he joined a few startups as CFO and CEO while taking a quantum computing company public. I met Stephen Potter as I was starting my last company, he had an awesome video startup that he and a friend had built and bootstrapped with impressive traction. He later joined companies like Vevo, Vydia and Amazon in senior engineering roles and I have seen this benefit our company incredibly over the last year. We would truly like to thank Jennifer Davis Aidan Kittredge Steve Bernard Anuj Adhiya 📈 Ben Greene Steve Walsh Carson O. and the entire Techstars team for an impressive first few days! When I met Jennifer a year ago, I was very impressed with her background and the Boston program and we were just a little too early. We have already met so many great mentors and alumni and this is an incredibly strong process that makes you challenge our own hypotheses, test and build what matters to your customers and users. So many people to thank, I will surely miss a few here. Chris Kilayko Johnny Caffaro Lindsey Rolston Alan Reznik Scott Stapleford Jonathan D. Drillings Mark S. Tuttle Carlos Handal David Zweier Nelson Wong Sharon Kaplow Joseph Iannotti Richard Steinfeld, MD, MBA Manny Medina Rob Doebelin Prerna Mahtani Matthew Suh Peter Yacoub Peter Gallo Aashutosh Pyakurel Susan Ghimire Sameer Maskey Abed Soleymani, Ph.D. Walter Olkowski Calvin Lin Peter Waterman Harsh Gupta Erik Greenhagen This is just the beginning. Ready to join us on this journey? 🚀 #AI #SurgeryTech #HealthcareInnovation #StartupLife #Founders #RedefineSurgery #Techstars #HealthcareTransformation

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💯agree with Dr. Mehta and to quote her: Healthcare is broken, and those that are in it understand why. Patients need - and deserve - quality health care. This requires safe staffing practices, skilled clinicians who can feel good about what they do, and insurance companies that pay their bills. We can’t have a system where insurance companies can get away with record profits while finding more and more reasons not to pay for care and eroding away at the heart of healthcare. You cannot scale your way out of America’s healthcare problem. You actually need to fix the incentives, regulate insurance companies, pay clinicians appropriately, prioritize clinician well being and retention, and focus on the patient. The days of paying lip service to physicians leaving medicine and physician burnout are numbered. Supply and demand forces will necessitate real solutions that move the needle.

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#question for #Healthcare #founders: you’re sitting across from the top decision maker of a major health system (think of one on your list). This person will answer ANY question you have about their organization. What do you want to know?

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The Telehealth Time Bomb: How Hims and Ro Are Risking Patient Safety for Profit The telehealth Men's Health industry is booming, with Hims reporting $872 million in revenue for 2023 and projections up to $1.20 billion for 2024​ (Hims)​. However, much of this profit comes from a dangerous loophole allowing online prescriptions for medications like Viagra and Cialis without adequate medical oversight. Hims and Ro use AI-driven questionnaires, bypassing real-time physician interactions, which can lead to severe health risks, misdiagnosis, and adverse reactions. Financial Success at What Cost? These companies capitalize on the convenience of online prescriptions, bypassing crucial steps in the patient-provider relationship, such as: Medical History Review: Vital to understanding potential health risks and medication interactions. Comprehensive Health Evaluations: Necessary for accurate diagnosis of men's health issues. Continuous Monitoring and Follow-Up: Ensures ongoing patient safety and treatment efficacy. The Legal and Ethical Concerns According to § 410.78 Telehealth Services of the U.S. Code of Federal Regulations, telehealth services must involve an interactive telecommunications system that allows real-time, two-way communication between the patient and provider. This regulation ensures a higher standard of care, which is often bypassed by the simple form-filling methods used by some telehealth companies. Hims and Ro often use AI-generated question and answer formats to determine if a prescription should be issued. This method bypasses real-time interaction with a physician, raising significant safety and ethical concerns. Such practices should be illegal and likely will be in the future as adverse reactions or deaths accumulate. Risks to Patient Health Cardiovascular Complications: Dangerous drops in blood pressure for heart patients. Drug Interactions: severe side effects from negative interactions with other medications. Misdiagnosis: ED can be a symptom of conditions like diabetes or hypertension, requiring proper evaluation. Overuse and Dependence: Easy access leads to overuse and psychological dependence. Ensuring Patient Safety at His Health His Health avoids these pitfalls by adhering to rigorous telehealth standards: Comprehensive Evaluations: Detailed medical history reviews and thorough consultations. Patient Education: Providing resources on medication risks and benefits. Ongoing Monitoring: Regular follow-up appointments and support. Legal Compliance: Adherence to all relevant state and federal regulations. Our Unique Approach At His Health, we prioritize patient safety and comprehensive care: Dedicated Telehealth Doctors: Patients are assigned to a specific telehealth doctor responsible for their care, like traditional practices. Secure Communication: Regular communication through our EHR system, including secure messaging, additional appointments, and access to medical records via our patient portal. THE DIFFERENCE IS CLEAR!

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Healthcare startup idea: Caregiver-centric models of care could be a great business model in healthcare. A lot of the highest margin patients are shepherded through the system by a caregiver, because their age or health issues require additional support. Most clinics are patient-centric today... I can see a world where a pure caregiver-focused offering would resonate with a lot of people. 

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The meeting went well, yet Bob Health Tech still lost the contract. WHAT HAPPENED???? Jen, founder of Bob Health Tech spent hours preparing for a critical partnership meeting with the Chief Medical Officer at the local 15,000 bed health system. This was a big deal! Jen killed it. In fact, the CMO was so excited about pushing this partnership further, he called in the CFO last minute to get some financial questions answers. And this is moment Jen lost the deal. Hours and hours of "messaging prep" helped her pitch to the CMO. Clinical heavy, quality driven metrics lead the conversation and the medical team was psyched to get started. But, answering the specific questions around ICD 9 & 10 codes, RAF reimbursement, payer onboarding and implementation costs just wasn't part of the prep. She knew the information but wasn't able to organize it in a coherent way. Jen panicked. The Health System got cold feet and the contract was lost. "Messaging Mayhem" is my term for the state of communication chaos when one loses control of their company narrative and struggles to find the right words, for the right setting. It usually sets in when there are a variety of stakeholders to account for, and limitations in the type of message one can share. In healthcare, messaging mayhem is common place. Messaging mayhem is also the reason I am always pitching the messaging foundation. It's not so you can build yet another elevator pitch you never use. --> It's so you can avoid loosing a contract like this founder did. --> It's so, whether you have prepared for the meeting or not, you know how to talk about your reimbursement strategy. --> It's so you know what annoying questions the financial folks are going to throw at you --> It's so you know how to massage a message to maintain transparency while focusing on the client benefits A messaging foundation doesn't mean you stop preparing for the big meetings. But, it does mean that you are confident , if you haven't. -------------- "Hi. I'm Jessi and I'm a content engineer. For 15+ years, I've helped healthcare leaders, founders and writers effortlessly engage with their audience and finally grow revenue, investments, partnerships & more. Follow me for more info and set up a call to learn more (link in my profile) #ContentEngineer #Founders #HealthcareMessaging #Communication

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The US Physician Workforce will be decimated by the boomer doctor retirement cliff between now and 2030. A disturbing pattern in recent study findings makes this issue much more urgent - and the timeline to impact much shorter - than the government predictions. Let me show you why. The new statistics, the references ... everything The dots will all line up when you watch this short video and I'm happy to have the chance to show them to you. If you are a physician leader, this video is a Must-Watch because the mainstream media is not covering this phenomenon. Employers are only focused on short-term results: the numbers at the end of this second quarter, or the end of 2024.  They don't see this long-term trend. I also strongly recommend you share these videos with your C-suite - especially if your organization does not have a Corporate Wellness Strategy in place at this time. Learn what to watch out for - and what you must start doing now - to implement a Physician Wellness Strategy while there's still time. This trend will play out over the next three or four years. It's inevitable. You can't fight father time and nobody's getting any younger. Every doctor needs to know what is coming. Watch these short outtakes from this week's Wellness Champion Summit Webinar https://lnkd.in/gFYckWS4 **You will learn** 👉 What is the Boomer Doc retirement cliff? 👉🏽 How bad is it? 👉🏿 Recent changes in female physician and medical student behavior make things much worse. 👉 How the answer to this one question to your CMO doubles the projected physician shortage of 2030. 👉 Does AI at the same time make things better or worse? 👉🏿 What your organization must do now to prepare. 👉🏽 Why I'm predicting a brief window of opportunity for a corporate Physician Wellness Strategy - but you must act now!

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