Tony Balda

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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There’s a category we believe is getting too little attention when it comes to AI in healthcare: AI Clinical Documentation Integrity (CDI) While AI ambient scribes and autonomous medical coding solutions have gotten most of the headlines, we’d argue AI CDI is equally impactful when it comes to quality care and accurate billing. For those not familiar, CDI ensures that clinical documentation accurately reflects the patient’s medical condition and the provided care. Historically, CDI was a manual slog, with dedicated CDI specialists, nurses, and physicians painstakingly reviewing patient charts to ensure documentation supported the care delivered. Today, AI is reshaping this landscape. While it’s still early days, we’re seeing three primary approaches to applying AI when it comes to CDI: 1️⃣ CDI + ambient scribing—an AI ambient scribe and AI CDI assistant operate simultaneously, generating comprehensive notes and surfacing codes for physicians to review at the point of care. (Example: Ambience Healthcare’s AutoCDI) 2️⃣ CDI via real-time diagnosis support—diagnoses are suggested at the point of care based on clinical data in the EHR, with auto-generated documentation and audit trails. (Example: Regard) 3️⃣ CDI via an AI-driven post-coding / pre-billing review—the entire patient record is ingested and analyzed against what is coded, surfacing suggestions for revenue and quality opportunities. (Example: SmarterDx) To date, AI in healthcare has focused primarily on administrative use cases. With the increasing adoption of AI CDI solutions, we’re now taking a step closer to clinical workflows. As clinicians get used to AI-suggested diagnoses in the CDI context, it will be interesting to see if this increases their comfort with AI playing a role in clinical care. Here's our working list of AI CDI vendors. Anyone else we should add? • Ambience Healthcare • Brellium • Iodine Software • Regard • Semantic Health • SmarterDx   

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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

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Healthcare is highly suited for AI automation, with many opportunities to improve accessibility, affordability, and outcomes. AI can drive efficiencies across various functions, though it will inevitably reduce the need for some human roles. #higherorder #ai #automation #healthcare #healthtech

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Recently, I had the opportunity to listen to a podcast featuring the CEO's of Prime Therapeutics and Cap Rx. Investing time to learn what I can has always been crucial to my growth, and this podcast hit the mark for me. I was able to uncover some nuggets of wisdom that I can use to educate myself further. It's always exciting to learn from industry leaders and gain insights that can help me excel in my field. https://lnkd.in/eZTMUmiu

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Pumped for this! Come learn how Eirini Schlosser and the Dyania Health team are deploying sophisticated AI and expert-trained models at major systems to improve the lives of providers, researchers, trial managers, hospital staff, and most of all, patients..See you there!

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Mandatory bundles in surgery are a bi-partisan objective, and (in)ability to optimize cost/quality will dramatically impact hospital P&L. Regular insights from granular data , and AI-based decision support are the only way to systemically reduce unwanted variability and be both profitable and high quality.

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Federally Qualified Health Centers (FQHCs)– Automation and AI is now attainable for you to help overcome the unique challenges your organizations face on a daily basis. Matt Sanner from Polaris Optimization Group and I are teaming up to host an insightful webinar on how Droidal automation and AI can optimize your RCM and administrative operations leading to growth, stability, and enhanced patient outcomes. Whether you’re just starting or already exploring these technologies, this session will provide actionable strategies to integrate AI and automation into your workflows. Register today!

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MeditSimple is featured in The Innovator by Jennifer Schenker for transforming healthcare with AI! Tomorrow, our wonderful CMO @ Dr. Mathilde Konczynski will speak at the Platform Leaders Conference on digital platforms’ role in solving the healthcare crisis. Read the article: https://lnkd.in/ePfFVg2Y and sign up here to join us: https://lnkd.in/grRAdUk. #HealthcareInnovation #AIinHealthcare”

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AI in healthcare is transforming the landscape—revolutionizing everything from patient care to operational efficiency. The conversations at Becker’s Health IT + Digital Health + RCM Meeting highlight the tangible impact AI has on precision medicine, predictive analytics, and enhancing the patient experience. Being at this conference, it’s clear that we're not just exploring possibilities but actively shaping a more intelligent and responsive healthcare system. It's exciting to witness how AI will soon become integral to every facet of healthcare. #AIinHealthcare #HealthTech #DigitalInnovation #HealthcareTransformation #beckersannualHITRCM #beckershealth

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One key reason why healthcare technologies like AI, telemedicine, and software haven't structurally lowered costs or broadened access for the entire system after decades of experimentation (excluding pure financial engineering of payer contracts) is the limited reimagining of care delivery itself, with asynchronous telemedicine as a notable exception. In the same way that digitizing physical paper failed to exploit the capabilities of a new computing medium for word processing, hosting physician-patient conversations over video does not transform the actual delivery of care. In telemedicine, many of the inputs (e.g., clinician time) and therefore cost structures of in-person care persist, which is why we often see fee-for-service telemedicine companies struggle to achieve economies of scale (i.e., growing revenues non-linearly while growing costs linearly). Until we deconstruct the components of a medical appointment – from intake and triage, to chart review, history gathering, physical examination, diagnosis, treatment, and follow-up – we will continue to be underwhelmed by the disconnect between the transformative potential of these technologies and real-world patient/system impact. I’m optimistic that the emergence of reliable and performant medical AI agents will urge us to perform this deconstruction and redesign the fundamental building blocks of a “medical appointment.”

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Blueprint really is THE platform for mental health therapists. Not only does it give time back to practitioners but also helps them deliver even better care through data-driven insights. And Danny Freed’s personal story on why he started Blueprint is becoming a reality with Blueprint 2.0

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HLTH continues to be a great networking event - for startups, health systems, investors and industry giants... between meetings and the exhibit floor. I do wonder how much people are getting out of the speakers/content here (or at any of the big meetings anymore). I usually am happy if I can hear 1 great nugget that changes how I think or design... This article gives some thought to the big trends.. and a few summaries from leaders who attended.

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There are plenty of ways we rely on interoperability in our daily lives – and we never think twice about it. Like sending a text message that is received by your daughter – that shows up exactly the way you sent it. We only think about interoperability when it doesn’t work and creates frustration for users – like the green bubble versus blue bubble text message debate. It’s no big deal when the photo of your dog is pixelated when it makes it to your friend. But when it comes to the exchange of your health information between your doctor, pharmacist and insurance provider – the consequence of incomplete information risks the safety and quality of your care. We’ve come a long way in healthcare interoperability – but we’re not there yet. Hope you’ll check out my recent article for Forbes Business Council on what we must continue doing as an industry so we can forget about interoperability in healthcare and restore the focus back on patient care. https://lnkd.in/ehi6YRTE   #healthcareonLinkedIn #interoperability Surescripts

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Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Clinician Assistant • Abridge , Epic , and Mayo Clinic are collaborating on a GenAI clinical documentation solution for nurses. 📈 Data & Analytics • Carta Healthcare is being leveraged by MedAxiom - An ACC Company with the goal of making data abstraction processes more efficient, high quality, and cost-effective.    • b.well Connected Health released its configurable AI architecture, which aims to allow healthcare organizations to more readily integrate AI capabilities.    • Medicom Technologies Inc. completed a strategic financing round that included healthcare investors UPMC Enterprises, Tampa General Hospital Ventures, Cone Health Ventures, and more.    • GE HealthCare is collaborating with Amazon Web Services (AWS) on foundation models and GenAI applications.    • John Snow Labs released an update to its Generative AI Lab that allows users to test custom language models. 📋 Patient Administration • Artera added new FQHC partners including Bedford-Stuyvesant Family Health Center and Mose Lake Community Health Center, bringing it to a total of over 250 community-based providers. 💼 Provider and Practice Administration • Navvis (healthcare) released its new Patient Throughput and Capacity product to optimize patient flow and reduce length of stay. ⚙️ Clinical Operations • Qventus, Inc released an update to its inpatient solution that leverages machine learning to optimize patient worklists directly in the EHR to reduce length of stay and risk of complications    • Oystehr launched updated branding, ONC Health IT certification, and new features including its eRx service for sending electronic prescriptions and managing medication and allergy lists. 🍎 VBC • San Mateo County Health Foundation signed with Innovaccer. • Astrana Health entered an agreement to acquire Collaborative Health Systems. 🧠 Food For Thought We previously shared the recent announcement of proposed rule HTI-2 from ONC. Well, Brendan Keeler did us all a favor and demystified it for us over at HTD Health. https://lnkd.in/gTcYdgYg JAMIA published an interesting study that explored the iterative process of prompting an LLM to answer in-basket messages, exploring how it impacted both clinicians’ and patients’ perception on the messages. Researchers found that after multiple prompt updates, patients couldn’t distinguish clinician- from AI-generated in 76% of messages. https://lnkd.in/gMmBKmcv --- Want the latest healthcare tech news delivered to your inbox each week? Sign up here 📬 👉 https://lnkd.in/e2UJ3ckP

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Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Clinician Assistant • Avaamo launched an AI ambient scribe solution with support for over 50 specialties with pre-trained models. • Wound AI, an AI clinical decision support solution built by VANTIQ, Telemedicine Solutions, LLC, and NTT DATA, launched and is now available 📞 AI Contact Center • Premier Inc. awarded a group purchasing agreement to TeleVox Healthcare. 🏥 AI Facility Management • Medely has integrated with Oracle, allowing users to leverage Oracle’s Cloud HCM capabilities. 🌡️ AI Remote Patient Monitoring and Triage • The Alliance for Smart Healthcare Excellence—established by care.ai, now a part of Stryker, and developed with assistance from CHIME—was established to promote the Smart Hospital Maturity Model (SHMM). 📈 Data & Analytics • Epic expanded its set of APIs available to developers to support USCDI v3. • Health Catalyst will acquire Intraprise Health, a cybersecurity provider; it was also selected for analytics and interoperability by CyncHealth, Iowa’s health information exchange (HIE). • Health Commons Project acquired OneHealthPort • Socially Determined released a new application that helps organizations access data for minors. 🧾 Orders & Fulfillment • Surescripts is expanding its Medication History for Populations product to health plans, enabling care management teams to identify gaps in care and improve outcomes. 🧑‍💻 Virtual & At-Home Care • Mass General Brigham launched a partnership with the New England Center and Home for Veterans to provide hospital at home services for veterans experiencing homelessness. • MedStar Health expanded its partnership with DispatchHealth to support care transitions.    🍎 VBC • i2i Population Health is partnering with CureMD to surface actionable data to providers at the point of care. 🧠 Food For Thought • Brendan Keeler shared an interesting post differentiating AI solutions across augmentative vs. autonomous and then further breaking down each. One take we found interesting was, “Active interfaces are fun, but ultimately have some of the same problems as Siri - they require explicit engagement and cognitive overhead to use. This means their adoption and impact often fall short of expectations - users must actively remember to use them and overcome the friction of engagement.” https://lnkd.in/eR39qFpK --- Want the latest healthcare tech news delivered to your inbox each week? Sign up here 📬 👉 https://lnkd.in/e2UJ3ckP

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📣 I HAVE SOME BANDWIDTH FOR A FEW MORE CLIENTS. I AM ALSO AVAILABLE FOR FRACTIONAL ROLES. ❗ 💲 ARE YOU A STARTUP OR EALY STAGE HEALTHCARE COMPANY NEEDING SOME ADDITIONAL RESOURCES? 📌 Attention: 💥 MEDICAL DEVICE COMPANIES ⚕MAYBE YOU WANT TO PLAY IN THE DIGITAL AI SPACE...LET ME HELP YOU NAVIGATE THE LANDSCAPE. THERE ARE ALOT OF COMPANIES OUT THERE AND MANY MORE COMING TO MARKET SOON. DON'T PICK THE FIRST ONE! MAYBE YOU ARE A HOSPITAL 🏥 AND YOU HAVE NO IDEA WHERE TO START ON YOUR JOURNEY TO ADOPT AI. I HAVE A GROUP OF ADVISORS WHO HAVE DEEP EXPERIENCE IN AI (BOTH SCIENTIST AND PHYSICIANS) AND WE WOULD LOVE TO BUILD OUT A CREDENTIALING PROCESS OR ONBOARDING PROCESS ON HOW TO ADOPT OR EVALUATE AI. (Our team can even provide a group of advisors to be your AI committee.) 👨‍⚕️ NOT ALL AI IS THE SAME AND DON'T 🚫 JUST TAKE A COMPANIES WORD FOR IT...SHOP, EVALUATE AND ENSURE IT'S CLINICALLY VALIDATED. www.go2market-ai.com

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This analysis explores how Point of Care Testing (POCT) digital health technologies impact emergency care. It highlights how AI-powered remote monitoring can significantly improve operational efficiency in healthcare and enhance patient outcomes. Read more: [Nature](https://lnkd.in/gYb4hjXX)

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