Andrew Hamilton’s Post

Americans are spending ever-rising sums of their own money on healthcare. So-called out-of-pocket expenses now top $470 billion annually, per the federal government’s latest accounting. Spending is expected to keep rising too, along with the spread of high-deductible health plans and care providers who don’t accept insurance. While consumers aren’t exactly thrilled about this trend, startup founders and their backers see some very scalable opportunities. In the past couple of years, hundreds of millions of dollars have gone to companies working on things like health savings account platforms, care price comparison apps, and tools for employers offering high deductible plans.

4 Funding Announcements Made By Payer/Employer Health Tech Startups in March – MedCity News - MedCity News #FundingAnnouncements In March, several payer and employer health tech startups announced significant funding rounds, showcasing the growing interest in this sector. These startups are leveraging technology to improve healthcare delivery and patient outcomes. #Bright Health Raises $750M in Series E Funding Bright Health, a health insurance startup, raised $750 million in Series E funding. The company aims to simplify the healthcare experience for consumers by offering affordable and personalized health insurance plans. #Collective Health Secures $280M in Series F Funding Collective Health, a health benefits platform, secured $280 million in Series F funding. The platform helps employers manage their employees' healthcare benefits more efficiently, leading to cost savings and better outcomes. #Oscar Health Raises $225 ai.mediformatica.com #funding #health #news #fundinground #medcity #hilabs #clinical #data #healthinsurers #provider #seriesb #this #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/3VGzE9M)

All About the Money 💸? ...Maybe, but bear with us... We champion a higher purpose. Healthtech startups aim to refine healthcare: 👏Streamlining effective processes into the healthcare system 👏 Democratising healthcare services 👏 Sometimes, even saving lives We get it - your higher purpose and growth might not be monetarily driven. You're here to make the world better. Fantastic! Having said that, you and your team still deserve payment. Your customers deserve access to your services everywhere... which isn't cheap. 🤔 Can your startup function indefinitely without funds? Unlikely. Is establishing a revenue model for your healthcare innovation easy? Never said it was, considering the varied environment, payment structures, and numerous stakeholders in healthcare, functioning differently worldwide. We aim to disscuss these questions in our upcoming workshop: What are the strategies for monetizing in the healthtech sector? How can one build a sustainable business that also contributes to social good? Who forms your customer base? Could you define various customer scenarios involving patients, healthcare providers, health professionals, and health insurance institutions? What are the unique characteristics of healthcare business models from the perspectives of clients, users, paying customers, and institutions? Intrigued? Register before May 12th for our free online workshop! 👇 https://lnkd.in/ebjYUGin

🚀 Considering alternative healthcare benefits for your startup? 🏥💼 In a recent Q&A with Vanessa Kruze, CPA, our CEO, and Founder, we explore the world of HRAs (Health Reimbursement Arrangements) and whether they're the right fit for your team. Here's a sneak peek into what you need to know: 🔍 What's an HRA? It's an IRS-approved employer-funded health benefit account to reimburse employees for medical expenses, often chosen for its cost-effectiveness. 📊 How Does It Work? We break down the funding, claims process, and reimbursement, making it easier for startups to navigate. 💰 HRA Platform Fees? Learn about these fees and why they're typically more affordable than traditional health insurance premiums. 🎯 Benefits of Using an HRA Platform? Discover the convenience, compliance, and flexibility advantages that could benefit your startup. 🤔 Key Takeaways? Consider the cost-benefit analysis, seek expert consultation, and maintain open dialogue with your team before making the switch. Read the full article by Vanessa Kruze, CPA, and get your startup's health benefits strategy on track. Link in the first comment! #StartupAdvice #HealthBenefits

🚀 Exploring alternative healthcare benefits for startups? 🏥💡 Read my latest Q&A on HRAs, Health Reimbursement Arrangements, to make informed decisions for your team's health benefits. Link to the article in the original Kruze Consulting post. #StartupAdvice #HealthBenefits

A Quick Glimpse at the Digital Health Market The digital health landscape is constantly evolving. According to CB Insights, the global digital health market surged to a value of $180.2 billion in 2023 and is poised to accelerate to $549.7 billion by 2028, showcasing a staggering Compound Annual Growth Rate (CAGR) of 25.0%. But what does this mean for digital health founders? Take a look at the investment breakdown provided by CB Insights for the year 2023: ✔Care Delivery & Navigation Tech: This sector secured the lion's share of funding, boasting $837 million. ✔Monitoring, Imaging, & Diagnostics Tech: Close behind, this segment raised $501 million. ✔ Health Insurance & RCM Tech: Not to be overlooked, this category garnered $295 million in investments. Understanding these investment trends is paramount for you as a digital health founder. ☑ It serves as validation for your market; ☑ provides insights into the competitive landscape; ☑ aids in strategizing your capital approach; ☑ and uncovers growth opportunities within the industry. Remember, your competitive advantage lies in your ability to deeply understand your customers and your market. Taking a step back from the day-to-day fundraising grind to analyze market trends and consumer behavior can lead to more informed decisions and a sharper go-to-market strategy. When was the last time you stepped back and analyzed your market, trends, and consumers? As a former founder, I can tell you I thought about doing this way more than I actually took the time to do it. Now, on the other side of the fence, I know firsthand the importance of this analysis in building a strong strategy, aquisition plan, and business model. If you're looking to decipher market trends and position yourself for investment success, feel free to reach out. #DigitalHealth #MarketAnalysis #InvestmentInsights #womenshealth #healthcare #startupstrategy

💼 Considering HRAs for your startup's healthcare strategy? 📊 Discover the cost-effectiveness and flexibility of Health Reimbursement Arrangements in our recent article. Link to the article in the original Kruze Consulting post. #StartupFinance #HRAs

Individual coverage health reimbursement arrangements, otherwise known as ICHRA, are enjoying a surge in popularity. QED's Victoria Zuo spoke with Fierce Healthcare's Noah Tong to discuss the tailwinds that could propel ICHRA to become a big category despite its infancy. Here's why we're searching for startups that do the boring administrative work for employers and that make direct enrollment easy for employees. https://lnkd.in/eT7vSK7P

Why Healthcare Businesses Take More Time to Turn a Profit In the fast business world, healthcare’s journey to profitability often takes a longer, more winding path. While tech startups might achieve unicorn status in a matter of years, healthcare ventures typically require more time and patience before seeing substantial returns. These are some reasons behind this extended timeline and what it means for investors and entrepreneurs in the healthcare sector: 1. Regulatory and Compliance Costs Healthcare is one of the most heavily regulated industries. New businesses must navigate a complex of governmental regulations and local and international standards, often requiring significant time and financial investment before even opening their doors. This is costly and time-consuming, impacting the bottom line in the early years. 2. High Initial Capital Requirements Many healthcare ventures require substantial upfront investments in specialized equipment, facilities, and technology. These initial costs can be significantly higher than in other industries, extending the time needed to recoup investments. 3. Building Trust and Reputation Trust is paramount in healthcare and it needs time to build credibility with patients, healthcare providers, and insurance companies. 4. Complex Revenue Cycle Systems Healthcare businesses must navigate intricate reimbursement systems involving insurance companies, government programs, and direct patient payments. The lag between providing services and receiving payment can impact cash flow and profitability. 5. Skilled Workforce Requirements Healthcare businesses typically require a highly skilled, specialized workforce. Recruiting and retaining qualified professionals can be costly and time-consuming, impacting the path to profitability. 6. Evolving Technology and Standards The healthcare industry is evolving and requires ongoing investments, which delay profitability but are essential for long-term viability. 7. Focus on Patient Outcomes Over Quick Profits Unlike some industries where cutting corners might lead to quicker profits, healthcare businesses must prioritize patient outcomes and quality of care. This ethical imperative often means choosing more expensive, higher-quality options that impact short-term profitability but build a stronger foundation for the future. Investors and entrepreneurs in this sector need to approach their ventures with patience, and understanding that this longer path to profitability is a must. It requires careful planning, adequate capitalization, and a steadfast commitment to navigating the unique challenges of the healthcare landscape. While the journey may be longer, the potential for creating significant value—both financially and in terms of societal impact—makes healthcare an attractive sector for those willing to invest the time and resources required for success.

What is CommonCare? We're not a TPA. We're not brokers. We're not another BenAdmin system. We're a health plan. Or really, a few different health plans, all enabled by our underlying in-house tech. So how do our health plans work? Well, it's pretty straightforward. Attached below is the decision-making tree that we walk employers through. At the end of the day, we think that all groups should EITHER: - Get out of the healthcare game, and give people access to ALL of their compensation by placing ~10% of the employer contribution in an ICHRA and the other ~90% in a cafeteria plan that is lined up with a few great pre and post tax options. (i.e. FSAs, HSAs, major medical, health shares, DPC...or even just cash it out as a taxable bonus) OR - Become a leveraged buyer of healthcare and run an optimized self-funded plan that is physician-led and sheds all of the insurance-industry bias imposed by TPAs, PBMs and networks. We help facilitate both of these models. For groups who are caught in the middle and not quite willing to make the jump to our radical self-funding approach...we've got a few simpler solutions that serve as gateway drugs to self-funding. Claim Map, Bill Eraser, PocketGuard and DPC. That's it. That's what we do. Oh yeah, and our fees? $5 PEPM for everything we offer. Any plan design. All the tech. Unlimited access. If you're in the space and this approach is intriguing to you - let's talk. Or if you disagree with our philosophy - let us know. We want to actually solve real problems, and welcome anyone who can help us see where we're falling short.