Ringing in 2022
2021 has been quite the year for digital health innovation.
As big believers in this space, we at LionBird couldn’t be more excited to see digital health solutions being rapidly adopted by consumers, payers, providers, and pharmaceutical companies alike. Through the first three quarters of the year, approximately $21.3B were invested in the sector across 541 deals, with telemedicine services, mental health, and women’s health accounting for the most dollars. 1
Just under two years ago, a little virus emerged that led to fundamental changes in how we work and live, and more importantly in how we consume and deliver healthcare services, because of rapid regulatory and reimbursement approvals. In light of this very busy year in digital health, we decided to invite several members of our LionBird Rings, experts from all US healthcare domains, to answer the hardest question of all:
If you were to start a startup in your field, what would you build?
We hope these inputs from the people on the other side of the table will help early founders in their quest to build the next healthcare game-changers in 2022 and here at LionBird, we’re always ready to help you along your path to turn a dream into a commercially feasible opportunity because, in the complex US healthcare system, it does take a village!
According to Adrienne Schneider, CEO of Camille Group and the former health benefits manager for American Airlines, “Employers are currently facing an even greater crisis than healthcare concerns — a competition on recruiting and retaining critical talent. While there may be a “boomerang effect” eventually, employees are leaving companies at record rates, forcing a demand for competitive salaries to be at an all-time high. However, companies are discovering that paying higher wages isn’t enough. A growing number of employers are seeking digital health solutions that provide “whole person” benefits, beyond the traditional medical and dental benefits.
Mental health/emotional well-being solutions addressing stress and burnout and tools for resilience are top of mind for employers. Further, the real winners in digital health are those increasing the availability and access to a holistic virtual approach to addressing more severe behavioral and mental health conditions. Additionally, women’s health digital and virtual care solutions beyond the already saturated market of fertility and maternity, will be a growing trend in 2022 and beyond. Women have led the “great resignation” at twice the rate of men, so there is a growing recognition that the right benefits combined with a lens on diversity, are necessary for an inclusive workforce. Employers will also remain focused on solutions that ultimately help them address the largest drivers of health care spend, so digital health solutions that assist with the burden of rising prescription drug costs and improve the health of those with expensive acute and chronic conditions in virtual, cost-effective settings are key as well” concluded Adrienne.
Joshua Habib, former VP at Optum and United Health concurred with Adrienne’s thesis on the raising importance of behavioral and mental health solutions and added that the top priorities for employers will be “helping employees in their caregiving tasks for elderly family members, which includes better coping with stress, anxiety, and depression, that obviously surges during a time of COVID”. Coming from a value-based care background, Joshua added that for his own startup he would focus on solving underserved, measurable problems, and tying revenue to performance.
Representing the voice of the leading health plans, Brad Fluegel, previously EVP, Walgreens, and SVP, Anthem believes “we will see an explosion of virtual-first health plans this year, with many health plans and employers offering them. I would focus on a suite of services (physical, digital, remote patient monitoring) that allow those in poor health to live independently at home. I think this is going to be the next big frontier!”
From the providers perspective, Paul Di Capua, MD, Medical Director, Devoted Health; Former regional medical officer, Caremore Health; Internal Medicine, Stanford, provided his angle on value-based care and stated that “providers in value-based care will continue to recognize the benefits of hybrid virtual/in-person models, and in Medicare Advantage, they will continue to over-index on optimizing risk scores as argued by Richard Gilfillan and Donald Berwick in this article in Health Affairs. This confluence will drive digital health towards more diagnostics including cardiovascular diseases and diabetes. An additional area of focus should be the rise of virtual treatment modalities paired with an “analog” intervention. For example, virtual sleep cognitive behavioral therapy will take off when it is combined with a behavioral health specialist and a prescription for a pharmaceutical. Despite Medicare Advantage’s strong recent growth (link); it’s bipartisan appeal; and the model’s ability to provide value, innovation, and equity (link), the voices critiquing Medicare Advantage are getting louder: that it’s more expensive than traditional Medicare, and it’s not delivering its promised value proposition (link). At some point within the next 5 years, CMS will tighten the screws on MA plans, and the winners will be the plans that are excellent at 3 things: (1) retaining their enrolled patients, (2) creating plans of care centered on patients’ needs and priorities, (3) avoiding unnecessary acute care. I would start solving for that now”.
We also asked Tom Davis, previously SVP Coventry Health Care, Market President, ChenMed to add his view of senior care:
“2022 may be a year of refining the digital experience for seniors. Seniors and their caregivers need better support to effectively use remote patient monitoring, telemedicine applications, and other interactive tools. I believe deeper engagement needs to precede broader adoption. I find myself gravitating to the niches where well-defined groups have particular needs. This could be ethnic PCP networks and value-based care or integrated delivery of care and Rx for high-cost diseases (e.g. RA and MS)”.
Michal Guindy, MD, Head of Ventures and Innovation Division and former head of medical imaging at Assuta highlighted she would focus on tools to empower the clinician at the point of care. This includes tools that also empower in collecting data to improve the diagnosis, monitoring, and eventual treatment of their condition. Three key therapeutic domains where Michal would focus on are imaging, senior care, and chronic illnesses.
Digital biology and precision medicine are some of the areas we have been seeing a lot of innovation in the past year. Representing the voice of both the young biotech and pharma stakeholder, we asked Mark Oldroyd, CBO, C2i Genomics and former executive at Tempus and Foundation Medicine to tell us where genomic and multi-omic founders should focus their efforts on and he shared his personal story and perspective:
“If I were free to form a new company in 2022, I would focus on discovery of genomic triggers in neonatal heart defects. My grandson Jax is a victim of hypoplastic left heart syndrome (HLHS), where his left ventricle never fully formed. The condition is considered a critical congenital heart defect (CCHD), requiring open heart surgery shortly after birth, as well as two additional surgeries in the first few years of life. Jax has fortunately had a good result after two surgeries, but many children do not.
Accessing expertise in genomics, cardiology, gene editing and tissue engineering, I would uncover which genes are the primary drivers of these deformities. Following discovery, the company would build a genomic diagnostic instrument for further research into disrupting the defects, by “turning on or off” the genes driving the mutation. Partnering with biopharma R&D we would pursue potential therapeutic solutions and using gene-editing technology, look for a mechanism to deploy within the fetal DNA itself to keep the heart developing normally. If we can identify, treat, or direct the genomic drivers for these conditions, we could positively impact the lives of millions of newborn children globally”.
Of course, the technologies mentioned above are all relevant to a wide range of genetic diseases, some caused by mutations in a single gene, others, caused by more complex factors including multi-gene interactions, protein post-translational modifications, and more. All these create challenges and opportunities for startups looking to make a difference in the lives of many people”.
