Marta Bralic Kerns

The (Healthcare) Ground Beneath Our Feet… This year it is likely that over $10 billion will be invested in the digital health sector – a robust amount, no doubt, but inconsequential when compared to the amount of capital tied up in healthcare real estate assets, which is estimated to be $1.2 trillion by Jones Lang Lasalle. Of that amount, approximately $790 billion is in the hospital sector while the remaining $490 billion is in medical office assets. It is estimated that there are 48.6k facilities with 3.4 billion square feet of healthcare real estate, 42% of which are owned by REITs and another 33% held by other private investment vehicles. Much of the digital health investment is meant to make the physical healthcare infrastructure more productive: greater operating efficiencies, greater patient throughput, more relevant personalized care models with better outcomes. As the healthcare system is being pushed to be more distributed to lower cost sites of care, accelerated now by the rapid proliferation of automation and AI capabilities, the potential impact on healthcare infrastructure assets will be profound. Thoughts on what that might look like... https://lnkd.in/eTfAdUbS #digitalhealth Flare Capital Partners

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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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Excited to announce Frist Cressey Ventures' investment in Qualified Health and privileged to partner w/ SignalFire, Healthier Capital, Town Hall Ventures and others!   Healthcare costs are increasing at a faster rate than ever before, with the US spending nearly twice as other wealthy countries and still ranking bottom in outcomes. It's a story you've all heard - - US healthcare is known for astronomical inefficiencies, waste, workforce supply constraints, fragmented access, appalling patient experiences, and driving patients and businesses into debt.   Yes these problems present opportunities. But opportunities are limited to the system's appetite for change, desire and incentive to try something new and the innovation available. At FCV we believe we've hit the trifecta with Generative AI. Generative AI has given us truly transformational tools in the toolkit and the healthcare ecosystem is demanding to absorb its benefits. This perfect collision of supply and demand means healthcare is poised for big change.   Generative AI is everywhere, it's buzzy, it dangles hope and opportunity. But many things need to be true for the Gen AI transformation in healthcare to take hold, such as but not limited to:   💡 Patient lives and data need to remain safe: We believe in a highly regulated and human life-touching sector such as healthcare we must ensure Gen AI can drive to unrivalled savings and improvements in the quality of care WHILE not putting patient lives or data at risk.   💡 Systems need to own their utilization of Gen AI: We believe systems will use some hybrid of external partners and homegrown solutions but importantly will want full control of data provisioning and utilization as well as the ability to solve an unlimited number of nuanced issues and not cookie cutter algorithms.   💡 Costs need to be looked at on an enterprise level: We believe the speed of innovation in Gen AI means costs will continue decreasing dramatically but at an enterprise level this will still not be a small detail. Systems will want the ability to understand costs and delegate as needed for the outcomes desired at the organizational level.   Enter Qualified.   We knew when we met Justin Norden, MD, MBA, MPhil and team we were standing in front of changemakers. These individuals have lived and breathed the true application and implementation of Generative AI far before we were asking ChatGPT to write our emails. In fact, if you’ve ever driven in a Waymo you’ve benefited from past products this team has built.   Qualified Health is on a mission to enforce governance in Gen AI, allow systems to rapidly build for their needs, monitor and make decisions for all GenAI (homegrown and external) and accelerate the value the sector can glean from these new technologies.   Huge shout out to William T., Tommaso Auerbach and Jamie Kuntz for their hard work!

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One of my proudest moments as an investor occurred today as Alaffia Health announced its series A because it shows how the Aperture® Venture Capital vision of multi-level, multi-generational #impactinvesting is succeeding in the marketplace. Here’s the model in its most basic form : ✅As diverse fund managers with meaningful capital to allocate, we are changing the VC landscape every day just by doing our day jobs. ✅As Black/Brown investors with ~40 years experience collectively, Aperture GPs have access to talent /excellence that others do not, so our portfolio *organically* is more inclusive by race, gender and geography even while optimizing for financial outcomes (all about the alpha). ✅Our most successful portco’s are using financial #innovation to solve market problems that impact underrepresented demographics and underserved communities. Alaffia Health is a shining example of the impact portion of our overall fund thesis, and we couldn’t be prouder of TJ Ademiluyi and Adun Akanni, MPH, PMP - the dynamic brother-sister founder duo whose vision we have steadfastly supported on their journey. Congratulations to TJ and Adun from William Crowder and myself, as well as the whole Aperture team- Marjorie King Philip McKenzie Yves Louis-Jacques Tanvi Lal Michelle Dhansinghani Lisha Bell Katie Kelly Amy Chung Cindy Chong, CFA Brian Fernandes-Halloran Monroe France Jayden Pantel Darren Herman Evan Wladis Neal Triplett Thomas Scriven Peter Ammon Irina Bit-Babik Tim Milanich Rob Rahbari

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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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It was wonderful to be in conversation with Madison Mills of Yahoo Finance at their annual Invest conference earlier this week. We covered everything from the venture outlook for 2025, impact of elections on women's health investing and innovation, and more. Full clip and summary below 👇 https://lnkd.in/gS67sc2Y

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What happened in mental health last week? ⏺ KHP Ventures announced the Innovations in Mental Health Fund, a £20m fund to invest in mental health startups ⏺ Amae Health raised $6m from Cedars-Sinai for psychiatrist-led integrated care and wraparound mental health services for severe mental illness ⏺ Warsaw-based Britenet, received a £1m grant from the EIT - European Institute of Innovation and Technology for Moodmon, an AI driven tool for management and treatment of chronic affective disorders ⏺ Pulvinar Neuro received FDA breakthrough device designation for its closed-loop transcranial alternating current stimulation (tACS) to treat major depressive disorder ⏺ Czech startup Elin.ai closed a €1m pre-seed round for a mental health app for Gen Z and Gen alpha users ⏺ MindMed announced that their first patient has been dosed in their phase 3 study for MM120, an optimised form of LSD for generalised anxiety disorder after being granted ‘breakthrough therapy’ status by the FDA in March ⏺ Isar Mazer from Tacklit and Jacinta Pollard from Caraniche published an intersting article on how to digitally transform mental health services ⏺ Autism therapy provider Proven Behavior Solutions, LLC acquired Prism Autism Education & Consultation Education and Consultation, expanding into a second state. ⏺ Redesign Health raised a $175m fund to back health-tech startups. Whilst not a mental health specific fund, Redesign have a track record of backing businesses in this space. (All links below) __ If you liked this and want insights on the mental health industry in your inbox every week, subscribe to The Hemingway Report newsletter and follow me Steve Duke 📩 #MentalHealth #BehavioralHealth

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2024 was a whirlwind of a year, and I can’t wait for 2025 to be an even bigger year for Zealthy and Revolution Venture Studios (RVS). In 2024, Zealthy, the telemedicine company I founded 2 years ago with the vision to build the world’s largest and highest quality telemedicine company, grew to serve over 100K patients in 2024 alone across 36 states. I see this as a continuation of the mission that drove me to start Cerebral at 27 years old and build it into a $4.8B industry leader that provided mental healthcare to nearly a million people. Rather than only focusing on mental health, Zealthy seeks to become the central point of care for the patient across every indication that can be treated safely & effectively via telemedicine, including weight management, mental health, sexual health, and primary care. While it is just the beginning for Zealthy, and we certainly have our fair share of issues to work through to achieve our vision, it’s a humbling milestone that I feel grateful to everyone that has been part of the Zealthy journey for making happen. In 2024, I also incubated a number of startups as Founder and Managing Partner at Revolution Venture Studios (RVS). At RVS, we ideate, co-found, and fund businesses with the potential to effect meaningful, positive change in the world. This allows me to bring new ideas to life while bringing in talented, passionate founding CEOs where I provide hands-on support to the companies as Co-Founder and Chairperson of the Board. I’m proud and grateful for co-founders and CEOs of businesses we’ve incubated such as: - Daniel FORTUNATO at BIOVERSE, which is pioneering online longevity care to help people live longer & healthier lives. The team has spent 2024 building the company from an idea to Series B/C level metrics profitably. - Lisa Bell at Amara as we continue to acquire med spas, grow the med spas we own, and organically build new med spas throughout the country. - Several in stealth, many of which involve AI applications in healthcare that are partnering with providers to help them provide more effective, cost efficient care. In fact, our newest incubation is using AI to transcribe notes for clinicians to ensure that they can focus as much of their time as possible on what they do best: providing care. It’s just the beginning, and the growth we saw in 2024 has me energized to build to new heights in 2025.

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Severe mental illness remains one of the most underserved areas in mental health, possibly because it is difficult to address with the type of virtual, easy-to-scale models that VCs love to back. We're so excited that Sonia Priscilla García and Stas Sokolin at Amae Health have been able to break the mold, bringing better in-person solutions for patients and families dealing with SMI, and attracting strong venture partners to do so cc: Lisa Jacobs Blau, Alison Ryu, Claire Akkan Quiet Capital, Healthier Capital, Jan Ellison Baszucki, Karin Kissane, Mike Volpi

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👀 HOW DO WE GET DIGITAL HEALTH TO REFOCUS ON PREVENTATIVE CARE?👀 Enter Inbal Tirosh co-founder and CEO of the incredible Livez on this week's episode!! My favorite question to ask founders is what is your founding story? Tune in to hear Inbal explain her founding story, and how they are impacting patients lives and futures! Livez is built to make preventative care easy, convenient, and reduce claims. The Livez screening solution detect 85% of preventable diseases!! Reduces a whopping 75% of healthcare claims. How do they do this? Inbal jumps into it all with me, explaining, "All together if you take every person and they get a plan of what they need to get screened for, based on their individual profile, and their specific data, you can do that with fusion of big data, and you take them on a journey to prevent their predicted risks, based on family history and their own history and so on..." Then you automatically book them with follow up appointments. This is backed by health authorities, and by large insurers! Key Points 🗝 🌐 Livez screening solution covers more than 50 clinical domains and 120 screenings and vaccines, impacting 75% of healthcare claims. Livez is a preventive health platform that focuses on holistic screening and interventions to prevent chronic diseases. 🏥 The platform helps employers and health plans prioritize the health of their population by identifying health risks and guiding individuals towards appropriate interventions. This is an absolutely fascinating conversation about the new frontier of preventative care. Get on board, and tune in to this week's episode of the Digital Health Heavyweights Podcast Also- major teaser that their pricing is FULLY at risk. Why NOT? Learn more about preventative care, and how Digital Health is continuing to evolve!

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On this week's Andreessen Horowitz Raising Health podcast, Vijay Pande, PhD and I interviewed Tom Hale, CEO of ŌURA. Our conversation spans lots of fun topics, including: -- Our love for our Oura rings, despite them being literal “buzz kills” in revealing the ruinous effect of alcohol on sleep  -- How the worlds of consumer and healthcare are merging, as consumers essentially now have access to clinical-grade wearable devices  -- How AI algorithms are deployed in wearable devices & what wearables might look like 20 years from now (implanted into our bodies and clothes)  -- How the sexiest people sleep in earplugs and eye masks Check it out! https://lnkd.in/eTAsX_sY

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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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Today, Two Chairs announces $72M of new funding to continue building a world where everyone has access to exceptional mental health care. Since late 2017, when Maveron led the Two Chairs Series A, the need for mental health services has grown considerably as our society has become lonelier and more isolated than ever. At the same time, our culture’s willingness to openly acknowledge these challenges is greater than ever. Sadly, the rapid growth of Two Chairs affirms the fact that our society is in desperate need of better mental health support. Two Chairs has built a business that believes clinical quality is the defining characteristic of success. Alex Katz has always emphasized the paramountcy of measurement-based clinical outcomes, which the team works tirelessly to achieve. In the process, Two Chairs has illustrated that embracing the ‘move fast and break things’ mentality doesn’t always work. Instead, Two Chairs opted for a different approach: they went slow to go fast. They built a proprietary algorithm that matches patients with the perfect therapist at the onset and hired a team of W2 clinicians oriented toward providing the highest quality care available. Even as the Two Chairs team has grown, their culture has remained small. This has enabled more intimate relationships within the team and between clients and clinicians. Reflecting on this milestone brings me back to the founding of Maveron and the values we hold dear. In 1998, my friend Howard Schultz and I founded Maveron to help entrepreneurs build companies that improve the lives of everyday people—their employees and their customers. There is perhaps no better example of this than Two Chairs. *** Thank you to TechCrunch's Marina Temkin, CFA for the great write-up. https://tcrn.ch/4aMt7yG

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Incredibly excited to share our updated Healthcare AI thesis. This is not a market map – in 4,000 words, we dive deeply into the research, products, business models, and market entry points that are reimagining healthcare with AI. More specifically, we cover: • Translating AI research into real-world products • Mapping modalities (software, copilots, agents, services, diagnostics, therapeutics) to problems in healthcare • Designing AI business models that unlock billion-dollar markets • Closing current gaps in healthcare AI infrastructure • Distinguishing AI platforms from point solutions Let us know what you think ⤵️

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Ubiquity in healthcare. It's what consumers are demanding and what we need to transform. There are few "best practices" to take from banking but this is one we can emulate. 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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What happened in mental health last week? ⏺ Anise Health raised $3 million to deliver culturally-responsive mental health care for the Asian American community ⏺ Goldman Sachs acquired autism therapy provider Center for Social Dynamics, a care provider to over 4,700 clients across 20 locations. ⏺ Lyra Health CEO David Ebersman announced that he will be stepping back from his role to care for his mental health. Ebersman will take on a new role as Board Chairman. ⏺ Substance use disorder (SUD) treatment provider BrightView is closing nine facilities in Massachusetts and Arizona citing challenging operating environments. ⏺ California introduced a bill that would require mental health warning labels on social media sites. It would be the first U.S. state to do so if the bill is passed. ⏺ The Australian Medical Association issued a position statement warning that chronic underfunding and increasingly complex patient presentations are pushing the mental health system to a crisis point. ⏺ Ukrainian startup Healthy Mind raised $1 million to launch an AI platform for mental health in the workplace. ⏺ Indian mental health platform GoodLives raised $129,000 in a pre-seed round, offering AI-driven self-directed exercises alongside expert-led therapy sessions. ⏺ We (The Hemingway Report) launched our 2024 founder survey. Link in comments to contribute. (All links below) __ If you liked this and want insights on the mental health industry in your inbox every week, subscribe to The Hemingway Report newsletter and follow me Steve Duke 📩 #MentalHealth #BehavioralHealth

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