Murray Brozinsky

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

113

6 Comments

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!

240

14 Comments

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

37

18 Comments

With Americans over 65 projected to grow from 58 million to 82 million by 2050, AI solutions like Foundation Capital portco SafelyYou are becoming increasingly crucial. They’re also a powerful answer to the industry’s persistent staffing shortages, acting as a force multiplier for caregivers. The benefits extend beyond individual residents and their families. For senior living homes, SafelyYou’s AI-powered fall prevention and response system translates to longer lengths of stay and higher net operating income (NOI). With AI, we are working towards a future where every individual—regardless of age or health status—receives the highest quality care, tailored to their unique needs and circumstances. Companies like SafelyYou are leading the charge in making this future a reality, and I’m immensely proud to work alongside them as they use AI to build a better world.

47

1 Comment

The healthcare landscape is rapidly evolving, driven by advancements in technology and a deeper understanding of patient care. I had the pleasure of speaking with Ambar Bhattacharyya, Co-Managing Partner at Maverick Ventures, on the latest episode of The Full Ratchet. Ambar has partnered with numerous billion-dollar companies like hims & hers, Cityblock Health, Devoted Health, and ConcertAI. His unique journey from rural America to becoming a prominent figure in venture capital offers invaluable insights into the future of healthcare and technology. We discuss his investment strategy at Maverick Ventures, the megatrends shaping healthcare, the impact of AI on the industry, and the importance of integrated care. Ambar also shares his thoughts on the challenges and opportunities in healthcare investment, offering a comprehensive view of what lies ahead. Check out TFR Episode 438 to catch our conversation. You'll be glad you listened. Link to the full episode is in the comment section below.

117

8 Comments

Open-source models can be a strong lever for increasing gross margins at AI companies, especially those that have hefty cost structures (e.g., enterprise sales orgs that require significant customer success or implementation resources, as well forward-deployed AI services models common in healthcare and life sciences). One of many reasons to maintain a modular and flexible stack with minimal dependencies when building an AI company. More on the importance of flexibility in the AI stack: https://lnkd.in/eA2XATRk h/t Delip Rao #ai #artificialintelligence #generativeai #healthcare

50

6 Comments

If you enjoyed our first blog on the metrics that matter for Verticalized SaaS then don't miss on the Part II of the series where my colleagues Devraj Hom Roy and Matt Schaar discuss the strategic and operational choices to improve these operational indicators. https://lnkd.in/g5QkCrcH

15

1 Comment

DeepCast shipped a number of really cool new features recently in advance of a broad outreach push to podcast listeners. One new feature is our new Daily DeepDigest tool that sends you a concise daily email including any new episodes from the trailing 24 hours from any podcasts you Subscribe to (on DeepCast). Think daily podcast cliff notes or podcast news ticker tape, with a hint of Morning Brew various brews or PitchBook News—it's increasing information throughput when you're pressed for time. And this feature is rapidly evolving to distill other key extractions from shows you're already interested in, but also exposing you to other shows you might be unfamiliar with that also have nuggets to share—and thus increasing your aperture yet still conscious of your time. Want to go deeper on any given episode? Click the episode detail and you're off to an episode on DeepCast, where you can subsequently read a longer form distillation of that episode or go straight to the source and listen to the episode. (And podcaster friends, these pages are definitely increasing indexing and thus Google entry points to your shows!) I'm loving this feature as a user, personally. Can't wait to see what others think! #BuildingInPublic #Podcasts #AllTheWorldsInformation #HowYouWantIt

24

1 Comment

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!

13

1 Comment

Abby Levy talks about venture's role in US healthcare and what we can expect to see as technology impacts the space on TFR. Check out the rest of the conversation with Abby & Alan Patricof of Primetime Partners on Episode 433.

35

6 Comments

I’m optimistic about the potential of generative AI to reduce provider burnout and improve provider-patient interactions. However, that optimism is tempered by the data that indicates the technology is not quite ready yet. Bright Ventures is interested in digital health founders who understand the realities of provider-patient interactions, and the role technology can play in strengthening clinical outcomes. Which founders and teams are getting this right? Tag them in the comments below.

50

2 Comments

According to the latest report from Rock Health, digital health funding in Q1 2024 totaled $2.7B across 133 deals, with an average deal size of $20.6M. It doesn’t break out device-related investments, but most medtech founders I meet these days are being forced to chase tiny rounds made up of endless little checks, consuming valuable energy and slowing their progress. The benign neglect of this next generation of diagnostic and therapeutic devices is counterproductive and surprising. Given the crowded virtual care market, for example, I’d expect more such companies would be exploring medtech partnerships, investments or acquisitions that'd enable them to back integrate into delivering sharper, and more differentiated, care and treatment. This is exactly what Maverix Medical is doing from the other direction: Reshaping the entire spectrum of lung cancer care by integrating more advanced + effective approaches to screening and diagnosis, treatment and therapeutics, and even palliative care…And putting it all to work through an innovative provider network. One notable investor exception is Y Combinator partner Surbhi Sarna who’s been backing great teams like Selera Medical (YC W24) doing foundational work on ambitious medical devices. Without more support from investors like her, we’re going to increasingly find ourselves stuck with the incremental portfolio improvements from the incumbents, and that’s just not nearly enough.

59

5 Comments

#hiring If anyone knows an awesome engineer that would be interested in joining an emerging #AI company doing important work in #healthcare, please drop me a line! Andy AI is backed by General Catalyst, YCombinator, Greater Ventures, and others, and they’re looking to hire a full stack engineer (US based) who's excited about using AI to improve healthcare and reduce nurse burnout. Andy is AI software that automates clinical documentation for nurses who do home visits. A nurse makes an audio recording of the visit and Andy automatically generates a form that usually takes nurses 90 minutes to complete. Nurses love the product because it potentially saves them 15 hours of charting a week! The founders previously built healthcare AI at Google Health and Apple, and are now building their vision to transform home health. More about Andy AI: https://with-andy.com/ Nurses love it: https://lnkd.in/g9XqZrUq #GenAI #digitalhealth #hiring #engineers #healthtech

32

2 Comments

👀 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!

53

10 Comments

Today's post is about our commitment at Bread and Butter Ventures to investing in women's health within our healthcare vertical, which is a big focus of our fund. Our mission in healthtech broadly is to invest in technology that democratizes access to quality care for all. A report this year from Deloitte shared that investment in women’s health rose by 5% between 2022 and 2023 - heading in the right direction, however, women's health represented just 2% of the $41.2 billion in venture funding that went to health companies in 2023, according to Deloitte’s analysis. There is such tremendous opportunity to innovate and invest for half the world's population. This an economic imperative. Spotlighting today 5 outstanding healthcare startups innovation in women's health who are very proud to have in our portfolio: ⭐ Gabbi: is building a comprehensive breast cancer risk assessment and early detection platform, combining cutting-edge technology with personalized care. As a woman's virtual breast specialist, Gabbi ensures every woman knows her risk and has access to early detection via telehealth. https://www.gabbi.com/. Shoutout Kaitlin Christine ⭐ Chiyo: is a personalized & integrative food-as-medicine platform that helps the next generation of mothers looking for guidance as they navigate the acute transitions of fertility, pregnancy and post-partum. https://wearechiyo.com/. Shoutout Irene Liu ⭐ Delfina: is creating an AI-powered pregnancy care platform to solve the global maternal health crisis. Delfina lowers rates of adverse outcomes, hospitalizations, and NICU stays to deliver substantial savings for health plans and risk-sharing providers. https://www.delfina.com/. Shoutout Senan Ebrahim, MD, PhD Priyanka Vaidya Ali Ebrahim ⭐ Nest Collaborative is the first to create a nationwide network of lactation consultants, available to mom 24/7 through virtual consultations. We were also the first to offer mom a no-cost, insurance-paid experience - which means when she has a problem we can connect her with a consultant within hours and we take care of all the payment and paperwork on the back end. We are, in all ways, her BFF - Breast Feeding Friend. https://lnkd.in/gKCVYvtF. Shoutout Judith Nowlin ⭐ Myya: provides breast cancer survivors completely customizable, fully insurance billable post-mastectomy prosthetics with a state-of-the-art fitting experience online and in-person. https://myya.com/ Jasmine Jones #womenshealth #digitalhealth #venturecapital #startups

92

4 Comments

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.

26

3 Comments

Exciting news! We just sent out the inaugural newsletter for Future Frontier Capital, our pre-seed venture fund backing frontier tech startups. As I hit "send," I realized how launching FFC parallels the path of the founders we support. Starting FFC has required the same passion, perseverance, and self-belief that drive entrepreneurs. Just like a startup, getting a VC fund off the ground demands relentless hustle—building the brand, perfecting the pitch, and networking tirelessly. There are constant challenges that test your resolve and endless hours of unglamorous work behind the scenes. And perhaps most daunting - the self-doubt, wondering if you're crazy for attempting something so bold. Pushing through that negative self-talk requires unshakable faith in your mission. Raising this VC fund reminds me of starting our IP strategy and patent analytics firm two decades ago. It’s a powerful reminder of the perseverance, creativity, and resilience needed to turn an ambitious idea into reality. This experience makes us more empathetic partners, ready to support the founders we back. Our work is just beginning, and this inaugural newsletter underscores our commitment to supporting frontier tech startups every step of the way. #startups #VentureCapital #EmergingManagers #Entrepreneurship #InnovationMindSet

21

2 Comments

This week Mikal Ventures brings you a 4-week breakdown of the US capital market with an emphasis on the Mikal verticals. Over the 4-week period ending December 9, just under 590 new companies were added, resulting in 101,195 companies included in the US Health Tech, Med Tech, Fin Tech, AI Tech, and Ed Tech verticals. We continue to see a slowdown in overall activity in all verticals. US AI Tech again saw the greatest percentage growth in new companies at 12%, vs. the vertical average of 6% for the period. AI Tech also led the group in transactions and news articles. US Med Tech led in SEC Filings. Mikal Ventures publishes these stats on a rolling 4-week basis to provide a perspective on how the verticals and new startups move through time. We hope you find them informative and thought-provoking. VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark https://mikalventures.com/ for additional insights and information.

3

1 Comment

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 👇

27

2 Comments