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When it comes to how people feel about the healthcare industry, there's only one aspect of it they distrust more than pharma: insurance.
A Harris Poll conducted in 2017 found that only 16 percent of adults in the U.S. believe health insurance companies put patients above profits, compared to 36 percent who felt the same way about healthcare providers. In addition, only 15 percent said that the health insurance industry had a high reputation, compared to 43 percent for providers, and 37 percent for hospitals.
It's not hard to see why insurance is so maligned; we've all had the experience of having a medication, or procedure, ordered by our doctor then be rejected by insurance, forcing us to either pay out of pocket or take an alternative therapy. Add to that misery is that the premiums keep going up, recently reaching more than $20,000 annually for families in employer-sponsored programs according to Kaiser Family Foundation. [See graphic below]
Luckily, the tech world has been answering that call, with a number of startups looking to shake up the industry. In fact, some of them have already raised hundreds of millions in funding with valuations of over $1 billion.
These are some of the top companies that are currently disrupting health insurance:
(Note: Vator will be holding its latest healthcare salon, called The Future of Health Insurance, on Nov. 20. Get tickets here!)
Description: Oscar Health is a tech-driven health insurance company that takes a concierge-like approach to healthcare. Rather than having the insurer be a faceless middleman, Oscar's mission is to be more personal -- treating patients like customers and giving them tools to be more proactive. Oscar provides a concierge team, including care guides and a nurse, who provide all sorts of services, from referrals to specialists to managing your condition. You can also use their Doctor on call service (text or call) to fill a prescription or just ask for advice. Have a dry patch of skin? Take a photo and text to Oscar. You can get answers in minutes. Oscar is also testing out brick-and-mortar clinics with its Oscar Center, facilitating wellness programs, such as yoga. Oscar Health was born during the Obamacare era when private exchanges were encouraged. Oscar's Mario Schlosser believed that in the new healthcare paradigm, consumers would be in greater charge of their healthcare, including their ability to select their plans and keep them as they move from employer to employer. While the exchanges haven't worked as well as expected, Oscar has continued to thrive, with 257,000 members across nine states.
Here's a great interview between Bambi Roizen and Mario Schlosser and Brian Singerman of Founders Fund about the beginnings of Oscar.
Amount raised: $1.3 billion
Investors: Alphabet, Founders Fund, Fidelity, CapitalG, Formation 8, Thrive Capital, Verily, 8VC, Khosla Ventures, General Catalyst
Valuation: $3.2 billion
Description: Clover is another new tech-centric healthcare insurance company born in the last decade to revolutionize the insurance industry. The company also partners with physicians and has its own care team working to assist members. Clover works specifically on Medicare Advantage (Medicare sold via private insurers). By analyzing behavioral and other new sources of data, Clover is identifying new benefits to cover, such as preventative procedures or services and in-home checkups.
Read Clover CEO Vivek Garipalli's thoughts on How big data is improving patient outcomes.
Amount raised: $925 million
Investors: Greenoaks Capital , DNA Capital, GV, Expanding Capital, Nexus Venture Partners, Refractor Capital, LifeForce Captial, Spark Capital
Valuation: $1.2 billion
Description: Bright Health, based in Minneapolis, is a tech-centered healthcare insurance company, with a mission to decomplexify (our words) the complicated world of insurance. Unlike Oscar, which has a network of nurses, coaches, doctors that make up its concierge and doctor-on-call team, Bright Health partners with clinics and local partners and works with their teams. In 2019, Bright Health started offering individual, family and Medicare Advantage plans in Ohio, Tennessee and New York, adding to its presence in Arizona, Colorado and Alabama.
Amount raised: $440 million
Investors: Declaration Partners, Meritech Capital, Bessemer Venture Partners, Cross Creek Advisors, Flare Capital, Greenspring Associates, Greycroft Partners, New Enterprise Associates, Redpoint Ventures, Town Hall Ventures
Valuation: $950 million
Description: Collective Health is a tech-driven health insurance company focused on working with self-insured employers and helping them navigate the complex healthcare ecosystem. Their value-add to employers is helping their employees understand health insurance in a way they're used to: with more user-friendly interfaces and easy-to-understand text -- something our tech-savvy society has become used to. Only four percent of Americans understand common health insurance terms, according to Collective. The company wants to change that by simplifying coverage details and processing of claims and documents, which in some cases still use fax machines! Collective Health manages plans for 50 employers.
Amount raised: $439 million
Investors: Mubadala Investment Company, Founders Fund, GV, NEA, Green Bay Ventures, Sun Life Financial, Maverick Ventures Israel, RRE Ventures, MSA Capital, DFJ Growth, PSP Investments
Valuation: $1 billion
Description: Boston-based Devoted Health provides seniors with a health care plan with personal guides and technology. It only offers Medicare Advantage plans, allowing patients to compare plans, look up a doctor or drugs, and get information about how Medicare works. The company has 3,000 members and a team of more than 200 employees across offices in Miramar, Florida and Waltham, Massachusetts.
Amount raised: $326 million
Investors: Andreessen Horowitz, Obvious Centures, PremjiInvest, Flat World Partners, F-Prime Capital, Uprising Ventures, StartUp Health, Venrock, Oak HC/FT, Maverick Ventures
Valuation: $1.8 billion
Description: Alan, which is based in Paris, is a digital health insurance platform with a focus on user experience, allowing its users to send your bills from their smartphone and access in real time the detail of all of their refunds. It also cover of alternative medicine and health-enhancing practices like Headspace and Little Bamboo. The platform has more than 38,400 members and and 3,200 businesses.
Amount raised: $86.5 million
Investors: DST Global, Index Ventures, Portag3 Ventures, Partech, Xavier Niel, CNP Assurances, AGORANOV, Power Financial Corporation
Description: Based in Minnesota, Bind On-Demand Health Insurance offers programs that are employer-sponsored, self-insured health plans. The company partners with UnitedHealthcare, and uses its own algorithms, which are powered by machine learning, to lower the cost of insurance by breaking out certain procedures. Bind health plans have no deductibles or co-insurance, and additional coverage can be added on when needed.
Amount raised: $72.5 million
Investors: Ascension Ventures, Lemhi Ventures, UnitedHealthcare
Description: The Minnesota-based Gravie says it "is reinventing health benefits, making them easier and more affordable for employers and employees." For employers, it allows them to decide how much money they want to provide to their employees, then Gravie helps them shop for and buy a plan that fits their needs. The company currently serves over 900 employers and over 62,000 individuals across the United States.
Funding raised: $44.1 million
Investors: GE Ventures, FirstMark Capital, Aberdare Ventures, Split Rock Partners, Brightstone Venture Capital
Description: Limelight Health focuses on automating the employee benefits industry, offering medical and ancillary carriers services such as quoting, rating, proposal generation, renewals, underwriting and enrollment support. The goal is to shorten sales cycles and improve turnaround times for carriers. Its first product, QuotePad, is a cloud-based quoting platform that allows health insurance agents to quote and compare health, medical, dental and vision benefits information.
Funding raised: $44 million
Investors: Principal Life, AXA Venture Partners, MassMutual Ventures, Aflac Ventures, Transamerica Ventures, Wells Fargo Strategic Capital, LaunchPad Digital Health, and Wanxiang America Healthcare Investments.
Valuation: Not disclosed
Description: Ooda Health is a company with the goal is to "reinvent the role of the payer," by allowing collaborative providers, payers and members to interact in real-time. It does that by offering digital and financial tools, collaborative administration and auto data-sharing. The company’s strategic partners include Anthem, Blue Cross Blue Shield of Arizona, Blue Shield of California, Zaffre Investments, a subsidiary of Blue Cross Blue Shield of Massachusetts, Dignity Health, and Hill Physicians.
Funding raised: $40.5 million
Investors: Oak HC/FT, DFJ, Blue Shield of California, Threshold
Description: New York-based Centivo "was founded to bring cost sustainability to employers and affordable, high-quality healthcare to the millions of Americans who struggle to pay their healthcare bills." Centivo’s clinical partners are provided with personalized patient/doctor matching tools, while members get access to an app and concierge that helps them choose care. Centivo is available in New York, New Jersey, Connecticut, and select other markets.
Funding raised: $36.4 million
Investors: Bain Capital Ventures, F-Prime Capital Partners, Maverick Ventures, Bessemer Venture Partners, Ingleside Investors, Rand Capital, Grand Central Tech Ventures, Oxeon Investments, Jim Foreman, Ken Goulet, Kevin Hill
Description: Based in Philadelphia, Picwell describes itself as "a SaaS-based solution to enhance the entire benefits lifecycle." The company uses software to help people pick the right benefits for themselves and their families. Its cornerstone offering is a SaaS decision support product that matches individuals to the right plan during enrollment by predicting future care considerations, estimating out-of-pocket expenses, and accounting for personal preferences.
Funding raised: $11.1 million
Investors: BlueCross BlueShield Venture Partners, Sandbox Industries, MassMutual Ventures, Springfield Armory, Aflac Corporate Ventures, Trevor Fetter, Paul Kusserow, Andrew Kress, Bruce D. Perkins
Description: New York-based Vericred calls itself the "infrastructure for the digital distribution of health insurance and employee benefits." The company operates as a data translation layer between carriers and insurtech companies, with a focus on the under 65 individual, Medicaid and Medicare markets, as well as the group market. It also delivers structured health insurance and employee benefit data to tech companies through its API. Vericred's platform provides health plan design and rate data, provider-network data and formulary data.
Funding raised: $9.9 million
Investors: FCA Venture Partners
Description: Barcelona-based Elma Care calls itself, "A personal digital health insurance, simple and for a new generation." It offers patients an app where they can get their prescription, view their medical history and book a visit from a medical center. It also allows 24/7 access to a medical team. Plans start at €17 per month and go as high as €32 per month.
Funding raised: €4 million
Investors: Albert Malagarriga, Miguel Ángel Antón, Mangrove Capital Partners, Antai Venture Builder, Joyance Partners
(Image source: pioneerreporter.com)
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Joined Vator on
It all started in February 2014 when three employee benefits industry experts (Jason, Michael and Garrett) and one technologist (Alan) began to reimagine the employee benefits quoting experience. In January 2015, we released QuotePad,the first real-time small group health insurance quoting app native to iPad, in California. Our vision and team have quickly scaled and other ancillary products have been added to supplement our platform for real-time quoting Medical with Dental, Vision, Basic Life, Voluntary Life, Short-Term Disability, Long-Term Disability, GAP Medical, Critical Illness and Hospital Indemnity. Most recently, our Enterprise Carrier Solution has been released at the close of 2015 to allow end-to-end quoting from an underwriter to a sales rep, to a benefits broker that allows employers and employees to shop and compare the best options.
We are Limelight Health. Employee Benefits Reimagined.