See the presentation that convinced 2 billionaires and Dr. Oz to invest in a new way of helping doctors care for patients at home
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- 100plus, a startup that offers remote patient monitoring devices and software, raised $25 million in seed funding.
- The round valued the company at around $100 million, the CEO told Insider.
- CEO Ryan Howard said he wanted more control of the company after his experience raising venture capital with his previous company went poorly.
Keeping tabs on patients’ health at home has become a surging business during the coronavirus pandemic.
With the virus spreading, physicians needed to find ways to make sure their patients’ health stayed in check while limiting in-person visits. They turned to virtual consultations and digital tools that could be used at home to track blood pressure, diabetes, and lung conditions like emphysema and COPD.
Upstart primary care offices and major hospitals have been quick to adapt to telemedicine and remote monitoring, but smaller doctors’ offices have struggled to bring the costly and complex technology into their practices. 100Plus, a San Francisco remote monitoring startup, thinks its approach could help clinicians navigate the world of remote healthcare.
100Plus offers remote patient monitoring services that are easy to set up and costs patients little or nothing. Instead, the company signs contracts directly with primary care physicians.
100Plus ships blood pressure monitors, pulse oximeters, digital scales, and other devices to patients’ homes, preprogrammed to operate as soon as the patient opens the box. The devices send the data they collect back to their physician’s office.
On Wednesday, 100Plus raised a $25 million seed round that valued the company at $100 million, CEO Ryan Howard told Insider. The financing came from private equity giants Henry Kravis and George Roberts of KKR, as well as self-help guru Tony Robbins, television personality Dr. Mehmet Oz and other angel investors. Two venture firms, Plug and Play Ventures and Correlation Ventures, participated in the round.
The structure of this funding round was by design, Howard told Insider. Prior to raising the funds, 100plus had never taken outside capital.
He said his experience fundraising for his last company, electronic health records startup Practice Fusion, showed him the “underbelly” of venture capital that promoted an unhealthy “growth-at-all-costs” mindset. He was ousted as CEO of Practice Fusion in 2015 and started working on 100Plus shortly after.
“We have a fair amount more autonomy than, I would say, almost every venture-funded company in the Valley. It was really important this time around just not to have a repeat of what happened to Practice Fusion,” Howard told Insider.
Now, Howard’s comeback hinges in part on whether his strategy of being highly selective with venture capital can be successful.
Remote patient monitoring has remained an area of interest for industry investors both inside and outside venture firms, and Howard maintained said that the industry is still in its early days, with just 4% saturation divided among a handful of upstarts like 100plus. The recent funding will help Howard hire aggressively and continue to add new devices, he said, but he was adamant that this business could grow rapidly and sustainably.
Investors bought into his vision. Here is the unredacted 21-slide pitch deck Howard used to win over billionaire investors without any ties to venture capital.
This article has been corrected to show that the funding round valued 100Plus at $100 million, according to CEO Ryan Howard. Howard previously told Insider that the round valued 100Plus at $150 million.
100Plus launched in January 2020 to provide what Howard describes as a remote patient monitoring “concierge service.”
The company takes on the upfront financial risks when signing contracts with small and medium physicians’ offices. It has an 80% gross after Medicare reimbursements, Howard told Insider.
The service is focused on seniors, who have high rates of chronic health conditions but underuse existing healthcare services. In its first year of operations, around 98% of the seniors that were using 100Plus stayed on the system, Howard told Insider.
Medicare pays between $700 and $2,100 per patient per year for 100Plus’ remote monitoring services, plus another $615 per patient to cover the monitoring devices. That saves patients and physicians money upfront, Howard said, and helps the company gain customers.
100Plus currently has access to 100,000 healthcare practitioners through deals with AthenaHealth, AdvancedMD, and DrChrono. Most of these are small or mid-size doctors’ offices that don’t have the bandwidth to set up monitoring systems for their patients themselves due to cost and resource constraints.
In its first 13 months of operations, 100Plus has brought in $7 million in annual recurring revenue, according to its presentation. Nixing charges to healthcare providers and any need for their staff to set up these services enables faster implementation and billing.
Devices are shipped directly to patients’ homes. They are preprogrammed to work upon arrival, Howard said, since many Medicare patients have limited access to the internet, smartphones, or working knowledge of connecting via Bluetooth.
100Plus’ system includes software that can detect when a patient’s health data — whether it’s their blood sugar, heart rate, or other health signs being tracked — falls out of the normal range or is in danger of falling out of the range. When this happens, the system sends out a warning alert and sends the data to the patient’s primary care provider. 100Plus sent out 40,000 of those alerts last year, Howard said.
100Plus also helps physicians track and bill all time spent on caring for individual patients in the software it developed for clinics. Howard said many primary care physicians can see up to 22 patients a day, making it difficult to accurately track and bill insurance companies throughout the day.
Part of 100Plus’ appeal, according to Howard, is that it sends devices directly to patients and handles setup without the doctors’ office having to set aside time to do it themselves, which is what many of his other competitors are doing, he said.
However, he said that the remote patient monitoring market is still incredibly new, with just 4% penetration among small and medium-sized clinics. Even the biggest players are small companies, he said, and all have room to grow.
Howard said he plans to use the $25 million in seed funding to rapidly grow the small team while also developing new devices and selling its services to new clinics.
The seed round was the first round of outside funding 100Plus took, Howard said, and was structured so that he and his executive team retained control over the company. “If we want to sell the company later this year, we have the power to do that,” he told Insider.
100Plus offers five devices so far, and has more in development.
Howard said, even now, telemedicine doesn’t quite meet every patients’ needs, and gave the example of a time he called his doctor and was asked if he knew his blood pressure off hand. Monitoring blood pressure is one of the most common applications for remote monitoring startups like 100Plus and can help patients experiencing hypertension and other conditions.
Smart scales are not new, but have been helpful in patients managing weight with their doctors, Howard said. It can be used for patients experiencing renal failure or other chronic conditions where changes in weight are indicative of a larger health concern.
Part of the $25 million in funding will go towards manufacturing additional devices, like the thermometer and pulse oximeter, Howard told Insider. Although there is some manufacturing cost upfront, the company is close to achieving profitability through its sales of new devices.
The company is close to breaking even, Howard said, but rapid growth has contributed to higher costs over time. If growth slowed, he said the company would already be profitable.
Learn more about the remote patient monitoring industry and the top RPM companies & startups leading the charge.