TTA’s Blooming Spring 5: Hinge Health’s IPO, 23andMe bought by Regeneron, sans Lemonaid, WeightWatchers’ future, debuts of Smarter Technologies and Fuze Health, VA EHR update, more!

 

23 May 2025

The major news this week was the Hinge Health IPO, the first for digital health in two years–but the downside was that it was at a lower valuation. Denouements abounded with most 23andMe genetic assets bought by Regeneron, without a drink of Lemonaid. WeightWatchers’ time may have passed, new heads for Calibrate and Oak Street, and two more ‘arranged marriages’, Smarter Technologies and Fuze Health. An update on the VA EHRM in the budget. Masimo’s recovering, as is Ted of Strata-gee

Remember our soldiers, sailors, airmen, and Marines who have passed on this Memorial Day. Our Monday newsletter will be on Tuesday.

News roundup 22 May: an inflight ‘save’ and AliveCor’s KardiaMobile, rolling out the VA/Oracle EHR in ‘waves’, Fuze Health formed from LetsGetChecked/Truepill, hacking and ransomware 92% of PHI data breaches (A renaming of a 2024 ‘arranged marriage’–can it be saved?)

News roundup: Hinge Health public @$32/share, lower valuation. Is WeightWatchers game over? Calibrate replaces CEO, new prez for Oak Street, NMC gets ‘Smarter’ rolling up 3 portfolio companies, another splash of investor ‘cold water’ (The first health tech IPO in 2 years and ‘smushing’ when they can’t)

Update: Masimo’s website status and an analysis of the Sound United sale (Getting up and running post-attack, but what happened?)

23andMe sold to Regeneron for $256M in court-supervised bankruptcy, sans Lemonaid. And is it worth it? (We come up with a number, it’s likely)

From last week: UnitedHealth Group changed out CEOs suddenly. The new one is a surprising ‘blast from the profitable past’ but that didn’t stop Mr. Market from taking the stock down down down. Another blast involves Elizabeth Holmes’ partner Billy Evans fronting a diagnostic testing- in-a-box startup.”Surprise, surprise!” No surprise that Holmes lost her appeal of an appeal–nor Omada Health filing for an IPO. Unfortunately, our investigator on all things Masimo met his own surprise walking on a sunny day–fortunately, Ted’s on the mend. More about BCIs with Apple integration, a chronic pain management startup, Parkinson’s data, two good raises, and what payers pay to keep their execs safe.

Short takes: Synchron BCI integrates with Apple devices, Shields Health partners with Duke on specialty pharmacy, raises for Cohere Health, Olio (More BCI action with Apple getting into it)

Theranos’ revenge? Holmes’ partner Billy Evans founds a startup for diagnostic testing, denies it is ‘Theranos 2.0’; Holmes loses Federal rehearing appeal. (Is Holmes advising long distance? Letters from a Texas Jail?)

News roundup: Omada Health files for IPO, UPMC-Redesign partner on chronic pain management, OK and PA AGs warn 23andMe users to delete data, Verily to build Parkinson’s dataset, what payers paid for exec security (Omada follows Hinge. But the last is surprising–between a lot and a little)

This just in: UnitedHealth Group CEO Andrew Witty steps down immediately, replaced by former CEO Stephen Hemsley (updated 15 May) (UHG may change out CEOs, but continues to be hammered by Mr. Market)

Best wishes to Strata-gee’s Ted Green on a fast recovery! (Ted, our ace Masimo investigator, was put rather suddenly in a bad place…use your eyes when you drive!)

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News roundup: Hinge Health public @$32/share, lower valuation. Is WeightWatchers game over? Calibrate replaces CEO, new prez for Oak Street, NMC gets ‘Smarter’ rolling up 3 portfolio companies, another splash of investor ‘cold water’

Hinge Health now public. Today (22 May) Hinge Health debuts as HNGE on the NYSE, the first big IPO for healthcare tech in two years. Last night, the virtual MSK/physical therapy provider raised $437.3 million in its IPO. Shares were priced at the high end of the offering range at $32. The timing is a small surprise, as in early April insiders said to press that they had not committed to any dates due to the market’s roller coaster, but they stayed on their original schedule [TTA 8 Apr].

The nitty-gritty:

  • The floating is 13,666,000 shares of Class A common stock, 8,522,528 of which are being sold by Hinge Health and 5,143,472 of which are being sold by certain selling stockholders.
  • The underwriters have a 30-day option to purchase up to an additional 2,049,900 shares of Class A common stock at $32, less underwriting discounts and commissions.
  • The valuation comes in at the $2.6 to $3 billion range. This is a shave-and-a-haircut from the bubbly days of November 2021, when its Series E raise of $600 million gave it a valuation of $6.2 billion–and this was on top of a January 2021 Series D of $300 million [TTA 5 Nov 2021]. 
  • Hinge also has a Class B voting share class that ensures that major investors including Insight Partners (19% prior to the IPO) and Atomico (15%), along with co-founder and CEO Daniel Perez (18.9%), retain control of the company

The IPO was delayed repeatedly in an uncertain market for health tech raises, much less IPOs. Starting in 2024, rumors flew, early filings were made from last April then in October last year [TTA 3 Oct 2024]. Total raises for Hinge as a private company were $826 million from multiple investors, who were undoubtedly clamoring for OPM (other people’s money) and a full or partial exit. Hinge also let some positive results sink in; they reported a 50% increase in Q1 revenue to $123.8 million from $82.7 million in Q1 2024. Net income went positive at $17.1 million, reversing a net loss of $26.5 million in last year’s Q1.  Endpoints (requires registration), Hinge Health release, CNBC  Will competitor Omada Health be far behind?

The rest of the news is a bit more sobering, reflective of the real challenges health tech/digital health faces, in multiple businesses.

WeightWatchers’ bankruptcy and fast reemergence may be only a brief waypoint in its troubles. This Editor opined at the time of the 45-day prepackaged Chapter 11 that WW was simply kicking the can down the road. Their subscription model of low calorie diets, points, and exercise no longer worked when well-funded teleprescribers such as Hims & Hers, LifeMD, FuturHealth, and Ro, along with traditional telehealth providers like Teladoc, had long since jumped on the GLP-1 promise of quick and assured weight loss. WW didn’t enter GLP-1 prescribing until October 2024, well after it took off even in high prices and scarcity, but continued to lose subscribers. The coup de grace? The partnering deals that teleprescribers as well as CVS Health’s Caremark PBM worked with Novo Nordisk to stimulate their volume for Ozempic and Wegovy. Thus the Chapter 11 and the dumping of $1.15 billion in debt may buy time, but not solve, their market disconnect.

An article from earlier this week in MedCityNews takes the same tack in an interview with industry analyst Michael Schnell, a director in health consultant West Monroe’s healthcare M&A group. Mr. Schnell regards WW as a legacy company in representing the old ‘diet culture’, with the new teleprescribers representing “private, digital-first, affirming wellness experiences that are in themselves a rejection of ‘diet culture.’” It’s a positioning (real estate in the mind/Denny Hatch) dilemma that in its clarity somehow evaded this marketer. It’s echoed by another industry analyst and Virta Health’s CEO Sami Inkinen, a company that has focused on diabetes control and weight loss via nutrition but pivoted last year to add GLP-1s.

WW’s fundamental dilemma is encased in its fundamental 60 year old promise–that you can lose weight, but it requires commitment and work. Their traditional weight loss model of diet and exercise, once fairly simple, grew complicated and not cheap. Complicated and costly will be beaten every time by those who promise a lot less effort, even with cost and side effects that are significant. Now it costs even less. Cigna’s Evernorth announced yesterday that its PBM Express Scripts now will cap monthly out-of-pocket costs of Novo Nordisk’s Wegovy and Lilly’s Zepbound at $200/month, saving an estimated $3,600 annually versus typical DTC discount programs. FierceHealthcare Can WW buy enough time to solve their market problem? Based on prior marketing experience, it’s not likely even if WW completely reinvents itself.

Even among the weight loss teleprescribers, all is not keen and peachy. Calibrate changed out its second CEO in just over a year. Rob Rebak, most recently CEO for three months of Mosaic Diagnostics and earlier CEO of Forefront Telecare (sold to Access TeleCare), replaces Rob MacNaughton, who joined in February 2024 from venture chair of Redesign Health. Other executives have also departed: CFO Bert Smith and chief clinical officer Jane Ruppert. According to CEO Rebak, MacNaughton will remain on Calibrate’s board as an advisor to him. Joining is a new COO, Paul Merrick, another former Forefront Telecare exec. The breaking report is in Endpoints (may be paywalled) and oddly, not elsewhere including the Calibrate website which does not have an executive list, nor press releases on Business Wire.

Originally a portfolio company of Redesign Health, Calibrate has had its ups and downs. The company sold a 70% interest in a 2023 ‘reorganization’ to private equity firm Madryn Asset Management along with other investors  with founding CEO Isabelle Kenyon departing. An early entrant in the GLP-1 obesity management game, promoting ‘metabolic reset’, it also received the brunt of drug scarcity and social media backlash, refunding millions to subscribers.[TTA 26 Oct 2023]

A sidebar on GLP-1s. A systemic review and meta-analysis of 497 articles by a team at Sacred Heart University (CT), retaining eight randomized controlled trials comprised of 2372 participants, all with a BMI ≥ 27 kg/m2, indicates that after discontinuing GLP-1 therapy, weight regain was proportional to the original weight loss. The regain varied by type of GLP-1 drug, but the study labels it ‘significant’. Obesity Reviews (Wiley) 4 April 2025   GLP-1 weight loss is not one course and done–actually good news for the teleprescribers and pharmas as in ‘they’ll be back’. 

Oak Street Health replaces its president. The CVS practice unit named Creagh Milford, DO, MPH as Oak Street’s new president. He comes from CVS’ Minute Clinic as head of retail health from January 2024. Dr. Milford replaces Brian Clem, a 10 year Oak Street veteran who according to the Crain’s Chicago Business article and his own LinkedIn posting, “had decided to move on” after being president since May 2019, prior to CVS. Previously, Mike Pykosz, CEO and co-founder of Oak Street Health, had moved up in the months after the May 2023 buy of Oak Street into CVS corporate, eventually heading up their Health Care Delivery unit. He departed fairly suddenly in November 2024 [TTA 27 Nov 2024]

New Mountain Capital (NMC) does the smush again with three portfolio companies. The new entity, Smarter Technologies, combines SmarterDx (AI for chart analysis catching missed billing codes and appeal denied claims), Thoughtful.ai (agentic AI for checking insurance eligibility and prior authorization), and Access Healthcare (RCM). The revenue cycle management (RCM) company for health systems and hospitals will be headed by Jeremy Delinsky, an executive advisor to NMC and founding COO of Devoted Health. It now totals according to their release 200 clients, including more than 60 hospitals and health systems with over 500,000 providers. It processes more than 400 million transactions and manages over $200 billion in combined revenue annually. No other management transitions are mentioned but on the website, the co-founders/CEOs of the three companies are listed alongside Mr. Delinsky. It’s the second big rollup in less than one year for NMC, which last September combined Apixio’s payment integrity business and Vario into The Rawlings Group to create one giant $3 billion payment integrity company. Last January, NMC acquired Machinify Inc. to roll into Rawlings.

NMC is a big investor with $55 billion in management assets that evidently buys with an eye to combining companies–and also isn’t afraid to back quickly out of deals that don’t work. Just ask Anne Wojcicki of 23andMe.

Gimlet EyeWe close with a Gimlety view from three health investors. MedCityNews’ recent INVEST conference hosted three investors who opined on three important topics: Raffi Boyajian, Principal, Cigna Ventures; Aman Shah, Vice President of New Ventures, VNS Health; Dipa Mehta, Managing Partner, Valeo Ventures. Your Editor’s comments follow.

  • Does every startup need to be AI-powered? Everyone may be pitching AI in their models, but it may not really mean anything. What really means something is building a good business first, then adding in AI to make it better, according to Aman Shah of VNS Health. When is AI just a buzz word and really machine learning? Much of the time. Do these companies really understand it? Or is it a money and time-burning diversion?
  • There aren’t a lot of new things to build anymore. It used to be that companies found a problem and invented a new way to solve it (ah, remember the cocktail parties of yore?), but that is not the way it works now. Where the most success is now is “creating companies with customers versus trying to create something on their own,” according to Dipa Mehta of Valeo. This is a partnership model that can go sideways if a young company is not careful. Customers may not want to pay and you remain in ‘pilot hell’.
  • Value-based care isn’t everything. For early-stage companies, “you can get upside down on your contracts very, very quickly in terms of a financial perspective,” according to Raffi Boyajian of Cigna Ventures. VBC is complicated for providers and for management service companies (MSOs)–imagine being an outsider. 

News roundup: Waystar’s $8B IPO plan takes delay, Perficient to buy SMEDIX, PicnicHealth buys AllStripes, MDLIVE buys Bright.md, Sage garners $15M, Cureatr shuts suddenly, Calibrate reorganizes, BetterUp lays off 16% (updated)

  • It’s a Tale of Two Cities…the best and worst of times, depending on what company you’re with.

Waystar files for the first IPO of 2023 in healthcare. Revenue cycle management (RCM) and payments software company Waystar filed a registration statement with the Securities and Exchange Commission (SEC) last week, after filing a draft with the SEC in August. Waystar, formed from RCMs ZirMed and Navicure, isn’t profitable (2023 first half net losses of $21 million on $387 million revenue) but it is big–30,000 provider organization customers in a subscription model generating $4 billion in healthcare payment transactions last year. The offering on Nasdaq under WAY potentially values the company at $8 billion.

The IPO offering is being led by JPMorgan Securities LLC, Goldman Sachs, and Barclays Capital. Swedish global investment firm EQT Partners and the Canadian Pension Plan Investment Board became majority investors in 2019 with Bain Capital retaining a share. Waystar also acquired that year Connance, Ovation Revenue Cycle Services’ transaction services tech, PARO and Digitize.AI.

A comparative factor is that its main competitor, R1 RCM, is public.

It’s been over a year since the last digital health company went public, but any speculation that this is a dambreaker for health tech IPOs would be premature, even in the ever-optimistic view of Rock Health. FierceHealthcare, Waystar release

Update: The WSJ reports that the Waystar roadshow to pitch the IPO to investors, scheduled for this week, has been delayed to December at earliest, pushing the IPO into 2024. Sometime. IPOs for other companies have gone south. Reuters

What is more typical are these three acquisitions and consolidations, mainly in the healthcare software and data collection areas, as time goes on and fresh funding rounds grow scarce.

Perficient, a ‘digital consultancy’, is in agreement to buy SMEDIX, a $12 million in revenue healthcare software engineering firm headquartered in San Diego, California, with offshore operations located in Cluj-Napoca, Romania. Acquisition cost was not disclosed. Closing is anticipated in January 2024. SMEDIX President and CEO Fayez Sweiss will join Perficient in a key leadership role and the release mentions the addition of 175 skilled global professionals.

Patient community, clinical data, and patient-reported evidence collector PicnicHealth is acquiring AllStripes, a platform for rare disease data and patient access. PicnicHealth’s partnerships are primarily with pharmaceutical companies and nonprofit research organizations for patient data. AllStripes generates research-ready evidence to accelerate rare disease research and drug development, as well as a patient/family-facing app connecting them to treatment research. AllStripes had a $50 million Series B funding round in 2021 and PicnicHealth had a $60 million Series C round in 2022 backed by new investor B Capital Group plus existing investors Felicis Ventures and Amplify Partners. But as is usual of late, the acquisition cost is not disclosed. Release

In TelehealthLand, MDLIVE is buying Bright.md. Announced at HLTH, MDLIVE, part of Cigna unit Evernorth, will add Bright.md’s asynchronous telehealth capabilities to its existing platform. The expansion will target their virtual urgent care area, adding chronic disease management and wellness visits in 2024. Asynchronous telehealth adds an information gathering and triage option to standard virtual consults in gathering initial information, optimally directing the patient to the right care at the right time. Acquisition costs (again) were not disclosed. MDLIVE also announced a care coaching option within its virtual primary care program. MDLIVE works with employers and health plans which gives them in total a 43 million member base. Healthcare Dive, FierceHealthcare

Sage scored a $15 million Series A. Funding for their senior housing care platform was led by Maveron with participation from Distributed Ventures, ANIMO Ventures, and Goldcrest Capital. The platform consolidates and coordinates nurse call and care information for residents. This follows on their August 2022 $9 million in seed funding.  Mobihealthnews

Also typical of late are closings, reorganizations, and layoffs.

NYC-based Cureatr shut down suddenly Tuesday 17 October. According to the sketchy reports on places like Reddit, it was with three days notice to staff nor severance and done on a Zoom call. Systems were shut down on Friday but not the website which is still up. Cureatr was a comprehensive medication management company with staff pharmacists working with topline providers like New York Presbyterian, Northwell, Penn Medicine, and DaVita. Surprisingly, they bought a competitor, SinfoniaRx, only last March. Posters on Reddit describe new hires starting in the last two months and people yet to start who had already left their jobs. From Glassdoor, posters state that the company went bankrupt after not getting more financing. Things went south fast. What is going on now is a bad rerun of the 2007-8 period when funding dried up and companies ran out of runway fast, a period that this Editor experienced firsthand at Living Independently Group. Shotgun takeovers and sudden closings. Thanks to HISTalk 23 Oct for the heads up.

Another NYC former high-flyer, ‘metabolic health’ weight loss digital health coach Calibrate, was sold in a ‘reorganization’ to private equity firm Madryn Asset Management along with other investors. Prior to the sale, Calibrate raised about $160 million in funding. With scarcity of their GLP-1  drug therapies Ozempic and Wegovy and insurers refusing coverage of their over $1,700 direct-to-consumer regimen (not including medication cost), plus new competitors like Teladoc, Calibrate lost patients, received rafts of angry social media postings, refunded millions to them, and laid off 150 staff in July 2022 with 100 departing last April. Weight loss/obesity management remains hot, but in more payer and employer-centered models, to which Calibrate announced it was pivoting to this summer. MedCityNews

Calibrate was one of the companies out of Redesign Health, which has developed about 50 health tech companies, the latest being Harmonic Health for care management of dementia patients and family support. 

Telemental health is also going wobbly, with BetterUp recently laying off 16% of its workforce or 100 employees. BetterUp provides virtual behavioral change coaching for corporate performance, including mental health. Their base is primarily enterprise clients with a B2C offering. The brief report in the Daily Beast states that the company has missed financial targets starting with last year and “grappled with internal tumult for many months, including a rebellion by its army of coaches last spring.” Back in the palmy days of 2021, BetterUp raised $300 million through a Series E in a total of seven funding rounds and achieved a $4.7 billion valuation, which is not likely to be the same now.

Yes, this is the company that employs Prince Harry, Duke of Sussex as its chief impact officer. No one quite knows what he does, how much time he spends on company business, nor what he is paid–which are issues with the employees, especially those facing or contemplating The Ax. The prince has made some corporate appearances at conferences. The CEO characterizes his duties as expanding “global community reach”. Perhaps this Editor is cynical, but Prince Harry a/k/a ‘This One’ is beginning to resemble one of his ancestors, Edward, the Duke of Windsor, without the splendid sartorial style.  The Mercury News manages to spin a whole article about this and Netflix. Certainly, a lesson to be learned about celebrity employees.

Week-end roundup of not-good news: Teladoc’s Q2 $3B net loss, shares down 24%; Humana, Centene, Molina reorg and downscale; layoffs at Included Health, Capsule, Noom, Kry/Livi, Babylon Health, more (updated)

Teladoc continues to be buffeted by wake turbulence from the Livongo acquisition. The company took a $3 billion goodwill impairment charge in Q2, adding to the $6.3 billion impairment charge in Q1. The total impairment of $9.3 billion was the bulk of the first half loss of nearly $10 billion. While their revenue of $592.4 million exceeded analyst projections of $588 million, adjusted earnings before interest, taxes, depreciation and amortization (EBITDA) of $46.7 million were barely up from projections and were down from $66.8 million year prior. Losses per share mounted to $19.22, versus $0.86 in Q2 2021.

Another weak spot is their online therapy service, BetterHelp, which in the US is pursuing a substantial TV campaign. CEO Jason Gorevic in the earnings release pointed out competitors buying the business at low margins and consumer spending pullbacks. Teladoc’s forward projections are bolstered by Primary360 and Chronic Care Complete. Projected revenue for Q3 is $600 million to $620 million. Shares on Thursday took a 24% hit, adding to the over 50% YTD drop misery. At best, Teladoc will muddle through the remainder of the year, if they are lucky. MarketWatch, Mobihealthnews, FierceHealthcare

Health plans are also presenting a mixed picture. 

  • Humana announced a healthy earnings picture for the quarter and YTD. It earned $696 million in profit for Q2, up nearly 20% year over year. For first half, Humana earned $1.6 billion, an increase of 14.8% from 2021’s $1.4 billion. Cited were growth in their primary care clinics, Medicaid membership, and investment in Medicare Advantage. Earnings surpassed Wall Street projections and Humana increased its guidance to $24.75 in earnings per share. At the same time, they announced a reorganization of its operating units that separates their insurance services (retail health plans and related) and CenterWell for healthcare services including home health. Some key executives will be departing, including the current head of retail health plans who will stay until early 2023, ending a 30 year Humana career. FierceHealthcare, Healthcare Dive
  • Under new leadership, Centene posted a Q2 loss of $172 million which in reality was a significant improvement over Q2 2021’s $535 million and looked on favorably by analysts.
    • Their ‘value creation plan’ has sold off its two specialty pharmacy operations to multiple investors, using third-party vendors in future, and agreed this week to sell its international holdings in Spain and Central Europe — Ribera Salud, Torrejón Salud, and Pro Diagnostics Group — to Vivalto Santé, France’s third-largest private hospital company.
    • Medicaid, their largest business line, has been growing by 7%.
    • Centene is continuing to divest much of its considerable owned and leased real estate holdings, which marks a radical change from the former and now late CEO’s* ‘edifice complex’ to house his ‘cubie culture’. As a result, it is taking a $1.45 billion impairment charge.  Healthcare Dive. [* Michael Neidorff passed away on 7 April, after 25 years as CEO, a record which undoubtedly will never be matched at a health plan.)
    • A cloud in this picture: Centene’s important Medicare Advantage CMS Star quality ratings for 2023 will be “disappointing” which was attributed to the WellCare acquisition (accounting for most of the MA plans), two different operating models between the companies, and the sudden transition to a remote workforce. For plans, WellCare operated on a centralized model, Centene on a decentralized one, and the new management now seems to prefer the former. (Disclosure: your Editor worked over two years for WellCare in marketing, but not in MA.) Healthcare Dive
  • One of the few ‘pure’ health plans without a services division, Molina Healthcare, is also going the real estate divestment route and going full virtual for its workforce. Their real estate holdings will be scaled down by about two-thirds for both owned and leased buildings. Molina does business in 19 states and owns or leases space across the US. Net income for the second quarter increased 34% to $248 million on higher revenue of $8 billion. Healthcare Dive

Many of last year’s fast-growing health tech companies are scaling back in the past two months as fast as they grew in last year’s hothouse–and sharing the trajectory of other tech companies as well as telehealth as VCs, PEs, and shareholders are saying ‘where’s the money?’. 

  • Included Health, the virtual health company created from the merger of Grand Rounds and Doctor on Demand plus the later acquisition of care concierge Included Health, rebranding under that name, has cut staff by 6%. The two main companies continued to operate separately as their markets and accounts were very different: Grand Rounds for second opinion services for employees, and Doctor on Demand for about 3 million telehealth consults in first half 2020. As Readers know, the entire telehealth area is now settling down to a steady but not inflated level–and competition is incredibly fierce. FierceHealthcare
  • Unicorns backed by big sports figures aren’t immune either. Whoop, a Boston-based wearable fitness tech startup with a valuation of $3.6 billion, is laying off 15% of its staff. (Link above)
  • Digital pharmacy/telemedicine Capsule is releasing 13% of its over 900 member staff, putting a distinct damper on the already depressed NYC Silicon Alley.  FierceHealthcare also notes layoffs at weight loss program Calibrate (24%), the $7 billion valued Ro for telehealth for everything from hair loss to fertility (18%), Cedar in healthcare payments (24%), and constantly advertising Noom weight loss (495 people). Updated: Calibrate’s 150-person layoff was reported as particularly brutally handled with employees. Many were newly hired the previous week, given 30 minutes notice of a two-minute webinar notice, then their laptops were wiped. Given that the company makes much of its empathy in weight loss, facilitating prescription of GLP-1 along with virtual coaching, for a hefty price of course. HISTalk 8/3/22
  • Buried in their list are layoffs at Stockholm-based Kry, better known as Livi in the UK, US, and France, with 100 employees (10%).
  • Layoffs.fyi, a tracker, also lists Babylon Health as this month planning redundancies of 100 people of its current 2,500 in their bid to save $100 million in Q3. Bloomberg