Rock Health’s sunnier 2025: up 35% due to AI, but a tale of ‘have and have nots’

Rock Health’s 2025 digital health roundup, published in January, was upbeat–as usual, and in no way Hemingwayan. Their calculation of US digital health fundings was up 35% versus 2024, rising to $14.2 billion from 2024’s $10.5 billion. This was a higher number and a stark contrast to Silicon Valley Bank’s (SVB) tracking of US and EU healthtech investments as a 1) lower number and 2) flat 5%, growing from 2024’s $13.2 billion to $13.9 billion [TTA 14 Jan].

Let’s do some unpacking:

  • The number of digital health deals went down from 509 to 482, a decline of 5.3%.
  • In terms of current dollars, 2025’s funding of $14.2 billion was, as projected, a snap back to 2020’s $14.4 billion, as 2024 was to 2019. In constant/inflation-adjusted dollars, applying a cumulative inflation of 25%, 2025 is well under 2020 but better than 2019; 2020’s $14.4 billion then is equivalent to $18.3 billion today.
  • Where Rock Health and SVB agree is the ‘barbell’ profile of what gets funded.  
    • Mega funds like General Catalyst and Andreessen Horowitz (a16z) do mega deals: 26 mega deals and 15 newly-minted unicorns (up from six last year), for a funding average by these two in D+ of $266 million, versus Series A of $24.1 million. 
    • The funding also skews towards “AI-enabled” companies and secondarily, wellness
    • Something that made this Editor go ‘hmmm…’:Rock Health’s usual analysis of letter deals across all funders is, unusually, missing in their 2025 report. The only comparison made is from GC and a16z, two mega funders. Inadvertently, Rock Health has drawn a bright line on the contraction of venture and private equity funders not only in available funds, but in sheer numbers. Discussed here intermittently, especially in the context of SVB’s failure and rescue, but at more length here in this 2023 commentary.
  • What they have picked up that SVB didn’t was the continuing significant number of unlabeled, non-letter financings–35% of deals, but down from 44% in 2023. Before 2021, unlabeled financings were fairly rare and in single digits.
  • The other significant pickup was that over 600 companies they track have not raised anything since 2021-2022. That could be a sign of health–that they are profitable and operating successfully on their cash flow–or barely staggering through and cannot get financing. 
  • M&A revived in 2025 with 195 deals in 2025, up 61% from 2024’s crater. Digital health companies were the majority acquirers (66%) with private equity at 10%. Rock Health attributes this to ‘tapestry weaving’ (creating more continuous solutions to flesh out platforms), legacy acquisitions by AI companies (a/k/a smush togethers, something New Mountain Capital excels at), and ‘acqui-hires’ to get top talent and tech.
    • They note of NMC: “Now, they’re weaving the largest “M&A tapestry” in digital health thus far: Matt Holt, NMC’s former managing director and president of private equity, is reportedly leaving to combine five NMC portfolio companies into a $30B holding company called Thoreau.”, a $30 billion deal broken out in a graphic. The five companies are Datavant, Swoop, Machinify, Smarter Technologies (itself a combine of SmarterDx, Thoughtful.ai, and Access Healthcare in RCM), and OfficeAlly. Whether this pending move (December) will actually work or turn into a petite version of Change Healthcare, we can only surmise.
  • IPOs haven’t really revived in digital health. Rock Health counts five IPOs in 2025, but only two are really digital health, Hinge Health and Omada Health, same as 2024. Both were at relatively flat valuations. The other three are more legitimately classified as biotech–Heartflow, Carlsmed, and Profusa. IPOs may improve in 2026, with Doc.com’s filing for a Nasdaq listing earlier this month and Devoted Health now at a post-F financing.
  • There is zero here about bankruptcies and reorganizations. No reference to the utter implosion of 23andMe and its shocking sale back to founder/CEO Anne Wojcicki.

The impact of ACCESS and ELEVATE. There is also a good graphic analysis of two CMS models that may support digital health more comprehensively than previous value-based care models such as ACO shared savings. The first CMMI model, ACCESS, will be debuting in July and is a 10 year voluntary payment model for Original Medicare outcomes in chronic care management. It reduces barriers for digital health to profitably work with CMS because it offers direct patient enrollment and waiving copays. The other from CMS is ELEVATE, launching in September, which funds up to 30 proposals with $100 million over three years to raise health and prevention for Original Medicare beneficiaries.

Rock Health’s 2025 wrapup

2026 remains Anyone’s Guess. It feels better…but….

Editor’s Note: Our Readers know that this Editor considers Rock Health a bit of a cheerleader for Sand Road. They play both sides of the fence as a venture fund/accelerator. There’s nothing wrong in that. SVB, like other financial institutions, funds a broad swath of healthcare and makes no bones about it. That is why their analysis, which also included EU and a bit of Asia, made its broader and tarter take on 2025 even more interesting.

What’s missing is year-to-year consistency in Rock Health’s analyses, notably what digital health sectors were funded and the Series letter breakdown across all funders.

2025 healthcare investment off 12% versus 2024, with AI nearly half: Silicon Valley Bank roundup (updated for Scheffel interview))

Silicon Valley Bank (SVB), now part of First Citizens Bank, is back with a roundup of the prior year in healthcare investment in the US and EU. 2025 was a year of contractions and skewed investments, what they called “barbells, bookends, and have-nots”, with fewer investors hotly chasing profitability and monetization. 

SVB broke ‘healthcare’ into four sectors: Biopharma, Healthtech, Dx (diagnostics)/Tools, and Device. This Editor’s analysis will concentrate on an overall look plus a deeper dive into Healthtech. SVB also broke out an area cutting across all four, emerging from side conversations into the spotlight. It’s an area where many of us have been laboring in for years–Longevity and Healthspan. (Surprise, surprise!)

Highlights:

  • 2025 total healthcare investment in US and EU totaled $46.8 billion, down 12% versus 2024’s $53.2 billion. European investment remained flat. 2025 still exceeded the dreary days of 2023 that dipped sharply to $41.6 billion. (page 12) Yet adjusting for inflation between the two years, 2025 fell below 2023, which would be today $48 billion (Bureau of Labor Statistics using the Consumer Price Index). 
  • Deal numbers fell 7% in 2025 to an estimated 2,517, versus 2024’s 2,704.
  • AI investments across all four sectors was $22 billion–46%. (pages 2, 5)
  • After Biopharma, Healthtech investments stayed relatively strong as the second largest category, growing from 2024’s $13.2 billion to $13.9 billion. (Note: SVB tracks only investment deals above $2 million)
  • Investments resembled a canyon–plenty in Series A, cratering for Series B and Cs (the have-nots), rising for mega-deals around AI, redefined from the traditional $100 million+ to $300 million+. The higher definition reflects the big capital investments required for AI companies. The report calls it a ‘barbell’ shape–and the plates at both ends are heavy.
  • There are fewer deals as investors seek companies with nearer-term scalability, strong fundamentals, defensibility, and strength of execution. Topping it–less money is available for investment from fewer VCs.
  • Healthtech dominated AI unicorns with valuations above $1 billion: Abridge, OpenEvidence, Innovaccer, and Cera. (page 11)
  • Healthtech saw only seven private M&As and three IPOs (Hinge Health and Omada in the US, 66nao Brain Training in China), versus 2024’s 14 and two respectively. (page 24)
  • Healthtech investments fell off in H2 from a decent pace in H1. Both Series A and later stage companies had generous rounds, though getting there is harder than ever. Page 15 presents a roundup of both the Series A and later stage deals.
  • Investor money raised fell to a decade low–$7 billion versus 2024’s $23 billion. Yet many name investors such as Venrock and General Catalyst closed $100 million healthcare funds, continuing the concentration on money following scale, fundamentals, and monetization versus story and potential. (page 7) 

A ‘must read’ is SVB’s discussion of the Longevity and Healthspan sector on pages 18-21. Finally, finally, the market is seeing the huge need and potential of therapies treating age-related conditions from ability to disease, growing 2.3x in 2025. The sector further concentrates into three areas:

  • Geroscience: R&D into the biology of aging to reverse or mitigate changes. Companies: NewLimit, Altos, Cambrian, Rubedo, Aspen Neuroscience
  • Consumer Healthspan: products for users that analyze everyday behaviors to stay healthy longer. Companies: Function, Viome, Oura, Whoop
  • Intrinsic Capacity Healthtech: apps and tools extending functional everyday abilities. Companies: Neuralink, Sword Health, Hinge Health, Science

Based on early indications of investments and deals, 2026 looks brighter, but still continuing AI and consolidation.

A preview of the report is available with registration here

Updated 20 Jan: Mobihealthnews interviewed Megan Scheffel, who heads up their healthcare and life sciences practice, outside of JPM last week. She reviewed some of the study findings, such as the ‘barbell’ shape of investment (above). M&As are also reviving, looking “pretty” on the mega/later stage side, but on the smaller side perhaps not the “fantastic outcome” founders and investors wanted, but allowing the technology or founders to live to fight another day. This Q&A was telling:

MHN: Do you see any companies eating up other companies just to bury them?

Scheffel: I don’t know if I would say they’re burying them. I keep saying, like, there’s clearance racks.

For companies, SVB operates on two sides: banking and debt. A strategy, according to Ms. Scheffel, that hasn’t changed since before their near-death experience in 2023. She should know as with them for “a gazillion years” prior to that bad time. “We still really want to help companies, even if they’re not raising $300 million rounds every six months. We still are trying to help find ways to support them and support their causes.”

Her advice to companies to succeed: have good management teams and ideas with a “moat”–innovation, IP, and advantages. For investors, the downturns clear out the dead wood (as this Editor predicted after the 2022-3 shocks). To her, times like now are when good investors can make money from better companies.

 

Signs of life: another view on healthcare investments and exits as of mid-year

Silicon Valley Bank and their reports live! Now under the aegis of First Citizens Bank, SVB’s 14th Healthcare Investments & Exits Mid-Year Report for 2024 covers four healthcare areas: biopharma, health tech, DX (diagnosis)/tools, and device. Concentrating on health tech, highlighting their findings which are very different than the other three sectors and mostly in line with H1 findings from Rock Health that this Editor analyzed as possibly a ‘dead cat bounce’:

  • Series A raises are easier than in other sectors, and growing. It is the second-strongest start for Series A health tech investment since 2021. While average valuation sizes are remaining static around $10 million, and deals to date are just under $8 billion.
  • For later-stage companies, their high valuations during the palmy days of 2020-early 2022 created a ‘valuation trap’. The report uses ‘nadir’ to describe it–“now investors (who) are now opening up their coffers for new investments.” (The picture might be less optimistic if one pulled out Transcarent, which is controlled by two investors, General Catalyst and 7wireVentures.) Flat and down rounds are the norm.
  • They term the above ‘price discovery’, defined as the opportunities to extend due diligence, “build conviction” and build the “right syndicate” of investors.(Above all page 14)
  • Investment is accelerating at a rate above the other sectors (page 18). 
  • Exits have cratered at $0.2 billion with only four M&A deals reported. “Companies are preparing themselves to be good public market performers by tuning their cash efficiency and ensuring good unit economics”. Their view is that this may accelerate in H2 2024. (page 21).

SVB is offering the report online as a free preview download. Contact them for the full report.

Figuring out the future for health tech after 2022’s realignments: new SVB study

As Readers who subscribe to our Saturday Alerts (repeated on Wednesday) have seen, this Editor has dubbed this season Realignment Autumn. From the fever pitch of funding, hiring, inflated valuations, SPAC funny money, and unrealistic expectations that started in 2020 and peaked in 2021, we in the industry are now fretting that we can’t get back to 2019 or 2020. Part of the new reality is that telehealth and health tech are far beyond that point in tech integration, ease of use, and takeup by enterprises, but has entered an uncertain business period more than a bit overextended and overexpecting. Unprofitable lines and side businesses, however promising, are being dropped or sold. Talented people who helped to start them are gone. The trend toward consolidation, which started last year, is accelerating.

For a more financial and data-oriented view, Silicon Valley Bank’s latest, “The Future of Healthtech 2022”, does not disappoint. This is a far deeper dive than served up by Rock Health, StartUp Health, and (unless you are a subscriber) CB Insights. This is a US and EU (including UK) view of how investment patterns have shifted, and a look at where investment may be going next year.

So far in 2022 they have seen:

  • Lower valuations and plummeting share value of public companies
  • A shift from ‘growth at all costs’ to a clear value proposition and creation: improving health outcomes, access or affordability.
  • Investments are more modest and at earlier stages–no more blockbuster Series Ds and Es (40% decline in mega-rounds of $100 million+)
  • No IPOs so far
  • Only 18 unicorns formed this year
  • M&A still rising at the right price
  • Companies have to deliver measurable value to continue driving innovation

Through 30 September, SVB tracked investment at $23 billion. Where it’s going:

  1. Provider operations: $7.0 billion–defined as technology that improves efficiency and accuracy of provider-provider, provider-patient interactions
  2. Clinical trial enablement: $6.8 billion
  3. Alternative Care (includes telehealth and mental health): $5.6 billion
  4. Wellness and education: $1.3 billion
  5. Healthcare navigation: $1.3 billion
  6. Medication management: $833 million
  7. Insurance: $117 million

Sections drill down on these sectors and subsectors such as mental health and women’s health, including an analysis of female-founded health tech companies, investors by sector, and a historical view of unicorns. Grab a cuppa and take your time with this one!

Digital health funding’s Q1 hangover from 2021’s bender–and Q2 is a question mark, even for Rock Health

Chug the Pedialyte and pickle juice, down those milk thistle caps for the liver. It’s a morning after quarter that we knew was coming. After 2021’s mighty year for health tech investment, doubling 2020’s, capped by a $29.1 billion total across 729 deals [TTA 29 Jan], the slump we knew would arrive, did. Rock Health’s tracking of 2022’s Q1 proved to be a less than stellar $6.0 billion across 183 deals. It mildly lagged 2021’s Q1 but was still 75% more than 2020’s depressed Q1 at the start of the pandemic.

Even in January, the 2022 projections were iffy. Silicon Valley Bank projected, based on anemic post-IPO performance, that there would be ‘massive consolidation’ and even acquiring companies to hire talent [TTA 14 Jan]. Rock Health and Silicon Valley Bank noted the waning of SPACs as an easy way to IPO for a variety of reasons, including SEC scrutiny. A combination of both was SOC Telemed. which IPO’d via a SPAC at $10, and was taken private seven months later at $3 per share–after trading at $0.64. SOC was not an outlier–larger telehealth brothers Amwell and Teladoc had taken major share price kicks in the head at 50% and more by February [TTA 8 Feb].

The rest of the story is mixed as the economy continues to open up with the pandemic over, but the stock market is wobbly, inflation soars as does a Russia-Ukraine war. 

  • Average deal size was $32.8 million, again below 2021
  • January was a cheerier month than the following two, with companies raising $3.0 billion. Some of this was carryover from 2021 deals that didn’t quite make it past the post. February slumped to $1.4 billion while March ticked up to $1.6 billion, not a good trend going into Q2.
  • Rock Health’s Digital Health Index (RHDHI), a composite of publicly traded digital health securities, fell 38%, far below the S&P 500’s 5% dip over that same time period.
  • SPACs tumbled along with the market, continuing their fall since 2021. Deals were canceled, taken private (SOC Telemed), and companies sued for misleading investors (Talkspace).
  • Late stage deals continued to roll: mega Series D+ deals in Q1 2022 included TigerConnect ($300M), Lyra ($235M), Alto Pharmacy ($200M), Omada Health ($192M), and Ro ($150M). D and above deal size fell by $16 million. But average deal size fell off at every Series, less so for B and C.
  • Lead clinical investment areas were mental health continuing far in the lead, followed by oncology, cardiovascular, and diabetes. Oncology rose from the fifth spot in 2021 to #2 in Q1, displacing cardio. In value proposition, the top three were on-demand healthcare, R&D, and clinical workflow–this up from the 11th spot.

A weak start for 2022, but only compared to 2021. Q2 and maybe even Q3 will be the test in this mid-term election year. Rock Health Q1 report

US/EU 2021 healthcare VC funding soared 65%, but health tech performance slumped 28%–and 2022 surprises

This isn’t the usual Rock Health report of puppies and unicorns. Silicon Valley Bank is a source new to this Editor, but even in topline, the report is pretty bracing. Their coverage is broad and detailed–biopharma, health tech, dx (diagnostic)/tools, and device–on US and European venture capital (VC) funding from 2019 to 2021. There are some warning flags for the health tech sector through their report (summary page; report available for free download here).

What you’d expect: total health care soared in 2021 to over $86 billion–a 65% increase over 2020 (not 30%!). This was led by biopharma at $36.3 billion, then health tech at $28.2 billion. Dx/tools and devices had far more modest funding gains. 

For health tech: 

  • Funding was up 157% versus 2020–42 new ‘unicorns’, four times 2020
  • Provider operations companies comprised a record 35% of total seed/series A funding, up from 20% in 2020. The other hot areas were clinical trial enablement and alternative care. Surprisingly, healthcare navigation was next to last, perhaps indicating that these companies are further along in maturity.
  • Investors were numerous, but high frequency investors were Tiger Global, Andreesen Horowitz, General Catalyst, Casdin, and Gaingels.
  • SPACs slowed in 2021, trying to find the right match before their two-year window to complete a merger and reflecting greater SEC scrutiny of blank checks. Of those who ‘de-SPAC’ed in 2021, Talkspace and Owlet led in market losses, 80% and 73% respectively.
  • Post-IPO performance dropped 28%, led by insurtechs Oscar, Bright Health, and Alignment Health
  • There were 122 M&A deals. The $63 million median value was down 25% from 2020. marking a shift to vertical integrations in care continuums or horizontal to capture consumer bases.

2022 The Year of M&A and Acquire-to-Hire? The end of the report sounds a cautionary note to health tech ‘bulls’. Expect “massive” consolidation. Healthy investment will continue, but the opportunities will be for companies seeking expand product offerings, expand to other markets, or acquire to hire talent (!)–the latter something quite new.

Also FierceHealthcare