Olive AI selling rest of business to Waystar Health and Humata Health, winding down: reports (several updates)

The final reorganization is to sell everything. Today’s report in Axios states that Olive AI’s remaining business has been sold to revenue cycle management/payments software Waystar Health and to Humata Health, a startup (see update below). Olive’s Clearinghouse and Patient Access business units went to Waystar and its Prior Authorization business unit to Humata. Sale prices and staff transitions were not disclosed. OliveAI’s business lines centered on automating routine tasks in healthcare so that more time could be spent on patient care and higher value tasks.

Olive’s statement was simple and brief, in part reading “These products represent the heart of Olive’s business and we believe this decision will provide important stability and a bright future for these customers. With the sale of our core business units, Olive will wind down the remainder of its business.” Other than this message, their website was almost totally disabled except for a customer login on a product named Lighthouse. In the message, there is no information on handoffs nor on the fate of remaining staffers.

This follows on our reporting of Olive AI’s slow bleed starting July 2022 when they pink-slipped 450 employees, or one-third of staff, followed by additional layoffs of 35% of staff (215 workers) this past February, then the sale of various businesses to an undisclosed sister company, business intel to BurstIQ, and its utilization management tool to Availity all between February and June. They had a lot to sell in refocusing on core business. Since its founding in 2012, Olive had pivoted its business model 27 times according to its CEO, which sounds to this Editor more like a constant pirouette. The final layoff reported was in July of another 450 staff, another one-third. An Axios report in April 2022 demolished much of their credibility with examples of overpromising on their technology producing savings and efficiencies, then underdelivering, an assessment echoed by KLAS. HISTalk

OliveAI’s demise as it reaches the end of the runway for near-total hull loss is almost in the Theranos class as a Unicorn Fail. They were valued at one point at $4 billion and burned through over $850 million in nine rounds of funding up to a Series H, including from top VCs General Catalyst, Tiger Global, and Vista Equity Partners. General Catalyst is now moving into the transformation business with the awkwardly named HATco,  The Health Assurance Transformation Corporation, announced at HLTH earlier this month and defined as “a more affordable, accessible and proactive system of care”.  As this Editor noted then, HATco’s promise is a song we’re heard before. (The Gimlet Eye would say it should be played on a tinny, out-of-tune piano.)

One of the remaining business buyers, Waystar Health, filed only two weeks ago to be the first IPO in digital health in over a year, for an estimated valuation of $8 billion. Mr. Market’s bad behavior though is delaying its roadshow till December at the earliest due to weakness. The IPO will be 2024. Sometime. [TTA 26 Oct] The cycle begins anew.

Even so, yet another demise of a once-promising company is sad news. This is developing and will be updated.

Update on Humata Health (see comment below). Turns out it is a startup that will be headed by a former Olive president for their payer business, Jeremy Friese, MD. According to his LinkedIn profile, Dr. Friese had that position November 2020 to September 2022 after the sale of Verata Health, where he was co-founder and CEO from 2017 until they sold their prior authorization business to Olive AI. Three former Olive employees contacted the author of Axios’ coverage, Erin Brodwin, after she published the original article on 31 October. So Dr. Friese, who lists a ‘stealth startup’ from April 2023 in his profile, is apparently taking back his prior authorization business. Does this seem reminiscent of Pear Therapeutics’ CEO, Corey McCann, obtaining backing to acquire many of Pear’s assets out of bankruptcy for a paltry $2.03 million [TTA 24 May]?

Was Olive AI a scam? HISTalk has an interesting discussion today on whether it met the definition, as some have claimed. Their POV is that it was not, but investors and customers didn’t do their due diligence despite poor KLAS reviews (except for prior authorization) and especially in the hothouse of 2020-2021 did not see past the hype. For those evaluating companies, whether to take them on as a vendor or to go work for them, there are three cautionary points that stood out in their seven lessons:

  • Companies can be wheezing their last even as they pay big money for impressive exhibits and sponsored events at conferences.
  • Rapid company expansion, acquisitions that look like an attention-diverting shell game, and a product line that is too confusing to summarize in a single “what does your company do” sentence are reasons for skepticism.
  • All companies and investors look smart when the economy is booming.

HISTalk’s Curbside Consult columnist Dr. Jayne takes on Olive AI, which in her health IT world is being much talked about. She and this Editor are on the same page about these running-out-of-funding runway startups which she summarizes so well:

In talking with friends who know the industry well, most are in agreement that it’s time for a lot of companies to pay the proverbial piper since they can’t deliver on the promises they made in exchange for startup funding. They forecast that many more companies will be trying to reinvent themselves over the coming months. Those that are successful may live to fight another day, but others may become the stuff of fire sales or ultimately closures.

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.

Comings and goings: Cuts hit Athenahealth, IBM Watson’s Drug Discovery unit; Bain may sell Waystar RCM

Athenahealth has announced they are trimming 4 percent of their total workforce. With a large 900-person campus in Belfast, Maine that once belonged to MBNA credit cards, and a workforce of about 5,000 headquartered in Watertown, Massachusetts, there is considerable local concern in an area of Maine that offers few well-paying jobs. Reportedly dozens of jobs there will be lost. This caps a tumultuous period with the company. Athenahealth was acquired last November by Veritas Capital and Evergreen Coast Capital, then merged with a GE Healthcare spinoff they owned, Virence Health, in value-based care, under the Athenahealth name. Bangor Daily News

IBM Watson’s Drug Discovery product, which was targeted to pharmaceutical companies, is being cut back to work with only current partners and with clinical trials due to poor sales. According to The Register, a tart-tongued UK tech website which actually reached an IBM spokesperson, IBM’s Ed Barbini stated that “We are not discontinuing our Watson for Drug Discovery offering, and we remain committed to its continued success for our clients currently using the technology.” Also Seeking Alpha. IBM Watson and Watson Health, like Athenahealth, are moving through a rocky period of closing initiatives (Watson Workplace), layoffs, executive departures (head Deborah DeSanzo last November), bad publicity, and clients like MD Anderson who don’t part quietly. [TTA 8 Nov 18].

Another merged health infotech company may have a new owner soon. Waystar, which was formed by the acquisition of ZirMed and Navicure in 2017 and manages revenue cycles for 450,000 practices, is rumored to be up for sale by owner Bain Capital. Interested parties include Visa and OracleBloomberg

CVS-Aetna, Cigna-Express Scripts reportedly on road to merger approval; Athenahealth in hostile takeover–or not (updated)

CVS’ pickup of Aetna, and Cigna‘s acquisition of Express Scripts are reported to be clearing the Department of Justice anti-trust review within the next few weeks, just in time for pumpkin season. The DOJ may have concerns on some assets related to Medicare drug coverage and may require a sell-off to resolve them. One potential buyer is WellCare Health Plans, which this week completed its acquisition of Meridian Health Plans and entered the S&P 500 on Monday. The Cigna-Express Scripts combine may not require any asset selloff. Seeking Alpha (report is from the Wall Street Journal).

The once blazingly hot Athenahealth is up for sale but can’t seem to get arrested by another healthcare company. Both Cerner and UnitedHealthcare passed on an acquisition. One of the larger shareholders, Elliot Management, initiated moves toward a hostile takeover in May, and in the process managed to oust founder and CEO Jonathan Bush on still-murky charges of past domestic abuse and workplace sexual harassment. Mr. Elliot is partnering with Bain Capital which owns Waystar, a revenue cycle management (RCM) company from the merged ZirMed and Navicure. Waystar could benefit from Athenahealth’s systems and IP. Mr. Bush would receive a relatively small sum in a sale –$4.8 million– with new executive chair and former GE CEO Jeffrey Immelt earning $150,000 a month in salary and $150,000 in restricted stock perhaps looking for a new job. Elliot’s reputation is that of a corporate raider–taking over businesses to strip assets and sell off the remains. New York Post, POLITICO Morning eHealth.

UPDATED 19 Sept Reports from yesterday indicate that Mr. Elliot has ‘balked’ at the $160 per share price that Athenahealth is asking, and may be angling for a lower price, according to the NY Post report. Reportedly no one else–Cerner and UnitedHealthcare–is interested, though Athenahealth has extended the bid deadline to 27 September. There may be problems uncovered by the due diligence. It’s also a recognized hardball lowball strategy to get the share price way down. The industry is betting on the latter because the former is difficult to contemplate for customers and healthcare as a whole. Also HealthcareITNews.