Startups Weekly: YC grad Revel’s plan to connect women over 50

Hello and welcome back to Startups Weekly, a weekend newsletter that dives into the week’s noteworthy news pertaining to startups and venture capital. Before I jump into today’s topic, let’s catch up a bit. I’ve been on a bit of a startup profile kick as of late. Last week, I was tired from Disrupt. Before that, I wrote about up and coming telemedicine company Alpha Medical.

Remember, you can send me tips, suggestions and feedback to kate.clark@techcrunch.com or on Twitter @KateClarkTweets. If you don’t subscribe to Startups Weekly yet, you can do that here.


Startup Spotlight

Y Combinator’s latest batch concluded two months ago, which means my inbox is beginning to fill with pitches from companies ready to talk about the first rounds of fundraising. We’ve profiled many of the companies already, like Tandem, Narrator, SannTek Labs and more to come.

This week, I have some notes on Revel, a recent grad from the hot accelerator network that plans to create a nationwide subscription-based network tailored to women over the age of 50. The startup’s founders, Harvard Business School graduates Lisa Marron and Alexa Wahl, say there are no good existing options in the market to help women in this demographic foster new relationships.

Revel

“I think a lot of the things that exist are nonprofits that are a little antiquated now,” Marron tells TechCrunch. “I think we saw that those are really serving the need of our members’ parents’ generation, but they haven’t really adapted as much to the modern age.”

Women 50 years and older can become a member of Revel. For now, the service is free, though the company plans to charge a $100 annual fee in the coming months. Currently, Revel’s community includes 500 women. With a $2.5 million funding led by Forerunner Ventures’ Kirsten Green, the small team plans to expand within the Bay Area. They said they won’t begin establishing Revel outside the region until they raise a Series A.

It’s hard to imagine women will stay committed to paying an annual Revel membership, considering the real value comes from the company’s ability to facilitate introductions to like-minded women. Once those introductions have been made, women can discontinue their membership and develop relationships outside the service. Forerunner Ventures, however, is known for backing successful and prominent brands, like Glossier, Warby Parker and Outdoor Voices. My guess is Revel has ambitions to become the brand representing women over 50 seeking meaningful connections.

“We want to take this wide in a short number of years because we feel there is a need and opportunity to build this strong community for women of this age; venture capital in that sense was rocket fuel,” adds Marron.


VC rounds


M&A

  • Uber plans to buy a majority stake in a Latin American grocery delivery business called Cornershop. The Chilean startup was founded in 2015 by Oskar Hjertonsson, Daniel Undurraga and Juan Pablo Cuevas. It will continue to operate under that leadership in its current form for now, says Uber.
  • To beat Amazon Go, Standard Cognition is buying DeepMagic, a pioneer in autonomous retail kiosks. “The $86 million-funded Standard Cognition is racing to equip storefronts with an independent alternative using cameras to track what customers grab and charge them. But Amazon’s early start in the space poses a risk that it could patent troll the startup,” writes TechCrunch’s Josh Constine.

Extra Crunch

Extra Crunch subscribers have a lot to chew on this week. Reminder, if you haven’t yet signed up for our premium content service, you still can here.

This week, I wrote about the importance of having a culture expert on staff at a venture capital firm. Increasingly, startups are being judged for their cultures, diversity of staff and more. VCs, for the most part, are unprepared to help their companies foster more inclusive environments, and that’s a problem. One firm, True Ventures, has taken a big step toward holding their companies accountable for culture and giving them real resources to help them improve things early. I talked to True Ventures’ Madeline Kolbe Saltzman about her new title, VP of Culture.


Equity

I took a break from Equity this week, but my co-host Alex Wilhelm was in studio with IPO expert James Clark. Listen to the excellent conversation here.

Equity drops every Friday at 6:00 am PT, so subscribe to us on Apple Podcasts, Overcast, Spotify and all the casts.

GoodRx is coming for subscription prescription services with the launch of GoodRx Care

Several months after discreetly acquiring the online prescription service HeyDoctor, GoodRx is launching a new service based on the acquisition, GoodRx Care and offering a direct challenge to online prescription services like Hims, Hers, Nurx, Ro and others.

Already a billion-dollar giant in the world of prescription fulfillment through its cost-comparison and discount medication fulfillment business, more than 10 million consumers use the company’s services already.

With GoodRx Care, customers can use the online medical service to get a consultation, treatment, prescriptions and lab tests from doctors. The array of services on offer, which covers conditions and ailments from urinary tract infection treatments and birth control pills to erectile dysfunction medication and hair replacement supplements, mirror those pitched by white-glove online prescription services like Ro, Hims, Hers, and Nurx .

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GoodRx Care services

“Over the years, we’ve helped millions of Americans find affordable solutions for their prescription medications, but have also learned that many people struggle to get to the doctor,” said Doug Hirsch, co-CEO and co-founder of GoodRx. “By introducing GoodRx Care, we aim to help fill in the gaps in care to improve access, adherence, and affordability of medical care for all Americans.”

For Hirsch and GoodRx, the expansion into these kinds of online consultations was a natural extension of the company’s services. “One third of people who come to GoodRx . are coming to GoodRx and they may not have the prescription that they don’t think they need,” he says. “For a long time now we’ve been  telling people you may need a prescription for the service and telemedicine options are available.” 

Now the company can keep those customers in-house by offering their own telemedicine consults.

Other technology companies are also pushing deeper into the healthcare industry with Amazon making a big splash with the launch of its employee-only healthcare service offering telemedicine and on-site consultations with staff doctors. Apple, too, has its own healthcare service for employees.

Even BestBuy is seeing big dollars in the healthcare industry. It expects healthcare services to become an increasingly important component to its bottom line as more technology hardware and software is developed to cater to both the aging population, remote health solutions, and infant and childcare.

Demand for more healthcare alternatives is only increasing even as the cost of care rises and the value of healthcare services declines.

As GoodRx notes, access to primary care physicians is hard for most Americans. Some patients can wait up to three weeks to see a doctor and there’s the potential that the country could see a shortfall of up to 120,000 doctors coming within the next 15 years. Add that to the fact that over 27.5 million Americans don’t even have health insurance and the demand for low cost access to care seems obvious.

What’s less obvious is that the care Americans need is access to physicians which will prescribe hair-loss or erectile dysfunction treatments, acne treatments, eyelash growth, or metabolic assessments.

Hirsch says more services will be coming in later months. “We’re at the very early stages of telemedicine,” he says. “We want to continue to expand into more primary services as is safe and affordable and as we can.”

For now, the focus was on bringing the price point down and having more control over where to refer customers. “A lot of these services are tied to mail-order clinics and that could be hundreds of dollars [for a consultation or prescription],” Hirsch says. “We’re going to say it’s $20 for a visit. You can do it today… and you can have a pricing options… we’re saying you’ve had your doctor visit… here’s a list of prices and coupons if you want them.”

Since its launch in 2017, HeyDoctor has had over 100,000 consultations and had already been working with GoodRx, according to Hirsch. The terms of the acquisition were not disclosed.

The acquisition of HeyDoctor is the first big strategic gambit from the company in the year since it raised money from the private equity firm, Silverlake, in a transaction which valued the discount pharmaceutical provider at roughly $2.8 billion, according to a CNBC report.

“In an increasingly fragmented and confusing healthcare system, our goal is to provide a one-stop shop for services that address most basic healthcare needs,” said Hirsch.

 

Amazon launches Amazon Care, a virtual and in-person healthcare offering for employees

Amazon has gone live with Amazon Care, a new pilot healthcare service offering that is initially available to its employees in and around the Seattle area. The Amazon Care offering includes both virtual and in-person care, with telemedicine via app, chat and remote video, as well as follow-up visits and prescription drug delivery in person directly at an employee’s home or office.

First reported by CNBC, Amazon Care grew out of an initiative announced in 2018 with J.P. Morgan and Berkshire Hathaway to make a big change in how they all collectively handle their employee healthcare needs. The companies announced at the time that they were eager to put together a solution that was “free from profit-making incentives and constraints,” which are of course at the heart of private insurance companies that serve corporate clients currently.

Other large companies, like Apple, offer their own on-premise and remotely accessible healthcare services as part of their employee compensation and benefits packages, so Amazon is hardly unique in seeking to scratch this itch. The difference, however, is that Amazon Care is much more external-facing than those offered by its peers in Silicon Valley, with a brand identity and presentation that strongly suggests the company is thinking about more than its own workforce when it comes to a future potential addressable market for Care.

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The Amazon Care logo.

Care’s website also provides a look at the app that Amazon developed for the telemedicine component, which shows the flow for choosing between text chat and video, as well as a summary of care provided through the service, with invoices, diagnosis and treatment plans all available for patient review.

Amazon lists Care as an option for a “first stop,” with the ability to handle things like colds, infections, minor injuries, preventative consultations, lab work, vaccinations, contraceptives and STI testing and general questions. Basically, it sounds like they cover off a lot of what you’d handle at your general practitioner, before being recommended on for any more specialist or advanced medical treatment or expertise.

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Rendered screenshots of the Amazon Care app for Amazon employees.

Current eligibility is limited to Amazon’s employees, who are enrolled in the company’s health insurance plan, and who are located in the pilot service geographical area. The service is currently available between 8 AM and 9 PM local time from Monday through Friday, and between 8 AM and 6 PM Saturday through Sunday.

Amazon acquired PillPack last year, an online pharmacy startup, for around $753 million, and that appears to be part of their core value proposition with Amazon Care, too, which features couriered prescribed medications and remotely communicated treatment plans.

Amazon may be limiting this pilot to employees at launch, but the highly-publicized nature of their approach, and the amount of product development that clearly went into developing the initial app, user experience and brand all indicate that it has the broader U.S. market in mind as a potential expansion opportunity down the line. Recent reports also suggest that it’s going to make a play in consumer health with new wearable fitness tracking devices, which could very nicely complement insurance and health care services offered at the enterprise and individual level. Perhaps not coincidentally, Walgreens, CVS and McKesson stock were all trading down today.

In healthcare these days, ‘There’s an app for that’… unless you really need it

When a digital health company announces a new app, everyone seems to think it’s going to improve health. Not me.

Where I work, in San Francisco’s public health system, in a hospital named after the founder of Facebook, digital solutions promising to improve health feel far away.

The patients and providers in our public delivery system are deeply familiar with the real-world barriers to leveraging technology to improve health. Our patients are low-income (nearly all of them receive public insurance) and diverse (more than 140 languages are spoken). Many of them manage multiple chronic conditions. The providers that care for them struggle with fragmented health records and outdated methods of communication, like faxes and pagers.

So when companies tell us they will cure diseases, drive down costs, and save lives with state-of-the-art technology, I am often hesitant. 

More than thirty billion dollars have been invested in digital health since 2011. The resulting technological innovations, such as mobile applications, telemedicine, and wearables, promise to help patients fight diabetes, treat chronic disease, or lose weight, for example.

However, we have yet to see digital health drive meaningful improvements in health outcomes and reductions in health expenditures. This lack of impact is because digital health companies build products that often don’t reach beyond the “worried well” – primarily healthy people who make up a small proportion of health expenditures and are already engaged in the healthcare system.

If we’re designing health apps for those who already have access to healthcare, nutritious food, clean air to breathe, and stable housing, we’re missing the point.

It’s no surprise that health apps are incongruous with the needs of low-income, diverse, and vulnerable patients when these populations are unlikely to be a part of user testing. In addition, the science that technology developers draw from is generated by clinical trials conducted on participants who often do not reflect the diversity of the United States.

Over 80% of clinical trial participants are white, and many are young and male. Women, racial and ethnic minorities, as well as older adults must be included in clinical trials to ensure the results — drawn on not only for product development but also for clinical care and policy — are relevant for diverse populations. 

Research conducted by my colleagues at the UCSF Center for Vulnerable Populations demonstrates that patients who are low-income are unable to access many digital health apps. One of our patients testing a popular depression-management app said, “I’d get really impatient with this” and expressed concern that “Somebody that’s not too educated would be like, ‘now, what do I do here?’” A caregiver testing a different app also voiced frustration, saying “Yeah, it’s an app that makes you feel like an idiot.” Yet, despite these barriers, the majority of our study participants (most of whom have smart phones) also express a high interest in using technology to manage their health.

 While the private sector is great for innovation, it will fail to improve health in a meaningful way without real-world evidence generated in partnership with diverse patients. In addition, these for-profit companies face long odds to benefit their shareholders in a substantial way without learning how to reach the 75 million patients on Medicaid (including 1 in 3 Californians) who stand to benefit from digital health solutions.

 There’s an answer, though, and it’s within reach. To truly improve health outcomes, digital health companies must partner with public health experts and patients to not only ground themselves in evidence-based research, but also build products that meet the needs of all patients. 

Along with the compelling business potential of innovating for Medicaid, infrastructure to support this work is growing. For example, organizations like HealthTech4Medicaid are bending the arc of innovation towards the patients who need it most through advocacy and key partnerships with payers, policy makers, care providers, and technology developers.

To truly revolutionize health, let’s demand that technology creators and scalers include diverse end users early and often. Otherwise, the app “for that” will be for them, not for all of us.