digital health valuation multiples 2022 digital health valuation multiples 2022

2022 Spending Benchmarks for Private B2B SaaS Companies. Valuation Multiples Over Last 12 Months The single biggest question facing my business today is what valuation multiple is the right one to use when pricing private financing rounds in this space. Similarly, we have seen a dramatic shift in market valuation multiples for digital health companies. In 2022, the rate of decline accelerated: H1 2022 averaged $5.2B in quarterly funding, and in H2 2022 average quarterly funding fell to $2.4B. After an astonishing $45 billion poured into new digital health companies in 2020 and 2021, and an early 2021 peak in market valuations of publicly-traded digital health providers, valuations and multiples have collapsed. About What If Ventures What If Ventures exists to invest in mental health and digital health focused startups. Fund documents StarCapital Equity Value plus, StarCapital Multi Income, StarCapital Strategy 1 and StarCapital Dynamic Bonds. End-to-end automation with human-in-the-loop AI will decrease the amount of manual administrative work, decrease staff burnout rates, and increase patient access to medication in healthcare., Ogi Kavazovic, Cofounder and CEO, and Tesh Khullar, Cofounder and President, HouseRx: Further consolidation in specialty pharmacy space, likely led by PBMs acquiring specialty pharmacy competition, which once again will result in fewer patient options and a suboptimal patient experience.. Lets dig in. The biggest M&A deal of the year was Data to Decision AG acquisition of MEDIQON GmbHa software company providing data analysis solutions to generate insights capable of driving healthcare sector decisionsfor $30bn. We have seen first-hand how this has led to a real battle for clinical talent among companies in this subsector. Be sure to check out Rock Health's Digital Health Funding Report. The most successful companies in this infrastructure category will enable virtual care companies to go to market quickly, be flexible to evolve as companies grow, and integrate seamlessly with other tools and API platforms. For example, Zaya Care uses this model in the maternal health space. Revenue multiples for B2B SaaS companies declined rapidly throughout 2022, with median multiples for Q4 below pre-pandemic levels, at 5.8x. Several D2C digital health equities including Peloton (-78%), Owlet (-79%), and Beachbody (-78%) ended the year at fractions of their 2022 opening prices. Stephen Hays, Founder of What If Ventures www.whatif.vc a mental health focused venture capital fund and host of the Stigma Podcast. In the digital health space, it is much more likely to be acquired than go public. Finally, its important to draw boundaries between conflicting business unitsprobably best to steer clear of mixing healthcare and consumer marketing, and focus instead on cloud hosting and patient data interoperability. 2021 was generally a very challenging year for small and mid-sized growth stocks. Deal count rose from 48 in 2020 to 75 in 2021, a record. Changes in foreign-exchange rates may also cause the value of investments to go up or down. These investments in people, processes, and protocols are one of the reasons why best-in-class healthcare companies tend to have lower gross margins than their software counterparts. U.S.-based digital health startups brought in almost $30 billion in 2021, almost doubling the total investment the year prior. The most impactful findings of the "2022 RIA Deal Room" report include: Eye-opening valuations and a flattening curve. Our most recent investment, HouseRx, is helping independent physicians in a different way by enabling doctors to run medically integrated dispensing of specialty drugs and helping them connect therapeutics with care journeys, which will ultimately be better for patient adherence and outcomes. As we redesigned GI care into a patient-centered, value-based model, we recognized that our virtual care supports many important clinical needs, but we also needed to bridge our services with in-person care like colonoscopies and diagnostic tests. Only one company, Amwell, has analysts who believe that their revenue will be lower in one year than it is now. Privacy policy. In addition to taking traditional expense reduction efforts and charging new fees, hospital systems evaluated nonclinical and clinical workflow improvements to unlock efficiency gains and reduce provider pain points at work. When we broadly examine what we call the Disruptive Healthcare peer group to get a sense of what is happening in public markets, this may translate into insights about our market, which is at the intersection of digital health and mental health. The price-to-revenue multiple for critical access hospitals was 0.52x, and the average price . EBITDA multiples are one of the most commonly used business valuation indicators that is often used by investors or potential buyers to assess a company's financial performance. Health systems also established partnerships as first steps into new revenue or equity pathways, shaking hands with venture capital teams like General Catalyst and a16z to establish digital health startup pilot sites on hospital campuses. USA February 28 2023. 2022 Public SaaS Valuation Multiples. We saw a record of more than 30 IPOs and 80 mergers and acquisitions. 1.91K Followers. Employers have begun to acknowledge that increasing access to care requires both a refactoring of existing insurance policies, coupled with investments that quantify and deepen LGBTQ+ specialization in provider networks. Strategic healthcare M&A rebounded in 2021 from a down year in pandemic-ravaged 2020, with volume up 16% and total deal value rising by 44%, to $440 billion. Mental Health Startup Community Slack Channel We have created a slack channel for founders, investors, and supporters of the mental health startup ecosystem. Interest in media companies is growing. The behavioral health industry is coming off a record number of transactions and as multiples remain high, companies are having to get smarter about . Fund documents Bellevue Entrepreneur Switzerland. 1. Investment or other decisions should not be made solely on the basis of this document. In short, we do not have the answers. WASHINGTON, Oct. 09, 2022 (GLOBE NEWSWIRE) -- Global Digital Health Market was valued at USD 145.57 Billion in 2021 and is projected to surpass the valuation of USD 430.52 Billion by 2028 at a . Revenue valuations have come in. These new companies are great examples of the new breed of digital MSOs serving the independent practitioner. Big H2 2022 splashes from retail giants Walmart and Walgreens have raised the stakes for primary care, at-home, and omnichannel care delivery expansion. The pandemic has led to an increase in workloads and burnout among clinicians. By clicking on "Accept", you confirm that you agree to the legal provisions. Average EV/EBITDA multiples in the health and pharmaceuticals sector in the United States from 2019 to 2022, by industry [Graph], Leonard N. Stern School of Business, January 5, 2022. Similarly, we have seen a dramatic shift in market valuation multiples for digital health companies. Health systems 2022 innovation grace under pressure is noteworthy and sets a precedent for other major healthcare companies facing less difficult, but nonetheless challenging situations. Mobile privacy updates gave way to rising customer acquisition costs (CAC); for some D2C digital health startups, CAC is estimated to have rocketed from $150 in 2018 to $500-$1,000 in 2022. 4 paragraph 3-5 and Art. Pharmaceutical & life sciences deals outlook. Denominator: Value Driver - i.e. Furthermore, we recommend that you consult an independent tax adviser in order to obtain information on the tax regulations relating to a specific investment in your legal jurisdiction and with regard to your personal circumstances. 2022. More than private market valuations, this trend will pressure the amount of capital available, and even more so if the public markets continue to contract and investors can find yield in less-risky public securities. The management company may decide to cancel the arrangements it has made for the distribution of the units of its collective investment undertakings in accordance with Article 93a of Directive 2009/65/EC and Article 32a of Directive 2011/61/EU. Sectors ranging from telemedicine to medical devices to AI healthcare all raised record-high funding. The management company may decide to cancel the arrangements it has made for the distribution of the units of its collective investment undertakings in accordance with Article 93a of Directive 2009/65/EC and Article 32a of Directive 2011/61/EU. Why does this matter? The multiple has been sliced over the last year. Staffing crises and wage inflation hiked up operating costs faster than CMS-influenced rate adjustments, squeezing health system margins rather than allowing hospitals to pass costs through to payers. These may be subject to change and the use of the site may be restricted or terminated at any time without prior notice. Exit, Investment, Tech and Valuation. You can read more about his story here. It is incumbent upon these solutions to demonstrate value on investment or risk losing market share to higher-impact offerings., Mudit Garg, Co-founder and CEO, Qventus: Over the last two years, hospitals struggled with capacity and staffing shortages. For example, our portfolio company US Health Partners is assisting cardiologists in breaking free from the traditional hospital structure to run independent practices as they transition to digital and value-based care. Healthcare stakeholders are increasingly joining efforts with HealthTech companies to improve and increase access to remote care. Ahh, 2022: the year of inflation, stock drops, and a whopping seven (7!) We need better integration of clinical models to enable the treatment of comorbid conditions, such as Diabetes and Major Depressive Disorder. The indications for the new year are good. Rock Health Advisory provides guidance on digital health strategy, access to proprietary funding data, and in-depth perspectives on the digital health market. Given the rise of many pill mill businesses, we expect the FDA and other regulatory bodies will enforce increased clinical protocol scrutiny. Pharma and biotech M&A will continue to focus on oncology and immunology, but other areas such as central nervous system and cardiovascular diseases as well as vaccines will see interest. Legal entities or natural persons to which such prohibitions apply must not access or use these sites. To be clear, we dont believe only hybrid-care companies will succeed, rather we believe digital-only companies will bridge the pre existing healthcare system to support a hybrid care delivery model. The indications for the new year are good. : Use the PitchBook Platform to explore the full profile. Two quarters ago, we noted a shift in investors attention from growth-stage players to early-stage digital health companies perceived as less likely to carry inflated valuations from 2020-2021. Ambitious hospitalathome initiatives were launched to free up hospital beds, allow top of license practice, and reimagine care pathways. To continue, please select your country of domicile and investor type. Revenue valuations have come in. . Though a source of some internal controversy, it is nonetheless Rock Healths official position that both unicorns and horses share the genus. If you can't read this PDF, you can view its text here. Notably, 2022s years Q4 $2.7B total was less than half of last years Q4 raise ($7.4B). Not only did 2022's annual funding total come in at just over half of 2021's $29.3B 2, but it also just squeaked past 2020's $14.7B sum. Revenue multiples for eCommerce businesses tend to be in the range of 0.7-3x. Strong growth momentum and non-cyclical demand put Digital Health stocks in an excellent position to deliver a pleasing performance in 2022. We also share information about your use of our website with our social media, advertising and analytics partners. Moreover, pure-play telehealth and mental health companies have underperformed not just the market, but also the peer group (see the chart below). Weve all been reminded that you cant fight Mother Nature (aka macroeconomic forces), with D2C startups bearing the brunt of the reminder. Prospectus, Key Investor Information Document (KID), fund contract as well as the annual and semi - annual reports of the Bellevue Fund under Swiss law are available free of charge from: Switzerland : PMG Fonds Management AG, Dammstrasse 23, 6300 Zug or Bellevue Asset Management AG, Seestrasse 16, CH - 8700 Kusnacht. You can also find us on twitter and LinkedIn. For employers, health plans, and life science firms bracing for cost challenges or new mandates in 2023not to mention the impending end of the COVID-19 public health emergencywe hope health systems 2022 moves set the tone for all enterprises balancing the immediate with long-term innovation decisions. Global healthcare funding grew 45% YOY in 2020, and then added a further 79% in 2021, reaching a record $57.2bn invested. It has been a rough year so far for digital health. Financial or Operating Metric ( EBITDA, EBIT, Revenue, etc.) In fact, the group is down 50% versus the S&P 500, which is up 10% during that period. Its worth calling out that competition is a powerful motivator for health system innovation, especially as retail giants battle their way into care delivery. At-home diagnostics, digital biomarkers, and remote patient monitoring innovation continue to improve the virtual care experience, however, telemedicine isnt a complete replacement for diagnosis or treatment that requires an in-person visit. Investors are wary of unicorns spells, but theyre on the lookout for strong horses: startups that dont rely on the promise of magical growth but are instead grounded in demonstrated cost savings, clinical workflow improvements, and interest from market buyers. 4 Abs. Digital Turbine's shares dropped by -9% from $55.61 as of February 15, 2022 to $50.39 as of February 16, 2022, and the company's last traded price as of February 23, 2022 was even lower at $42.83 . This tells me that analysts believe the operating environment for companies in our space will continue to be at least good, if not improving. Finally, stay up to date with the latest headlines in healthcare technology and Rock Health news by subscribing to the Rock Weekly. While diminishing margins have forced big healthcare organizations (especially health systems) to focus on near-term needs, successful players will continue to plant seeds for better seasons. Lets dig in. As Bessemer has been investing in healthcare for four decades, last year was unlike anything we have seen before. In 2022, 35 digital health startups raised rounds of $100M or more. Medly Pharmacy, which operates a full-service digital pharmacy, saw . Enterprise value = Market value of equity + Market value of debt - Cash . 2022's total funding among US-based digital health startups amounted to $15.3B across 572 deals, with an average deal size of $27M. Based on M&A transactions over the last 5 years, Hampleton Partners found that the median Revenue multiple for PropTech companies was 3.7x. Growth and crossover funds that are new to digital health have been particularly active in digital health (e.g., Tiger Global made 25 digital health investments in 2021) On the other hand, 55% of digital health investors in 2021 were repeat investorssimilar to the average 58% repeat investors across the prior three years 2018-2020 And clinical workflow software, which earned eighth place in 2022 ($1.5B), moved up from eleventh in 2021. Of course, I am not hoping this happens, but when it does, I will not be surprised. The financial products mentioned on this site are not suitable for all investors. Ultimately, the wheat will be separated from the chaff in digital health in 2022; clinical outcomes will support patient adoption. In all other countries, the funds may, if any, via "Private Placement" according to the local applicable laws. As Chief Clinical Officer of Healthspace Health Dana Udall said, The system has mounting costs associated with untreated or poorly managed conditions, and ongoing siloed nature of care. Companies able to unlock non-obvious types of workers and a new supply of practitioners are well-positioned to scale in a world of limited clinician supply. Of course, I am not hoping this happens, but when it does, I will not be surprised. Multiples dropped in four of the seven sub-sectors whose multiples we track, led by outsourcing (down from 19.2x to 15.0x) and managed care (down from 17.3 to 14.2). The management company may decide to cancel the arrangements it has made for the distribution of the units of its collective investment undertakings in accordance with Article 93a of Directive 2009/65/EC and Article 32a of Directive 2011/61/EU. We see three prominent themes emerging: Lastly, the siloed nature of care doesnt only exist between the virtual and the physical world, it also exists among specialties. Published on 15 November 2022, 09:32 America/New_York. In part a response to COVID-19, investors have poured $4.0 billion this past quarter into 97 digital health companies (per Rock Health), suggesting that this sector will likely see more than $12.0 billion invested in 400 companies for the year. Lyra hit unicorn status in 2020 in a pandemic-fueled funding round, and Modern Health, BetterUp and Ginger . But as the year unfolded and cash grew costly, several of these health experiments were scrutinized, discontinued, or divested. Additionally, startups that once expected to mega-raise their way into the unicorn club were faced with investors who were less willing to take flights of fancy on $1B valuations; as a result, they may have chosen to delay big raises. LGBTQ+ people are a large and growing part of the workforce, with 1 in 5 Gen Z identifying as LGBTQ+. In this article, we provide an overview of the digital health . H2 2021 averaged $7.1B in quarterly funding, a small decline from the first half of that year. According toRock Health, a US-based venture fund dedicated to digital health, the number of HealthTech unicorns is growing, and share prices for digital health companies have broadly increased since the COVID-19 pandemic took hold. Last year we predicted that the commoditization of telemedicine would unlock holistic virtual care. A notable contributor to 2022s downhill funding trajectory was investors reluctance to invest heavily in late-stage deals, leading to a dearth of mega deals relative to prior years. We expect to see activity in areas of high expected future growth in 2023. How much do SaaS companies spend on customer support or marketing? Although we continue to see red-hot valuations in the mental health space, I have to wonder, when will the re-rating of earnings in the public market impact private markets? We expect future M&A activity in the data center industry to be largely driven by the shrinking supply of available, high-quality data center real estate, which will continue to push valuation multiples higher. For example, in mental health, the massive uptick in need has driven a huge amount of activity and access, however clinical and financial outcomes remain opaque. Digital technology has the potential to capture huge value in healthcare systems around the world, with the benefit of improving care while also driving down its cost. Equity Multiples. This marked a reversal in capital concentration (a funding environment where late-stage companies attract a disproportionate share of total dollars invested), a phenomenon prevalent in digital health from 2019-2021. Providers like nurse practitioners, physician assistants, health coaches, nutritionists, counselors, and pharmacists have served as critical providers in the healthcare system given the physician shortage and the high cost of hiring a large physician team. At one point, the group traded at 15.4x NTM revenue and most recently traded at 4.6x NTM revenue. This is what we finance types call a re-rating. The Digital Health 150 is CB Insights' annual ranking of the 150 most promising digital health startups in the world. Not only did 2022s annual funding total come in at just over half of 2021s $29.3B2, but it also just squeaked past 2020s $14.7B sum. The number of startups in digital health will increase even faster next year as entrepreneurs jump into the fray out of sheer frustration that our pre-existing healthcare system, despite the learnings from COVID, doubles down on old strategic plans and the traditional fee for service system which has proven time and again to neither lower cost nor improve quality, said Ming Jack Po, Founder and CEO of Ansible Health. EBITDA multiples valuation is a go-to technique for most investors and financial analysts dealing with high-profit mergers and acquisitions. We assume that large healthcare companies are eyeing deals with disruptive, fast-growing digital health companies. Drivers toward this cycles crest in mid-2021 have been well documented. As of 2022, the global SaaS market was valued at $186.6 billion. Investment decisions make use of equity multiples especially when investors look to acquire minor positions in companies. We dont rule out short-term market fluctuations, especially in reaction to news about the vaccination rates and the effectiveness of vaccines against coronavirus variants, or as a result of short-term tactical shifts in the flow of investment capital (sector rotation). The table below lists the current & historical Enterprise Multiples (EV/EBITDA) by Sector.The multiples are calculated using the 500 largest public U.S. companies.Comparing the current enterprise multiple of a sector/industry to its historical average value can be used to evaluate if the sector is currently undervalued or overvalued.Note: The ratio is not available for the Financials sector as . We expect the narrative in mental health to shift focus from access to quality. The EV/Sales multiple of the Bellevue Digital Health fund portfolio is currently under the long-term range of 6-10x, and about 40% lower than it was 12 month ago. As you can see from our index of disruptive healthcare peers, the group has been drastically underperforming the broader S&P 500 over the last 12 months leading into January 2022. Launched two years ago, the startup netted $300 million in a Series C round in December, increasing its valuation to $4.8 billion. Disclosed value also surged from $15.1 billion to $38.1 billion. These companies will focus on different steps in the value chain of virtual care: For example, (1) communication and remote patient monitoring with companies like Memora Health and Avon Health, (2) EHR, data storage and analysis with companies like Zus Health, Healthie, and Canvas Medical, (3) provider workforce management and productivity with companies like our portfolio company AspenRx, and (4) billing and payment pipes with companies like Candid Health. Its too early to say whether weve reached the end of this macro funding cycle, or if more low funding quarters are on the horizon. Supply chain challenges, inflation, interest rate hikes,3 and investor pullback reversed investment momentum. performing companies, the valuation premium is much higher. Here are 16 statistics on the valuation multiples most typically observed for various interests in predominantly in-network centers: Minority interest, single-specialty. Surgery Partners' revenue was $707.1 million in the fourth quarter of 2022 and $2.5 billion in the full year 2022, respective increases of 15.9 percent and 14.1 percent year over year. The purpose for a Global Strategy on Digital Health is to promote healthy lives and wellbeing for everyone, everywhere, at all ages. The increased acceptance of digital solutions in the wake of the pandemic has pushed up the potential growth trajectory of the Digital Health investment case.