Nicola Braginsky Rheaume

Is Hinge Health About to Break the Digital Health IPO Curse? Hinge Health is preparing to IPO and it may revive the digital health listing scene. Timing remains uncertain amid market volatility, but there are several reasons for optimism: ✅ Hinge are built on a B2B2C model, selling to employers and payers rather than directly to consumers. Their value is clear to buyers focused on reducing absenteeism and managing MSK costs ✅ They offer a hybrid solution combining digital tools (apps, sensors, virtual coaching) with human-led care, helping scale while still delivering clinical outcomes ✅ They expanded into device-based care with the FDA-cleared Enso wearable and introduced TrueMotion, a sensor-free motion tracking technology ✅ Also broadened into new clinical areas such as pelvic health and menopause-related MSK care ✅ Hinge have strong engagement and outcome data, including reduced pain and surgery intent, which resonates with cost-conscious employers ✅ They benefited from macro trends like rising MSK costs, growing employer demand, and greater acceptance of remote care post-COVID ✅ Focused on institutional clients, with over 2,250 employers and health plans and 20 million lives covered. Now contracted with the five largest US health insurers. Recent partnerships include Cigna, Amazon Health, Teladoc, Midi Health, and Sun Life ✅ Financial performance is improving: $390M revenue in 2024 (up 33 percent), $124M in Q1 2025 (up 50 percent), and $17.1M in Q1 profit after prior losses. But there are still some challenges ahead ⚠️ Last valuation was $6.2B, but the IPO may price lower given broader skepticism about 2021–2022 valuations, and timing remains uncertain ⚠️ In 2024 Hinge still closed with an $11.9M loss, though a major improvement from a $108M loss in 2023 ⚠️ Revenue concentration among a few large clients may pose a risk. ⚠️ Hinge faces rising competition from Sword Health, Vori, RecoveryOne and others in the MSK space Whatever happens it will be interesting #DigitalHealth #IPO

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Wrapped up the last day with my team at OpenLoop at HLTH Inc. 2025 yesterday and, like everyone else, trying to identify the key themes that will shape healthcare as we head into 2026. Here are my top 3: 1️⃣ Startups without a clear niche or product–market fit only talk about AI. The ones that do have it talk about client ROI and measurable results. I’ll sound like a broken record, but we’re entering a reality where AI will be ubiquitous. It’s no longer a differentiator on its own. What will set companies apart is how they handle distribution and workflow integration. 2️⃣ The rise of healthtech founders who are tech experts but healthcare outsiders. AI has dominated every conversation, but I keep noticing more founders coming from outside of healthcare. They’re often brilliant engineers or data scientists, but many lack a real understanding of how the healthcare system works. On the flip side, the industry still lacks deep AI literacy. The startups best positioned to define the future of healthcare will combine healthcare veterans with top AI and LLM talent. You can usually spot an outsider - they’re the ones asking: “Why does a healthcare sales cycle take up to 18 months?” 3️⃣ Selling to healthcare providers and systems is…..becoming increasingly harder. With major incumbents now launching or already offering their own AI solutions, the bar for startups has never been higher. Unless you can (1) deliver a higher ROI from day one and (2) integrate seamlessly into existing workflows - you’re not getting picked. What are some other themes you all observed at HLTH 2025? 

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SVB released it's 2025 Healthtech report with some very clear takeaways. Provider operations, which includes all the buzzy AI tools you hear about (scribes, RCM automation, etc.) are increasingly taking up VC dollars. They now represent ~44% of Healthtech VC dollars. There's also been a clear pullback for alternative care models since the telehealth boom in 2020 & 2021. In care delivery, we're continuing to see a shift from transactional, urgent care-style companies to those with truly groundbreaking clinical models that not only move the needle on outcomes & cost, but can also scale efficiently, often with the help of AI. What's clear in this data: gone are the days of "growth at all costs" for care delivery companies (we can't say the same about AI companies, though!). Sustainable business models are critical. (link to report in comments) #healthtech #digitalhealth

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Just published a deep dive into how organizational structure can literally create billion-dollar value in health tech. Sword Health's CEO Virgílio (“V”) Bento credits their "CEO team" model with generating $1B+ in company value. It's a 7-person team that acts as a force multiplier for the founder, providing what they call "dynamic elasticity" - basically a flexible pool of high-quality talent that can be rapidly deployed wherever fires need fighting. The model is brilliant in its simplicity: take top-tier consulting/banking talent, expose them to the hardest problems in the company, then expect full team turnover every 18 months as they get promoted into senior roles across the organization. It's leadership development that actually scales founder judgment. I also looked at how OpenAI pulled off their Codex launch - concept to full product in 7 weeks with a small senior team. Their bottom-up culture and bias toward action is something health tech companies could learn from, especially in our heavily regulated environment. The pattern across companies like Teladoc, Cedar, and Virta Health is clear: traditional hierarchies don't work for rapid scaling in health tech. You need structures that can integrate clinical expertise with tech capabilities while maintaining the agility to pivot quickly. The companies winning in this space aren't just building better products - they're building better organizational machines. Structure as competitive advantage is real, especially when you're trying to coordinate across providers, payers, and patients simultaneously. Worth thinking about how your own organization scales decision-making and develops talent. The companies that figure this out are the ones capturing the biggest exits.​​​​​​​​​​​​​​​​ _________________ Disclaimer: The thoughts and opinions expressed in this essay are my own and do not reflect those of my employer or any affiliated organizations.​​​​​​​​​​​​​​​​ _________________ See link in comments for full essay

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The $10M Decision That Almost Broke Us (But Built InsightPro) Ten years ago, we bet everything on transforming healthcare operations through technology. EVERYONE questioned the move. We pulled resources from profitable projects. Invested heavily in automation (and eventually in AI) before it was trendy. Built solutions for problems the industry didn't even know it had yet. For 18 months, we burned through cash reserves while our traditional revenue streams took a hit. Leadership meetings turned into pressure cookers. There were nights I questioned if we'd made a catastrophic mistake. But here's what kept us going: We saw healthcare operations drowning in manual processes across every department. Claims backlogs. Call center chaos. Enrollment errors. Provider data nightmares. And we knew there had to be a better way. SO WE BUILT INSIGHTPRO! Not as just another point solution, but a unified platform that could transform entire operations: • Claims Productivity: What took days now takes hours with automated workflows • Call Center Intelligence: Real-time insights increasing first call resolutions • Enrollment Management: Error detection before members even notice • Provider Data Maintenance: Data accuracy that actually stays accurate • Quality Assurance: Compliance monitoring across every operational touchpoint Fast forward to today: • InsightPro powers operations for 50+ health plans and TPAs • Processing volumes that would have required armies of staff • 99% client retention because the platform delivers what we promised • Just recognized on the Inc. 5000!! The lesson? Sometimes the biggest risk is playing it safe while your industry needs transformation. Every revolutionary platform starts with a decision that feels like it might break you. The key is having the conviction to build the future your clients need, even when they can't see it yet. Ready to see what InsightPro can do for your operations? Visit www.insightpro.ai #InsightPro #HealthcareTransformation #OperationalExcellence #MDINetworX #Innovation #DigitalHealth

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An MSO leader told me: 'We have fee-for-service, capitation, shared savings, and direct pay contracts. We have no idea which ones actually make money.' Sound familiar? Digital health companies scaling across markets often end up with a portfolio of payment models: Fee-for-service with traditional payers Value-based contracts with progressive ACOs Direct pay arrangements with self-insured employers Hybrid models with Medicaid managed care The successful ones? They track performance across ALL models: ✓ Margin analysis by contract type  ✓ Administrative burden per payment model  ✓ Cash flow predictability across payers  ✓ Scalability assessment for each arrangement Enabling doubling down on your most profitable contracts types and sunsetting the ones bleeding money. We want to get you paid consistently. Good growth means knowing which arrangements serve your mission and which just serve your ego.

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