Morgan Cheatham
@morgancheatham
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investing in bio, healthcare, AI @bessemervp | MD candidate @brownmedicine | editorial @NEJM_AI @decodingbio | bayesian, he/him
Brooklyn
Joined October 2016
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incredibly excited to share our updated Healthcare AI thesis.
this is not a market map – in 4,000 words, we dive deeply into the research, products, business models, and market entry points that are reimagining healthcare with AI.
more specifically, we cover:
• translating AI
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everybody tryna be an early-stage investor but nobody tryna take early-stage risk
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doximity launched Docs GPT last week.
it's a workflow tool that can generate clinical correspondence, denial appeals letters, procedure notes, progress notes, referrals, patient education, and more -- supported by a robust prompt library.
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last night I asked one of the most prolific bioinformaticians (h index > 100) - if he could do a PhD right now, what would he focus on?
without hesitation he said “clinical data from EHRs. we haven’t even scratched the surface.”
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stumbled across this new "genomics for engineers" resource - written "by computer scientists for computer scientists."
i found the plain-English overviews of genomics file formats (FASTQ, BAM, VCF) + tooling (BLAST, BLAT, BWA, STAR, etc.) super helpful.
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new benchmark for health tech founders:
build a product that becomes so entrenched that thousands of people pay $75k/year to a third party in order to learn how to use it
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over the last few years, I've met with thousands of startups raising capital + have supported many portfolio companies doing the same.
here are some best practices for fundraising efficiently that I've learned from rockstar CEOs:
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early-stage VC is doubling down on bio, AI, and health
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@nikillinit
tuition-free medical school may attract many people who avoid the profession because they aren't positioned / don't want to take on six-figures of debt in their early 20's.
it won't solve the residency choke point but can help address selection bias in who considers the
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went to CVS to pick up meds, was told the script was being held for auth
pharmacist is on the phone for 10 minutes… I start to worry
she comes back saying: “I just got off the phone with the dumbest person on the planet, but your meds will be ready in 15”
AI could never 😂
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this meme has aged well.
amazon buying one medical - add Primepatient to the list
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the history of software in medicine is fascinating.
judy faulkner wrote the first 30 lines of code for Epic in her college dorm room and bootstrapped the business to a deca-billion dollar market leader.
here's the story of UpToDate, the
#1
medical reference tool in the world:
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as i reflect on this milestone, i'm grateful for the teams that have invested in me
@HingeHealth
@carebyginger
@folxhealth
@productboard
+ many others, the
@BessemerVP
team, and the unwavering support of
@stephenkraus
.
healthcare + life sciences founders: let's get after it!
An aspiring physician-investor,
@morgancheatham
invests in cutting-edge healthcare and life sciences startups from pre-seed to growth stages.
Today we recognize his accomplishments as Bessemer's newest Vice President—congratulations, Morgan!
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big healthcare AI news today as
@TempusAI
received the first-ever CPT code for an algorithm-only analysis of previously-sequenced, laboratory developed test transcriptomic data. TLDR: AI molecular phenotyping has a new business model.
the PurISTSM test uses RNA profiling to
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grateful. thanks
@Forbes
for this recognition - proud to represent
@BessemerVP
on the
#ForbesUnder30
list this year!
i hope the next 27 are as fun as the last 🥳
Major congrats to Bessemer Vice President
@morgancheatham
for landing on the
#ForbesUnder30
2023 list 🎉🙌
Read more about our talented colleague and the young leaders who are shaping a brighter future 🌟
@Forbes
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the economy spawned by programmable biology will dwarf that of software.
but barriers to entry are high and we need easier onboarding into bio for roles that don't require a PhD or MD.
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it's conceivable that soon, with access to a large enough // clean enough corpus of clinical notes and EHR data, large language models will be able to auto-generate first-draft notes for physicians when coupled with deterministic clinical decision-making algorithms.
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1/ i expect virtual clinical operations // "telemedicine operations" to become a tablestakes functional area in digital health with a high demand for talent over the coming years
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our team
@BessemerVP
has closed $4.6b across 2 new funds:
• $3.85b for global early-stage investments
• $780m for our inaugural growth-focused private equity fund, BVP Forge
and yes, we're doubling down on healthcare and life sciences across all stages.
let's get after it!
Excited to announce we’ve raised $4.6 billion to back entrepreneurs and CEOs at scale, across all stage.
🔵$𝟯.𝟴𝟱 𝗯𝗶𝗹𝗹𝗶𝗼𝗻—𝟭𝟮𝘁𝗵 𝗳𝗹𝗮𝗴𝘀𝗵𝗶𝗽 𝗳𝘂𝗻𝗱, 𝗕𝗩𝗣 𝗫𝗜𝗜
🔴$𝟳𝟴𝟬 𝗺𝗶𝗹𝗹𝗶𝗼𝗻—𝗶𝗻𝗮𝘂𝗴𝘂𝗿𝗮𝗹 𝗕𝗩𝗣 𝗙𝗼𝗿𝗴𝗲 𝗳𝘂𝗻𝗱
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getting labs in 2022:
-ask doc to send labs to Quest
-Quest can’t find forms in portal
-ask doc for PDF, bring on phone to lab
-lab now out of network
-try new lab. can’t print there, must bring paper copy
-brings paper copy, lab calls doc to ask for a fax 😳
labs: 1, me: -5
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telehealth now accounts for 8% of health care visits relative to 1% pre-pandemic and 13% at the peak
expansion of coverage has played a huge role in this shift, which underscores the importance of post-public health emergency regulations over the coming year
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0/ i was today years old when i learned that the PHQ-9, a leading tool for depression screening, was developed in collaboration with
@pfizer
in the 90's as a means to broaden/expand prescribing of Zoloft outside of psychiatry into primary care settings
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somewhere along the way, we found ourselves with an uninspiring two-party system in healthcare:
fee-for-service vs. fee-for-value
i'm interested in moving the conversation forward.
would folks be interested in joining a debate/discussion on alternatives to value-based care?
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one key reason why healthcare technologies like AI, telemedicine, and software haven't structurally lowered costs or broadened access for the entire system after decades of experimentation (excluding pure financial engineering of payer contracts) is the limited reimagining of
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nothing is stronger than a community investing in itself.
thank you
@HBCUvc
for naming me an Emerging Leader in Venture Capital.
grateful to be among such talented investors changing the face + name of this game 🙌
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.
@TempusAI
has filed for IPO
interesting look inside a ~$580m revenue run rate biomedical AI company
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what a time to be alive.
in 2023, you can spend $35 buying paper-based health insurance claims forms from the U.S. government book store...
and you can also ask ChatGPT to parse ICD-10 and CPT codes from a clinical vignette.
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if you work in health tech and the only "on the ground" experiences you have are 1) your personal healthcare journey, 2) reading headlines...
now is a great time to volunteer, shadow, + engage with the system IRL
you will learn something that makes you better at your job
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UpToDate, arguably the most widely used clinical decision support tool, generated <$800m in 2022 revenue and grew +7% y/y organically.
this underscores the importance of business model innovation for clinician-facing tools by tapping into other (e.g., pharma and payer) budgets
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value-based care makes net new demands of physicians that we cannot ignore.
i didn't realize that several for-profit VBC clinics like
@OakStreetHealth
@ChenMed
@AledadeACO
and
@onemedical
are partnering with medical schools and residency programs to provide exposure to VBC
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rheumatologist shows how to use ChatGPT to address insurance denials.
prompt: “write a letter to UHC asking them to approve an echocardiogram on a patient with systemic sclerosis. make references to supporting scientific literature and list articles.”
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Epic's price transparency tool finally made its way to my MyChart account.
it allows you to explore the cost of proposed medical services at the hospital(s) affiliated with the health system providing your MyChart account in real-time (with and w/out your insurance).
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new post on
@BessemerVP
's Atlas 👇
introducing the new DTC: 'direct-to-clinician' go-to-markets and product-led growth in healthcare + life sciences.
from clinician influencers to
#medtwitter
, read why we're investing in community-centered products for next-gen professionals.
⚕️The PLG business model transformed SaaS – now, healthcare and life sciences.
🏥📄
@morgancheatham
introduces ‘direct-to-clinician’ models and the go-to-market motion for people in healthcare and life sciences.
Read the full Atlas article →
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JPM takeaway - if you’re selling to providers this year, it may not be enough to save them money.
your solution needs to actually make them money in year 1.
this is the difference between provider companies blitzscaling right now and those that are flat or growing slowly
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0/ healthcare has a labor supply issue. there are 2 ways to solve it:
1. train more clinicians/HCWs
2. make clinicians/HCWs more efficient
many companies are focused on
#2
. but we need both.
50% of the fastest-growing jobs are in healthcare, and many don't require a bachelor's
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signed up for
@ForCerebral
to learn more.
the entire intake felt like it was trying to push me into a subscription for psychiatry meds.
<24 hours later I have 3 emails and a text message pushing me to sign up.
this doesn't feel like the future of psychiatry...
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laundromats are a compelling site of healthcare delivery:
• 35k laundromats in the US
• avg box size: 1-5k sq feet
• typical hours: 6am-11pm, many 24/7
• 87% of customers live within a mile
• 90% of patrons become repeat customers
• $28k median customer household income
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the readability of scientific texts has decreased dramatically over time
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excited to join the
@NIH
for additional training in medical genetics and experimental pharmacology.
i'll be in the DMV area through the fall – DMs are open!
@CCMedEd
@BrownMedicine
Welcome Morgan Cheatham! Morgan is coming from Warren Alpert Medical School
@BrownMedicine
and rotating with Medical Genetics with the NIH Clinical Electives Program.
#NIHCEP
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"LLMs are going to eat the EHR"
EHR: former smoker 🤝 tobacco use = never
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it's a privilege to join the Board of Directors for the Coalition for Health AI.
decades of research have brought us to a transformative moment for AI and the applications in medicine are unbounded.
CHAI is dedicated to meeting urgent concerns pertaining to safe, fair, and
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new post! 3,400 words on "the evolving healthcare product landscape" covering:
• stakeholder mapping
• working w/ clinicians
• SaaS vs. services "product"
• healthcare product teams + stacks
• build vs. buy
• your 1st product hire
and more!
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if bio is where software was ~30 years ago, we need to expand the functionally bio-fluent workforce.
comp bio is well-suited for online learning, but wet lab approaches are not.
is anyone building "general assembly for wet lab techniques?"
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the best data rooms write the investment recommendation for the investor.
having seen thousands of data rooms over the last 5 years, i've compiled best practices: folder-level breakdowns, common mistakes, + tools for efficiency. secure the bag! 💰
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Epic has overwhelming marketshare as the leading EHR for U.S. hospitals and generated just $3.8b in revenue last year.
this is why it's critical for healthcare SaaS companies to monetize with multiple stakeholders beyond provider - spanning payers, biopharma, employer, OEMs,
Kinda crazy that despite being effectively a government mandated monopoly and in one of the most valuable spots in healthcare (control of patient data) - Epic does less than $4B of revenue a year
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hot take: the greatest shifts in healthcare cost structure and outcomes will come from the development of new disease-modifying therapies, not virtual care + value-based care
but we need both b/c each unlocks potential in the other (e.g., virtual care as distribution for new Rx)
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thanks
@NVCA
for this recognition!
in truth, this award is a testament to the hard work and dedication of my
@BessemerVP
colleagues, my team
@stephenkraus
@andrewhedin
@SofiaGuerraR
, and the founders who entrust us with their visions.
grateful to be here... now back to work :)
Congratulations to our Vice President
@morgancheatham
for being recognized as a 2023
@NVCA
Rising Star 🌟
As a physician-in-training and investor, Morgan invests in cutting-edge healthcare and life sciences startups from pre-seed to growth 🩺📈
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goal for HLTH: tryna see how much free healthcare i can get from exhibitor demos this year
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sharing lessons from last week’s session on “payer contracting best practices” featuring ~20 virtual care + payer executives representing:
• $500m+ raised
• tens of thousands of patients served
• oncology, cardiology, + LGBTQ health to name a few
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i asked a world-renowned surgeon what he thought would be possible in AI x surgery in our lifetimes.
without hesitation, he said "it's conceivable – in a not too distant future – that we will have fully autonomous robotic surgeries, and we should. ultimately, it will be harder
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.
@Meta
has released Galactica: “A Large Language Model for Science.”
trained on >48m papers, textbooks, compounds, proteins and more, the open-source library can generate lit reviews, wiki articles, answers, lecture notes.
try it via GUI here:
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medicine in 2023: clutching your pager with one hand and prompting ChatGPT with the other
#medtwitter
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what health tech companies were born in the last recession?
2007: Auris, Fitbit, One Medical, Accolade, ZocDoc, Counsyl
2008: Livongo, Noom, Health Catalyst, Castlight
2009: MDLive, Sharecare, Unified Women's Healthcare
and during the rebuild era:
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abortion is a fundamental human right.
abortion is a fundamental human right.
abortion is a fundamental human right.
abortion is a fundamental human right.
abortion is a fundamental human right.
abortion is a fundamental human right.
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"the browser is open for business" in medicine.
the more time i spend at the hospital, the more i realize the massive oppty to build web applications for clinicians.
most clinicians use the browser alongside Epic, but only a few apps (U2D, MDCalc, email) occupy this real estate
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Walgreens is moving into clinical trials a year after CVS. Walmart will be next.
with only 3% of physicians and patients participating in clinical trials, bringing sites to patients is key.
i'm convinced we've yet to unleash the full potential of existing B&M healthcare assets.
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founders: call BS when a VC gives you an exploding term sheet.
this is a manipulative tactic - I’ve never seen a term sheet expire.
if they wanted to invest a week ago, they’ll want to invest in 2.
you might be embarking on a 10-year journey - don’t feel pressured into it.
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had a blast repping
@BessemerVP
at the
@nvca
Leadership Gala last week! big night with
@bdeeter
taking the stage and
@TheValuesVC
championing
@VCForward
.
grateful to be a part of this incredible team - thank you for being there every step of the way
@stephenkraus
@andrewhedin
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at this pivotal moment for AI in healthcare, congrats to
@shivdevrao
+
@abridgehq
on partnering with Dr.
@zacharylipton
as Chief Scientific Officer.
Zack works at the leading edge of many areas, including NLP + LLMs in medicine:
@BessemerVP
@stephenkraus
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stoked to represent
@BessemerVP
and
@BrownMedicine
as a speaker at the 2022
@Rock_Health
Summit alongside mentors, colleagues, and friends.
if you'll be in SF from Sept 13-14, drop me a line!
full speaker list and registration link below 👇
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today is a special day for AI as
@AbridgeHQ
announces a $150 million Series C financing to advance applications of AI in medicine, starting with the most sacred part of healthcare: clinician-patient conversations.
it’s been a privilege for our team to learn from the unique
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i'm far from a value-based care absolutist. and i'm openly interested in alternatives.
one of many questions i have is whether VBC will drive greater variation in care due to the snowflake-like nature of contracts (if you've seen one VBC contract, you've seen one).
for example:
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some of the largest pharmacies in the US - Walmart, CVS, + Walgreens - are delaying or blocking fulfillment of adderall from telehealth co's like Cerebral.
pharmacy review of prescriptions for controlled substances remains a key "opioid epidemic era" pharmacy workflow...
Walmart and CVS pharmacies have blocked or delayed telehealth Adderall prescriptions via
@WSJ
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we need shared language for articulating clinical outcomes in health tech.
love this framework by
@ahahospitals
/
@ACCinTouch
that maps clinical recommendation strength to the levels of evidence.
i imagine most startups are Class 2b/3 + Level C (if there's any evidence at all).
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interested in how CVS's acquisition of Signify Health will bolster its care delivery + burgeoning clinical trials businesses.
the tuck-in adds >10k clinicians nationally covering 2.5m patients in-home, on top of the 100m lives served by CVS retail + Aetna.
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value-based care still feels like the wild west.
you can look at two payer contracts for the same population and intervention and find:
• 2x delta for upfront payments (PMPM fees)
• radically different shared savings quality metrics
• differing benchmark adjustment schedules
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foundational paper on the ethics of LLMs by
@DeepMind
featuring 21 potential risks as well as various mitigation approaches.
the most salient risks for healthcare and life sciences applications seem to be:
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Today is a very special day as my good friend
@andrewhedin
made Partner at
@Bessemer
. His passion for healthcare + life sciences is unparalleled, and it's been such a gift to learn from him over the years.
Excited for all the founders who will get to work with him!!
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more healthcare execs I speak to are skeptical of the impact value-based care will have in current form (not whether it can make $$$).
VBC is not a silver bullet. one of the greatest opportunities for health services research is to move beyond the myopic FFS vs. VBC paradigm.
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payers are still cash-rich following the height of the pandemic, except now everything's on sale.
tech-enabled companies (e.g., virtual care) are looking a lot cheaper than trad specialty providers (>16-20x EBITDA).
if you're United with $25b of cash, what do you buy first? 🤔
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healthcare founders - i'm hosting a small session in early April on how to unlock payer reimbursement as a cash-pay consumer health company.
the session will be led by the CEO of a category-leading virtual care business.
i have a few slots left - DM me if you want to attend!
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interesting observation: the most powerful company in healthcare technology didn't have a booth at
#HLTH22
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how does async telemedicine evolve in the era of generative tech?
today ChatGPT lacks the accuracy necessary for front-office applications in healthcare.
but could a nurse practitioner oversee async communication generated by chatGPT to serve >10x more patients/day?
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starting
#JPM24
week with some healthcare AI news!
more than 1200 organizations across private and public sectors have joined the Coalition for Health AI (CHAI), an organization that is leading AI assurance, technology, and policy initiatives for healthcare AI in collaboration
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3 out of every 4 healthcare workers are women.
women represent a majority of healthcare support workers (nursing assistants, personal care aides).
25% of all healthcare support workers are Black.
the folks who have historically been held down are the ones holding us all up.
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how do you demonstrate clinical outcomes as a care delivery company? what studies should you run? what can you claim?
new post coming out co-authored w/
@suhas_gondi
feat. insights from
@willshrank
CMO
@humana
,
@deanakbell
+ Kate Fitch
@millimanhealth
subscribe to get it👇
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FOLX is transforming healthcare+wellness for Queer and Trans people — centering dignity, celebration, and clinical excellence ✨
We're honored to support
@agbreiten
and the talented
@folxhealth
team on this journey! 🌱🚀💛
@stephenkraus
@BessemerVP
@definevc
@PolarisVC
Folx Health raises $25 million for virtual clinical offerings and care for the LGBTQIA+ community by
@jshieber
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healthcare will be the next industry where we see media + community-focused companies acquired for material value.
why?
1 - LTV/CAC
2 - most patients spend far more time online + in community than they do with their clinicians
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one of the most unhinged job descriptions i've ever seen: Director of Rodent Mitigation for NYC
salary: $120-170k
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today we’re committing $1 billion to AI-led companies across stages and industries, including healthcare and life sciences!
since launching our Deep Health thesis in 2018, we’ve been fortunate to work with companies leveraging AI in drug discovery, clinical and scientific
We are amidst a major computing revolution. AI is here and nearing escape velocity.
We’re crossing the Rubicon with AI and there has never been a better time for small, ambitious teams to positively transform life as we know it.
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fun request for product / GPT-3 application in medicine: prescription translator
a physician writes a prescription in shorthand, and the product translates it into natural language with relevant information for the patient (e.g., Rx instructions, side effects, etc.)
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Announcing
@BessemerVP
's 10 Laws of
#Healthcare
! After 40 years of investing in the industry, we share:
🧠 lessons from the trenches
🚀 best practices for building, selling, + scaling
💭 thoughts on what's next for the industry
@stephenkraus
@andrewhedin
1/ COVID has highlighted both the resiliency of our care delivery models and the many ways in which healthcare must be reimagined—STAT. After four decades of investing in the industry, Bessemer offers these guiding principles for healthcare entrepreneurs.
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over the last 18 months, i've had the pleasure of spending time with
@nikillinit
as he's built arguably the best course for learning about the healthcare industry.
many late nights in Williamsburg later, this week, OOP's Healthcare 101 Course launched!
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Thanks for this thoughtful feature
@thrive
-- enjoyed sharing how I approach my work in healthcare + venture capital with
@BessemerVP
and my role as an Associate Board Director with the Cancer Research Institute.
@CancerResearch
#healthcare
#digitalhealth
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interesting report on the state of provider SaaS (2022):
• providers are spending more on SaaS
• priorities: RCM, security/privacy, patient intake, EHRs
• new products from existing platforms (esp EHRs) prioritized over net new vendors
• Epic is absolutely crushing it
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"To Do No Harm — and the Most Good — with AI in Health Care" is now published in
@NEJM_AI
and
@NatureMedicine
.
We hope this body of work sparks deeper conversations, inspires new research, and facilitates urgent consideration of healthcare AI.
Sincere thanks to
@zakkohane
and
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our work showing that ChatGPT passed the US Medical Licensing Exam (USMLE) is published
@PLOSDigiHealth
!
there's tons of chatter about LLMs in healthcare.
AI is not going to replace doctors anytime soon, but here are the key takeaways from this work:
👉
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total number of lectures in the cardiology block in medical school: 34
number of lectures about preventative cardiology: 1
if the job of the physician is no longer prevention, whose job is it?
#medtwitter
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what's a category in healthcare that venture capital was bullish on, but got wrong? and why?
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why is there no urgent care for psychiatric crises?
feels like there's an immense gap between crisis support lines and going to the emergency department
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for the past two weeks i’ve been on a high risk pregnancy service where i’ve seen firsthand how we are failing pregnant people and families.
one case in particular stood out to me – a story not uncommon for pregnant patients in the US:
we were caring for a patient who was
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it’s official!
@NEJM_AI
has launched.
congratulations to the founding editors
@zakkohane
@AndrewLBeam
@arjunmanrai
and rest of the team, whose contributions to biomedical AI have transformed the field.
DMs are open if you’re interested in submitting work!
All in for AI in Medicine with a strong dose of empiricism
@nejm_ai
and a strong public-facing voice with veteran health and science journalist
@goldbergcarey
Reported by
@statnews
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1/ awesome piece on disruption theory in telemedicine published in
@NEJM
the most important aspect of this framework is the x-axis: time.
telemedicine is a longitudinal solution, not just a virtual option for urgent care.
a few observations:
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if you needed a prescription 10 years ago:
• 26 days to get a doctor’s appt
• 30-45 minute wait at the pharmacy in-person
• +2-7 days if prior auth is needed
today:
• book telemedicine appt in 15 minutes
• same-day Rx pick-up or delivery
• refill by async messaging
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something i've noticed that sets people apart when joining healthcare companies from other industries is on-the-ground experience.
unlike other sectors, it's super easy to do this in healthcare: volunteering, part-time gigs (e.g., medical translation, EMT, etc.), + shadowing.
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the dizzying pace of advancement of AI in healthcare + life sciences is a reminder that most technical moats are fleeting.
in healthcare, distribution is a long-term durable moat
in life sciences, making new medicines efficiently + safely matters most (not what widget you used)
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after 5 years in VC, i've observed that People & Culture (P&C) challenges are among the most frequently discussed topics at the board level.
today i’m launching “From PIP to RIF” - a 4-part series that explores People & Culture via tactical frameworks!
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