FT Partners & QED - Healthcare Payments

FT PARTNERS & QED INVESTORS | September 2021
FinTech Industry Research
Healthcare
Payments
About FT Partners & QED Investors
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www.ftpartners.com qedinvestors.com
Steve McLaughlin steve.mclaughlin@ftpartners.com Matt Risley matt@qedinvestors.com

Founder, CEO, Managing Partner (415) 992-8880 Partner
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Table of Contents
I. Executive Summary 6
II. Healthcare Industry Overview 9
i. Key Constituents & Background 10
ii. U.S. Healthcare Policy 30
iii. Impacts of COVID-19 on the U.S. Healthcare System
43
iv. Healthcare Payments 101 48
III. Healthcare Trends 52
i. Digitization 53
ii. Consumerization 61
IV. Pain Points and Emerging Solutions 66
V. FinTech Healthcare Landscape 88
VI. Executive Interviews 92
VII. Selected Company Profiles 219
VIII. Financing & M&A Activity 284
IX. Overview of FT Partners & QED 296
Highly proprietary information. Unauthorized distribution without prior consent from Financial Technology Partners LP, FTP Securities LLC or FinTech Partners Limited (together “FT Partners”) is strictly prohibited. The information in this report relies
upon a variety of public sources, the accuracy of which cannot be guaranteed. No persons or entities should use the information in decision making without independent investigation or professional advice. This communication should not be regarded
as an offer to sell or as a solicitation of an offer to buy any financial product or service, nor is it an official confirmation of any transaction, or representative of an official position or statement of Financial Technology Partners LP, FTP Securities LLC or
FT PARTNERS / QED
any other related entity. FTP Securities LLC is a FINRA registered broker-dealer and FinTech Partners Limited is an FCA appointed representative. © 2021
3
Table of Contents (cont.)
Executive Interviews
Industry Experts / Large Corporates
& &
Laura Bock Anya Schiess Parie Garg Sarah Snider Mary Butler-Everson Laurie Olender Evan Goad Rahul Gupta
Principal General Partner Partner, Health & Principal, Health & SVP, Healthcare Product SVP, Healthcare VP & GM of Industry Expert
Life Sciences Life Sciences Innovations Solutions, Product Patient
Mgmt. & Delivery
CEOs, Executives & Founders Experience
Randal Clark Chris Lee Alberto Casellas Florian Otto Musheer Ahmed Nick Soman John Talaga Imran Ahmad
CEO, Co-Founder & CEO CEO & EVP CEO & Co-Founder CEO & Founder CEO & Founder EVP of Healthcare COO
President
Mario Schlosser Bird Blitch Rob Pinataro Brendon Kensel John Morris Ted Ferrin Clayton Bain Andrew Rueff Tim Barry
CEO & Co- CEO & Co- CEO CEO & Founder CEO & Co- CEO & Co- CEO Executive CEO & Co-Founder
FT PARTNERS / QED Founder
Founder Founder Founder Chairman 4
Table of Contents (cont.)
Company Profiles
FT PARTNERS / QED 5
I. Executive Summary
FT PARTNERS / QED 6
Executive Summary
The healthcare industry, which

accounts for 18% of GDP in the United The majority of providers have digitized patient records now, and new digital
States, is transforming as the industry tools are improving patient care and communication. Additionally, digital tools
are improving the efficiency of providers’ and payers’ administrative functions.
adapts to more widespread adoption of
digital technologies and confronts the
challenges of ever rising costs and the
pressures it puts on patients, hospitals
Patient responsibility has increased due to growth in high deductible health
and physicians (“providers”), insurance plans, rising premiums and out-of-pocket costs, among other factors. These
companies (“payers”), the government, increases in patient financial responsibility have led to care avoidance, late
and other participants. payments and medical debt.
Similar to other areas of financial Pushing costs onto employees can cause financial stress and absenteeism or
attrition at work. Employers are seeking solutions to make healthcare benefits
services, technology is only becoming
affordable for their workforce.
more important to the delivery of
financial services related to healthcare,
Providers are seeing higher levels of uncompensated healthcare costs and bad
resulting in the emergence of a debt, longer payment cycle times, and higher administration costs. They are
Healthcare Payments ecosystem. looking for solutions to help with billing and collections, as well as liquidity.
Innovative business models and new
technologies are eliminating As providers have been forced to collect larger shares of their revenue directly
inefficiencies within the current system, from patients, the payer-provider relationship has moved away from mutualism
towards a relationship in which one benefits at the expense of the other. Payers
and challenging incumbents and
are looking for preventative and automated solutions to combat fraud as well
traditional models. as electronic payments methods for more efficient claims processing.
FT PARTNERS / QED 7
Highlights of the Report
Key constituents in the Healthcare Significant trends driving the A detailed landscape of the FinTech
industry, and explain the background developing FinTech ecosystem companies servicing the Healthcare
behind policy, regulations, and size around Healthcare Payments and Health Insurance industry
of the industry in the U.S.
$ $
24 CEOs and Executives of Of recent financing and M&A 64 FinTech companies in the space
companies driving innovation in transactions among FinTech
the Healthcare Payments space Healthcare companies
FT Partners / QED 8
II. Healthcare Industry Overview
FT PARTNERS / QED 9
i. Key Constituents & Background
FT PARTNERS / QED 10
Constituents in the Healthcare Industry
Premiums Care
Insurance Coverage Direct Payment
Individuals who receive medical

care from providers
Claims & Bills

Payment
Institutions that provide insurance

Institutions that provide care to patients and
coverage to patients and pay providers for
charge payers and patients for that care
healthcare services – can be private
companies and/or government-run
programs
FT Partners / QED 11
Size of Industry
$4,000
($ in billions)
$3,500 2018
$3.6 trillion
$3,000 17.7% of GDP
$2,500
2005
$2.0 trillion
15.5% of GDP
$2,000 1995
$1.0 trillion
$1,500 1985 13.4% of GDP
1975 $442.9 billion
1960
$1,000 $133.3 billion 10.2% of GDP
$27.2 billion 7.9% of GDP
$500 5.0% of GDP
$0
(1) CMS.gov
Size of Industry (cont.)
($ in billions)
$1,400 Hospital Care
Physician / Clinical Services Other

$1,192 Home Professional
$1,200 Prescription Drugs Health Services
Medical Products
/ Equipment
Dental Services
$1,000
3% 3%
3%
Nursing Care 4%
$800 5% Hospital
$726 Other Health &
33% Care
Residential 5%
$3.6 tr
$600
8% Total
Administration
$400 $333 9%
Prescription 20%
Drugs
$200
Physician /
Clinical Services
$0
1960 1968 1976 1984 1992 2000 2008 2016
2018
(1) Peterson-Kaiser Health System Tracker

FT Partners / QED (2) Kaiser Family Foundation using NHE data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group 13
Size of Industry (cont.)
This category covers services provided by hospitals to patients This category covers nursing and rehabilitative services provided in
such as room and board, ancillary charges, services of resident stand-alone nursing home facilities. These services are generally
physicians, inpatient pharmacy, and hospital-based nursing home provided for an extended period of time by registered or licensed
and home health care. The value of hospital services is measured practical nurses and other staff. Care received in state & local
by total net revenue, which equals gross patient revenues government facilities and nursing facilities operated by the U.S.
(charges) less contractual adjustments, bad debts, and charity Department of Veterans Affairs are also included.
care. It also includes government tax appropriations as well as
non-patient and non-operating revenues.
Covers services provided in establishments operated by a Doctor of

This category covers services provided in establishments operated Dental Medicine (D.M.D.) or Doctor of Dental Surgery (D.D.S.) or a
by Doctors of Medicine (M.D.) and Doctors of Osteopathy (D.O.), Doctor of Dental Science (D.D.Sc.).
outpatient care centers, and some medical lab services that are
billed independently. Clinical services provided in freestanding
outpatient clinics operated by the U.S. Department of Veterans’
Affairs, the U.S. Coast Guard Academy, the U.S. Department of
Defense, and the U.S. Indian Health Service are also included. This category covers the sale of non-durable medical products such as
non-prescription drugs and medical sundries. Additionally, it covers the
sales of durable medical equipment items such as contact lenses,
eyeglasses and other ophthalmic products, surgical and orthopedic
products, hearing aids, wheelchairs, and medical equipment rentals.
This category covers retail sales of human-use dosage-form
drugs, biological drugs, and diagnostic products that are
available only through a prescription.
Covers medical care provided in the home by freestanding home

health agencies (HHAs). Medical equipment sales or rentals not billed
This category includes local, state and federal administrative through HHAs and non-medical types of home care (e.g., Meals on
costs of healthcare programs such as Medicare and Medicaid as Wheels, choreworker services, friendly visits, or other custodial
well as the net cost of private health insurance. services) are excluded.
This category includes spending for Medicaid home and

community-based waivers, care provided in residential care Covers services provided in establishments operated by health
facilities, ambulance services, school health and worksite health practitioners other than physicians and dentists. These professional
care. Generally these programs provide payments for services in services include those provided by private-duty nurses, chiropractors,
non-traditional settings such as community centers, senior podiatrists, optometrists, and physical, occupational and speech
citizens centers, schools, and military field stations. therapists, among others.
Source: Peterson-Kaiser Health System Tracker

Constituents in the Healthcare Industry: Providers
2018 data ($ in billions)

Hospitals Emergency Care Centers
Long Term Care Facilities Laboratories 33%
Medical Offices Home Health Care $1,192
Dental Offices Hospice
Clinics Mental Health 20%
$726
Optical Centers Physical Rehab Facilities
5% 5%
4%
3%
$192 $169
6,210 486k+ 884mm+
$136 $102
Number of U.S. Active U.S. Primary Care Visits to U.S. Physician Hospital Physician / Other Health Nursing Dental Home Health
Hospitals in 2019 (1) Physicians in Mar. 2020 (2) Offices in 2016 (3) Care Clinical & Residential Care Services
Services
1) American Hospital Association Annual Survey 2019

FT Partners / QED 2)
3)
Kaiser Family Foundation using information from Redi-Data
CDC.gov
15
4) Kaiser Family Foundation using NHE data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group
Type of Hospitals
Non-profit hospitals must serve the needs of their communities and

in return they receive tax exemptions
Other *
120 Must prove community benefit to receive exemptions: Charity care,
Non-Federal
participation in government programs such as Medicaid, medical
Psychiatric
education and research, subsidized health services and community
health improvement
Federal 620
208
For-profit hospitals are investor-owned with the profits going to the
State / Local shareholders
Government 972
6,210 2,968 ▪ Able to access investor capital to upgrade equipment / facilities
▪ Ability to pick more profitable services to provide
Total
Government-funded hospitals (Local, State and Federal) are provided

grants and public funding to operate
1,322
Includes Veterans Affairs hospitals, for example
For-Profit Non-Profit
Both non-profits and for-profits must offer charity care (i.e.
Community Community
uncompensated care and care provided to Medicaid beneficiaries
that may cause losses; it does not include bad debt, write-offs and
patients who do not pay)
▪ Amount varies based on hospital
▪ For top hospitals, the average proportion of operating expenses
devoted to charity care is 5.2% (2)
1) American Hospital Association: “Fast Facts on U.S. Hospitals 2019” (2017 data)
FT Partners / QED 2) Modern Healthcare: “How much charity care do not-for-profit hospitals provide?” 16
• Other includes non-federal long term care hospitals and units within an institution such as a prison hospital or school infirmary
Largest Hospital Networks
185 151
105 * 142
86 92
65 51
65 50
45 50
37 48
30 48
26 44
17 41
40
39
1) Becker’s Hospital Review: “100 of the largest hospitals and health systems in America | 2019” (2019 data)
FT Partners / QED * Formed through the merger of Dignity Health and Catholic Health Initiatives which closed Feb. 2019 17
Integrated Delivery Networks
▪ A network of facilities under one parent company providing a continuum of healthcare

services – a patient can receive all types of care from one healthcare company
▪ A system that provides health care services as well as the health insurance coverage in a
defined geographic region
▪ The main goal of an IDN is to provide holistic, comprehensive care
▪ Early IDN pioneers include Kaiser, UPMC and Baylor Scott & White
2,116 MO 1,020 PA
1,807 TN 903 OH
1,560 CO 872 TX
1,504 DC 846 TX
1,467 TN 803 CA
1,424 WA 797 NC
1,384 MI 753 CA
1,289 PA 692 NY
(1) IQVIA: “Top 25 Integrated Delivery Networks” (2018 data)

Administrative Burden on Providers
▪ Since the 1970’s, the number of providers in the U.S.

has increased relative to total population growth, but
the number of administrators has grown
3,500%
Admin Growth 3,200% exponentially
3,000% Physician Growth ▪ Although there has been an influx of administrative

staff at hospitals and clinics, doctors must also
perform administrative tasks in between
2,500% appointments, which leads to plenty of costs and
complexities
2,000% ▪ Administrative tasks can include notes and medical

record updates, prescription and lab test order
entries, and billing and coding
1,500%
▪ Even with more administrative staff, nearly 1/2 of a
primary care physician’s workday is spent on
1,000%
Electronic Health Record (EHR)-related work,
essentially non-patient facing work (2)
500%
150% ▪ 25% of all U.S. hospital spending costs are
administrative related – the highest out of many other
0% countries (3)
1975 1980 1985 1990 1995 2000 2005 2010
(1) athenahealth, “The rise (and rise) of the healthcare administrator”

FT Partners / QED (2)
(3)
Annals of Family Medicine: “Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations”
ReferralMD
19
Constituents in the Healthcare Industry: Payers
Privately run insurance companies provide plans that are distributed

/ purchased directly, through marketplaces or through an employer
Everyone receives the same access to healthcare services at an

affordable rate
Network of “not-for-profit” insurance companies funded through
employers as well as taxes
Government funded comprehensive coverage

Simplified administration because of single funding source
Universal and Single Payer typically go “hand-in-hand” but there are

countries that have universal coverage through other systems
(more on page 42)
907 198mm $670bn

TPAs manage administrative services such as claims administration,
People covered by private
Health Insurance 2017 Direct Written employee benefits, loss control, and risk management, operating as
health insurance
Companies (1) Health Premiums (1) part of an insurance company or independently
in the U.S. in 2017 (2)
Source: NAIC: “Industry Snapshots – December 31, 2018”; NAIC: “2017 Health Insurance Industry Analysis Report”
2)
Insurance Information Institute: “Facts + Statistics: Industry Overview” – 2017 Data
United States Census Bureau: “Health Insurance Coverage in the United States: 2017”
20
Constituents in the Healthcare Industry: Payers (cont.)
($ in billions) $1,243
Private Health Insurance
$1,200
Medicare
Medicaid
$1,000 Out of Pocket Spending
Dept. of Veterans Affairs (VA)
Department of Defense (TRICARE)

$800 $750
Children’s Health Insurance Program (CHIP)
$600 In total, government

$597
programs cost
approximately
$1.5 trillion in 2018
$376
$400
$200
$78
$42
$19
$0
1960 1967 1974 1981 1988 1995 2002 2009 2016 2018

FT Partners / QED Note: Not all sources are shown 21
Constituents in the Healthcare Industry: Payers – Public Insurance
Covers seniors 65+ years of age and

certain people with severe disabilities 24.2% 14%
Covers low-income people of all ages –

Programs are administered and run by the 19.2% 21%
individual states
Coverage for military veterans 2.5%
Covers active-duty and retired uniformed 1%

services members and their families 1.3% of the U.S. is covered
by these programs
Covers children in families that earn too

much money to qualify for Medicaid;
0.6%
In some states, CHIP covers pregnant
women

Constituents in the Healthcare Industry: Payers – Private Insurance
Individual
Managed Health insurance that is either fully paid for, or subsidized by,
Medicaid Employer employers for employees and their families
5% Group Risk
19%
Individual plans purchased on Healthcare.gov or state
22%
exchanges
Medicare ▪ 75% of total individual plans in 2018 (2)
Advantage 8%
Individual plans purchased outside of exchanges, generally

directly from insurers
▪ Premiums are often lower than on-exchange plans, but
46% subsidies are generally unavailable
▪ 25% of total individual plans in 2018 (2)
Employer Group –
Administrative Services Only
1) Mark Farrah and Associates : Health Insurance Enrollment Trends for Year-End 2018. Note: “Employer Group ASO” represents administrative services only for self-funded business
FT Partners / QED 2) Mark Farrah and Associates: A Brief Analysis of the Individual Health Market 23
▪ The Healthcare Maintenance Organization Act of 1973 promoted and ▪ As a response to the rise of HMOs in the ‘80s and ‘90s, PPO or Preferred
popularized the development of HMOs Provider Organizations were created
▪ Plans typically have low premiums and low out-of-pocket costs with no ▪ Plans have higher premiums and all plans have deductibles
deductible, but only allow patients to go to a limited network of providers
▪ Patients are able to see doctors outside of the network and specialist
▪ Additionally, care is required to be coordinated through a primary care
referrals are not required
physician (“PCP”)
▪ In order to curb costs, patients are steered towards less expensive
treatments first before an HMO will cover more costly ones ▪ Patients must file claims for out-of-network healthcare appointments
▪ Specialist visits need to first be referred by the patient’s PCP for it to be ▪ Potential for high out-of-pocket costs when seeing a doctor outside
covered of the network
▪ More patient responsibility for managing and coordinating their own care
▪ Better coordination of care reduces unnecessary costs for payers and
time spent for providers and patients
▪ Simplified billing and little to no claims paperwork for patients
▪ High price transparency for patients with little to no unexpected costs
▪ In some cases, providers are either paid a flat fee for service or have a
quota for number of patients served, which may incentivize providers to
actually give patients less care than needed in order to see a higher
volume of patients in a given time period
▪ One of the most well-known HMO plans is through Kaiser, an integrated
delivery network
($ in billions) (in millions)
$201.0 49.5
$90.0 40.2
(1) $79.7 22.2
$60.6 15.9
(2)
$53.7 15.0
$48.3 14.0
$41.6 12.2
(2) (1)
$35.9 12.2
$18.8 4.4
$16.9 4.4
Source: Becker’s Hospital Review: “America's largest health insurers in 2018”

2)
Kaiser Permanente: “Kaiser Foundation Health Plan and Hospitals Report 2018 Financial Results”
HCSC.com: “HCSC By the Numbers” – approximately 15 million
25
($ in billions) Average annual premium, 2018:

$0 $30 $60 $90 $120 $150 ▪ Individual: $6,896 (2)
▪ Family: $19,616
Average employer contribution:
UnitedHealth
▪ Individual: 83%
▪ Family: 72%
Anthem 25% cumulative premium increase between 2012

and 2018, compared to 14% growth in wages (2)
Aetna
Average annual premium, 2018: $5,772 (3)
Humana
▪ Increase over 2017: 34%
Cigna
Often offer lower premiums to enrollees who do

not qualify for subsidies
Seeing dip in enrollment due to rising premiums
Commercial Medicare Medicaid Tricare Other and repeal of ACA individual mandate (4)
(1) Economist.com (4) Kaiser Family Foundation, Changes in Enrollment in the Individual Health Insurance Market through Early
(3)
Kaiser Family Foundation : 2018 Employer Health Benefits Survey
Kaiser Family Foundation, average premium based on average benchmark silver plan
2019 26
Constituents in the Healthcare Industry: Patients
Individuals who receive medical care from providers
(# in millions) Americans spent an average of $4,928 on healthcare in 2017,

making healthcare the fifth biggest line item after food, housing,
Total transportation, and insurance / retirement savings (2)
884 million visits American patients are required to pay for healthcare through
252
several different forms:
239
Monthly payment made to the insurance company for the health

insurance policy / coverage.
In 2018, the average monthly premium for individual health plans
171 was $440. (3)
157
The amount of medical costs that the patient must pay before
insurance coverage begins; Low deductible plans typically have
higher premiums and vice versa.
In 2018, the average annual deductible for individual health plans
65 was $4,578. (3)
Fee paid to healthcare provider for services

j
Doctor’s office visit ($15 – 20), specialist visit ($30-50), Urgent Care
($75-100), ER ($200 -300) and various prices for prescription drugs (4)
Under 15 15-24 25-44 45-64 65+
(1) CDC.gov

(3)
Bureau of Labor Statistics: Consumer Expenditures – 2017
eHealth: “How Much Does Health Insurance Cost Without A Subsidy?” 27
(4) Debt.org: “Health Insurance Premiums, Deductibles, Copays and Coinsurance”
Constituents in the Healthcare Industry: Patients (cont.)
$1,400
In Constant 2018 Dollars Unadjusted
$1,200 $1,150
$1,000
$800
$600
$400 Out-of-pocket costs are in

addition to the amount
individuals contribute towards
$200 health insurance premiums
$0
1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018

Constituents in the Healthcare Industry: Patients (cont.)
Uninsured
Uninsured Other
12% 9%
Public* 15% 15%
14%
Public 11% 13%
Public
U.S. Insurance
Medicare 12%
Population
13% 21%
18% 19%
Medicaid 6%
5% 6% 7%
Insured
Self
Private
Sponsored 54%
Private 49% 49% 49%
Insurance
Employer
Sponsored
* Other Public includes the VA, TRICARE and CHIP 2008 2011 2014 2017
Source: U.S. Census Bureau, “Health Insurance in the United States: 2017 – Tables”
FT Partners / QED Note: Private and Government category represents those who had both throughout the year
(1) Kaiser Family Foundation estimates based on the Census Bureau's American Community Survey, 2008-2017
29
ii. U.S. Healthcare Policy
U.S. Healthcare Policy Timeline
President Johnson
signs Social Security President Reagan signs
Act, creating Medicare Consolidated Omnibus Budget
and Medicaid Reconciliation Act (COBRA) President Clinton enacts President Bush signs
allowing former employees to Health Insurance Portability Medicare Prescription
stay enrolled on prior employer's and Accountability Act Drug, Improvement President Obama
health plan for a time (HIPAA) which created and Modernization
President Nixon signs the Patient
security and privacy Act which updated
expands Medicare Protection and
standards for health data Medicare to cover
through the Social Affordable Care
prescription drugs Act (PPACA, ACA)
Security Amendment
President Clinton creates The Health Information

President Nixon establishes President Clinton proposes
After proposing a single- Children’s Health Insurance Technology for Economic
Health Maintenance the Health Security Act, that
payer plan, Senator Ted Program (CHIP) which and Clinical Health Act
Organization Act, which has similarities to the
Kennedy and President expands Medicaid to (HITECH), part of the
supported the development Kennedy / Nixon plan, which
Nixon work together to uninsured children whose American Recovery and
of HMOs, organizations that ends up failing
develop a health plan that families do not qualify for Reinvestment Act (ARRA),
provide all health services
is a comprise, mixing Medicaid incentivized healthcare
through one network
aspects of universal providers to begin using
coverage, while working Electronic Medical Records
with the private health (EMR) and it widened
insurance system – the privacy and security
plan falls by the wayside protections of HIPAA
after Watergate
Source: JP Griffin Group

Affordable Care Act
▪ On March 23, 2010, the Patient Protection and Affordable Care Act (“ACA”) was signed into law by President Obama
▪ Its impacts on the health insurance sector (and associated insurance services) will be important and far–reaching
▪ Implementation timeline has stretched several years, from 2010 up to potentially 2022, but since its initial passing, there has been
contention between the political parties as how to best implement it and, from its opponents, how to repeal it
▪ Individual mandate ▪ Administrative simplification ▪ Comparative effectiveness research

▪ Employer shared responsibility mandate ▪ Restructuring Medicare ▪ Reducing medical malpractice
▪ Expansion of public programs ▪ Restructuring Medicaid ▪ Restructuring Medicare
▪ Premium and cost-sharing subsidies ▪ Reduce waste, fraud and abuse ▪ Restructuring Medicaid
to individuals ▪ Changes to patent laws for prescription drugs ▪ Improve care coordination for dual eligibles
▪ Premium subsidies to employers ▪ Develop a national quality improvement
▪ Tax changes strategy
▪ Health insurance exchanges ▪ Require disclosure of financial relationships
between health entities
▪ Changes to private insurance
▪ Require enhanced collection and reporting
▪ Changes to the state role on patient data
Affordable Care Act (cont.)
All ACA health plans must cover:

▪ Ambulatory patient services ▪ Prescription drugs
▪ Emergency services ▪ Rehabilitative and habilitative services and devices
▪ Hospitalization ▪ Laboratory services
▪ Pregnancy, maternity, and newborn care ▪ Preventive and wellness services, and chronic disease management
▪ Birth control ▪ Pediatric services, including oral and vision care
▪ Mental health and substance abuse services
The ACA also includes provisions designed to expand affordable coverage and access to health insurance
▪ Children can stay on their parent’s health insurance plan until the age of 26
▪ Insurers cannot raise rates or deny coverage based on medical history or preexisting health conditions
▪ Insurers can no longer charge women more than men for the same health benefits
▪ Businesses with more than 50 full-time employees must offer health insurance
The ACA created new challenges for employers and individuals in its goal to reduce
costs, improve quality of care and create affordable healthcare for all
Employers Individuals
ACA forced companies to look at how they administer benefits To ensure the new law works towards lowering overall healthcare
Requires employers to accurately identify full-time employees, track costs, while improving quality, all citizens that are able to purchase
and understand hours of service and provide affordable plans with insurance must do so
minimum essential coverage
Individual Mandate
Two of the most significant ACA regulations are the “Play or Pay” Effective as of Jan. 2014 – Repealed in 2018 (more on this on the
Employer Mandate and the “Cadillac Tax,” which will both cause following page)
significant changes to employee benefits ▪ The Individual Mandate required all individuals that were able to
afford insurance and that are not exempt, to obtain health
“Play or Pay” insurance or pay a tax penalty
▪ Fees were planned to get progressively higher each year
Effective as of Jan. 1 2015 ▪ To avoid the penalty, individuals and families were required to
The Employer Shared Responsibility Provision requires large employers purchase minimum essential coverage during open enrollment
(50+ full time employees) to:
Reasons why ACA needs full participation:
▪ Offer minimum value and affordable coverage to 95% +
▪ Uninsured citizens will still use medical care and will help
full time employees & dependents
contribute to the tens of billions in unpaid medical bills
▪ Report benefits information
▪ When those in good health opt out of insurance, prices rise to
▪ Pay fines for not providing adequate, affordable coverage compensate for the higher proportion of poor health individuals,
making it more costly for everyone
▪ Preventative care creates positive externalities for the general
population
“Cadillac Tax” ▪ The Excise Tax on High End Plans, originally planned to start in 2018, but delayed by President Trump to start in 2022,
is a 40% excise tax on plans above $10,200 for individuals and $27,500 for family coverage
▪ Though not directly taxed (taxes are directed at insurance issuers and sponsors), employers and individuals will bear
the cost for holding high-cost health insurance plans through rising prices
▪ The goal of the tax is to restrain healthcare costs and reduce the historical disparity between quality of coverage based
on income / ability to afford healthcare
President Trump issues an executive order announcing the administration’s plan to “seek the
prompt repeal of the Patient Protection and Affordable Care Act”
House Republicans introduce plans to “repeal and replace” the ACA with the American Health Care
Act; the bill ultimately did not pass in the Senate
The Center for Medicare and Medicaid Services shortens the 2018 open enrollment period from 90
days to 45 days (November 1, 2017 – December 15, 2017)
Senate Republicans propose new ACA replacement bill, the Better Care Reconciliation Act (BCRA),
which ultimately fails to pass in a 49-to-51 vote
President Trump issues an executive order that instructs executive agencies to expand access to
short-term, “skinny plans” – plans that do not meet all essential health benefits (EHBs) outlined in
the ACA, including maternity care, mental health services and prescription drugs (many of which
were previously not covered by several health plans); Additionally, due to the short-term nature of
the plans, insurers can ignore ACA regulations and charge higher premiums or deny coverage
based on pre-existing conditions
The Trump administration also announces that it will no longer fund cost-sharing reduction (CSR)
payments – Subsidies to reduce out-of-pocket health plan expenses (deductibles, copays etc.)
for low-income households
The Republican’s Tax Cuts and Jobs Act of 2017 passes, a tax reform bill which includes the
repeal of the Individual Mandate - effective in 2019
The Congressional Budget Office releases a report detailing that repealing the individual mandate
will result in a decrease of the number of people with health insurance of 4 million in 2019 and
13 million in 2027
Source: CBO
U.S. vs. International Healthcare
▪ Highest healthcare spending as a ▪ Less overall visits to the doctor Due to a number of factors, the U.S.
percent of Total GDP than other countries has worse overall healthcare outcomes
despite the high amount of spending
▪ Highest per capita spending ▪ Lower likelihood of making a
same or next day appointment
▪ More often than not higher drug
and procedure costs ▪ Fewer hospitals per capita
U.S. vs. International Healthcare - Cost
Luxembourg 5.5% Italy $2,840

Ireland 7.2% United Kingdom $3,859
Iceland 8.3% New Zealand $3,937
Italy 8.8% Japan $4,169
New Zealand 9.2% Finland $4,206
Australia 9.2% France $4,380
Finland 9.2% Belgium $4,507
United Kingdom 9.6% Canada $4,755
Netherlands 10.1% Netherlands $4,911
Denmark 10.1% Austria $4,940
Belgium 10.3% Ireland $4,977
Austria 10.4% Germany $5,033
Norway 10.4% Australia $5,332
Canada 10.6% Luxembourg $5,783
Japan 10.9% Denmark $5,800
Sweden 11.0% Sweden $5,905
Germany 11.2% Iceland $6,086
France 11.3% Norway $7,936
Switzerland 12.3% Switzerland $9,956
United States 17.1% United States $10,246
(1) World Bank

Adjusted for Differences in Cost of Living
Out of Pocket Spending $1,090
Private Spending
Public Spending
$2,313 $3,906
$930
$690 $22 $599
$605 $834
$169
$466 $404 $70
$712
$351
$839
$630 $732
$500 $223 $562
$289
$5,399
$4,869 $5,030 $4,836
$4,378 $4,606
$4,068
$3,341 $3,382
$2,894 $3,109
New Zealand UK Australia Canada France Netherlands Sweden Germany Norway Switzerland USA
1) The Commonwealth Fund: “Multinational Comparisons of Health Systems Data, 2018”

FT Partners / QED Note: Numbers may not sum to total healthcare spending per capita due to excluding capital formation of health care providers, and some uncategorized health care spending. 38
$1,119 $15,930
$788
$503
$6,040
$215 $3,814
$2,003
USA Switzerland UK Australia USA Switzerland Spain Australia
$3,930
$2,669
$1,253 $1,362 $1,752

$1,534
$822
$470
USA Switzerland Spain UK USA Switzerland Spain UK
(1) Vox: “America’s health care prices are out of control. These 11 charts prove it”
FT Partners / QED Note: Humira treats multiple forms of arthritis, skin conditions and inflammatory bowel diseases, while Avastin is used to treat various cancers 39
U.S. vs. International Healthcare - Consumption
10.0
8.8 77%
7.7 7.6 67%
57% 56%
6.1 53%
51%
49%
5.0 43%
4.4
4.0 3.9
3.7
2.8
Netherlands
New Zealand
Netherlands
Switzerland
Germany
Australia
Germany
Sweden
Australia
Canada
Sweden
France
Norway
Canada
France
USA
USA
USA
UK
UK
1) The Commonwealth Fund: “Multinational Comparisons of Health Systems Data, 2018”

FT Partners / QED 2) Peterson-Kaiser Health System Tracker: “How does the quality of the U.S. healthcare system compare to other countries?” 40
U.S. vs. International Healthcare - Outcomes
96.4
95.9
95.5
94.1 93.9
19%
92 91.7 17%
90.5
15%
14%
88.7
11% 11%
10%
8%
7%
Netherlands
Netherlands
Switzerland
Germany
Germany
Australia
Australia
Sweden
Sweden
Canada
Austria
France
France
Japan
USA
USA
UK
UK
HAQ Index is measured 1 – 100 and is based on mortalities that could Medical errors include wrong medication or dose, or delays or
have been prevented from timely and effective healthcare; lower errors in lab results
scores indicate high mortality rates for causes amenable to health care
(1) Peterson-Kaiser Health System Tracker: “How does the quality of the U.S. healthcare system compare to other countries?”
U.S. vs. International Healthcare
There are four basic models of Healthcare Systems throughout the world (1,2)
▪ Funded by the government through taxes – consumers do not pay ▪ Uses private sector providers with the federal government as
healthcare bills the sole payer
▪ Most hospitals and clinics, but not all, are owned by the government ▪ Government run insurance program that all citizens pay into
▪ Some doctors are government employees, while there are also private ▪ “Universal” insurance programs are typically cheaper and
doctors that collect payment from the government simpler from an administrative standpoint
▪ Additional private insurance coverage is also available in some countries
Canada South Korea Taiwan

UK Spain New Zealand Norway Finland Sweden Italy
▪ This model occurs in underdeveloped countries without

▪ Not-for-Profit insurance plans that must cover everyone called established systems
“Sickness Funds” ▪ People pay for healthcare services as needed
▪ Strict regulation allows the government to have control of costs ▪ Higher income people / families receive care while the poor
▪ Costs are funded by employers and employee payroll deduction do not because they are unable to afford it
▪ Providers and hospitals are typically privately run
Rural Africa, South
Some of America, China and India
Latin Cambodia
Germany France Japan Netherlands Belgium Switzerland America
“When it comes to treating veterans, we’re Britain...For Americans over the age of 65 on Medicare, we’re Canada.
For working Americans who get insurance on the job, we’re Germany. For the 15 percent of the population who
have no health insurance, the United States is Cambodia or Burkina Faso or rural India.” – T.R. Reid (1)
(1) PNHP: “Health Care Systems – Four Basic Models”

FT Partners / QED (2) UCSF 42
iii. Impacts of COVID-19 on the
U.S. Healthcare System
Costs Due to COVID-19
$88,114
▪ The number and severity of COVID-19 cases is an important but
unknown factor driving increasing healthcare costs in the United
States
▪ Treatment is currently supportive, not curative, but if an effective

treatment is identified soon, this could significantly reduce the strain
$20,292
of the pandemic on the healthcare system
▪ The price of the new treatments, however, could add

additional costs to the system Respiratory System Diagnosis Pneumonia with Major
With Ventilator Support for 96 Complications or Comorbidity
▪ About 15% of people infected by the coronavirus could require Hours or More
hospitalization or invasive mechanical ventilation
▪ Patients with more severe symptoms may have higher costs
▪ Patients who need to be put on a ventilator will have much

Average hospitalization cost for COVID-19 treatment, with
higher costs possibility of costing much more for severe cases (1)
Source: WHO
(2)
Johns Hopkins University Coronavirus Resource Center
Peterson-KFFF Health System Tracker, “How Health Costs Might Change with COVID-19”
44
Costs Due to COVID-19 (cont.)
By Type of Admission
Psych /
Substance
Surgical,
Non-Emergency
▪ Delayed or foregone care may offset additional costs of treating 3%
people with COVID-19, but the degree of the offset is uncertain Emergency
Admission 37%
▪ In the United States, hospitals are canceling or delaying some elective
25%
procedures to leave more beds, equipment, and staffing available for
COVID-19 patients, making it difficult to analyze cost effects
▪ Hospitals are making differing decisions regarding which

procedures to cancel or delay, which raises uncertainty about
premiums that insurers will set for the following year 15%
20%
▪ Delaying or foregoing procedures may alleviate pressure on health Maternity / Medical,
Newborn Non-Emergency
costs this year, but the delayed care could shift costs to and raise
spending for the next calendar year
▪ There is also concern that certain types of delayed care could worsen
health outcomes and cause higher spending later due to health
complications from reduced access to medical providers 37% of hospital admission spending in 2018 was on surgical
procedures that did not originate in the emergency room, some
of which will now be delayed or foregone
Source: Peterson-KFFF Health System Tracker, “How Health Costs Might Change with COVID-19”
Costs Due to COVID-19 (cont.)
▪ Commercial insurers must base premium ▪ The pandemic is putting pressure on ▪ COVID-19 has increased enrollment
justifications on cost assumptions for the Medicare spending due to the number and created higher costs due to
next calendar year and may over-price their of COVID-19 hospitalizations, the testing and treatment, and states
plans to subsidize current losses amount Medicare pays to treat cannot restrict eligibility through the
▪ Out-of-pocket costs are a concern for COVID-19 patients, and the number of emergency period
enrollees, although some insurers have patients that require ventilator ▪ States may have options to negotiate
waived cost-sharing for COVID-19 support rate adjustments, implement carve
treatment ▪ Beneficiaries will not face out-of- outs of COVID-19 related care, or
▪ Some of the largest private insurance pocket costs for testing related establish risk corridors
companies in U.S. have recently reported services, but may incur costs for ▪ Strategies typically employed to
huge profits though due to less overall treatment depending on their reduce costs in response to economic
claims from delayed / forgone care; It has coverage conditions may not be viable since
yet to be seen when members will receive ▪ The impact of telehealth services on many providers are strained by the
rebates for this additional revenue Medicare spending is unknown coronavirus response
Source: Peterson-KFFF Health System Tracker, “How Health Costs Might Change with COVID-19”
Digitization of Healthcare
Patients can seek out medical advice, prescription

orders, and treatment options through video chat, text,
email, mobile apps, or chat bots, relieving hospitals of
patients who may not need immediate attention. Since
January 2020, telehealth companies have seen
anywhere from a 70% increase to 158% increase in
appointments. (1)
Big Data, artificial intelligence, and complex models are

helping physicians and health systems to closely track
the spread of COVID-19. (3) Researchers can then use
the data gathered to develop treatment options and
vaccines and to forecast how interventions could help
manage the virus.
(1) The Medical Futurist, “COVID-19 and the rise of Telemedicine”

(3)
Harvard Business Review, “How Hospitals Are Using AI to Battle Covid-19”
Deloitte, “Digital Tools in the Fight Against COVID-19”
47
iv. Healthcare Payments 101
Healthcare Billing and Payments Workflow
• Patient enrolls in • Patient provides • Patient is checked- • Patient receives • Receives notice
health insurance demographic in at Doctor’s bill from Provider of any past due
plan with Payer and personal office and pays for any non- amounts,
information copay; receives reimbursable responsible for
ahead of first treatment from amounts, and is payment to
appointment Provider responsible for Provider or
payment to collection agency
Provider
• Verifies insurance • Provider collects • Provider submits • Provider receives • Provider posts • Follows up with
coverage available copay and gives claims, which report from Payer payment internally Patient regarding
to Patient; Confirms treatment to are processed detailing and is responsible for past due amounts,
Patient data; Patient by Payer reimbursement evaluating any denial enlists collection
Obtains prior amount and / underpayment; agency if bills
authorization where explanation prepares bill and remain unpaid
necessary sends to Patient
• Provide Patients • Confirms Patient • Payer receives • Payer processes • Payer sends
with health coverage with claims from the claims, payments to
insurance Provider via Provider determines Provider and
options and phone, fax, web reimbursement Explanation of
enrollment portal or third- amount, and Benefits to
party vendor sends a report to Patient
solutions Provider
Payment Models
▪ Costly to the patient ▪ Typically used in HMO plans – more

▪ Potential for uncoordinated care Payers estimate the total cost of all services a on HMOs (explained on page 24)
across multiple doctors, and patient would receive per episode over a set period ▪ Simplifies billing
duplication of services of time for a certain procedure / treatment ▪ Can detract from quality of care and
▪ Primary model used in conventional / lower overall time spent with each
indemnity health insurance plans, and patient because revenue is made by
Providers are rewarded by payers for reaching
to an extent in PPO plans number of patients seen
pre-determined levels of quality and efficiency
x x
risk for Payer as it is harder to risk for Provider because flat
control costs Group of providers who come together voluntarily, payment amount may not account for
often organized by a larger entity, to give coordinated unpredictable high cost patients
risk for Provider as a patient high-quality care to Medicare patients; share in cost
that requires more care will be priced savings amount of risk for Payer as costs
accordingly are pre-determined by flat fee structure
▪ Focuses on patient population wellness,
preventative care and efficient treatment
▪ Correctly pricing the bundles / quantifying value
levels can be complex
▪ Complexities around pricing bundles, quantifying
value and technological and clinical administration
for providers and payers
Source: Brookings.edu, CMS.gov

Payment Methods
Premium / Health Insurance Premium / Health Insurance

Payment to Payer Payment to Payer
Medical Bill / Payment to Provider Medical Bill / Payment to Provider
61%
57%
44%
41%
29%
23%
20% 20%
14% 15%
10% 11% 11%
7% 8%
6% 5% 6%
2% 1% 2% 1% 2% 3%
1% 1%
Cash Prepaid Money Debit Card Check Credit ACH Don't Know Phone Direct Debit In Person Mail Website
Card Order Card
(1) ACI: “Enabling Digital Payments in the U.S. Healthcare Market: Your Transformational Opportunity” – as produced by Aite
III. Healthcare Trends
i. Digitization
Digitization – Overview
Provider search tools and online appointment booking,

e-referral and triage management, data-driven
personalized patient engagement and outreach strategies
o Patient Shopping / Plan Comparison

Advanced clinical decision support, virtual diagnosis and
evaluation such as telehealth / telemedicine, remote patient o Payments, Billing & Collections
monitoring, population health analytics, digital pharmacies
o Patient & Provider Financing Options
Health trackers and fitness apps, wellness programs o Provider and Payer Operations
and incentives
All records were paper- Starting in the 1960s, Electronic records evolved from Cloud based, multi-channel and
based prior to the 1960s medical records began to be single-practice electronic charts to open-source data solutions are
stored electronically comprehensive health records that the future of health data
can be shared across providers
Digitization – Key Regulatory Milestones
▪ President George W. Bush signed an ▪ Beginning of the re-branded Promoting

executive order kickstarting the Interoperability (PI) Program, continuing
“development and nationwide focus on improving patients’ access to
implementation of an interoperable health health information
information technology infrastructure” ▪ Providers are required to meet a set of
▪ Also appointed a National Health stringent requirements in order to be
Information Technology Coordinator eligible for EHR incentives
▪ Highly manual processes and physical ▪ As part of the American Recovery and ▪ By 2017, 86% of physicians reported
record storage Reinvestment Act (ARRA), all public using an EHR or EMR system (1)
▪ Records stored locally, often in arbitrary and private healthcare providers were ▪ Significant incentives are in place to
locations required to demonstrate meaningful ensure usage - for example, clinics
use of EMRs by January 1, 2014 not using an EHR / EMR system may
▪ Difficult to find records if patient checked in
at different location from physical record ▪ Financial incentives offered for the be subject to a 1% reduction in
use of EHRs Medicare reimbursements
▪ HIPAA (Health Insurance Portability and
Accountability Act of 1996) enacted to
modernize the flow of healthcare information
1) Office of the National Coordinator for Health Information Technology

Digitization – American Recovery and Reinvestment Act (ARRA)
▪ Recording and maintaining an active ▪ Increased exchange of health ▪ Expectations at Stage 3 moved
medication list, an active allergy list, information between healthcare away from “inputs” that Stage 1
vital signs and more providers and between healthcare and 2 dealt with, and more
▪ Generating and transmitting medical providers and patients towards outcomes
prescriptions where allowed by ▪ Patient access to EMRs online ▪ Outcomes are measured
state law ▪ Cloud-based (SaaS) programs that according to the usual outcome
▪ Keeping an up-to-date list of patient integrated with existing practice framework that is put in place by
problems that is current and has management systems were the care providers and insurers
active diagnoses, documents preferred option to meet this criteria
smoking status for patients over 13
Digitization – Increased Usage of EHRs
$30.8 billion
86.9%
96.0%
51.0%
23.9% 28.0%
9.0%
2005 2010 2015 2008 2011 2015
1) Office of the National Coordinator for Health Information Technology

Digitization – Health Insurance Portability and Accountability Act (HIPAA)
Required employers The Administrative Set guidelines for the Specified coverage Regulations about
and insurers to provide Simplification amount individuals and conditions for company-owned life
continuous coverage provisions required can save per person group health plans insurance plans and
for individuals between national standards for in a pre-tax medical provisions for non-
jobs, also ensuring electronic healthcare savings account U.S. citizens
coverage unaffected by transactions and new
pre-existing conditions requirements for
privacy and security of
patient information
Protects the privacy of individually identifiable health information held or transmitted by health plans,
clearinghouses or providers through any channel – electronic, paper or spoken
Ensures security safeguard of electronic personal health information through securities management
processes, implementation of policies for role-based authorization, and workforce training
HIPAA was amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. The new law extended liability to
all business associates and subcontractors that receive personal health information of individuals, increased penalties of violations and expanded the
options patients have for obtaining their health information.
Sources: HHS.gov, DHCS.ca.gov

Digitization – EHR / EMR & Practice Management Systems
▪ Practice Management Systems offer a broad set of administrative tools and management
functionality while also housing EHRs / EMRs
▪ Specific features include medical billing and collections, practice administration, appointment
scheduling and reminders, and patient engagement and communication
▪ Offers immediate access to patient’s comprehensive medical history from multiple sources
▪ Designed to be shared with other providers
▪ Reduction in errors relative to EMRs
▪ Can offer advanced tools to improve decision-making, communication, reporting and efficiency
▪ Computerized physician order management
▪ Largely limited in scope to diagnosis and treatment information
▪ Generally not designed to be shared outside of the practice
▪ Reduction in errors relative to paper-based records
Digitization – EHR / EMR & Practice Management Systems (cont.)
EPIC and Cerner are the most widely used EHR systems, but there is a large ▪ The large landscape of EHR / EMR vendors causes
landscape of players providing EHR / EMR software, with some focusing on integration and interoperability issues for hospitals and
specific medical specialties, such as behavioral health or oncology providers that use them
Others ▪ Interoperability is the structure that allows different EHR

systems to communicate and exchange information between
different systems and providers
▪ HIMSS Analytics found that 75% of hospitals have 10 or more

different EMR vendors in use throughout its affiliated practices
(including specialty EHR providers such as oncology) (2)
2% 9%
▪ Following the HITECH Act of 2009, the Medicare Access and
CHIP Reauthorization Act of 2015 (MACRA) created a federal
4% 28% definition for interoperability as well as goals to achieve
Nasdaq:MDRX
6% nationwide interoperability (3)
▪ Additionally, third party software and applications for providers

9% and patients need to integrate with the various EHR systems
Nasdaq:CPSI Epic’s App Orchard and the Athenahealth Marketplace allow third-party
payments, billing, communication software and more to integrate
with the EHR system
16%
26%
▪ Companies like Redox provide healthcare

connectivity solutions essentially coding
Nasdaq:CERN connections between non-partners
(1) Beckers Hospital Review: “KLAS: Epic, Cerner dominate EMR market share”
(3)
Healthcare IT News: “Why EHR data interoperability is such a mess in 3 charts”
Formstack.com: “The Legislative History of Healthcare Interoperability”
60
ii. Consumerization
Consumerization – Overview
▪ Out-of-pocket health spending has grown to ▪ In 2000, patient payments only accounted for about
over $1,000 per person annually 5% of total healthcare provider revenue. (1) This
portion has grown significantly over the last two
decades.
▪ With the increase in costs and overall financial

▪ Between 2006 and 2017, private sector employee responsibility in healthcare, patients are becoming
enrollment in HDHPs increased from 11.4% to 46.5% (2) the primary payer in many scenarios
▪ Healthcare is not structured like, and therefore does not behave like, a normal consumer industry
▪ The lack of price transparency and limited ability to shop around for healthcare services leaves consumers with little power to affect costs
▪ Without complete information, consumers may not know the best way to shop for healthcare services and often will pick higher priced services
thinking that reflects the quality
▪ Additionally, there can often be a misalignment of objectives given the number of different stakeholders in healthcare, the provider,
the payer and the patient
(1) Forbes: “What We Can All Do About Rising Healthcare Costs”

FT Partners / QED (2) CDC Survey: Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–March 2018 62
Consumerization – Cost Growth
Inflation Adjusted
$11,172
$6,879
▪ Aging U.S. population that requires more care
▪ Changes in disease occurrence, for example, $3,165

$1,208
chronic illnesses such as diabetes and heart
disease have become more prevalent (1)
1960 1980 2000 2018
▪ Rising costs of specialty pharmaceuticals
▪ Increasing technological complexity and variety 2000 – 2018 $19,616

$17,545
of medical procedures Single Coverage
Family Coverage $13,770
▪ Overall greater access to care through
$10,880
government policies (Medicaid & Medicare) and
higher utilization / demand of medical services $6,438 $6,896
$6,251
$5,049
$4,024
$2,471
2000 2005 2010 2015 2018
(1) The Balance: “The Rising Cost of Health Care by Year and its Causes”
(3)
Centers for Medicare and Medicaid Services, adjusted for inflation using data from Bureau of Labor Statistics
Kaiser Family Foundation, 2018 Employer Health Benefits Survey
63
Consumerization – Shift of Burden
Since 2010, premium growth has slowed due to the implementation of

Employer Contribution
the ACA, but premium increases still outpace raises in workers’ earnings
Worker Contribution
Premium Increases
Inflation
% Paid by $20,576 Worker’s Earnings Increases
72%
Worker
$16,834
$13,375
14,561
12,011 34%
9,860 26%
22%
19%
17%
13% 13% 14%
11% 11% 11%
6,015
4,823
3,515
2009 2014 2019 1999-2004 2004-2009 2009-2014 2014-2019
(1) The Kaiser Family Foundation: “Employer Health Benefits: 2019 Summary of Findings”
Consumerization – Shift of Burden (cont.)
▪ High Deductible Health Plans typically have lower monthly

premiums than other plans but high deductibles, meaning
HDHP no HSA 43.4%
that a consumer must pay for more of the healthcare costs CDHP (HDHP with HSA) 39.2%
35.5% 35.8%
out-of-pocket before the insurance company will start paying
30.8% 19%
27.8% 17%
▪ For 2020, HDHPs are defined as a plan with a deductible of 25.9% 14% 14%
22.5% 11%
at least $1,400 for individuals and $2,800 for a family plan (1) 9% 10%
7%
▪ HDHP’s total annual out-of-pocket expenses for deductibles,
22% 22% 23% 25%
17% 18% 20%
copayments and coinsurance cannot exceed $6,900 for an 16%
individual and $13,800 for a family, although these limits do
not include out of network services (1) 2010 2011 2012 2013 2014 2015 2016 2017
▪ Many people that have HDHPs use tax-free Health Savings

Accounts (HSAs) to save money to be able to pay for their $1,655
$1,573
deductible and other qualified medical expenses $1,478 $1,505
$1,318
$1,217
− This combination is often called a Consumer Directed $1,097 $1,135
$991
Health Plan (CDHP) $826
$917
$735
▪ Providers are increasingly feeling the financial strain from $584 $616
this as well, as the amount of payments they need to collect

directly from the patients increases
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
(1) Healthcare.gov
(3)
NCHS, National Health Interview Survey, 2010 – 2017, Family Core component
The Kaiser Family Foundation: “Employer Health Benefits: 2019 Summary of Findings”
65
IV. Pain Points and Emerging Solutions
Patient – Pain Points
▪ Only 23% of Americans are able to afford a

medical bill that’s more than $2,000 (1)
Relied on home remedies or over-the-counter
▪ 59% are pursued by a debt collector because drugs instead of going to see a doctor (5)
of past-due medical bills (2)

Did not take a prescription medicine as
▪ 1 in 5 have a credit report that includes
directed because of cost (5)
medical debt (3)
▪ Medical debt is the #1 cause of personal

Skipped a recommended medical test
bankruptcy (4) or treatment (5)
(1) Simplee: “Top Providers Are Fighting Back Against Patient Bad Debt” 5) Kaiser Family Foundation: “Data Note: Americans’ Challenges with Health Care Costs”
(3)
CFPB: “Consumer Experiences with Debt Collection”
Consumer Reports: “What Medical Debt Does to Your Credit Score”
67
(4) CNBC: “Medical Bills Are the Biggest Cause of US Bankruptcies: Study”
Provider – Pain Points
▪ Uncompensated healthcare costs are measured as hospital care ▪ Providers are suffering from billing longer cycle times
provided for which no payment was received from the patient or
insurer – It is the sum of a hospital's bad debt and the financial ▪ Historically, providers could expect to receive a payment
assistance it provides within four to six weeks from the day a claim is submitted
with the insurer (2)
▪ These costs have risen dramatically in that last two decades, but
have fallen some after the implementation of the ACA due to more ▪ Due to an increase in deductibles and out-of-pocket patient
individuals having insurance coverage expenses, providers are more reliant on when the patient is
able to pay rather than receiving a money back from the
($ in billions) $46.4 insurer for a claim
$41.1
▪ With higher deductibles, patients typically take longer to
$36.4 $38.3
use up the amount before the insurer will start to pay for
services
$28.9
− 83% of small physician practices say that slow
$22.3 payments from high-deductible plan patients are their
top collection challenge (3)
$18.0 $20.7
$16.0 ▪ Additionally, many patients will enroll in installment-based
$12.1 payment plans with their medical provider
▪ On top of the longer cycle times, it costs roughly 4x more to

collect from a patient than from an insurance company (3)
− The complexity of the billing and collections process
can create significant administrative costs and burden
on the provider
Source: Collector Magazine: “The Rise of Self-Pay Accounts”

(2)
American Hospital Association: Uncompensated Hospital Care Cost Fact Sheet, 2019
APS: “The Impact Of The Higher Patient Deductibles To The Modern Medical Practice”
68
(3) InstaMed: “2016 Trends in Healthcare Payments Annual Report”
Provider – Emerging Solutions: Patient Payments / Billing
▪ Given increased patient responsibility, the financial ▪ Many providers have not developed the capabilities to
wellbeing of many providers relies on their ability to effectively engage with and collect payments from patients
effectively collect from patients
▪ Electronic health record and practice management
▪ These increases in patient responsibility are serving as a software suites usually lack features / functionality
wakeup call to providers that they need to improve their required for payment acceptance
billing and collections processes − While they sometimes include basic click-to-pay
functions, they do not address card on file accounts,
payment plan management, and other advanced
▪ In the past, patient responsibility was a negligible portion of
functions
the bill. Now that it has increased to more than a quarter of
total provider receivables, patient losses cause noticeable
top line pain to providers (1) ▪ As a result, providers are suffering from high patient losses,
high cost of billing / collections, and long cycle times
▪ Many providers are seeking to institute new processes and

technologies to recover the money owed them, and they are
seeking solutions that can help them better manage patient
collections from the outset
▪ In a survey, 83% of providers plan to meet the rise in patient

consumerism with more retail-like technology solutions (2)
▪ Providers hope to address high losses, high costs, and long

cycle times by providing and utilizing solutions focused on:
(1) AMA: National Health Insurer Report Card

FT Partners / QED (2) Pointclear Blog 69
Provider – Emerging Solutions: Patient Payments / Billing (cont.)
▪ The eligibility process is the verification of insurance

coverage – solutions will check for and review patient Nasdaq:CHNG
benefits, determine the amount of coverage a patient has
Pending acquisition by
as well as identify patients that will self-pay
Change Healthcare provides a range of services for
▪ Estimation of costs of services (and the amount covered by providers and payers. For hospitals and health systems
insurance) enables patients to make informed decisions it provides eligibility and enrollment solutions to identify
coverage and potential recovery opportunities for
▪ Increased price transparency helps to manage patient self-pay patients.
expectations and allows patients to plan for financial
obligations
PointCare provides solutions to help health systems find

coverage for self-pay patients. PointCare has up-to-date
information on every public and private coverage program
managed by its in-house eligibility experts. Its solutions
Want insurance eligibility verification prior to the
assist in choosing where to apply and automatically
appointment (1)
checks for Medicaid coverage.
Want transparency via cost estimation, essential

to prepare consumers on what they will pay (2)
Anagram helps providers access out-of-networks benefits
for its patients. The Company serves independent practices
in the ancillary market – ophthalmologists, dentists, etc. –
▪ A leading reason for patient non-payment is simply not providing real-time health insurance benefits and eligibility
understanding the obligation from a variety of networks. Providers also have the option to
create their own prices or offer discounts for cash
payments.
(1) InstaMed: “91% of Consumers Are Demanding Price Transparency”

FT Partners / QED (2) Kaiser: “Predict out-of-pocket health costs before your appointment” 70
▪ Several companies focus on providing pre-appointment and in-

office / point-of-sale payment solutions
▪ Providers can increase patient collections rates through point NYSE:PHR

of care collections such as charging at check-in based on
estimations
Phreesia’s platform manages end-to-end patient intake
▪ Providers are able to take a card on file (by tokenizing and process including registration, insurance verification,
storing card numbers) and auto-debit patients’ accounts patient questionnaires, patient-reported outcomes, or
following claim adjudication PROs, payments and scheduling. Phreesia provides
self-service intake tools like the PhreesiaPad, Mobile
and Arrivals kiosks to customize workflows that help
▪ According to Health iPASS, providers see an average
providers collect a complete patient record and allowing
improvement in collections of 97% from leaving a card on file
patients to process payments themselves.
Salucro’s patient payment technology platform is designed to

facilitate patient payment collections across the revenue cycle,
including pre-service, at the point of care, and in the back Health iPASS provides patient intake, process and
office. With over 16 different payment methods, including payment solutions. Specifically, the Company provides
PayPal, Venmo, ApplePay and access to third-party financing, smart appointment reminders, check-in / check-out
Salucro provides healthcare organizations with the ability to kiosks, a patient cost estimator and insurance verification,
process secure, compliant P2PE transactions while integrating as well as electronic statements and digital billing. Health
with their EHR. Salucro’s card-on-file, flexible payment plan, iPASS also recently launched RevSure, a receivables
and proprietary multi-AR reconciliation features allow financing solution for providers’ patient payments (more
healthcare providers to move complex payment activity on page 78).
upstream in the patient collection process.
▪ Patients are looking for the consumer-friendly, digital

communications that they are accustomed to in other settings
▪ Bills that are understandable and aggregated for one episode InstaMed allows patients to pay at the point-of-service, online,
of care are more likely to be promptly paid in full over the phone, through bank bill pay, walk-in bill pay, online or
mobile app. Providers can drive online payments and eStatement
▪ Patients also desire digital payment options, including credit adoption by displaying a link to the InstaMed Patient Portal or an
and debit card existing portal on patient statements. InstaMed claims to help
providers achieve 25% eStatement adoption in six months with
▪ Checks and cash, and other traditional methods of payment, the InstaMed Patient Engagement Program.
are less preferred by majority of patients
More than 68% of Americans would prefer their bills and BillingTree’s CareView solution offers providers’ patients an
omni-channel payment experience through web and online
statements to be delivered through electronic channels (1)
portals, phone and IVR payments, text payments, credit and
debit card payments as well as point-of-care payments.
71% of patients in a survey by Black Book said that mobile
payment options and billing notifications have improved NASDAQ:FLYW
their satisfaction with the provider (2)
Flywire presents patients with one bill and one balance across
multiple accounts and entities. Patients can view and set up
payment plan offers on pre-service estimates and post-service
balances automatically.
Cedar’s platform delivers personalized engagement and patient

NASDAQ:RPAY
payment experiences for hospitals and physician groups. Cedar
tailors billing outreach throughout the dunning cycle to engage REPAY provides payment processing solutions, including virtual
patients in the most compelling way – text, email, ringless calls card and ACH, along with a robust omni-channel payment and
etc. Cedar’s clients have seen a minimum 30% increase in electronic billing management platform for TPAs. REPAY also
patient payments (with 70% digital payments), alongside a 95% offers full print / mail and electronic communication services to
patient satisfaction rate. streamline workflows and reconciliation processes.
(1) InstaMed: “2016 Trends in Healthcare Payments Annual Report”

FT Partners / QED (2) Healthcare Finance: “As patient responsibility jumps 29%, providers to focus on patient-centric payment solutions” 72
▪ Majority of Americans are unable to afford steep medical bills,

and out-of-pocket medical costs keep rising
▪ Spreading payments over time can dramatically improve a

patient’s ability to pay and therefore the amount the provider
is able to collect Patientco provides payment solutions from
communications to billing – Additionally, it provides,
▪ Payment plans are offered through a providers’ billing software SmartDraftTM Payment Plans where patients can
break up high account balances into automatic monthly
▪ There is no loan or credit line as there is with Patient Financing - installments, as well as SmartFinanceTM, which allows
detailed on the next page - the provider is simply agreeing health systems to provide tailored, flexible financing
to be paid overtime and the payment processor facilitates options for patients.
the exchange
▪ Many solutions utilize analytics to understand a patient’s

propensity to pay, to then tailor the plan to the highest collection Cedar’s platform delivers personalized outreach
rate for the provider strategies and billing communications for each patient.
It allows for multiple payment options and sets up options
▪ Ultimately, Payment Plans help providers capture additional for “self-select” payment plans for each patient.
revenue from patients that may not be able to pay the full
amount upfront
with recent acquisitions of
In a survey by PYMNTS and Flywire, 91% of patients said
they can pay off their payment plans in full, either early or
by the schedule (1)
Flywire provides personalized payment plans using an
analytics powered platform that segments patients by
And 90% of respondents said they would consider using their capacity to pay.
payment plans in the future (1)
(1) Pymnts.com & Flywire: “The Changing Landscape of Healthcare Payment Plans”
▪ External or third-party patient financing options offer

additional pay-over-time solutions for patients’ medical
bills
▪ These loans and lines of credit can be more long-term than

internally created payment plans
CarePayment offers a 0% APR open-ended revolving line
▪ Patient financing options range from 0% interest rates to of credit of up to $25k. As a recourse financing option,
double-digit APRs depending on the case after 90 days of non-payment, an account is returned to
the provider. CarePayment does not report to credit
bureaus for delinquencies and the Company makes
▪ There are two types of patient financing plans: (1)
money through program fees charged to the provider.
Unpaid patient balances are returned to the provider
to determine follow-up collections; Generally accepts all
applicants; Typically offer zero to low interest rates
Patients will undergo a credit check and will

have interest rates determined by underwriting factors; Not all
patients will qualify, and unpaid balances will ultimately be the CareCredit, a Synchrony solution, offers a credit card for
responsibility of the third-party lender a variety of medical, health and wellness services. It
offers shorter-term financing options of 6 months to two
▪ Additionally, medical credit cards provide a line of credit for years with no interest on purchases of $200 or more
when minimum monthly payments are made, and the
specific health services
balance is paid in full by the end of the promotional
− Credit cards may offer 0% interest rates for certain periods period. Longer-term options are available as well for 24 –
of time as long as the consumer makes timely payments of 60 months periods with higher APRs (14.9% - 17.9%+).
a specific size
(1) HFMA: “The Pros and Cons of Recourse and Nonrecourse Patient Financing”
Provider – Emerging Solutions: Payer RCM
▪ Providers are struggling to collect from payers due

to denials, non-payment, and delays in payment A claims denial is the refusal of an insurance company or carrier
to pay for healthcare services for an individual
▪ Providers are looking for tools to help with claims
administration and denials management
A claims appeal is the right for an individual to appeal a health
insurer’s decision to refuse to pay a claim and to have the appeal
▪ Claims may initially be denied due to improper coding,
reviewed by a third party
missing patient information, outdated coverage, prior
authorization needs, non-covered service, untimely
filing and more
Clearinghouses review and scrub claims to check for errors and
ensure they can be received by the payer’s processing software
(1) Change Healthcare: “Reinventing Claims Management for the Value-Based Era”
Provider – Emerging Solutions: Payer RCM
Nasdaq:CHNG
Waystar provides claim and denial management Availity provides revenue cycle management Change Healthcare provides a range of services for
solutions for providers of all sizes among other RCM solutions for providers across eligibility, providers and payers. For physicians, hospitals and
services. Waystar provides tools such as the claim authorization, claims management, denial health systems it provides an analytics-driven
monitoring calculator that alerts the provider when a prevention and denial management processes. claims and remittance management solution.
claim needs attention, prioritization of denials that are Availity can develop custom denial strategies Change connects to more than 800,000 providers
more likely to be overturned, and pre-populating through claim edits and rules, appeals workflow and 2,100 payers. With direct connections to
appeals forms. Additionally, Waystar acts as the tools, analytics and pattern reporting. Availity also majority of government and commercial payers,
medical billing clearinghouse in the process. provides EDI clearinghouse services for Change can send most claims straight to their final
In the last few years, Waystar has acquired several electronic claims. destinations without rerouting.
healthcare tech companies to expand its capabilities. The Company’s investors include PE firms Change Healthcare was formed through the merger
Francisco Partners and Prettybrook Partners as of McKesson Technology Solutions and Change
well as strategic investors, Blue Cross Blue Healthcare (originally Emdeon and founded in 1987)
Shield, Anthem, and Humana. in 2017. The Company went public on the Nasdaq
stock exchange in March 2019.
The Company has raised over $450 million in

Olive has developed a process automation software that builds an artificial intelligence financing from investors that include Tiger
workforce for healthcare, utilizing robotic process automation, computer vision and machine Global, General Catalyst, Ascension Ventures,
learning. Olives helps automate error-prone processes such as claim status checks, benefit Oak HC/FT, Drive Capital and Khosla Ventures.
verification, prior authorizations, denial management, invoice processing and more.
Provider – Emerging Solutions: Financing
▪ Due to the extended periods for days sales ▪ While hospitals have access to asset backed lines of
outstanding (“DSO”) for both patient and payer credit, smaller clinics and offices often do not
receivables, some providers – especially smaller
clinics – are facing liquidity challenges
▪ Accounts receivables financing solutions allow providers to ▪ Providers also turn to practice and equipment loans
get immediate funds, borrowed against their medical distributed through online channels
receivables − Traditional channels for practice and equipment
loans include commercial banks
▪ Some companies will buy patient and / or payer

receivables from the provider at a discount to fully
outsource collections activities
(1) Richter: “DAYS SALES OUTSTANDING (DSO) BASICS FOR HEALTH CARE ORGANIZATIONS”
FT Partners / QED (2) Healthcare Finance: “Cash flow, reimbursement are biggest challenges facing physicians in 2017, survey shows” 77
Provider – Emerging Solutions: Financing
Acquired by Acquired by
OODA Health offers a healthcare payment platform ClearGage provides funding solutions for Health iPASS provides patient intake, process
connecting payers, providers and patients. Using providers such as Batch Underwriting, where and payment solutions. The Company recently
OODAPay, payers send a guaranteed payment of providers can offload all patient balances to launched RevSure, a receivables financing
the patient liability to providers immediately upon ClearGage and get paid upfront. Additionally, the solution for providers’ patient payments. Health
adjudication of the claim. Each provider is paid a Company provides propensity to pay technology iPASS guarantees 24 hour funding after
guaranteed rate based on their historical collection on the individual patient level that offers extended insurance processes the claim. The financing
rate that is then adjusted over time. Patients also payment terms for patients, while the provider product is non-recourse, meaning Health iPASS
have the option to choose 0% interest payment receives immediate payment from ClearGage. assumes the risk from the provider, but there are
plans, with a term length of their choosing, which no patient credit checks required.
ensures bills are affordable and paid as patients
prefer.
2017 2009 2013
Cedar in May 2021 for $425 million $250 mm

SphereCommerce in December 2020
Welsh, Carson, Anderson &

Stowe as of September 2019
Other Receivables
Financing Companies
2013
Provide is a lender for healthcare practices, offering loans for $36 mm

new and current practice owners to refinance debt, purchase
equipment, remodel or more. With online applications, the Montage Ventures;
QED Investors; Fifth Third
Company claims to move 5 times faster than a traditional bank.
Bancorp; Clocktower
Technology Ventures
Employer – Pain Points
▪ Given the rising cost of healthcare, employers are ▪ These employers fear the negative impact on
increasingly forced to push costs to their employee satisfaction, loyalty, absenteeism,
employees (often in the form of high cost-sharing and recruitment / retention
plans)
▪ In short, with family premiums approaching
▪ As a result, their employees are struggling to $20k, employers worry that their employees will
cover healthcare expenses incurred before view these pricey benefits as “worthless” when
reaching their deductible/out of pocket maximum overwhelmed with high plan out-of-pocket costs
▪ Employers are concerned about the financial

stress these plans place on their employees
▪ Employers are looking to address these issues by providing their employees with:
Employer – Emerging Solutions
▪ Employees are struggling with healthcare expenses as

deductibles rise and more employers switch to offering
High Deductible Health Plans (HDHPs)
Lively provides free health savings accounts for individuals
▪ Health Savings Accounts (HSAs) are triple tax-advantaged and an administration platform for employers that features
savings accounts that can be used to pay for qualified paperless onboarding, automated payroll deductions and
medical expenses integrated TD Ameritrade Self-Directed brokerage accounts
for online investing.
− Money put in an HSA is not taxed and account
balances earn tax-free interest Nasdaq: HQY
− Accounts and contributions are entirely owned by the HealthEquity was founded 2002 and provides HSAs along
consumer even if they change insurance plans or with COBRA solutions, flexible spending accounts and other
employment health reimbursement arrangements among other services.
Its mobile app allows users to send payments to providers
− HSA funds can be invested as well or reimburse themselves for out-of-pocket expenses from
their HSA. The app also allows users to submit claims using
▪ Consumers must have an HSA-qualified plan, typically ones photo documentation.
with high deductibles, to open an HSA
▪ For 2020, HSA contribution limits are $3,550 for an

individual and $7,100 for a family Starship is a modern, mobile health savings account. Saving
accounts are free, earn account holders 0.25% APY and
▪ After the age of 65, funds can be used like a retirement
come with a debit card to be used on eligible expenses.
account and be withdrawn for any purpose Users are also able to pay through Apple Pay or Google
Wallet. Additionally, users have access to invest in low-fee
▪ New start-ups and well-established companies alike are
index funds, with a robo-advisor. Starship’s current
providing modernized HSAs along with additional tools to customer base includes the fleet of drivers for Postmates
help employees navigate using and paying for healthcare and Uber, among others.
Employer – Emerging Solutions (cont.)
▪ Both patients and self-insured employers are

increasingly focused on seeking high-value care
options NYSE:CSLT
Castlight provides a care guidance navigator that helps employees
▪ Shopping tools can help employees choose
choose the right benefits and give clarity on provider cost and
providers wisely based on quality and price
quality with real price estimates.
▪ While nearly half of the dollars spent on health care
services for commercially insured people is
considered shoppable, shopping tools have
historically had low utilization (1) Amino is a healthcare financial wellness platform that integrates
with employers’ existing healthcare benefits to assist employees in
− Patients are usually solely focused on doctor finding, booking, and paying for high value care. Amino’s Smart
recommendations than other factors Match uses claims data as well as quality measures like Leapfrog
Hospital Safety Grades, to highlight providers and facilities that are
− Checking the price and shopping around for in-network, highly experienced, safe, and affordable.
healthcare services is not top of mind or a part
of normal workflows for when a patient is
looking for care
▪ Employers can help to encourage employees to

compare prices by using employee benefits MDsave allows consumers to search for healthcare services by
platform that are integrated with shopping and procedure, location, and price. Consumers have the option of
comparison tools paying online before the visit. For those paying upfront, MDsave
pre-negotiates bundled pricing with its network of providers
− Solutions that balance quality and affordability offering significant savings for the consumers. MDsave also
of healthcare services using physician ratings offers a digital savings card that provides discounted prices on
and reviews can help guide consumers to the prescriptions.
best choice
(1) Health Care Cost Institute: “Spending on Shoppable Services in Health Care”
▪ In response to the proliferation of high-deductible health ▪ These new companies are better aligning patient health
plans, some companies are bypassing traditional insurance objectives with methods of controlling costs
models, opting to create alternative plans that help both ▪ The offerings are generally deductible-free which reduces the
employers and employees reduce costs, while focusing on amount of outstanding patient collections for participating
better health outcomes providers
▪ These offerings are a new tech-focused take on managed ▪ Provides greater overall price transparency and limits
care programs unexpected costs for patients
Flume is a digital health plan Centivo offers a digital platform, a network Bind is available to self-insured Collective Health provides one
administrator for self-insured employers, of high-value, outcome-focused providers, employers with over 350 employees. connected system that allows self-
replacing traditional third-party claims processing, customer support, and Plans have $0 deductibles and funded employers to administer
administrators “TPA”. Flume population health management for full members pay flat copays for a core health plans and control costs. The
automatically negotiates payments on health benefits administration for set of medical services and platform features include core HR
behalf of its members before they even employee populations. A member’s care is prescriptions including primary and needs from claims adjudication,
book an appointment. This means directed through a primary care physician specialty visits, urgent care, maternity administration, financial operations
Flume always knows the price and pays who helps the patient make decisions. care and cancer treatments. Bind also and analytics. Collective Health
20-40% less than employers’ current These providers receive incentive provides the option for on-demand optimizes employers’ program
PPO. Flume pays providers in their payments for providing and coordinating “add-on” services which are paid for strategies by helping identify the right
network quickly, meaning providers do quality care with good outcomes. Patients as an additional premium as needed programs the employee populations,
not need to try to collect from individual never have a deductible as long as they (ie. hip replacement). The Bind app streamlining implementation, driving
patients, so in turn they are willing to follow and receive care as directed by their allows members to compare prices smart member engagement, and
offer Flume members cheaper rates. primary care physician. The Centivo plan for different services / procedures validating program impact.
holds both the patient and provider showing the cost upfront.
accountable to help reduce costs.
2017 2016 2016 2013
$34 mm
$4 mm $178 mm $755 mm
Bain Capital Ventures;
Accomplice VC; Founder Bessemer Venture Partners; Ascension Ventures; SoftBank; NEA; DFJ
Collective; Primary F-Prime; Maverick Ventures; Lemhi Ventures; Growth; GV; Sun Life;
Venture Partners Oxeon; Company Ventures UnitedHealth Group Redpoint Ventures; Rock
Health; Founders Fund
Sources: Company websites, FT Partners’ proprietary transaction database

▪ While, the companies highlighted on the prior page operate ▪ These disruptive, next-gen health plans focus on telehealth
through the employer channel, there are a number of other and other technologies for ease of use and real-time care
players that are emerging as disruptive payers outside of
the employer-sponsored insurance market
These new insurance players are not beholden to any legacy
▪ Some companies are focusing on the self-employed and payment models, infrastructure, or status quo mentalities.
freelancers, others on individuals without employer Indeed, these companies get to start from scratch to
coverage through consumer-direct marketplace plans, redefine how patients interact with their health plan.” (1)
while many are focused on the Medicare population
Other Tech-Focused
/ Emerging Payers
NYSE:OSCR NASDAQ:CLOV
Oscar offers coverage for individuals, families, Clover Health is a PPO and HMO, providing Decent provides affordable health insurance
and small businesses across 15 states and 29 Medicare Advantage plans. Plans feature plans for freelancers and self-employed
markets. As of the coverage year beginning low / $0 premiums, low copays, and low people, with year-round open enrollment.
January 1, 2020, Oscar has 420,000 members. prescription costs, plus there’s a cap on The Company offers EPO plans (“Exclusive Medicare Advantage Plans
Oscar’s mobile app allows members to find out-of-pocket expenses. Clover provides Provider Organization”), which fall in between 2017
doctors, view lab results and prescriptions, refill customized support based on its members’ HMOs and PPO. Decent patients get unlimited $362 mm
prescriptions, talk to a doctor, get rewarded for particular needs and focuses on collecting access to same-day appointments with
exercise, track deductibles, and more. Oscar has and monitoring patient data for better primary care physicians and 24/7 telehealth
the highest mobile engagement of any insurer, preventative and real-time care. Clover plans services, with $0 out of pocket payments.
and 30% of members have used its also include 24/7 telemedicine, in-home Decent is currently administering plans in NASDAQ:ALHC
telemedicine service. Oscar works with 3,500 visits, dental, vision and hearing coverage Austin, TX, with plans to expand to more cities. Medicare Advantage Plans
nationally ranked doctors across 140 and free gym memberships. 2013
specialties, is partnered with more than half of Mar. 26, 2021
the top 20 health systems in the U.S. $3,349 mm
2013 2018
2012 On October 6, 2020, Clover Health agreed to merge
with SPAC, Social Capital Hedosophia III at an $18 mm
NYSE:BHG
March 3, 2021 Enterprise Value of $3,700 mm
QED Investors; Menlo Ventures; Individual, Family &
Digital Currency Group; Lux Capital, Medicare Advantage Plans
Jan. 8, 2021 Maverick Ventures; Core Innovation;
~$3,632 mm
Meridian Street; Healthy Ventures; 2015
$3,324 mm ChinaRock; Abstract Ventures; Jun. 23, 2021
Sequoia; Foundation Capital $5,791 mm
Sources: Company websites, FT Partners’ proprietary transaction database

FT Partners / QED Market caps as of 09/21/21
(1) Rock Health: “Next-generation payers and providers: Setting a strategy for tech-enabled innovation”
83
▪ Patients are looking for financing options to

spread payments over time for large medical
bills
HealthBridge pays the provider immediately and then offers the patient
▪ Employers, who increasingly supply high- a no-interest payment plans, allowing them to pay their bills over a set
deductible health plans, are looking to period of time. HealthBridge sells the service directly to employers,
supplement the offering by providing as well as to health systems that become part of a network of providers
using the service to collect unpaid patient balances.
employees with access to financing options
▪ Similar to integrated payment plans through
providers’ billing software, these offerings are MedZERO provides a virtual Mastercard to be used for medical bills with
available to patients through their employer zero interest and zero fees with the ability to be repaid over 12 months.
Provided through employer benefits, employees are able to get approval
quickly and sign up anytime.
▪ Another way patients and employers have sought to reduce healthcare costs is by using services that create narrow networks
of providers that will the offer discounted care in exchange for increased volume
Zero allows self-funded employers to cut healthcare costs while improving MedPut allows employees to upload healthcare bills via their
employee benefits plans. The Company’s marketplace approach matches employer dashboard, MedPut then audits and negotiates bill
plan members with the right providers based on cost, quality and payments and will ultimately facilitate the repayment through
convenience. Then, bundled payment contracts lock in fair market prices small payroll deductions.
that create savings for both the plan and plan members.
Payer – Pain Points
▪ Historically, insurance companies (“Payers”) enjoyed a symbiotic relationship with providers

▪ Until recently, most health insurance coverage was negotiated between the insurance companies and employers, and providers
mostly received payments from payers (with only a modest component coming directly from patients)
▪ Providers offered discounts on services in exchange for the roles payers played as aggregators and guarantors of payment
▪ As providers have been forced to collect larger and larger ▪ Fraud, waste, and abuse has also become a larger and larger problem
shares of their revenue directly from patients, the payer- for payers; 3 – 10% of U.S. healthcare spend is fraudulent due to: (1)
provider relationship has moved away from mutualism
• Billing for services not performed or unnecessary /
towards a relationship in which one benefits at the ineligible services
expense of the other
• Inappropriate claiming of payer / patient responsibility
▪ Payers are looking for preventative and automated solutions to

combat fraud
▪ Additionally, payers want to be able to rely on electronic payments
methods for claims remittance for in and out-of-network providers
(1) National Health Care Anti-Fraud Association

Payer – Emerging Solutions
▪ Payers are working hard to identify and reject fraudulent claims
▪ Several software providers are offering automated solutions to ▪ Automatically identify claim-level fraud, waste, and abuse
identify potential fraud, waste, and abuse through exploration of before claims are paid through comparison to historical data
claims data and further investigation these claims
▪ Create risk scores to help launch investigation into potentially
fraudulent claim
▪ Expediate investigations by providing insights from various

data sources
Codoxo is an AI-assisted platform that accelerates the

identification of fraud, waste, and abuse. Its claims ▪ Measure providers against peers through scores that
investigation platform utilizes patented AI-based technology to consider financial and frequency metrics to identify
enable investigators and analysts to gain insights and conduct up-coding, unbundling, and billing for services not rendered
full investigations into suspect claims. Features include
proactive analytics, automatic prioritizing of claims for ▪ Identify outlier providers within peer groups and understand
maximum savings, detection before claims are paid and more. level of deviation for procedures and diagnoses
▪ Identify spikes in payment and billing trends for providers,

procedures, and diagnoses and illuminate potential network
opportunities
Cotiviti’s Fraud, Waste, and Abuse solution is an automated
overpayment detection and protection system that enables
▪ Examine relative risk scores for providers who have
payers to identify potential fraud, catch billing mistakes, and
been paid significantly more than their peers for a selected
comply with medical policies. Cotiviti also offers a
procedure or diagnosis
pre-payment fraud detection tool and other advanced data
analysis solutions for finding irregularities in payers’ data.
Payer – Emerging Solutions
▪ Electronic claims payments can help reduce the time it takes for a provider to be paid, as well as reduces overall costs for both
the payer and provider
Number of ACH EFT payments made
▪ The is an electronic payments from payers to providers in 2018 (1)
system in the U.S. that can directly debit bank accounts
▪ Healthcare are direct An increase of from 2017
electronic claim payments made by the payer and sent to a
provider through use of the ACH system Value of ACH EFT payments made
from payers to providers in 2018 (1)
▪ The claims payments are moved through an
or through the use of a to securely transfer the An increase of from 2017
money between the payer and provider An increase of from 2014
VPay provides electronic claim InstaMed allows payers to immediately deliver Zelis delivers a real-time, integrated electronic
payment methods for third party electronic payments to providers. Payers can payments solution for in or out-of-network
administrators and health plans. access detailed reporting and handle financial medical, dental and workers compensation
VPay’s signature offering is claims monitoring through the cloud-based platform. claims payments. Zelis has access to more
payments through virtual card, but the than 1.5 million providers and a proprietary
Company also offers payments payments network of more than 700,000
through ACH and check. All payments NASDAQ:RPAY contracted providers. In 2019, Zelis merged
are processed through a single system with RedCard to boost its healthcare
of record. Virtual Cards (single-use REPAY provides payment processing solutions, payments platform.
accounts) are auto-generated card including virtual card and ACH, along with a
numbers available for one-time use for robust omni-channel payment and electronic
a specific transaction amount, billing management platform for TPAs. REPAY
timeframe, supplier name, number of also offers full print / mail and electronic
transactions, etc. communication services to streamline
workflows and reconciliation processes.
Sources: HealthPayer Intelligence

FT Partners / QED (1) Nacha.org: “Healthcare Providers are Receiving More Claim Payments by ACH” 87
V. FinTech Healthcare Landscape
Interactions Between Constituents and Relevant Solutions
Premiums Care
▪
Insurance Coverage Direct Payment
▪ ▪
▪
▪
▪
Claims & Bills
Payment
▪
▪ ▪
▪
▪ ▪
▪ ▪
Category Descriptions
Practice Management Software designed to help Technology that provides Technology intended Third-party system End-to-end claims
Comprehensive software designed providers track revenue real-time decisions on to reduce denials by that interprets claim processing tools that
to manage day-to-day operations from patients and payers medical eligibility and automating workflows data between provider aim to improve the
within health organizations spanning from encounter to final benefits, insurance for tracking and systems and insurance accuracy and reduce
clinical and clerical work payment of balance verification, and handling reworking of denials payers and scrubs a the administrative costs
copay, co-insurance and claim for errors before of claims management
Electronic Health Records Note: Companies in end- deductible data submitting
System of digital patient records to-end RCM fall into
that makes real-time information various other categories
available instantly and securely to as well, such as Eligibility,
authorized users Claims Admin etc.
Solutions that offers payment Payment solution that enables Payment and
Solution that helps providers improve medical bill and patient financing options for patients payers to collect premium payments from financial solutions
payments collections with medical bills they cannot health plan members specifically for
Includes point-of-care intake / check-in and registration pay in full clinical trials
solutions, modern payment options, electronic billing and including site
multi-channel communications, online payment portals, Categories: Employer / Payer payments and
installment-based payment plans and payment gateways Channel participant
Payment solution that enables payers to payments
disburse payments to providers for
accepted claims
Entity other than the patient that finances

or reimburses the cost of health services
Solutions that offer financing to providers for practice Digital tools that provide Tax-advantaged (i.e. insurance carriers, private employers, the
acquisition, equipment, or borrowing against patient or increased transparency around consumer medical savings government) that pay providers for healthcare
payer receivables the costs and quality of accounts (ie. HSA, FSA) services
healthcare services to support available to taxpayers who
Categories: Practice Financing, Receivables Financing, informed consumer decisions are enrolled in a high- Categories: Traditional and Emerging
Equipment Financing deductible health plans
Narrow networks of providers that will offer

discounted care in exchange for increased volume
Selected Healthcare Payments Companies
Healthcare Business
Healthcare Business Healthcare Business
Point-of-Care / Billing / Collections / Payment Plans
Employer / Payer Channel
Practice Financing Traditional Emerging
Receivables Financing
Equipment Financing
FT Partners / QED Parent / Acquirer logo shown on top 91

VI. Executive Interviews
Originally published September 2020
Interview with QED Investors
Laura is a Principal at QED Investors and focuses on U.S. FinTech investments. She has helped
lead the firm’s exploration of opportunities at the intersection of healthcare and financial
services and has invested in several early stage companies in the space. Prior to joining QED,
Laura was an Engagement Manager at management consulting firm Oliver Wyman where she
advised large financial institutions on growth, product, operations, and strategy. Laura also
spent time at the World Economic Forum, leading an initiative focused on bringing better
financial infrastructure to emerging economies.
Interview with QED Investors (cont.)
Interview with Healthy Ventures
Prior to co-founding Healthy Ventures in 2015, Anya led strategy and business
development for Cardinal Health’s Hospital Sales and Services businesses. She was also
previously an investor at Thomas, McNerney & Partners, where she focused on life
sciences and the emerging digital health sector. Before entering the investing arena,
Anya held sales and marketing leadership roles at Medtronic. She also helped
implement HIV/AIDS programs for The Clinton Foundation, consulted with McKinsey and
worked as part of the Piper Jaffray biotech equity research team.
Interview with Healthy Ventures (cont.)



Interview with Oliver Wyman
Parie is a Partner within Oliver Wyman’s Health and Life Sciences practice. She specializes in playing
at the seams between payer and provider organizations and has helped multiple clients set strategies
covering broad-reaching efforts like growth into new markets, expansion into new populations and
large scale transformations. As the healthcare payment space has evolved (e.g. value-based care,
revenue cycle management in the environment of high deductible health plans, etc.), Parie has
advised clients on how to develop strategies around payment transformation, integrate companies
that utilize AI/machine learning, monitor fraud, waste and abuse, and develop solutions that ease the
path for healthcare consumers.
Sarah is a Principal within Oliver Wyman’s Health and Life Sciences practice. She spends most of her
time working with health insurers - both in the US and in international markets - on growth strategies
and business transformation. She has looked at healthcare payments from both the payer and service
provider side, and understands the hassles that consumers, payers, and providers face today. She
frequently advises clients on both innovation in the payments space, as well as on navigating the
challenges and complexity of the current infrastructure supporting the system.

Interview with Oliver Wyman (cont.)





Interview with PNC Healthcare
Mary Butler-Everson is Senior Vice President of Healthcare Product Innovation, part of Treasury
Management services at PNC Financial Services. Mary and her team are responsible for
identifying, developing and launching new products and services to continually advance the
fluidity, transparency and security of data and dollars movement for our clients and the
healthcare industry. Prior to joining PNC Healthcare, Mary served as Senior Vice President/
Chief Strategy & Brand Officer for a national life and health insurance company. Before making
the move to financial services, Mary spent nearly two decades working in health systems
leading strategy, business development, M&A, as well as direct patient care services.
Laurie Olender is the head of Healthcare Product Management and Operations for PNC
Treasury Management. In this role, she is responsible for managing PNC Healthcare’s
clearinghouse services and patient-centric solutions. She focuses on executing PNC’s
healthcare strategy and product roadmap, including helping improve the healthcare
ecosystem by connecting payers, providers and patients through leading-edge
payment solutions.

Interview with PNC Healthcare (cont.)



•
•

FT Partners / QED (1) AccessOne Report: COVID-19 Consumer Survey, 2020 114

PNC is a registered mark of The PNC Financial Services Group, Inc. (“PNC”).
All other trademarks are the property of their respective owners.
Banking and lending products and services, bank deposit products, and treasury management services, including,
but not limited to, services for healthcare providers and payers, are provided by PNC Bank, National Association, a
wholly-owned subsidiary of PNC and Member FDIC.
©2020 The PNC Financial Services Group, Inc. All rights reserved.

Interview with TransUnion
Evan Goad is the General Manager of TransUnion’s Patient Experience business, which
includes TransUnion’s front-end revenue cycle management and social determinants of health
solutions. Evan has been with TransUnion for nine years in various roles, including Mergers &
Acquisitions, Investor Relations, Business Development and General Management. Prior to
TransUnion, he spent seven years at Sara Lee Corporation in progressive roles within Investor
Relations, Treasury, Corporate Development, Strategy and Mergers & Acquisitions. Evan lives
in Denver, Colorado with his wife and three kids. Evan holds an MBA from the University of
Chicago Booth School of Business, a B.A. in Economics from DePauw University, and is a
Chartered Financial Analyst with the CFA Institute.

Interview with TransUnion (cont.)


•
•
•
•
•
→ →

Interview with Rahul Gupta
Rahul has worked in the FinTech space for more than two decades. Most recently he was CEO of
RevSpring, a healthcare payments company, and before that he was at Fiserv for ten years where
he served as Group President of Digital Payments and Group President of Billing and Payments.
He also previously held management positions at eFund Systems (later acquired by FIS), i2
Technology, Summit Marketing, Fidelity Investments and PwC. He is currently a board member
and advisor to companies including Cardtronics, Zego and Nyca Partners.

Interview with Rahul Gupta (cont.)

Interview with Rahul Gupta (cont.)

Interview with AxiaMed
Randal Clark, Co-founder, CEO and President, is the chief strategist and vision-architect for AxiaMed.
AxiaMed’s primary mission is to build technology solutions to serve the healthcare industry. AxiaMed
started as an idea born out of nearly 20 years of payment industry experience. With a large percentage of
clients in the healthcare vertical, Randal saw a huge need for an integration-driven payments company
that would serve the unique demands of the healthcare industry. Randal has built successful payment
companies, founded and oversaw a private, college-preparatory Christian school, and supports a number
of non-profits and businesses, including orphanages in South Africa. He invests in ideas, charitable
causes, technology, and most of all great people and corporate cultures. Randal earned his BS in
Marketing and Management from DePaul University in Chicago, Illinois.

Interview with AxiaMed (cont.)




Interview with BillingTree
Chris’ extensive career in FinTech and Payments spans nearly 35 years. She has worked in many
facets of the Payments industry for several companies such as Moneris, Vantiv (now Worldpay),
National Processing Company, Bank of America and Mastercard. Her areas of expertise include
Executive Management, Product Management, Mergers & Acquisitions, Operations, Sales and Account
Relationships. Chris has been a leading member of Wnet board nearly since its inception and served
as President. Chris sits on the Board of Directors for the ETA (Electronic Transactions Association)
and has been elected the incoming President for the upcoming term.

Interview with BillingTree (cont.)
•
•
•
•
•
•
•
•
•
•
•
•


Interview with CareCredit
Alberto “Beto” Casellas brings nearly 30 years of experience to his role as EVP & CEO for CareCredit. In this
role, he oversees the strategic direction of CareCredit to become a comprehensive healthcare financial
solution and the nation’s leading brand for health, wellness and personal care financing. CareCredit is part
of Synchrony Financial (NYSE: SYF), a premier Fortune 200 consumer financial services company and the
largest provider of private label credit cards in the U.S. Prior to his current role, Beto served as EVP & Chief
Customer Engagement Officer at Synchrony. He has also held leadership assignments in the Retail Card
Client Initiatives Group, Sales, Operations, P&L and e-commerce across various businesses throughout GE.
Beto received a Bachelor of Arts degree in economics from Yale University. He is the Executive Sponsor for
Synchrony’s Hispanic Network and serves on the Board of Directors of Domus Kids.

(2)
CareCredit Payment Benchmark Study with Enrolled Providers, conducted by Chadwick Martin and Baily, December, 2017
Federal Reserve Board, Report on the Economic Well-Being of U.S. Households in 2018, May 2019 134
* Subject to the representations and warranties in your agreement with CareCredit including but not limited to only charging for services that have been completed or that will completed within 30 days of the initial charge, always
obtaining the patient’s signature on the in-office applications and the cardholders’ signature on the printed receipt.
Interview with CareCredit (cont.)
FT Partners / QED (1) CareCredit Generational Health Research Study, Q3 2018

135

FT Partners / QED (1) CareCredit Cardholder Engagement Study Q2 2019

137

FT Partners / QED (1) Mastercard Consumer Polling Data, April 2020.

139
Interview with Cedar
An accomplished entrepreneur and former physician, Florian now drives growth and sets overall
direction across all facets of Cedar’s operations. Prior to founding Cedar, Florian was an executive at
Zocdoc where he drove the commercial adoption of the platform. Florian also founded a daily deal
company in Brazil (ClubeUrbano) that was eventually acquired by Groupon. After the acquisition, he
became CEO of Groupon Brazil, growing the company to one of Groupon’s top three international
markets. Florian began his business career as a strategy consultant at McKinsey & Company within their
healthcare practice. Florian holds a M.D., D.D.S. and PhD from the University of Freiburg, Germany.

Interview with Cedar (cont.)






Interview with Codoxo
Dr. Ahmed is the CEO and Founder of Codoxo. Codoxo’s patented technology was developed
as a part of his PhD dissertation at Georgia Institute of Technology. A report by the JASON
advisory group, the prestigious scientific advisory panel to the US government, reinforced that
his doctoral research tackled some of the biggest challenges within the emerging health data
infrastructure in the United States. Dr. Ahmed has been interviewed by several media outlets
such as NBC/11Alive, WSB-TV, CBS46, Business RadioX and Georgia Health News for his work
in healthcare fraud detection.

Interview with Codoxo (cont.)





Interview with Decent
Decent’s CEO Nick is a serial entrepreneur who loves people and culture and growth. He scaled
his first company to millions, Reveal Chat, and sold it to Napster in 2015. He also previously
worked at Amazon as Senior Product Manager building the Kindle and he was part of the
growth team at Gusto. He started Decent after recovering from paralysis because he believes
affordable healthcare will help more people do what they want to do. Nick received his BA from
Stanford and his MBA from Harvard.

Interview with Decent (cont.)

Interview with Decent (cont.)

Interview with Flywire
John brings more than 20 years of experience to his role as Executive Vice President of
Healthcare. Prior to joining Flywire, John was co-founder and CEO of OnPlan Holdings
(acquired by Flywire), which launched healthcare’s first automated payment plan solution, and
a next generation student tuition management solution for education. John also co-founded
HealthCom Partners in 2001, which sold to McKesson in 2006 as the first acquisition to form
RelayHealth, John led the patient billing and payment business at RelayHealth for five years
before launching and leading the healthcare vertical for doxo, a multi-biller payment network.

Interview with Flywire (cont.)







Interview with Health iPASS
Imran is the Chief Operating Officer at Health iPASS. Prior to joining Health iPASS, Imran was a
Partner at OCA Ventures, helped co-found MouseHouse an iPad and web application for life
sciences research, and worked in Mobile Strategy and Operations at PayPal – specifically
focused on PayPal Here, PayPal's entry into the small business mobile payment systems
market. He also founded Edit Huddle, a crowdsourced blog and newspaper editing tool, and he
began his career at William Blair in investment banking.

Interview with Health iPASS (cont.)




Interview with Oscar
Mario is Co-Founder and CEO of Oscar Health, a consumer-focused health insurer

founded in 2012 and headquartered in New York City. He has utilized his background in
technology and data to help humanize and simplify the healthcare experience. He
previously co-founded the largest social gaming company in Latin America, Vostu, and
worked as a Senior Investment Associate at Bridgewater Associates. He began his
career as a consultant for McKinsey & Co. in Europe, the US and Brazil.

Interview with Oscar (cont.)




Interview with Patientco
Bird Blitch is the CEO and co-founder of Patientco, a next-generation patient payment technology
company. Under Blitch’s leadership, Patientco achieved HFMA’s Peer Review designation and the
Company now facilitates more than $1 billion in transactions annually between patients and
providers across the country. Blitch currently serves as an Advisory Board member of Georgia Tech's
Advanced Technology Development Center (ATDC), a growth accelerator that helps technology
entrepreneurs launch and build successful companies. He has also served as Chair, Board of
Trustees for the Georgia Tech Alumni Association (2018 - 2019) and as chairman for the HIMSS
Revenue Cycle Improvement Task Force.

Interview with Patientco (cont.)








Interview with Payspan
Rob joined Payspan in 2015 to lead the Company’s execution of growth and
expansion strategies. Rob has previously served in the roles of chief operating
officer, chief service officer and general manager for Fortune 500 and privately
held SaaS companies. He has experience in supply chain automation, benefit /
consumer-driven healthcare administration, and online banking and payments.

Interview with Payspan (cont.)





Interview with PrimaHealth Credit
Brendon is an experienced entrepreneur and operator who has founded and led
several high growth technology and healthcare service companies including,
Salesmation, Elite Smiles, and MediaShift. His previous experience, building a medical
services organization that managed orthodontic offices in Southern California,
developed his point-of-view on elective care finance and highlighted the opportunity to
disrupt the space with innovative technology and financial products.

Interview with PrimaHealth Credit (cont.)



Interview with REPAY
John Morris co-founded REPAY in 2006 and currently serves as a member of the Board of
Directors and CEO. He has over 20 years of experience in the payments and FinTech industry.
Prior to REPAY, John served as the co-founder and president of Security Check Atlanta. John
also previously served in several corporate finance positions for Bass Hotels and Resorts
(now IHG). He began his professional career at KPMG where he earned his C.P.A. John holds
a Master of Accounting and a B.B.A. in Accounting from the University of Georgia where he
currently serves on the UGA Entrepreneurship Board.

Interview with REPAY (cont.)

Interview with REPAY (cont.)

Interview with Rivet Health
Ted is the Co-Founder and CEO of Rivet. Rivet elegantly decodes the complexities of
healthcare insurance easy-to-use software so that provider practices, clinics, and surgery
centers can offer transparent, upfront pricing to their patients, and collect patient payments
fast. Before founding Rivet, Ted was Vice President of Sales at Canopy, a business with a
mission to modernize the tax industry. He also previously served as a sales executive at
Instructure and he began his career in investment banking at Arbor Advisors.

Interview with Rivet Health (cont.)



Interview with Salucro
Clayton Bain is the founder and CEO of Salucro, a healthcare payment technology company
based in Phoenix, AZ. As an innovative technology leader, Clayton drives the Company’s
strategic vision, development, and technology partnerships while building international
relationships. In 2004 Clayton transformed his small web development company into one
of the leading healthcare fintech companies serving some of the largest names in
healthcare across the US, Canada, UK, UAE and India.

Interview with Salucro (cont.)





Interview with Sphere
Andrew has more than 25 years of experience in the legal, banking and financial technology
sectors. Previously, he was one of the original founders and architects of the recapitalization of
TransFirst Holdings, Inc., where he served in numerous executive roles. During his 14 years at
TransFirst, Mr. Rueff served as VP of Mergers and Acquisitions, Secretary of the Board, General
Counsel, Chief Administrative Officer and SVP of Corporate Development. Mr. Rueff currently is an
Operating Partner at Waud Capital and serves on the Board of Integrated Practice Solutions (IPS)
and CyberGrants and is Executive Chairman of Sphere Payments.

Interview with Sphere (cont.)








Interview with VillageMD
Tim has spent his career creating and providing solutions to help providers bring a
different level of care and support to their patients in a variety of experiences
including running an IPA, a $3 billion Medicare Advantage plan, and a Population
Health business. His favorite part about coming to work is spending time with the
physician partners at the center of VillageMD’s model, and seeing where real
healthcare change happens.

Interview with VillageMD (cont.)



VII. Selected Company Profiles

Alignment Healthcare
Black Card
With a simple phone call, the personal concierge will
schedule doctor appointments, arrange transportation, and
CEO: John Kao
answer health care questions—24 hours a day, 7 days a
Headquarters: Orange, CA
week
Founded: 2013
24/7 Concierge Experience
• Alignment Healthcare has created a new model for health care delivery Dedicated ACCESS On-Demand Concierge team provides
that cuts costs and improves lives by unraveling the inefficiencies of around-the-clock access to services and personalized care
the current system to drive patients, providers and payers toward a programs, including in-home and telemedicine doctor visits,
common goal of wellness easy-to-access electronic health records and everything that
• The innovative data-management technology allows the Company to basic Medicare covers plus more
commit to caring for seniors and those who need it most: the
chronically ill and frail Real Time Information, 365 Days a Year
Proprietary data command center AVA™ (Alignment
• Alignment Healthcare provides partners and patients with customized
Virtual Application) provides doctors with real-time
care and service where they need it and when they need it, including
clinical coordination, risk management and technology facilitation reporting that allows them to make more informed
choices about patients’ health
Selected Transaction History
Date Type Size ($ mm) Investor(s) / Buyer(s)

Market Cap 09/21/21 $3.3 bn
$35.0
LTM High 06/21/21 $27.27
03/26/21 IPO $490 Public market investor(s) $30.0
LTM Low 09/15/21 $17.22
$25.0
Fidelity Management & Research
03/04/20 Series C 135 Company; T. Rowe Price; Durable $20.0
Capital Partners
$15.0
03/08/17 Growth 115 Warburg Pincus $10.0
Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21
04/28/14 Early Stage 125 General Atlantic
Sources: Company website, FT Partners’ Proprietary Transaction Database, PitchBook

Amino
CEO: David Vivero

Headquarters: San Francisco
CARE SEARCH SMART MATCH
Founded: 2013
• Amino provides a healthcare financial wellness platform that integrates

with existing healthcare benefits to help employees find, book, and pay for
high value care
• Patients can easily look up doctors and facilities using over 800
simplified search terms, and then be directed to care anywhere
in the country INTEGRATED BENEFITS APPOINTMENT BOOKING
• The Company combines its own claims data with quality measures, such
as Leapfrog Hospital Safety Grades, to highlight highly experienced, safe,
and affordable providers and facilities
• Amino is powered by a database of more than 12 billion health

insurance claims, which helps the Company identify high value
care settings and providers for any network
Selected Transaction History INSURANCE DASHBOARD HEALTH SAVINGS ACCOUNT

04/20/20 Later Stage VC $18 Undisclosed Investor(s)
Highland Capital
Management; Accel; Aspect
04/04/17 Series C 25 Ventures; Charles River Insurance Dashboard Health Savings Account
Ventures; Northwestern Mutal
Future Ventures Helps employees and their dependents Offers healthcare guidance and a
understand how much they’ve spent health savings account together in one
Charles River Ventures; Red towards their deductible and out-of- platform
10/20/15 Series B 12
Swan Ventures; Rock Health pocket maximum
04/20/14 Series A 7 Accel Partners; NFX

Sources: Company website, FT Partners’ Proprietary Transaction Database
Anagram
CEO: Jeremy Bluvol

Headquarters: Santa Monica, CA
Founded: 2014
o Calculate patient costs and your return
• Anagram (formerly Patch) provides real-time price transparency and o Submit claims digitally with almost no denials
insurance benefits processing
• Anagram’s solutions helps providers access out-of-networks benefits

for its patients o Real-time eligibility and coverage
• The Company serves independent practices in the ancillary market –
ophthalmologists, dentists, etc. – providing real-time health insurance
o Set your own price and discounts to support
benefits and eligibility from a variety of networks
cash pay patients
• Providers also have the option to create their own prices or offer
discounts for cash payments
o Track profitability of your business
Date Type Size ($ mm) Investor(s) / Buyer(s) ✓ Anagram customers on average receive an additional
ManchesterStory; Healthy $2,472 / month in each location from cash pay patients
Ventures; KEC Ventures;
Waterline Ventures;
03/04/20 Series A $9 ✓ Anagram customers on average help an additional 22
Synchrony Ventures; Rogue
Venture Partners; Launchpad patients per month after using Anagram’s software
Digital Health Accelerator
✓ Anagram has processed more than $55 million worth of

claims
Sources: Company website, Company press release, FT Partners’ Proprietary Transaction Database
Athenahealth
Medical Billing
Athenahealth’s medical billing and revenue cycle
management solution offers claims management, a
revenue cycle dashboard, appointment scheduling,
Chairman & CEO: Bob Segert patient check-in, and performance reporting
Headquarters: Watertown, MA
Electronic Health Records
Founded: 1997
A cloud-based medical records service that intuitively
organizes the patient visit and helps providers document
• Athenahealth provides healthcare IT services through cloud-based and faster and more accurately
mobile application products largely for smaller to midsize medical groups
and health systems
• Its services include revenue cycle and practice management, electronic Patient Engagement
health records, patient engagement, population health management, and Athenahealth’s patient engagement tools and services
include automated messages, a patient portal, call
care coordination
support, and tailored outreach programs
• The business services segment, which provides cloud-based
solutions and support to healthcare providers, generates 97% of
revenue Population Health
Helps manage risk through digestible data, care team
Selected Transaction History coordination, care gap identification, a mobile app, and
network-based knowledge analysis
Evergreen Coast Capital;
02/07/19 LBO $5,700 Care Coordination
Veritas Capital
With a network of over 160,000 providers, Athenaheath
09/20/19 IPO 113 Public Investors makes care coordination between internal an external
care teams and specialists easy and efficient
06/29/07 Corporate 23 PSS World Medical
ORIX Growth Capital; Aspect Epocrates

12/28/05 Series E 7 Ventures; Eastside Partners;
A top U.S. medical app used by over 1 million healthcare
The Lambda Funds
professionals worldwide that provides interaction
Oak Investment Partners; tracking, disease content, and practice tools
12/04/00 Series D 31 Venrock; Cardinal Partners;
DFJ

Availity
CEO: Russ Thomas

Headquarters: Jacksonville, FL
Founded: 2001
• Availity aims to solve the communication challenges between

healthcare stakeholders by creating a richer, more transparent
exchange of information among health plans, providers, and
Provider Solutions
technology partners
• Revenue Cycle Management
• Availity facilitates over 4 billion clinical, administrative, and financial
transactions annually
• Portal
• EDI Clearinghouse
• The Company’s suite of products enables real-time collaboration for
success in a competitive, value-based care environment Vendor Solutions
• Platform & Clearinghouse Solutions

Selected Transaction History • Supported Systems
• Supplier Code of Conduct
09/26/17 Growth na Francisco Partners Developer Solutions

Anthem; Humana; Health Care Service
• Healthcare APIs
Corporation; Blue Cross and Blue Shield
07/17/17 Debt $200
of Florida; Blue Cross and Blue Shield
Association Healthplan Solutions
03/17/09 Early Stage na Wellpoint Health Networks
• Provider Engagement Portal
• Intelligent Gateway
• Clinical Gateway

AxiaMed
Acquired by
Epic Integration
CEO: Randal Clark With Payment Fusion, Epic users can improve their financial performance
by accelerating patient payments and streamlining administrative
Headquarters: Santa Barbara, CA workflows
Founded: 2012 Point-of-Care
Collecting co-pays and balance due amounts from patients at the time of
• AxiaMed partners with independent software vendors (ISVs) to offer
service (or “point-of-care”) delivers numerous financial benefits to
secure patient payment solutions from within their healthcare applications
healthcare providers
• The Company’s integrated offerings help improve the financial
performance of healthcare providers by expanding the payment options Online and Mobile
available to patients, streamlining administrative workflows, and reducing
bad debt AxiaMed offers an “omnichannel” payment strategy, making it easier and
more convenient for patients to use their preferred method of payment,
• SaaS-based product, Payment Fusion, is a patient payments platform that anywhere, anytime
is integrated into leading EHRs, practice management systems, and
revenue-cycle management applications
Hospitals and Health Systems
• AxiaMed simplifies integration and accelerates time-to-market by
providing a single API that supports multiple processors, payment AxiaMed’s Payment Fusion technology platform was purpose-built to meet
methods, and transaction types the rigorous and complex demands of enterprise health systems
Merchant Services
AxiaMed offers a full suite of merchant services, including payment
Date Type Size ($ mm) Investor(s) / Buyer(s) gateways, payment processing, batch settlements, and reporting
04/02/21 M&A na Bank of America
Text&Pay + Scan&Pay
Health Enterprise Partners,
08/14/18 Early Stage VC $12
Nashville Capital Network Text&Pay Patient Payment Messaging is a secure solution that
automatically notifies patients via text and email when their bills are ready.
07/19/17 Early Stage VC 3 Nashville Capital Network Scan&Pay is a mobile solutions that uses QR codes that link to invoices or
online payment portals to enable patients to quickly and easily pay their
04/29/16 Corporate <1 i3 Verticals medical bills.
Bend
The Bend Advisor

The Bend Advisor leverages artificial intelligence and machine
Co-Founder & CEO: Tom Torre learning to recognize patterns and suggest optimizations. It
automates work, identifies qualified medical expenses,
Headquarters: Boston, MA supports and guides actions, learns with the user, and helps
maximize HSA benefits.
Founded: 2017
• Bend is a technology and services company that provides health savings

account (HSA) and financial wellness solutions to individuals, employers,
and organizations in the group benefits distribution market
• The Company's application allows users to keep track of expenses, User Transparency
contribute just the right amount into their HSA based on personal needs Experience 360-degree view of
and maximizes tax benefits, enabling users to manage their rising cost of expenses through links
Customized based on
healthcare to personal savings
individual activity
account
• Its platform learns individual behavior and situations, predicts
outcomes and delivers actionable advice that helps using
manage their health savings
• Bend also offers the Bend Advisor, which pulls data from other accounts,
such as checking, credit cards, payroll and health plans, to guide Simplify Education
customers every step of the way Simplifies HSA use and Reduces planning and
drives engagement education needs
06/19/19 Series A $10 Undisclosed Investors

Savings Reimbursement
12/21/17 Seed 4 RRE Ventures; .406 Ventures
Uses behavioral
Makes reimbursements
economics to nudge
simple and easy
savings

Bind
Core Coverage
• Bind is an on-demand health insurance company serving self-insured
employers with over 350 employees ✓ Preventative
Care Add-Ins
• Plans have $0 deductibles and members pay flat co-pays for a core ✓ Primary and ✓ Only if you need
set of medical services and prescriptions including primary and Specialty Care it
specialty visits, urgent care, maternity care and cancer treatments
✓ Urgent, ✓ Adjust as needs
• Bind also provides the option for on-demand “add-on” services which Emergency and change
Hospital Care
are paid for as an additional premium as needed (ie. hip replacement)
✓ Chronic Care
• The Bind app allows members to compare prices for different services
✓ Pharmacy needs
/ procedures showing the cost upfront.
Key Features
Selected Transaction History • No restrictions on pre-existing conditions

• No lifetime max coverage
Date Size ($ mm) Investor(s) / Buyer(s)
• $0 deductible
10/21/20 $105 Undisclosed Investor(s)
• Simple co-pays
Lemhi Ventures; Ascension Ventures; • Can purchase add-ins at any time through
02/20/18 70
UnitedHealth the year – no restrictive enrollment periods
07/26/17 3 Lemhi Ventures; Undisclosed Investor(s)

BillingTree
Acquired by
CEO: Christine Lee

Headquarters: Phoenix, AZ
Founded: 2003
• BillingTree is a provider of omni-channel, integrated payments processing Payrazr Portfolio CareView

services
With Payrazr’s omni-channel From on-site POS payments, to
• The Company’s business model includes developing strategic alliances
with service, software, billing, and telephone service providers
payment platform, users can phone or mobile payments, to
accept more payments via the complicated post-care patient
• BillingTree’s Payrazr platform is a one-stop resource for fully compliant customer’s preferred channel payment plans, the CareView
omni-channel payments that provide customers the multiple options they and device, all through platform vastly improves the
need to make payments faster, easier and more frequently BillingTree overall patient experience
• For the Healthcare industry, BillingTree provides HIPAA-compliant
solutions for collecting onsite and post-care payments when, where, and
how the patient prefers to pay, as well as easy-to-activate patient payment
plans
− Provides payment services to hospitals, medical practices,

pharmacies and dental offices
Date Type Size ($ mm) Investor(s) / Buyer(s) 2-Way Text Payments Account Updater
05/10/21 M&A $503 REPAY

2-Way Text Pay is a technology Payrazr Account Updater works
04/18/18 Debt na Barings tool that enables consumers to to eliminate missed payments
make payments via text due to cards expiring, being
10/04/16 Buyout na Parthenon Capital Partners
messaging cancelled or re-issued
06/19/14 Debt na Comerica Bank

Bright Health
CEO: Mike Mikan

Headquarters: Minneapolis, MN
Individual Plans Family Plans Medicare Advantage
Founded: 2015
✓ Fully Coordinated Care ✓ Preventive Care & Prescription Drug
• Bright Health partners with health systems and care partners to provide ✓ Predictable Premiums & Out-of-Pocket Coverage
health plans and a connected healthcare experience to support Costs ✓ Curated Network of Doctors, Clinics &
relationships between consumers and care providers using personalized Hospitals
technology
• The Company’s Care Partner Health Plan Model works in narrow network
• Bright Health plans are currently available in 22 markets in 12 states
arrangements to remove difficulty between payers and providers including Alabama, Arizona, Colorado, Ohio, Tennessee, & New York via its
• On June 23, 2021, the Company went public on NYSE under the ticker website, call center, broker partners and through government websites as
“BHG” raising $924 million in gross proceeds well as public health insurance exchanges

• In 2021, Bright Health plans will be available in Florida, North Carolina, and
Date Type Size ($ mm) Investor(s) / Buyer(s) Illinois, and in some markets, Bright Health will begin offering employer-
The Blackstone Group; Tiger Global; T. Rowe Price; sponsored plans
09/22/20 Series E $500 NEA; Greenspring Associates; Bessemer Venture
Partners
NEA; Bessemer Venture Partners; Cross Creek

12/17/19 Series D 635
Advisors; Declaration Partners; Flare Capital Care Partners
Partners; Greenspring Associates; Meritech Capital;
Redpoint Ventures; Town Hall Ventures
Declaration Partners; Meritech Capital Partners;

Bessemer Venture Partners; Cross Creek Advisors;
11/29/18 Series C 200 Flare Capital Partners; Greenspring Associates;
Greycroft Partners; NEA; Redpoint Ventures; Town
Hall Ventures
Greenspring Associates; Greycroft Partners;

06/01/17 Series B 160 Redpoint Ventures; Cross Creek Advisors; NEA;
Bessemer Venture Partners; Flare Capital Partners
Bessemer Venture Partners; NEA; Flare Capital

04/06/16 Series A 80 Partners

CareCredit
Owned by
CEO: Alberto Casellas

Headquarters: Costa Mesa, CA
Founded: 1987
Payment Pay a Doctor or
Mobile App
Calculator Provider
• CareCredit, a Synchrony solution, is a healthcare credit card offering

promotional financing to consumers for health, medical, veterinary and How to Apply
personal care procedures, services and products
• Instant approvals, no activation fee, and no need to re-apply
• The CareCredit credit card offers special financing options with
convenient monthly payments, and ensures that providers get paid in two • Apply online using online form
business days
• Apply by phone with a live agent or with an automated application
• CareCredit is accepted at more than 240,000 locations for a wide variety of
health and wellness procedures, treatments, products and services system
• With over 12 million cardholders, CareCredit helps consumers complete

recommended treatment plans and reach their health and wellness goals
Promotional Financing
Partners
1 No Interest if Paid in Full within 6, 12, 18, or 24 Months
Reduced APR and Fixed Monthly Payments Required Until

2 Paid in Full
• Purchases of $1,000 or more may be eligible for a 24 months offer
with a 14.90% APR, a 36 months offer with a 15.90% APR or a 48
months offer with a 16.90% APR.
• Purchases of $2,500 or more may be eligible for a 60 months offer
with a 17.90% APR.
Sources: Company website

CarePayment
For Patients
CEO: Craig Hodges

Headquarters: Nashville, TN
Founded: 2004
• CarePayment partners with healthcare providers to dramatically

Register for Online Find a Provider Make a Payment
improve their financial health by offering 0.00% APR financing to
Services
their patients
Sponsored by Pay securely online,
Manage medical
• The Company’s solution helps patients meet their financial healthcare providers with automatic
expenses online
obligations and protect their financial health, while helping nationwide and payments, by mail, or
providers stay financially healthy by reducing bad debt and serves thousands of over the phone
improving cash flow
patients
• CarePayment is available in more than 2,000 locations across For Providers

the U.S.
08/07/17 Debt $90 Comvest Capital Co-Branded Patient Significantly Increase Compliance and
Engagement Net Collections Consumer Finance
03/13/17 Buyout na
Cedar Springs Capital; Crestline Expertise
Investors
02/11/15 Debt 100 Wells Fargo
05/13/14 Debt 60 Bank of America Merrill Lynch
Patient-Friendly Eliminate Financial Tailored to Revenue

Payment Options Risk Cycle

Castlight Health
Castlight Complete
Comprehensive health navigation helps

employees improve their health journey,
whether they are healthy, managing a
condition or actively seeking medical care
CEO: Maeve O’Meara
Care Guidance Navigator
Headquarters: San Francisco, CA
Founded: 2008 Castlight Care Guidance allows employers
to empower employees to make better
healthcare decisions, demystify available
• Castlight Health’s mission is to make it as easy as humanly possible to benefits, and engage in the right programs
navigate healthcare and live happier, healthier, more productive lives at the right time
• The comprehensive health navigation platform guides users to their best Wellbeing Navigator
available healthcare resources, resulting in lower healthcare costs, higher
engagement, and improved outcomes Wellbeing Navigator instantly connects
employees to the enterprise vendors
• Through the unique combination of hundreds of health data integrations and
employers already offer, best-of-breed
machine learning that leverages its data to personalize the user experience, partners from the Ecosystem, and apps and
Castlight simplifies healthcare for 20 million users wearables employees use every day

Market Cap 09/21/21 $255 mm
Date Type Size ($ mm) Investor(s) / Buyer(s) $3.0 LTM High 06/30/21 $2.63
$2.5
05/18/16 PIPE $18 SAP Software Solutions $2.0
LTM Low 11/03/20 $0.80
$1.5
03/14/14 IPO 178 Public Investors
$1.0
$0.5
05/01/12 Series D 100 T. Rowe Price
$0.0
Maverick Capital; Oak Investment
Partners; Venrock; Morgan Stanley
06/11/10 Series C 60 Investment Management; The Cleveland
Clinic; Welcome Trust; US Venture
($ in mm) FY 2018 FY 2019 FY 2020
Partners
Maverik Capital; Oak Investment Revenue $156 $143 $147
09/04/09 Series B 17
Partners; Venrock; Fidelity Investments
Adj. EBITDA (33) (35) (6)
Net Income (40) (40) (62)
Sources: Company website, FT Partners’ Proprietary Transaction Database, PitchBook, Cap IQ
Cedar
The Cedar Suite is an end-to-end solution

Co-Founder & CEO: Florian Otto o Self-service check in and registration
Headquarters: New York, NY
o Communicates price estimates
Founded: 2016
o Pre-visit collections for copays
• Cedar provides a patient payment platform intended to offer a smarter
way for hospitals, health systems and medical groups to manage the
patient payment ecosystem Cedar Pay provides personalized patient billing
• The Company's platform delivers modern intelligence to improve billing
o Personalized outreach through text, email
operations and ensures a personalized billing experience for patients
and ringless calls
− The platform combines data science and machine learning to
o Easy-to-understand statements
connect patients with healthcare providers
• Plain language billing code
• It enables healthcare givers to consolidate billing information across
descriptions
multiple caregivers, while also delivering clear invoices on what patients
owe, with personalized click-to-pay options • Visit-level statements with
explanation of coverage
Through Cedar
providers
30% 70% 88% • Consolidated statements for families
Increase in Digital self-service
experience… Patient Satisfaction o Advanced bill resolution includes
collections payments
• Denial alerts and insurance capture
• Live chat for real-time support
• Self-select payment plans
Tiger Global; Andreessen Horowitz; Thrive
03/09/21 Series D $200
Capital; Concord Health Partners o Flexible payment methods and auto posting
Andreessen Horowitz; Kaiser Permanente and reconciliation
Ventures; Kinnevik; Thrive Capital; Lakestar;
06/22/20 Series C $102*
Founders Fund; JP Morgan Chase & Co; • Credit / debit cards
Concord Health Partners
• ACH debit
Kinnevik; Founders Fund; Thrive Capital;
06/26/18 Series B 36
Lakestar; Sound Ventures; Miroma Ventures • Apple Pay and Google Pay
Martin Ventures; Founders Fund; Thrive Capital;
12/06/17 Series A 13
SV Angel
FT Partners / QED * Includes $77 mm of equity financing and $25 mm of debt 233
Centivo
For Employers
CEO: Ashok Subramanian Centivo connects every family with a

dedicated Primary Care Team, led by a
Centivo Select physician, and nurture
Founded: 2017 that partnership. The company offers
employers cost savings, full
• Centivo offers a type of health plan that allows self-funded employers and transparency, and a happier and more
clinicians to join forces and deliver high quality, affordable healthcare to productive workplace.
their employees
• Centivo offers the technology, network, claims processing, customer

support, and population health management to fully administer health For Employees
benefits for all or a portion of an employee population
• The Centivo model emphasizes the partnership between individuals and The Centivo Partnership Plan is designed
their primary care team as the proper model to coordinate healthcare needs to help people use the healthcare system
more effectively and offer them
• Members are rewarded for working with their primary care team and affordable healthcare. The platform
choosing high-value care and are supported through a user-friendly app and offers affordable care, predictable costs,
their concierge care and guidance, and an easy to use
plan.
Date Type Size ($ mm) Investor(s) / Buyer(s) For Providers

Bain Capital Ventures, F- Centivo Select providers act as the go-to
Prime Capital; Maverick destination for care and help members
Ventures; Bessemer Venture
07/18/18 Series A $34 navigate the healthcare system. They are
Partners; Ingleside Investors;
Rand Capital; Grand Central rewarded with increased compensation,
Tech; Oxeon Partners less bad debt and tedious admin work,
informed patients who share financial
07/12/17 Early Stage na Grand Central Tech incentives, and a respected business
partner.

Change Healthcare
CEO: Neil De Crescenzo

Founded: 1986
• Change Healthcare (NAS: CHNG) is a healthcare technology platform that

provides data and analytics solutions to improve clinical, financial, and
network solutions that help drive improved results for healthcare payers and
providers
• Change Healthcare was formed through the merger of McKesson
Technology Solutions and Change Healthcare (formerly emdeon) in
2017
• The Company’s solutions are designed to improve decision making, simplify
billing, collection and payment processes, and enable a better patient
experience
• On January 6, 2021, Optum announced it has agreed to acquire Change
Healthcare for $13 billion Selected Transaction History
$30
$25
$20 06/27/19 IPO (NAS) $641 Public Market Investors
$15
LTM High 01/08/21 $24.14
$10 06/28/16 Acquisition 4,450 McKesson
$5 LTM Low 07/09/20 $10.00
$0 11/02/11 Acquisition 2,070 The Blackstone Group
08/11/09 IPO (NYSE) 367 Public Market Investors

FY 2019 FY 2020
($ in mm)
(Ends 3.31.19) (Ends 3.31.20) 11/16/06 LBO 1,200 General Atlantic
Revenue $3,282 $3,303
Kleiner Perkin Caufield & Byers;
Adj. EBITDA 935 996 03/04/04 PE Growth 100
PCG Capital Partners
Net Income 177 (6)
Sources: Company website, FT Partners’ Proprietary Transaction Database, Cap IQ
ClearGage
Products
CEO: Chip Hunziker AutoPay Interactive Voice QuickPay

Headquarters: Tampa, FL Securely store patients’ Response Connect on-the-go and
payment information in PCI Automate patient get paid faster by
Founded: 2009 compliant payment vault and, payments by using allowing patients to pay
with their consent, use to interactive voice their bills from their
automate and collect future response smartphone or tablet
• ClearGage has developed innovative healthcare payment solutions and payments
financial services that employ revenue cycle technology that are HIPAA and
PCI compliant
• The Company is bringing proven retail payment solutions to the healthcare HealthePayment ClearFund ClearCalc
market and simplifying the process of calculating and collecting patient Allow patients to make Sell patient receivables Calculate patients’ out-of-
payments when convenient and get paid upfront pocket expenses with
payments
through a fully customizable greater accuracy
• ClearGage’s mission is to enhance the consumer’s quality of life by providing practice branded portal
flexible and ethical payment solutions that enable them to receive and pay
for the health care products or services they need or want
Solutions
Patient Financing Patient Engagement

Help patients get access to Build a stronger practice
healthcare services without and nurture patient
waiting to get paid and relationships with a smart,
provide quick and flexible innovative patient
financing engagement platform
Chip Hunziker John Zdanowicz Rashawn Allen
CEO & Founder COO & Chief Revenue
Co-Founder Officer
Patient Payment Tools Patient Estimation
Grow practice with payment Empower patients to
tools built to increase cash understand their financial
flow and to accelerate the responsibility with
revenue cycle accurate, upfront cost
Jim Connor K. Travis Berry
estimates
Chief Technology Officer General Counsel & Chief
Compliance Officer
Clover Health
With Clover Plans, every member gets their own

CEO: Vivek Garipalli Personal Care Team

Nurse Practitioners Customer Experience
Founded: 2012 ■ Visit your home and do check-ups to ■ Help to coordinate members with
make sure you're healthy and safe available services and work to ensure
■ Follow up after hospital visits and members have a great experience with
procedures to speed up recovery Clover
• Clover Health is a Preferred Provider Organization (PPO) with a Medicare
■ Answer questions about bills or
contract coverage, whenever you need help
• The Company utilizes patient-centered analytics and dedicated care
management to better prevent illness and help seniors Clover Plan Core Benefits
• Like Medicare, Clover offers coverage to see any doctor and visit any ■ 24/7 Access to Doctors: If you’re not feeling well, you can speak to a board-certified
hospital, but also includes prescription coverage with $0 generic doctor 24 hours a day, 7 days a week by phone, video call, or mobile app
prescriptions ■ Dental, Vision, & Hearing: Plans include routine dental, vision, and hearing exams for
as little as $0, plus allowances for glasses or contacts and hearing aids
• In October 2002, Clover announced it is merging with SPAC, Social Capital ■ Gym Membership: Free membership to 13,000 gyms and fitness centers
Hedosophia III, through which it will become a public company
■ Mail Order Pharmacy: Save time (and often money) by having 100-day refills of your
prescriptions delivered directly to your home instead of making multiple trips to the
Selected Transaction History pharmacy

10/06/20 M&A $3,700 Social Capital Hedosophia III (SPAC)
Late Stage
01/29/19 $500 Greenoaks Capital Management Market Cap 09/21/21 $3.3 bn
VC
Greenoaks Capital Management, Palm LTM High 01/08/21 $15.90
05/11/17 Series D 130
Drive, GV, Sequoia, WTI, First Round $22.0 LTM Low 05/17/21 $6.82
GreenOaks Capital Management, AFIG

Funds, First Round, Spark Capital, Nexus $17.0
Venture Partners, AME Cloud Ventures,
04/26/16 Series C 160
Arena Ventures, Sequoia, Floodgate, $12.0
Wildcat Venture Partners, Casdin
Capital, Refactor Capital
$7.0
Wildcat Venture Partners, Sequoia,
08/20/14 Series B 35
Arena Ventures, Athyrium, First Round
$2.0
09/08/15 Series A 13 First Round Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21

Codoxo
CEO & Founder: Musheer Ahmed

Headquarters: Atlanta, GA
Founded: 2018
• Codoxo is an AI-assisted platform that accelerates the identification of

fraud, waste, and abuse
• The Company’s comprehensive claims investigation platform utilizes proven

and patented AI-based technology to empower investigators and analysts to
derive insights and conduct full investigations of suspect claims
The platform contains an intuitive, easy-to-use tools suite and AI-assisted solutions for…
integrated workflow and case management that supports
collaboration and sharing across the organization • Managed Care Plans • Union-sponsored Plans
• Codoxo’s patented technology was developed as part of Musheer Ahmed’s • Medicaid Agencies • Provider-sponsored Plans
Ph.D. dissertation at the Georgia Institute of Technology
• Employer-sponsored Plans • Federal Agencies

QED Investors; Brewer Lane
Ventures; GRA Venture Fund;
07/02/20 Series A $7
Mosley Ventures; Spider
Capital; TechSquare Labs 1
93%
Spider Capital; GRA Venture billion
05/01/19 Seed na Fund; Mosley Ventures;
$500
TechSquare Labs
72%
06/21/18 Early Stage <1 Undisclosed Investors Claims processed million Reduction in false
by AI positives
Spider Capital; GRA Venture
Fund; TechSquare Labs; Identified savings Increase in
06/15/17 Seed 2
Mosley Ventures; Service by Codoxo productivity
Provider Capital Fund
Collective Health
HOW IT WORKS
One Connected System

CEO: Ali Diab Combines networks across medical, dental, vision, and pharmacy
benefits, core HR, and an open ecosystem of point solutions into one
integrated system
Founded: 2013
Financial Management & Payments
• Collective Health provides a cloud-based self-insurance platform for Adjudicates claims, manages eligibility, and data sharing across health
businesses programs and automatically reconciles and processes partner
payments
• The Company enables integrated administration of health plans through a
single portal for employers and helps guide and support employee access to Program Optimization
benefits options
Comprehensive web and mobile app, advocacy support, EOBs that
Selected Transaction History actually make sense, and data-driven, proactive messaging
Date Type Size ($ mm) Investor(s) / Buyer(s) Performance Measurement

Health Care Service Corporation; DFJ
Growth; Founders Fund; G Squared; Integrated analytics, predictive intelligence, and live performance
05/04/21 Series F $280 Maverick Ventures; NEA; PFM Health dashboards provide visibility into how programs are impacting
Sciences; SoftBank Vision Fund; Sun Life
employees every day
SoftBank Vision Fund; PSPIB; DFJ Growth;
G Squared; Founders Fund; GV; Maverick
06/17/19 Series E 205 Ventures; Mubadala Ventures; NEA; Sun By the Numbers
Life Financial
02/28/18 Series D 110

NEA; Founders Fund; GV; Maverick
Ventures; Sun Life Financial; Mubadala 2-3% 70s 60%
Ventures
Annualized medical Net Promoter Score, Reduction in
04/15/16 Growth 30 Undisclosed Investors
trend, compared to compared to industry employee questions
GV; NEA; Founders Fund; Maverick Capital; industry average of 5% average of 8
10/20/15 Series C 81 Redpoint Ventures; RRE Ventures
Formation 8; Redpoint Ventures; RRE 140 2 – 4x 600

03/18/15 Series B 38 Ventures; Subtraction Capital; Rock Health;
Founders Fund; NEA
Health Increase in program Successfully enabled
Signatures Capital; Citizen.VC; Undisclosed partnerships today partner engagement integrations
01/31/14 Series A 6 Investors

Cotiviti
Payment Accuracy Solutions

Unlocks value, increases efficiency, and improves
performance. Services include clinical validation, billing
accuracy, contract compliance, payment responsibility, clinical
President & CEO: Emad Rizk chart validation, and fraud, waste, and abuse solutions
Founded: 1979 Risk Adjustment Solutions
Ensures compliant, accurate compensation for members’ risk
burden. Services include suspect analytics, medical record
• Cotiviti provides risk assessment and decision analytics services to the retrieval, in-home assessments, medical record coding, and
global healthcare industry submissions
• The Company leverages data analytics and technology to limit costs and
ensure regulatory compliance for various stakeholders in the healthcare
Quality and Performance Solutions
industry, including payers, providers, and employers
Analyzes, communicates, and improves clinical and financial
• It works with over 180 healthcare payers, including 96% of the top performance. Services include quality intelligence, star
25 plans navigator, medical record retrieval and abstraction, medical
intelligence, DxCG intelligence, and network value
• Cotiviti also services the retail industry, providing audit and recovery
services that increase efficiency and maximize profitability
Retail Solutions
Finds and prevents losses while improving supplier
relationships. Services include merchandise payables,
Selected Transaction History pharmacy, freight, activations, expense payables, statements,
and contract compliance
Verscend (combined entity

08/27/18 Merger $4,900
operates under Cotiviti brand)
05/25/16 IPO 238 Public market investors

>$7 bn 51% >$2 bn
In annual medical cost Of Cotiviti’s quality clients In incremental Risk
savings in Payment are 4 stars or higher Adjustment revenue
Accuracy alone across Medicare clients

Decent
CEO: Nick Soman Pathfinder Bronze Plan

Headquarters: Austin, TX For those looking for a higher-deductible,
higher out-of-pocket plan that has lower
Founded: 2018
premiums, the Pathfinder bronze plan is
the most affordable option.
• Decent provides affordable health insurance plans for freelancers and self-
employed people, with year round open enrollment
• The Company offers EPO plans (“Exclusive Provider Organization”)
• Decent patients get unlimited access to same-day appointments with
primary care physicians and 24/7 telehealth services, with $0 out of pocket
payments
• Decent is currently administering plans in Austin, TX, with plans to expand to
Lonestar Bronze Plan
more cities
The Lonestar bronze plan is one of the
first of its kind, a bronze plan without a
medical deductible that gives out access
to copays on day one.
Nick Soman Richard Luck Molly Moore

Trailblazer Silver Plan
CEO COO Chief Health Plan
Officer
This plan is designed specifically for
freelancers to be affordable,
comprehensive, and easy-to-understand.
In addition to free primary care, users
enjoy low or no copays for care before
they’ve hit their deductible.
Korina Stark Chris Boscolo Ryan Scott
VP of Product VP of Engineering VP of Operations

Devoted Health
Compare Plans
CEO: Ed Park
Platform with assistance for finding and comparing
Headquarters: Waltham, MA different plans
Founded: 2017
Look Up Doctors
• Devoted Health is an online provider of Medicare Advantage plans; the
Company partners with providers and brokers to streamline the entire
Search nearby doctors, pharmacies, or other healthcare
healthcare process
providers
• The Company tries to simplify the health insurance and care process by
working closely with physicians and other providers to help patients avoid
unnecessary procedures and treatment, while getting better overall care Look Up Drugs
• Founders Ed and Todd Park both have extensive experience in the Find out if Devoted covers your specific medications
Healthcare field:
• Todd Park: Co-founded Athenahealth and Castlight Health and

served as U.S. Chief Technology Officer under President Obama
Find Nearby Events
• Ed Park: Former Athenahealth CTO and COO
Find nearby events that provide information on Devoted
plans

How Medicare Works
Andreessen Horowitz; Premji Invest;
10/16/18 Series B $300 Uprising; Venrock; F-Prime Capital Detailed overview of Medicare and how it works as well as
Partners
how to shop for plans
Venrock; Todd and Ed Park; Oak
HC/FT; F-Prime Capital Partners;
10/06/18 Series A 62 NextView Ventures; Obvious
Ventures; O’Reilly AlphaTech Help Shopping
Ventures; Undslosed Investors
Devoted team member can help find the right product /
05/12/17 Early Stage 5 Venrock; Todd Park; Ed Park plan for customers over the phone

ECHO Health
✓ ECHO clients achieve “Day 1” electronic conversion

Founder & CEO: William Davis ✓ Immediate access to over 900,000 providers and
Headquarters: Westlake, OH vendors
Founded: 1997 ✓ Meets the requirements of HIPAA, OFAC, and IRS
1099
• ECHO Health was founded in 1997 by William Davis
− He developed a proprietary, patented payment system

✓ Manages all payment types through a single source
which now serves healthcare payers of all sizes
✓ Streamlines banking and data into a single access
• ECHO manages every aspect of payment processing from data point
import, disbursement, provider and vendor on-boarding,
compliance, reconciliation, and reporting ✓ Provider and vendor enrollment is completely
• Benefits of using ECHO include the elimination of costly bank fees, automated
real-time access of payment data, improved efficiency, and
enhanced compliance ✓ 99% client retention rate
• ECHO also serves the property & casualty and specialty insurance
industries
ECHO’s unique consolidation and electronic settlement
services reduce costs for payers throughout the United
States, processing more than 60 million claims and over
$23 billion in payments annually

Eligible
Patient Collections
• Estimate the cost of care for over 92% of the insured
population
Founder & CEO: Katelyn Gleason
• Improve patient experiences and collection rates by
Headquarters: Brooklyn, NY increasing transparency
• Simple API’s that provide advanced functionality
Founded: 2011
• Eligible provides a platform that streamlines insurance eligibility checks

for doctors and patients
Insurance Collections
• The Company's platform offers an online software for healthcare eligibility • Offers Claims.js, a Javascript tool to imbed standard
queries that seamlessly integrated with healthcare systems claims templates inside any web application
• End-to-end claims lifecycle management for creation,
− This enables doctors to process queries in real-time and validation, submission, and processing
provides real-time eligibility functionality from patient cost • Payment status polling once the claim has been accepted
estimations to denial scrubbing into adjudication
• Eligible’s customers process millions of cases per month resulting in

billions of dollars in healthcare services annually

EHNAC SOC II Compliant
Accreditation Measures operating
effectiveness of privacy controls
Naval Ravikant; Steve
Assures strictest compliance
04/14/16 Early Stage $25 Huffman; Drew Huffman;
with privacy and security
Undisclosed Investors
Y Combinator; QueensBridge
11/01/15 Early Stage 2 Venture Partners; Tiny Capital;
Fresco Capital
HiTrust CAQH CORE
AngelList; Y Combinator;
Certification Certification
01/24/13 Seed 2 S.A.W Capital Partners; Start Assures responsibility in Confirms ability to exchange
Fund; Fresco Capital protecting medical information electronic healthcare
information

Flume Health
CEO & Founder: Cedric Kovacs-Johnson

Founded: 2017
Members Employers
• Flume Health develops a healthcare application designed to address
healthcare related queries via a virtual assistant • Find high-quality, local providers • No increasing member deductibles
who offer fair pricing and premiums
• The Company's application includes private communication with a trained • Nominate doctor to Flume • Offers plans with sustainable costs
care guide, provides data to find quality medical care at the best price, also community • Allows employees to afford to use
books appointments and sets multiple reminders as the date approaches,
• Submit coordination of benefits their health benefits
enabling users to effectively find affordable medical providers to fit their
• Upload a medical bill • No open enrollment season
needs
• The Company’s payment platform, Flume Pay, allows employer plans to

pay medical claims at the time of services
− This reduces uncertainty and overall costs, and payments are

processed within 72 hours
• Flume Health offers services for both employers to manage their practice
and patients seeking additional information
Selected Transaction History Providers Advisors

• Get paid in full within 3 business • Integrate partner ecosystem to
Date Type Size ($ mm) Investor(s) / Buyer(s) days of submitting a claim manage health plan supply chain
Primary Venture Partners; • Waive all patient deductibles and • Access real time reporting to live
Accomplice VC; Founder coinsurance for members after a claims, eligibility, and partner data
05/02/19 Seed $4
Collective; Entrepreneurs small copay
Roundtable Accelerator
• View transparent fee structures
• Flume Members see practice as a
Entrepreneurs Roundtable $0 deductible provider option
01/08/18 Accelerator <1
Accelerator
• Easy sign up process

Flywire
✓ Present a consolidated bill across multiple accounts
CEO: Mike Massaro

✓ Leverage analytics to identify ability to pay
Headquarters: Boston, MA
Founded: 2009 ✓ Self-service payment plan offers
• Flywire (Nasdaq: FLYW) provides an online payment platform

✓ Advanced payment management allocates funds
designed to streamline the international and domestic payment
experience for businesses and institutions
✓ Simplifies the payments for international patient
− The Company's platform fully reconciles global payments
and offers scope for global refunding while keeping all
parties updated throughout the process ✓ Ensures payment security
• Flywire works with education, healthcare, and business transactions,

✓ Simplifies patient experience
enabling clients to get fast, secure and convenient payments
collections from all over the world and different currencies.
Selected Transaction History 58% 12% $1 mm

Reduction in average Improvement in Eliminated in annual
Date Type Size ($ mm) Investor(s) / Buyer(s) payment plan length patient pay spending
05/26/21 IPO $251 Public market investors
Goldman Sachs; Tiger Management;

02/13/20 Series E 120 February 13, 2020
Adage Capital Management
Temasek Holdings; Bain Capital Technology platform that leverages patient interactions and
07/26/18 Series D 100
Ventures; F-Prime proprietary algorithms to drive a recommendation engine for
patient payments and engagement, addressing affordability
Bain Capital Ventures; Spark Capital;
01/13/15 Series C 22
Accel with personalized payment plans
12/23/13 Series B1 6 Spark Capital; Maveron; FIDES January 18, 2018

QED Investors; Eight Roads; FIDES; Web portal and payment solution offering providers an
05/01/13 Series B 6
KIBA Ventures automated way to settle balances for patients with high out-
of-pocket costs through tailored and flexible payment plans.
08/16/11 Series A 8 Spark Capital; Maveron
Spark Capital; Project 11 Ventures;

10/29/10 Seed 1
500 Startups
HealthBridge
Employees
CEO: Gregory VandenBosch • Financial security
Headquarters: Grand Rapids, MI • One singular consolidated monthly bill
Founded: 2017 • Pay now or pay later
• HealthBridge is a solution that sits right alongside a company’s health plan
• When a member has a claim, HealthBridge covers the costs immediately on Employers
their behalf and then provides that member a consolidated monthly
statement and friendly repayment terms, giving them financial security and • Protect employees from financial strain
flexibility • Stop the barrage of bills
• The Company has created a program design that is sustainable, scalable, • Improve workforce wellbeing
and beneficial for employees, employers, providers, and payers
Providers
• Focus on care, not on collections
• Serve more patients
• Increase patient satisfaction
Gregory Amy O'Meara Tim Heger
VandenBosch Chambers CTO
CEO COO
Payers
• Greater financial security and flexibility
• Friendly repayment terms
Paul Iles Jim Slubowski
CFO Chief Strategy Officer

Healthcare Bluebook
CEO: Jeffrey Rice

Founded: 2007
Search Compare Save
• Developer of a price transparency software designed to provide fair
price information regarding healthcare Intuitive search Compare cost and Tailor solutions to
• The Company's applications help employers and employees save engine is user- quality data using a optimize users’
money by enabling consumers to understand local healthcare friendly and supports comprehensive savings potential
natural language text analytics dashboard
prices, compare providers on price and quality and shop for care
that enables users to that illustrates the
anywhere in the United States
find thousands of exact movement
• By combining objective price and quality data with industry-leading shoppable healthcare from high-cost to
usability, Healthcare Bluebook provides people and organizations procedures high-value providers
with everything they need to be more effective healthcare
consumers Search By:
By Procedure:
Selected Transaction History • When members search for a procedure,
Bluebook shows a Fair PriceTM for the
Date Type Size ($ mm) Investor(s) / Buyer(s) procedure
10/04/17 Growth na Primus Capital Funds
By Facility:
• Color-coded guide makes it easy to find high-
01/14/14 Series A $7 The Martin Companies quality, affordable providers
By Physician:
• Shows Patient Savings Rating, overall quality
rating, specific quality ranking by procedure,
and patient reviews

HealthEquity
CEO: Jon Kessler

Headquarters: Draper, UT HSA FSA HRA
Founded: 2002 Works with health plan to Delivers a fully integrated Employer-owned accounts
deliver a fully integrated approach to flexible that are used by
consumer-driven health care spending accounts (FSAs) employees for specific
• HealthEquity (Nasdaq: HQY) connects health and wealth by delivering health
that combines industry- with easy enrollment, less medical expenses, such
savings accounts (HSA), 401(k), and other consumer health and retirement leading health savings paperwork, and hassle- as deductibles,
solutions accounts (HSAs) and free payments / copayments, coinsurance,
reimbursement accounts with reimbursements dental or vision
• The Company works in partnership with over 40,000 employers and 124
health plan design
health plans and administrators nationwide
• HealthEquity is the custodian for $6.8 billion in assets for 3.4 million HSA
members nationwide
• The end-to-end platform offers personalized savings strategies, multiple

investment options, and integrated health insurance plans COBRA Commuter Retirement
Comprehensive solution Simplify the management Offers a number of retirement-
Selected Transaction History makes overseeing COBRA of the benefits package by integrated HSA solutions with
simple and effective— partnering with trusted partners that can help
Date Type Size ($ mm) Investor(s) / Buyer(s) allowing users to manage HealthEquity for commuter individuals get a more holistic
their COBRA program with benefits in addition to the view of their retirement savings
10/20/16 2PO $90 Unknown Public Investors confidence health savings accounts and help them better prepare
(HSA), 401(K) and more for retirement
05/04/15 2PO 100 Unknown Public Investors
$120 Market Cap 09/21/21 $5.1 bn
07/31/14 IPO 127 Unknown Public Investors $110 LTM High 01/26/21 $91.01
$100
$90 LTM Low 09/24/20 $46.15
Napier Park Financial
09/09/11 Series D3 12 $80
Partners; Prettybrook Partners $70
$60
10/22/08 Series D1, D2 7 Undisclosed Investors $50
$40
$30
11/28/06 Series C 16 Berkley Capital Management

Health iPASS
Acquired by
President & CEO: Rajesh Voddiraju

Promote Price Build Patient Increase Income
Headquarters: Oakbrook, IL
Transparency Loyalty/Trust Many providers
Founded: 2013
Displays co-pay / Price transparency have realized 90-
deductible / co- builds customer 95% net collection
• Health iPASS provides a patient-centric payment system designed to make
healthcare payment easy for staff and patients insurance eligibility loyalty rates
• The Company's patient-centric payment system ensures quick patient

payments while allowing patients to know that the bill from the physician
provider has been reconciled with their insurance company
Pre-Arrival /
• The Company helps providers promote price transparency and increase Point-of-Service
operating income by simplifying the check-in process and streamlining both Appointment Reminders
time-of-service and residual patient payments
• Many Health iPASS providers have realized 90 – 95% patient net collection
rates, decreased denials by over 50%, and reduced the cost and time to
Electronic
collect Cost Estimates Statements
• The Company was acquired by Sphere in December 2020

RevSure
12/17/20 M&A na Sphere

• Health iPASS pays providers their patient account receivables
as soon as insurance processes the claim, guaranteeing the
QED Investors; FCA Venture funds within 24 hours
Partners; OCA Ventures;
05/15/19 Venture $10
HealthX Ventures; Healthy • The financing is non-recourse, so Health iPASS assumes the
Ventures; Waterline Ventures risk from the provider, but there are not any patient credit
OCA Ventures; HealthX checks required
10/08/15 Venture 2 Ventures; Beverly Capital;
MPG Equity Partners

HealthPay24
Point Of Service: Healthcare Payments

• Capture payments as early as pre-service estimation
Acquired by
• Increase upfront collections
• Offer secure transactions & multiple payment options
CEO: Julie Gerdeman Patient Self Service: Digital & Mobile
Headquarters: Mechanicsburg, PA • Pay-by-text & mobile alerts
Founded: 2001 • Mobile-friendly & branded payment portal
• Customized statements & IVR
• HealthPay24 empowers healthcare organizations to maximize patient-pay Patient Messaging: Mobile Alerts & eBilling
revenue by providing the innovative and comprehensive payment solutions
• Drive web & visitor traffic from digital payment
− HealthPay24 was the first solution dedicated to processing communications (email, text, web)
healthcare point-of-service payments
• Increase payment adoption
• The Company’s solution is both provider and patient-facing and includes • Promote events, donations & fundraisers on payment
POS services, online payments portals, embedded patient messaging and an receipts
analytics engine
• The solution captures and manages patient financial responsibility as early Data Analytics: Patient / Payment Behaviors
as pre-service estimation through post-service digital touchpoints • Identify & monitor KPIs
• HealthPay24 services over 2,000 healthcare facilities including, major health • Track patient satisfaction levels
systems, physician groups, dental practices and medical billing companies • Enhance & track patient payment journeys
• The Company was acquired by Invoice Cloud in 2015
Patient Payment Options
Selected Transaction History Providers can offer…

• Discounts at point-of-service
• Loan programs
• Flexible payment plans
12/22/15 Acquisition na InvoiceCloud
• IVR pay-by-phone or pay-by-text

Healthsparq
Acquired by
HealthSparq One
CEO: Mark Menton Empower members and lower costs by offering greater
Headquarters: Portland, Oregon
insight into health care options by using suite of health care
transparency solutions to easily research quality,
Founded: 2012 convenient providers, and determine out-of-pocket costs
right from the portal
• Helps people make smarter health care choices by partnering with health
plans to provide members with cost and quality information about doctors,
hospitals, and medical services based on their individual benefits HealthSparq Rx Compare
• Conducts continuous usability testing, eliciting consumer feedback to Engage members with information and personalized
enhance product development, hosting industry panels featuring everyday support whether at home, in the physician's office, or at the
people, and bringing human stories to the forefront through their pharmacy
#WhatTheHealthCare campaign
• Serves more than 70 health plans and 72 million members nationwide

HealthSparq Rewards
• On December 17, 2020 Kyruus acquired HealthSparq
Offer an integrated program that encourages members to
shop for high-quality, lower-cost providers and services —
and earn financial rewards while they’re at it
HealthSparq APIs
Create new digital experiences to drive member

Mark Menton Angela Lott Matt Parker engagement, reduce health care spend and boost
CEO VP, Client Delivery VP, Product efficiency — all using the user’s brand, UX and workflows
HealthSparq Appointment Scheduling
Make it easier for members to stay on top of their health by

offering the convenience of scheduling their next medical
appointment online
Heather Burton Mark Vo Todd Peterson
VP, Marketing VP, Engineering VP, Sales
InstaMed
Acquired by InstaMed Online for Providers

InstaMed Online for Providers simplifies the entire healthcare
payments process on a secure, cloud-based portal
Features include detailed reporting, managing workflow and

the ability to access InstaMed Online anywhere with the
President & CEO: Bill Marvin InstaMed Go mobile app
Headquarters: Philadelphia, PA
Founded: 2004
InstaMed Connect
Simplify every healthcare payment by using every InstaMed
• InstaMed provides solutions for healthcare payments on one platform that
solution through an existing system with InstaMed Connect,
connects consumers, providers and payers for every healthcare payment
the healthcare industry’s first real time and open Application
transaction
Programmatic Interface (API) for healthcare clearinghouse
• The InstaMed Network connects over two-thirds of the market and and payment transactions.
processes tens of billions of dollars in healthcare payments annually
• The first company to receive financial (FSAP) and healthcare (HNAP)

accreditations from the Electronic Healthcare Network Accreditation InstaMed Online for Payers
Commission (EHNAC) InstaMed Online for Payers seamlessly integrates with payer
systems to improve efficiency and simplify the healthcare
payments process
Selected Transaction History Features include detailed reporting, end-to-end

implementation support and financial monitoring /
reconciliation
05/15/19 M&A na JPMorgan Chase

For Patients
09/26/16 Series B $50 Carrick Capital Partners View and pay healthcare bills on any device including
mobile phone, tablet, laptop or desktop computer
09/24/14 Series A 14 Undisclosed Create a digital wallet to save payment information to pay
all healthcare bills through InstaMed

Lively
Individuals
• Users can seamlessly fund, manage and invest their HSA
Co-Founder & CEO: Alex Cyriac
• 100% fee-free for individuals and families
Headquarters: San Francisco, CA • Simple transfer to bank account
Founded: 2016 • Free access to investment capabilities
• Lively is a developer of a Health Savings Accounts (HSA) platform

designed for individuals and businesses Employers
• Streamline HSA administration
• The Company's platform offers a no strings attached free HSA account for
• Intuitive employer dashboard
individuals and helps employers to administer an HSA for their employees
• Dedicated onboarding support
• This enables consumers to optimize their healthcare spending, • Automated payroll deductions
maximize their savings and better their livelihood
• Lively features paperless onboarding, automated payroll deductions and

integrated TD Ameritrade Self-Directed brokerage accounts for online
investing Brokers
• Simplified HSA management from proprietary syncing
Selected Transaction History capabilities
• Easy sign-up, automated payroll contributions,
Date Type Size ($ mm) Investor(s) / Buyer(s) administrative dashboard
• Dedicated point of contact
Costanoa Venture Capital; Ally
Financial Strategic Investments;
10/16/19 Series B $27 Liquid 2 Ventures; PJC Capital;
Teamworthy Ventures; Streamlined
Ventures; Y Combinator
Partners
Costanoa Venture Capital; Y
• Offers easy TPA services
10/30/18 Series A 11 Combinator; PJC Capital; Transmedia
Capital • Easy data integration
• Employer HSA sync
Streamlined Ventures; Transmedia
• Can offer fee-free HSA to clients
Capital; Y Combinator; SV Angel; PJC
09/26/17 Seed 4
Capital; Durant Company; Liquid 2
Ventures; Teamworthy Ventures

MDSave
Process
CEO: Paul Ketchel

Founded: 2012
Compare Prices Buy Procedure Schedule Procedure

• MDsave allows consumers to search for healthcare services by
Search the site by Pay through secure site or Follow the scheduling
procedure, location, and price procedure and location to by phone, or buy the instructions given by
browse local providers and procedure when the provider, and bring the
• Consumers have the option of paying online before the visit. For pricing patient checks in for the voucher to the
those paying upfront, MDsave pre-negotiates bundled pricing with appointment appointment
its network of providers offering significant savings for the
consumers
• MDsave also offers a digital savings card that provides discounted For Patients
Save money by prepaying the bill online before the
prices on prescriptions
doctor’s visit. Choose from the network of 290+
hospitals and 1,600+ procedures.
For Providers
Date Type Size ($ mm) Investor(s) / Buyer(s) Providers can reach new patients through the site.
Providers are also willing to offer better prices since
01/07/19 Strategic na Change Healthcare patients can pay online before the visit.
07/27/16 Strategic $5 Cambia Health Solutions

Providers
05/13/15 Early Stage 12 WindRose Health Investors
05/31/12 Seed 3 Undisclosed Investors 336 275 240 215

Providers in TX Providers in FL Providers in NE Providers in TN

MedData
MedData OneTouch
Identifies all payer sources and the most appropriate coverage in the properly
CEO: Michael Shea compliant order through a single touchpoint of payments for patients, whether
they’re insured, under-insured, or uninsured
Headquarters: Spring, TX
Founded: 1980 MedData FastTrack
Combines fast, streamlined coding & billing with dedicated, integrated patient
balance services to deliver the most comprehensive solution in the industry
• A provider of tech-enabled revenue cycle management services
designed to engage patients, empower hospitals and health
Eligibility Services
systems, and improve financial outcomes
Finds appropriate assistance to help pay medical bills, in fewer days than
• The suite of solutions includes a range of revenue cycle competitors
management solutions, consulting and analytics services, full-
service eligibility, billing and coding, third party liability and other Third Party Liability, Workers Compensation, Veterans Administration,
complex A/R services, and mobile-first engagement and and other A/R Services
communication software for patients and providers
Spans the gap between the identification of a payer and payment, while also
• Handles billing for more than 200 million patients at the growing increasing hospital revenue, mitigating denials, and avoiding bad debt
network of more than 2,000 hospitals
Patient Balances
Works with providers to connect and engage with patients throughout the entire
Selected Transaction History financial life-cycle – making sure they understand their bills, informing them of
payment options, and helping them navigate any insurance issues
Workers Compensation
10/10/19 Buyout $300 Frazier Healthcare Partners
Assists with locating liable parties and ensuring accurate and timely payments
08/18/14 M&A na MEDNAX Disability Insurance Services
Secures disability insurance benefits for the eligible individuals we represent

10/08/07 Buyout na Baird Capital

MedPut
Benefits for Employers
Founder: Stefan Sharma

Founded: 2017
• MedPut helps employees avoid charging healthcare bills on credit Supercharge Reduce Happier and No Financial Risk
cards by providing interest-free credit for all healthcare expenses Health Plans Employee Loans Healthier
MedPut owns the
for employees, regardless of credit score Workforce financial risk of the
MedPut can make Prevent employees
healthcare plans from taking 401(k) program, so there's
• Employees can upload healthcare bills via their employer MedPut keeps
more powerful by loans or going into no liability to
employees healthy,
dashboard, MedPut then audits and negotiates bill payments and covering out of debt to pay for their employers
stress-free, and
will ultimately facilitate the repayment through small payroll pocket costs health productive
deductions
Benefits for Employees
No Interest Save Money Covers Any Visit Any Doctor

1. Snap a Photo 2. MedPut Pays 3. Repay MedPut Healthcare Bill
Bill repayments are Negotiation team will Send bills from any
it Off
Upload a Pay back seamlessly always at 0% interest try to negotiate Includes medical, doctor or healthcare
photo/scanned copy MedPut will pay the from paycheck discounts on large dental, vision, even facility in the US
of the bills doctor or hospital bills elective procedures

MedZero
CEO: Michael Sobek

Headquarters: Kansas City, MO
Founded: 2015
Funds Available Within Zero Interest and Zero Zero Hassle
Minutes Fees
Employer-provided benefit
• medZERO provides immediate mobile access to funds to pay for makes it fast and easy to get
Get up to $5,000 on a virtual Repay medical bills at 0%
healthcare bills Mastercard via the APR without paying high approved and sign up
medZERO mobile app or interest rates for credit cards anytime
• These funds are made available with zero interest and zero fees
online or fees required for 401k
• Employees repay bills via payroll deductions or through pre-tax HSA payroll loans
contributions
• Utilizing payroll deductions through their HSA creates significant tax

savings for the employee that would have otherwise been lost without
medZERO
Benefits for Employees 1. Employees download the 2. Employees select Pay My

• Use for medical, dental, vision and medZERO app or go online Provider and enter the
pharmaceutical bills Benefits for Providers and complete enrollment amount needed
• Zero APR to help pay for • Patients make immediate
healthcare expenses payments to providers
• Easy to enroll and access funds • Employers promote providers who
within minutes accept the medZERO program
• HSA utilization maximizes tax • Reduce cancellations due to
savings patient financial concerns
• Mobile app for Apple iOS and • Eliminate delayed patient care
Google Android smartphones
• Safe and secure 4. Employees repay at ZERO 3. Virtual Mastercard issued
interest, directly from their immediately to pay for up to
paycheck or pre-tax HSA $5,000 in medical expenses
payroll contributions

Olive
Alpha
Alpha identifies and implements high-value automations, allowing organizations to prioritize top
processes for automation and accelerate time to build them
CEO: Sean Lane
Headquarters: Columbus, Ohio Pursue the Highest Value Enable Ready-made, Resilient Drive Enterprise-wide
Processes for Automation Solutions Transformation
Founded: 2012
• Olive develops a process automation software that builds an artificial AlphaSite

intelligence workforce for healthcare, utilizing robotic process automation, AlphaSite provides organizations with a centralized hub for AI workforce operations, giving
computer vision and machine learning healthcare leaders speed, agility and partnerships to accelerate impact
• Olives helps automate error-prone processes such as claim status

checks and account updates to prior authorizations, and more Onsite Location and Dedicated Commitment to Meet ROI Exclusive Co-development
Team Goals
• It automates high-volume tasks and workflows, monitors their performance,
identifying improvements and finding opportunities for new work Omegaa
Omega is Olive’s central operations center that relieves customers of the burden of AI
• This enables healthcare organizations to improve efficiency and
maintenance and optimization, ensuring the best results
patient care while reducing costly administrative errors

Ongoing Performance Optimize / Improve Effectiveness Extend Olive’s Impact Over Time
Date Size ($ mm) Investor(s) / Buyer(s)
07/01/21 $400 Vista Equity Partners; Base10 Partners Deep Purple

Deep Purple delivers AI workforce intelligence, enabling providers to improve decision
Tiger Global; General Catalyst; Drive Capital; Silicon Valley making and elevate performance
12/01/20 226 Bank; GV; Sequoia Capital Global Equities; Dragoneer
Investment Group; Transformation Capital Partners
General Catalyst; Drive Capital; SVB Capital; Oak HC/FT;
09/17/20 106 Ascension Health Ventures Tap Into a Bigger Brain Elevate Results Upskill and Specialize
General Catalyst; Ascension Ventures; Drive Capital; Oak

03/31/20 51 HC/FT
Common Olive Tasks
11/01/18 5 MemorialCare Innovation Fund
• Benefit & Verification Discovery • Invoice Processing
Ascension Ventures; Drive Capital; Moonshots Capital; NCT
07/30/18 33 Ventures; Oak HC/FT • Prior Authorization Management • Inventory Management
Drive Capital; Healthy Ventures; Khosla Ventures; Broadway • Denial & Rejection Management • Periodic Reporting
04/06/16 15 Video Ventures; Moonshots Capital; NCT Ventures; Silicon • Vendor Contract Management
Valley Bank

OODA Health
Acquired by
CEO: Seth Cohen

Founded: 2017
• OODA Health offers a healthcare payment platform connecting

payers, providers and patients
• Using OODAPay, payers send a guaranteed payment of the patient

liability to providers immediately upon adjudication of the claim Payer Benefits Provider Benefits
• Each provider is paid a guaranteed rate based on their historical A simplified member experience Immediate payment & resolution of
collection rate that is then adjusted over time No confusing provider bills, patient liability
uncoordinated EOBs, or aggressive billing Providers are paid upfront compared to
• Patients also have the option to choose 0% interest payment plans, tactics the months required to collect today
with a term length of their choosing, which ensures bills are
affordable and paid as patients prefer Financial upside on patient collections Payment certainty & predictability
Payers can leverage ongoing Each provider is paid a guaranteed rate
relationships with members along with based on their historical collection rate
Selected Transaction History best-in-class consumer tools that is then adjusted over time
Date Type Size ($ mm) Investor(s) / Buyer(s) Reduced administrative expense Improved patient experience
Eliminate the time and resources that Patients are given a consolidated bill
05/13/21 M&A $425 Cedar both providers and payers currently instead of disconnected provider bills
invest in collecting from patients and EOBs piling up in patients’ mailboxes
Oak HC/FT; Threshold Ventures; Blue Shield
09/19/18 Series A 41 of California Differentiated payer capabilities Reduction of admin cost & effort
Design new products with meaningful Providers no longer have to bear the
12/01/17 Seed 2 Undisclosed Investors incentives, sell concierge billing services, burden to collect as the billing function is
and even offer financing for elective care transferred to payers

Oscar
Plan Types
CEO: Mario Schlosser
Founded: 2012
• Oscar Health provides health insurance for individuals, families and businesses
through its online and mobile platform
• Oscar tools and benefits offered to most members include a dedicated virtual
care team, $0 24/7 ‘Doctor on Call’ telemedicine service, $3 co-pays on 100 Individual & Family Business Plans Medicare Advantage
common medications, perks like discounted access to Calm for sleep and Plans Plans
anxiety reduction tools, free annual physicals, and health incentives like Step • Get more savings, more • Give the best care to the • Save more with easy and
Tracking rewards; and other essential health benefits such as flu shots, perks, and better care whole team personalized care
vaccinations, etc.
Plan Benefits
IPO $1,445 Public market investor(s)

Concierge Team Doctor Network Doctor on Call Mobile App
Tiger Global; Dragoneer Investment Group; Baillie Gifford;
Late Stage 140 Coatue Management; Founders Fund; Khosla Ventures; Get your own Find top-rated Talk to or message a Easily find care,
Lakestar; Reinvent Capital Concierge team of healthcare providers board-certified doctor manage your
experts to help you and prescriptions and get a diagnosis, a dedicated care
Alphabet Inc.; General Catalyst; Khosla Ventures; Lakestar;
Late Stage 225 Coatue Management; Thrive Capital; Baillie Gifford understand your that are in Oscar’s new prescription, or a team, review your
health plan, find network of trusted refill-in as little as just plan information,
Late Stage 375 Alphabet doctors, answer provider partners 15 minutes for free and more through
questions, and more the app
Founders Fund; 8VC; Verily Life Sciences; Fidelity; General
Late Stage 165 Catalyst; CapitalG; Khosla Ventures; Thrive Capital
$45.0
Fidelity Investments; Founders Fund; General Catalyst
Growth 400 Partners; CapitalG; Khosla Ventures; Lakestar; Thrive $40.0
LTM High 03/10/21 $36.77
Capital
$35.0
LTM Low 05/13/21 $20.51
Growth 33 CapitalG $30.0
Founders Fund; Horizons Ventures; Wellington $25.0

Management; Goldman Sachs; Thrive Capital; Formation
Growth 145 8; Breyer Capital; Khosla Ventures; General Catalyst $20.0
Partners
$15.0
Formation 8; Breyer Capital; Thrive Capital; Founders
Series A 80 Fund; General Catalyst Partners; Khosla Ventures; Thrive $10.0
Capital Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21
FT Partners / QED Sources: Company website, FT Partners’ Proprietary Transaction Database 261
Patientco
Acquired by eBills
Empowers Healthy Systems to provide patients with a
paperless billing option without risking payment rates
due to deliverability issues
Founder & CEO: Bird Blitch
Headquarters: Atlanta, GA Patient Financing
Allows Health Systems to provide tailored, flexible
Founded: 2009 financing options for every patient within seconds
from any internet-connected device
• Patientco provides payment technology designed to facilitate better
Payment Plans
healthcare patient experiences
Provides patients with the options to break up higher
− Patientco’s integrated communication and payments tools, along account balances into automatic installments to
afford their care
with machine learning capabilities allows it to analyze millions of
billing interactions to better understand patients
Online Bill Pay
• The Company offers personalized communication and payment options, Offers a secure, mobile-friendly payment and
communication portal that allows patients to track,
leveraging user preferences, behavioral data and propensity models to
manage and pay their expenses
improve patient engagement
• Its platform is convenient and simple, offering mobile-friendly, self-service

payment options and eBills
• Additional options include a suite of payment plan products, recourse and

non-recourse financing, unfunded payment plans, and revolving credit
lines, all with online enrollment Communications Analytics Automated
Paper SMS Messaging
Statements Platform Posting &
Selected Transaction History Reconciliation

07/15/21 M&A na Waystar
Automated Digital Mailroom Staff-Assisted
Accel-KKR; BlueCross Pay-By- Payments
BlueShield Venture Partners; Phone
07/25/18 Series B $28
Atlanta Seed Company;
Sandbox Industries
Sandbox Industries; Advanced Staff Payment Security & Staff
Reporting & Digital-First
08/16/12 Series A 4 Technology; Pamplona Capital Management Compliance Gamification
Insights Billing
Management
Payspan
Payers
CEO: Rob Pinataro
• Core Payspan Network removes inefficiencies in
Headquarters: Atlanta, GA the e-payments cycle that results in claims delays
Founded: 1984 • Premium Payments solution designed to make the
customer payments experience enjoyable
• Payspan offers payment solutions for health plans and providers seeking • Quality Incentive Communications System that
to increase adoption of electronic payments and engage patients / helps engage providers in value-based care
members reimbursement
− The Company’s solutions reduce costs, drive revenue and help
boost Star Ratings and HEDIS scores by leveraging the largest
multi-payer, provider-centric electronic payment network as a Providers
foundation • Online Bill Pay software that enables patients to
• The Company transfers healthcare payments and facilitates alternative make online responsibility payments on any smart
reimbursement strategies that improve health, improve patient experience device
and reduce costs • QuickPay that provides payments options at the
point of service, making it easier for patients to
Selected Transaction History pay consistently and on time
Primus Capital; PNC Erieview
01/05/17 PE Growth na
Capital
Stonehenge Partners; HLM
08/24/15 Later Stage VC $3
Partners
ABS Capital; Stonehenge
02/10/09 Later Stage VC 22
Partners; Bac One; Wachovia
Wachovia; Stonehenge
Partners; ABS Capital
02/08/05 Later Stage VC 6 Wachovia; ABS Capital 600 1.3 mm 100+ mm

Health Plans in the Provider Payees on the Consumers in the
05/29/02 Later Stage VC 13 ABS Capital network platform network
Stonehenge Partners; Banc
One Ventures

Phreesia
70mm $1.4 bn 235 mm 5.4 mm

CEO: Chaim Indig patient intakes payments insurance clinical screenings
Headquarters: New York, NY per year processed / managed verifications administered
per year per year per year
Founded: 2005
• Phreesia (NYSE: PHR) provides an automated patient intake management

platform which streamlines the patient check-in process
• The Company’s solutions increase efficiency, reduce costs, and improve clinical
effectiveness
• Registration solution: automates patient self-registration
• Patient activation solution: communicate through surveys,
announcements, etc.
• Revenue cycle solution: insurance-verification process, point-of-sale
applications, cost estimation
• Clinical support solutions: clinical intake and data
• Appointments solution: scheduling system
• Life sciences solution: channel for clients to connect with patients
• Phreesia has checked in more than 15% of the U.S. population since its founding Date Type Size ($ mm) Investor(s) / Buyer(s)
$85 07/17/19 IPO $167 Public Market Investors
$75
$65 Echo Health Ventures; LLR Partners;
12/11/17 Venture 34
$55 Ascension Health Ventures
$45 Market Cap 09/21/21 $3.4 bn LLR Partners; HLM Venture;
$35 10/23/14 Venture 30
Ascension Health Ventures
$25 LTM High 02/09/21 $80.61
$15 Blue Cross; Sandbox Industries; Polaris
LTM Low 07/24/20 $27.00
$5 Partners; HLM Venture; Long River
04/15/10 Venture 20
Ventures; Ascension Health Ventures;
VantagePoint
Blue Cross; Sandbox Industries;
($ in mm) FY 2019 FY 2020 FY 2021 02/02/09 Venture 12 Long River Ventures;
HLM Venture; Polaris Ventures
Revenue $99.9 $124.8 $148.7
Village Ventures; Polaris Ventures;
EBITDA (1.9) (6.3) (15.3) 09/17/07 Venture 10
HLM Venture; Long River Ventures
Net Income (15.1) (20.3) (27.3)
12/14/06 Venture 3 HLM Venture; LRVHealth
Phreesia’s fiscal year ends January 31
Sources: Company website, FT Partners’ Proprietary Transaction Database, Capital IQ
PointCare
Qualify API
• Quickly implement with API documentation
• Eliminate the need to track the 2,000+ changes to enrollment programs
Co-Founder & CEO: Everett Lebherz each quarter; PointCare keeps an up-to-date database
Co-Founder: Philip Lebherz • Improve approval outcomes by providing application details and
checklists to patients via text, email or print
Headquarters: Walnut Creek, CA
• Report on critical qualification data across locations
Founded: 2012
Total Enrollment Management

• PointCare’s goal is to help health systems find coverage for self-
pay patients Manage the entire enrollment process from end-to-end
• The Company’s web-based products make the qualification and • Qualify patients in 90 seconds for all programs and benefits
enrollment tracking process fast, consistent, and data driven • Easily manage the enrollment process with centralized data including
screening results, enrollment tasks and automatic Medicaid
− Its rules engine qualifies patients accurately in 90 seconds
verifications; Maximize approvals and improve patient satisfaction
− Accurate qualifications lead to more approvals and more • Integrated reporting lets you share data and improve operational
covered visits, resulting in more revenue for providers efficiency
− PointCare has found that its customers have witnessed an
increase in approval rates of 53%
• PointCare’s solutions serve Hospitals, Clinics, and Revenue Cycle ✓ Data on Self-Pay Qualifications
Management organizations ✓ Consistent Enrollment Numbers
✓ Productivity and Results Dashboarding
✓ Automated Medicaid Verification
✓ Identify Areas of Improvement
✓ Consistent, Transparent and Transferable

PrimaHealth Credit
Founder & CEO: Brendon Kensel
Headquarters: Newport Beach, CA

Alternative Patient Finance Platform
Founded: 2014 A secure, scalable, and easy-to-use payment
management solution for Elective Care,
Outpatient Care, and Patients
• PrimaHealth Credit is an alternative patient finance platform used by healthcare
providers to offer payment solutions to credit challenged and underbanked patients at
the point of the care
Generate More Revenue Stay Informed
− PrimaHealth Credit’s propriety platform offers affordable monthly payment An automated, easy-to-use Detailed, real-time reports available
solutions for patients who pay for out-of-pocket healthcare expenses, even payment platform with instant online with payments, receivables,
those with credit challenges credit decisions and other portfolio details
− At the same time, the platform helps solve the challenges healthcare providers
face with assessing a patient’s ability to pay, collecting recurring payments,
and managing accounts receivable
• Innovative technology, sophisticated credit algorithms, and turn-key payment

management makes the Company’s solution unique to get patients the treatment that
they deserve Reduces Risk Improve Account Receivable
The proprietary credit analytics engine and Reduce Costs
can assess a patient’s ability to pay Use the platform to complete loan
and presents them with payment servicing and collections
options if approved

Provide
Practice Financing
The industry's only paperless experience,
Co-Founder & CEO: Daniel Titcomb saving practices hours of time and thousands
in lost production
Founded: 2013
• Provide (formerly known as Lendeavor) is the modern finance company Deposit Account
for healthcare practices, offering better rates and faster approval, all driven FDIC-insured business operating accounts with
by technology world-class banking institutions
• The Company provides innovative software, services, and

industry expertise that takes complicated transactions, like
buying a first practice, and makes it simple
• Provide offers no paper transactions, a simple application

process, and a team of industry experts in order to maximize Insurance
both speed and quality of service All the insurance coverage a practice needs to
run, from property to business overhead and
• With its bank partners, Provide also offers a fully integrated suite of more
financial products like deposit accounts and insurance

$800 million+ 1,000+
Date Type Size ($ mm) Investor(s) / Buyer(s) Loans originated Practices Funded
12/15/20 Series A & B $34 QED Investors
09/07/17 Corporate na First Internet Bank ✓ Pre-qualify in 2 minutes

Montage Ventures; QED
07/22/15 Seed 1.5
Investors
✓ Serves Medical, Dental, Optometric, and Veterinary
practices
01/01/14 Angel <1 Undisclosed Investors

R1 RCM
President & CEO: Joseph Flanagan

Headquarters: Chicago, IL
Founded: 2003
• R1 RCM Inc (NASDAQ: RCM) helps U.S. hospitals, physicians and other
healthcare providers to more efficiently manage their revenue cycle operations
• The Company’s services encompass patient registration, insurance
and benefit verification, medical treatment documentation and coding,
bill preparation and collections
• Its core offering consists of comprehensive, integrated technology and
revenue cycle management services
• R1’s services target hospitals & health systems, medical groups, physician
groups, and EMS

$36 LTM High 02/16/21 $30.58
$31 LTM Low 06/26/20 $10.59
$26
$21
$16
$11
$6

($ in mm) 2018 2019 2020
01/23/18 PIPE $20 Intermountain Healthcare
Revenue $869 $1,186 $1,271
TowerBrook Capital Partners;
EBITDA 35 140 213 02/16/16 PIPE 200
Ascension Health
Net Income (45) 12 117
Sources: Company website, FT Partners’ Proprietary Transaction Database, Capital IQ

Rectangle Health
CEO: Dominick Colabella

Headquarters: Valhalla, NY
Founded: 1992 Payment Practice Payment Processing
Processing Management Bridge Security
• Rectangle Health is a healthcare payment and premium processing
company, helping healthcare organizations or insurance groups increase Rectangle Health’s Practice With Rectangle
payment compliance, streamline processing, and improve overall real time system Management Bridge Health, the audit to
satisfaction places money in the technology determine
hands of the combined with compliance is
• The Company provides hospitals, physician practices, insurance groups
healthcare existing practice always simple
and billing services with tracking, reporting, and systems to effectively
practitioner’s office management because patient
manage payments, all with no implementation or integration fees
within 24 hours of a system, helps users payment information
• Rectangle Health helps providers with challenges like outstanding transaction, quickly leverage is completely hidden
balances in accounts receivable, outdated payment tools, and lack of capturing payments comprehensive from the systems
patient compliance into a system that’s reporting, make with technologies
• Rectangle works with 60,000+ healthcare providers, processing $6 billion easy for the office to informed business that encrypt and
annually use and simple for decisions and tokenize data
patients to improve efficiencies
Selected Transaction History understand
10/11/19 Debt $5 Ares Capital

Payment Methods
• Debit Cards, Credit Cards, Checks, Prepaid Cards, ACH Payments, EBT
03/14/19 Debt 5 Ares Capital
03/31/17 Debt 5 Ares Capital

Credit Card on File
03/31/17 Debt 5 CION Investments • Keeping credit card information on file can ensure that the customers’ bills
are always paid, and that these payments are credited to the account,
02/13/17 Growth na TA Associates giving businesses quick and reliable access to cash
Sources: Company website, FT Partners’ Proprietary Transaction Database, Pitchbook

REPAY
Co-Founder and CEO: John Morris

Founded: 2006
• REPAY (NASDAQ: RPAY) is a leading, omni-channel payment technology

provider for multiple verticals including healthcare, personal lending, auto
lending, mortgage servicing, B2B, receivables management and credit unions
− REPAY offers virtual card and ACH processing to help payers remit
claims payments to providers; REPAY also offers full print/mail and
electronic communication services
• The Company’s proprietary, integrated payment technology platform reduces
complexity for its clients and enhances the consumer / business experience
• REPAY serves more than 14,000 corporate clients across the US and Canada
• In 2019, the Company processed over $10.7 billion of card payment volume
across its core verticals
LTM High 12/22/20 $27.90

$37
LTM Low 05/10/21 $20.79
$32
$27
$22
$17
$12
$7
($ in mm) 2020 May 2021: REPAY Acquires BillingTree for $503 million
Revenue $155 February 2020: REPAY Acquires Ventanex for up to $50 million
Gross Profit 114 October 2019: REPAY Acquires APS Payments for up to $60 million
Adj. EBITDA 68 August 2019: REPAY Acquires TriSource for up to $65 million
Sources: Company website, FT Partners’ Proprietary Transaction Database January 2019: Thunder Bridge Acquisition Merges with REPAY for an Implied Total
FT Partners / QED Enterprise Value of $665 million
270
RevSpring
OmniChannel Engagement
• Digital Channels: Shift confidently to digital delivery and reduce
costs
CEO: Scott MacKenzie • Voice Channels: Automate transactions for patients who prefer
phone calls
Headquarters: Livonia, MI
• Printed Communication: Use print communications more
Founded: 1997 strategically, when patients prefer it
• RevSpring enables patient and consumer financial engagement by delivering

Analytic Insights
end-to-end technology-enabled solutions that accelerate cash flow, improve
• Patient Insights: Make payment options clear and appropriate for
consumer satisfaction and strengthen client relationships
each patient
• As a provider of revenue cycle technology services, RevSpring offers data • Performance Dashboards: Measure, adjust, optimize
analytics, multi-channel customer communications, and payment solutions -
all while ensuring compliance with regulatory guidelines
Payment Touchpoints
• RevSpring facilitates over one billion customer interactions annually • Pre-Service: Educate patients and enable payments pre-service
• The Company serves a large and diverse customer base across the • Patient Portal: Make payment options clear and appropriate for
healthcare and financial services markets each patient
• Call Center / VR: Balance personal service and automation for the
Selected Transaction History right experience at the right time
• Merchant Services: Strengthen cash flow and minimize collection
Date Type Size ($ mm) Investor(s) / Buyer(s) risk
01/30/19 Debt na The Carlyle Group

Pre-Service Engagement
10/11/18 Debt $4 Audax Group
• Estimation: A patient-friendly solution that lives up to its promise
Jefferies Finance, Madison • Appointment Reminders: Help patients honor and prepare for
09/21/18 Debt 485
Capital, RBC Capital Markets each appointment
03/02/17 Debt 3 KCAP Financial
11/07/16 Buyout na GTCR

Print and Mail
10/01/11 Buyout 41 CIP Capital • Production: We don’t outsource print. We own the experience.
• End-to-End Reconciliation: Validate delivery integrity. Every mail
Bolder Capital, JZ Capital
04/29/05 Buyout 30 piece matters
Partners, Edgewater Funds

Rivet Health
Co-Founder & CEO: Ted Ferrin
Headquarters: Salt Lake City, Utah
Founded: 2018
• Rivet Health is a revenue cycle management software platform used by

healthcare practices across the country to bring price transparency and
seamless transactions to patients
− Rivet’s estimate system provides patients with fast and accurate estimates of
their healthcare costs before services are rendered, complete with automated
insights into health insurance coverage and deductibles
− The platform enables providers to understand contracts and fee schedules

while gaining an easier method of payment collection
• Rivet’s platform enables providers to give patients upfront pricing estimates

with the ability to pay prior to or shortly after receiving care in a way that is
convenient to them
Ted Ferrin Vicky Thomas Andrew Harding

Co-Founder & CEO VP of Product VP of Customer
Paul Draper Jeremy Nef Success Co-
Co-Founder & CTO Director of Marketing Founder

Salucro
Provider Collection Solutions

Salucro provides a point-of-service and back-office payment
platform, enabling revenue cycle teams to streamline
CEO: Clayton Bain
collection workflows and automate transaction activities.
Headquarters: Phoenix, AZ
Founded: 2004 Retail-Like Online Bill Pay Solutions
An experience driven online bill-pay solution that enables
• Salucro’s Patient Payment Technology Platform enables healthcare patients to make one-time payments or set-up payment
plans in a self-service environment, with access to 24/7 live
providers to enhance the patient financial experience, driving increased
chat support and 16+ payment types, including access to
patient payments and higher provider-loyalty to the 44% of consumers
third-party recourse and non-recourse financing.
whose provider evaluation relies on a positive financial experience.
• From point-of-care payments to back-office collection solutions, Salucro Tailored Patient Financial Engagement
delivers payment technology to hospitals, health systems, physician
From text-to-pay to comprehensive print and digital
groups, revenue cycle partners, and more to drive higher quality patient
statements, Salucro provides advanced communication and
financial experiences and increased provider collections. functionality to tailor patient financial outreach to each
• Salucro’s platform offers real-time payment solutions with flexible patient’s unique preferences.
payment options, allowing providers in the US and internationally to
capture more revenue by meeting patients where they are most likely to Seamless Payment Integrations with Any EHR
engage with responsive, self-service payment options. The Salucro payment platform seamlessly integrates with
any EHR or Patient Accounting System, including Epic,
Selected Transaction History Cerner, Meditech, Allscripts, NextGen, and more.
10/31/19 Angel $5 Undisclosed Investors
11/03/17 Angel 6 Undisclosed Investors
Mobile-Friendly Comprehensive IVR Solutions for Automated PCI-Validated

07/03/12 Angel <1 Undisclosed Investors and Text-Initiated Print & Digital Automated Payment Posting P2PE Payment
Payments Statements Phone Payments and Reconciliation Solutions
Sources: Company website, 2019 Salucro Patient Payment Technology Report, FT Partners’ Proprietary Transaction Database
Softheon
Government Agencies
• Softheon provides a comprehensive suite of cloud-based, HIPAA-enabled
and MITA-aligned solutions to assist states in developing healthcare IT
infrastructure
Founder & CEO: Eugene Sayan • Removes duplicate and administrative inefficiencies, promotes
collaboration with stakeholders, enhances transparency, and provides
Headquarters: Stony Brook, NY visibility into insurance transactions
Founded: 2000
Health Plans
• Softheon offers configurable, cloud-based solutions to help health plans
• Softheon‘s mission is to drive down costs, simplify access and
build healthcare IT infrastructure
create more insurance options for Americans
• The Company offers modules that target common pain points in the
• The Company's services include health insurance exchange eligibility and enrollment, member billing, and reporting process
integration, direct enrollment, premium billing, pharmacy prior-
authorization, claims pre and post-adjudication, billing
management system, and more Group & Consumer / Private Exchange
• Softheon is trusted by over 55 health insurance companies, CMS • Provides members with access to healthcare, dental, and vision plans
in a white-labeled shopping experience with decision support and
and 7 state agencies, and 38 million consumers
enrollment
• Users can analyze data in near-real-time reviewing transaction trends,

member demographics, geography, financial information, and cost
Selected Transaction History comparisons

Long Island High Technology
03/18/09 Angel <$1
Incubator
Associations Brokers Employers

SaaS ecosystem with Simplify enrollment Control benefit cost,
enrollment portals, process, update carriers predict future healthcare
member management, automatically, & engage expense, & stay up to date
& EDI filing processing employer groups with benefit plans

Sphere
Executive Chairman: Andrew Rueff

Founded: 2017
• Sphere, powered by TrustCommerce, delivers end-to-end secure

payment technology solutions for large enterprises, local merchants
and businesses of all sizes
• Sphere serves several verticals and offers multi-channel solutions
across eCommerce, kiosks, mobile, and in-person point-of-sale
payments
• For healthcare organizations, Sphere offers broad payments
acceptance options, centralized reconciliation and reporting, support
for healthcare flexible spending accounts, and security and fraud tools
— Its solutions integrate with EHR providers, such as Epic and
athenaIDX, and the Company serves over half of Epic’s EHR
clients
• •
• Sphere is owned by Waud Capital Partners
• •
• •

Starship HSA
Overflow Investing
Sets a threshold and auto-invests extra funds into
low-fee ETF funds
CEO: Sean Engelking
Headquarters: New York, NY Auto Contributions
Founded: 2017 Puts savings on auto-pilot with a recurring monthly
contribution
• Starship allows anyone with an HSA-eligible health plan to sign up and Freeze Card
begin saving tax-free money on tens of thousands of eligible medical Ability to freeze and reorder replacement cars in the
expenses, with the option to invest their account balance tax-free for app in the event of a loss or stolen card
retirement
— Its application offers investment automation, record keeping, Serious Security
receipt management, card management, and family Data is protected with a passcode, TouchID (iOS) and
management 256-bit bank-level encryption
• The Company offers the highest savings rate in the industry at 2% and
customers can sign up for free in 5 minutes or less
Reimburse Expenses
Ability to link funding accounts to quickly pay
• Starship’s current customer base includes the fleet of drivers for
Postmates and Uber, among others
customers back for health spending
Expert Advice
Selected Transaction History Available, every step of the way, top help make HSAs
Date Type Size ($ mm) Investor(s) / Buyer(s) easy to understand
500 Startups; Broadhaven Capital Family Management
10/21/19 Series A $7 Partners; Clocktower Technology
Ventures; Third Prime; Valar Ventures Easily keep track of who in the family is spending
500 Startups; Broadhaven Capital what with family tags
08/22/19 Seed ~4 Partners; The Gramercy Fund; Third
Prime
Receipt Capture
04/18/18 Accelerator <1 500 Startups Attach receipts to any payment using a phone
camera

TransUnion Healthcare
Acquired by
Patient Experience
President, TransUnion Healthcare: Dave Wojczynski Healthcare providers are enabled to foster trust by engaging patients early
and providing transparency throughout the financial experience
Headquarters: Chicago, Illinois
Website: TransUnionHealthcare.com IDENTITY/ ADDRESS

VERIFICATION &
MEDICAL
Blog: TransUnion.com/Insights/Healthcare CONTACT
NECESSITY
INFORMATION
Validate medical
Verify patient
necessity
• TransUnion Healthcare makes mutual trust possible between patients, demographic and
contact data
providers and payers by helping them navigate payment complexities
• The Company’s solutions leverage comprehensive data, accurate insights and
INSURANCE
industry expertise to help its clients engage patients early, ensure earned PATIENT PAYMENTS*
ELIGIBILITY
revenue gets paid, and optimize payment strategies Offer customized
Confirm eligibility and
payment plans and
benefits prior to
• 1,850+ HOSPITALS and healthcare systems use TransUnion Healthcare method options
service
solutions
• 570K+ PHYSICIANS and other providers use its solutions

CHARITY
PATIENT PAYMENT
SCREENING
• $7.6+ BILLION in cash recovered by its provider clients ESTIMATION
Qualify self-pay
Calculate out-of-
patients for financial
pocket costs
• 7 PATENTS + 1 pending for its market-leading revenue cycle technologies assistance programs
• 85 HEALTHCARE COMPANIES partner with TransUnion Healthcare

SOCIAL RISK
PROPENSITY
• 880+ PAYER CONNECTIONS covering 98% of U.S. insured lives ATTRIBUTES
TO PAY
Improve care
Determine propensity
coordination and
to pay
treatment adherence
ClearIQ Patient Payment Insurance

*Delivered in partnership with VisitPay
Estimation Eligibility
VillageMD
✓ Team-Based: Deploys a team of clinical experts led by physicians and

supported by nurse practitioners, pharmacists, mental health specialists,
and dietitians, who collectively address patient medical, mental health,
and lifestyle needs
CEO & Co-Founder: Tim Barry
Headquarters: Chicago, IL ✓ Physician-led: Rooted in a clinical model with the primary care
physician as the quarterback
Founded: 2013
✓ Tech-enabled: Provides an operating system, docOS™, which has an AI
• VillageMD provides healthcare solutions for organizations moving engine that continuously analyzes hundreds of millions of messages to
towards a value-based primary care model enable patient self-care, better clinical decision making, and the best use
of primary care modality whether virtual, in the clinic, or in the home
• The VillageMD solution provides the tools, technology, operations, and
staffing support needed for physicians to drive the highest quality ✓ Data-informed: Analytics center and data experts have deep expertise
clinical results across a population
in integrating clinical and claims data for a more complete picture of
• The Company works with physician groups, independent practice patient populations; utilizes machine learning and predictive models
associations, and health systems to improve quality, deliver a first-rate
patient experience, and lower costs in the communities they serve
Village Medical
Selected Transaction History Provides primary care for patients at traditional free-standing clinics
Partnership with Walgreens: In July 2020 the Company announced that
Date Type Size ($ mm) Investor(s) / Buyer(s) Walgreens will be the first national pharmacy chain to offer full-service
doctor offices co-located at its stores at a large scale. Through the
07/08/20 Late Stage VC $250 Kinnevik; Walgreens partnership, 500 to 700 “Village Medical at Walgreens” physician-led primary
care clinics will be opened in more than 30 U.S. markets in the next five years.
Kinnevik; Adams Street
09/04/19 Series B 100 Partners; Town Hall Ventures; Independent Practices
Oak HC/FT; Walgreens
VillageMD aligns with independent primary care physicians as partners
Athyrium Capital for success in value-based healthcare
01/04/18 Early Stage VC 80
Management
Health Systems
09/17/15 Series A 36 Oak HC/FT; Oxeon Partners
VillageMD partners with health systems to build a comprehensive
strategy based on success in risk and shared savings contracts, while
pursuing narrow network payor contracts and direct employer
Sources: Company website, FT Partners’ Proprietary Transaction Database, PitchBook relationships to enhance market share
VPay
Total Payment Solution

CEO: Andy Roberts
VPay’s total claim payment solution leverages its secure
Headquarters: Plano, TX platform and patented technology to eliminate costs and
inefficiencies traditionally associated with claim
Founded: 2008 payments
• VPay is focused on delivering electronic alternatives for claims Card-Only Programs

payments designed specifically to streamline the payment process
Using patented technology, VPay facilitates virtual card
while significantly reducing costs payments between Payers and Payees allowing for
− Serves clients across several verticals, including Healthcare, faster transfer of funds into accounts, fewer labor hours
Dental, and Other Insurance for payment processing, and simplified reconciliation,
including real-time tracking and daily reports
• The Company facilitates billions of dollars in payments to over 1.2
million medical providers on behalf of over 100 clients
Merchant Services
• The payment solutions help payers and providers reduce manual
processes, automate payment reconciliation, mitigate fraud losses Low processing fees, reliable reporting, great customer
and limit delays in funding or settlement without any account service, and complimentary access to Card Pointe, a full
enrollment reporting and transaction management tool that allows
users to securely accept and manage transactions from
anywhere
Date Type Size ($ mm) Investor(s) / Buyer(s) Mobile Claim Payments
02/01/16 Growth $76 FTV Capital Web-based solution enables policyholder and multiparty
claim payments from any device, and policyholders can
quickly review their claim, approve service provider
payments or select a preferred payment type for
receiving their own claim payment

Waystar
Revenue Integrity
CEO: Matthew Hawkins Find missing charges and collect
revenue that’s due
Headquarters: Louisville, KY
Founded: 2006 Patient Financial Experience
Collect patient payments, determine
propensity to pay and improve patient
• Waystar is a leading provider of cloud-based revenue cycle technology experience
• Its solutions remove friction from payment processes, streamline
Agency Management
workflows, and improve the financials of providers
Get insights into outsourced
• Waystar integrates with all major practice management, hospital agency effectiveness
information and EHR systems
Patient Insights
Use data on broad factors that
influence health to improve clinical
450,000+ 5,000 outcomes
Providers Health plans
2 bn 20+ 98%
Transactions annually Years in the industry Client satisfaction rating
Matthew Hawkins Ric Sinclair Chris Schremser Steve Oreskovich

Chief Executive Officer Chief Strategy & Chief Technology Chief Financial Officer
Product Officer Officer

WEX Inc.
CEO: Melissa Smith

Headquarters: South Portland, ME
Founded: 1983
• WEX Inc. (NYSE: WEX) provides corporate payment solutions in three segments:
fleet solutions, travel & corporate solutions, and health & employee benefit
solutions
• Fleet solutions, the Company’s largest segment by revenue, provides
fleet vehicle payment-processing services for commercial and
government fleets
• Travel & corporate solutions offers B2B payment processing and
transaction monitoring services
• Health & employee benefits offers healthcare payment products and a
consumer-directed software platform
LTM High 02/24/21 $230.00
$250 LTM Low 10/29/20 $126.00
$200
$150
$100
$50

($ in mm) 2018 2019 2020
11/20/16 Debt $3 Invesco
Revenue $1,493 $1,708 $1,553
07/01/16 PIPE na Warburg Pincus
EBITDA 550 583 360
Net Income 168 99 (244)

Zelis
o Zelis works with more than 100 payers (including seven of the eight largest),
leveraging provider data from more than 3,500 provider networks and
Headquarters: Bedminster, NJ approximately 200 million user interactions
Founded: 2016 o Used by Payers and Benefit Consultants, Brokers & Health IT Companies
• Zelis is a provider of healthcare claims cost management and payments o Network Solutions - Improves network access and maximizes network cost
optimization solutions to price, pay and explain healthcare claims savings through tailored network design, network management, and access to
more than 1.5 million Medical, Dental and Workers’ Comp providers
• The Zelis Intelligent Claim Routing Platform is a single, real-time technology
interface that powers its fully integrated healthcare claims cost o Payment Integrity – Maximize claims cost savings through claims editing,
management, payment optimization and communications solutions hospital bill review, specialty clinical audits, optimal cost-savings on out-of-
network claims, reference based pricing and more
• The Company delivers integrated network analytics, network solutions,
payment integrity, electronic payments and claims communications for
payers, healthcare providers and consumers in the medical, dental and
o Payers – With access to more than 1.5 million providers and a proprietary
workers' compensation markets nationwide
payments network of more than 700,000 contracted providers, Zelis helps save
• Zelis was created through the merger of four companies, Premier payers an average 60% of the cost of making healthcare payments by converting
Healthcare Exchange, Stratose, GlobalCare and Pay-Plus Solutions, that was from paper-based payments to electronic payments
sponsored by Parthenon Capital Partners in 2016
o Providers – One easy to use portal to match bills with payments from more than
330 payers; Ability to paid through ACH, Virtual Card or check
Selected Acquisition History
Date Size ($ mm) Target o Enrollment – Streamlines enrollment communications across departments and
partners with custom document / ID card designs
09/17/21 na Sapphire Digital
o Claims – Consolidates transactional claims communications with episodic
08/01/19 $6,000 RedCard
explanation of benefits
11/05/18 na Netminder
11/06/17 na EthiCard Advisors
03/31/17 na Strenuus
02/28/17 na Maverest Dental Network

Zero
Members
CEO: James Millaway • Access to care for no extra money
Headquarters: Tulsa, OK • Zero covers hundreds of procedures and services ranging from lab
to imaging to surgery
Founded: 2016
• Members are supported by their own Personal Health Assistant
• Plan members are matched up with local healthcare providers that
will deliver the best combination of cost, quality and convenience
• Zero allows self-funded employers to lower health plan costs while
improving the employee benefits Providers
• The Company works with innovative employers and providers to
• Zero makes it easy for providers to attract new patients, speed up
build an entirely new ecosystem of healthcare delivery payment and simplify administration
• Members are supported by their own personal health assistant and • Providers are always paid in full, with nothing to collect from
health plans cover 100% of the costs members
• Participating providers have access to a new marketplace of Employers

patients and get paid in full, without needing to collect deductibles
and co-pays
• Zero lets employers dramatically lower plan costs while improving
employee benefits
Selected Transaction History • Employers save up to 50% compared to average costs of those
legacy “one-size-fits-all” health plans
George Kaiser Family Foundation;

11/22/19 Early Stage $7
Revolution’s Rise of the Rest
05/22/17 Early Stage <1 Undisclosed Investors
James Millaway Stan Schwartz Wim de Pril

CEO CMO CTO

VIII. Financing & M&A Activity

Selected Largest Private FinTech Healthcare Financing Transactions in the U.S. in the Last 5 Years
Financings
Amount
Announced Date Company Selected Investors
($mm)
NEA; Bessemer Venture Partners; Cross Creek Advisors; Declaration Partners; Flare Capital
12/17/19 Bright Health Partners; Greenspring Associates; Meritech Capital Partners; Redpoint Ventures; Town Hall $635
Ventures
01/29/19 Clover Health Greenoaks Capital Management 500
The Blackstone Group; Tiger Global; T. Rowe Price; NEA; Greenspring Associates;
09/22/20 Bright Health 500
Bessemer Venture Partners
Formation 8; Goldman Sachs; GV; Hommels Holding; Horizons Ventures; Wellington
Management; Swordfish Investments; Breyer Capital; Glynn Capital Management; Red
02/22/16 Oscar 400
Swan Ventures; Cambria Group; VGC Partners; Fidelity Investments; CapitalG; General
Catalyst
07/01/21 Olive Vista Equity Partners; Base10 Partners 400
08/14/18 Oscar Alphabet Inc. 375
10/16/18 Devoted Health Andreessen Horowitz; Premji Invest; Uprising Ventures; Frist Cressey Ventures 300
Health Care Service Corporation; DFJ Growth; Founders Fund; G Squared; Maverick
05/04/21 Collective Health 280
Ventures; NEA; PFM Health Sciences; SoftBank Vision Fund; Sun Life Financial
07/08/20 VillageMD Walgreens; Kinnevik 250
05/10/17 Modernizing Medicine Warburg Pincus 231
Tiger Global; General Catalyst; Drive Capital; Silicon Valley Bank; GV; Sequoia Capital Global
12/01/20 Olive 226
Equities; Dragoneer Investment Group; Transformation Capital Partners
Alphabet Inc.; General Catalyst; Khosla Ventures; Lakestar; Coatue Management; Thrive
06/26/20 Oscar 225
Capital; Baillie Gifford
SoftBank Vision Fund; PSPIB; DFJ Growth; G Squared; Founders Fund; GV; Maverick
Ventures; Mubadala Ventures; NEA; Sun Life Financial
03/09/21 Cedar Tiger Global; Andreessen Horowitz; Thrive Capital; Concord Health Partners 200
Declaration Partners; Meritech Capital Partners; Bessemer Venture Partners; Cross Creek
11/29/18 Bright Health Advisors; Flare Capital Partners; Greenspring Associates; Greycroft Partners; New 200
Enterprise Associates; Redpoint Ventures; Town Hall Ventures
09/09/20 Grand Rounds The Carlyle Group 175
Founders Fund; 8VC; Verily; Fidelity Investments; General Catalyst; CapitalG; Khosla
03/27/18 Oscar 165
Ventures; Thrive Capital
Arena Ventures; Wildcat Venture Partners; AME Cloud Ventures; Casdin Capital; Floodgate;
05/23/16 Clover Health Nexus Venture Partners; Refactor Capital; Spark Capital; Greenoaks Capital Management; 160
Sequoia Capital; First Round Capital
Source: FT Partners’ Proprietary Transaction Database
Selected Largest Private FinTech Healthcare Financing Transactions in the U.S. in the Last 5 Years (cont.)
Financings
Amount
($mm)
Greenspring Associates; Greycroft Partners; Redpoint Ventures; Cross Creek Advisors; New
06/01/17 Bright Health $160
Enterprise Associates; Bessemer Venture Partners; Flare Capital Partners
02/11/21 ZocDoc Francisco Partners 150
Tiger Global; Dragoneer Investment Group; Baillie Gifford; Coatue Management; Founders
12/17/20 Oscar 140
Fund; Khosla Ventures; Lakestar; Reinvent Capital
03/04/20 Alignment Healthcare Fidelity Management & Research Company; T. Rowe Price; Durable Capital Partners 135
BoxGroup; GV; Palm Drive Capital; Western Technology Investment; Greenoaks Capital
05/11/17 Clover Health 130
Management; Sequoia Capital; First Round Capital
Drive Capital; Bond Capital; Tiger Global; Menlo Ventures; Cathay Innovation; GreatPoint
01/26/21 Sidecar Health Insurance 125
Ventures
03/08/17 Alignment Healthcare Warburg Pincus 115
Insight Partners; Spark Capital; Concord Health Partners; Hummer Winblad Venture
03/16/21 Clarify Health Solutions 115
Partners; Kohlberg Kravis Roberts & Co.; Rivas Capital; Sigmas Group
New Enterprise Associates; Founders Fund; GV; Maverick Ventures; Sun Life Financial;
Mubadala Ventures
05/11/21 Aetion Foresite Capital Management; Flare Capital Partners; NEA; B Capital Group; Warburg Pincus 110
09/17/20 Olive General Catalyst; Drive Capital; SVB Capital; Oak HC/FT; Ascension Health Ventures 106
10/21/20 Bind Undisclosed Investor(s) 105
01/19/21 Aledade Meritech Capital Partners; Tiger Global; IVP; OMERS Growth Equity 100
04/01/21 Friday Health Plans Vestar Capital Partners; Leadenhall Capital Partners 100
03/30/21 Rightway Healthcare Khosla Ventures; Thrive Capital; Tiger Global 100
03/10/21 Advise Health Holdings Oak HC/FT; Hamilton Lane; Adams Street Partners 100

Financings
Amount
($mm)
04/06/16 Bright Health Bessemer Venture Partners; New Enterprise Associates; Flare Capital Partners $80
Andreessen Horowitz; Kaiser Permanente Ventures; Kinnevik; Thrive Capital; Lakestar;

06/22/20 Cedar 77
Founders Fund; JP Morgan Chase & Co; Concord Health Partners
FutureFund; Ziff Davis; NF Trinity Capital; Itochu Corporation; New Enterprise Associates;
04/04/18 Welltok 75
Bessemer Venture Partners; Georgian Partners
Norwest Venture Partners; UPMC; MultiCare Health System; SVB Leerink; Sequoia Capital;
02/29/16 Health Catalyst Sands Capital; Kaiser Permanente; CHV Capital; Partners HealthCare; EPIC Ventures; 70
Leavitt Equity Partners; Tenaya Capital; OSF Healthcare System
08/10/16 Accolade Madrona Venture Group; Andreessen Horowitz 70
02/20/18 Bind Lemhi Ventures 70
OMERS Growth Equity; California Medical Association; Meritech Capital Partners; Echo
04/20/20 Aledade 64
Health Ventures; The Central Valley Fund; GV
Venrock; Obvious Ventures; Oak HC/FT; NextView Ventures; Maverick Ventures; F-Prime
10/20/17 Devoted Health 62
Capital; Eight Roads
08/24/16 ClearCare Battery Ventures 60
03/23/21 Akasa Andreessen Horowitz; Bond Capital; Costanoa Venture Capital 60
Aspect Ventures; Company Ventures; Flare Capital Partners; FLEX Capital Management;
02/18/21 Eden Health 60
Insight Partners; Max Ventures; PJC Capital
03/30/17 Decisely EPIC Insurance Brokers; Two Sigma Private Investments 60
GGV Capital; Tenaya Capital; Sequoia Capital; True Ventures; Matrix Partners; Scale
08/02/18 Namely 60
Venture Partners
General Catalyst; 7wire Ventures; Merck Global Health Innovation Fund; Kleiner Perkins;
06/10/21 Transcarent Leaps by Bayer; GreatPoint Ventures; Threshold Ventures; Alta Partners; Jove Equity 58
Partners
02/12/16 Maestro Health Undisclosed Investor(s) 53

Financings
Amount
($mm)
03/31/20 Olive General Catalyst; Oak HC/FT; Drive Capital; Ascension Health Ventures $51
07/13/21 VisiQuate Sixth Street Partners 50
05/12/21 DrFirst Sixth Street Growth 50

Union Square Ventures; FirstMark Capital; Bain Capital Ventures; Index Ventures; Redpoint
01/28/20 Justworks 50
Ventures; Thrive Capital; Spark Capital
Andreessen Horowitz; Carrick Capital Partners; Madrona Venture Group; McKesson
03/30/18 Accolade 50
Ventures; Cross Creek Advisors; Madera Technology Partners
09/26/16 InstaMed Carrick Capital Partners 50
12/18/19 OM1 Scale Venture Partners; General Catalyst; Polaris Partners; 7wire Ventures 50
01/08/20 Komodo Health Andreessen Horowitz; Oak HC/FT; IA Ventures; Felicis Ventures 50
01/13/21 Healthcare Fraud Shield Charlesbank Technology Opportunities Fund 50

Scale Venture Partners; Altimeter Capital; Sequoia Capital; Matrix Partners; True Ventures;
01/05/17 Namely 50
Greenspring Associates; Four Rivers Group
02/23/21 Circulo SVB Capital; Oak HC/FT; General Catalyst; Drive Capital 50
02/02/21 Capital RX Transformation Capital Partners; Edison Partners 50
12/10/19 Friday Health Plans Peloton Equity; Leadenhall Capital Partners 50
09/02/21 Solv Health aCrew Capital; Corner Ventures; Greylock Partners; Benchmark Capital 45
Lead Edge Capital; Martin Ventures; Jackson Square Ventures; Health Velocity Capital;
11/24/20 WELL 45
Summation Health Ventures; Structure Capital; Freestyle Capital
01/11/18 Evive Susquehanna Growth Equity 43
09/19/18 OODA Health Oak HC/FT; Threshold Ventures; Blue Shield of California 41

Financings
Amount
($mm)
Tiger Global; GreatPoint Ventures; Cross Creek Advisors; SpringRock Ventures; Wildcat
01/17/21 Carrum Health $40
Venture Partners
SVB Capital; ICONIQ Growth; Bow Capital; Felicis Ventures; Social Leverage; SemperVirens
06/02/21 Nayya Health Venture Capital; Guardian Strategic Ventures; Unum Business Ventures; CNO Financial 37
Group
03/06/18 Justworks FirstMark Capital; Index Ventures; Thrive Capital; Bain Capital Ventures; Redpoint Ventures 40
01/14/20 Medsphere Systems TPG Sixth Street Partners 40
12/10/20 Elation Health Generation Investment Management; Threshold Ventures; Kapor Capital 40
Formation 8; Redpoint Ventures; RRE Ventures; Subtraction Capital; Rock Health; Founders
Fund; New Enterprise Associates
SVB Capital; ICONIQ Growth; Bow Capital; Felicis Ventures; Social Leverage; SemperVirens
06/02/21 Nayya Health Venture Capital; Guardian Strategic Ventures; Unum Business Ventures; CNO Financial 37
Group
06/25/18 Cedar Investment AB Kinnevik; Founders Fund; Thrive Capital; Lakestar; Sound Ventures 36
New Enterprise Associates; Amgen Ventures; Flare Capital Partners; Lakestar; Oxeon
04/11/18 Aetion 36
Partners

Selected Largest FinTech Healthcare IPO Transactions in the U.S. in the Last 5 Years
IPOs
Exchange / Ticker Amount Raised
IPO Date Company IPO Offer Price
Symbol ($mm)
03/03/21 Oscar NYSE: OSCR $39.00 $1,445
09/23/20 GoodRx Nasdaq: GDRX 33.00 1,142
06/24/21 Bright Health Group NYSE: BHG 18.00 924
07/15/20 GoHealth Nasdaq: GOCO 21.00 914
02/11/15 Inovalon Nasdaq: INOV 27.00 600
02/11/21 Signify Health NYSE: SGFY 24.00 564
06/28/19 Change Healthcare Nasdaq: CHNG 13.00 557
03/26/21 Alignment Healthcare Nasdaq: ALHC 18.00 490
NYSE: COTV
05/25/16 Cotiviti 19.00 238
Acquired by Verscend in 2018
07/02/20 Accolade Nasdaq: ACCD 22.00 221
06/10/15 Evolent Health NYSE: EVH 17.00 196
07/24/19 Health Catalyst Nasdaq: HCAT 26.00 182
07/17/19 Phreesia NYSE: PHR 18.00 167
06/02/16 NantHealth Nasdaq: NH 14.00 91
09/28/16 Tabula Rasa Healthcare Nasdaq: TRHC 12.00 52

Selected Largest FinTech Healthcare M&A Transactions in the U.S. in the Last 5 Years
M&A
Amount
Announced Date Target Buyer
($mm)
07/12/21 MSP Recovery Lionheart Acquisition Corp. II $32,634
01/06/21 Change Healthcare OptumHealth 13,000
07/12/20 Multiplan Churchill Capital Corp. III 11,000
01/25/21 Alight Solutions Foley Trasimene Acquisition 7,300
08/19/21 Inovalon 22C Capital; Nordic Capital; Insight Partners 5,700
11/12/18 athenahealth Veritas Capital; Evergreen Coast Capital 5,700
06/19/18 Cotiviti Verscend 4,900
06/29/16 Change Healthcare McKesson Corporation 4,450
10/06/20 Clover Health Social Capital Hedosophia Holdings III 3,700
12/21/20 HMS Holdings Gainwell Technologies 3,400
02/18/16 Truven Health Analytics IBM Watson Health 2,600
06/27/19 WageWorks HealthEquity 2,000
05/17/17 Global Healthcare Exchange Temasek 1,800
01/26/17 CoverMyMeds McKesson Corporation 1,400
10/13/20 CarePort Health WellSky 1,350
08/29/17 Advisory Board OptumHealth 1,300
08/12/20 eSolutions Waystar 1,300

Selected Largest FinTech Healthcare M&A Transactions in the U.S. in the Last 5 Years (cont.)
M&A
Amount
($mm)
03/07/18 ABILITY Network Inovalon $1,200
04/25/16 Verscend (fka: Verisk Health) Veritas Capital 820
02/22/16 Brightree ResMed 800
11/05/18 MDI Achieve ResMed 750
08/02/18 AdvancedMD Global Payments 700
05/10/21 BillingTree REPAY 503
02/11/16 HealthPlan Services Wipro 460
02/26/18 Intermedix R1 RCM 460
05/13/21 OODA Health Cedar 425
01/17/19 Discovery Benefits WEX 425
07/13/20 Benefytt Technologies Madison Dearborn Partners 420
06/07/21 Sentry Data Systems Craneware 400
06/13/16 Cardon Outreach MedData, LLC 400
07/30/20 Enterprise Performance Systems Strata Decision Technology 365
11/25/16 Constellation Healthcare Technologies CC Capital; Constellation Management 307
10/10/19 MedData Frazier Healthcare Partners 300
05/04/21 VisitPay R1 RCM 300
01/08/20 Brand New Day Bright Health 280
04/14/21 benefitexpress WEX 275

M&A
Amount
($mm)
09/12/16 Anthelio Healthcare Solutions ATOS Origin $275
11/23/20 e-MDs CompuGROUP 240
05/01/18 SCIO Health Analytics ExlService Holdings 237
07/13/16 Valence Health Evolent Health 219
09/12/18 NCH Management Systems Evolent Health 217
09/05/17 T-System FNFV Group 200
01/13/20 SCI Solutions R1 RCM 190
07/18/19 Health Credit Services Ally 190

McKesson Corporation's Hospital and
08/03/17 Allscripts Healthcare Solutions 185
Health System Business
05/19/20 HintMD Revance Therapeutics 180
10/04/16 Emmi Solutions Wolters Kluwer 170
03/13/17 Eliza HMS Holdings Corp 170
06/24/21 Twistle Health Catalyst 170
09/11/20 Franco Signor Verisk Analytics 160
01/22/18 Maestro Health AXA 155
11/10/20 HSTechnology Solutions Multiplan 140
08/04/21 Vital Decisions Evolent Health 130
06/30/16 HealthiestYou Teladoc 125

M&A
Amount
($mm)
01/08/18 Practice Fusion Allscripts Healthcare Solutions $100
03/23/17 HealthHelp WNS Holdings 95
07/15/21 Patientco Waystar na
09/14/21 Sapphire Digital Zelis na
04/02/21 AxiaMed Bank of America na
12/17/20 Health iPASS SphereCommerce na
12/17/20 HealthSparq Kyruus na
03/09/20 HealthEdge Software The Blackstone Group na
02/04/20 Acurity Premier na
01/09/20 Centauri Health Solutions ABRY Partners na
12/04/19 Recondo Technology Waystar na
07/29/19 Waystar EQT Partners; CPPIB na
06/26/19 NexTech T.H. Lee na
05/15/19 InstaMed JP Morgan Chase & Co na
08/22/19 Ontario Systems New Mountain Capital na
08/20/19 Remedy Partners Signify Health na
08/01/19 RedCard Zelis Healthcare na

M&A
Amount
($mm)
09/27/18 GENEX Services Mitchell International na
08/07/18 Alegeus Technologies Vista Equity Partners na
07/11/18 Medicity Health Catalyst na
01/04/18 Connecture Francisco Partners na
11/20/17 BenefitMall The Carlyle Group na

IX. Overview of FT Partners & QED

i. Overview of QED Investors

QED Investors Overview
• QED was founded in 2007 by Nigel Morris, who co-founded Capital One
and served as President and Chief Operating Officer, Frank Rotman,
and Caribou Honig
• Invests in early-stage, disruptive financial services companies in the

U.S., U.K. and Latin America
• Hands-on approach that leverages its partners’ decades of

entrepreneurial and operational experience to help portfolio companies
achieve breakthrough growth
• Notable investments include Credit Karma, ClearScore, Nubank, Avant,

SoFi, Klarna, GreenSky, AvidXchange, Remitly,
QuintoAndar, Wagestream, Loft, Konfio, and Creditas
• QED primarily invests in seed and Series A rounds, but invests as early
as formation stage, through its Belay platform, and as late as Series B

QED Investors Overview (cont.)

ii. Overview of FT Partners

Selected FT Partners Healthcare Payments / IT Transactions
Largest Wholesale
Healthcare Payments Healthcare Payments Revenue Cycle Management Health Insurance Distribution
Brokerage in the U.S.
Patient Engagement / Agency Management / Health Insurance Premium

Population Analytics Payment Integrity / Audit
Marketing Technology Billing & Payments

Ground-Breaking Payments Transactions Pioneered by FT Partners

FT Partners Advises BillingTree on its $503 million Sale to REPAY
Overview of Transaction
•
Significance of Transaction
•
FT Partners’ Role
•

FT Partners Advises InstaMed on its Sale to JPMorgan Chase Bank
•
FT Partners’ Role
•

FT Partners Advises Assurance on its $3.5 billion Sale to Prudential Financial
•
•
FT Partners’ Role
•

FT Partners Advises REPAY on its Merger with Thunder Bridge
•
•
FT Partners’ Role
•
•

FT Partners Advises AvidXchange on its $388 million Growth Financing
•
•
FT Partners’ Role
•

FT Partners Advises Eliza on its Strategic Sale
•
•
FT Partners’ Role
•

FT Partners Advises Marqeta on its $150 million Growth Financing
•
•
FT Partners’ Role
•

FT Partners Advises Benaissance on its $80 million Sale to Wex
•
̶
•
•
•
FT Partners’ Role
•

FT Partners Monthly Market Analysis Reports
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SUBSCRIBE

FT Partners’ Recent Awards and Recognition
Bloomberg
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M&A Advisor Awards

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LendIt FinTech Industry Awards 2018:

o
The FinTech Finance 40:

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The Information’s “Silicon Valley’s Most Popular Dealmakers”

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The Largest FinTech Advisory Practice in the World

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FT PARTNERS & QED INVESTORS | September 2021

FinTech Industry Research

Steve McLaughlin steve.mclaughlin@ftpartners.com Matt Risley matt@qedinvestors.com

To receive regular updates from To receive regular updates and a

Industry Experts / Large Corporates

The healthcare industry, which

Individuals who receive medical

Claims & Bills

Institutions that provide insurance

$1,400 Hospital Care

Physician / Clinical Services Other

(1) Peterson-Kaiser Health System Tracker

Covers services provided in establishments operated by a Doctor of

Covers medical care provided in the home by freestanding home

This category includes spending for Medicaid home and

Source: Peterson-Kaiser Health System Tracker

2018 data ($ in billions)

Long Term Care Facilities Laboratories 33%

Medical Offices Home Health Care $1,192

Dental Offices Hospice

Clinics Mental Health 20%

1) American Hospital Association Annual Survey 2019

Non-profit hospitals must serve the needs of their communities and

Government-funded hospitals (Local, State and Federal) are provided

▪ A network of facilities under one parent company providing a continuum of healthcare

(1) IQVIA: “Top 25 Integrated Delivery Networks” (2018 data)

▪ Since the 1970’s, the number of providers in the U.S.

3,000% Physician Growth ▪ Although there has been an influx of administrative

2,000% ▪ Administrative tasks can include notes and medical

(1) athenahealth, “The rise (and rise) of the healthcare administrator”

Privately run insurance companies provide plans that are distributed

Everyone receives the same access to healthcare services at an

Government funded comprehensive coverage

Universal and Single Payer typically go “hand-in-hand” but there are

907 198mm $670bn

$1,000 Out of Pocket Spending

Dept. of Veterans Affairs (VA)

Department of Defense (TRICARE)

$600 In total, government

(1) Peterson-Kaiser Health System Tracker

Covers seniors 65+ years of age and

Covers low-income people of all ages –

Coverage for military veterans 2.5%

Covers active-duty and retired uniformed 1%

Covers children in families that earn too

(1) Peterson-Kaiser Health System Tracker

Individual plans purchased outside of exchanges, generally

($ in billions) (in millions)

(1) $79.7 22.2

Source: Becker’s Hospital Review: “America's largest health insurers in 2018”

($ in billions) Average annual premium, 2018:

Anthem 25% cumulative premium increase between 2012

Average annual premium, 2018: $5,772 (3)

Often offer lower premiums to enrollees who do

Individuals who receive medical care from providers

(# in millions) Americans spent an average of $4,928 on healthcare in 2017,

Monthly payment made to the insurance company for the health

Fee paid to healthcare provider for services

FT Partners / QED (2)

$400 Out-of-pocket costs are in