Here's my take on the rise of new mental health companies (Ginger, Lyra, Spring, Modern, etc.). These companies have raised a ton of money and are getting traction in a large market.

The question is: what now? who wins?
Mental Health is a hot button issue right now. That's driving massive adoption from employers looking to have an answer. Here's the problem: mental health is *expensive.* The least it can cost to impact someone's mental health is $600 (6 sessions * $100/session).
A commercial insurance plan costs $300-1000/mo (including employee contributions). Material mental health coverage can add 20% to the healthcare bill.

There's another catch: more usage of the benefit means more cost, less usage means you're paying for an unused benefit.
When employers look at their spend in 3 years (after 1st contracts expire) and there's less press coverage on MH, will they keep it?

Digital Health is full of co's that become checkbox items, massive adoption, then fizzle out (see: Castlight). Mental Health has a similar risk.
Mental Health is fundamentally a supply problem. Everyone wants a therapist, but it's *really expensive.* The only solutions, and the long term winners in this category, are going to be the ones with innovative models for activating new labor forces and AI counseling.
This is why I'm bullish on Ginger over these other companies (disclosure: my dad is an investor, but I have no inside Info). Ginger's model of using health coaches helps activate a new workforce and make high quality mental healthcare affordable. Ginger is also emphasizing AI.
tl;dr of this thread: cost matters a ton, therapists are super expensive. health coaches + AI will win to increase the labor force and make mental healthcare more affordable. watch out for ginger.
PS - this is a great example of my tweet from the other day. it *sounds* great to give everyone mental health benefits, but it's really expensive and cost realities will come into play. Winners will break that cycle and offer great care at lower cost.

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More from @nealkhosla

5 Jan
1/ A thread on the future + the pandemic:

As @Dale_W_Harrison notes, it looks like the vaccine may prevent serious illness, but not transmission. We'll probably need to continue social distancing + masks until 90% of the population is vaccinated.

dalewharrison.substack.com/p/results-from…
2/ Now read The Vaccine War by @Noahpinion: noahpinion.substack.com/p/the-vaccine-…

The virus is mutating. If we can't stop it, we're going to have to keep vaccinating ourselves to these mutations. This means we're going to need a wartime economy style vaccination program for a while.
3/ Lastly, read "New Defaults," by @stratechery, to understand what we should learn from COVID about how society should function, and recognize we have an opportunity to apply these learnings... right now... as we fight the second battle with the virus.

stratechery.com/2021/new-defau…
Read 4 tweets
29 Oct 19
1/ Saw this tweet from @DavidSacks and it prompted a bunch of thoughts.

There are are two types of co's that are facing a reckoning.

1. Tech-enabled w/o proficiency in cost attribution ("The WeWork/Uber effect")
2. Pre-PM Fit ("The YC effect")

2/ The "WeWork effect" proposes a real challenge for tech-enabled businesses where the unit economics and leverage from technology is typically unclear until you actually build the business, which often takes capital and time.
3/ The YC effect is a result of YC co's finding PM fit very early due to YC's effectiveness at getting founders to focus on PM fit and YC's popularity meaning more YC "seed" co's being further along w/ less capital raised.
Read 8 tweets
16 Jul 19
1/ Building on @pmarca’s “Software is eating the world” paradigm: It occurs to me that many early software co’s ate the world by virtualizing a formerly analog thing. Netflix w/ DVD's, Salesforce w/ rolodexes/CRM, other SaaS companies for things like billing, HR, collaboration.
2/ As the low hanging, fully digital fruit was picked, the next generation of companies took hybrid models: software eating industries that needed a physical components but not deep vertical integration or ownership. Uber, Airbnb, etc.
3/ The next version of companies are going to have deep vertical integrations. Low margin businesses (grocery, hospitals, etc.) have been incredibly resistant to tech. Much of our lives are at their core, unchanged from 20 yrs ago. Why not reinvent w/ tech (not just software)?
Read 7 tweets

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