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Market Muscle, Capital Shifts, and a $285M Signal to Europe
HealthTech capital is concentrating: NA leads, payers feel the pressure, and digital MSK consolidation accelerates.
Good morning, ! Today we’re covering United Health’s dominance in managed care, the market share of healtech VC value by region, and Sword Health $285M investment into Germany’s healthcare
Sponsor Spotlight: Whereby is a video call API for telehealth platforms built to improve reliability, trust, and retention in virtual care, with a migration approach designed to reduce risk and time-to-value. In Huli’s case, the team launched an embedded telemedicine experience in ~1.5 weeks and has since seen 20X growth in video consultations, supporting 10,000+ healthcare professionals while reducing no-shows by 20%. Read the Huli Story →
— The Healthcare150 Team
REGIONAL FOCUS
Capital Has a Zip Code
Global HealthTech VC in 2024 had a clear mailing address: North America. The region captured $9.14B, dwarfing Europe’s $1.8B and Asia’s $908M . After that, the numbers fall off a cliff. Rest of World and Oceania hover near $140M each. Africa and the Middle East barely clear $20M combined.
North America continues to dominate in growth equity depth, IPO optionality, and strategic buyer density. Europe is competitive but capital-light. Asia appears more cautious amid broader venture pullbacks.
Emerging markets may offer compelling patient demand and digital adoption curves. But until capital formation and exit ecosystems mature locally, scaling ambition will likely keep crossing the Atlantic. (More)
PRESENTED BY WHEREBY
Huli, a Costa Rica-based healthtech platform that helps doctors manage their practices, needed to enable telemedicine fast without pushing doctors and patients into external apps. They chose Whereby, a video call API for telehealth, prototyped an embedded experience within days, and launched a production-ready solution inside their platform in ~1.5 weeks.
Since then, Huli has achieved 20X growth in video consultations, supports 10,000+ active healthcare professionals across multiple countries, and has seen a 20% reduction in no-shows, even in low-bandwidth environments.
They chose an approach that could roll out quickly, scale reliably, and keep ongoing maintenance low, so the team could focus on growth and experience improvements.
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HEADLINE OF THE WEEK
The King of Managed Care
UnitedHealth Group dominated a bruising 2025, posting $12.05B in profit on a staggering $447.6B in revenue—both industry highs. That’s more than double Cigna’s nearly $6B profit and miles ahead of peers navigating rising medical loss ratios and cost inflation.
But the victory lap comes with a limp. Q4 profit clocked in at just $10M, alongside a 92.4% MLR, as utilization surged. Meanwhile, Centene was the lone major payer in the red, losing $6.7B amid Medicaid and ACA turmoil.
Add in CMS’s proposed flat 2027 Medicare Advantage rates, and even giants like CVS Health and Humana are grumbling.
The takeaway: scale still wins—but margins are on life support. 2026 will be less about growth and more about execution under pressure. (More)
MICROSURVEY
What will matter most for successful healthcare M&A in the current cycle? |
DEAL OF THE WEEK
Sword Health Acquires Kaia Health for $285M
Digital MSK consolidation just turned strategic.
Sword Health’s $285M acquisition of Kaia Health does two things at once. It eliminates a U.S. competitor and secures entry into Germany’s DiGA reimbursement pathway, covering 70M+ lives. Sword will sunset Kaia’s U.S. MSK product and migrate members onto its own AI platform, signaling confidence in outcome differentiation and cost performance.
This is less about geography and more about platform control. In a virtual care market facing penetration ceilings, scale without reimbursement durability is fragile. Germany offers a regulated digital health on-ramp. That optionality matters.
Meanwhile, Premise Health and Crossover Health are merging to form a nearly 900-site employer primary care platform serving 400+ organizations. Premise’s prior data showing 30% cost savings, or $2,434 per member per year, strengthens the underwriting case for advanced primary care at scale.
Two themes converge. Digital point solutions are consolidating into defensible platforms. Employer primary care is doubling down on integrated, risk-aligned models.
Capital is shifting toward assets that control patient flow, reimbursement pathways, and longitudinal data. Execution now decides who survives the 2026 filter. (More)
PUBLISHER PODCAST
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See how Huli used Whereby to scale telemedicine quickly and reliably, with low ongoing maintenance as usage grew.
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