All over the world, public healthcare systems are struggling to reset post-pandemic, and in particular, the growing elderly population in Western countries is putting pressure on services, not least in the UK where 'NHS in crisis' is a regular headline in the media. As a result, private companies, many of which are technology-enabled, are seeing a gap in the market. It has this background already Waxa proprietary software platform and in-home healthcare provider in the UK, has raised $150 million in a mix of debt and equity. The company said most of it was debt, but declined to give a breakdown and also denied its value.
The round was led by funds affiliated with BDT & MSD Partners and Schroders Capital to scale Cera's platform. The company says it's heavily AI-driven, with proprietary modeling based on its own data, though it admits to using soma aspects of both Google's Gemini AI platform as well as ChatGPT's version by Microsoft.
In 2022 Cera raised $320 million (£260 million) in an equity and debt financing round, split roughly 50/50.
According to CrunchBase it has 14 investors. Notable equity investors to date include Earlymarket, Guinness Ventures, DigitalHealth. London Accelerator, and long-time UK investor Robin Klein.
A spokesperson for Cera added that although this is not yet reflected in the publicly filed accounts, the company is EBITA positive in 2023 and free-cashflow positive in 2024, and it is “primarily a going concern itself,” so why can it raise this debt circle.
In an interview with TechCrunch, Dr Ben Maruthappu MBE, Founder and CEO of Cera, said: “We are gaining profitability, and we have a very significant legacy in how we use our technology and AI, and we are expanding more home service.”
Cera caregivers use its app to plan their work and log patient symptoms. Using its AI modeling, Cera is able to take that unstructured data (for example, “patient fell at night” etc) and use it to predict the potential for patients to be at greater risk of disease or damage. The company says this has resulted in hospitalization reductions of up to 70%, a 20% reduction in patient falls, and hospital discharges that are up to five times faster, it said in a statement.
The company has raised more than $407 million to date in a mix of equity and debt.
UK competitors include Home Instead and Bluebird Care, which use non-proprietary apps to direct their staff. In the US, the closest comparisons to Cera include Signify Health and CVS Health, both of which were acquired by Nasdaq-listed CVS Health. Another is Honor, which has raised $625 million to date.
Maruthappu said: “We are holding back the NHS and supporting it to have more capacity to care for other patients. We are also expanding other service lines such as nursing services, physiotherapy, learning disabilities , physical disabilities, and also providing mental health services at home. So we are a more comprehensive home health care provider.”
He also said that the business aspect driven by AI is based on the data it collects: “Another major advantage is what we do with technology, more specifically AI… We log information about patients from those visits to our app that has now given us one of the largest home healthcare data sets in the world, certainly the largest in Europe, and we've analyzed that data set in many different way to build algorithms, algorithms that are related if someone is going to have a fall before they do.”
“We can predict more than 80% of crashes a week before they happen. That's statistically significant… So we actually reduce crashes by more than 20% because of our AI algorithm… Predictable we also have about 83% of rehospitalizations a week before they happen… reducing hospitalizations by up to 70%,” he said.
In a statement, Rob Platek, partner and global head of credit at BDT & MSD, said: “Cera has achieved strong growth through a demonstrated ability to leverage technology to deliver exceptional care. We believe Cera is well positioned to further grow its business.”
Cera says it is the largest non-NHS healthcare provider, covering around 30 million people with 10,000 carers and nurses and working with more than 150 local authorities and two-thirds of NHS Integrated Care Systems.
It also claims that an independent review carried out by the UK consultancy Faculty found that Cera's AI-led home healthcare model saves the UK healthcare system £1 million per day.
Cera is clearly keen to avoid the disruption of healthcare startups like Babylon Health, admittedly a very different business, which went bankruptcy and sold for parts after trying to do healthcare with just a chatbot.
