Innovating for the Health Care Safety Net: Sources of Funding
STANFORD GRADUATE SCHOOL OF BUSINESS—Medical Technologies with high "social value" — those that have the potential to reduce costs, improve health care, and improve access to care — can play an important role in helping safety-net providers use their resources more efficiently to better serve millions of patients. However, because the conventional wisdom among traditional investors is that the total market potential for such technologies small relative to other, more immediate opportunities, many companies have struggled to secure capital to fund the development and commercialization of these innovations. Venture capitalists are one of the most common sources of funding for medtech innovations. Typically, they screen their investment opportunities using criteria that place high value on factors such as proven business model, a large and accessible market, limited adoption risks, a clear reimbursement pathway, and a high return on investment. Venture capitalists use the same demanding criteria to evaluate all opportunities, including those with high social value, which can make it difficult for technologies that could benefit the safety net but pose greater investment risk to secure capital. Even if a technology meets the standard criteria, many venture capitalists remain skeptical; fundamentally, they do not believe that unbounded, profitable opportunities exist in low-resource environments. Despite this perception, the safety net shows some promise as a market opportunity for commercial investors because: As financial circumstances across the health care industry worsen, cost-reducing technologies are sure to become more universally appealing; The lack of competition in the safety net represents a "white space" that could attract investment; The size of the underserved market is compelling, especially given that another 20 million people are expected to become eligible for Medicaid by 2014; and Low-resource environments outside the United States abound and could significantly increase the size of the market for innovations with high social value. If one accepts the premise that innovations with high social value, such as remote monitoring technologies, are beneficial to the safety net, then foundations and the other social investors could play an important role in overcoming the market failures that prevent these innovations from being funded. At least three key strategies are worth considering: 1. Early-stage investments, which would help drive down the mounting costs associated with addressing a product’s market and adoption risks; 2. Targeted grant-making, which could help reduce risks unique to the safety net that contribute to negative perceptions of it as a market for innovations; and 3. The creation of social venture funds to supplement traditional funding models for medtech innovations and thereby help technologies with high social value reach a point at which they are attractive to venture investors