ViVE 2022: Former Livongo execs launch rural healthcare startup Homeward with $20M investment

Health tech veteran Jennifer Schneider, M.D., helped build up chronic condition management startup Livongo, then helped lead the company through a massive IPO and the industry's largest merger with Teladoc.

Schneider and other Livongo veterans are reuniting and taking on their next challenge—improving rural healthcare.

The executive team, including Amar Kendale, former chief product officer at Livongo, and Bimal Shah, M.D., former chief medical officer at Livongo, announced Monday the launch of Homeward, a startup focused on improving access to high-quality, affordable primary and specialty care in rural communities.

"It's a big, audacious, hairy goal, for sure," Schneider told Fierce Healthcare on-site at the ViVE 2022 conference in Miami Beach. "If you look at rural markets, the amount of hospital closures and access to care has just plummeted. There's really not been a great solution."

She added, "I grew up in a rural market. This is super personal to me; this is my family, these are the people that I care about. The ecosystem in rural healthcare is not just kind of broken, it's massively broken."

Schneider, now the CEO of Homeward, said the new startup aims to "rearchitect" rural healthcare.

"We're not reinventing it; we're not throwing everything out. We're really eager to partner and work with the care providers in rural communities," she said.

Homeward will be the first comprehensive provider to take on full risk in rural markets, according to executives. The company will initially partner with regional Medicare Advantage plans.

"We want to align all the economic incentive payments and take on the responsibility for total cost of care. We really want to do true value-based care, not performance-based care. And we're going to do that in a hybrid model that leverages technology and services for both primary care and specialty care," she said.

General Catalyst led an initial $20 million investment in the startup to help fuel its launch.

Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes and higher costs. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities, according to executives.

Americans living in rural communities suffer a mortality rate 23% higher than those in urban communities, in part because of the lack of access to quality care, according to a study published in Health Affairs.

Homeward plans to deliver a hybrid model of technology and services that will immediately increase access to primary care and specialty services, beginning with cardiology. Homeward employs a multidisciplinary care team, available both virtually and on the ground via mobile care units, with in-home remote monitoring that keeps patients connected to their care team.

"We can't magically create a bunch of new providers and force them to live in rural markets. But what we can do is enable the technology that we have to really further our region, our extension," Schneider said.

But she points out that telehealth, by itself, has not solved rural healthcare disparities. Homeward offers a comprehensive care solution that includes telehealth visits, remote patient monitoring and in-person visits via mobile care units.

Rather than rely on broadband in these markets, Homeward will employ cellular-based monitoring devices and virtual services to better connect to even the most remote members, Schneider said.

"We believe that by combining easy-to-use technology, evidence-based care delivery, in-home and in-community services and aligning the care model to the right incentives, we'll be the first to offer a new approach that provides the high-quality care that everyone deserves—no matter where they live," she said.

Homeward plans to use proactive measures, including remote patient monitoring to detect, for example, the signs of a heart problem early, followed quickly by an in-home visit to test, diagnose and treat the problem and then followed by virtual visits.

Homeward's executive team includes Kendale, who joins as co-founder and president; Shah, who joins as chief operating officer; Dr. Aaron Friedkin, M.D., former senior vice president of care delivery transformation at Blue Cross Blue Shield of Michigan, who joins as chief revenue officer, and Brian Vandenberg, former general counsel at both the American Medical Association and Livongo, who serves as chief administrative officer and general counsel.

Homeward is the first investment in General Catalyst's new $800 million Creation fund.

"One of the core tenets of health assurance is health equity, and serving our rural communities is an urgent imperative for us," said Hemant Taneja, General Catalyst's managing partner, in a statement. "We feel privileged to be working with the incredible Homeward team that deeply cares about this mission."