What does the future of health care look like? For San Francisco startup Forward, the future has no health insurance, no copays, a network of AI-powered self-service health care pods, an app store and no cost to patients.
Legally known as GoForward, the concierge health care startup announced a $100 million funding round on Wednesday to fuel the next phase of its ambitious vision.
Forward isn't calling this a Series E or an extension round, but the fresh capital comes more than two years since Forward announced a $225 million Series D round which, at that time, more than doubled its total funding to around $400 million.
Forward also declined to confirm its exact total funding and valuation. However, the new round would bring the company's total funding to around $500 million based on its previous fundraising. The company was also valued at more than $1 billion last year, according to PitchBook.
Investors in the new round include Khosla Ventures, SoftBank, Founders Fund, Tencent, John Doerr, the Abu Dhabi Investment Authority, Samsung Next, Garrett Camp, Josh Buckley and Tim Kendall
CEO Adrian Aoun founded Forward in 2016 after selling his previous startup, Wavii, to Google a decade ago. Wavii used natural language processing, a form of artificial intelligence, to automatically surface recommendations from content on the internet, such as news. He then joined Google where he worked on AI-related efforts and led special projects like Sidewalk Labs.
Aoun then pivoted to the health care space after his brother had a heart attack.
His vision for Forward is powered by AI, involves an ecosystem of health-related apps and reserves in-person doctor's visits for things like specialized care, emergencies and other acute conditions.
It might take a while for Forward to fully realize this long-term vision, but Aoun isn't fazed by the prospect of long horizons or the pressure to deliver investor returns.
"What we're doing is like a Tesla-level execution challenge," Aoun said. "Hopefully we make it work. We're not so arrogant to say it's easy" but "we know where we are in our game."
Zero cost, not zero sum
Aoun's long-term goal also includes driving down the cost to patients all the way to zero dollars.
Forward doesn't accept traditional health insurance, though, making its services an out-of-pocket expense. So, how will the company generate revenue while driving down patient expenses?
"I'm not a big fan of the advertising business model, but I think there are a lot of models that can help you get there," Aoun said. "We'd like health care to be roughly free."
Part of that strategy is using technology to lower costs through becoming more efficient.
"Now what I'm working to do is just lower the cost by automating more and more," Aoun said. "The more I automate, and the more I rely on hardware and software, the more I can just lower my costs."
In the nearer term, a CarePod membership will cost $99/month, around one-third less than the membership fee for its full-service clinics which costs $149/month.
Future currently has 19 full-service clinics and a handful of CarePods that were deployed for early testing. The company is aiming to double its total number of clinics and pods by the end of 2024, with most of its expansion efforts focused on launching CarePods, the company said.
Eventually, Aoun wants to have its CarePods installed all around the world but Forward is starting with malls, gyms and office buildings in the Bay Area, New York, Chicago and Philadelphia.
During a video call ahead of Wednesday's announcement, Aoun demonstrated how blood tests can be self-administered in the pods.
Aoun used a small Dexcom-like device that uses suction to pull a small amount of blood from the upper arm. He peeled the backing off of a sticker, suctioned the device to his arm and a small vial began to fill with blood.
Forward isn't disclosing the manufacturer of its blood draw devices but researchers have been chasing needle-free and other alternatives for years.
Switzerland-based Loop Medical is developing a blood draw device that uses suction and no needles but notes in its FAQ section that it hasn't yet received regulatory approval. A device called the TAP Micro Select from Massachusetts-based Seventh Sense Biosystems uses suction and microneedles rather than a traditional lancet — it secured FDA clearance earlier this year.
Forward's CarePods should be able to handle 90%-95% of a patient's needs, Aoun told me, including some but not all lab work. For those high-touch edge cases, Forward refers patients to other providers.
Tapping into AI
Large language models, also known as LLMs, will be used to surface personalized apps and recommendations based on a patient's health needs and search queries.
For example, if a patient asks the pod to help with diabetes management, the LLM will search for the latest research on diabetes care and make recommendations based on that. Likewise, a patient looking for help with hypertension will be sent directly to an app specifically created for heart health.
At the moment, Forward's CarePods can also be used for depression and anxiety management, and the company will continue to add conditions that can be managed with through its pods, such as prenatal care, cancer screening and genetic testing.
Aoun's vision of a tech-enabled, futuristic health care system also includes building out a third-party developer platform for AI-powered health apps — essentially launching their own app store, but that's a ways off.
"The first iPhone actually had a YouTube app, which is kind of interesting because they didn't have an open platform but ... they had some partnerships," Aoun said. "You want to go cautiously into this sort of stuff ... We'll probably do kind of the same thing."
