LIVONGO

Glen Tullman had already sold a healthcare company (Allscripts, electronic health records) and knew the industry's central failure: it treats illness, not health. Diabetes affects 37 million Americans and costs $327 billion in annual healthcare spending — most of which goes to treating complications that proper management could prevent.

Livongo launched with a simple promise: give diabetics the information and coaching they need, when they need it, and watch the expensive stuff stop happening. The first product was a blood glucose meter that connected to a cellular network and uploaded readings automatically — no app required, no phone sync, no effort from the patient.

Livongo sold a membership-based chronic condition management platform. The core product was a smart cellular glucose monitor for diabetics — it automatically uploaded readings, sent coaching nudges in real time, and flagged dangerous trends before they became emergencies.

Livongo charged employers and health plans a per-member-per-month fee. It made money when diabetics stayed healthy enough to stay employed.

Employers saved on catastrophic health costs. Insurance companies paid less in claims.

Livongo's incentives aligned with outcomes in a way that most healthcare businesses don't.

Livongo for Diabetes (smart glucose monitor + coaching), Livongo for Hypertension, Livongo for Behavioral Health, Applied Health Signals platform

Livongo went after self-insured employers first — companies with thousands of employees who directly bore the cost of chronic disease management. The pitch was ROI: pay Livongo X, save 10X in avoided hospitalizations.

That framing landed. After cracking employers, it expanded to managed care organizations and individual markets.

The COVID pandemic accelerated digital health adoption dramatically, which is part of why the Teladoc acquisition happened so fast.

Proving outcomes in healthcare is brutally slow. You can show that your product makes people healthier.

Convincing insurance companies that this translates to lower costs — and getting them to pay for it before that proof is five years old — is a different challenge. Livongo also had to fight the perception that digital health was a fad.

It won that fight by going public in 2019 and showing actual unit economics.

General Catalyst, Kleiner Perkins, Merck Global Health Innovation Fund, Humana, Temasek Holdings