Across the world, public health systems have struggled to get back on their feet after the pandemic, with increasingly ageing populations in Western countries in particular putting pressure on services, particularly in the UK, where 'NHS in crisis' is a regular headline in the media. As a result, private companies, many of them technology-driven, see a gap in the market. It is against this background that Wax, a proprietary software platform and home healthcare provider in the U.K., has raised $150 million in a mix of debt and equity. The company said the majority of this is debt, but declined to detail the split and also objected to its valuation.
The round was led by funds affiliated with BDT & MSD Partners and Schroders Capital in order to scale Cera’s platform. The company says it is highly AI-driven, with proprietary models based on its own data, though it admits it uses some aspects of both Google’s Gemini AI platform and Microsoft’s version of ChatGPT.
In 2022, Cera raised $320 million (£260 million) in an equity and debt funding round, split roughly 50/50.
According to CrunchBase, it has 14 investors. Recognized venture capitalists to date include Earlymarket, Guinness Ventures, DigitalHealth, London Accelerator and long-time UK investor Robin Klein.
A Cera spokesperson added that while this has not yet been reflected in the publicly filed accounts, the company achieved positive EBITA in 2023 and positive free cash flow in 2024, and is “increasingly a self-sustaining business”, hence it could raise this debt round.
In an interview, Dr Ben Maruthappu MBE, Founder and CEO of Cera, said: “We are reaching profitability, plus we have a very significant plateau in how we use our technology and AI, and we have expanded into more in-home services.”
Cera’s caregivers use its app to plan their work and record patient symptoms. Using its AI modeling, Cera can take that unstructured data (e.g., “patient fell during the night,” etc.) and use it to predict the likelihood of patients being at higher risk of illness or injury. The company claims this has resulted in reductions in hospitalizations of up to 70%, a 20% reduction in patient relapses, and up to five times faster hospital discharges, it said in a statement.
The company has raised more than $407 million to date in a combination of equity and debt.
Competitors in the UK include Home Rather 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 acquired by Nasdaq-listed CVS Health. Another is Honor, which increase $625 million in investments to date.
Maruthappu said: “We are taking pressure off the NHS and supporting it to have more capacity to care for other patients. We have also expanded into other service lines such as nursing services, physiotherapy, learning disabilities, physical disabilities and we also provide mental health services at home. So we are a much more comprehensive home healthcare provider.”
He added that the AI-driven aspect of the business was based on the data it collects: “The other key advantage is what we’re doing with the technology, more specifically the AI… We’re recording information about patients from those visits into our app. This has given us now one of the largest home healthcare data sets in the world, definitely the largest in Europe, and we’ve been able to analyse that data set in many different ways to build algorithms – algorithms that correlate to anticipate whether someone is going to have a relapse.”
“We can predict over 80% of relapses a week before they happen. That’s statistically significant… So we actually reduced falls by over 20% thanks to our AI algorithm… We can also predict about 83% of hospitalizations again a week before they happen… reducing hospitalizations by up to 70%.”
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 expand its business.”
Cera says it is the UK's largest non-NHS healthcare provider, covering around 30 million people with 10.000 carers and nurses and working with more than 150 local governments and two-thirds of NHS integrated care systems.
It also claims that an independent analysis by UK consultancy Faculty found that Cera’s AI-powered home healthcare model saves the UK healthcare system £1m a day.
Obviously, Cera is keen to avoid tarnishing healthcare startups like Babylon Health, admittedly a very different company, which went bankrupt and was sold off for parts after attempting to deliver healthcare through a simple chatbot.
