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Healthcare tech startup Ro has raised $500 million to help fuel continued growth of its hybrid telehealth/in-home primary care platform, which also includes a growing pharmacy business as the company pursues a strategy of vertical integration to optimize delivery and reduce costs for clients. The company’s latest raise is a Series D round, and means it has now raised over $876 million since its 2017 founding.

That may seem like a lot of money, but as Ro co-founder and CEO Zachariah Reitano told me in an interview, it’s actually “peanuts” when it comes to the healthcare industry – which is part of why they founded the company in the first place.

“Sometimes people talk about how great it is to be in the healthcare arena, in tech circles,” Reitano said. “They say, ‘Oh, healthcare is a $4 trillion market – it’s so massive.’  But that’s the worst thing in the entire world; it’s awful how large it is. And I think what we have the opportunity to cut it in half with technology.”

That’s what Reitano says will be the primary focus of this round of funding: Fueling its efforts around vertical integration of healthcare services and technology, to further the eventual end goal of reducing costs to patients through the efficiencies realized in that process.

“To me, what I’m really excited about is being able to continue to invest in that infrastructure and add even more,” Reitano told me. “We’ll continue to invest in telemedicine, we’ll continue to invest in our logistics and pharmacy, and continue to invest in in-home care, as well as the connection between the three, and then we’ll also invest in additional diagnostics, remote patient monitoring – so collecting and distributing devices to patients to go from reactive to proactive care.”

Ro’s model focuses on primary care delivered direct to consumer, without involving any payer or employer-funded and guided care programs. The idea is to reduce costs through vertical integration and other efficiency engineering efforts in order to get them to the point where they’re effectively on par with your out-of-pocket expense with co-pays anyway. Reitano explained that the insurance system as it exists in the U.S. now only effectively masks individual costs, making it less clear that much of what a person pays out in healthcare costs comes out of their pocket anyway, whether it’s through taxation, or employers allocating more of the funds they have available for compensation to healthcare, vs. take-home pay.

Image Credits: Ro

That’s what’s behind Ro’s recent push into operating its own pharmacies, and growing that footprint to include more all the time. Reitano told me that the company will have 10 pharmacies by the end o this year, and 15 by the end of next, all placed strategically around the country to ensure that it can provide next-day shipping to patients at ground shipping rates pretty much anywhere in the U.S.

Doing that kind of vertical optimization has enabled Ro to offer 500 common drugs at $5 per month, including treatments for heart disease, anxiety, depression and diabetes — with a plan to ramp it to 1,000 drugs available at that price by year’s end. That’s roughly equal to the co-pay required for many insurers for the same treatments.

Meanwhile, Reitano says Ro has seen big changes in the healthcare system generally that favor its model and accelerate its hybrid care plans owing to the COVID-19 pandemic.

“I would say that there are two most profound impacts of the pandemic on the healthcare system,” he said. “One is that it simultaneously shed light on all of the inequities for the entire country to see, right at the same time where we all cared about it. So those things were sort of known for the people impacted day to day — the geographic inequity, the financial inequity, the racial inequity. If someone felt that that inequity, then they would talk about it, but it wasn’t something everyone cared about at the same time. So this massive spotlight was shed on the healthcare system. And the second was that everyone’s healthcare journey now starts online, even if it is going to end in person, it will still start online.”

Ro’s model all along has espoused this time of healthcare delivery, with remote care and telehealth appointments handling most day-to-day needs, and follow-up in person care delivered to the home when required. That obviously generate a lot of efficiencies, while ensuring that older patients and those with mobility issues also don’t need to leave the house and make a regular trip into their physician’s office for what amounts to a 15-minute visit that could’ve been handled over video.

Ro co-founders Rob Schutz, Zachariah Reitano and Saman Rahmanian (left to right)

According to most industry observers, Reitano is likely right that healthcare probably won’t go back to the old, inefficient model of favoring primarily in-person care after the pandemic ends. One of the positive outcomes of the COVID-19 situation has been proving that telehealth is more than capable of handling a lot of the primary care needs of a lot of people, particularly when supplemented with remote monitoring and ongoing proactive health measures, too.

While Ro doesn’t work with insurance currently, Reitano points out that he’s not against the concept entirely – he just says that health insurance as it exists now doesn’t actual work as intended, since it’s meant to pool risk against an, expensive, uncertain and rare outcome. Eventually, he believes there’s a place for insurance in the overall healthcare mix, but first the industry needs to face a reckoning wherein its incentive structure is realigned to its actual core customer – patients themselves.

Dispo is in the midst of a sexual assault controversy, Zoom introduces an SDK and Android owners will have to continue waiting for Clubhouse access. This is your Daily Crunch for March 22, 2021.

The big story: Investors back away from Dispo

After a recent story in Business Insider brought allegations to light that a member of David Dobrik’s vlog squad had sexually assaulted an extra during a shoot, Spark Capital announced that it would “sever all ties” with Dobrik’s photo-sharing startup Dispo, as did fellow investors Unshackled Ventures and Seven Seven Six.

“We have stepped down from our position on the board and we are in the process of making arrangements to ensure we do not profit from our recent investment in Dispo,” said Spark, which led a $20 million Series A in Dispo less than a month ago. That means any potential profits will be donated to organizations supporting survivors of sexual assault.

Dobrik, meanwhile, has stepped down from the Dispo board and left the company.

The tech giants

Zoom introduces new SDK to help developers tap into video services — The company envisions application developers embedding video in social, gaming or retail applications.

Next Billion Users head Caesar Sengupta is leaving Google — Sengupta, who also led the company’s payments business, is leaving the firm after nearly 15 years.

Tim Cook and Tim Sweeney among potential witnesses for Apple/Epic trial — A proposed witness list filed by Apple for its upcoming trial against game-maker Epic reads like a who’s who of executives from the two companies.

Startups, funding and venture capital

Side raises $150M at $1B valuation to help real estate agents go it alone — Side works to turn agents and independent brokerages into boutique brands and businesses.

Indonesian savings and investment app Pluang gets $20M in pre-Series B funding — The company offers proprietary savings and investment products that allow users to make contributions starting from 50 cents USD.

Clubhouse says its Android launch will take ‘a couple of months’ — Clubhouse co-founder Paul Davison said the company is working “really hard” to come to Android, but said it’s going to take a “couple of months” to make that happen.

Advice and analysis from Extra Crunch

NFTs could bridge video games and the fashion industry — Real-life fashion brands use NFTs for marketing in virtual worlds like Minecraft, as well as in several Atari and Microsoft video games.

ironSource is going public via a SPAC and its numbers are pretty good — Before you tune out to avoid reading about yet another blank-check company taking a private company public, you’ll want to pay attention to this one.

Where is the e-commerce app ecosystem headed in 2021? — Superapps are likely to emerge, according to PipeCandy’s Ashwin Ramasamy.

(Extra Crunch is our membership program, which helps founders and startup teams get ahead. You can sign up here.)

Everything else

US privacy, consumer, competition and civil rights groups urge ban on ‘surveillance advertising’ — Nearly 40 organizations expressed their concern in an open letter.

Five reasons you should attend TC Early Stage 2021 in April — We’re just days away from kicking off TC Early Stage 2021: Operations & Fundraising on April 1-2.

The Daily Crunch is TechCrunch’s roundup of our biggest and most important stories. If you’d like to get this delivered to your inbox every day at around 3pm Pacific, you can subscribe here.

Shares of Box, a well-known content-and-collaboration company that went public in 2015, rose today after Reuters reported that the company is exploring a sale. TechCrunch previously discussed rising investor pressure for Box to ignite its share price after years in the public-market wilderness.

At the close today Box’s equity was worth $23.65 per share, up around 5% from its opening value, but lower than its intraday peak of $26.47, reached after the news broke. The company went public a little over five years ago at $14 per share, only to see its share price rise to around the same level it returned today during its first day’s trading.

Box, famous during its startup phase thanks in part to its ubiquitous CEO and co-founder Aaron Levie, has continued to grow while public, albeit at a declining pace. Dropbox, a long-term rival, has also seen its growth rate decline since going public. Both have stressed rising profitability over revenue expansion in recent quarters.

But the problem that Box has encountered while public, namely hyper-scale platform companies with competing offerings, could also prove a lifeline; Google and Microsoft could be a future home for Levie’s company, after years of the duo challenging Box for deals.

As recently as last week, Box announced a deal for tighter integration with Microsoft Office 365. Given the timing of the release, it was easy to speculate the news could be landing ahead of a potential deal. The Reuters article adds fuel to the possibility.

While we can’t know for sure if the Reuters article is accurate, the possible sale of Box makes sense.

The article indicated that one of the possible acquisition options for Box could be taking it private again via private equity. Perhaps a firm like Vista or Thoma Bravo, two firms that tend to like mature SaaS companies with decent revenue and some issues, could swoop in to buy the struggling SaaS company. By taking companies off the market, reducing investor pressure and giving them room to maneuver, software companies can at times find new vigor.

Consider the case of Marketo, a company that Vista purchased in 2016 for $1.6 billion before turning it around and selling to Adobe in 2018 for $4.75 billion. The end result generated a strong profit for Vista, and a final landing for Marketo as part of a company with a broader platform of marketing tools.

If there are expenses at Box that could be trimmed, or a sales process that could be improved, is not clear. But Box’s market value of $3.78 billion could put it within grasp of larger private-equity funds. Or well within the reaches of a host of larger enterprise software companies that might covet its list of business customers, technology or both.

If the rumors are true, it could be a startling fall from grace for the company, moving from Silicon Valley startup darling to IPO to sold entity in just six years. While it’s important to note these are just rumors, the writing could be on the wall for the company, and it could just be a matter of when and not if.

There has been a growing industry trend in recent years for large scale companies to build their own chips. As part of that, Google announced today that it has hired long-time Intel executive Uri Frank as Vice President to run its custom chip division.

“The future of cloud infrastructure is bright, and it’s changing fast. As we continue to work to meet computing demands from around the world, today we are thrilled to welcome Uri Frank as our VP of Engineering for server chip design,” Amin Vahdat, Google Fellow and VP of systems infrastructure wrote in a blog post announcing the hire.

With Frank, Google gets an experienced chip industry executive, who spent more than two decades at Intel rising from engineering roles to Corporate Vice President at the Design Engineering Group, his final role before leaving the company earlier this month.

Frank will lead the custom chip division in Israel as part of Google. As he said in his announcement on LinkedIn, this was a big step to join a company with a long history of building custom silicon.

“Google has designed and built some of the world’s largest and most efficient computing systems. For a long time, custom chips have been an important part of this strategy. I look forward to growing a team here in Israel while accelerating Google Cloud’s innovations in compute infrastructure,” Frank wrote.

Google’s history of building its own chips dates back to 2015 when it launched the first TensorFlow chips. It moved into video processing chips in 2018 and added OpenTitan , an open source chip with a security angle in 2019.

Frank’s job will be to continue to build on this previous experience to work with customers and partners to build new custom chip architectures. The company wants to move away from buying motherboard components from different vendors to building its own “system on a chip” or SoC, which it says will be drastically more efficient.

“Instead of integrating components on a motherboard where they are separated by inches of wires, we are turning to “Systems on Chip” (SoC) designs where multiple functions sit on the same chip, or on multiple chips inside one package. In other words, the SoC is the new motherboard,” Vahdat wrote.

While Google was early to the ‘Build Your Own Chip’ movement, we’ve seen other large scale companies like Amazon, Facebook, Apple and Microsoft begin building their own custom chips in recent years to meet each company’s unique needs, and give more precise control over the relationship between the hardware and software.

It will be Frank’s job to lead Google’s custom chip unit and help bring it to the next level.

Techstars NYC just announced the 10 startups participating in this year’s program, making up what Managing Director Jenny Fielding described as the accelerator’s most global class yet.

“We’ve always had applications from around the world and I was always able to take companies from anywhere,” Fielding said. “But the truth is, when you run Techstars New York, if you don’t have five companies from New York, there’s a feeling that you’re letting the ecosystem down a little bit.”

Now that the program is almost entirely virtual, Fielding said she felt free to “open up the geos.” In fact, not a single one of the startups is based in New York — instead, there are multiple San Francisco and Washington, D.C. companies, as well as others based in the France, Israel, Kenya, Portugal and the United Kingdom.

Fielding argued that even without New York startups, the accelerator still has a New York identity, because it connects global startups with the New York ecosystem.

After conducting last year’s accelerator virtually, Fielding said the hardest element to recreate has been the in-person camaraderie between the founders. So she’s hoping to have an in-person meetup here at the end of May, although the logistics of that meetup will depend on what’s safe and legal at that time (and what the entrepreneurs are comfortable with).

Other aspects of the virtual experience are likely to stick around post-pandemic. After all, Techstars hosts around 200 mentors per class, and Fielding said the virtual program marked the first time “nobody was late.” Similarly, she suggested that demo day remains an “open question,” as an extended period of investor meetings seems to be driving more fundraising for the startups.

Meanwhile, here are the startups:

• Dash (Nairobi, Kenya) — An alternative, cross-currency payment network for African consumers.
• Detach.ai (Lisbon, Portugal) — An AI operations platform focused on resolving issues procatively.
• Elanza Wellness (San Francisco and London, U.K.) — A fertility platform that brings together medical, lifestyle and mental health data.
• Gable (San Francisco and Tel Aviv, Israel) — A “workspace as a service” company helping businesses find neighborhood workspaces for their employees
• Hiitide (Chicago) — A marketplace that turns books into virtual book clubs and courses
• OneVillage (Washington, D.C.) — An online wishlist, planning tool and retailer for cancer patients and their supporters.
• Paerpay (Boston) — A contactless payment platform that doesn’t require additional hardware or app downloads.
• Phalanx (Washington, D.C.) — A company that secures AI systems using data, model validation and vulnerability scanning.
• Phood (Boulder) — A startup digitizing university student cards so they can be used payments in various online services.
• Prediko (London, U.K. and Paris, France) — A startup focused on e-commerce inventory planning.