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In addition to chemfool2’s points, I would think it is just as appropriate to question the trustworthiness of the blog you posted as it is to question the validity of Livongo’s solution. The author of this article shed some light on that here:

“With respect to your blogger himself, they (Livongo Management) noted that the blogger had approached them a number of years ago and solicited compensation to endorse LVGO on his site. They obviously declined, and since the post you referenced, he has been unwilling to respond to their requests to engage in discussion. They claim he has been paid in the past by one of their competitors and is running a pay-to-play scheme. We noticed that he is very promotional of the Validation Institute on his site. It turns out he is listed as a certified consultant/broker for the VI (https://validationinstitute.com/certified-professionals/), which offers a certificate program starting at $1195 (https://validationinstitute.com/certification/). In a prior post, he trumpeted the benefits of the CORA Pro certificate course while simultaneously cherry-picking a couple of points to disparage LVGO (https://dismgmt.wordpress.com/2019/05/23/questions-to-ask-li...). We find his motives at best ambiguous. Needless to say, numerous 3rd party consultants have raised concerns to LVGO about this blogger and his claims.”

Regarding the author’s point that those study results were self-reported, there are certainly better methods to perform a study but may not be realistic to implement with live clients. In any case, Livongo's results can be corroborated by additional studies that used more controlled methods: https://www.hindawi.com/journals/jdr/2018/3961730/#B13.

A commenter on the Seeking Alpha article I wrote raised similar concerns and I addressed them thoroughly: https://seekingalpha.com/article/4316581-livongo-health-revo....

The rest of your points seem to be related to questioning the effectiveness of Applied Health Signals as a whole. Livongo is the first to scale but they are by no means without competition as their largest competitor, Omada Health, is focused on pre-diabetes / weight management but is expanding to compete in the same conditions as LVGO. A look at their app reviews tells it all about how effective they are. Livongo is also no slouch, they clock in a 4.8/5 rating on 13,134 reviews on the app store, some of the reviews are of patients saying it has changed their lives.

But forget all that, look at their results. Employers signing up in droves for multi-year contracts, churn at only 2% a month, and an NPS of +64. They claim demonstrable cost savings of $1900 per year per patient which translates into an average 3.7x ROI after one year, and 4.4x after two years. Is that all due to good salesmanship? In an interview, the CEO said this: “What's fascinating is that we have a handful of clients where the experience and the outcomes are so good that they're paying for the insulin if the member uses Livongo (https://www.fool.com/investing/2019/11/27/exclusive-intervie...).

And insurers are also loving it. It was the only “preferred service” on Express Script’s new digital health formulary. This was a clear indication of their dominance as Express scripts staked their own reputation behind LVGO. https://pharmaphorum.com/news/livongo-takes-centre-stage-in-...

So here we have really happy insurers, employers, and patients. Patients get to see better outcomes from gaining a better overall picture of their health and having access to personalized resources at their fingertips to help them manage it; providers can better utilize precious appointment times to more effectively engage with patients on a deeper level, having been provided with the real-time dataset that the app has gathered; and insurers can save costs from fewer hospitalizations, lower intake of medications, and more productive and happy patients. I think the results speak for themselves.

I was first introduced to this space because my friend is doing something really similar with his digital health startup he founded for managing behavioural health and I can attest to the validity of the research behind it. I think it’s not uncommon for investors to share your concerns considering that nothing like this has been done before (the technology simply wasn’t there yet), but that is the reason why LVGO gave such an incredible buying opportunity in the months following IPO. Now, with COVID-19 shining a spotlight on this space, I think that investors are starting to realize that there is a revolution going on in healthcare and it’s based on empowering patients.
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