TMCx names 9 health tech startups to its 2020 cohort

X-CITING NEWS

TMCx's 2020 cohort has been selected, and the program will begin virtually. Courtesy of TMCx

Now, more than ever, is time to think about the future of health care. Lucky for the Texas Medical Center, they've been doing that for years with their accelerator program, TMCx, which has just announced its latest cohort of health tech startups.

After redesigning the program, TMCx has been reimagined to better connect the startups and technology to TMC's member institutions. New this year was a bootcamp, in which 19 companies were invited to the TMC Innovation Institute in February to engage in programming with the TMCx team and TMC members.

"Bootcamp went off without a hitch," says Lance Black, associate director of TMCx, on a recent episode of the Houston Innovators Podcast. "And the companies all got something meaningful out of it and we were actually very surprised with the reaction and response we got from our member institutions."

The goal of the bootcamp was to connect the 19 potential cohort members to the TMC community to see which companies the health care institutions gravitated toward for potential relationships, such as a pilot program, clinical trial, or a joint development opportunity, for instance, Black says on the episode.

Black says his team took into consideration all of the feedback and selected nine startups to be a part of the cohort. At this point, with the COVID-19-caused travel issues and closures, face-to-face interaction in the program has been postponed, but the accelerator will start of virtually.

"Out of respect for our hospitals and member institutions, we want to delay the physical presence of the companies in Houston," Black says in the episode. "But that doesn't mean we're not able to call or virtually meet with the companies. There's a lot of pre-work we can do in order to prep the companies appropriately so that when they do have meetings face to face, they can put their best foot forward."

Here are the nine startups selected to be a part of the TMCx 2020 cohort:

  • San Francisco-based Atlas Health — connecting patients with payment resources
  • San Francisco-based DeepScribe — autonomous medical scribe
  • Los Angeles-based Elly Health — live healthier through positivity
  • San Francisco-based Ferrum Health — reduce preventable medical errors
  • Toronto-based HelpWear — clinical grade wearable heart monitor
  • London-based Lantum — total workforce solution for healthcare
  • Denver-based Manatee — connected, everyday therapy for kids
  • Copenhagen-based Radiobotics — automate analysis of routine medical X-rays
  • Evanston, Illinois-based Rhaeos — wearable shunt monitor (Rhaeos previously won fourth place in the 2019 Rice Business Plan Competition.)
This week's Houston innovators to know are Megan Eddings, Lance Black, and Todd Burke.

3 Houston innovators to know this week

who's who

The city of Houston — much like most major cities in the country — is in crisis mode, with a stay-at-home mandate and rising COVID-19 case numbers.

But these three Houston innovators are emerging as leaders in making masks, discussing the importance of telemedicine at this time, and providing tips on keeping a stable supply chain.

Megan Eddings, founder of Accel Lifestyle

Photo courtesy of Accel Lifestyle

Former scientist Megan Eddings designed a fabric that doesn't hold onto bacteria, and she's launched an activewear brand of men's and women's T-shirts that don't stink. But when the coronavirus hit the country and medical professionals worried about personal protection equipment, Eddings sprung into action.

"We have enough supplies here to make 9,000 masks and I have 2,800 yards of fabric sitting at my factory in California," she says. "That's enough fabric to make more than 100,000 masks." Click here to read more about Houston fashion designers looking to help out.

Lance Black, associate director of TMCx

Photo courtesy of TMCx

Telemedicine has a unique opportunity during the coronavirus-cased shutdown. Lance Black, associate director of the Texas Medical Center's accelerator, TMCx, joined the Houston Innovators Podcast to discuss the health tech potential as well as how startups are coping in this uncertain time.

"This is going to force the health care system to take a hard look at what these platforms are capable of doing," Black says in the episode. "And it's going to stress the capabilities of these companies. To be honest, if there's a silver lining, that is one of them in my mind, that this will prove out the technology [in telehealth.]" Click here to read more and stream the episode.

Todd Burke, president at Smith and Associates

Photo courtesy of Smith and Associates

The COVID-19 outbreak has already greatly affected supply chains across industries, and companies should keep moving forward with that in mind. Todd Burke, president at Houston-based Smith and Associates gives three tips for properly managing your supply chain during the coronavirus outbreak in a guest article.

"During my 23 years at Smith, the world's largest open-market distributor of electronic components, I've witnessed various market disruptions and shifting supply chain dynamics," writes Burke. "I can confidently say that the coronavirus outbreak is heavily uncharted territory for the technology industry." Click here to read more.

Lance Black says the COVID-19 outbreak has led to some interesting opportunities for Houston startups and health tech as a whole. Photo courtesy of TMCx

COVID-19 provides huge opportunity for telehealth, says Houston health tech leader

HOUSTON INNOVATORS PODCAST EPISODE 24

The Texas Medical Center's accelerator program has one foot in the health care system of today — operating in collaboration with the TMC's wide network of member institutions — as well as representing the future of health care as it cultivates new technologies those medical institutions need.

This unique setting makes Lance Black, associate director of TMCx, an interesting perspective on the COVID-19 outbreak, and something he says he's excited to see rise to the occasion — and, in this case, crisis — is telehealth.

"One of the things we focus on at TMCx is the ability to remotely monitor and care for patients outside the four walls," Black says on this week's episode of the Houston Innovators Podcast, "and this particular crisis really lends to that."

For better or for worse, the outbreak has forced a turning point in health care, and it's also put telehealth and other health tech companies to the test.

"This is going to force the health care system to take a hard look at what these platforms are capable of doing," Black says. "And it's going to stress the capabilities of these companies. To be honest, if there's a silver lining, that is one of them in my mind, that this will prove out the technology [in telehealth.]"

In the episode, Black provides some tips for startups going through the crisis, as well as praises the collaborative effort within the tech community in Houston. And in a way, something felt familiar to Black, a medical doctor who previously served in the United States Air Force.

"In the military, we joked about how there's a 'hurry up and wait' attitude. You hurry up to get things ready, and then you're just sitting there waiting for the right time to respond," Black says. "I feel like that's what our startups are doing now."

Black says he has seen startups taking inventory of their resources, accommodating their products for different uses, assessing their personnel, and waiting to see where they fit in to help.

Meanwhile, there's plenty Black can do to help serve TMCx's startups. This year marked the first cohort of TMCx's revamped program, and last month the TMC Innovation Institute welcomed in 19 startups for a bootcamp. While that went off without a hitch, Black says, the next phase — due to start in May — could be pushed back.

"Out of respect for our hospitals and member institutions, we want to delay the physical presence of the companies in Houston," Black says. "But that doesn't mean we're not able to call or virtually meet with the companies. There's a lot of pre-work we can do in order to prep the companies appropriately so that when they do have meetings face to face, they can put their best foot forward."

Black discusses the coronavirus' effects and offers his advice to startups on the podcast. Listen to the full episode below — or wherever you get your podcasts — and subscribe for weekly episodes.


TMCx will select its 2020 cohort from the 19 startups it has invited to attend a bootcamp this month. Courtesy of TMC

TMCx names 19 startups to be considered for 2020 cohort

that x-factor

The Texas Medical Center is one step closer to narrowing down its next TMCx cohort. It will be the first group of startups for the accelerator following an overhaul and redesign of the program that was announced last year.

TMCx has identified 19 companies from around the world to attend a two-week bootcamp within the TMC. At the conclusion of the two weeks, TMCx will select its 2020 cohort, which will then go through a six-month accelerator program.

While TMCx has been accelerating digital health and medical device startups for five years, this is the first year the program has taken this approach. The TMCx team first announced these changes on its last demo day in November. The program redesign was put into motion in order to find startups and technologies that solve the problems and challenges that TMC institutions face.

"The TMCx team is razor-focused on ensuring X companies find a landing spot here in the TMC," says Lance Black, associate director at TMCx. "Our north star metric is agreements between the startup and the member institution. With this as our determiner of success, we need to be intimately familiar with not only what the startups are doing but with what our hospitals need."

The TMCx team selected this batch of 19 startups based on their ability to hit the ground running at TMC, Black explains, and the two-week bootcamp will be filled with customer meetings, in-hospital exploration, social events, and educational programming.

"From these bootcamp participants, we are looking for companies who are ready to have meaningful conversations with their customers on day 1," Black says. "The access to enterprise health systems here in Houston is like no other place in the world, so TMCx is focused on curating these conversations and subsequent relationships so our member institutions are truly able to remain cutting edge."

Ultimately, Black says, his team is looking for the companies ready to "show up" for the TMC's member institutions.

"One of the most exciting aspects of TMCx's new phase is how we are now working hand-in-hand with the offices of innovation and internal champions of our member institutions to investigate needs and scour the globe for the best solutions," Black explains. "This community is one of collaborators and TMCx is a proud partner in improving the quality of life for patients."

Here are the health tech startups participating in the TMCx bootcamp this month:

  • San Francisco-based Atlas Health connects patients with payment resources.
  • Austin-based CareStarter automates and scales care management.
  • Houston-based CaseCtrl is a surgical case management platform.
  • San Francisco-based DeepScribe is an autonomous medical scribe.
  • Austin-based Diligent Robotics created a clinical robot assistant.
  • Los Angeles-based Elly allows users to live healthier through positivity.
  • San Francisco-based Ferrum reduces preventable medical errors.
  • San Antonio-base GaitIQ evaluates gait in primary care.
  • Toronto-based HelpWear is a clinical grade wearable heart monitor.
  • Pessac, France-based inHEART combines imaging and electrocardiology technologies.
  • London-based Lantum is a total workforce solution for healthcare.
  • Denver-based Manatee has created connected, everyday therapy for kids.
  • Cupertino, California-based Pyrames is a continuous, non-invasive blood pressure monitoring system.
  • Copenhagen-based Radiobotics automates analysis of routine medical X-rays.
  • Philadelphia-based Repisodic is a discharge planning solution.
  • Evanston, Illinois-based Rheos is a wearable shunt monitor.
  • College Station-based Solenic Medical eliminates biofilm on metallic implants.
  • Melbourne-based TALi can assess and strengthen attention in early childhood.
  • New York-based Yosi is creating the waiting room of the future.
The Digital Fight Club made its Houston debut on November 20 at White Oak Music Hall. Emily Jaschke/InnovationMap

Photos: Houston innovation leaders weigh in on cybersecurity, tech, and more at inaugural event

total knock out

What do you get when you cross the information of an innovation panel with the ferocity of a boxing match? A verbal sprawling among innovation leaders that can only be known as the Digital Fight Club.

Houston's DFC came about with the help of Accenture, which had been a partner at the Dallas events, and InnovationMap, who teamed up as presenting sponsors for the event. DFC's founder, Michael Pratt, came up with the idea for Digital Fight Club as a way to liven up technology-focused events and networking opportunities.

The setup of the event is five fights, 10 fighters, and five judges. Each fighter has just a couple minutes to take their stand before the event moves on.

"This is Digital Fight Club," says Pratt, CEO of the company. "You get subject matter experts, and serious founders and CEOs on the stage and make them make their case. You learn something, it's a lot of fun, and it's a lot better than a panel."

The hour of fighting is coupled with a VIP event ahead of the showdown and an after party where further networking can continue on. At Houston's VIP event, InnovationMap got to check in with partners, fighters, and referees about how they thought the event was going to pan out. Check out the VIP event video here.

The panel of referees included Gabriella Rowe, CEO of Station Houston; Denise Hamilton, CEO of Watch Her Work; Tim Kopra, partner at Blue Bear Capital; Lance Black, Director at TMCx; and Barbara Burger, president of Chevron Technology Ventures.

The refs asked two questions per fight, and were able to vote on the winners of each round — as was the audience through an interactive web-based application. The break down of the fights, topics, and winners are as follows:

Fight #1: Future Workforce of Robotics/AI. Matt Hager, CEO of Poetic Systems, vs Pablo Marin, senior AI Leader, Microsoft. Hager took the win with 77 percent of the vote.
Fight #2: Whose responsibility is cybersecurity. Ted Gutierrez, CEO of SecurityGate vs Tara Khanna, managing director and Security Lead at Accenture. Khanna won this round, snagging 66 percent of the votes.
Fight #3: Oil & Gas Industry and the Environment. Michael Szafron - commercial adviser for Cemvita Factory, vs Steven Taylor, co-founder of AR for Everyone. Szafron received 76 percent of the voites, securing the win.
Fight #4: Digital in our personal lives. Grace Rodriguez, CEO of ImpactHub, vs Javier Fadul, chief innovation officer at HTX Labs. Rodriguez won with the largest margin of the night — 85 percent.
Fight #5: Future of Primary Care Geetinder Goyal, CEO of First Primary Care, vs Nick Desai, chief medical information officer at Houston Methodist. Goyal received 72 percent of the votes to take home the win.

The fights were heated, and some of the fighters had knockout quotes, from Hager's "AI is mostly bullshit" to Khanna's "Compliance doesn't mean you're secure." For more of the knockout quotes, click here.

The fight is on

  

Emily Jaschke/InnovationMap

Mike Pratt, who hosted the event, founded the Digital Fight Club in 2016.

At TMCx's Demo Day, the cohort's companies boasted of local deals and accomplishments. Courtesy of TMC

TMCx companies plant Houston roots with pilots, partnerships, and more

Lasting impact

At the conclusion of TMCx's recent Digital Health cohort — the most international group to date — there was only one Houston company among the 19. However, most of that group have developed a presence in Houston throughout the program.

Besides just being based here in Houston for four months, TMCx associate director, Lance Black, says the city has a lot to offer these startups.

"Why Houston? Why are these companies coming from everywhere to be here? Three big reasons," he says to the crowd at Demo Day. "The size and scale of the Texas Medical Center, the diversity of Houston, and the willingness and hunger of Houstonians wanting to be involved in innovation."

From pilots and partnerships to funding and mentorship, these TMCx08 companies announced the impact they've made on Houston at the Demo Day on Thursday, June 6. Meanwhile, TMCx had its own announcement that it would create early stage programming for professionals connected to the Texas Medical Center.

"It is the TMC's mission to advance health care, research, and education. It's our mission at the Innovation Institute to bring value back to the med center through health care technology," Black says. "And, through TMCx, we do that through startup companies."

Here are some examples of TMCx companies setting foundations in the Houston ecosystem.

Virti

Photo via virti.com

California-based Virti has developed an extended reality simulation technology for training medical staff. It's a cheaper, more effective way to train personnel, says Alex Young, CEO of the company.

Virti was selected to be in England's National Health Service accelerator — the only evidence-based AR/VR training company ever to be picked for the program, says Young.

With a presence in California and England, Young says he's also planted roots in Texas too, with sales representation based in the TMCx offices.

"In the time that we've been here, we've closed deals in Texas and back in California," Young adds.

Optellum

Photo via optellum.com

Optellum is changing the way lung cancer is being detected. With the startup's artificial intelligence-enabled detection software, oncologists can better identify at-risk patients, which translates into more treatment for those in need, and less for those who don't.

The company, which is based in the United Kingdom, has raised funds abroad while networking locally.

"TMCx has been amazing for a small British company like us. We have started pilots and trials at four TMC member institutions," says Vaclav Potesil, CEO.

Oncora Medical

Photo via oncoramedical.com

Angela Holmes, the director of product and customer solutions of Oncora Medical, sets the stage at her company's Demo Day pitch by telling a story of her friend's daughter who was diagnosed with cancer. She was forced to pick between two treatment options. She had no data or insights to help.

Oncora Medical's mission is to help fight cancer using data. Though based in Philadelphia, Oncora has Houston ties, since it formed a partnership with MD Anderson Cancer Center in April of 2017.

"We are so honored and gratified to be in a strategic, multi-year collaboration with MD Anderson to build this software system to save the world," Holmes says.

PreOp MD

Cody Duty/TMC

Within health care, the projected annual aggregate surgical expenditure by 2025 is expected to be $912 billion, says Christiana Obi, founder and CEO of PreOp MD, and a Houston-based anesthesiologist. She sees lack of information causing wasted surgical resources regularly.

PreOp MD — the only Houston-based TMCx company this cohort — has an app that allows for pre-procedure education, communication, and more that aims to prevent surgical delays.

While based here, PreOp is truly rooted in Houston, and even more so with their latest news.

"We are happy and excited to say that we have landed our first medical pilot at an medical right here in town," Obi says.

RoundTrip

Cody Duty/TMC

RoundTrip has a solution to 3.6 million missed or postponed medical visits that happen annually that are inconvenient to hospitals and a major health risk to the population: Ride sharing.

The Philadelphia-based company enables all forms of transportation and puts the power in the hands of the medical institution. From ambulances to other medical vehicles, the company can optimize utilization of all vehicles to get patients to their appointments and even has a partnership with Lyft.

While completing the TMCx program, RoundTrip closed its Series A round of $5.14 million led by Virginia-based Motley Fool Ventures in April. The funds will be used for expansion.

"Now we have all this new money to expand really rapidly. Texas, we're coming for you, whether you're ready or not," says Jackson Steeger, account supervisor.

Meru Health

Photos via meruhealth.com

Meru Health is also one of the 2019 TMCx Digital Health companies that has raised money while in the program. Palo Alto, California-based Meru completed a $4.2M raise in April 2019. The round was led by San Francisco-based Freestyle Capital.

Access to mental health professionals is increasingly more difficult, so Meru Health has created a low-cost digital clinic that offers an app-based treatment program from licensed therapists. Kristian Ranta, CEO and founder, while not yet providing specifics, that they aren't done in Texas.

"I'm happy to say there's some good stuff brewing here in Texas for us. More to follow," says Ranta.

Cloud 9

Photo via cloud9psych.com

Mental health is a key contributing factor in the legal system cycle, but it doesn't have to be Liz Truong, co-founder of Cloud 9. Better educating officers and providing them with mental health resources is the best way to get them out of the hospitals and court rooms and back out in the field to protect the city.

While some police departments have instituted ride-along programs with mental health professionals that have showed success, it's expensive for the police department and risky for those professionals. Cloud 9 has created a digital solution.

"We proved this works in the Harris County Sheriff's office right here in Houston," says Truong. "Officers reported that 97 percent of Cloud 9 care was superior or equal to their current program and showed an immediate 632 percent return on investment for our customers in the same budget cycle compared to what they were already spending."

Truong also says they have other local customers they are working with, including the Harris County Health Department.

Axem Neurotechnology

Photos via axemneuro.com

Recovering stroke patients need rehabilitation to get back to 100 percent, but getting patients into the facility is challenging and at-home compliance is hard to track.

Canadian company Axem Neurotechnology has a solution. With their external device and mobile application, physical therapists can track progress and communicate with patients remotely.

"When we talk to rehab professionals, they are excited about what we're doing," says Tony Ingram, CEO and co-founder. "That's why we have leading institutions in both Canada and the U.S. onboard for clinical trials — this includes TMC's own TIRR, which is consistently ranked in the top five rehab centers in the U.S. We're collecting core baseline data in the most diverse city in the country."


Correction: A previous version of this article said Oncora's partnership with MD Anderson was formed during the TMCx program, when the partnership began in 2017. 

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Innovation Labs @ TMC set to launch for early-stage life science startups

moving in

The Texas Medical Center will launch its new Innovation Labs @ TMC in January 2026 to better support life science startups working within the innovation hub.

The new 34,000-square-foot space, located in the TMC Innovation Factory at 2450 Holcombe Blvd., will feature labs and life science offices and will be managed by TMC. The space was previously occupied by Johnson & Johnson's JLABS @TMC, a representative from TMC tells InnovationMap. JLABS will officially vacate the space in January.

TMC shares that the expansion will allow it to "open its doors to a wider range of life science visionaries," including those in the TMC BioBridge program and Innovation Factory residents. It will also allow TMC to better integrate with the Innovation Factory's offerings, such as the TMC Health Tech accelerator, TMC Center for Device Innovation and TMC Venture Fund.

“We have witnessed an incredible demand for life science space, not only at the TMC Innovation Factory, but also on the TMC Helix Park research campus,” William McKeon, president and CEO of the TMC, said in a news release. “Innovation Labs @ TMC enables us to meet this rising demand and continue reshaping how early-stage life science companies grow, connect, and thrive.”

“By bringing together top talent, cutting-edge research, and industry access in one central hub, we can continue to advance Houston’s life science ecosystem," he continued.

The TMC Innovation Factory has hosted 450 early-stage ventures since it launched in 2015. JLABS first opened in the space in 2016 with the goal of helping health care startups commercialize.

13 Houston businesses appear on Time's best midsize companies of 2025

new report

A Houston-based engineering firm KBR tops the list of Texas businesses that appear on Time magazine and Statista’s new ranking of the country’s best midsize companies.

KBR holds down the No. 30 spot, earning a score of 91.53 out of 100. Time and Statista ranked companies based on employee satisfaction, revenue growth, and transparency about sustainability. All 500 companies on the list have annual revenue from $100 million to $10 billion.

According to the Great Place to Work organization, 87 percent of KBR employees rate the company as a great employer.

“At KBR, we do work that matters,” the company says on the Great Place to Work website. “From climate change to space exploration, from energy transition to national security, we are helping solve the great challenges of our time through the high-end, differentiated solutions we provide. In doing so, we’re striving to create a better, safer, more sustainable world.”

KBR recorded revenue of $7.7 billion in 2024, up 11 percent from the previous year.

The other 12 Houston-based companies that landed on the Time/Statista list are:

  • No. 141 Houston-based MRC Global. Score: 85.84
  • No. 168 Houston-based Comfort Systems USA. Score: 84.72
  • No. 175 Houston-based Crown Castle. Score: 84.51
  • No. 176 Houston-based National Oilwell Varco. Score: 84.50
  • No. 234 Houston-based Kirby. Score: 82.48
  • No. 266 Houston-based Nabor Industries. Score: 81.59
  • No. 296 Houston-based Archrock. Score: 80.17
  • No. 327 Houston-based Superior Energy Services. Score: 79.38
  • No. 332 Kingwood-based Insperity. Score: 79.15
  • No. 359 Houston-based CenterPoint Energy. Score: 78.02
  • No. 461 Houston-based Oceaneering. Score: 73.87
  • No. 485 Houston-based Skyward Specialty Insurance. Score: 73.15

Additional Texas companies on the list include:

  • No. 95 Austin-based Natera. Score: 87.26
  • No. 199 Plano-based Tyler Technologies. Score: 86.49
  • No. 139 McKinney-based Globe Life. Score: 85.88
  • No. 140 Dallas-based Trinity Industries. Score: 85.87
  • No. 149 Southlake-based Sabre. Score: 85.58
  • No. 223 Dallas-based Brinker International. Score: 82.87
  • No. 226 Irving-based Darling Ingredients. Score: 82.86
  • No. 256 Dallas-based Copart. Score: 81.78
  • No. 276 Coppell-based Brink’s. Score: 80.90
  • No. 279 Dallas-based Topgolf. Score: 80.79
  • No. 294 Richardson-based Lennox. Score: 80.22
  • No. 308 Dallas-based Primoris Services. Score: 79.96
  • No. 322 Dallas-based Wingstop Restaurants. Score: 79.49
  • No. 335 Fort Worth-based Omnicell. Score: 78.95
  • No. 337 Plano-based Cinemark. Score: 78.91
  • No. 345 Dallas-based Dave & Buster’s. Score: 78.64
  • No. 349 Dallas-based ATI. Score: 78.44
  • No. 385 Frisco-based Addus HomeCare. Score: 76.86
  • No. 414 New Braunfels-based Rush Enterprises. Score: 75.75
  • No. 431 Dallas-based Comerica Bank. Score: 75.20
  • No. 439 Austin-based Q2 Software. Score: 74.85
  • No. 458 San Antonio-based Frost Bank. Score: 73.94
  • No. 475 Fort Worth-based FirstCash. Score: 73.39
  • No. 498 Irving-based Nexstar Broadcasting Group. Score: 72.71

Texas ranks as No. 1 most financially distressed state, says new report

Money Woes

Experiencing financial strife is a nightmare of many Americans, but it appears to be a looming reality for Texans, according to a just-released WalletHub study. It names Texas the No. 1 most "financially distressed" state in America.

To determine the states with the most financially distressed residents, WalletHub compared all 50 states across nine metrics in six major categories, such as average credit scores, the share of people with "accounts in distress" (meaning an account that's in forbearance or has deferred payments), the one-year change in bankruptcy filings from March 2024, and search interest indexes for "debt" and "loans."

Joining Texas among the top five most distressed states are Florida (No. 2), Louisiana (No. 3), Nevada (No. 4), and South Carolina (No. 5).

Texas' new ranking as the most financially distressed state in 2025 may be unexpected, WalletHub says, considering the state has a "bigger GDP than most countries" and still has one of the top 10 best economies in the nation (even though that ranking is also lower than it was in previous years).

Even so, Texas residents are stretching themselves very thin financially this year. Texans had the ninth lowest average credit scores nationwide during the first quarter of 2025, the study found, and Texans had the sixth-highest increase in non-business-related bankruptcy filings over the last year, toppling 22 percent.

"Texas also had the third-highest number of accounts in forbearance or with deferred payments per person, and the seventh-highest share of people with these distressed accounts, at 7.1 percent," the report said.

This is where Texas ranked across the study's six key dimensions, where No. 1 means "most distressed:"

  • No. 5 – "Loans" search interest index rank
  • No. 6 – Change in bankruptcy filings from March 2024 to March 2025 rank
  • No. 7 – Average number of accounts in distress rank
  • No. 8 – People with accounts in distress rank
  • No. 13 – Credit score rank and “debt” search interest index rank
Examining these financial factors on the state level is important for understanding how Americans are faring with economic issues like inflation, unemployment rates, or natural disasters, according to WalletHub analyst Chip Lupo.


"When you combine data about people delaying payments with other metrics like bankruptcy filings and credit score changes, it paints a good picture of the overall economic trends of a state," Lupo said.

On the other side of the spectrum, states like Hawaii (No. 50), Vermont (No. 49), and Alaska (No. 48) are the least financially distressed states in America.

The top 10 states with the most people in financial distress in 2025 are:

  • No. 1 – Texas
  • No. 2 – Florida
  • No. 3 – Louisiana
  • No. 4 – Nevada
  • No. 5 – South Carolina
  • No. 6 – Oklahoma
  • No. 7 – North Carolina
  • No. 8 – Mississippi
  • No. 9 – Kentucky
  • No. 10 – Alabama
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A version of this article originally appeared on CultureMap.com.

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