Optellum, Liongard, and Cart.com have hired new members to their executive teams. Photos courtesy

A handful of Houston tech startups have recently announced new appointments to their C-suites. A med tech company with its national headquarters in Houston has a new leader, a Houston software has a new exec focused on strategy, and a e-commerce company has a new chief revenue officer.

Optellum names new CEO

Jason Pesterfield will lead United States operations for Optellum. Photo courtesy of Optellum

Optellum, a medical software startup based in the United Kingdom and has its United States HQ in Houston, has appointed Jason Pesterfield as CEO to lead growth in the U.S. clinical market. Optellum AI-based software enhances early lung cancer diagnosis and therapy with its medical device software platform, Virtual Nodule Clinic.

Pesterfield was previously the president and CEO of Veran Medical Technologies, a leader in image-guided lung cancer diagnosis. He brings 25 years of leadership experience in the medtech sector. Optellum was founded by Václav Potěšil, Lyndsey Pickup, Timor Kadir, Professor Sir Mike Brady, and Jérôme Declerck.

"It took us almost a year to find the right successor who shares our vision and has the right expertise to take Optellum on to the next stage of growth," says Potěšil in a news release. "I am really excited to work with Jason, to make Optellum's platform available to every clinician in the USA and around the world, and to help them diagnose their lung cancer patients as early as possible. With Jason on board, I can focus on advancing Optellum's vision to transform early lung cancer therapy through partnerships that harness the power of AI software combined with molecular diagnostics, robotics and interventional devices, and drugs."

Liongard announces chief strategy officer

Patrick Schneidau is the chief strategy officer for Liongard. Photo courtesy

​Houston software-as-a-service company, Liongard, has named Patrick Schneidau as chief strategy officer. The company, founded in 2015, was a 2021 InnovationMap Awards finalist and reported that the team was looking to expand by around 70 new hires over the next year.

"Liongard is an incredible Houston growth story," Schneidau tells InnovationMap. "Our founders, Joe Alapat and Vincent Tran, have built a first-class team that allow technology service providers to operate at 10x by providing unprecedented insight and data into the systems deployed in the modern IT stack. In a rapidly growing market, they are quickly becoming 'must have' technology. I'm excited to join to team to accelerate their growth into new markets and with new products."

Schneidau spent over a decade at Houston-based PROS before serving in C-level positions at two other Houston startups — Commtrex and Truss. He's also previously served as talent committee chair for Houston Exponential.

Cart.com hires a new chief revenue officer

Randy Ray is Cart.com's first chief revenue officer. Photo courtesy of Cart.com

Fresh off its $98 million series B, Cart.com has named its first chief revenue officer. Randy Ray is tasked with driving sales growth across the company. He has over 15 years of sales and operations experience and was previously senior vice president at supply-chain solution provider High Jump.

"I've worked with the world's biggest retail and SaaS brands, and I've seen the need for a unified Ecommerce-as-a-Service hub to create operational efficiencies and unlock scalable success," Ray says in a press release. "I'm a firm believer in the Cart.com mission to drive success for online brands, and I'm looking forward to tripling our sales organization and building out a world-class revenue infrastructure as we take the company global over the next 6 to 9 months."

Startups all over Houston and across industries are answering the call for tech solutions to COVID-19-caused issues from real estate and mental health to new software and services. Duy Do/Getty Images

9 Houston startups that are pivoting to provide COVID-19-related services

Startups to the rescue

From software to new services, several Houston startups are using this time of crisis to roll out new options for people living in the time of the COVID-19 crisis.

Last week, InnovationMap rounded up seven health tech startups providing health care solutions. This week, here are nine more startups that have reacted to the coronavirus with new tech solutions.

GotSpot

Reda Hicks, founder of GotSpot, has launched Rescue Spot to help out Houstonians dealing with the COVID crisis. Courtesy of GotSpot

Reda Hicks founded her company Gotspot — a digital tool that helps connect people with commercial space with people who need it — on the heels of Hurricane Harvey after seeing how hard it was for Houstonians to activate physical spaces in an emergency.

Now, in the face of another — albeit drastically different — situation, Hicks has created Rescue Spot to be that activation portal for specific COVID-19-related crisis needs.

"We are working with local community leaders to try to activate specific kind of space for emergency response," Hicks says in a Facebook interview with Bunker Labs, "so, restaurants turned into community kitchens, cold storage for perishables, storefronts that can be used as drive-by distribution centers, and places for people to house their pets while their owners are feeling overwhelmed and can't take care of their four-legged family members as well."

People with space or in need of a Rescue Spot can list their space or needs online.

SocialMama

Houston-based SocialMama uses its platform to connect mothers based on location, interests, and the things their children have in common. Courtesy of SocialMama

Houston-based SocialMama was founded in May of last year to connect mothers using machine learning that factors in vicinity, children's ages, shared motherly struggles, and more to create a support group digitally and socially. Now, the startup has sped up the release of a new feature so that users have more mental health resources during the pandemic.

Founder and CEO Amanda Ducach created SocialMama's expert program — an update to the app, which has been downloaded by over 15,000 users since launch — to connect moms to professionals specializing in everything from family medicine and mental health to career and personal safety. A portion of these experts join from Gravida, a post partum and return to work resource, according to a news release.

"Knowing someone is on the other side of the screen with a very similar story is truly comforting. The app considers all females, including those planning to become moms, those who are trying to conceive, those who have lost a child, etc. SocialMama is here for our community in a whole new way with the launch of our expert program," says Ducach in the release.

With mothers being tasked with educating and entertaining their children at home during the crisis on top of their regular jobs and duties, many are turning to SocialMama's online forum and app for support, ideas, and solidarity.

Accel Lifestyle

Accel's masks are made out of their specialty anti-bacteria fabric. Photo courtesy of Accel

While you might not usually think an activewear brand has anything to contribute to the fight against the coronavirus, you have to remember that Accel Lifestyle isn't a typical activewear brand. Founder Megan Eddings created the Prema® anti-bacterial fabric for an anti-stink feature in her clothing. That feature has another use: Preventing the spread of the disease.

Accel quickly pivoted her t-shirt-making supply chain to designing and sewing the masks. The reusable, washable masks are available online for individuals to purchase, but one Houston hospital system has made a huge purchase. Houston Methodist ordered 9,000 masks to be made for their hospital staff.

"The fact that a hospital system that is on the forefront of COVID-19 is choosing Accel Lifestyle to create PPE is profound and humbling," Eddings says in a press release. "I truly believe we're all in this together and we all have a role to play during this pandemic. If Accel Lifestyle can help flatten the curve in any way, then we're going to do it."

Predictive Solutions

A Houston startup has created a web tool for tracking the coronavirus. Pexels

Houston-based Predictive Solutions created a web application in March to give the residents of Harris County all the local information on COVID-19 in the palm of their hands — and now the tool has been expanded to the entire state.

The online map identifies nearby testing locations as well as indicates cases that have been self reported in the area. While not trying to be comprehensive, the website is trying to track trends with the disease.

"We developed the app to help streamline communication between the City of Houston, the healthcare community, aid organizations and Harris County residents, while mitigating the logistical nightmare of making sure presumed cases get tested," says Stewart Severino, co-founder and CEO of Predictive Solutions, in a news release. Read more.

Truss

Truss has modified its software to advance communications while hospitals are cracking down on visitors amid the coronavirus outbreak. Getty Images

Houston-based Truss usually focuses on digital community engagement, but Patrick Schneidau, CEO of the company, says he felt called to do something to help families separated due to strict emergency visitation rules at hospitals.

"You read all the stories of loved ones not being able to be together during this time," Schneidau, who is a member of InnovationMap's board, previously told InnovationMap. "That was the area we wanted to focus on."

Schneidau describes the software as a secure portal for small groups to interact via smart devices. Physicians can interface with family members via video chat or recorded messages, as well as answer any questions. Schneidau is looking for health care organizations to work with the technology so that patients and their doctors can have secure access to loved ones. Read more.

ChaiOne

Houston-based ChaiOne has launched a new tool that can help companies track supply chain delays resulting from COVID-19. Photo courtesy of ChaiOne

Houston-based ChaiOne recently announced the soft launch of its new software called Velostics — the "slack" for logistics that solves wait times and cash flow challenges in the supply chain and logistics industry. The digital logistics platform is set to aid the struggling supply chain as surging demands stretch suppliers, offering their platform free for 60 days.

"At ChaiOne we have a history of helping Houstonians whenever disaster strikes," says CEO and founder, Gaurav Khandelwal. "We created a disaster connect app during Hurricane Harvey for free that connected people with the resources they need. Velostics by pure happenstance happened to be ready for situations like [the coronavirus] when there's a lot of parties that need to collaborate."

Velostics results in an improved cash cycle for clients, cutting a 90-day settlement down to one day, along with an overhead reduction that reduces costs and improves output along with error reduction. The digital platform is specially engineered to reduce waste while keeping the supply chain running efficiently. Read more.

Umanity

Launched in Houston, Umanity's new tool aims to better connect nonprofits with supplies and volunteers amid the COVID-19 crisis. Photos via umanity.io

Umanity, which is a part of the Ion Smart and Resilient Cities Accelerator's first cohort, has created a philanthropic supply chain tool that's now available as an app or through desktop. The software can match and map local individual or nonprofit needs to organizations or volunteers, plus provide real-time analytics. During the coronavirus outbreak, they have mobilized its resources connecting supplies with nonprofits and volunteers with safe ways to help organizations that need it most during this crisis.

The company, which is working with several city of Houston officials to direct citizens the resources they need during the crisis, is creating a network of communities to efficiently provide them the resources they need. The centralized platform shows a complete picture of who needs help and who can help all on the same platform while measuring the real-time economic impact of donations and every volunteer hour.

"I started this company because I wanted to transition everyday acts of service into actual data-driven solutions," says Ryan-Alexander Thomas, CEO and founder of Umanity. "My goal is that during the next crisis, for example, hurricane season, if somebody needs something they have access to get it when they need it, not two years later or after the crisis." Read more.

Otso

Houston small businesses are struggling to pay their rent with doors closed and operations ceased — but where should the relief come from? Getty Images

When Josh Feinberg had the idea for his newest startup, Otso, he was hoping to remove the pointless burden of cash deposits required for new commercial and retail leases. But as the coronavirus pandemic began enacting stay-at-home mandates that forced small businesses to close their physical spaces, he had another idea.

Otso, with its financial partner Euler Hermes, provides landlords with an alternative to cash security deposits. While he first envisioned this tool for new leases, Feinberg created a system so that local businesses that are struggling to pay their rent can opt into this type of contract through an addendum to the lease. They can get back their cash deposits and use that capital now when times are tough.

"If we can get some liquidity back into the hands of the business, they have some a better chance of survival," Feinberg previously told InnovationMap.

Tenants or landlords can begin the process online. Feinberg recently joined the Houston Innovators Podcast to discuss the unprecedented state of commercial real estate and offer his advice for business owners. Click here to listen.

Spruce

Houston-founded Spruce has added some new services to help sanitize multifamily facilities during the COVID-19 pandemic. Getty Images

Houston-founded, Austin-based Spruce, which has an office locally, has launched a new suite of services for disinfecting common areas — like leasing offices, hallways, mail rooms, etc. — using EPA-compliant chemicals.

"Now, more than ever, it is critical for apartment communities to make sure their common areas are regularly decontaminated and disinfected to help slow the spread of the coronavirus and to prevent as many infections as possible," says Ben Johnson, founder and CEO of Spruce, in a statement.

The services include a weekly disinfectant of high-touch spots — like door handles and elevator buttons — as well as a weekly comprehensive cleaning that involves mopping, surface cleaning, and vacuuming. The startup also offers a bimonthly fogging service that can completely cover both indoor and outdoor areas with disinfectant. This solution can protect surfaces for months, according to the news release.

"This is an unprecedented public health crisis, and we worked closely with our clients to determine the biggest need and hope these services will give apartment communities one more weapon to use in the fight against COVID-19 and will help give both operators and their residents peace of mind," Johnson continues in the release. Read more.

This week's Houston innovators to know are Jan Odegard of The Ion, Josh Feinberg of Otso, and Patrick Schneidau of Truss. Courtesy photos

3 Houston innovators to know this week

who's who

The month is, thankfully, flying by, and InnovationMap has another set of Houston innovators to know this week that are all reacting to COVID-19 and its unique set of challenging consequences across industries — from commercial real estate to software.

Jan E. Odegard,  senior director of Academic and Industry Partnerships at The Ion

Jan E. Odegard is the senior director of Academic and Industry Partnerships at The Ion. Photo courtesy of The Ion

When it comes to envisioning normal life after COVID-19, Jan Odegard realizes things will probably change for good. In a guest column for InnovationMap, he writes that, as a society, "we may never work and learn the same again." The Ion is trying to prepare the city for this affected future.

"As senior director of Academic Programming, my job will be to implement those ideas and move new programs forward," he writes. "To do this, the team is developing and pivoting programs we had on the drawing board and are engaging in conversations with academic stakeholders, workforce development programs and executives with innovation-driven hiring needs."

Click here to continue reading.

Josh Feinberg, co-founder of Otso

Josh Feinberg is the co-founder of Otso and Tenavox. Photo courtesy of Otso

Josh Feinberg hates security deposits. It's a sum of money sitting in an account, not earning interest and not doing either the landlord or the tenant any good.

That's why Feinberg and his co-founder, Marissa Limsiaco, created Otso. The duo previously founded Tenavox, an online portal for commercial real estate listings for brokers to generate leads, and have now launched this fintech platform that provides landlords with an alternative to cash security deposits.

Feinberg tells the Houston Innovators Podcast that, while he originally envisioned Otso to be a new deal product for landlords to offer an alternative to cash deposits, he saw the tool as an opportunity for small businesses struggling to pay rent that have a shortage of liquidity. He tossed out the original marketing plans and pivoted to present Otso as that liquidity solution for small business tenants.

Click here to read more and stream the podcast.

Patrick Schneidau, CEO of Truss

Patrick Schneidau is the CEO of Truss. Photo courtesy of Truss

Patrick Schneidau, CEO of Houston-based Truss, was trying to figure out his startup's role amid the COVID-19 crisis, and says he felt called to do something to help families separated due to strict emergency visitation rules at hospitals.

"You read all the stories of loved ones not being able to be together during this time," Schneidau says. "That was the area we wanted to focus on."

Schneidau describes the software as a secure portal for small groups to interact via smart devices. Physicians can interface with family members via video chat or recorded messages, as well as answer any questions.

Click here to read more.

Truss has modified its software to advance communications while hospitals are cracking down on visitors amid the coronavirus outbreak. Getty Images

Houston startup pivots to make communication software for hospitals limiting visitors

helping hands

With hospitals cracking down on people allowed into patient rooms, a Houston startup has adjusted its software to provide a solution to communications issues between patients, doctors, and family members.

Houston-based Truss usually focuses on digital community engagement, but Patrick Schneidau, CEO of the company, says he felt called to do something to help families separated due to strict emergency visitation rules at hospitals.

"You read all the stories of loved ones not being able to be together during this time," Schneidau says. "That was the area we wanted to focus on."

Schneidau describes the software as a secure portal for small groups to interact via smart devices. Physicians can interface with family members via video chat or recorded messages, as well as answer any questions.

"We've done some preliminary research — doctors themselves want to communicate with the family," Schneidau says, "but they can't be on six different phone calls throughout the day for one patient."

So as not to burden hospital staff unnecessarily, the platform would also provide answers to common questions and resources. Perhaps most importantly, the software can allow patients to interact with their family members from afar.

According to Schneidau, Truss is seeking hospitals that might be interested in the technology and recognizes that hospitals are currently jumping on new tech opportunities in this time of crisis, like Houston Methodist, which is equipping its hospital rooms with tablets.

"We've talked to a number of hospitals, and every one is facing this issue," Schneidau says. "We're figuring out who would be the right people to participate in the tool itself."

Beyond the COVID-19 pandemic, Schneidau, who's a member if InnovationMap's board of directors, says he thinks the platform could be helpful communications in nursing homes.

"The outside forces being what they are and preventing visitors in the room doesn't preclude the need to communicate with family members," says Schneidau. "So you have to come up with an innovative solution very quickly to be able to address that particular issue. This is a possible answer to that."

Gina Luna and Sandy Wallis will both be key in moving forward Truss as new board members. Courtesy photos

Houston startup adds 2 big names to its board of directors

All aboard

A Houston startup specializing in digital community engagement has added two big names in Houston innovation to its board of directors.

Sandy Wallis and Gina Luna will both be key in moving forward Truss as new board members. Sandy Wallis is the co-founder and managing director of Weathergage Capital and the managing director of the HX Venture Fund, and Gina Luna is CEO of Luna Strategies and active member of several boards of directors.

"Our new board members are leaders in the Houston technology and innovation community, and their joining the Truss team is a testament to our compelling mission and broader market potential," says Patrick Schneidau, CEO of Truss, in a news release. Schneidau is a member if InnovationMap's board of directors.

Schneidau was tapped for his position as CEO in March and was tasked by former CEO Chris Buckner to grow the company. Schneidau is excited about the two additions to Truss's leadership.

"Gina has extensive experience across corporate, nonprofit and startup companies, as well as financial operations," Schneidau says in the release. "Sandy brings invaluable insights into capital raises; her experience in venture funding is unmatched in our city. Both new board members bring the expertise necessary to catapult our growth and expand our customer base."

In September, Truss announced its rebrand and name change from FanReact. The transition opens doors for the company to reach new clients that aren't in the sports industry — but that maybe want to take a page out of the fan experience's book.

Luna, who is the founding chairman of the board for Houston Exponential, has decades of pertinent experience and is very involved in the innovation ecosystem.

"Truss is leading in digital community experiences for athletics and is in a high-growth phase as they expand into other sectors," says Luna in the release. "I'm excited to join the board to help propel the mission and future direction of the company. The sky's the limit as groups of any kind can create the communication, collaboration and connections they desire with Truss."

Wallis has also been very invloved in the ecosystem and was named managing director of HX Venture Fund this summer. Weathergage Capital, a venture capital fund of funds with approximately $1 billion in venture partnership commitments, has been under her leadership for over 13 years.

"Truss is for organizations and their audiences who want better user experiences and levels of engagement in their digital communities," says Wallis in the release. "The market is ready for Truss's privacy-focused platform to serve these organizations. I appreciate the focus on diversity at the company and its passion for hiring the best talent across the board — goals from the company's leaders I look forward to seeing continue long term."

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Texas Space Commission launches, Houston execs named to leadership

future of space

Governor Greg Abbott announced the Texas Space Commission, naming its inaugural board of directors and Texas Aerospace Research and Space Economy Consortium Executive Committee.

The announcement came at NASA's Johnson Space Center, and the governor was joined by Speaker Dade Phelan, Representative Greg Bonnen, Representative Dennis Paul, NASA's Johnson Space Center Director Vanessa Wyche, and various aerospace industry leaders.

According to a news release, the Texas Space Commission will aim to strengthen commercial, civil, and military aerospace activity by promoting innovation in space exploration and commercial aerospace opportunities, which will include the integration of space, aeronautics, and aviation industries as part of the Texas economy.

The Commission will be governed by a nine-member board of directors. The board will also administer the legislatively created Space Exploration and Aeronautics Research Fund to provide grants to eligible entities.

“Texas is home to trailblazers and innovators, and we have a rich history of traversing the final frontier: space,” Lieutenant Governor Dan Patrick says in a news release. “Texas is and will continue to be the epicenter for the space industry across the globe, and I have total confidence that my appointees to the Texas Space Commission Board of Directors and the Texas Aerospace Research and Space Economy Consortium Executive Committee will ensure the Texas space industry remains an international powerhouse for cutting-edge space innovation.”

TARSEC will independently identify research opportunities that will assist the state’s position in aeronautics research and development, astronautics, space commercialization, and space flight infrastructure. It also plans to fuel the integration of space, aeronautics, astronautics, and aviation industries into the Texas economy. TARSEC will be governed by an executive committee and will be composed of representatives of each higher education institution in the state.

“Since its very inception, NASA’s Johnson Space Center has been home to manned spaceflight, propelling Texas as the national leader in the U.S. space program,” Abbott says during the announcement. “It was at Rice University where President John F. Kennedy announced that the U.S. would put a man on the moon—not because it was easy, but because it was hard.

"Now, with the Texas Space Commission, our great state will have a group that is responsible for dreaming and achieving the next generation of human exploration in space," he continues. "Texas is the launchpad for Mars, innovating the technology that will colonize humanity’s first new planet. As we look into the future of space, one thing is clear: those who reach for the stars do so from the great state of Texas. I look forward to working with the Texas Space Commission, and I thank the Texas Legislature for partnering with industry and higher education institutions to secure the future of Texas' robust space industry."

The Houston-area board of directors appointees included:

  • Gwen Griffin, chief executive officer of the Griffin Communications Group
  • John Shannon, vice president of Exploration Systems at the Boeing Company
  • Sarah "Sassie" Duggleby, co-founder and CEO of Venus Aerospace
  • Kirk Shireman, vice president of Lunar Exploration Campaigns at Lockheed Martin
  • Dr. Nancy Currie-Gregg, director of the Texas A&M Space Institute

Additionally, a few Houstonians were named to the TARSEC committee, including:

  • Stephanie Murphy, CEO and executive chairman of Aegis Aerospace
  • Matt Ondler, president and former chief technology officer at Axiom Space
  • Jack “2fish” Fischer, vice president of production and operations at Intuitive Machines
  • Brian Freedman, president of the Bay Area Houston Economic Partnership and vice chairman of Wellby Financial
  • David Alexander, professor of physics and astronomy and director of the Rice Space Institute at Rice University

To see the full list of appointed board and committee members, along with their extended bios, click here.

City of Houston approves $13M for new security tech at renovated IAH​ terminal

hi, tech

A new terminal currently under construction at George Bush Intercontinental Airport just got the green light for new security technology.

This week, Houston City Council unanimously approved the funding for the new Mickey Leland International Terminal's security equipment. The Mickey Leland International Terminal Project is part of the $1.43 billion IAH Terminal Redevelopment Program, or ITRP, which is expected to be completed by early next year.

This new IAH International Terminal will feature an International Central Processor, or ICP, with state-of-the-art technology in a 17-lane security checkpoint — among the largest in the country — as well as ticket counters and baggage claim.

“Houston Airports strives to get passengers through TSA Security in 20 minutes or less. Today, we meet that goal at Bush Airport more than 90 percent of the time,” Jim Szczesniak, director of aviation for Houston Airports, says in a news release. “This investment in innovative technology will enhance our efficiency and ensure that our passengers have a world-class experience each time they visit our airports.”

Going through security at IAH is about to be smoother sailing. Rendering courtesy of Houston Airports

The funding approval came from two ordinances, and the first one appropriates $11.8 million from the Airports Improvement Fund to buy, service, install, and train staff on nine new automated screening lanes, called Scarabee Checkpoint Property Screening Systems, or CPSS.

Per the news release, each of these CCPS automated lanes "is capable of screening more than 100 additional people and bags/hour than existing equipment used today." Currently, Terminal D's TSA is using eight CPSS Lanes, so the additional nine lanes will bring the total to 17 lanes of security.

The other appropriates another $1.2 million from the Airports Improvement Fund to buy, install, maintain, and train staff on six new Advanced Imaging Technology Quick Personnel Security Scanners.

The new scanners, which don't require the traveler to raise their arms, "is capable of screening more than 100 additional people/hour than existing equipment used today," per the release.

“These new security screening machines are faster, have fewer false alarms and have improved detection rates, which creates a safer experience for our passengers and airlines,” Federal Security Director for TSA at IAH Juan Sanchez adds.

The Mickey Leland International Terminal originally opened in 1990 and is currently under renovation. Rendering courtesy of Houston Airports

Texas has the 5th highest health care costs in the nation, Forbes says

dollar signs

A new Forbes Advisor study shedding light on Americans' top financial worries has revealed Texas has the fifth highest health care costs in the nation.

Forbes Advisor's annual report compared all 50 states and Washington, D.C. across nine different metrics to determine which states have the most and least expensive health care costs in 2024.

Factors include the average annual deductibles and premiums for employees using single and family coverage through employer-provided health insurances and the percentage of adults who chose not to see a health care provider due to costs within the last year, among others. Each state was ranked based on its score out of a total 100 possible points.

Texas was No. 5 with a score of 91.38 points. North Carolina was No. 1, followed in order by South Dakota, Nebraska, and Florida.

According to Forbes, out-of-state families considering a move to the Lone Star State should be aware of the state's troubling statistics when it comes to family health care. More specifically, nearly 15 percent of Texas children had families who struggled to pay for their medical bills in the past 12 months, the highest percentage in the nation.

Furthermore, Texans have the highest likelihood in the U.S. to skip seeing a doctor because of cost. The report showed 16 percent of Texas adults chose not to see a doctor in the past 12 months due to the cost of health care.

"Unexpected medical bills and the cost of health care services are the top two financial worries for Americans this year, according to a recent KFF health tracking poll," the report said. "These financial fears have real-world consequences. The high cost of healthcare is leading some Americans to make tough choices—often at the expense of their health."

In the category for the percentage of adults who reported 14 or more "mentally unhealthy" days out of a month, who could not seek health care services due to cost, Texas ranked No. 3 in the U.S. with 31.5 percent of adults experiencing these issues.

The report also highlighted the crystal clear inequality in the distribution of health care costs across the U.S.

"In some states, residents face much steeper health care expenses, including higher premiums and deductibles, which make them more likely to delay medical care due to costs," the report said.

For example, Texas' average annual premiums for both plus-one health insurance coverage ($4,626, according to the study) and family coverage ($7,051.33) through employer-provided policies was the No. 4-highest in the nation.

Elsewhere in the U.S.

The state with the most expensive health care costs is North Carolina, with a score of 100 points. 27 percent of adults in North Carolina reported struggling with their mental health who could not seek a doctor due to cost, and 11.3 percent of all adults in the state chose not to see a doctor within the last 12 months because of costs.

Hawaii (No. 50) is the state with the least expensive health care costs, according to Forbes. Hawaii had the lowest percentages of adults struggling with mental health (11.6 percent) and adults who chose not to see a doctor within the last year (5.7 percent). The average annual premium for employees in Hawaii using a family coverage plan through employer-provided health insurance is $5,373.67, and the average annual deductible for the same family coverage plan is $3,115.

The top 10 states with the most expensive health care are:

  • No. 1 – North Carolina
  • No. 2 – South Dakota
  • No. 3 – Nebraska
  • No. 4 – Florida
  • No. 5 – Texas
  • No. 6 – South Carolina
  • No. 7 – Arizona
  • No. 8 – Georgia
  • No. 9 – New Hampshire
  • No. 10 – Louisiana

The full report and its methodology can be found on forbes.com.

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This article originally ran on CultureMap.