How Houston startups can find funding in the age of coronavirus

Houston voices

Finding funding might be harder during the pandemic. But there are some startups thinking outside the box to attain theirs. Miguel Tovar/University of Houston

Almost eight months in to the pandemic and many startups are still fighting to survive. Finding funding has become harder in an era the New York Times calls "The Great Unwinding." But not every startup is succumbing to a bleak fate. Some have shown unique strategies for attaining funding. Here, we'll delve into a few examples of startup companies whose founders have managed to snag funding and stay afloat amid the crashing waters of coronavirus.

Government contracts

Payam Banazadeh, CEO of Capella Space, told Graham Winfrey, senior technology editor for Inc., that it would behoove tech startups to look into acquiring government contracts if possible. His Silicon Valley-based satellite communications startup snagged a lucrative government contract with the Department of Defense. "The government seeks startups that are doing unique things. If they find a product they like, they're going to pursue it. Government contracts help raise additional funding while also de-risking companies in the eyes of investors," Banazadeh said.

Funding conversations matter

Nesh is a company based in Houston that acts as a smart assistant for the energy industry. The startup spent the pandemic engaged in conversations with potential investors. "It's easier to talk to investors at this time. We've had more conversations in the past few months than all of 2019, but nobody is willing to write checks just yet," said Sidd Gupta, founder of Nesh, to Cr unchb ase News, a tech startup-centric outlet.

The Houston-based company also pivoted by expanding into other oil and gas areas like renewables. Nesh even decided to make its platform accessible free of charge during the shutdown.

Take matters into your own hands

Laally is a breastfeeding assistance device company. During their funding strategizing, they examined all the usual funding avenues: VC, angels, debt, non-profit and potential partnerships with bigger entities. Most of these sources asked for proof of concept and a proven history of solid sales before even thinking of putting money on the table.

Well, that wasn't possible for founders Max and Kate Spivak. They decided to go it alone. Self-funding. "As a family and rookie entrepreneurs, we made the decision to put our money in the balance and hire a partner for the tech part of the business," Max Spivak said told Crunchbase News.

"Even when things got rough as the pandemic worsened, and they did get very rough for us, we didn't have pressure from investors to liquidate assets or investors demanding their money back. That's because we were our own funders," said Kate Spivak.

Creativity can conquer COVID-19

Sometimes adversity is the mother of creativity. These three startup founders stepped outside the box of traditional funding strategies. They discovered ways to change their companies and attain funding during a pandemic that has its foot on the neck of the economy.

Thanks to people like Sidd Gupta, Payam Banazadeh, and the Spivaks, startup founders have a better idea of what they need to do for their startups to live another day. For their companies to see a light at the end of an 8-month long tunnel. The pandemic might have our faces covered, our friends at arm's length, and our jobs in limbo. But it cannot strip away the power of human ingenuity, innovation, and creativity. The founders named above are walking proof.

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This article originally appeared on the University of Houston's The Big Idea. Rene Cantu, the author of this piece, is the writer and editor at UH Division of Research.

Three young professionals took the stage to discuss the future tech of offshore operations in oil and gas. Courtesy photos

Overheard: Here's the future of oil and gas tech, according to this panel at OTC

Eavesdropping in Houston

The oil and gas industry has a reputation for being a slow adapter when it comes to technology advances, but that's changing — as is the workforce. In the next few years, half of the United States workforce will be millennials, according to the Bureau of Labor Statistics.

A panel at the 2019 Offshore Technology Conference discussed the future of oil and gas technology — and the young professionals who are taking over the industry.

"It is just exhausting to be continuously interrupted in meetings — day in and day out — for your full career. What makes it worse, is no one seems to notice but you, unless you're lucky and have another woman in the year."

— Allison Lami Sawyer, partner at the League of Worthwhile Ventures, when asked about being a young, female leader in industry. She adds that what's even worse is when you internalize it yourself and stop noticing.

“There’s a whole population of frustrated visionaries in oil and gas who are really excited to work with new tech.”

— Sawyer says the challenge is less getting a foot in the door at large companies and more going from pilot to mid- to widespread use.

“Oil and gas is essentially banking. Did you know you’re all bankers?”

— There's more labor to it, Sawyer says, but the C-suite at oil and gas companies are approaching it like banking. And in banking, there's a lot of AI-based fintech that goes into that decision making process and that might, down the road, come to oil and gas when the data is there.

“It’s happening. New technologies are being added, but it’s about finding the right value proposition for the company. That needs to resonate.”

— Sidd Gupta, founder and CEO of Nesh, says, adding that maybe it's not happening at as fast a rate as people wished.

“There’s been an increased demand for people internally who can take 3D models and put them into an AR environment. … Maybe four years ago, I would never have said that oil and gas companies would have internal AR/VR experts.”

— Lori-Lee Emshey, co-founder of Future Sight AR, on the rising need for professionals with augmented and virtual reality skills.

“Anything that can positively impact safety has been a big winner — especially on the contractor side.”

— Emshey, when asked about what sort of technology is attractive to big oil and gas companies.

TMCx is looking for members for its ninth cohort. Courtesy of TMCx

Houston software company raises $16.3 million, TMCx opens applications, and more innovation news

Short stories

From rounds closing to accelerator applications opening, there's a lot of Houston innovation news that might not have reached your radar. Here's a roundup of short stories within tech and innovation in the Bayou City.

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Houston software company closes a $16.3 million Series A

Innovapptive raised its round lead by a New York-based firm. Getty Images

Innovapptive, a software-as-a-service company with clients in industrial industries, announced it closed on a $16.3 million Series A investment led by New york-based Tiger Global Management LLC. The company will use the funds for continued global growth. As of the raise's completion, company's valuation is now more than $65 million.

"We are connecting the enterprise by providing a platform that improves real-time data collaboration and communications between the field and back office. The communications and collaboration data are captured and converted into executive insights for continuous workforce optimization," says Sundeep Ravande, CEO and co-founder of Innovapptive, in a press release. "This additional capital will allow us to accelerate our strategy and development to transform the digital experience of the industrial worker to help increase revenues and margins for our customers."

TMCx opens its medical device cohort applications

The deadline to apply for the next TMCx cohort is May 24. Courtesy of TMC

The Texas Medical Center has announced that TMCx's 2019 medical device cohort applications are now open. The deadline to apply is May 24, and selected companies will be notified by June 21. The program will run from August 5 to November 8th. For more information, click here.

Nesh closes Seed round of funding

Aristos Ventures lead the round for the Houston energy startup. Courtesy of Nesh

The Siri of oil and gas, Hello Nesh Inc, has raised its first round of funding thanks to seed funding from Aristos Ventures and a LOOP contract with Equinor Technology Ventures. The funding will be used for new hires and expansion plans.

"Securing LOOP funding from ETV and seed funding from Aristos provides us with a unique mix of strategic knowledge and domain expertise, coupled with investment experience in digital technologies, artificial intelligence, and SaaS," says co-founder and CEO of Nesh, Sidd Gupta in a release. "This will enable us to further build Nesh's petrotechnical and natural language understanding and scale our business in the North America market."

ETV has chosen not to disclose the dollar amount of the round, however last fall Gupta at the Texas Digital Summit, Gupta announced that the company was seeking to close a $800,000 seed round. Read more about the company here.

Shell Oil Co. gives $2.5M to fund research, inform public policy at Rice University’s Baker Institute

Shell and Rice University have entered a partnership.Courtesy of Rice University

Following a $2.5 million commitment from Shell Oil Co., the Center for Energy Studies at Rice University's Baker Institute for Public Policy has announced five-year research program to study the global energy system — including the policies, regulations, geopolitical forces, market developments and technologies.

"We are grateful for Shell's commitment to advancing the study of critical energy issues affecting our region, the nation and the world," says Baker Institute Director Edward Djerejian in a release. "This partnership with Shell furthers our mission to provide unbiased, data-driven analysis of factors that will shape our energy future with the aim of engaging policymakers, corporate leaders and the general public with the results."

Texas improves its ranking as an innovative state

The Lone Star State is moving on up as an innovative state. Getty Images

Texas is slowly but surely moving on up as an innovative state. According to Bloomberg's newest U.S. State Innovation Index, Texas is the 17th best state for innovation. The study factors in six metrics: research and development intensity, productivity, clusters of companies in technology, "STEM" jobs, populous with degrees in science and engineering disciplines, and patent activity. Last year, the study found Texas at the No. 19 spot.

Texas' score was 60.1 — which is just over a point's difference from being in the top 15. It's also worth noting that the Lone Star State is the highest ranked in the south.

"What is most important is the construction and catalyzation of super vibrant advanced industry sectors and clusters in a state," says Mark Muro, a senior fellow at Brookings, a think tank in Washington DC, to Bloomberg. "Commercialization has not been a top priority of universities in the heartland, especially in the South."

Houston companies take home Napier Rice Launch Challenge prizes

Abbey Donnell's startup, Work & Mother, won the award for the Best Alumni team at the H. Albert Napier Rice Launch Challenge at Rice University. Courtesy of Work & Mother

On April 4, 10 teams competed in the H. Albert Napier Rice Launch Challenge at Rice University. Here are the Rice University alumni- and student-led companies that won awards.

LilySpec took home $2,500 as the Audience Favorite award winner.
CardStock Exchange won $12,500 in the Best Undergraduate category.
WellWorth walked away with $12,500 as the Best Graduate team winner.
Abbey Donnell, founder of Work & Mother, took home first place the Best Alumni category — along with $12,500.
UrinControl was the Grand Prize winner and scored $20,000.

BBL reverse pitch contest extends deadline

The deadline for a new pitch competition with ExxonMobil and BBL Ventures has been extended. Getty Images

BBL Ventures, which announced its reverse pitch competition with ExxonMobil earlier this year, has extended the challenge deadline to May 13.

"BBL Ventures is excited to be working with a forward-thinking partner like ExxonMobil, engaging the external innovation ecosystem is a key step in advancing the energy industry's continued success," says Patrick Lewis, managing partner of BBL Ventures, in a release. Full details for the competition are available here.

Startup Grind Houston is calling all female founders

Calling all female founders. Getty Images

Houston's Startup Grind chapter announced a female founder pitch event on May 2 at the TMC Innovation Institute. The organization is calling for teams to pitch at the event. The deadline to apply is April 23 at 5 pm.

Click here to nominate yourself or someone else for the pitch.

Sysco invites UH tech students to first-ever UHacks Hackathon competition

Sysco and AWS are teaming up for a hackathon. Getty Images

Houston-based Sysco Corp. — along with Amazon Web Services — is hosting its first-ever, university student-led hackathon event. The one-day competition takes place on Friday, April 19, from 8 am to 5 pm at the new Houston office of AWS ( 825 Town & Country Lane, 10th floor).

The student teams with focus on four hypothetical themes in Sysco's business landscape, including a spend management platform enhancing the customer shopping experience, identifying locally grown foods, proof of purchase technology, and a "best before" portal to streamline expiration data.

It might not be surprising to discover that the energy capital of the world is a hub for energy startups. Getty Images

5 emerging energy tech companies in Houston revolutionizing the industry

The Future is Now

If you thought Houston's wildcatter days were exciting, just you wait. Houston has an emerging ecosystem of tech startups across industries — from facial recognition devices used at event check in to a drone controller that mimics movement in space.

A somewhat obvious space for Houston entrepreneurs is oil and gas. While the energy industry might have a reputation of being slow to adapt new technologies, these five Houston startups are developing the future of the industry — one device at a time.

Future Sight AR

Lori-Lee Emshey's Future Sight AR is revolutionizing antiquated construction tools using augmented reality. Courtesy of Future Sight AR

Working on an oil and gas construction site is like constructing a really large puzzle — one that, if constructed incorrectly, could have dangerous and costly consequences. On her first job in the industry, Lori-Lee Emshey was required to move through the site with a pen and a clipboard to mark down any issues or problems, only to later log that information into a computer. It was a slow process, and she felt frustrated by that.

"I was really shocked at how much work they were doing with such little technology," Emshey says. "I thought, 'there's so much room for innovation here.'"

She created Future Sight AR that uses artificial reality technologies on a smart device so that technicians can instantly see instructions and solutions for the hardware they are constructing on the site.Read more about Future Sight AR here.

Nesh

Nesh's digital assistant technology wants to make industry information more easily accessible for energy professionals. Photo courtesy of Thomas Miller/Breitling Energy

Access to information is endless in the digital age, but Sidd Gupta wanted to create a digital assistant that specifically focused on the energy industry. Nesh is an information bot that users can chat questions to. Think: Siri or Alexa, but with an engineering degree.

"We created Nesh as something super-simple to use," Gupta says. "There's no learning curve, no technical knowledge required, you just need to speak plain English."

Nesh has the potential to change productivity and hiring requirements in various energy companies. Read more about Nesh here.

Cemvita Factory

The Karimi siblings have created a way to synthetically convert CO2 into glucose, and they are targeting the energy and aerospace industries for their technology. Courtesy of Cemvita Factory

Energy companies are getting more and more pressure to create a sustainable solution for the carbon dioxide refineries produce on a daily basis. Houston-based Cemvita Factory has a solution. The company has a patented technology that can convert CO2 into glucose — just like plants do in the photosynthesis process.

"We go to these companies and say, 'What do you want to convert CO2 into?,'" Moji Karimi, co-founder of Cemvita, says. "Then, we do a quick pilot in six months in our lab, and we show them the metrics. They decide if they want to scale it up."

The company also has big plans for making an impact on the aerospace industry too. Read more about Cemvita here.

NatGasHub.com

Jay Bhatty looked at how pipeline data reached traders and thought of a better way. Getty Images

Information around natural gas pipelines — such as whether a pipeline has capacity issues that could trigger a spike in prices — has, for years, been scattered across the web. Now, Houston-based NatGasHub.com aggregates pipeline data from dozens upon dozens of websites.

Jay Bhatty, a veteran of the natural-gas-trading business, founded the Houston-based NatGasHub.com platform, which runs on cloud-based software, launched in late 2017. The company is already profitable and hasn't taken any outside funding. Read more about NatGasHub.com here.

Arundo Analytics

This growing Houston company is providing industrial industries with smart analytics. Courtesy of Arundo

While information can be slow and siloed between energy companies, energy professionals come across the same problem within their own organization. Arundo Analytics is developing software to help connect the dots within an energy company's operations.

Stuart Morstead, co-founder and chief operating officer of Arundo, says that most industrial companies that encounter issues with operations such as equipment maintenance "lack the data science and software capabilities to drive value from insights into their daily operations." Read more about Arundo Analytics here.

These three innovators are using their technology to provide solutions across industries. Courtesy photos

3 Houston tech innovators to know this week

who's who

Innovation isn't always about being the first to create a technology. Sometimes, innovation is seeing the potential an existing technology has to impact a different industry. That's what all three of this week's innovators to know have done across industries. And, they are are only just getting started.

Sidd Gupta, founder of Nesh

Courtesy of Nesh

Sidd Gupta wanted to know what would happen if you took Siri or Alexa, sent her to college, made her an oil and gas industry expert, and allowed energy employees access to her information via a chat room. And that's pretty much what he's done with Nesh, a smart assistant for the energy industry. Read the full story here.

Kim Raath, CFO of Topl

Courtesy of Topl

When Kim Raath was backpacking around the world, she realize the social inequalities of entrepreneurs in struggling companies. Potential business owners couldn't get a loan for their businesses because banks didn't have the time to evaluate business plans. Topl uses blockchain technology to track the impact of money spent — from investments to donations and beyond. Read the full story here.

Ted Gutierrez, co-founder and CEO of Security Gate

Courtesy of Security Gate

According to Ted Gutierrez, an Army special forces vet, the startup life isn't too unfamiliar to his days in an Army reconnaissance unit.

"I love high-conflict, low-impact settings," he says. "It's you and a few guys and you're in a place for a week and you don't know what you'll find. I love that chaos of jumping out of a plane and right into the job."

Instead of protecting our country, Gutierrez's goal is protecting company's cyber security threats with his company, Security Gate. Read the full story here.

Nesh's digital assistant technology wants to make industry information more easily accessible for energy professionals. Photo courtesy of Thomas Miller/Breitling Energy

Houston startup creates the Alexa or Siri for oil and gas companies

Hey, Nesh?

When Sidd Gupta's friend lost his job and struggled to find a new position after the major oil downturn in 2014, Gupta noticed a systemic problem within the industry.

"A company rejected him because he was unfamiliar with the software they used in their operations," Gupta explains. "In our industry, companies will judge a potential hire's technical capabilities based on which software they know how to use rather than how good they would be at the job."

While software requirements for oilfield jobs are common, it made Gupta consider how we can make complex data and knowledge more accessible.

Gupta saw something else brewing in the energy industry that also piqued his interest.

"There was entrepreneurship in the oil and gas space and an interest in data science during the oil downturn. We saw startups created in Austin then Houston. There was an infectious entrepreneurial energy at that time," he says.

Last year, he took the entrepreneurial leap, quit his job and founded Nesh, a smart assistant like Alexa or Siri, but specifically for oil and gas companies. Nesh sources information from public data, vendor sources, technical papers, journal articles, news feeds and more to give answers to complex, technical questions related to energy.

Nesh explained
Because this tool is meant for businesses and not personal use, the software must be trustworthy, Gupta says, and he asked himself what he needs to do to make an engineer or a CEO of an energy company believe Nesh's response.

The answer: transparency. With Nesh, users can see how the smart assistant came to its answer. The software shows the data and workflow behind the answer as part of the user interface.

And Nesh learns from its users too. If an unfamiliar question is posed to Nesh, users can add new training phrases to teach Nesh what to do next time the question is posed.

"We created Nesh as something super-simple to use," Gupta says. "There's no learning curve, no technical knowledge required, you just need to speak plain English."

Gupta, who was raised in India, came to the United States to pursue his master's degree in petroleum engineering at the University of Texas at Austin. After working in oil and gas for over a decade, he started Nesh last year with co-founder and CTO Seth Anderson.

Gearing up for the future
This year, Nesh is in the process of fundraising, and, with the new funds, he plans to expand his workforce, which is currently five employees (including Gupta himself) based in Houston. Due to its size, Nesh currently can run only one pilot program at a time. With more employees, Nesh will be able to scale up its pilot programs and run multiple pilots in parallel. The larger user pool for these pilots will give Gupta and his team better insights into Nesh and allow them to continue refining the tool.

Right now, Gupta wants to commercialize in those operations where Nesh is already running pilot programs. He says he hopes for Nesh to have both internal and external growth, with the next surge of hiring and an expanded user pool for the product.

He plans to make Nesh available as a commercial product in fall of this year with a target market of small to mid-sized oil and gas companies.

Gupta says Nesh is different from anything in the market.

"With enterprise software in general, it can be very hard to get a demo version of software without talking to a sales representative—something that people dislike," he says. "I want to bring the B2C aspect of trying a software to the B2B world."

The business model goal for Nesh is for potential clients to be able to test the software themselves, Gupta says, and then contact the company if they're interested.

"I want transparent pricing to be visible on our website," he says. "I want potential customers to be able to experience the demo just by giving their information."

As Gupta sees it, one of the main advantages to being in Houston is the important support networks as well as the potential customer base. He's grateful to local organizations such as Station Houston and Capital Factory for connecting him with many resources.

"I'm seeing a lot of innovation here in Houston," Gupta says. "There's a lot of oil and gas companies, so as we begin looking for potential customers, that's a very important advantage of being here."

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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.