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Sarah Lynch
With the Venture X Business Card from Capital One, you earn unlimited double miles on every purchase. Plus, the Venture X Business Card has no preset spending limit, so your purchasing power can adapt to meet your business needs. Capital One what's in your wallet? I'm Sarah lynch and you are listening to youo Next Move Audio edition produced by Inc. And Capital One Business. In this episode, you'll hear from Inc. Editor in Chief Mike Harper as he chats with Dr. Brigham Hyde from Atropos Health, Anne Follenweider from Alloy Health, and Amir Al Najjar from Vitalyes to discuss how they are identifying and addressing critical pain points in healthcare. At our recent Inc. Founders House in Philadelphia, they chatted about how they can leverage innovative approaches, integrate patient insights, and transform challenges into opportunities to enhance the overall customer experience. Hear how they have identified critical industry needs while building smart, scalable solutions and learn how to apply their strategies to your own business and drive innovation.
Mike Hoffman
How are you guys doing? How's Philadelphia today? Thank you for the beautiful weather and I'm glad we're all in here together, although maybe at some point sneak out to the patio and get a beverage and enjoy the beautiful sunshine. But we've got a great program here today. We're really excited to have so many company founders in the room representing so many companies. I'm Mike Hoffman, Agranchief of Inc. As I said, and I'm really delighted to get together with you because I feel like when we're together with founders, there's so many interesting ideas that come forth. There's so much great knowledge that folks can share, whether it's about how to deal with difficult employees or how to deal with difficult investors. Sometimes you deal with difficult employees and investors at the same time. I don't know if that resonates with anyone, but also best practices about things like marketing and HR and managing growth and managing through growing pains. On behalf of everyone at Inc. And our partners at Capital One Business, we're really delighted to have you here. So please give yourselves a round of applause for coming out today. And now let's get things started. We're going to have our first panel again which is on healthcare. So I'm really excited about this panel because we have lots of great growth companies who've had lots of amazing experiences. And we also Amir is the co founder of the Number One Inc. 5000 company for 2024. So big round of applause for Amir. And remind me, what was the revenue for the company?
Amir Al Najjar
It was from a million to like over 4 billion in a few years.
Mike Hoffman
Over 4 billion in a few years. So, real amazing growth story which we're excited to tell here. But first we'll start with Ann. Ann, why don't you tell us about your company, Alloy Health and what the market you serve is and sort of what the main trend that you see right now in your space.
Anne Follenweider
Thank you. And thank you so much for having me. It's really nice to be here on the stage. Alloy Women's Health is a menopause digital health platform. We connect the 55 million women in Menop to the 2000 or fewer menopause specialist practitioners in the country. And we deliver the care, the questions, the education, and the actual prescription solutions sent right to your door. Thank you.
Mike Hoffman
Round of applause.
Anne Follenweider
I would say the biggest trend that we're seeing, and I think we have a lot to do with it, is the demand for better menopause care. We started the company in 2000 and in 2023, I believe we were part of a New York Times magazine cover story that women have been misled about menopause. And it talked about the fact that 20 years ago there some faulty data put out there in the world that really went from 40% of menopausal women getting the prescribed first line care to 4%. And that number has actually declined since 2000 when we started.
Mike Hoffman
So 2020, less than 4%.
Anne Follenweider
Less than 4% of menopausal women are getting the first line care recommended by all of the medical establishments. And so the longer and more that we've talked about it and generated the education and really have created the demand. So every room we go into, women are surprised and shocked to hear how badly they have been served, if at all at this stage of life. And we've really generated the demand to the point where the estrogen patch, which is one of the FDA approved generic solutions that's out there, has actually we've seen shortages and this is before the current administration. And so that's been exciting to see. And it's sort of hard to see all the vast sort of suffering and misinformation that's been out there for so long. But it's really encouraging to see women getting the information and education that they need to have the agency to demand these very simple solutions.
Mike Hoffman
So, Ann, if your audience is consumers, Brigham, your audience is clinical trials and clinicians. Can you tell us about your company and also what the biggest trend you're seeing in your space is?
Brigham Hyde
Yeah, I love Ann's comments. I almost think Ann should be a customer. What we Focus on is going to.
Mike Hoffman
Do a deal right here on stage, live deal.
Brigham Hyde
We focused on personalized evidence for care for everyone. And you know, the story she tells highlights this. You know, we don't have enough evidence for what to do for the average patient. Even worse, when we get into certain underrepresented populations, the stat we use is only about 14% of daily medical decisions have any high quality evidence behind them at all. That leaves our clinicians in a position where they have to do their best. This is maybe the art of medicine, but we think we can solve that evidence gap problem. And what we build is automation for producing high quality evidence on real patient data from all the data we've created over the last 15 years in healthcare. Taking that from an average study, an observational research study, whether it's a researcher at Stanford or at a pharma company, usually take months. We can do it in under three minutes now at the point of care. So you could be in your doctor's office, they could say for okay, patient with this background, treatment A, treatment B, we'll run a study on tens of thousands of people just like you. And that is brand new that that's possible in the last year. It's one of the exciting things about this broader automation wave to trends. I mean, you know, clinical trials were how we classically generated evidence, you know, the gold standard, double blind, placebo controlled, randomized. And we still think that's the top of the pyramid. But observational research and the methods behind it, if done properly, can actually supplement and help the underrepresented groups. 70% of clinical trials systematically exclude everybody with comorbidities, let alone other underrepresented groups. So we're running these trials on healthy male triathletes at Memorial Sloan Kettering and then taking them out and trying to treat everybody with it. So I just think there's a role to supplement that and again bring that dream of personalized medicine to bear. It also matters when we talk about research funding. NIH been a lot of discussion of what's going on there. My spouse is at Columbia University as a researcher, so we're seeing it on the ground. I think one of the things we're trying to do is help supplement in this time where basic science research is being challenged and bring the ability to do those types of studies and publications quickly and cheaply and democratize them to more people. Get the young faculty going. Now we also have more out of D.C. there's not just that going on. The broader moves of the FDA and the Maha Movement. While there's maybe some good areas of focus there, I think the areas of disruption are a concern. And you know, if you're a pharma, how are you going to come up with the next cure if, you know, you're not sure about your regulatory timelines? Is there a role for some of this automation that companies like us are building to help speed that up, make it more efficient? Maybe it's a win for both. And then in the broader Maha conversation, well, I think we're all happy about Red Dye 40. Let's talk about evidence again. I think this is a moment where really well done, well crafted evidence that is really clear is really needed to remove some of the buzzword of what's going on in health. I also think it's an opportunity to open up that personalization of care into new venues. Maybe there should be evidence that certain supplements work really well in certain groups or that certain people should get this treatment without a prior authentic. Like, why can't we do that now if this automation using generative AI tools like ours has created that abundance? So that's what we're hopeful about, dealing with the challenges. In the meantime, it's sort of this.
Mike Hoffman
Interesting moment right where the technology and the science is advancing at this incredibly rapid rate. And then at the same time, the policy framework that has been in place for the last 20 years is also changing in a really dynamic way with, you know, potentially, you know, a lot of harm.
Brigham Hyde
The change is good. Sometimes change has to happen quickly. Let's just hope we don't break all of it. And I think that's what we're all hopeful about while remaining optimistic about what could emerge.
Mike Hoffman
Amir, I was bragging on you a minute ago about having the number one Inc. 5000 company, Vitalize Health, based in New Jersey, so just across the river, I'm sort of curious. Can you tell us a little bit about your company and what you do and then what the biggest trend is that you see in your space?
Amir Al Najjar
Yeah, absolutely. Thank you for having me again. So my company, Vitalize Health, we're in the value based healthcare space. So we always keep hearing about healthcare costs going up. We don't necessarily have a lot of quality to show for it in the United States. And what we do, we work closely with primary care docs, other providers in order to deliver better care. We work directly with the federal government, Medicare and other private insurers to help cut healthcare costs while improving quality. You may think, how is that possible? How are you cutting costs and improving quality? Well, healthcare Is that bad in this country that you could do both? And that's really where we're coming at it from. And you know, we're very fortunate where we're in an environment where we're able to generate win, win, win wins, you know, like vitalize my company. We get paid when patients are doing better, when our providers are able to earn, you know, shared savings checks by saving the health system money and by the taxpayer saving money. So it's sort of fully aligned incentives and we work closely with our primary care providers. So, you know, a lot of this stuff we know is helpful and beneficial in healthcare, but doesn't happen. Like, everyone knows a patient should have a follow up after they've been hospitalized for a week by their primary care doctor. It only happens 40% of the time nationwide.
Mike Hoffman
40% of the time.
Amir Al Najjar
40% of the time. So 60% of the time it's not half. Yeah, yeah, it's not happening. Well, why? There's a million reasons why. And that's what we try to solve with our primary care partners. One by one, they may not have the data or the feeds to let them know that, hey, Mrs. Smith just left the hospital. So we provide that they may not have enough staffing to proactively call patients. So we provide either funding or staffing resources for our primary care clinic. And a lot of what we do is just listen, listen. Because honestly, like, if you just listen to people, you usually get the answer. It's not really that hard. And I always say, like, every one of our problems that we're dealing with is very easy. It's just that we just have a million of them and they're all sort of stacked up on top of each other. And you don't have to solve all million day one. You just work at a couple at a time, keep moving forward. So, you know, what we're seeing is people are beginning to believe in value based care. You know, Medicare came out and said by 2030, every Medicare patient needs to be in a value based care program. The data is conclusive that whether they're called ACOs, the mechanism that delivers value based care, Accountable care organizations, they deliver savings, they generate savings for Medicare. Better outcomes for patients. And you know, the example, you know, I give, is it better to ignore a Medicare patient in the home for two, three weeks, couple months go by and they end up in the hospital for a $20,000 admission, or is it better to proactively send the nurse practitioner to the home that may only cost the system $200 and they're able to get their needs addressed right off the bat. So Obviously, you know, $200 of care is a lot better than $20,000 of care. You know, we're not buying cars here, you know, so preventative is the way to go. And I appreciate what my co panelists are doing. I think what you're doing with clinical based evidence is huge. That's something that we could also potentially be a client as well looking into.
Brigham Hyde
You said win, win, win. That's what we're seeing in the data. You could have better evidence based treatments that actually reduce drug costs and improve total cost care.
Amir Al Najjar
Well, what we see is, you know, the clinical content doubles every 72 days. So like every 72 days, double the amount of research papers existed. I'm lucky to increase my knowled a year, let alone double every 72 days. So like, how do these providers keep up? They don't. And what we see is trends like, oh, if you're a doctor and you graduate in the 1980s, you typically prescribe a certain way versus someone that may have graduated in 2000, you prescribe a different way. And you know, and there's evidence. So you know, why can't we tee it up, you know, And I guess you guys are trying to solve and we're all trying to solve.
Mike Hoffman
So Amir, you're a medical doctor, do I have that right?
Amir Al Najjar
Yeah, yeah. Internal medicine, physician primary care. Yeah.
Mike Hoffman
So for all of us here, as we think about our doctors and the practices that we go to, what are the pressures on those practices and then how does that create opportunity for your business?
Amir Al Najjar
A lot of people sometimes, especially with COVID and you know, they're beginning to view doctors not as favorably as maybe 10, 15 years ago. And the reality is they're just human beings and they're being asked to see more patients every day. They're being given more administrative paperwork every day. So they would love to spend the time and really get to understand what's driving the issue. But unfortunately, the way the system is set up, it's set up in a way where if they don't just check the box and move on, they're going to get backed up and they'll get fired from their job. And if they're running their own private practice, they won't make enough money to cover their expenses. That's the problem with a lot of what's going on. And what we're trying to help is bring additional resources. You know, a lot of our practices that are able to add an extra several thousand dollars a month from these, you know, bonus payments in order to maybe slow things down a bit. There's a lot of new tools like AI scribing, which is able to write the notes on behalf of the doctors. So that way they're able to focus. You know, ultimately what we believe at Vitalize, our job is to, like, get as much off their plate as possible, to just focus on the patient in front of them. And I believe that's where all the magic will happen. We just have to sort of like, cut the noise. And they're just human beings that want to do the good, the right thing, but they're just sort of overwhelmed by very cumbersome system.
Mike Hoffman
Ann, you came into the healthcare space as an outsider. You were a media executive for many years. Fans of Project Runway may recognize Ann, but I'm sort of curious. As you started to get involved in the healthcare space, what were some of the biggest surprises that you learned about how it works and what opportunities came out of discovering those surprises?
Anne Follenweider
So I left my whole Previous career, 25 years in magazines, because I believed that serving women in menopause is a good idea. The biggest surprise to me is how bad the problem was, even though I had already decided to really take a giant risk in fixing it. The doctors, to your point, have not received medical training. Only 20% of OB GYN residents have even heard about menopause for one hour. And often it's a lunch and learn in medical school. And so again, they can't be blamed for what they don't know. But the result is that women are getting completely ignored, dismissed. Our average patient has spent three years trying to get care, and that's those people who can find care. We have also found that building a business that works for the doctors and the patients and the business is a win, win, win that actually provides the good old fashioned continuous relationship with one healthcare provider who really knows your health history, but also your menopause care. I couldn't believe how bad the system was and how misaligned the incentives were. So we're cash pay, and we tried to build something that worked for the insurance. And there was also a business that was viable. And we also went through the employer route. And we finally realized that There were about 11 different middlemen taking a cut between the doctor and the patient and the business. And there was so little care under 2,000 providers certified in menopause that we just actually had to use technology, AI to build this digital system, basically build our own lane. We had to just completely scrap the system that existed. And we're actually providing care that costs $50 a year for the doctor care plus the price of our mostly generic FDA approved prescriptions. So it's affordable. We have 30 doctors who are working on our platform, all been working in ob GYN for decades, mission driven to help menopausal women. We have zero doctor attrition in three years. No one has ever heard of that. And the doctors are saying this is their favorite way to practice medicine that they've ever practiced. We're the only ones in the digital health space in menopause also providing only access to physicians. So many other companies have to try to save costs because of the various players taking a cut that they actually are trying to save money on the thing that matters most, which is the medical expertise. So they're doing low cost providers trying to train them up really quickly on what takes really a whole career to learn because it's not again in medical school. And so I just been so amazed. And I'm not the everyone out there saying it for better or for worse that the system is broken. But it was broken to the point where no one was winning except for a couple of the middlemen and women were dying of UTIs in hospitals. I mean it's really dire out there and yet the solutions are actually so simple. And when we actually just focus on the patient and the doctor and building a business that worked, everyone wins.
Mike Hoffman
And I'm curious, are you seeing consumer behavior change?
Anne Follenweider
Oh, absolutely. I mean, I think not just in the menopause space. Right. I was just talking about this earlier where my mother was like, you've got to be friends with your doctor because that person's going to take care of you your whole life. Right. And then I grew up, I'm Gen X, so you know, I learned to find solutions online. I'm not digital native, but I'm digital fluent. Right. So when I had my babies I was going on baby center and crowdsourcing information. But the millennials and below, they have experienced the healthcare system from the point of view of digital driven point solutions at every stage from mental health to fertility to breastfeeding support to menopausal care. They're not there yet, but they're almost there. The oldest millennials are in perimenopause. So and they frankly are just going to demand the this change and they're not. They've never experienced or even expect to experience the fact that they'll have a doctor for a long period of time who will know them and be able to refer them to other Experts based on their network that doesn't exist anymore. I mean, it's a lot of people are getting really good care at one medical, but that is based on the entire completely opposite. Right. Centralize the care and just have people come in. The behavior really, really was changed before we got here. And then Covid, of course, completely accelerated the shift and the acceptance of digital solutions.
Mike Hoffman
Now I'm interested. Let's talk a little bit about sort of growing a business. And healthcare is a $4.9 trillion industry. Investors are always very hungry for fast growth healthcare startups. And yet I think in every case, I think all of your companies have raised money. But I also think that you've been wary of raising too much or been thoughtful about the sources of funding that you have. So Brigham, can you tell us a little bit about your philosophy of raising money and what you raised and how that has shaped your company over time?
Brigham Hyde
So we raised a series B last year, 34 million. We've raised about 60 million to date through three rounds or about four years old. Great group of investors, I would actually say on sort of themes and maybe just things for people to think about. Thinking about the mission of our company, which we think of as very broad. I want everybody to have access to this personalized evidence that's in the world. So that's a big goal. You have to have the right investor set to, to do that. And that's people with maybe a longer vision. So we work with people like Jim Breyer of Breyer Capital, led the Avron investment in Facebook, the Yosemite Ventures, which is the Jobs family, re Jobs, big mission, obviously focus for him in oncology. So choosing investors that had that long view is important later on. We've added a lot of strategic partners because I think the way to navigate healthcare is to understand the institutions within it and be able to work within that system. There's always the epic side of this when we talk about EMR and distribution. There's different dynamics obviously in pharmacy and payments. For us, McKesson Syncora, two very large sort of distributors between pharma and provider, were good alignments for us. We also work with Merck. So I've built a big community of investors that I think is something that I wanted to do here because of the size that we're trying to do and to help us navigate it in terms of just thinking about fundraising amounts. Every one of my peers who took big rounds in 20 and 21 are miserable right now if they're still employed and their jobs day to day. As founders turned into firing people real fast. So I think the lesson for our community, particularly for healthcare, is it's been tried in different cycles. You can't by the market the same way you might do if you're trying to be a category winner and direct to consumer. I would say consumer health care is testing that now. It's actually getting kind of interesting. But broadly in B2B or B2B 2C health tech, you have to be careful with that ethos. Even if it's tempting to get that great valuation or, you know, to have so much money, you can throw big company parties or whatever, or even spend it on marketing, you want to make sure that's effective. So I try and be really thoughtful about that. At our B round, I turn down an additional 40 million and piss some people off, frankly. But they can always invest later at a higher valuation.
Mike Hoffman
Of course, through their anger, they can write a check.
Brigham Hyde
The other part of this, just to say, and if people are in the early stages here, and we may talk a bit more about tech with the toolkit we all now have with AI, LLMs and generative AI technology, everything that's come out of the cloud layer, you should be able to build a more capital efficient startup. Okay. And while every part of health tech still requires talent, domain knowledge and relationships, you should go LLM first, AI first within your company. From day one, our big focus, and I know we talked about this a bit off stage, like we have to build a profitable business to do this at scale. And, you know, our gross margins are way ahead of where our peers are at this stage, because we made that decision early. And I just think that's a new.
Mike Hoffman
Model and your company's fully remote, is that right?
Brigham Hyde
Yeah, we're 100% remote. We're a Covid company spun out of Stanford. I've got 50 employees in 14 states, which is its own headache. If anybody's solving virtual hr, please talk to me afterwards. But we deal with that. And that efficiency lets me get great talent for the right price, regardless of where it is. So there's advantages all over the place to build a more capital efficient business. And I think that's kind of what investors are demanding a little bit. You two probably have experiences that are similar.
Anne Follenweider
Well, I come from media and I covered female entrepreneurs as editor in chief of Marie Claire magazine. And I believed then, and I see it now from the other side that a big raise was a big success. We did stories. A big round of money is a very exciting story for a journalist and for and for the reader of the audience, what I understand now as a founder is that, you know, and the other reason of that is like big names with big amounts, big amounts of money validating an idea seems like almost it sort of helps the journalist validate. This is a good thing to write about. But now I see from the other side that those people are just giving away more of their company, have more people to report to and more pressure to deliver a certain return in a certain amount of time. And so it's been completely, for me, flipped on its head to raise the least amount of money to be able to grow responsibly and quickly and to find investors who first of all don't think they know your business better than you do and who have this timeline of like, this is healthcare, this is not crypto. And yes, AI is helping us be a lot more efficient and a lot more quick and being able to deliver care at scale. But that sense of like, we know what we're doing, we want as little involvement as possible and we don't want to be rushed in the timeline for the return.
Mike Hoffman
Yeah. And Amir, you got shot down by a strategic a would be potential strategic investor and ended up funding the company its early days through friends and family. Money from your friends and family and your co founders, friends and family. In the end, was that sort of a blessing in disguise?
Sarah Lynch
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Amir Al Najjar
You know, a lot of things didn't happen and you know, some of the things that didn't happen end up being the best things that happened to you. You know, we've been at this for 11 years. We started the company in 2014 and you know, the first few years it was friends and family because who else is going to invest in you other than your friends and family the first couple of years when it's just you and your co founders. But you know, as the business has grown and evolved and we're able to bring in angel investors Then smaller seed round investors, Series A. It's interesting, it's a lot of it is maintaining the relationship and having sort of clear lines of communication with your investors. Like, you know, one of the things, you know, my co founder, the CEO Faris, he does a lot of the investment side of things and you know, he's very close with our board and our investors. He speaks to them on a regular basis. And we've never had a situation where we had a vote in a board meeting where we had to go one way or the other. It was always sort of unanimous because we're always on the same page at all given times. And I hear what some of my colleagues are here. You know, we did in the last couple years raise a lot of money and grew pretty fast. And we're dealing with some of the pain there as well. So I completely agree. You know, you don't want to overdo it with growth.
Mike Hoffman
You know, what's the biggest pain point?
Amir Al Najjar
Well, in 23 to 24, we made up roughly 40% of the growth in value based care nationwide. If you compare all the health systems, everyone out there in the, you know, we had 200,000 lives, Medicare lives, the whole group was 450,000. So we ended up a lot of adding a lot of practices that were primary care practices that we partner with, that were not good fits, that were maybe less inclined to practice value based care. And you know, so that ended up leading to a little bit of some pain points in 24 and then we had to separate from 24 to 25. But you learn, you learn and absolutely there's always a middle road. And I agree ultimately the goal is not to lose rather than to gain more quickly. So going slow has its benefits, but at the same time everything's a balancing act. You don't want to go too slow either. So I think that's one of the hardest things of startups is everything's in a shade of gray in the middle. And it's like hard, you know, like it's hard to know whether you're on one extreme or another, you know, and.
Mike Hoffman
You were saying that between you and your co founder and your board, you've made it a real focus this year on improving EBITDA. Is that right?
Amir Al Najjar
EBITDA? Yeah. So in 21, 22, when we were going for the rapid growth, everyone was like top line revenue growth, growth, growth, land grab. That's what everyone wanted, you know, including our investors. And a year, year and a half goes by, we get the fastest growing company in the World with Inc. Magazine and they're like, all right, it's no longer growth, guys. It's profitability. We don't care about your growth anymore.
Mike Hoffman
Take that off and move on to the next thing.
Amir Al Najjar
It makes sense. You know, we're running a business, not a growth engine. So, you know, I think that's the goal of a business. You're supposed to make money at some point. So it's transition, but it's, you know, it's been a good journey and you know, we're just very, you know, fortunate. The one positive thing of growth is enables you to attract talent and people that you normally wouldn't have been able to attract. Our current COO was the COO of UnitedHealthcare. You know, that wouldn't have been able to happen. You know, he's managing 400,000 employees now. He works at Vitalize. You know, it wouldn't have happened if we were still a tiny startup. So. But it's a double edged sword. You want to be careful, you want to be able to walk that middle lane, which is, I think one of the hardest parts of a startup is knowing if you're on one extreme or the other.
Mike Hoffman
Yeah. So this is obviously our your next move session, which Inc Produces in partnership with Capital One Business. And so let me ask the very obvious question, Brigham, what's your next move?
Brigham Hyde
What I'm really focused on right now is distribution in the provider market. I think we've got the product, we've got the product market fit, we've got the users that love it. The reality, getting down to providers is if you're a startup in the room trying to figure out, well, okay, so I just like put up a website and send the providers to. It's like, no, we have a big announcement coming this week. Bruno, am I allowed to preview Ambient?
Mike Hoffman
Let's make some notes.
Brigham Hyde
AI scribes a lot. Over the last year, it's been one of the big success stories. We're going to be announcing ambient integration at Stanford University, our home university. So imagine you're a physician. Your visit gets recorded, your note gets automatically generated and then there's a personalized evidence study for that patient on what to do. They don't have to do anything. So we're really focused on that. I'd say a bigger idea that I'm interested in, that we'll see if it's time for this. But it's really feeling like prior authorization might be having a moment. I also think the efficiency of it and the potential win, win if we can Remove some of the administrative burden there. Add to that what's starting to look like a potentially really thoughtful and aggressive cms. So we're watching that closely. I would love it if, if we could all be talking a year from now and saying there's a path to removing prior auth and evidence based prior auth playing a really key part of that. So that's what's up for us.
Mike Hoffman
Great, great. Ann, what's your next move?
Anne Follenweider
We are exploring direct to consumer. We first tried and did sort of conquer and get the woman to come straight to us and that's been our biggest source, obviously of business. But we are also having built this reputation among doctors and having happy doctors who work for us are now about to launch hcp. Like basically getting doctors to refer their patients to us because none of them actually want to do menopause care because they don't get reimbursed at a high enough rate. The OB GYNs really want to deliver babies. That's what they went into this for. And then also we're at the stage we were encouraged by an investor. We did not take on early to do this very early, but we are now at a revenue stage where we can think about vertical integration of our doctor network and our pharmacy.
Mike Hoffman
Yeah. You were saying earlier that even though menopause is like a very hot area in healthcare right now, the total market is still, well, the addressable market is huge, but the total market is still small. Is that right?
Anne Follenweider
Yeah. I think if you took all the menopause companies out there and there are about five of us, then there are some of the bigger players have said over the years that they're getting into menopause but just haven't been able to conquer it because it's complicated and there are not enough providers for all the reasons I've been talking about. I think if you, you know, 55 million went to menopause, if you include perimenopause, is 83 million. And I think, I would say if you take all of us together, we've probably cornered 1 50th of the market. And so we have a lot. And still the demand is so high. And again, recent the menopause society this past fall gave that 4% stat of women in menopause seeking help. That's the number of women going to get help who don't receive it or who do receive it. So that leaves 96% of that 55 to 83 million looking for help and not getting it yet.
Amir Al Najjar
Wow.
Anne Follenweider
Wow.
Mike Hoffman
And Amir, having run the number one company, healthcare or not, in America in terms of revenue growth over the past couple of years. What's your next move?
Amir Al Najjar
So we've been historically focused on the primary care doctor patients directly. We're expanding, working more with specialists, skilled nursing facilities, other people in the healthcare space. It's not enough to make sure that the primary care is where we started because we do view them as sort of the quarterback where it all sort of starts from. But obviously specialists, health systems, skilled nursing facilities, they all have a role to improve patient outcomes. And we're also trying to craft ways how we could win, win. How can an ophthalmologists serve better care for a Medicare patient while profiting their clinic more and while helping the taxpayer save money? So it's not always straightforward, but I really do believe in the majority of things. If you really spend the time you could figure out, win, win, win, wins. And I do believe it's not a zero sum game in the world, so you are able to structure a lot of that. So expand outside of the primary care. We're beginning to do some of that, but go a lot deeper into the network play.
Mike Hoffman
Great. Well, Brigham Hyde of Atropo Health, a.m. fulenweiler of Aloy Health, and Amir Al? N of Vitalized Health, thank you so much for being with us here today.
Amir Al Najjar
Thank you.
Mike Hoffman
Thank you, everybody.
Sarah Lynch
That's all for this episode of youf Next Move. Our producers are Blake Odom and Avery Miles. Editing by Matt Toder. Executive producer is Josh Christensen. If you haven't already subscribe to youo Next Move on Apple Podcasts, Spotify or wherever you listen, your Next Move is a production of Ink and Capital One Business.
Podcast Title: Your Next Move
Host/Producer: Inc. Magazine in partnership with Capital One Business
Episode Title: Innovating Industries—How These Entrepreneurs Are Addressing Pain Points
Release Date: May 6, 2025
In this episode of Your Next Move, Inc. Magazine's Editor-in-Chief, Mike Fuller (referred to as Mike Hoffman in the transcript), engages in a dynamic panel discussion with three innovative entrepreneurs in the healthcare sector:
The conversation revolves around identifying and addressing critical pain points in healthcare through innovative approaches, leveraging patient insights, and transforming challenges into opportunities to enhance the overall customer experience. The panelists share their experiences in building smart, scalable solutions and offer strategies applicable to other businesses aiming to drive innovation.
Mike Fuller opens the session by welcoming the founders and setting the stage for a deep dive into healthcare innovation. He highlights the impressive growth of Vitalyes Health, noting Amir Al Najjar's company as the top Inc. 5000 company of 2024, with revenues skyrocketing from $1 million to over $4 billion in just a few years.
Anne Follenweider introduces Alloy Health as a digital health platform focused on menopause care. The company connects the 55 million women experiencing menopause with the limited number of menopause specialists available in the country. Key Highlights:
Addressing a Critical Gap: Anne emphasizes the dire state of menopause care, citing a New York Times cover story that revealed only 4% of menopausal women receive first-line care—a significant drop from 40% two decades ago.
"Less than 4% of menopausal women are getting the first line care recommended by all of the medical establishments." [03:47]
Innovative Solutions: Alloy Health utilizes AI and digital platforms to streamline access to care, reduce costs, and eliminate middlemen, ensuring that both patients and doctors benefit.
"We're providing care that costs $50 a year for the doctor care plus the price of our mostly generic FDA approved prescriptions. So it's affordable." [14:27]
Consumer Behavior Shift: Anne observes a generational shift in how consumers engage with healthcare, with millennials and younger generations demanding digital-driven solutions.
"They're not digital native, but they're digital fluent... millennials and below have experienced the healthcare system from the point of view of digital driven point solutions." [17:13]
Dr. Brigham Hyde discusses Atropos Health, focusing on personalized evidence-based care. The company automates the production of high-quality evidence from real patient data, significantly reducing the time required for clinical research.
Filling the Evidence Void: Dr. Hyde highlights that only about 14% of daily medical decisions are backed by high-quality evidence, leaving clinicians to rely on limited data.
"14% of daily medical decisions have any high quality evidence behind them at all... we're running these trials on healthy male triathletes and then treating everyone else differently." [04:45]
Technological Innovation: Atropos Health leverages generative AI to conduct observational research in under three minutes, compared to traditional months-long studies.
"We can do it in under three minutes now at the point of care." [04:54]
Policy and Regulation: Dr. Hyde discusses the dynamic regulatory environment and the potential for automation to streamline processes like prior authorization.
"We're watching closely on removing prior auth and evidence-based prior auth playing a really key part of that." [28:39]
Amir Al Najjar presents Vitalyes Health, a leader in the value-based healthcare space aiming to reduce costs while improving quality through close collaboration with primary care providers and insurers.
Value-Based Model: Vitalyes Health partners with Medicare and private insurers to incentivize better patient outcomes, aligning interests across stakeholders.
"We get paid when patients are doing better, when our providers are able to earn shared savings checks by saving the health system money." [08:55]
Operational Efficiency: The company addresses common pain points such as lack of data integration and staffing shortages, enabling proactive patient care.
"We provide funding or staffing resources for our primary care clinic... listen to people, solve problems one by one." [10:08]
Growth and Challenges: Amir shares insights into scaling rapidly, maintaining investor relationships, and focusing on EBITDA for sustainable growth.
"We're running a business, not a growth engine... you want to make sure that's effective." [27:02]
The panel delves into strategies for funding and scaling healthcare startups:
Thoughtful Fundraising: Dr. Hyde emphasizes raising capital thoughtfully, prioritizing investors with long-term visions aligned with the company's mission.
"Choosing investors that had that long view is important... Turned down an additional $40 million because they can always invest later at a higher valuation." [18:54]
Capital Efficiency: Embracing AI and remote work to build capital-efficient startups is highlighted as a crucial strategy for sustainability.
"Build a more capital-efficient business... leverage AI tools from day one." [22:05]
Cultural Shifts in Funding: Anne reflects on the pressures of large funding rounds and advocates for raising minimal necessary funds to maintain control and agility.
"Raise the least amount of money to grow responsibly and quickly... find investors who don't want to be rushed in the timeline for the return." [23:51]
Digital Transformation: The panelists agree that digital solutions have transformed consumer expectations in healthcare, pushing traditional models to adapt or risk obsolescence.
"Covid accelerated the shift and the acceptance of digital solutions." [17:13]
Market Potential: Anne highlights the vast untapped market in menopause care, with Alloy Health addressing only a fraction of the 55 to 83 million women needing support.
"We have probably cornered 1/50th of the market... 96% of women looking for help and not getting it." [30:27]
The discussion concludes with each panelist outlining their company's strategic next steps:
Atropos Health (Dr. Brigham Hyde):
"We're really focused on distribution in the provider market... announcing ambient integration at Stanford University." [28:15]
Alloy Health (Anne Follenweider):
"We are exploring direct to consumer... vertical integration of our doctor network and our pharmacy." [29:34]
Vitalyes Health (Amir Al Najjar):
"We're expanding, working more with specialists, skilled nursing facilities... deeper into the network play." [31:21]
Mike Fuller wraps up the episode by thanking the panelists and emphasizing the importance of thoughtful innovation in addressing healthcare's most pressing challenges. The entrepreneurs' insights provide valuable lessons for businesses aiming to drive impactful change through sustainable and scalable models.
Notable Quotes:
Anne Follenweider:
"Less than 4% of menopausal women are getting the first line care recommended by all of the medical establishments." [03:47]
Dr. Brigham Hyde:
"We can do it in under three minutes now at the point of care." [04:54]
Amir Al Najjar:
"Every one of our problems that we're dealing with is very easy. It's just that we have a million of them and they're all sort of stacked up on top of each other." [12:05]
Anne Follenweider:
"We're providing care that costs $50 a year for the doctor care plus the price of our mostly generic FDA approved prescriptions. So it's affordable." [14:27]
Amir Al Najjar:
"You're supposed to make money at some point. So it's transition, but it's been a good journey." [27:22]
This episode of Your Next Move offers a comprehensive look into how innovative entrepreneurs are tackling significant pain points in the healthcare industry. From menopause care to personalized evidence-based treatment and value-based healthcare models, the panelists provide actionable insights and inspiring stories of growth, resilience, and strategic foresight.
For more insights and in-depth conversations with industry leaders, subscribe to Your Next Move on Apple Podcasts, Spotify, or your preferred podcast platform.