Closing Time Podcast

We've enjoyed working on Closing Time over the last year and meeting with incredible healthcare founders and VCs. Thank you, listeners, for tuning in!Going forward, you can find us on The Heart of Healthcare podcast. We'll continue to explore the world of healthcare startups and innovation, bringing you conversations with founders, innovators, and thought leaders every Monday.Search for and subscribe to The Heart of Healthcare wherever you listen to podcasts. Or visit our website: https://www.heartofhealthcarepodcast.com/

In this episode of Closing Time, Michael and Halle sit down with Seth Sternberg, the co-founder and CEO of Honor. Seth shares his inspiring journey of tackling the immense challenge of providing quality home care at scale.We cover:- Building the largest home care network with the most advanced care platform- Treating care professionals with respect, providing job stability, and crafting attractive roles to retain top talent- Honor's unique business model, its acquisition of Home Instead, and the company's vision for expansion- The importance of passion and support from forward-thinking investors in solving big societal problems

In this episode, Cobi Blumenfeld-Gantz, CEO and co-founder of Chapter, discusses how his personal experience with his parents' struggle with Medicare inspired him to create a platform that simplifies and optimizes the Medicare enrollment process. Chapter operates as a Medicare brokerage, assisting seniors in navigating the complex Medicare system. They also offer a consumer-focused app that allows users to redeem benefits in their Medicare plans. The company has experienced significant growth and has raised $50 million in a recent funding round. They aim to become the retirement platform of the future, helping seniors live the retired lives they want.We cover:Developing a recommendation engine to improve how seniors choose health coverageManaging a seasonal businessHow seniors technology interaction patterns differNew regulations and changes in the Medicare worldGrowth, hiring, and fundraising

In this episode of Closing Time, Vanessa Rissetto, registered dietitian and co-founder of Culina Health, pitches her company's personalized nutrition platform. Culina Health pairs patients with registered dietitians to provide one-on-one nutrition counseling, with 91% of patients utilizing their insurance benefits. Rissetto discusses how her company is democratizing access to clinical nutrition care, leveraging technology and AI to make dietitians more efficient, and generating compelling health outcomes data. She also shares insights on the powerful combination of GLP-1 medications with personalized nutrition for weight management, and her vision for making nutrition counseling a standard part of preventive healthcare.We cover:- Going from making $1 million in their first year of business to $5.8 million this year- Developing creative user acquisition strategies with $0 marketing dollars- How GLP-1 medications has impacted the business- The pros and cons of taking funding from payors- Digital health business models including D2C and B2B2C- Vanessa's personal journey with breast cancer and how it influenced her mission to improve healthcare access and health literacy- Culina Health's $10 million Series A fundraising round, and the company's potential exit strategies

With a focus on profitability over hyper-growth, the team at Hone Health has built one of the largest men's health telehealth platforms. In this episode, co-founder & COO Stuart Blitz pitches this concept to our hosts. Our guest VC in this episode is Lynne Chou O’Keefe, Founder and Managing Partner at Define Ventures, and investor in hims, Folx, Found, and more. We dive into the business and discuss: Which parts of healthcare work well for D2C business models, and is this one of themUser acquisition and their pay-back period The trade-off in top-line growth and building healthy unit economics How they ensure positive customer experience even for those who don’t qualify for treatmentLynne also discusses how fundraising today is like managing A Tale of Two Cities, investors want to see the growth of 2020 along with the business fundamentals of 2022.

We’re back talking about startup employment law! In this episode, we double click on terminations. One of the hardest things every founder and manager has to do in their job is letting people go. Whether it's due to poor performance or a restructuring, there are right and wrong ways to handle it. Our guest, Fenwick employment lawyer Sheeva Ghassemi walks us through the steps on handling terminations legally and compassionately.We cover:Common grounds for termination including poor performance and reorganizationHow behavioral-based performance issues can be harder to support than job description performance issuesHow to handle terminations legally and with fairness and compassionThe importance of documentation and performance management in the termination processHow to conduct termination meetingsWhen and how to cut off access to company resources and ensure compliance with state-specific requirements

In this episode, Fenwick employment lawyer Sheeva Ghassemi joins us to discuss various aspects of employment law that all founders should know. From the legal risks and consequences of misclassifying workers to navigating employment laws with remote employees across multiple states, this episode is a must-listen for anyone hiring and growing a team.We discuss:The difference between employees and contractors, and exempt vs non-exempt classificationsHow misclassifying workers can lead to major legal issuesHow to navigate employment laws with employees in multiple statesPEOs, AORs, and EORs, oh my!What non-compete agreements are and when they are and aren’t enforceableHow AI algorithms in hiring can introduce bias and discrimination

May is Mental Health Awareness Month! In this episode, Michael Esquivel and Halle Tecco sit down with David Ko, CEO of Calm, to discuss the mental health challenges founders and their teams face. They discuss practical strategies for building resilience, managing the relentless pressure, and why destigmatizing mental health is crucial for startup success. David shares how leaders can champion well-being, creating a workplace where mental health support is the norm, not the exception. This episode is a must-listen for anyone who believes building a thriving business starts with a healthy mindset.We cover:- How resilience is built through learning from mistakes and taking risks- Where stress comes from and if you can really eliminate it- How to lead by example and create a supportive work environment- Generational shifts in the conversation around mental health- Why mental health should be normalized throughout the year and not just during Mental Health Awareness Month

In this episode, Christine Lemke, co-founder and CEO of Evidation Health, shares how her personal struggles with chronic pain fueled her mission to transform how we measure and improve health outcomes. She shares the company's evolution and innovative approach to generating real-world evidence (RWE) using a global research platform serving millions of people.We discuss:- The power of real-world data and understanding health outside the clinic- Lessons from pivots: Evidation's journey to its current focus- How they recruit diverse participants, prioritize consent, and even compensate individuals- Accelerating research and making it more representative of the populations drugs will actually serve- Where the company's unique data platform goes next, and how it could change healthcare

In this episode, Sebastian Seiguer, CEO of Scene Health, introduces his company’s innovative use of video technology to drive medication adherence, particularly among underserved populations. He shares how Scene Health supports patients, leading to better outcomes and significant cost savings for payers.We discuss:- The challenges of medication non-adherence and its impact on patients and the healthcare system- How Scene Health's video platform empowers patients and creates unique engagement opportunities- Strategies for successful implementation within public health departments and Medicaid plans- The importance of building a care team passionate about this unique approach- The potential of AI to further enhance the Scene Health model

In this episode, Dr. Bob Schafer, CEO of Lumos Labs, discusses the company's evolution from the popular brain training platform, Lumosity, to a leader in the development of digital therapeutics for the brain. Lumos Labs is pioneering the use of science-backed gameplay to tackle cognitive issues associated with conditions like ADHD.We discuss:- The unique dataset behind Lumosity, with over 100 million users and 8 billion gameplays- How their extensive research fueled the shift towards digital therapeutics- Challenges faced by early digital therapeutic companies, and the need for adaptable business models- Lumos Labs' approach to commercialization and ensuring accessibility- The future of digital health and medicine in addressing brain health and cognitive function

In episode 25, Halle and Michael discuss the process of building a board for a startup. We cover topics such as the importance of board structure, when to formalize the board, adding independent board members, the primary responsibilities of a startup board, changing board composition, and compensating board members.We discuss:- Why it is crucial to consider the right board structure- How many board members startups typically have at each stage of the company’s growth- The primary responsibilities of a startup board inclluding setting strategy, guiding the CEO, and making important decisions- How to address conflicts of interest and ensure the right fit for the company's needs- Typical compensation for board members

In this episode, Halle and Michael discuss the process of raising a seed round. They cover topics such as when to raise a seed round, building relationships with investors, and the difference between convertible notes and SAFEs. They emphasize the importance of storytelling and having a clear vision when pitching to investors. They also provide tips for first-time founders, including being mindful of dilution and knowing your use of funds. Overall, the episode provides valuable insights and guidance for entrepreneurs navigating the seed funding process.We discuss:- Why timing is crucial when raising a seed round, and it how factors such as market conditions can influence your chances of success- How to get in front of investors (hint: cold calling isn’t your best bet)- Convertible notes vs. SAFEs- Understanding dilution, and how each round impacts your ownership- Knowing your use of funds and setting clear goals for growth and profitability

In this episode, Dr. Alicia Jackson, co-founder and CEO of Evernow, discusses the importance of women's health research and the need for improved menopause care. She shares the inspiration behind starting Evernow and the challenges faced in addressing the under-researched and underserved field of women's health. Dr. Jackson shares the founding story of Evernow, from idea to raising $28M to creating the largest database on menopausal and perimenopausal women that exists today.We discuss:- How women's health, particularly menopause care, is an under-researched and underserved field that requires deep science and evidence-based solutions.- How they’re moving towards profitability by improving acquisition and engagement- Using strategic partnerships to expand access to care and reach a wider audience- How to determine pricing of a new offering that doesn’t yet exist- Why they allow their members to fulfill prescriptions with them, or at their own local pharmacy

You only get to incorporate once, and you want to get it right. In this episode, we dive deep into the process of incorporation for startups. We cover everything from choosing the right business entity structure to splitting founder equity. You’ll want to listen to this before filing your incorporation paperwork!We discuss:- How the choice of business entity structure depends on the goals and plans of the startup- Why you should prioritize simplicity and avoid over-engineering the legal structure in the early stages- Vesting structures, including alternatives to the traditional four-year vesting with a one-year cliff- How to have open and transparent conversations among co-founders to determine fair equity splits and relative contributions- Single vs. double trigger, and the importance of acceleration protection in the event of termination or an M&A exit- What we think is the optimal number of co-founders

In this episode, cancer survivor Kaitlin Christine, the CEO and founder of Gabbi, shares her vision to make all late stage breast cancer obsolete by ensuring all women know their risks and have access to early detection. Gabbi offers women a breast cancer risk assessment along with a Care Concierge team that guides members through the complex healthcare system.We discuss:- How their mobile risk assessment helps individuals understand their risk level and guides personalized care plans- How the company has pivoted from selling to employers to D2C to better serve patients- The process of becoming in-network- Ideas for acquiring customers in creative ways and through partnerships- Setting up a management services organization (MSO), and when that should happen

In this episode, pharmacoeconomist Yoona Kim, the founder and CEO of Arine, shares her mission to solve the problem of medication mismanagement in healthcare and building a fast-growth, 140-person company. Arine is an AI-driven SaaS platform company focused on medication intelligence that grew 100% last year, and has produced more than 33 million life-improving recommendations for over 15 million patients.We discuss:- The problem of medication mismanagement in healthcare, and the potential to cause harm and increase costs- How Arine’s medication intelligence platform helps optimize treatment and reduce errors by providing actionable recommendations based on patient data- Their target customer, versus who actually uses the platform (spoiler: they are different stakeholders)- How they’re using AI, carefully

In this episode, Ankit Gupta, CEO and founder of Bicycle Health, discusses his telehealth treatment program for opioid use disorder. He shares the inspiration behind starting the company and the comprehensive care model they provide. Gupta explains their business model and pricing, highlighting the challenges of affordability and value-based care. He also discusses the importance of retention rates in addiction medicine and how Bicycle Health aligns incentives with patient outcomes. Gupta addresses the involvement of families in the virtual care model and the strategies they use for user acquisition.We discuss:- Retention rates, and how they differ between self-pay and insured patients- How the opposite of treatment for opioid use disorder isn’t full recovery- The involvement of families and care givers in addition to the patient you’re serving- How they acquire patients through online channels

In this episode, Neil Batlivala pitches his startup Pair Team, connecting underserved communities to high quality care. Pair Team's innovative approach brings a community-led, virtual care model to the forefront, addressing the interconnectedness of social and clinical care. We discuss:Bridging the gap between underserved communities and quality healthcare through community partnershipsIntegrating community organizations like shelters and food pantries into the healthcare delivery system, with an emphasis on upskilling staff to become community health workersThe role of technology in creating shared care plans and ensuring seamless coordination among different care providersChallenges and breakthroughs in engaging high-need individuals, including those without regular access to primary care, and reducing emergency department utilizationBuilding trust within communities, especially amongst populations that have been historically marginalized or overlooked by traditional healthcare systemsPair Team's business model, focusing on sustainable funding and value-based care, and how this impacts their service delivery and partnershipsHow Pair Team maintains its culture and values while scaling and adapting to new challenges in the healthcare sector

In this episode, Belgian entrepreneur Thomas Vande Casteele pitches his healthcare startup, Awell, a low-code platform designed for clinical and product teams to create and integrate clinical workflows into their tech stacks.We discuss:Building a low code platform for designing clinical workflowsThe challenges and strategies of managing a global company, especially in the healthcare sectorInsights into Awell's customer base, including both traditional hospitals and tech-enabled service providersAwell's pricing model and approach to customer engagementThe company's growth in 2023, including fundraising and scaling challengesThe importance of corporate structure, especially for international startupsAwell's approach to employee engagement and maintaining company culture remotely

Last week on Closing Time we talked about M&A in digital health, how we saw 23% YoY dip in 2023, and what’s in store for 2024. Today we’re going to talk about another type of ending for a company, and that’s a wind down.The majority of startups fail, but we don’t talk enough about how to conduct an orderly wind-down. In this episode, we tackle the challenging decision of when and how a founder should wind down their startup (yes— there’s a right way to do it). We delve into legal responsibilities under Delaware and California law, key strategies for an orderly wind-down, and setting yourself up for success next time.

In 2023, digital health M&A was down 23% YoY. How did this compare to the tech sector? What are digital health acquirers looking for today? And what will 2024 have in store for us? We dive into all these questions and more in this episode about M&A.Here is the link to the blog post Selling Your Healthcare Startup that is mentioned in this episode.

In this episode, founder Jenna Xu pitches her vision for massively more accessible mental healthcare, starting with sleep. Docbotic uses clinically-proven therapy bots available over SMS and WhatsApp. Their first product is Sleepbot, a 4-week text messaging program that is “monumentally helpful to having the most meaningful night's rest”.

In this episode, ALS patient Brian Wallach and his caregiver wife Sandra Abrevaya pitch their virtual clinic for neurodegenerative diseases, Synapticure. Led by neurologists, behavioral health providers, and care coordinators, Synapticure has served over 1,500 patients since launching 18 months ago.

In this episode, serial entrepreneur (3x exited) Dr. Giovanni Colella pitches his fifth healthcare startup — and this time it’s personal. Vanna Health is reimagining care and community for people with serious mental illness.Focused on the most vulnerable and overlooked patients, Giovanni believes in the psychosocial rehabilitation model bringing together community inclusion and the social dimension of care. But how does this scale? And what’s the end goal?Towards the end of the episode, we also discuss actionable advice for founders on taking funding from strategics, including the scoop on warrants. Here’s the list of healthcare CVCs Halle shared.

In Part II of our series on term sheets, Closing Time co-hosts Halle Tecco and Michael Esquivel unpack "clean” and “dirty” terms in startup financing. With the pressure to maintain high headline valuation numbers, investors often grant founders their desired valuations while sneaking in terms that our resident lawyer Michael does not like. The episode breaks down the nuances of terms like liquidation preference, liquidation multiples, cumulative dividend structures, anti-dilution provisions—and the trade-offs founders must consider between valuation and terms. 

In Part I of our series on term sheets, Closing Time hosts Halle Tecco and Michael Esquivel tackle the reverberations from the term sheets of yesteryear. With the generous valuations and optimistic multiples of 2021—many startups now find themselves struggling to justify these figures in the current economic climate. The hosts delve into the nuanced reality of flat and down rounds, dissecting their implications for founders and investors alike. They posit that while no one truly wins in a down round, it's a shared and necessary hurdle in the long race of business growth. Addressing the trend that "flat is the new up," they emphasize the importance of clean terms during down rounds, and suggest strategies to minimize the impact on employee morale and equity.

After her own mental health crisis, founder Sophia Pages set out to create culturally centered care options for Latine patients struggling with moderate to severe mental illness. With her startup Charla House, she now offers a virtual intensive mental health program for this population. Sophia is early in the journey and looking for a co-founder. Listen in to hear why guest investor Cheryl Cheng of Vive Collective thinks she should skip the VC funding, and what Sophia should do instead.Visit the Closing Time website for more.

After a career dedicated to health access for vulnerable populations, from communities in Appalachia to Kenya, this year Peter Park decided to co-found Alchemy Health. Alchemy builds and operates in-house pharmacies for safety net providers leveraging the 340B program. In just a few months, they’ve onboarded one clinic and have six more in the works. Our guest investor in this episode is Elana Berkowitz, a Managing Partner at Springbank Collective. Disclosure: Elana and Halle are both investors in Alchemy.Visit the Closing Time website for more.

A two-time digital health founder, Pelu Tran is on a mission to use AI to reduce the impact of medical errors, modernize quality improvement, and improve patient outcomes. His company, Ferrum Health, works directly with hospitals and clinics, serving as a middleware layer that everyone seems to be missing. With over 60 AI vendors, and a number of leading health systems on board, he aims to build the Plaid for healthcare AI.Our guest investor in this episode is Jeff Hammerbacher, long time angel investor, data scientist, and a Board Member at DataVant, PerkinElmer, and Emids.Visit the Closing Time website for more.

After his own struggle finding a culturally-competent therapist, James Edward Murray left his cushy job at Facebook to solve this problem for others. He’s since built an incredible product and landed 10 employer customers. With just a seed round, Therify is making $400K in ARR today, and burning about $60K/month. Our guest VC in this episode is Blake Wu, Partner at NEA where he co-manages their private healthcare services, digital health, and public biopharma investing. Visit our show website, closingtimepodcast.com.

Dr. Florence Comite wants to take her private practice digital. In this episode, she pitches Groq Health, an app to prescribe clinically proven treatments tailored to your unique body. Our guest VC in this episode is Christina Farr, health-tech lead at Omers Ventures and long-time digital health expert. Visit our show website, closingtimepodcast.com

With a focus on profitability over hyper-growth, the team at Hone Health has built one of the largest men's health telehealth platforms. In this episode, co-founder & COO Stuart Blitz pitches this concept to our hosts. Our guest VC in this episode is Lynne Chou O’Keefe, Founder and Managing Partner at Define Ventures, and investor in hims, Folx, Found, and more. We dive into the business and discuss: Which parts of healthcare work well for D2C business models, and is this one of themUser acquisition and their pay-back period The trade-off in top-line growth and building healthy unit economics How they ensure positive customer experience even for those who don’t qualify for treatmentLynne also discusses how fundraising today is like managing A Tale of Two Cities, investors want to see the growth of 2020 along with the business fundamentals of 2022.

It takes someone 10 years from the day they want to quit alcohol to the day they are successfully sober. Can this app accelerate that journey? In this episode, Founder & CEO Brooke LeBlanc pitches her startup Edge, building for the next generation of sobriety.Our guest VC in this episode of Closing Time is Bob Kocher, GP at Venrock and investor in Devoted Health, Virta Health, Aledade, Lyra Health, and more. We dive into the business and discuss: Building a community-driven coaching businessShould coaches be employees or contractors?Achieving differentiation Pricing a consumer product to align incentives Listen to her pitch her new startup, and why she’s building a pain killer and not a vitamin.

In this episode, CEO Sonali Bloom presents her mobile eye care clinic to Kindred Ventures GP Kanyi Maqubela and our co-hosts. Boasting 75% year-over-year growth and over $6 million in revenue last year, Sonali details how her company is filling a critical gap in eye care accessibility in the United States.We discuss how they manage three separate sales channels — to pharmaceutical companies, employers, and directly to consumers. We delve into the workings of reimbursement and discuss whether the total addressable market size can sustain this as a stand-alone business (spoiler: the answer is yes).We also touch upon the concept of "spiritual ownership" and what it means to have a founder is no longer involved in the company's day-to-day operations.

In this episode, serial entrepreneur and cancer survivor Lisa Alderson pitches her new startup Clarified Precision Medicine to Lux Capital GP Deena Shakir. Clarified is making world class precision medicine expertise accessible to every cancer patient and every oncology practice.We discuss their go-to-market strategy, using genomics in oncology, building a moat, how they’ll make money, SAFEs vs priced rounds, and how they’ll keep a large founding team motivated. 

We are thrilled to introduce Closing Time to the world!