In this episode of The Pulse, I sat down with Lauren Makler, co-founder and CEO of Cofertility, to talk about one of the most personal and overlooked challenges in women’s health: the cost and complexity of egg freezing and donation. Lauren’s career is a study in conviction — from launching Uber Health to channeling a deeply personal health journey into a company reshaping third-party reproduction in the U.S.

In our conversation, Lauren and I explored:

• Her path from Uber to healthcare entrepreneurship and the personal diagnosis that sparked Cofertility
• Why existing egg freezing companies were making the problem worse, not better
• How Cofertility’s Split model works and what makes it fundamentally different from traditional egg donation
• Building a three-sided marketplace in a high-stakes, highly sensitive industry
• How AI is changing the pace of product development at Cofertility
• What Lauren looks for in the people she hires and what it really takes to thrive at an early-stage company

From Uber to Healthcare Entrepreneurship

Lauren didn’t set out to build a fertility company. She studied at Northeastern, took her first job at an advertising agency, and following a mentor’s advice, “if you’re going to work this hard, go to a startup and get a piece of the action,” landed at Uber in 2013, when the company was in roughly 12 cities and had around 200 employees.

Her entry into healthcare came through an unexpected inbound: a support ticket from the Chief Innovation Officer of Boston Children’s Hospital at the time asking whether Uber could do something meaningful in health. Nobody else on Lauren’s team wanted it, so she took it on. That experiment led to her pitching Uber’s leadership in 2017 on Uber Health, which allowed healthcare organizations to order rides on behalf of low-income and elderly patients. The pitch was rejected more than once before it was finally approved.

“‘Just you wait’ is my motto. If I have conviction in something, trusting that has proven me well.”

Shortly after launching Uber Health, Lauren was diagnosed with a rare abdominal disease that put her ovaries at risk and forced her to confront egg donation firsthand. What she found shocked her: a space that felt antiquated, transactional, and unethical. Her sister donated her eggs as a backup ahead of Lauren’s surgeries. Three surgeries later, she kept her ovaries and had her first child without using her sister’s eggs, but the experience left a mark.

“I remember holding [my baby] in my arms and feeling like I had to run toward this feeling. I don’t want to spend my time doing anything other than helping other people have this feeling.”

At the end of 2021, Lauren connected with her now co-founder Halle Tecco, a longtime digital health pioneer who had been developing the concept of egg sharing, freezing your eggs for free in exchange for donating half. The timing felt right, and Cofertility was born.

Why the Existing Egg Freezing Market Wasn’t Working

By the time Cofertility launched, there were already companies trying to improve access to egg freezing. Lauren acknowledges the trail they blazed, but is also direct about where they fell short. The core problem is that existing solutions were making egg freezing more expensive, not less. The optimal window to freeze is in your 20s and early 30s, precisely when you’re least likely to have $15,000–$20,000 to spare. Adding another few thousand dollars to that cost doesn’t make the product better. It just prices out the people it’s supposed to help.

A pre-launch survey of nearly 1,000 women validated both the magnitude of the problem and the way they were trying to solve it. Over 90% of respondents said they wanted to freeze their eggs. Over 90% cited cost as the primary reason they hadn’t. And 66% said they’d be open to egg sharing if the system was reworked.

How Cofertility is Rebuilding the Family Building Process

Cofertility’s flagship “Split” program allows women ages 21–34 to freeze and store their eggs for free by donating half to intended parents. Its “Keep” program serves women who want to freeze their eggs without donating, connecting them with financing and storage partners. Both run on a proprietary three-sided matching platform connecting egg freezers, intended parents, and more than 225 fertility clinics across the U.S.

What sets Cofertility apart isn’t just the financing model, but how donation is structured. Traditional egg banks compensate donors up to $10,000 or more based on demographic factors like education, what Lauren calls “surge pricing for egg donation.” Cofertility charges all intended parents the same regardless of donor. The company offers what it calls disclosed donation as an option: most donors and intended parents choose to meet, exchange contact information, and in many cases stay in touch. And where a single donor at an egg bank might contribute eggs for up to 25 families, Cofertility caps its family limit at three.

“For the first time in history, we have enough donor-conceived people who are grown adults who can give their perspective about what it means to be donor-conceived. We’re building with them, for them.”

50% percent of Cofertility’s donors identify as women of color and the pool represents more than 55 ethnicities, which is central to why fertility clinics partner with them. When they refer an intended parent looking for a donor who reflects their background, they reliably find someone.

Building the Platform and Why They Started Off the Shelf

When Cofertility launched, Lauren and Halle deliberately held off on building proprietary technology immediately, using off-the-shelf egg donation software to prove product-market fit first. The platform handles donor screening, profile creation, and multi-stage matching funnels between donors and intended parents. Today, fertility clinics sit outside the platform by design; Cofertility sends reports directly to clinics rather than integrating with their EHRs, given how frequently fertility clinics switch software.

Lauren describes the business as a “tech-enabled service.” The emotionally laden nature of fertility means that every member interaction needs a real human on the other end and the technology exists to help that person move faster and manage more relationships at once.

AI as a Booster Pack

Lauren equates AI to a “booster pack” for builders, creating an ability to jump ahead in ways that companies before Cofertility never had, and that future companies will take for granted.

For example, Cofertility has long wanted to offer calculators to help members understand how many eggs to freeze based on their goals and help intended parents determine how many eggs they need. The logic existed, but building the tool never made it to the top of the tech team’s queue. With AI coding tools, non-technical team members can build those calculators in hours. “Me, as a non-technical person, is coding. It’s the coolest thing.”

That mindset has gone company-wide. Cofertility’s cultural value of “everything is figureoutable” manifested this year as a vibe coding hackathon with every team member building solutions in Claude Code. She also acknowledges the guardrails a sensitive space like fertility requires. But her view on AI is unambiguous: if you’re not leaning in, you’re falling behind.

What Lauren Looks for in the People She Hires

Lauren’s hiring philosophy comes down to three things: obsession with the problem, willingness to do whatever it takes, and the power of persuasion.

The people who thrive on her team aren’t attached to any particular solution, instead, they’re fixated on the problem. She advises job seekers to apply the same filter and only pursue companies whose problems they genuinely care about. On grit, she’s a firm believer that it can’t be faked. And on persuasion, she wants people who can get on a call and convince anyone of anything.

Looking Ahead

For the first time in U.S. history, more women had children in their 40s than in their teens last year, a milestone made possible by IVF, egg donation, and egg freezing. That trend, in Lauren’s view, will only continue. The task now is to normalize it and make sure the infrastructure keeps pace with the demand.

“We need to normalize and destigmatize feelings around egg donation and third-party reproduction. This trend will only continue.”

Lauren Makler, Cofertility, on Making Egg Freezing Accessible through Tech-Enabled Services was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

When I sat down with Priyanka Jain, CEO and co-founder of Evvy, it became clear that this company is much more than just testing. It’s built around a much bigger idea that women’s health has been held back for decades by a lack of data, and that if we want better outcomes, we first need better signals.

Evvy is tackling that challenge by starting with one of the most overlooked areas in medicine: the vaginal microbiome. While vaginal discomfort is one of the leading reasons women seek healthcare, it remains a space shaped by stigma, poor diagnostics, and treatments that too often miss the mark.

In our conversation, we explored Priyanka’s founding journey, why Evvy chose the vaginal microbiome as its starting point, how the company built trust with patients and providers, and what the future of precision women’s health could look like.

A Personal Frustration That Turned Into a Startup Thesis

Like many founders in women’s health, Priyanka’s journey started with personal frustration. She described experiencing mysterious health issues and bouncing from doctor to doctor without getting meaningful answers. Despite repeated tests and appointments, she kept hearing some version of the same thing: maybe you are stressed, maybe you should sleep more, maybe you should drink more water.

That experience pushed her to start doing her own research. She found that women were only required to be included in U.S. clinical research beginning in 1993, and even today, women are diagnosed later than men across hundreds of diseases. For Priyanka, that was the lightbulb moment.

“This is actually a data problem fundamentally.”

The female body is unique “right down to the cellular level,” yet the healthcare system still tracks and measures health largely according to signals derived from studying men. In other words, women’s bodies may be giving off important markers all the time, but we just have not spent enough time learning how to read them.

Why Start with the Vaginal Microbiome?

Evvy’s answer to that question is both practical and ambitious.

On the practical side, vaginal discomfort is incredibly common. Priyanka noted that it is one of the leading reasons women seek healthcare in America, yet women are more likely to be misdiagnosed than correctly diagnosed, and more likely not to get better than to get better.

“When we go to the doctor, we are more likely to be misdiagnosed than correctly diagnosed. And we are more likely not to get better than to get better.”

That alone would make this an important area to focus on. But what makes the vaginal microbiome especially compelling is its broader relevance across women’s health. Priyanka explained that disruptions in the vaginal microbiome can influence inflammation and infection throughout the reproductive tract, with implications for infertility, IVF failure, preterm birth, cervical cancer progression, menopause symptoms, STI acquisition, and more.

This is what makes Evvy’s work feel so much larger than a single diagnostic product. The company is treating the vaginal microbiome as a foundational biomarker. Evvy’s test is about finally being able to “turn on the lights” and see what is happening.

“It’s the first time that you can actually turn on the lights and actually see what is happening in this really kind of critical set of biomarkers in your body.”

Building More Than a Test

What Evvy has built is not just a test, but a platform.

The first layer is the metagenomics-based assay itself, which allows patients to collect a swab at home and sequence the bacteria and fungi in the sample. But the second layer is where Evvy becomes especially interesting, as the company combines that molecular data with what Priyanka called “the whole person.”

That means looking beyond the sample itself and asking:

• Is the patient in menopause?
• Is she postpartum?
• What birth control is she using?
• What symptoms is she experiencing?

From there, Evvy uses that information to predict the specific treatments or ingredients most likely to help that individual patient, and providers on the platform can prescribe more tailored care. That combination of biomarker discovery, real-world patient context, and individualized treatment pathways is what makes Evvy a precision health company.

A Patient-Led Go-to-Market Strategy

One of the most interesting parts of our discussion was Priyanka’s explanation of why Evvy started direct-to-consumer. Simply put, the people most motivated to change the system are patients themselves.

Doctors, she pointed out, are often not incentivized to learn an entirely new science or deliver a radically different care experience, especially in a system that rewards speed over complexity. Women, by contrast, are the ones living with the consequences of delayed diagnoses, recurring symptoms, and ineffective treatments. They are the ones most eager for a better solution now.

“The people who don’t want to wait thirty years for a better solution, they want a better solution today.”

That patient-first approach has also created a kind of demand flywheel. As women use Evvy and get answers, they bring those answers back to their clinicians. Over time, that patient demand has translated into provider interest and adoption. Priyanka shared that Evvy now works with over 100,000 patients and more than 2,000 practitioners across the country.

Priyanka notably doesn’t frame DTC as the end state. She frames it as a way to generate enough patient outcomes and real-world data to eventually bring in providers and, later, payers.

Why Brand and Trust Matter So Much

Another thread that came up repeatedly in our conversation was trust.

Priyanka said one of the biggest bets Evvy is making is on building a brand that is both scientifically rigorous and culturally relevant. The company did not want to be another “pink brand.” It wanted to speak to women in a way that felt smart, credible, and modern.

Priyanka described brand trust and data as a flywheel: women trust Evvy enough to use the platform, that usage creates more data, and that data then improves the care experience, which in turn deepens trust.

“The reason we have the data is because we have consumer trust.”

That idea feels especially important in a category where so many women have been dismissed, misunderstood, or made to feel that their symptoms are somehow too minor or too taboo to deserve serious attention.

What the Future Could Look Like

Looking ahead, Priyanka is excited about using Evvy’s growing dataset to validate that the vaginal microbiome may play a significant role across multiple areas of women’s health.

She mentioned active research across infertility, IVF failure, preterm birth, menopause symptoms, cervical cancer progression, and even the potential to help diagnose conditions like PCOS and endometriosis. The long-term vision is not just better vaginal health, but better women’s health outcomes more broadly, all beginning with one simple at-home swab.

When I asked her about AI’s impact on women’s health, rather than dismissing the fact that women are increasingly turning to AI tools for answers, Priyanka argued that the right response is to make those tools better and hold them to a higher standard, especially for women.

Women are already searching for answers. The task now is to build systems, datasets, and technologies that can actually serve them well.

Closing Thoughts

My biggest takeaway from this conversation is that Priyanka Jain is building Evvy with a very clear sense of what has been missing in women’s healthcare: the data and research infrastructure to drive outcome improvement.

Better outcomes in women’s health will come from better measurement, better data, better diagnostics, and better treatment pathways designed around women’s bodies.

There was one line from the conversation that felt especially fitting for me as an aspiring entrepreneur:

“Every topic is learnable and every problem is solvable.”

Priyanka Jain, Evvy, on Using Biomarkers to Unlock Precision Women’s Health was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

In this episode of The Pulse, I had the opportunity to sit down with Giovanni Colella, MD — a psychiatrist and experienced healthcare entrepreneur — to discuss his journey from clinical care to company-building, and what it takes to design care models for healthcare’s most complex populations.

Over the past several decades, Giovanni has co-founded several influential healthcare companies, including RelayHealth (acquired by McKesson), Castlight Health, OODA Health (acquired by Cedar), Solara Health, and Brightline, focused on pediatric behavioral health. Today, he’s the co-founder and CEO of Vanna Health, a company delivering community-based care to individuals with serious mental illness (SMI), primarily within Medicaid populations. His perspective is shaped by both deep clinical training and lived experience building and operating companies at the intersection of care delivery, administration, and technology.

In our conversation, Giovanni and I explored:

• His path from clinical psychiatry to healthcare entrepreneurship — and what ultimately brought him back to behavioral health
• Lessons from building multiple healthcare companies before launching Vanna
• How Vanna’s psychosocial rehabilitation model is designed around people, place, and purpose
• What it takes to scale a high-touch, in-person care model within Medicaid
• How technology and AI can support frontline care teams without replacing human judgement

From Psychiatry to Entrepreneurship and Back Again

Unlike many physicians, Giovanni didn’t enter medicine with a lifelong dream of becoming a doctor. He initially studied mathematics and philosophy before choosing psychiatry early in medical school, a path he followed through residency and years of clinical practice.

His move toward entrepreneurship was catalyzed by something deeply personal: his father’s struggle with serious mental illness. That experience led Giovanni to believe that while clinical care matters, it often isn’t sufficient on its own — and that creating change at scale would require building new models, not just treating individual patients.

His early companies focused on structural challenges in healthcare, from patient-provider communication to claims and benefits infrastructure. Only later, after selling OODA Health, did Giovanni return fully to behavioral health, leading first to co-founding Brightline, and most recently Vanna Health.

What Vanna Health Is Building

Vanna Health serves individuals living with SMI, primarily within Medicaid — a population often marked by high utilization and inconsistent care due to systems that fail to meet people where they are.

Giovanni describes Vanna’s philosophy through the “four Ps”:

• People — consistent, trusting relationships
• Place — somewhere to belong beyond a clinical appointment
• Purpose — vocational and social re-engagement
• Payment — a value-based model that aligns incentives

Operationally, Vanna deploys a psychosocial rehabilitation model that pairs members with coaches — often peers or community health workers — who engage them in their homes and communities. These teams are closely supported by clinicians and nurses, with standardized protocols and clear escalation pathways.

“We’re not just an engagement engine. We’re a social rehabilitation engine — designed to help people stabilize their lives, not just show up to appointments.”

A core part of this approach is Vanna’s partnership with clubhouses, community spaces that allow members to participate in running daily operations — from cafés and art studios to transitional employment programs. Giovanni pointed to Fountain House in New York as the archetype. Where traditional clubhouses don’t exist, Vanna builds “clubhouse-light” environments that provide members with somewhere to go, something to work toward, and people who know them. This emphasis on community shapes how Vanna enters new markets.

“You can’t parachute into a community and expect trust. You have to build relationships long before you ever enroll a member.”

Vanna partners with Medicaid health plans, identifies high-cost members using claims data, and takes on financial risk — earning revenue only if outcomes improve and total cost of care declines.

Scaling a High-Touch Model in a Medicaid World

Vanna first launched in Philadelphia, where early pilots showed reductions in cost and utilization. The company has since expanded into Arizona and Indiana, with plans to launch in New York.

Giovanni is candid about the challenge ahead: scaling an in-person, clinician-supported model is operationally complex and expensive — but a level of investment necessary to serve this population well.

“Medicaid forces you to be disciplined — the margins are tight, the needs are real, and the model either works or it doesn’t.”

While much of behavioral health has gravitated toward virtual-only care, Giovanni is skeptical that teletherapy alone can meet the needs of individuals with SMI. For this population, consistent in-person support is foundational.

Technology as an Enabler in Behavioral Health

Despite his background in health tech, Giovanni is clear that Vanna is a services company, though technology plays a critical role in enabling high-touch care at scale.

Vanna built its own internal platform, Vanna Connect, to reduce administrative burden and support care coordination. Giovanni noted that traditional case managers often spend more than half their time on paperwork and faxing. Vanna’s technology is designed to give that time back to frontline teams. The platform has been strong enough that one health plan licensed it independently, signaling that gaps in Medicaid care management infrastructure persist.

That services-first mindset also shapes how Giovanni thinks about AI. He sees AI as a powerful support tool — helping teams route cases appropriately and reduce cognitive load — but not as a replacement for human care.

“AI won’t replace human care for this population — but it can make the people doing the work far more effective.”

Advice for Aspiring Healthcare Founders

Giovanni closed with advice for MBA students and early-stage founders interested in healthcare:

• Be prepared for a long, iterative journey — progress comes from steady execution, not quick wins
• Healthcare doesn’t behave like textbook markets; expect inefficiency, regulation, and long timelines
• Build with humility and openness — the people closest to the problem will teach you more than any framework

That guidance, he noted, applies whether you want to found a company or join one.

As Giovanni put it:

“If you’re serious about this space, you have to go see the work. Spend time with patients, spend time in the field — that’s how you learn if this is really for you.”

Dr. Giovanni Colella, Vanna Health, on Reimagining Community-Based Care for Serious Mental Illness was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

In this episode of The Pulse Podcast, I sat down with Rahul Naidoo, co-founder and CEO of Superscript, an early-stage health tech company on a mission to redefine the financial experience in healthcare for both patients and providers.

Founded in 2021, Superscript spent nearly three years in R&D building what Rahul calls “healthcare’s first pricing protocol” — technology that turns surprise, after-the-fact medical bills into clear, upfront prices. The company now works with nearly 300 providers across New York, New Jersey, and Texas, has empowered close to 50,000 patients with upfront prices, and is backed by investors including Mark Cuban, early backers of Uber and SpaceX, and founders from Dropbox and Everly Health.

Rahul and I talked about his unconventional journey from Cape Town to Harvard to health tech founder, why he believes consumer-style pricing is the missing backbone of U.S. healthcare, and how Superscript is betting on a radically different approach to pricing transparency — one that doesn’t just “estimate” costs, but actually takes on financial risk to guarantee them.

First-Time Founder on Taking the Leap

Rahul grew up in Cape Town, South Africa, and came to the U.S. to study computer science at Harvard. Unlike many of his classmates, he never bought into the traditional idea of a “career.” While friends lined up banking and consulting internships, Rahul resisted recruiting altogether. After graduation, that decision caught up with him, and he ultimately joined Roivant Sciences on a digital product team tasked with spinning internal tech into standalone startups. Within weeks, that team itself spun out as Lokavant, a clinical trial data company.

At Lokavant, Rahul learned what it really means to build from scratch: standardizing messy data sets, shipping tools for clinical researchers, and watching how startup incentives collide and intertwine with those of a large parent company. But after a couple of years, something hadn’t changed: his instinctive aversion to a traditional job. In August 2021, he left Lokavant and, with one of his closest friends from college, Rit Chakraborty, they started brainstorming ideas to reach their ultimate goal to build something worth building.

What finally changed wasn’t the perfect idea. It was risk.

There’s no substitute for real risk. The garage project, side-hobby model doesn’t really work. At some point, you just have to jump off the cliff and build the plane on the way down.

They changed their LinkedIn bios to “building something in stealth”, and then they started actually talking to the healthcare system. The early team grew from there, and Superscript was officially born.

From Theory to Action, and Why You Can’t “Game” Startups

Rahul describes his biggest personal growth area as the shift from highly theoretical to deeply applied. At the beginning of Superscript, he was inclined to respond to every problem with a long, philosophical write-up: how one ought to deploy customers, design products, or run operations in an ideal world. Superscript was built on first-principles thinking — which Rahul still believes is essential. But he learned the hard way that staying in theory is its own kind of trap.

The second big learning was realizing that you can’t gamify company-building the way you can exams, recruiting, or student competitions. Growing up in structured systems like school, Rahul found the shortcut: figure out the rubric, optimize for what evaluators want, and you’ll win. That mindset can even carry you through early parts of startup life, especially fundraising, where a good narrative might temporarily outpace your actual product. But, as he put it, quoting Jeff Bezos, “In the long run, the market is a weighing machine.”

You might be able to game your way through one or two rounds. But at some point the market asks, ‘Are you creating real value?’ And there’s no way to fake that.

For him, building Superscript has been a lesson in radical realism and authenticity: making sure the story, the spreadsheets, and the user experience all reflect something real.

Building “Healthcare’s First Pricing Protocol”

When Rahul and his co-founder looked at U.S. healthcare with fresh eyes (and almost no “traditional” healthcare experience), one thing jumped out immediately:

Healthcare is the only major consumer-facing category that doesn’t actually function like one.

In every other industry, consumers can wake up, see a price, click a buy button, and know exactly what they’re going to pay. That simple “proactive buying motion” — prices + choice + action — is the backbone of all consumer markets.

In healthcare, it’s almost entirely missing, and the consequences are everywhere, ranging from wild price variation, to sky-high U.S. spending, to terrible patient experiences. Rahul shared his core belief: if you can restore a true consumer purchasing motion to healthcare, you can start to fix both pricing and experience from the ground up.

Superscript’s first ambition was bold: become the Amazon of healthcare — a marketplace where consumers could shop across providers and treatments with clear, upfront prices. They quickly realized that to do that credibly, they’d first need something more fundamental: a way to generate prices that don’t currently exist. Contrary to the common assumption that prices are “known but hidden,” Rahul explains that, structurally, healthcare prices aren’t really computed until after care is delivered.

The current process looks like this:

1. You get care.
2. A biller converts your clinical notes into a claim using a combination of codes (CPT, modifiers, etc.).
3. Your insurer attaches internal rates to each code, sums them, and then applies your specific benefits to determine your cost-share (copay, coinsurance, etc.) relative to theirs.
4. Only then does a patient-facing number appear — which becomes the bill you get weeks later.

Superscript’s answer is the pricing protocol, a stack of two engines that together produce a deterministic patient price before care happens. The result: for every service, across every insurance plan, Superscript can generate a single, stable patient price upfront — the same number that would otherwise have shown up on a bill weeks later. That price is then displayed on platforms built by Superscript — consumer facing websites, and a practice-facing tool for the front desk. Once the patient pays, they’re done. No surprise bill in the mail. No chasing. No mystery.

Why Providers Care: Capturing Lost Patient Revenue

Superscript was originally built with consumers in mind. But as the team brought their technology into the real world, they discovered it also solves a significant problem for providers. Under the status quo, practices miss somewhere between 20–60% of patient payments they’re technically owed. Patients move on, feel blindsided by bills, or simply choose not to pay.

If practices can’t quote accurate prices upfront, they can’t have meaningful financial conversations with patients, or reliably collect the money they’re owed. By enabling practices to price every service upfront and take payment before the visit–while still respecting insurance benefits–Superscript turns previously lost dollars into real, collected revenue. For many practices, patient payments represent 20–40% (and sometimes more) of total revenue, so leakage here is existential.

Superscript’s long-term vision still includes the marketplace. For now, they’re in Phase 1: deploy pricing technology broadly across practices, build a robust supply network, and then someday turn those pipes outward toward consumers.

The Biggest Misconception About Healthcare Prices

Ask most people what’s wrong with healthcare pricing and you’ll hear some version of: “The prices are there — the system just doesn’t want us to see them.”

Rahul thinks that framing is incomplete.

The truth is more frustrating. Prices don’t exist in a consumer-friendly way at all. What exists is a giant, messy pile of building blocks.

When hospitals were required to publish rates data in 2021, the result didn’t look like a menu of services with prices. It looked like hundreds of thousands of service codes, each with multiple potential rates, none of which directly reflect what you, as a specific patient on a specific plan, will pay. To turn that into “your price,” you’d essentially have to replicate what Superscript’s pricing protocol does: anticipate which codes will apply, identify the associated rate, sum them, and then correctly apply your unique plan rules.

In other words, the problem isn’t just that prices are hidden. It’s that they’re never available in a consumer-friendly format — until it’s too late to decide.

Why Superscript Thinks It Can Win

When I asked Rahul why he believes Superscript will succeed where other pricing transparency efforts have struggled, he pointed to two things:

1. A radically different bar for what “pricing” even means.
   Most of the industry has focused on speed (“real-time adjudication”) or estimates (“your CT scan may cost $50–$600”). Superscript insists that real prices — numbers you can actually buy against — are the only thing that will change behavior. That decision forced them to treat pricing as a financial problem, not just a data or transparency problem — and to be willing to assume risk when their estimates and reality don’t match.

We decided not to play the estimates game. We wanted prices that are as actionable as any other consumer category.

1. The team’s belief-driven motivation.
   Rahul describes Superscript’s team as unusually mission-aligned. He’s convinced that if you maintain that level of intensity and alignment over a long enough period, “victory is almost inevitable.”

No one here is just doing a job or pushing spreadsheets. People are here because they believe something about how healthcare should work.

I left this conversation energized by Rahul’s combination of philosophical depth and practical intensity — and by Superscript’s willingness to tackle one of the gnarliest parts of U.S. healthcare with both financial rigor and consumer empathy. If Superscript can make upfront prices real in healthcare — not just estimates — it could unlock a wave of consumer behavior, market discipline, and practice sustainability that we haven’t yet seen in this space. I’m excited to follow how Rahul and the Superscript team continue to build, and how their work might reshape how all of us experience the cost of care.

Rahul Naidoo, Superscript, on Rewriting the Rules of Healthcare Pricing was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

Jake Sussman, Marble Health, on Building a School-Centered Model to Address the Youth Mental Health Crisis

In this episode, I had the pleasure of sitting down with Jake Sussman, co-founder and CEO of Marble Health, a company building a new model of mental health care for children and teens. Jake shared why the youth mental health crisis demands a fundamentally different approach than adult care — and how Marble is using schools, insurance-aligned incentives, and thoughtfully applied technology to expand access.

Founded in 2023, Marble delivers virtual therapy for students, offering both one-on-one and group sessions with no waitlists and appointments available in as little as four days. In its first 15 months, Marble scaled from zero to millions in revenue, with more than half of the children it serves covered by Medicaid. The company recently raised a $15.5M Series A to expand its school-based model nationwide.

In our conversation, Jake and I explored:

• His path from Headway to the classroom — and ultimately to Marble
• Why access, not treatment quality, is the core issue in youth mental health
• How school counselors became Marble’s entry point to care
• How Marble delivers no-waitlist care amid a clinician shortage
• How Marble uses technology and AI to support collaboration, not replace clinicians

From Platform Builder to the Front Lines of Youth Mental Health

Jake’s connection to mental health started early. He’s the son of a therapist and a psychiatrist and experienced firsthand how difficult it can be to find affordable, in-network care, which helped inspire the first company he co-founded, Headway.

After helping scale one of the fastest-growing platforms in mental health, Jake made an unexpected pivot into teaching at Success Academy in New York City — an experience that would go on to shape Marble’s model in a fundamental way.

“I didn’t realize before teaching how much school counselors had been pushed into a clinical role. Kids were showing up with depression, anxiety, suicidality and counselors were expected to manage it with almost no resources.”

That insight became foundational to Marble. School counselors, Jake realized, were already the front door to youth mental health — they just lacked the infrastructure to connect students to timely, effective care.

Where the Youth Mental Health System Breaks Down

While evidence-based treatments for anxiety and depression are well established, access remains the core challenge, especially for kids. School counselors field daily requests for help but are often forced to refer families to overburdened community clinics with months-long waitlists. Private practice therapists, meanwhile, face administrative barriers that limit their ability to serve adolescents.

“Everyone wants the same thing. School counselors, therapists, insurers, families — they all benefit when kids get into care early. But none of them can solve the problem on their own.”

Marble’s strategy was to build the connective tissue between these stakeholders.

Marble’s Mission to Connect Schools, Therapists, and Health Plans

Marble contracts with insurers to become an in-network youth mental health provider, aggregates a network of therapists who accept both commercial and Medicaid plans, and makes that capacity immediately available to schools — at no cost to the school counselor.

With a referral that takes less than 30 seconds, counselors can connect students to care with no waitlists. Just as importantly, Marble closes the loop: counselors can see where a student is in their care journey and collaborate directly with therapists.

Marble’s model reflects the realities of youth mental health, which requires close coordination among parents, school counselors, and clinicians. Therapy is delivered after school and on weekends to avoid disrupting academics, guardians play an active role in care decisions, and Marble’s platform enables ongoing collaboration so care doesn’t happen in isolation.

“Collaborative care isn’t just nice to have for kids. It’s predictive of better outcomes.”

Marble first launched in New York and is now expanding into New Jersey and Ohio, prioritizing large markets with manageable Medicaid complexity and strong reimbursement environments. Over time, the company plans to operate nationally.

Using Technology to Reduce Friction Across Youth Mental Health

Marble has built its own EHR and operational tooling to make insurance, including Medicaid, “magically easy” for therapists and referrals frictionless for schools.

The company is actively investing in AI as a way to meaningfully improve care quality, not just increase efficiency. The team has already built its own AI scribe, which has listened to thousands of therapy sessions and automatically proposes progress notes to reduce administrative burden for clinicians. Over time, that scribe has become something more important: a quality wedge. By having visibility into what actually happens during sessions, Marble can continuously evaluate and curate its clinical network, even as it scales to hundreds of thousands of appointments.

That same foundation is now powering the next phase of Marble’s product roadmap. They are currently building an AI-powered patient companion that engages students between sessions, reinforcing progress and providing support when it’s needed most. Because the companion listens during therapy appointments, it can interact with patients in a highly personalized and context-aware way in the days between visits, while always keeping human clinicians in the loop.

“Our view is that AI should amplify human care, not replace it. Especially when you’re working with kids.”

Staying Connected with Marble

Marble is still early in its journey — “the first inning,” as Jake put it — and team building remains the company’s top priority. Jake encourages mission-driven operators, clinicians, and students interested in youth mental health to reach out, even if there isn’t an obvious open role.

“The company you build is the team you build. That’s been true everywhere I’ve worked, and it’s especially true here.”

Jake Sussman, Marble Health, on Building a School-Centered Model to Address the Youth Mental Health… was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

In this episode, I had the pleasure of sitting down with Felicity Yost, Co-Founder and CEO of Tia and one of the leading voices in women’s health.

Tia is a modern women’s health company that combines virtual and in-person clinics to deliver integrated, whole-body care for women, spanning primary care, gynecology, mental health, fertility, perimenopause and menopause, and more. Founded in 2017, Tia has raised roughly $150 million in funding from leading investors, as it scales a “whole-woman, whole-life” care model across markets in New York, California, and Arizona with plans to open more this year.

Felicity brings a deeply analytical and product-oriented perspective to healthcare. Before co-founding Tia, she worked at Bridgewater Associates and Owler, where she honed her expertise in high-velocity product execution.

In our conversation, Felicity and I explored:

• How her personal experiences shaped her passion to co-found Tia
• How Tia redesigned women’s care around concerns, not specialties
• Why the consumerization of care may be doing more harm than good
• What it really takes to build sustainable healthcare businesses and teams
• Her long-term bets on AI and preventive care

How Passion and Pain Drove Felicity to Co-Found Tia

Felicity’s journey started with lived experience and, most notably, frustration. Felicity’s mother passed away from breast cancer when she was still in high school. Around the same time, her aunt was also diagnosed. As a teenager, Felicity began asking doctors pointed questions about cancer risk, prevention, and how reproductive health decisions might affect long-term outcomes.

The response was dismissive.

“They basically laughed me out of the room… it didn’t feel data-driven or thoughtful about how the body actually works as an interconnected system.”

Years later, after being diagnosed with rheumatoid arthritis post-college, the pattern repeated. She was bounced between specialists, shut down for asking questions about how medications might affect her reproductive health, and left without a clear, holistic care plan.

These experiences revealed something fundamental: modern healthcare systems and medical research were built around a “male default,” and that has led to real gaps in care for women.

“I still have not met a single woman who doesn’t have a bad healthcare story.”

How Primary Care at Tia Is Reimagined Around Concerns, Not Specialties

It became quickly evident to me that, at its core, Tia challenges the way modern medicine is organized. Traditional healthcare is built around specialties — primary care, gynecology, dermatology, mental health — each operating in its own silo. Women are expected to bounce around between them. Tia flips that model. Instead of asking “Which doctor do you need?”, Tia starts with “What are you experiencing?”

“We design around a patient’s symptoms and care needs, not around the way the medical system has broken specialties into boxes.”

The Tia Care Model: Designed for Continuity

For those who are unfamiliar, Tia integrates primary care, gynecology, mental health, dermatology, and wellness into a single, coordinated experience delivered through both physical clinics and virtual care.

Key components include:

• Unified medical records across all providers
• Collaborative care teams who actively communicate with one another
• Hybrid care journeys intentionally designed to include both in-person and virtual touchpoints

One of the most critical pieces of the experience is onboarding, especially because Tia serves what Felicity calls a “medical orphan” population. Over 90% of Tia’s patients have not had an established primary care relationship before coming to Tia. Given that reality, Tia treats intake and onboarding as a clinical foundation, not an administrative hurdle. The onboarding process includes a comprehensive pre-visit intake form completed at home, a whole health exam (which includes a full-body physical exam, blood panels, ultrasounds if needed), and detailed lab review and follow-up.

“For many patients, it’s the first truly comprehensive baseline they’ve ever had.”

An Example: Meeting Women Where They Are with Tia’s Hormone & Vitality Assessment

I then dove into one of Tia’s newest offerings, the Hormone & Vitality Assessment. It was born from a simple but common patient refrain: “I just don’t feel like myself.”

Women in their 30s and 40s often experience changes in mood, sleep, weight, and energy, but are frequently misdiagnosed or prematurely labeled as perimenopausal. Tia designed this assessment to widen the diagnostic lens. Rather than jumping to conclusions, the assessment creates a structured process to explore root causes (whether hormonal, autoimmune, metabolic, or otherwise), while re-engaging women in preventive care during a period when many fall out of the system.

How Increasing Consumerization of Care May Be Doing More Harm Than Good

According to recent data by KFF, nearly half of adults under 30 in the U.S. do not have a primary care provider, a trend that has serious implications for long-term health outcomes. When I asked Felicity what’s the driving force behind this, she hypothesized that it was the result of two overlapping forces: increased mobility in young adults and the increasing consumerization of care.

“Care has become incredibly episodic.”

First, younger adults are far more geographically mobile than previous generations. People move cities for school, work, or relationships every few years, making it difficult to establish and maintain long-term provider relationships.

Secondly, as medical care becomes increasingly consumerized (from on-demand prescriptions, one-off telehealth visits, direct-to-consumer testing, etc.), care shifts from relationship-based to transactional. In this model, patients are rewarded for speed and convenience, not continuity, and there becomes little incentive to establish a primary care provider when immediate needs can be solved in isolation. Tia’s model intentionally resists this fragmentation by emphasizing provider relationships, unified records, and repeat engagement over one-off transactions.

Building sustainable business models and team models in healthcare

Felicity is unapologetic about the fact that building healthcare the “right way” is slower.

“If we don’t do it right, we’re not actually solving the problem. And then what’s the point? Why do any of it if we’re not actually making women healthier?”

Tia’s commitment to brick-and-mortar clinics, health system partnerships, and complex care coordination means it is not likely to scale like a pure software company or a standard telehealth model. That requires a specific kind of investor and board member alignment — people who understand Tia’s not going to move as fast as other digital health companies. These are also individuals who understand that Tia’s main OKR is achieving profitability without compromising clinical outcomes.

With Felicity’s background in product management, she treats Tia’s entire clinical strategy from the technology to care delivery as a product to be optimized around real user needs. Teams are structured that way too. For example, one of the most distinctive decisions Tia made was creating a Clinical Strategy & Innovation (CSI) role inside the product organization. This role thinks horizontally across patient, provider, and admin experiences to make sure that each stakeholder’s perspectives in the care experience are considered.

“Instead of optimizing one guide process or specialty, we slice across the entire care experience from the end user’s perspective.”

The result is a deeply cross-functional organization. It may be harder to manage and slower at times, but it’s ultimately been more cohesive for patients.

Felicity’s long-term bets on AI and preventive care

Lastly, I asked Felicity about the future of AI in guiding women’s health outcomes. She shared that she’s most excited by the promise of AI not as a replacement for doctors, but as a tool to better guide patient decision-making. Specifically, she highlighted the need for a precision-medicine backend powered by personalized, longitudinal data — ranging from family history to a patient’s most recent biometrics and bloodwork.

“People are really trying to answer one question: should I go to the doctor or not?”

She highlights that AI is most powerful when paired with user trust, an accurate context, and real clinical data, not when operating in isolation. The open question in her mind was which company would be the first to try and the first that users trust.

However, her biggest bet remains unchanged. Preventive care is the transformational lever.

“Getting women to engage in care repeatedly, over decades, is what will ultimately improve outcomes — and unlock better clinical protocols for the future.”

Final Thoughts

Tia’s story is not about disruption for disruption’s sake. It’s about rebuilding trust — between women and their bodies, between women and their providers, and ultimately between women and the healthcare system meant to serve them.

There’s been increasing discussion about the need for greater ecosystem collaboration in women’s health, and it’s clear that companies like Tia are open to (and actively pushing for) those conversations. Progress in this space won’t come from isolated solutions, but from ecosystem players that are willing to integrate, partner, and prioritize continuity over competition.

Lastly, over the past year, much of the industry has rightly focused on the impact of AI. But in that focus, we risk overlooking what may be the true table stakes: getting women back into consistent, preventive care. Without that foundation, even the most advanced innovations in wearables, remote diagnostics, hormone intelligence, and care navigation risk falling short of meaningfully improving women’s health outcomes.

🎧 Subscribe to The Pulse by Wharton Digital Health on Apple and Spotify for more conversations with the leaders reshaping the health tech landscape.

Felicity Yost, Tia, on Designing a Healthcare System Women Actually Want to Use was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

In our latest episode of The Pulse, I sat down with Samir Malik, founder of firsthand, a company pioneering a trust-first, peer-led model to reach individuals whom the traditional behavioral health system has failed to reach. Samir shared powerful insights on why trust is the missing ingredient in serious mental illness (SMI) care and how firsthand is rebuilding it through lived experience, community-based engagement, and value-based partnerships.

In our conversation, Samir and I explored:

• His path into behavioral health and the origins of firsthand
• Why SMI requires a different approach than traditional clinical models
• How firsthand’s peer-led model engages individuals the system has struggled to reach
• firsthand’s value-based partnerships with Medicaid Managed Care Organizations (MCOs)
• The role technology plays in enabling high-touch, trust-first care

Samir’s Path to Behavioral Health and the Origins of firsthand

After studying at Wharton as an undergrad, Samir joined McKinsey, where analyzing early drafts of the Affordable Care Act first sparked his interest in healthcare. He later worked at a psychiatric hospital in St. Louis, where he saw the realities of behavioral health up close: outdated, paper-based systems, limited outpatient support, and individuals repeatedly cycling in and out of crisis.

Motivated to expand access to care, Samir returned to Wharton for his MBA and began building 1DocWay during his time in the Healthcare Management program, refining the concept through coursework, faculty mentorship, and the Venture Initiation Program. 1DocWay was later acquired by Genoa Healthcare and then by Optum, where the telepsychiatry platform ultimately grew into the largest in the country.

Across these experiences, Samir saw the same theme: individuals with behavioral health conditions weren’t engaging in care, not because treatment was ineffective, but because trust had been broken. That insight inspired the idea behind firsthand: a model built to meet individuals where they are and rebuild trust through lived experience.

Why SMI Requires a Different Approach

Samir explained that while treatments for schizophrenia, bipolar disorder, and major depressive disorder are well studied and effective, access remains a major barrier. Many individuals with SMI interact with the healthcare system only during acute crises, often involving police encounters, ER visits, or involuntary psychiatric holds.

“The challenge today isn’t the quality of treatment — it’s that far too few people who need these services are accessing them.”

These crisis-driven interactions erode trust, making it difficult for individuals to stay engaged long enough to benefit from care. Samir emphasized that any model hoping to improve outcomes must first repair trust, which is the foundation of firsthand.

Inside firsthand: A Peer-Led, Trust-First Model

firsthand’s care model centers on peer support — individuals with lived experience with SMI or substance use. Peers build trust in ways that traditional care teams often cannot. They knock on doors, meet people where they are, and help navigate both clinical and social needs: medication access, housing, benefits, family dynamics, transportation, and more.

“If we’re going to build trust, we have to come from a place of lived experience.”

firsthand currently operates in Washington, Florida, Virginia, Ohio, and Michigan, expanding into new markets in partnership with Medicaid MCOs who identify regions with significant unmet behavioral health need.

A Value-Based Partnership Model Built on Outcomes

firsthand works with Medicaid MCOs through value-based arrangements tied to total cost-of-care improvements. As individuals engage consistently with peers and stabilize clinically and socially, health plans see meaningful reductions in avoidable utilization.

Across markets, firsthand typically observes:

• ~15% reduction in all-cause inpatient and ER utilization by month nine
• 30–40% reduction in inpatient psychiatric admissions
• Increased outpatient engagement as individuals connect to ongoing care

These improvements allow firsthand and its partners to structure models that reward measurable impact and long-term stability.

“To build a durable business, it has to be a good deal for everyone involved — the health plan, the individual, and us.”

Technology’s Role: Enabling Human Connection at Scale

While firsthand is rooted in in-person relationships, technology plays a critical supporting role. The company uses data science to risk-stratify populations, prioritize outreach, and guide peers toward the “next best action” for the individuals they support. firsthand’s technology is designed to reduce burden, not replace human connection, and ensure peers spend their time where it matters most.

“Tech that abstracts away the non-top-of-license work means we deliver more outcomes for more folks at a higher quality.”

Samir also sees potential for emerging technologies, including AI, to help the broader healthcare system better direct resources toward the highest-impact interventions if deployed thoughtfully and in service of individuals.

How to Follow and Support firsthand

For those inspired by firsthand’s mission, Samir encourages reaching out, especially students and operators interested in behavioral health, community-based care, or value-based models. Several Wharton alumni have already played key roles across firsthand’s operations, clinical strategy, and product organization.

More broadly, Samir encourages early-career leaders to think intentionally about where they apply their talent in healthcare.

“There’s so much good work that needs to be done in healthcare. Being thoughtful about where you spend your time and talent is what will pay dividends.”

Samir Malik, firsthand, on Building Trust-First Care for Serious Mental Illness was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

In this episode, I had the pleasure of sitting down with Emma Silverman, Partner at TMV and one of the most thoughtful voices shaping early-stage healthcare investing today. TMV, founded in 2016 as a female-led venture firm reimagining legacy industries, has carved out a reputation for backing founders with conviction, clarity of purpose, and missions that endure beyond market cycles. At the helm of their healthcare practice, Emma helps guide the firm’s investment strategy across domains like health equity, clinical AI and consumer health.

Before joining TMV, Emma began her career at Bain & Company, was one of the first hires at Flamingo, a women’s personal care and shave brand, and was the Chief of Staff at Truebird Coffee. Her experience across these roles now informs a thoughtful and grounded view of what it takes to build, scale and sustain healthcare companies.

In our conversation, Emma and I explored:

• Emma’s path to venture and TMV’s purpose-driven origin story
• TMV’s health & bio thesis and notable investments
• A deep dive into Clinical AI
• And finally, advice for founders and aspiring investors

Emma’s Path to Venture and TMV’s purpose-driven origin story

Emma’s path into venture was anything but linear, an arc she now sees as an advantage. She studied English literature, creative writing and economics at UPenn, drawn equally to storytelling and analytics, but unsure where she fit. Her first real pivot came while working with Soraya Darabi, now one of TMV’s founders, when she realized there was space in the startup world for generalists who could move fluidly across functions. That insight carried her to Bain, where she built her diligence toolkit, then to Harry’s Labs to help launch Flamingo, and later to Truebird Coffee, a TMV portfolio company, where she touched everything from finance to go-to-market. Being on the ground with early-stage operators and seeing the impact of the right investors at the right moments, pulled her toward venture and specifically TMV.

Founded by Soraya Darabi and Marina Hadjipateras, TMV reflects their clear conviction: venture should help shape the world we want to live in. Coming from opposite ends of industry, New York tech and a multigenerational shipping business, they shared a belief in backing founders with deep purpose, especially in legacy sectors like healthcare and logistics where stakes are high and change must be thoughtful. TMV’s operator DNA means showing up where it counts: go-to-market, hiring, industry navigation and the hard calls that define a company’s early years. As Emma put it:

“We’re the folks that answer the call in the middle of the night, that are available in the moments to celebrate, and in the hard moments that require us to roll up our sleeves.”

TMV’s Health & Bio thesis and notable investments

TMV’s people-centric lens heavily informs the firm’s healthcare thesis, whose three core pillars are focused on improving the care, systems and workplaces that power the healthcare industry.

· Patients: Improve quality of care and address healthcare inequity to deliver outcomes for everyone

· System: Achieve system-wide efficiency by solving challenges from workforce shortages to operational bottlenecks

· Workers: Support the people who power the system and address burnout among physicians, nurses, therapists, and non-clinical staff

“Those three themes can exist independently, but I think where it gets really powerful is when they start to work together,” Emma explained. She also touched on recent investments that highlight the breadth of the thesis such as Elion, which helps healthcare leaders and buyers cut through the noise and assess, compare and select AI technology platforms with confidence. On the patient side, TandemStride provides peer support and care navigation for patients recovering from traumatic injuries — an area with few structured pathways today. And Slingshot AI, which is building one of the largest and most robust clinical LLMs for therapy and stood out to TMV given its clinical-protocols and purpose-driven approach for a sensitive area. Emma underscored:

“When we think about what the future of care delivery looks like, Slingshot AI is really powerful in that vision. It’s not a replacement for therapists. It’s working alongside therapists. It’s supporting, augmenting, supplementing.”

A Deep Dive Into Clinical AI: Promise, Tension, and the Path Forward

Emma’s recent deep dive into clinical AI, captures both the excitement and the unease running through the ecosystem: the opportunity is real, but the path is anything but simple. AI is already demonstrating strong diagnostic potential in areas like radiology and pathology, and with the clinician shortages worsening, the utility is obvious. But clinician environments are high-acuity spaces, as Emma put it:

“You can’t just ship something and hope it works. We’re talking about patient care, patient data. It requires a high level of fine tuning of safety, security, compliance, accuracy”

Health systems want clearer regulatory guardrails and payers are still trying to understand where clinical AI fits into reimbursement models — what they’ll pay for, what should remain experimental and how to avoid creating perverse incentives. Across healthcare AI, there sits the essential infrastructure work: data labeling, validation, fine-tuning, capabilities that become far more powerful when done in deep partnership with hospitals and health systems, where clinical validation can meaningfully accelerate adoption.

From an investor perspective, when it comes to evaluating AI-companies, Emma returns to first principles:

· Is there a real, hair-on fire problem?

· Does the team understand healthcare’s regulatory and integration maze?

· Can they execute a go-to-market that is unique and works in this ecosystem?

· Do they have the leadership and resilience to scale responsible?

Clinical AI is coming, but it will take alignment across the entire ecosystem — and teams who understand that adoption hinges as much on trust and execution as on model performance will be best positioned to succeed.

Advice for founders and aspiring investors

For founders building in uncertainty, Emma’s advice is refreshingly tactical: run experiments, not guesses, pay attention to where the market is naturally pulling you and diversify early pathways to avoid binary exposure. Emma believes:

“One of the hardest parts of being an early-stage founder is knowing when to power through and when to pivot”

For aspiring investors, Emma’s guidance mirrors her own journey. Venture isn’t about becoming a strong generalist: it’s about figuring out your own style, your own superpowers and the kinds of founders you want to work with. Every great investor she knows is shaped less by a formula and more by a perspective: a way of seeing problems, people, and markets that’s distinct and repeatable.

“There isn’t one right way to do this job. The only way to be great at it is to figure out what makes you good”

Whether that’s go-to-market instincts, an operator’s intuition, a network that others don’t have or simply the ability to listen deeply, success comes from the ability to sharpen what’s already yours.

Emma Silverman, TMV, on Backing Visionary Healthcare Founders was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

In this episode of the podcast, I sat down with Marta Bralic Kerns, founder and CEO of Pomelo Care, a virtual-first maternity care company delivering high-quality, personalized care to pregnant people and newborns across the United States. Pomelo’s mission is to improve outcomes in maternal and infant health through proactive, data-informed, and accessible care. Marta and I spoke about her path from consulting to founding Pomelo, how she’s scaling care for the most underserved populations, and why she believes we’re only at the beginning of a new era for women’s and children’s health.

From Consulting to Care Innovation

Marta’s career began in healthcare consulting, where she focused on projects that examined cost and quality within Medicaid. An early project with the state of Arkansas, focused on bundled payment models, exposed her to both the inefficiencies and the gaps in maternal care outcomes. That laid the groundwork for her understanding of how data could be used to improve care, particularly for vulnerable populations. She later joined Flatiron Health, where she saw firsthand how oncology data was being leveraged to personalize treatment and inform research. But when she became a mother herself, she realized just how little data and personalization were informing prenatal and postpartum care.

That realization sparked her curiosity and, ultimately, her drive to create Pomelo. Marta saw an opportunity to bring together the lessons from her experience within the oncology and Medicaid spaces and apply them to maternal health, an area plagued by some of the worst outcomes in the developed world. From the start, Pomelo was designed to deliver proactive, evidence-based care that meets patients where they are — whether that’s virtually through an app, or physically through a growing network of doulas and providers. While Marta’s path to founding Pomelo wasn’t linear, it was fueled by a consistent desire to solve real problems with data and empathy.

Building with Intention and Scaling with Discipline

Pomelo took an unusual approach to growth in digital health. Instead of starting with employer pilots or direct-to-consumer offerings, the team chose to launch within Medicaid — arguably the most complex and underfunded payer segment. Medicaid covers nearly half of all U.S. births and often serves patients in rural or underserved areas with limited access to OB/GYN providers. Marta believed that if Pomelo could succeed there, the company would be well-positioned to expand elsewhere. That bet paid off: starting with high-risk patients helped refine Pomelo’s model and built a strong foundation for later commercial expansion.

As the company gained traction, a major payer partner asked if Pomelo could expand from one market to 13. Despite traditional wisdom warning against rapid scaling, the team said yes — backed by meticulous hiring plans and detailed forecasting models. At one point, Pomelo was hiring 30 people a month. Growth was not taken lightly; instead, it was executed with precision, ensuring that quality of care remained high and that new clinicians aligned with Pomelo’s approach and mission. The result was a successful expansion that catalyzed further growth across both Medicaid and commercial lines of business.

“We were really thoughtful about that scaling plan — forecasting how many clinicians we needed, when to hire, how to train — because we knew we had to protect the patient experience while growing fast.”

Delivering Proactive, Personalized Care

Pomelo’s approach to care is rooted in early detection, patient-centricity, and scalable tech. The team built an algorithm that uses over 800 data points to identify pregnancies early — often in the first trimester — and flag potential risk factors such as preeclampsia, gestational diabetes, and mental health conditions. These insights are used to generate personalized care plans that align with both clinical guidelines and each patient’s personal goals. By marrying predictive analytics with deep empathy, Pomelo delivers care that is both data-driven and human.

The company’s hybrid model allows patients to access support via app-based messaging, on-demand virtual visits, and now, in-person support through their acquisition of The Doula Network. This full-spectrum approach not only improves access but also closes critical gaps in care — especially for patients who may otherwise miss appointments due to transportation or work challenges. Pomelo’s technology also empowers its clinicians: AI tools assist with documentation, care planning, and relationship continuity, helping providers deliver more consistent and compassionate care.

“For every single patient, across every single risk that they might have, we’re building care plans tied to their personal goals — and then proactively working with them every step of the way.”

Market Momentum and Industry Shifts

The last five years have brought a surge of interest and funding into women’s and children’s health, and Marta believes this shift is long overdue. Media coverage, increased awareness of poor maternal outcomes, and the aftermath of the Dobbs decision have all shone a light on the disparities in U.S. maternal care. The COVID-19 pandemic further accelerated innovation by proving that hybrid models of prenatal care are both safe and often more effective. Data from that period showed no deterioration in outcomes with telehealth — while also increasing patient engagement and convenience.

Pomelo’s value-based care model is well-positioned to meet this moment. By partnering with payers through shared-savings contracts, Pomelo is able to offer free care to patients while demonstrating real impact on cost and outcomes. This includes reduced NICU admissions, fewer emergency room visits, and lower rates of preterm birth. Marta shared how they tailor each payer relationship around quality metrics, cost goals, and access needs, proving that a virtual-first approach can be both sustainable and transformative.

“We’ve been able to provide entirely free care to our patients because of our value-based contracts with insurance companies — and the results we’re delivering speak for themselves.”

AI, Collaboration, and What’s Next

AI plays a growing role at Pomelo — not to replace care, but to enhance it. From surfacing early risk factors to helping clinicians surface key personal details about their patients, AI is seen as a tool to strengthen, not dilute, the care experience. What’s unique is how Pomelo develops its tools in close collaboration with its clinicians. Feedback loops are built into the development process, ensuring that products are rolled out with buy-in from the people using them daily.

Looking ahead, Pomelo is focused on scaling its core maternal and newborn care offering, while exploring adjacent areas within women’s and children’s health. Customers are already asking for expanded support in pediatric conditions and broader women’s health, and the team is eager to continue building responsibly. Despite Pomelo’s rapid growth, Marta believes they’re still in the early innings — and that there’s so much more to be done.

Advice to the Next Generation of Founders

As we wrapped up, I asked Marta what advice she would offer aspiring entrepreneurs, especially those interested in healthcare. Her answer was clear: “Just go for it.” She shared a piece of advice she once received: if you’re thinking in multi-step plans — “I’ll do A so I can do B so I can eventually do C” — why not just try doing C now? That mindset shift helped her move from idea to action in founding Pomelo, and she’s passed that advice on to many others since.

For those building in healthcare — particularly in underserved or overlooked areas like maternal health — Marta’s story is a reminder that meaningful innovation is possible when driven by empathy, data, and a relentless focus on outcomes. I am very excited to see how Pomelo grows to care for even more mothers and their families.

Marta Bralic Kerns, Pomelo Care, on Reimagining Maternal and Infant Health was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

In The Pulse’s latest episode, we were joined by Mike Roaldi, President of Cityblock Health. Cityblock Health is a valued-based primary care company on a mission to radically improve health outcomes for Medicaid and dually eligible populations across the U.S.

Cityblock Health is one of the most ambitious care delivery companies today, serving its eligible populations with a tech-enabled, community-rooted approach to care. Cityblock is focused on building deep relationships with members and addressing social determinants of health to drive real impact in cost and quality. The company delivers high-quality primary and behavioral care — often in members’ homes — to those who traditionally struggle to access it.

Since spinning out of Sidewalk Labs, an Alphabet company, in 2017, it’s raised almost $900 million to scale a new model of tech-enabled, community-based care for vulnerable populations.

In this episode, we’ll explore what it takes to serve the most complex, high-need patients in America — and how Cityblock is rethinking trust, tech, and care delivery from the ground up. Mike also shares how his unique career journey— from law to nearly a decade at UnitedHealth Group — shaped his operating philosophy, and why he believes trust and execution are the two most critical ingredients for success in healthcare today.

The Power of Bold Moves: Building a Career Through Unlikely Turns

When Mike was a kid, he dreamed of becoming a professional wrestler — and then a U.S. senator. He started as a litigator, working in big law firms where he built a strong foundation in structured thinking and professional rigor. But he soon realized that traditional legal pathways didn’t offer the operational impact or business-oriented roles he was drawn to. That insight led him to make a bold leap into state government. It was a move that gave him his first taste of management, budget responsibility, and policymaking. More importantly, it gave him a broader systems-level view of how government, policy, and healthcare intersect.

That pivot eventually opened the door to UnitedHealth Group, where he spent nearly a decade in senior roles across both UnitedHealthcare and Optum Behavioral Health. In his first role as National Vice President of Medicaid Policy and Product, Mike was focused on expanding UHG’s outreach to its Medicaid and duals members, to better support their access to care. Along the way, he also led the UnitedHealthcare Community Plan of Ohio, led Optum Behavioral Solutions’s Government Programs, and most recently served as Chief Growth Officer for the Community & State business.

As someone who has pivoted industries and responsibilities successfully over the course of his career, Mike leans on three key principles for taking risks around big career jumps: learning, impact, and mentorship. First, he encourages viewing each move as an investment in your knowledge base — one that sets the foundation for future growth, even if it means leaving something comfortable behind. Second, he suggests looking for roles where you can make a tangible difference and point to real outcomes, whether operational, financial, or strategic. Finally, Roaldi underscores the power of mentorship in making unfamiliar transitions feel less daunting. Surrounding yourself with experienced guides not only builds confidence but also accelerates learning and integration in a new space.

“As your confidence grows, you realize that your your knowledge gap isn’t as big as you originally thought it was, and you can always figure those things out. But mentors really help smooth over the learning curve.”

What Payers Really Look For

During his time on the payer side, Mike reviewed countless startup pitches — and developed a clear view for what stood out. While compelling ideas and passionate founding teams were common, what truly set successful startups apart was their ability to prove they could execute.

“What is more rare is a startup with the commitment to the operational discipline necessary to fulfill their mission.”

He looked for companies that could not only articulate their value proposition clearly but also experienced founding teams that could back it up with real-world performance data and a detailed understanding of how their processes worked in practice. In other words, big ideas mattered — but follow-through mattered more.

This experience carried over as Mike began considering his own transition to Cityblock. Cityblock was a company with outsized influence on the broader healthcare landscape. Just as UnitedHealth Group has the ability to help shape industry trends, Mike recognized that Cityblock was setting a new standard for what care delivery in Medicaid could look like. Further, what impressed him most during the interview process wasn’t just the boldness of Cityblock’s vision, but the team’s fluency in the details: clear performance metrics, market positioning, and clinical delivery at scale.

Cityblock Health’s Integrated Model

Cityblock Health is a care delivery company designed from the ground up to serve Medicaid and dual-eligible populations — groups that have traditionally been underserved by the healthcare system. As compared to traditional primary care providers, Cityblock has built a more expansive, tech-enabled model that integrates behavioral health, chronic care, and social services. What sets the organization apart is its proactive approach — instead of waiting for members to seek care, Cityblock reaches out directly, via phone, text, or even knocking on doors, to engage members before issues become emergencies.

A key differentiator in Cityblock’s approach is its focus on access and trust. Many of its members face significant barriers to care: transportation challenges, language differences, and a lack of familiarity or comfort with navigating health systems. Cityblock addresses these by offering mobile care, virtual visits, and in-home services — delivered in the language and modality the member prefers. Engagement is intentional and sequenced to reduce friction — for example a mailer to establish familiarity, followed by outreach that builds trust by offering immediate help rather than asking for something in return.

“First and foremost, we focus on being able to reach and establish trust with members, then being able to actually provide the services that our members need.”

From a business model standpoint, Cityblock is able to partner with payors through value-based arrangements (e.g., taking on full-risk at one end of the spectrum). For example, it might take on a population that historically costs an insurer $2,500 per member per month, and be paid a fixed fee to manage that population more effectively. The financial upside comes from reducing avoidable emergency visits and hospitalizations by investing in upstream care. In some cases, Cityblock also offers its services a la carte — providing care coordination or behavioral health capabilities on a fee-for-service basis. This flexibility allows the company to meet partners where they are, while still scaling its impact across different markets.

Where Cityblock Goes from Here: Scaling, Standards, and AI

As Cityblock Health looks toward 2025 and beyond, the mandate is clear: scale thoughtfully, without compromising what makes its model work. After seeing meaningful cost reductions and engagement improvements in long-standing markets, the company is eager to bring its approach to more communities across the country. Already operating in eight states, Cityblock plans to expand its footprint and reach more high-need populations through partnerships with both national and regional plans.

Each new market requires rapid hiring, tailored community engagement, and adaptation to local Medicaid policy structures. Success hinges not just on replicating clinical processes, but also on building local trust and integrating with existing provider ecosystems. Cityblock’s implementation team has developed robust playbooks to manage these transitions, but the company remains deeply invested in fine-tuning the balance between local nuance and national scale.

To maintain the organization’s success as it scales, Cityblock leans heavily on building the right processes for accountability, discipline, and culture. The organization holds itself to internal performance benchmarks that often exceed payor requirements — tracking metrics like care delivery turnaround times, engagement rates, and emergency room avoidance across markets. Market leaders participate in a regular cadence of performance reviews, followed by detailed remediation plans where needed.

“We as a company have a culture of of performance that is as rigorous as any that I’ve ever been in, and it shows up in how we hold ourselves to incredibly high standards internally.”

Technology is also central to this the company’s ambitions going forward. Cityblock, with its roots in Alphabet’s Sidewalk Labs, continues to operate as a tech-forward provider, and is focused on investing a great deal in AI. The current focus is on clinician support: ambient listening tools are streamlining documentation and care assessments, helping reduce administrative burden while making interactions with members feel more natural. Looking ahead, Mike is also excited about member-facing AI tools, particularly in regards to sensitive questions, where a well-designed chatbot might actually lower the barriers to honest engagement.

What Actually Matters for Healthcare Builders

For founders looking to build in healthcare, Mike offers a focused playbook grounded in his experience on both the payor and provider sides.

1. Have a clear value proposition — and test it with stakeholders early.
   A great idea isn’t enough. Mike emphasizes that founders should engage with payers, policymakers, and health plan leaders early in their journey to understand real pain points. Listening closely and incorporating feedback ensures the product or service solves an actual problem.
2. Bring healthcare credibility to your founding team.
   While startup experience is valuable, Mike strongly advises having at least one senior team member who has worked at a payor, provider, or large health system. This person brings not just credibility, but insight into how the industry operates and what drives purchasing decisions. Founders who lack this experience should make it a priority to bring that expertise in-house early.
3. Obsess over execution.
   Sophisticated buyers — especially in healthcare — can immediately tell when a startup is glossing over execution. Founders should be ready to dive deep into how their model will actually work on the ground. That includes implementation, compliance, data integration, and outcomes measurement.

Within Medicaid specifically, Mike is excited about continued growth and investment in solutions targeting dual-eligible populations and long-term services and supports (LTSS). These members often have complex needs — spanning both medical and social care — and are at the center of evolving payment and care delivery models. As Medicare and Medicaid integration gains traction, solutions that effectively serve these populations will be in high demand. For founders willing to do the hard work of listening, building with rigor, and operationalizing with care, Medicaid remains one of the most meaningful and impactful frontiers in healthcare.

🎧 Catch the full episode with Mike Roaldi on The Pulse Podcast.

Mike Roaldi, Cityblock Health, on Scaling with Empathy and Excellence was originally published in The Pulse by Wharton Digital Health on Medium, where people are continuing the conversation by highlighting and responding to this story.