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It's such a treat to have you on the NFS podcast today. So we've known each other for such a long time. We worked together. You were like one of the first team members at Truly are back in 2006. We Pete together something like 9 crazy years up until the acquisition and Mote Wizzillo. And then we stayed in touch over the years. And straight after that, you started Solve Health with our other good friend, your cofounder, Danny Ali, the Julius CTO. So so good to have you today.
So thanks for joining us. Such a treat, Pete, can't wait to be able to do this in person in the not too distant future. But until then, I'm very happy to do it. On a podcast with you. So thank you for having me. Oh, it's such a pleasure. So let's just dive in. Like, tell me a bit about solve how things today. It feels like the either all men in many ways. What are you so proud of right now?
Gosh. When I think about what I'm proud of, the first thing that comes to mind is that we've helped 30,000,000 consumers see a provider since founding Wow. Just pretty astounding number. You know, one of the things you have to do when you shift from a consumer tech background to a health tech company is you need to recalibrate on all of your numbers. They're all much, much smaller.
Now that being said, over the course of the last 4 years, we've built a national network We've built a supply side product because we're a SAS enabled consumer marketplace. We've built a consumer app and experience to organically acquire and engage consumers and damn it, Pete, 30,000,000 doctor visits through the platform. And so I think it's the scale of what we've been able to accomplish in that time that I'm most proud of.
And so just maybe gonna break it down for folks that are not familiar with the product. So, you know, I remember back when in 2016 when I had the privilege to be a early angel investor that sort of a pitch in some ways with OpenTable for kind of the Beller care industries. How much has that has evolved? Was that kind of like where you are? Explain the kind of 2 sides of this marketplace. Absolutely. So health care in America is complex. Right?
You can't say I'm gonna stand up a marketplace, and tomorrow I have Uber for health It just doesn't work that way. And what we realized very early on was there was a trend where consumers were disaggregating their health care out of the traditional Beller care system and getting it from apps in their community.
Sort of this disaggregation was happening, and what we thought was to build a SaaS enabled consumer marketplace in healthcare, we would want to get that capacity that exists across the country through our SaaS software. So our core SaaS offer that we sell on the Pete side is effectively online booking, wait time management, SMS based communications, digital paperwork, insurance intake, all the way through pay. And we didn't start with all of that.
Of course, we started just with the online bookings and in clinic experience, and that's expanded over time. So what we realized early on was if we could build a national network of providers running the solve software, we would then have access and visibility into the capacity that exists, the supply liquidity across the United States.
And you've written and talked many times about marketplaces as a start on the consumer side or the supply side, after some learning and some mistakes early on, we realized that national acquisition of supply was our priority to start. Right? And at the same time, we have this massive American Beller care problem, which is figuring out where should I go for problem I have, when can I be seen and how much does it cost is effectively impossible to do? Right?
And so for us, it was let's build a supply side software where we can acquire effectively liquidity in our marketplace. Let's build a consumer app which helps you answer those three questions, which if I can go back to our Trulia days, what's quite actually different, right, at Trulia, we wanted to acquire you at the top of the funnel.
Mhmm. Awesome kitchens, real estate near me, law Lucky Loos, engaging you so that once every 7 years you transact through us coming through our lead gen, at solve, we were not gonna go through top of the funnel It's a very busy crowded space. Google's very good at it. So we're lots of other companies. For us, it was we're gonna acquire you when you need care.
We're gonna hire you when you were ready for the transaction, and we were gonna have the supply liquidity to be able to make that transaction happen. And so more of a, I mean, would you characterize as a b to b model in the sense you're enabling these clinics, these service providers on the supplier side, or is it more that, like, you've figured out how to target consumers at the point of burning need and have this unique solution that you're able to provide at that moment? Yes. Absolutely be.
Okay. Right. There are many B2B to C solutions in Beller care where really that first B is your north star, right, as a SaaS enabled consumer marketplace in health care, Our north star is the consumer. Yep. And the supply side liquidity that we're building in the marketplace is the type of providers who want to deliver that consumer experience. And so we've had this mental model basically as our framing from the very beginning.
We just realized that acquiring supply that grindy work of knowing when Pete can go and see someone within the next two hours was what would be effectively the magic moment for Sol, and we wanted to be able to build that. Yep. So here we are last 12 months has been a crazy, crazy year. Our offices work on the next door to each other to see each other all the time. And, unfortunately, we've not had that Charles, but, like, we've not caught up for a little while. COVID, what happened to you?
I mean, obviously, that sort of the human tragedy, but also the kind of implications your business, like, what happened? It sort of feels in some ways that your business was designed for kinda COVID in some ways. Beller us what's happening with the positives and negatives. So 2020 was just an incredible year on every dimension for all of us. However, had you told me in 2019 that you would be the CEO of a company that was playing a meaningful role in a pandemic that was to come.
It just would have No way. In no way. Like, what are you talking Right? I mean, prior to COVID, our focus was let's build out a massive national network of providers so that we could connect consumers with care. What that means is today actually at the start of COVID, roughly, you know, 80 to a 100,000,000 Americans are within five miles of a bookable same day appointment on solve. Wow. Right? That's massive. Right? That's the massive scale that we've been able to achieve then comes COVID.
And all of a sudden, it effectively pulled our roadmap and the future forward. When I think about the COVID year for us, there were really 2 main levers of growth. Right? The first one was this hardship to telemedicine because all of a sudden, it wasn't a nice to have, but it was required to have so people could receive the care that they needed and so that physicians could see their patients Right? So if I had the numbers on that Pete March 2020, so we shipped the product in 2018.
Became very obvious to us at the time that nobody really gave a shit about telemedicine. Not consumers nor physicians because of the consumer mental model shift on how do I receive health care? And is this real? And then on the provider side, very heavy workflow as well as disincentives to enable telemedicine visits. If I can get 20 bucks or a 120 bucks to do the same thing. 1 Beller and one person. Of course, I'm gonna be in person.
So acceleration number 1 for solve was Telemet Pete March 2020 9000 total telemedicine visits across the SALT platform. From March 2020 to today, I think it's at roughly 1,500,000 telemedicine visits. Across the cell platform. 2nd big acceleration for us was really around COVID testing and the expansion of our overall supply base. Right? So we started with an urgent care, with the realization that that was effectively sort of the red hot center of the consumerization of health care.
But nobody was talking about it. So we started with an urgent care as COVID testing became sort of the only thing that Americans agreed about in the pandemic, couldn't agree with masks, couldn't agree on policy, but everyone wanted to get tested. We effectively were able to activate and work with our partners around enabling COVID testing across the United States to the tune of over 5,000,000 COVID tests were managed through the salt platform.
Just as a point of comparison, in 2020, I believe the CVS number is something like 7,000,000. Wow. So they did 7,000,000. We did 5,000,000. And then the 3rd accelerant for us, which is overall consumer volume to solve because our purpose in life is to get you the care that you need now. That is how we tool the consumer experience from the beginning. And so, again, by the numbers, January of 2020, we were at roughly a million visits per month inconsequential and consumer tech land. Pretty big.
When you think about a 25% conversion rate for all of that traffic Mhmm. Right in health care land. By the end of the year as the COVID demand really surging. We were at probably 14,000,000 visits per month. Wow. Right? And then to today, we've normalized at around 5,000,000.
So we're 5 x where we were a year ago because we are solving a job to be done for consumers, which enables us to organically acquire them, engage them through our app, and build an experience around them to guide them in their everyday health So it was a big deal. So I guess this has not been your first rodeo. In terms of a crisis, so we worked together a trulia during the housing collapse 2008.
And, you know, we often see in some ways these dislocations of markets, however painful are they are at the time. Yeah. They end up, you know, often benefiting a fast moving technology start up. I imagine there's a bunch of sort of similarities, but also a bunch of differences with both the real estate crisis and then obviously this health care price is driven by COVID?
Like, I guess when you think about that, what do you think is similar and what do you think is different, you know, about how you approach the problem, how you build a company, etcetera. Before I answer that question, can I ship it back to you? Okay. This is a two way podcast. Right? We when we had the real estate downturn, was that 2008. Yeah. Can you share some reflections on that moment in time and the decisions that we made?
Because I think I have a version of it in my head, which of has informed so much of what we've done at Sol, but I'd actually love to hear it from you. Okay. I guess so I remember sort of those conversations, and we were Sakoya Portfolio company. So going to their kind of like, the world is ending, you know, dead buttchess, star pictures, and all that is visible on the web.
I guess I kind of had sort of, you know, and now and I'd also been through that last minute.com experience at September 11th and when I travel, and I there were really 2 outcomes. One is that we're all screwed. This is gonna be a disaster, like global terrorism, you know, economic disaster. We're gonna go back to the depression or, like, Well, this is gonna be tough.
This is gonna be really sort of painful, but, you know, belief in human ingenuity and, you know, some of the infrastructures of our society that will figure it out. And, you know, where we are, you know, you kinda had to be positive and the sort of the what I saw in travel was that, you know, it's the fast moving startups, which end up, like, taking market share, even if the market becomes dramatically smaller in the online real estate cases it did back then.
So stay the course consumers need housing, consumers need travel, and we'll kinda hear from you. But, like, you know, the future is gonna be okay. Yeah. I mean, I remember that time, and, obviously, consumer search and being very relevant to consumer search was what we were so good at. And I remember sort of this mentality of, wait a minute. Now we can surface for consumers the deals in the market. Yep. Or where there might be shifts, whereas prior to that moment, it was really about what's hot.
What are the hot neighborhoods? What are the hot markets? And I remember that shift in terms of how we were thinking about the product experience, which in that moment, we could not have been more relevant. Yeah. There's certainly in those businesses, the supply side was struggling, and the demand side was uninterested.
Yeah. Imagine it was quite different in COVID So for us, you know, just to tell a little bit of a story on this, right, we were all reading the newspapers about this thing that was happening, Wuhan, China, right, in the United States with lots of academic conversations around what that might look like in the United States. And it was, gosh, I wanna say early March when we got a call from one of our customers, which is a incredible regional health system in the Pacific Northwest called multicare.
And they said, hey. We need your help. We've just received a call that there is a COVID patient located at around a mile from one of our locations. If the news is true, like, this could become very big, very quickly and overwhelm remember, the initial concern was overwhelming the hospital system capacity. Right, with this thing that nobody understood, and they said we need your help. Right? We had a 9 AM meeting on the calendar. It was effectively a war room of, like, what do we know?
What can we do to help? Then getting on the phone side by side with this partner in order to, in the beginning, triage people to keep them out of the hospital or out of the Flint, if they had COVID symptoms and then treat them via telemedicine. So unlike the real estate crisis, in this one, it was immediate.
Like, we felt it right away it became very obvious to us that the one being able to triage patients are you symptomatic or not, but 2, being able to treat you via telemedicine to figure that out was going to move from a nice to have one of the three things on every physician's innovation board. Every hospital system across the country says innovation. Telemedicine. Yeah. Check Paul. Yeah. Check Paul. Right.
It was gonna go from that to I need it right now, and we also knew that the incumbents could not work as fast as we would. Right? And so for us, I think there are a couple things that were at play. 1 is as humans, we thought, holy shit, we can be very useful in this moment. And we don't actually have to worry about the ARPU of the customer or the conversion rate of the call or whatever it was.
We have a tool where we can be very useful today, and we should do And then second, as the pandemic, sort of, we had more months under our belt, it was really thinking ultimately as a company, this is a moment where we can accelerate what we were already set out to do. And so many companies pivoted pretty hard. Right? They were doing one thing. They're like, wait a minute.
I'm now gonna go do this other Morgan, what we have always cared about in building our liquidity in our marketplace is expanding our supply side and giving increased access to same day next day care and then growing our organic consumer audience to fulfill a job to be done to get them the care that they need. Right? And as we were looking at all of the different ways to navigate through the pandemic, we sort of looked at it with those 2 very simple filters.
And if it was a great monetization opportunity, but have nothing to do with those 2, we said, right, because we recognize that we had mission alignment and moment alignment and product alignment. That was incredibly unique, and so we leaned into it as an Morgan. I mean, you kinda just threw out your previous plan and just say, okay. This is like, you know, the stream of inbounds. We just gotta fulfill that. And then on the you just have observe what's happened to society.
You just, like, leaned in and the team kind of rallied together and switch road maps. I mean, obviously, the road map, the director of the road map was the same, but the details were probably very different. Very different. Right? And coming off of a end of year planning for all of 2020. No. We'd effectively burned the road map because it was irrelevant to the moment at hand. What we recognize is that we had an opportunity to be of service to the country.
I hate to sound so cheesy, but I feel that very deeply, right, service to the country through the business that we have built and accelerate the mission. Yep. And so with that, it became very easy to reassess what are we working on, what matters, right, as we are moving forward week by week and month by month through this phase that nobody really knew how to process. You know, we didn't know how long it would be.
Certainly didn't know the impact that it would have or that would be home, you know, 15 months later when we all walked out the door and said, see you guys in a month or so. We hope. The speed notion here is just reminds me a little bit of, like, Vitalic was on a podcast with my partner, Morgan, and it's and it's saying, like, speed is a public good. And then sometimes, like, you know, in startup world, like, Pete can be wrecked or seen as reckless?
Like, I guess, how do you think about the role that technology has to play in this crisis? How you think it might sort of affect sort of Beller this industry and just your thoughts on kind of speed and this impact on society. Yeah. You know, our good mutual friend, Sami Inconen, said something to me along this journey as He's the CEO of a different health tech company, Verta Health. He said as a startup, we only have 2 assets or speed and our agility.
I might be misquoting him, but that's what I remember. And, like, that quote has been in my mind from the beginning of solve, which is, you know, as we make decisions ensuring that we still have that speed and the agility is what will enable us to be meaningful. It's what will enable us to have an impact on the consumers and the ecosystem that we want to have.
And so, you know, I think when you then take that to something like Beller care, right, you have to balance that speed and agility with your responsibility to your stakeholders, right, speed that will ultimately, you know, lead you to low quality care or speed that will ultimately lead you to a surprise $2000 bill, right, is not, you know, sort of runs counter to the mission.
So I guess for me, the way I think about it is speed and agility is especially in Beller care is required, and you need to weigh that against the mission that you have to ensure that you are still true to So how do you balance that? And there's obviously health care is like, you know, Silicon Valley products are famous for AB testing and, like, okay. That does not work in the health care reasons. Industry, rightfully so. So I guess, how do you balance that between your business?
And then, also, I'm curious, like, speed internally in your Morgan, like, you know, you you're a CEO. You run a startup. Like, you have a thirst of Pete. Like, any ticks that you've employed just to help to, you know, move from 3rd gear to 4th gear to 5th gear. I mean, what is very helpful in health care is you recognize that there are very big titans who are very powerful. And so that adage that it's always day 1 or whatever it is. It's always you're always at the beginning.
Yep. Yeah. The Jeff Bezos, you actually feel that every single day. Right? And so I think particularly at solve, recognizing that to get to relevance, we need to service 1,000,000 of consumers. We need to save 100 of 1,000,000 of dollars And if we don't do that, we will die. I don't even know how to answer this question other than that is a very clear reality and mental model that we have at solve. Which I'm not very satisfied with my answer for you.
But, I mean, the feedback that I get from the team, which probably many founder CEOs Pete, is we're just celebrating enough. I guess it's the mission that you're in just that there's an urgency. I mean, let's face it. Like, some companies building, you know, a widget within, I don't know, a photo sharing app is like, that's interesting, and that's helpful.
But Yes. I imagine the mission that you've created and the urgency of the demand, you know, provides people with this sort of urgency and necessity that kind of, like, it forces a speed of execution. I really love your answer to your question for me. I mean, that is a 100% correct and never more so than through the pandemic. Right? Access to care is a urgent problem in the United States of America.
And so that's the mission of the company and enabling providers to deliver a great service monetizing that because we are a business and not a nonprofit and doing that very well is motivating and drives urgency.
Now add COVID to that where we have providers who are frantically trying to deliver care to patients that they care about but can where you have consumer, the fertility of humanity is now something that we see in our inboxes as people are really worried about their grandmother or themselves or their kit, and it is our responsibility to be part of the solution.
And so back to your last question on speed versus the responsibility, I feel like that is the natural tension of what we do, but we will never opt for speed and harm our users. Yeah. Right? And so you just have to balance that reasonably depend on what you do. I mean, it's worth also stating, Pete, not all health tech is the same. Yep. Right? If there is a device that I'm gonna implant in somebody's body to deliver you know, medicine every day.
That's a very different risk profile than here as software, which enables access and ease and clarity of cost. Those are very important to both of them, but very different in terms of the risk. And I think as a founder, you need to recognize where am I in terms of the actual ability to do harm. And use that to measure how much risk at any moment or how much speed at any moment is appropriate. It fills today Pete we are in the US spring of 2021.
Like, we're about to enter a third chapter for kind of in the sense that we're gonna be living with, COVID in some respects. For a while. I guess what does that mean to solve itself? You know, the sort of persistence of testing, annual injections, vaccinations seem to maybe sort of Pete in California at least? Yes. Where's it go from here?
Look, I think just like every other vaccination that we receive, every other test that we take, within our day to day Beller care lives from birth to today, COVID becomes part of that. Right? So whether that ends up as annual injection or whether testing becomes more ubiquitous as new variants arise. All of those things are possible, but the spike of what we experienced has certainly come down, and that is a wonderful thing.
I think one thing that happens is all of our public health organizations, our government organizations, to the health systems, to the clinics now does have a much higher level of sensitivity to what could happen. And I think that's transformative in terms of how we fund and continue to effectively plan for whatever the next thing is, hopefully Beller again in our lifetimes. For solve, when I think about the 3rd wave for solve, it's now getting people healthy. Right?
The avoidance of care in the past year was very high, right, for very human, very real, very logistically challenging reasons. As we've expanded the overall network of high quality providers and diversity of providers on solve, we're now taking those tens of millions of consumers and saying, hey. Let me help you get the you need, right, as we're moving back towards a world, which, sure, we may still have to get a booster shot or a test or something like that.
But, really, that hopefully isn't The rearview mirror in not too long, knock wood, right, and part of our normal course of health care in America. And, really, I think where we are seeing the biggest acceleration is reengagement to be well. Yep. Right?
And we happen to be in the great place to be able to do that as we have just delivered on this job to be done through a incredibly emotional burdensome, scary year, and have been able to build some of the brand equity with our users to reengage them again. Yeah. Know, we've seen the sort of statistics around. They'd figured out the vaccine in 48 hours, but it took them a minimum, I don't know, 9 months before that. She got into kind of humans and, you know, appropriately.
So but when you kind of, like, look at that sort of 9 month process of speculation a year ago, that actually would be like a 3 year process. And so there's sort of just like you've seen this acceleration within, you know, in that approval process, like, thank goodness. What do you think are some of the permanent changes to what COVID to tap into Beller care broadly. It's typically been an industry which has been, you know, the amount of investors I meet is like, I never touch health care.
It's Yeah. Heavenly regulated. Yep. It's full of all these incumbents. It's just like small people don't focus on health care because it's brain damage. Like, but does that change from here? I mean, the complexities of American Healthcare are very real. And that means that if you are coming in for a quick buck, you probably shouldn't come as I interview candidates I say there's a lot easier ways to make a quick dollar and work less hard. So if that's what you're about, that it's cool. Bless you.
Don't join solve. Right? You've gotta come here because you want to be part of the transformation that needs to happen, right, and you're willing to put in the work and there's an incredible business many incredible businesses to be built in this category. I mean, when I think about what changes, right, I think about, you know, effectively accelerations of what already happening, which are now here to stay. Right?
So the first one was, as I mentioned before, this disaggregation out of the health system as the center of all of your Beller care life Right? So whether that's ordering a test to be delivered in your home or getting your mental health care through an app or going into a retail clinic maybe is now your primary care physician, right, doing all of it virtually.
I mean, that shift is permanent and What that means is that hospital systems, as they should, will protect their Pete and L and try very hard to bring it back But my point of view on that is the ship has sailed. Right? Consumers experienced Beller care in an entirely different way. It broke some paradigms And now how my son sees a provider if he has a rash on his chest because he's always rolling around in the dirt and doing all kinds of disgusting things.
So he has and cuts always versus my mom who has exacerbated asthma and a number of other things, how they are treated for that individual instance should be different, right? And so the consumer shift happened through COVID, but also the provider side shift happened, right? Like I said, both workflow as well as incentives for the 2 key Currier. And those are now gone. So while there might be some institutional energy to shift back to the way everything was, I just don't think that be possible.
Yeah. No. It's not feels like it's permanently kinda shifted. So I guess what's still is broken in health care and what the transformation needs to happen? Just, you know, broadly as you think about it. I mean, Pete, so much is still broken. Right? When I first entered the category, right, all anyone would ever talk about is the change is value based care. And I went to these conferences, and I was in a room with 2 very prominent executives from 2 very large health systems.
And I said, please tell me the truth. Is anybody doing this, or do you all just talk about it in these academic forums? Mhmm. And they started with a courses should happen and here's why. And, no, we don't do it, and we will win forced. So, like, that's just a long evolution. And what happens between now and then, there's a tremendous need to focus on enabling consumers to get the care that they need at a cost that they understand that doesn't cause them to go bank Right?
50% of all bankruptcies in the United States are Beller care related. It's an astounding 50. Yes. Crazy. Crazy. 25 to 30% is the last number I saw of GoFundMe's are to fund Beller care expenses. Beautiful. I mean, what's broken? Everything is still broken.
And so there are plenty of space for innovators to come in and try and solve pieces of the problem because ultimately as I think about the situation in the United States, Everyone says, like, maybe Bernie's gonna make it and fix everything, and it's gonna be great. There is a scenario when that happens, and people may or may not think that's great.
I think it is very unlikely I think it is more likely that you need change from all of the different stakeholders, whether you're the hospital systems and the innovators who exist like Bob Walker at UCSF as an example, whether you're the payers, right, where Yeah. They're doing more experimentation. They're very large. Of course, they're doing it in their self interest, but great. Because they're realizing the change is happening or the consumer wave. And that's where Solv lives. Right?
I'm just a believer that consumers can transform industries. And I believe that, well, again, Americans disagree on basically everything. What feels like being wronged by the Beller care system is ubiquitous. And that is a nerve that entrepreneurs can tap into as they're thinking about how do I build the next thing in order to build this transformative business? Are there any as you think about sort of founders and entrepreneur, I know you support a bunch of early stage founders.
Are there any, like, sort of sectors or opportunities you see in that elect someone really should go out for that, or this is a hot sec. Any ideas or general themes that come to mind? Gosh, Pete. When you were building Trulia. I don't know how much you were looking around at the rest of the non Trulia ecosystem, but I will tell you. It's so much time of the day. Yeah. There. Would all of my extra time between my 3 children, my spouse, trying to be a decent friend and build a remarkable business?
I don't spend that much time on the outside, but that being said, couple of things to share. I think and people may already know this. I just didn't come from the category. Physicians are a very entrepreneurial group. Right? They are a group, and I'm gonna say this as compliment that have so many side hustles. And I think my mental model on the physician, because I grew up without physicians and my family, was very different than that.
And so I think it's an entrepreneurial group who also has the highest dissatisfaction of any other white color job. Is that right? I had no idea. Yes. That is fascinating. Right? When you take those 2 components, when you think about a problem space, especially with the momentum around and consumers disaggregating the health system. I think there's something particularly interesting potentially in there. Alright. We're new to that away. Pete. I mean, there's so many interesting spaces. Right?
Like, the consumerization around the lab space and being able to just be more of an owner in your own care. I guess I would say this. For a very long time, you had to sell to payers or sell to employers or sell to the largest enterprise health systems to be taken seriously in health tech. Yeah. I do not think that's the case today. Yeah. Right?
Like, the wave is real, and we've now proven it across companies like solve Beller, companies like Everly Beller, a number of companies in the space, Right. And so I just think it unlocks a lot of opportunity that I think many health tech investors might have laughed at even 18 months ago. Yeah. For sure. And so do you Pete, I mean, there's a perception that perhaps governments lose things down, and that's not unheard of.
You know, they're not for kind of, like, necessarily wrong reasons, but do you see that as an inhibitor or you think that smart entrepreneurs will figure out a way around kind of the regulations in the industry? I think smart entrepreneurs who give a shit will identify the pockets where there's opportunity. And if you're a smart entrepreneur who does not give a shit, go to a different category because it is friction full. Yeah. It is friction full, but it's worth doing.
You know, I think about, you know, Medicare and Medicare Advantage as a really interesting pocket of opportunity where really cool companies have now been focused on taking that very large population that most, quote, unquote, you know, smart investors or smart entrepreneurs wouldn't touch previously, and there is a ton of innovation in that space through companies like city health.
You know, you think about what seem at Varma did from the head of CMS, right, at the beginning of this year, regulations to make real pricing visible across hospital systems. Requiring them to use understandable words and share, I think it's something like their highest negotiated insurance rate as well as their lowest and some other data points.
Like these are pockets of data availability, pockets of experimentation, which when you're talking about government programs, talking about 1,000,000,000 of dollars of opportunity in what is theoretically a small pocket. And so I think the brave and someone who wants to be transformative should absolutely take a look.
I mean, just notwithstanding the billions of dollars that are spent in the industry and the kind of, like, outcomes on that, it's just like entrepreneurs are focused on change the world and making money as Beller, and there's, for sure, the opportunity to do both. Yes. And, Pete, I remember one of our early slides talking about the shift to consumer search online, which is something like 80% of all consumers now search online. Back in real estate days? Yes. Back in truly a days.
You and I, right, and there was some something like 5% of the marketing spend is online. I remember the slide. I think that at least that slide called it a $12,000,000,000 in terms of the advertising budget. Is that right? Am I remembering that right? Yep. Yeah. I mean, American Beller care is $3,500,000,000. So take a tiny pocket of that solving a particular problem where you have passion.
And that is a 100 of 1,000,000 of dollar opportunity, multiple $1,000,000,000 opportunity, right, against Beller that's post acute care, whether that's chronic conditions, whether that's access. Right? So my advice would be don't be so overwhelmed by the fact that there is a regulatory environment Yep. Right. This is a giant industry, which is begging for innovators, and so we should have more people in it. For sure. You're listening to the NFX podcast.
If you're enjoying this episode, feel free to rate and review our channel and share this conversation with someone you think would benefit from these sites. Follow us on social, nfx, and visit nfx.com for more content. And now, back to the show. So maybe switching gears a little bit and talk about marketplace building and kinda how you kinda got that sort of firewall going back in the early years. So Yeah. You know, is to think about the soil products. So one end is consumers.
The other end is supply side. So, you know, clinics, Beller care services, and maybe you Pete into a little bit about figuring that out. I guess, how did you very curious how you thought about kind of matching that supply and demand? Cause I remember Currier conversations with you about, like, whether Pete regional focus should be matching supply demand at the same time or capturing the easy low hanging supply to kind of build relationships and then scale demand off of that.
What did you learn from that process and kind of what's the playbook that you're building out now? Yeah. I will tell you all of the operational detail, and I find this part fascinating. Like, what? Right. An early observation for us. You know, startups in Beller care was littered with, you know, tons of stories of companies with really great products.
That really got the go to market wrong, and go to market in Beller care is very important because titans exist because blocks exist both regulatory blocks as well as some consumer emotional blocks exist. And so we did something that was very business school Pete which is we took the Beller ambulatory visits that happened in United States per year. So ambulatory is non in hospital We put them on a wildly oversimplified 2 by 2. So on the x axis was frequency of visit.
The left side was low frequency. On the right side was high frequency oversimplified. Right? So call that, you know, sorry, the x axis was frequency. The y axis was fidelity to a provider. Right? So at the top of the y axis, was I have low fidelity to the individual provider. So when you say fidelity, just like the strength of the relationship with them, Correct. I care a lot if Doctor Fernandez is there to see me or not. Yeah. So the top of the y was low fidelity to a provider.
The bottom of the y was high fidelity to the provider. And we basically took the Beller ambulatory visits and, you know, thinking about marketplaces, you want high frequency, and you want low fidelity to the individual person. You wanna believe that it's high quality or other criteria, but the person itself needed to be more flexible.
And we discovered something that I'd realized in my day to day life, but all of a sudden, we were seeing in numbers, which is that top right quadrant was a box that we called Convenient Care, which basically meant urgent care, retail clinics, and telemedicine. We sized it roughly a 150 to a 170,000,000 visits of the 1,000,000,000, and it was growing rapidly.
And as a mom of 3 kids, I am a frequent visitor to urgent care clinics in between the pediatrician because access and convenience is more important to me than a known provider particular visit, right, being able to go between my meetings or in the morning or in the evening after work. And so just going around on the 2 by twos, if you want the the bottom right, was your primary care. The bottom left was your specialist. That's where I have low frequency and high fidelity. Right?
And then the top left quadrant was low fidelity and low frequency, like your ER or your lab. And so, well, we're like, well, this is very interesting. This top right quadrant has effectively we took that to mean not that urgent care was the end all be all, but they were the tip of the spear of something that was happening in health care that was driven by consumers.
And we validated that by doing a second thing is we went to Google Trends and we looked up searches for urgent care in the United States versus primary care versus Viagra versus birth control versus what felt like the things that people would search Morgan I encourage your listeners to do it. You look at from 2000 fours today in the United States, and it's astounding.
And then what I did, because Google Trends doesn't give you real numbers, is I put Trulia on the list because I knew what truly a searches look like at the time, and I thought, holy shit. Like, this is really big. Right. So those 2 validation points made our go to market very clear, which was This is a incredible industry. It happens to be much more mid market and long tail than the traditional Beller care system, and it's where all of the consumer wave happening.
Mhmm. And so that made the go to market very clear to us. That's number 1, unlike the entry point. The second thing I'll share is when you and I talk, We were initially thinking we were gonna do this in one market. And so we looked at the it got really great advice, which was optimized for your highest levels of success on both the supply and consumer side. So on the supply side, that meant lots of competition.
And on the consumer side, what that meant in health care is Morgan consumers with high deductible health plans because that's the national trend and consumers with high deductible health plans are more likely to be paying attention to the cost because they're paying it out of pocket.
So we took those 2 criteria, and then I did a 2 a half to 3 hour flight radius out of San Francisco because I knew that wherever it was, I would be there all the time, and we picked Dallas because it scored the highest on those two dimensions plus proximity, my flight path. We executed in Dallas and then had a very clear realization, which was there was a wave happening on the provider side around overall digitization. And stickiness in the category is high.
And if we miss that, it would be harder to get someone to switch versus being the first solution that they had. Right? And so at that point, we made the decision. We're not gonna do market by market. We're actually gonna get national liquidity. As we build up our consumer side, actually became a bit more like Trulia at that point. Yeah. Yeah. Let's build out the national network and build a consumer product. And then we'll focus on use cases versus geographies. Mhmm. So that was the beginning.
Mean, just to sort of play that back a little bit. So figuring out proxy data, so, like, finding proxies for the kind of real data to help to sort of narrow in on the segments and mark some burning need. And, you know, there's a ton of proxy data that's out there, like, as you say. And then really figuring out where the supply pull is, So the supply pool is, like, the providers were kind of like, that was the hard thing to solve because you knew consumers would lap this up.
If it was available to them, the hard thing to figure out what supply side. And so, like, if a provider is kinda sniffing at it and they can embed, you know, integrate you across all their clinics, then that was the best go to market. And then from there, you'd start to layer, you know, you'd say, okay. We've got density in this particular market. Let's double down the consumer side. And then that would give the sort of flywheel Beller flow.
So very different in some ways than the kind of Uber playbook, which was like, okay. Let's land Beller density and then stamp it out somewhere else. Exactly. Very well said that. You must do this for a living. I remember these debates with you because it was like Yeah. This sort of some of these, like, marketplace models which are like, okay. Uber's very successful company. Let's copy that or kind of like Airbnb is very successful company. Let's copy that.
And I think the nuances around these different, you know, supply constrained or demand constrained or local network effect and global network effect businesses is requires very different very different playbooks. That's exactly right. And a low frequency marketplace versus a high frequency marketplace is also something that you really have to consider as your rolling out, you know, your marketplace go to market.
When you think about building a marketplace, you have to have all these considerations. Had we been building a B2B software company? We would have approached this entirely differently. Right? We would have gone hard at trying to create some kind of demand gen and then really been totally agnostic on what specialty or what type of provider And, you know, there are a number of companies in the space who've done quite well with that model, but that's just not the company that we are.
So I guess the last point is you need to know what company you're trying to Beller, both in terms of how you outline your strategy and roadmap, but also how to talk to find folks like you, Pete. Right? Because when founders are talking to investors, ensuring that you're being comped against the right type of company. Mhmm. Right? If you're looking at Sol versus any other SAS company that's B2B only, Yeah. You need to understand why things look different.
And as an entrepreneur, that's my responsibility to try and lay that out early. Right? Otherwise, there are more questions than answers. Yeah. Very kind of you to say that. So we talked a little about supply side and, like, was there any sort of catalyst or because this is obviously pre COVID. Like, again, the sort of selling into kind of the health care industry is you've done it. A lot of people say, don't cry avoid it. Like, is there any lessons that you learned from doing that?
Ultimately, when you're building out a sales organization, you have to look at there's obviously an enterprise sales motion versus mid market versus pure SMB or consumer. Yep. That will lead you down the path of developing one version of a demand gen engine to sale. And then, of course, there is sort of the difficulty of the industry overall. And so maybe Beller care Financial Services would be on the high end of that.
I would say the primary motion in health care The primary paradigm is you must sell to the largest systems to be relevant. And so as an entrepreneur, I recognize that that is not how you create liquidity in the marketplace. And, therefore, we had to orient on something different as we were building the company. And I got some great advice from Anne Wajikki when I was sharing hear what I was doing. And she said And is that 23 and me? Yes. Excuse me. The 23 and me founder.
And she said given what you are trying to do, you need to get to consumer scale very quickly because if you are not already validated by having big company x, y, or z, On your logos page, you will need to get your validation, both from the investor side, but also from the sales side, from your consumer strength. Now that is already what we were doing, but she just made it so clear.
And as we have, you know, reduced our sales cycles and gotten better at really driving a more efficient sales Morgan. The core differentiator of solve is, of course, a superior consumer experience and that we have in organic and engaged consumer audience who is looking to solve to get care.
So I don't know that I have a precise answer for you in that except if you're going to sell into health care, know what your superpower is going to be because no matter who they are, their SMB or the largest enterprise, they will ask you for lots of customization. They will try and increase the scope because once they like you, they want you to do more and more of course, that's a great signal as an entrepreneur, but you need to be very focused on what is the strategy powering your roadmap.
In our case, if you're building a marketplace so that you can get to that both supply side liquidity, which enables that consumer engagement. You know, and just to credit, you are truly you initially started running the consumer marketing business, and then you moved over the supply side, the real estate industry, it sells leadership, and so you ran that whole big function. So you've done both on the sort of supply and demand side. I'm switching gears to the demand side.
Is there any just observations about consumers in choosing Beller care providers because it seems to be very tough to present a consumer, a new product or service in this moment of urgent need, you know, if my son kind of falls over and I think he's fractured is armed, like, I'm not gonna go and, like, okay. Do a bunch of research about the best. I just want something that's convenient and available. Like, how do you get in front of consumers in that environment?
I mean, Pete, you just nailed it. What is we recognized that There is an academic version of how Beller care is supposed to work, which gets a lot of media coverage and a lot of academic conversation. And there is a way that consumers operate which is meaningfully different. And for many of our use cases, this paradigm of access and convenience being more critical to me than known provider is significant.
And it started in this red fiery hot tip of urgent care, but it is now as we anticipated, we're seeing that expand across multiple categories, whether that's women's health or mental health or physical therapy or primary care, because, ultimately, I want the care that I need. Right? And my orientation as a consumer is around those two dimensions on every other part of my life. Why should health care be different?
Mhmm. And so many companies in the Beller tech space will start with symptom search. 1 in 20. Actually, I think the new numbers are 1 in 18 Google searches are health care related. Woah. How's that for some SEO magic, a place that you can play? But what we realize is that our unit of value is the transaction. And so to play in that space, if you're looking up how do I take the splinter out of my child's hand, you're unlikely to have a transaction.
And so we decided to orient at the bottom of the funnel where we knew we could actually deliver on the value. And so that started by building a very relevant search experience across solve. Mhmm. Right? And much like Trulia, acquiring traffic organically, traffic directly, and through word-of-mouth, and then driving reengagement through our app and through our experience. So I'd love to make it sound more clever than that, but I think our insight was don't believe the hype.
Like, consumers are looking to solve a problem, and we can go and solve it for them. Yeah. And in doing so, build a relationship with them in order to be on the journey with them through more parts of their care. Yeah. Knowing the evolution of the product, I can see that now. It's like you're starting with a simple product experience. You're trying to kinda capture.
Once you've kind of, you know, engaged the supply side, you're trying to figure out all the channels for kind of, like, the work and that could scale to attract that demand to get that firewall going? Yes. And, you know, just like in real estate, You have the innovators who are the real estate agents or brokerages who are leaning Flint Trulia early on. And do you remember we got kicked out of the Prudential conference? Oh, yeah. With our marker man, troublemakers. Troublemakers.
There's little green startup for troublemakers. And so those were really useful experiences for me to have as we were building Trulia when we thought about the evolution of self. Right? And so recognizing that the titans with all the power might be less interested to begin.
So our strategy with them was to influence to be at the strategic table, but not necessarily for them to buy our product today because we wanted to validate we could get to scale and relevance and really provide an ROI on the provider side because that's critical in a marketplace. Both sides need to benefit and get to massive consumer scale, right, at a very high NPS around solving their core needs. Yep. And so that was our path to do it.
So just thinking with a lot of founders listening to the show and and I expect, and I see it a lot more, you know, eighteen year olds, twenty year olds who are kind of at university thinking about, okay, Pete opportunities for them are to impact health care in some way as opposed to building the next photo sharing app. Which is cool. I love photo sharing. Yeah. Me too. Love photos. But you know, bigger fish to fry and bigger opportunities.
That and let's say a 3 piece of advice you give to a new cohort of founders who are building companies in this broader category. I just actually talked to a group of prints and students all who are quite entrepreneurial, and it was so fun, Pete. Great. So fun to talk to these, like, young, hungry Beller. Who have none of the experiences or scars? Ours, and now it's all belief. Naive optimism. The most magical kind. So let me think. What would I say? What do you say to them? I don't know.
Tell me. What are your advice when you talk to these people? Well, I guess a few things. So, I mean, you talked a little bit about the mission of things. It's just like you know, maintaining positivity and endurance through the ups and downs requires this, you know, mission orientation, which is like you know, you had since the beginning. I also think that, you know, the bigger the problem, the solution is inevitable. And so it's just a question of time.
Like, you met ambassadors through the years that kind of, you know, good luck with that, Heather. But it's like, it's inevitable. It's just like these problems will happen. Has to happen. It's going to happen. Just question of, like, what is the catalyst to make that happen? I don't know. Those are the kind of 2 things that come to mind for me. I like that very much. Let me add 2 more. That I don't know would be my 2 best, but have come to mind for me when you are speaking.
One is the advice that was given to me, which is identify the consumer wave and accelerate that Right? I think lots of entrepreneurs think they need to create something totally new that doesn't already exist where actually if what you are trying to do is build something for the consumer you can often find what they are already doing in some inefficient way and make that way better for them as your catalyst to be able to acquire and engage them. Yeah. I thought that for me was very useful advice.
The second one that I would give is there is a narrative around what you should do with your Currier, and then you have a gut. On what you really want to do. Mhmm. I am not so dreamy to say, just follow your gut, but I will say balance the 2. Right? Balance what you think is the right smart thing to do next in your career with where your fire is because it's the combination of those 2 that can become really magical. Seen Pete, obviously, we both have.
Beller like my most frequent call that I get from former colleagues from Stanford is I'm in this job. I make so much money, and I'm really not into it at What should I do? And that's a waste of talent. So we all want to be prudent in how we manage the next step in our Currier. And so do that. Right? I'm a child of immigrant from the Philippines and Iran, and I don't have only dreams. I also have responsibilities, and I have a gut and energy around what I want to go do.
And where I've been most successful in my career is when I have paid attention to both. Yeah. That'll be my second. That's like where passion meets opportunity. And a bit of luck. Let's face it in different ways. It's like it's where the magic happens. Beller, on that note, Heather, that was amazing. So good to chat with you and hear the story and the highs and the lows. Thank you so much for joining us today on the NFX podcast. Oh, so great to chat with you, Pete.
And I can't wait to get together in real life. Very soon. I hope. Very soon. I'm sure. Okay. Well, thank you. At NFX, we believe creating something of true significance starts with seeing what others do not. Send this episode to any friends that may need these insights and frameworks, and feel free to rate and review us on your favorite podcast platform. Thanks for listening. The NFX podcast.