Providing the First to Last Mile of Care: Taking the Wheel as Student Entrepreneurs
Christine Yang and Sumun Khetpal on starting a venture as students, pitching a product as female leaders, and aligning incentives for stakeholders in healthcare. Christine is now a healthcare investor in early-stage ventures at NEA and Sumun is an MD candidate at Yale.
A significant barrier to health care is transportation, since it disrupts the continuity of care for patients. In fact, all healthcare stakeholders are implicated, as billions of dollars are lost every year due to missed appointments caused by transportation difficulties. Sumun Khetpal and Christine Yang are two of the co-founders of Ride Health: a platform for coordinating medical transportation.
Have a vision
Recognizing the problem
While volunteering at the Children’s Hospital of Philadelphia, Sumun witnessed a young patient who could not get home after chemotherapy. This shocked her, because getting to and from medical appointments seemed like a basic necessity, but also a problem that could be fixed.
In 2015, the existing transportation brokers were operating at a very archaic level. Logisticare, the largest transportation provider, was operating like a cable company — dealing with paper printouts and phone calls for ride dispatch. The major players (transportation providers, doctors, and patient coordinators) were not communicating with each other, and drivers used their own dispatch systems which did not integrate well with existing clinical workflow. As a result, many did not get to appointments on time or waited hours on end to get home, a horrible burden for patients. Although transportation can often be taken for granted, it is a major social determinant that has a tremendous impact on access to care for millions of patients.
Putting together the team
Sumun and Christine were involved in a healthcare entrepreneurship class at the University of Pennsylvania, and they began thinking about a solution to this pervasive issue. Through Christine’s work on the board of Wharton’s healthcare business organization, she came to know Imran, who had done research on NEMT. He joined the co-founders on building out the venture. Each brought unique clinical, business and health policy backgrounds to the table and with that, the early team was formed.
“There is always going to be a trade-off between quality and speed. It’s just about making the right decisions for the company in the long-term,” Christine reflects.
Having a vision, and acting on it
The team recognized that a tremendous amount of resources (USD $6 billion) was already being spent on non-emergency medical transportation (NEMT) yearly, but it was not allocated to be most beneficial to providers and patients. To get a sense of how large this market really is: 4 million patients missed their appointments every year. There were almost $4 billion in lost provider revenue alone from no-shows — “and this is just the tip of the iceberg.”
Patients that need rides are typically Medicaid and Medicare patients — some of the most vulnerable in the country. If they do not get access to the care they need, they are at a greater risk of getting hospitalized in the future, which translates to a higher bill incurred by health systems and insurers. The team found a solution to the transportation issue: a web-based platform to connect all of the relevant stakeholders (social worker, care coordinator, patient, insurer, and driver) to ensure that patients are being taken care of and get to appointments on time. Since the money was being spent on NEMT already, it was a matter of communicating a better solution, and convincing providers and insurers to get onboard.
Sumun and Christine highlighted the importance of optimizing your product and its placement by asking: what is your addressable market? What is your business model, and does it make sense for all stakeholders involved? How do you design a fit-for-purpose solution around the current workflow? They appreciated the value of laying groundwork for your business in the first couple years of founding:
“You are never going to have as much control of your company as you do in the first couple years,” Christine advises.
Doing the work to build the company at an early stage, and creating a really collaborative and transparent culture at your firm, Christine says, will set you up for success in the long run.
“When it comes to fundraising in the early stages, it’s less about valuation and more about having the right people around the table to help you build out your vision.”
Share your vision
Christine shared her experience as a current early-stage investor, which speaks to being a woman pitching to investors, and her advice resonates with us across industries and pitches. The founders had advice for pitching…
…as a woman
“You often have to walk the line between being too nice or too assertive. The role of an executive doesn’t naturally blend with the deep-seated social expectations for women which is why it’s so difficult to strike that balance. While we are miles ahead of where we were five or ten years ago, there is still a big gap to fill before women are on a level playing field.” Christine noted that she is consistently impressed by female CEOs and founders she meets and works with. In pitch meetings, she’s observed that women tend to be more prepared than their male counterparts and are often extremely qualified. But there’s this seemingly paradoxical trend of women getting lower valuations than men for companies in the same stage or industry.
Christine advises “When walking into a room as a female founder, be aware of inherent biases that others will have about you before you set foot in the room, and bear those in mind while you present. VCs have become a lot more supportive of backing female founders in the last few years. But no matter what situation you’re in, always know the worth of your ideas and experiences instead of letting others decide that for you.”
Christine observes that women entrepreneurs are often much more conservative and tend to aim a bit lower when asked for their valuations in negotiations.
“We need to do our own part as women as being our own advocates,” and she continues to urge to all women entrepreneurs and investors, “We are a team — every success is a collective success for the industry as a whole, so we really need to stick out for each other. We have much more in common than we realize.”
…with supportive investors
“Before I joined NEA, I had the impression that venture investors were just financial sponsors who took riskier bets. But what I’ve come to appreciate is that a truly great VC is going to help you with so much more than the cash on your balance sheet. They are going to be your sounding board when you need to work through major strategic decisions, they’ll extend their network when you build out your team and they are going to help you fundraise for larger growth rounds down the line. Your term sheet should be fair and reasonable, but if you’re in it for the long haul, your Series A valuation isn’t going to matter a whole lot to you. When it comes to a successful outcome for both the founder and investor, I would emphasize trust, experience, and commitment to a shared vision above all else.” Christine reflects.
…with an understanding of the status quo
“When you are thinking about building something new and disrupting an industry, you are asking people to change the status quo. You want to keep in mind that you need to understand who are the key decision makers, and align the incentives in the current system. Ask yourself why your solution is so much better than what is currently available that will drive people to your product. Essentially, you are powerless until you have those key decision makers on board.” This starts with partnering with your stakeholders to create a solution that is truly tailored to the purpose and the user. Sumun and Christine recognize that if a solution does not adapt perfectly into the already existing workflow of your customer, there will be pushback, and adherence will be a challenge.
…as a team of young students
As Sumun was working to bring Ride Health to New Haven, she walked into a meeting with a potential investor having communicated only by email.
Upon seeing Sumun, a female first year medical student, the investor remarked, “Wow, I expected you to be a 35-year-old man.”
Clearly, this interaction speaks to how people may envision healthcare entrepreneurs building burgeoning businesses, especially as healthcare leadership has historically been a relatively homogeneous field. Changing the image of what a healthcare entrepreneur “looks like” is something we at Theia support wholeheartedly, and we are excited to see more young female leaders pushing the boundaries of healthcare. But the investor was also certainly impressed by Ride Health, and his initial surprise shows how professional and prepared the team came off, even over email.
Christine and Sumun point out that, in this way, the student status can actually work in your favor. The team went into each meeting prepared, arguably more prepared than most of the industry might expect from college students. They had detailed questions, had bootstrapped their MVP, knew the investors’ backgrounds and interests, and approached each meeting as a learning opportunity. This approach helped the team blow the low expectations of potential investors out of the water.
A key piece of advice for student entrepreneurs from the founders of Ride Health is to leverage the opportunities available to you. Take advantage of all the pitch competitions and grants available. Use your student status to meet with important people in the industry that you are hoping to engage under pretense that you are a student looking for advice. Mentioning your institution can give you credibility and help you connect with alumni, who are a few steps ahead of you and can share very helpful insights. It goes a long way, especially for young founders.
…to your first degree network
The founders of Ride Health discussed the value of warm introductions through your first-degree network. The team reached out to family, friends, and professors, building relationships organically and inorganically. They say never take an opportunity to pitch or discuss your venture for granted, whether the person you’re meeting with ends up being a long-term investor or a one-time advisor. It is also vital to manage these relationships in the long run, as you never know what your mentors’ interests will be in the future.
“Be proactive in seeking advice but also have realistic expectations when it comes to mentorship. Show gratitude for every opportunity and go into those meetings well-prepared with questions and know their background and interests.”
Believe in your vision
As the team was excitedly getting their product off the ground, they came across a company called Circulation that had just launched; it was a direct competitor building a very similar product. Circulation’s team had decades of experience, executives from Uber and Harvard Medical School — “we were crushed. We were ready to throw in the towel,” Sumun recalls.
But the team was able to rebound from this setback. They shifted from stressing about what was already out there to hunkering down and believing in what they were building. This is an important reminder to all founders: it all comes down to execution. “No matter how many titles you have, it is about the product you build.”
The team’s confidence in its vision was really important for getting past this moment of weakness. Sumun and Christine reflect, “You need to assume that you will succeed. That really helps you get through these lows, and view them as part of the journey as opposed to a sign that it is not meant to be. You need to have a strong mentality, and that is why having co-founders is so important because you are all in it together.”
Build momentum in the face of failure
“All it takes is one [investor]. After there is one, then all the dominoes fall from there,” Sumun advises.
During the first year of Ride Health, there were a lot more lows than highs. They started off getting rejection after rejection in fundraising. Looking back, they realize that the question-answer period of any pitch is critical because it exposes points of interest and where improvement is needed. Over time, they iterated the feedback they got from advisors and investors and soon after got their first angel investors and were finalists in a competition at the Wharton School, which also gave them funding. They started to get traction, and they were approached by Uber in 2016 and were invested in by Startup Health in 2017.
Now, Ride Health is a venture-backed business with 30 team members and over $6M in funding.
“We got there eventually, but it did take some time and did not come without challenges.”
Through the highs and lows, Christine and Sumun found motivation in knowing that their work could improve patients’ lives — providing the first and last mile of care, while advocating for patients and addressing a key social determinant of health.
Theia is a 501(c)(3) non-profit dedicated to inspiring and empowering the next generation of women entrepreneurs and investors in healthcare. Visit our website to join our community and access resources that will support your entrepreneurial journey and pursuit of changing healthcare.
Story written by Luiza Perez and Priya Kumar.
