By: Steven Berman
Ari Brenner is the Co-Founder and COO of Stellar Health, an NYC-based healthcare technology company empowering providers and practice staff to deliver high quality care through real-time notifications and meaningful incentives, aiding in the shift towards value-based care and helping control healthcare costs.
Steven: How did Stellar come to be? What was the inspiration behind it?
Ari: We were a co-founding team of four. Three of us came together at the beginning, all non-technical. Mike came from Apax Partners, Ben consulted in healthcare at McKinsey before going in-house doing VBC (value-based care) services, I was also from management consulting and VBC tech/services. We were introduced to Octavian, who was a former Googler who subsequently was a technical cofounder of a large e-commerce company. When we met Octavian, he was specifically targeting healthcare for his next venture, and a VC firm put us in touch.
The three of us in healthcare all had our “why we did it” motivation, and for me specifically I came at this primarily because of passion for healthcare and VBC specifically. An anecdote I’ll share is from my consulting days, where I built experience and passion for VBC. I was consulting for a state (public sector healthcare initiative) and we had convened a grand group of stakeholders (insurance, provider, public sector, patient advocacy, etc.), and we were trying to theoretically work through what VBC should look like across the state system. We would have these big conceptual meetings and talk through things like ‘what is the appropriate amount of funding insurance companies should be providing to doctors to switch them to being VBC providers?’ There was this one practicing provider who sat on the governing board, and he would sit and listen and every once in a while he would exclaim, “this is not my reality, this is not what it’s like to be a doctor today!” That really stuck with me, because so much of the work I did in consulting was so conceptually good, but didn’t reflect the reality of providers who were being asked to make this change. I truly believe the concept of VBC – of holding providers reliable for outcomes – is great, but we haven’t put power in the hands of providers yet to do that, and I picture this doctor’s reaction all the time.
Steven: What was the biggest challenge in getting started?
Ari: A lot of healthcare founders will understand this: when you don’t have a track record with new technology, you need a large incumbent to bet on you and they won’t do it in a hurry. That classic enterprise B2B sales “chicken and egg” dynamic was hard. The first year or so, we had built a great Version 1 of our product, but could only land small pilots.
The positive side of this is, now 3 years in, we’ve had some real breakthroughs and confirmed impact on customer metrics with those incumbents, and recently, the network effects have accelerated. We recently had a potential customer backchannel with a current customer (directly through their network, without us actually making that intro), and we landed the contract given the power of a peer speaking directly about Stellar’s positive impact on their business.
Steven: Now that you’ve scaled how have the challenges changed?
Ari:The challenges that I personally work most closely on relate to implementation and scale, and there are two sides of that for us. The buyers of our services are large enterprise clients like insurance companies, who also have end-users logging into our software application who are healthcare practices of various sizes; and we’re scaling against the needs of both audiences. Regarding the enterprise side, we’re taking in magnitudes of new data constantly, which is required to set up our application and its point-of-care prompts. On the provider side, we are deployed in solo-doc practices in rural areas, as well as large multi-specialty groups of hundreds of doctors in urban areas and we serve them both with the same application. We’re constantly working to ensure everyone has a great experience. Scaling for both audiences, and delivering consistent impact while we do so is the summary of Stellar’s central challenge. The question we’re trying to solve is ‘how do we deliver this value at scale?’ There are many companies in my opinion that truly have great solutions built for VBC, but only are deployed at a small scale, and are not well-matched to the needs of most of the US healthcare landscape. We want to work anywhere – especially where starting sophistication with VBC is low.
Steven: The people you’ve hired have played a big role in how you’ve succeeded, how have you been deliberate about attracting and hiring the right people?
Ari: Our hiring strategy includes sourcing widely. We invest in the upfront pipeline, like by going to non-traditional sources when looking for talent, beyond our immediate network and referrals. We also spend a lot of time on hiring and interviewing, with more and more of my time these days spent thinking of who and how to hire. I think many would be surprised how rigorous our processes are. We give a lot of quantitative and analytical exercises on top of the more traditional fit stuff that startup companies tend to do when hiring. We do this because anywhere you sit in Stellar, there is a lot of analytical thinking taking place. Even our most junior employees need to be excellent analytical thinkers.
Steven: How do you ensure your culture stays aligned with your founding principles as you grow?
Ari: We have thought of culture as a continuous cycle. First, we figure out what we want as the core principles of our culture – theoretically. Second, as we expand, we listen and synthesize what we feel the culture actually is in practice (not theory). As we listen and observe and take in what we believe the culture is in practice, we then again message that out company-wide to ensure it encapsulates what everyone is feeling. Then, we go back to observation to see how culture evolves and do some course correction along the way. Overall, we believe that culture is lived – not told or instructed.
Steven: Providers can get labeled as being stuck in their ways, what has been the most difficult part about working with them?
Ari: I like this question! I do argue with the premise of the question, though. . . I think that providers are not just stuck in their ways, I think there is a second level here and that is they are simply very busy people. Most providers want to treat their patients and make them better, so anything that is knocking on their door and looking for their attention, it’s going to be easy for them to look at it and say “great… something new that is going to make me busier and take away from the time I have to treat patients.”
So a lot of our deployment is getting to an “aha” moment when providers realize, “this is not what I thought it was, this is something that will actually give me more time with my patients.” They’ll see that while there is some limited investment (this isn’t complete magic), quickly our platform gives them time back, and rewards them in the process. Once we get to that “aha” moment, they’re on our side. Our solution is purpose-built for getting to that “aha” as soon as possible. In one recent deployment, we worked with a doctor here in NYC who didn’t have a printer or a computer, until we got them both of those things through our implementation program. Now, that doctor is an ideal user of Stellar, logging in daily to review patient information and update action prompts, earning thousands of dollars while doing it.
Steven: How do you think Covid has changed digital health, and are these changes temporary or permanent?
Ari: I won’t talk about the stuff that is super common like going remote. Speaking more about the digital health space, we certainly saw the effects it had on providers in the tri-state area during March/April/May. It was an emotional and turbulent time, speaking to the personal impact, we had some providers in our network close their offices to go work in a hospital and be on the front lines. Many got Covid, and some are still out ill and recovering to this day.
With that said, though Stellar has adapted in certain ways, nothing has fundamentally shifted. Our lane is preventive care, including secondary prevention for patients diagnosed with chronic disease. Covid is not as much a VBC scenario right now – it’s primarily one where acute response is needed to slow down a massive public health crisis. For that reason, our marching orders have stayed solidly around improving preventive care. It’s stuff we work on with people with chronic diseases, or enabling patients to see doctors virtually, or helping providers support patients get their patients lifesaving medication for chronic disease. We also work a lot on how patients can safely get screened for disease on time, like getting them a home cancer testing kit. That’s been our rallying cry, and in response to Covid, one of the macro trends is actually an uptick in interest for VBC. This is because despite the prominence of the public health crisis, VBC is a way to keep limited hospital and emergency room resources available for the treatment of those with Covid. We believe VBC is becoming more important as we run to catch up with the months of preventive healthcare we lost in shutdown. With that said, depending on how the system evolves in the wake of Covid, I could see eventually tackling Covid (and pandemics generally) through a VBC lens (e.g., PCPs taking accountability for disseminating public health measures like mask-wearing and general hygiene habits).
Steven: Any final comments for those reading?
Ari: These days, I’ve gotten comfort and inspiration from the work I’m doing and the team I’m doing it with. I feel fortunate to be part of a mission-driven company, and I believe in the mission and I wake up -most days, though perhaps not every day – energized about the stuff we’re tackling. There is a constant set of quotes and anecdotes about our implementation work that hit my Slack and email, and each one is a bump of energy. I’m grateful for the team I work with for giving me this energy.