DGTL Voices with Ed Marx - The Next Right Action (ft. John Erwin)

Episode Date: August 6, 2026

John Erwin is the CEO and Founder of Carenet Health, a health engagement and virtual care company serving more than 400 healthcare organizations across telehealth, patient access, and clinical navigation. He describes Carenet's job as walking alongside the patient and making sure they take the next right action. Whether they need the ER or don't. Whether they picked up the prescription. The parts of care that happen outside the clinic, where most of a patient's health actually gets decided. In this episode of DGTL Voices, John tells Ed about growing a business from 20 people, why he believes the healthcare consumer has more leverage now than at any point in his career, and the two skills he credits for everything that worked. https://bio.marxadvisory.com/

Think about us as being that group that is walking alongside the patient and really making sure that they're taking the next right action. The healthcare consumer has a voice like they've never had. In my pocket, there's some real power that wasn't there. Everything we are seeing with AI and specifically the ability for the LLMs is opening up a world of expertise in the pocket of the consumer that just did not exist. Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marks. Welcome to another edition of Digital

Voices. Our guest today is John Irwin, CEO and co-founder of CareNet Health. John, welcome to Digital voices. Thanks, Ed. Glad to be here. No, I'm so excited to speak with you. You're a long-time leader in healthcare for a couple different companies. We'll get into that. And we really only met kind of through the social media aspect and through LinkedIn, but I definitely have followed you and all the things that you've accomplished and done. And so super happy to chat with you. But the first thing, John, maybe the most important question some people would say for digital voices are what songs are in your playlist? Like, what kind of music do you like to listen to? I was excited when I saw that question. I because I don't think I've ever been asked that.

So thank you for letting me. And once again, my kids will roll their eyes when they hear this. But it's the, and he'll see a theme here. The Harry Chapin, John Denver, George Strait, Billy Joel, Elton John. Kind of, I guess I'm stuck in that era. Yeah. It's great. And right now, you know, I don't know if you guys are doing this at all,

but I'm starting to see these cool shows that are coming out where they're showcasing these kind of groups. from that time. And it's kind of reigniting me. Like I saw one from Billy Joel the other day. I'm like, you know what? That's anyway. So that's my stuff right there.

No, I like it. I definitely can relate to a lot of that music. Yeah, and it's funny. It does come back around. You'll see people and, you know, successive generations come back to the good music. So if it's a good music, it's a good music, like a Billy Joel, right?

It's just fantastic. The lyrical content as well as the musicianship. And so you see those withstand the test of time. What about life message and mantra? Are there words that kind of guide how you operate, how you live? On the life stuff, I've been blessed with my wife to have seven kids. So that's been a real joy. They're all doing things that are just absolutely fascinating to me. So that's a big, big thing. And then, you know, I feel like I've led one of those charmed lives where everything has seemed to be. you know, whenever the coin could have flipped one way or the other, it flipped the way that

I would have maybe preferred it. So that's, that's been kind of how it's gone. That's kind of the, and then, you know, I think we'll talk more about business as we go through the day. And I have things there that are interesting to me. But I really, I really try to say, you know, we're all given some things that we're probably pretty okay at. And how do we, how do we figure out a way to grow that? So when you were getting married, what was the discussion? like when you talk about kids, was there always this hope for many? You're not going to believe this. I never talked about it. So I grew up with there were four boys. My wife was the oldest of six. And I cannot ever remember a discussion that her and I had about kids. I was I was kind of a typical guy. I was not thinking about it really. Now my kids are because we we talk about. about it with them. We're like, well, what are you thinking? And so my, my family, well, I don't know if it's

just because we had four boys. We just didn't talk about it. Yeah. So we honestly, it was never on the radar. Funny story, we had six of them. And then I kind of woke up. And there was a set of twins in the middle, a boy and a girl, which is my only daughter. There was, we had six. And I woke up, and I don't know what happened. They were, the oldest was like 10. And I said to myself, this, This is how, you know, guys think sometimes I said, I said, you know, if you have more than this, are you taking away from the ones that you have? That was a question. It just popped into my brain. And so I actually went to the kids and I started saying, I asked them, I said, you know, would you guys like another brother?

Are we good? And they looked at me like I had asked them, like, it'd be like, I asked them, do you want four kids at your birthday party this Saturday? are six. And it was like, is that a trick question, Dad? So while we as adults, we may think about things like resources and time and kids don't think that one. Yeah. So anyway, ended up having another child. I've learned now that I can't really tell that story too much because that number seven is kind of like, hey, if I was hanging in the balance here, that is not a good thing, Dad. Yeah. That's funny. That's hilarious. But there is a proverb that says, Blessed is a man who's quiver is full. So tremendous joy.

I wish I could tell you. I planned it. I wish I could tell you. But I got, once again, as those coins drop, the woman that I married, she probably had a pretty good sense of where things would go. And she's made that all work. Yeah, that's definitely key to happy life, no doubt about that. So yeah, tell us a little bit more, John. Tell us about you.

Like, where did you grow up? Interesting grow up. My dad was an army guy. and he was in recruiting and he loved it. And in fact, he made me go take the Army recruiting test in seventh grade, which I was successfully past that. But it led to us living in 13 places by the time I was 17. So even later in life, I went to three high schools, one in Minnesota, one in El Paso and then finished up in Omaha. So I can I can definitely attest that there are jostling that can occur as you grow up.

Thank God I hunt the four boys, all brothers, that, you know, we could kind of go anywhere. And now it's, you know, some people in that group that way, they kind of are nomads and they want to go everywhere. I'm personally very happy to stay in one place now. Like, this is good. We'll stay here. I had enough moves. But it was a fun upbringing. I can't say enough about, you know, we were in great little cities because it was recruiting.

We weren't really on bases as much. And it's, you know, the story of a life, right? My kids would all say, boy, I wish I could do that. And I'm like, well, you know, everything's different. Growing up, was there a pivotal moment in life that fundamentally changed your trajectory? I would say I had a passion for golf. I was a hockey player, and this is, you know, stuff that I thought was really, I loved sports. And I found out in hockey that at certain age, 13, 14, 15, there's a certain group of people that get bigger, stronger, faster.

And they were, they were just like cruising by. So I was like, okay, that one there, it's not going to work. And then on golf, golf is, you know, an incredible fun thing to think about and kind of how it looks. but I got to that place too where I probably got to an okay level as a 15, 18 year old. Maybe that's a call it a three handicapper or something, whatever. And I thought that just by working harder, I could maybe take that next level. And what I found out for me was, you know, there's just built in ceilings. Yeah.

And I had my level that I could get to. So it was really, you know, and today I'll talk to my kids about it because I've had kids that are played a little bit of college golf here and there and stuff. And I'll say to them, I'll say, you know what, guys, I am comfortable that I gave it my all. Yeah. I gave it 1,000 percent and that produced, you know, a 74 and it needed to produce a 69. So anyway, I'd say that's an interesting time. And the business, you know, like I said, we'll get up talking a little bit about that. But that's been fun too because I think those same ideas happen there. Yeah, absolutely. They certainly can mirror one another. Yeah, let's talk about, I want to talk a little bit about your courier and then we'll go specifically into CareNet Health. So you've been with two companies, which kind of unusual as well, especially now, both with West Corp and Carinette Health. So tell us a little bit about this.

Like, because that doesn't happen very often, right? but someone these days, if someone is, let's just say 50, they've probably been with, I don't know, I don't have a stat in front of me, but probably five different companies. But you stuck with two primarily. So tell us about some of the thinking and how that happened. Well, I feel super fortunate. I joined West as a 25-year-old after college and a couple of, you know, just, you know, where do you go in life? joined them and they really had an idea of some things they wanted to do from an expansion perspective and grow their company. And at that point, we were doing about, the company was doing about $17 million in revenue, West Corporation. And they said, hey, John, you know, we like some of the things that you've done. I had a background in contact center sales and engagement efforts back in

you know, college and the 80s. And so they said, you know what, we think we're going to expand our business. We were primarily, they were a company that took the 1-800 calls off of the TV. The old days, that was a big business. Yeah. But they said, you know, we're probably going to expand and get into more proactive sales and stuff. So as we do that, we think he'd be a great guy to run that. So they hired me and said, hey, let's get this off the ground. I spent my first couple, you know, year and a half in Omaha and then said, we did a study and found out San Antonio was the right place for the, for the location, end up being maybe the best home run that West ever had in terms of locations. We ended up having, I don't know, more than 5,000

people in this city. But so they, what's cool about that business and that company was the growth. I got to be there for taking the company from 17 million up to a billion, organically, really fun. The business that I got to run for them was. We got up to about 220 million and 17, you know, kind of Fortune 500 clients, but, but no two days the same, right? So it was, it was never one of those things where you felt like the dynamics were such that the road was ending. It was not that at all.

So it's super exciting. Great story went public and West just did, you know, fun, fun things. And after the billion dollars and the public offering, we started to buy some companies, and it was at that point that I had the smart idea, which really wasn't smart, I had the smart idea that I'm like, you know, I've been doing this for 20 years now in this kind of the world. What else is there in life? Am I, you know, I'm now 40?

What else is there to do? Yeah. And I decided to just go see what that next thing would be. What I didn't realize. And it came to true, I think, was while you might be good at, at one, thing, it doesn't necessarily translate. So I couldn't excel in the environment I was in and then run across the street and say, okay, I'm going to build pools or I'm going to, you know, start a, you know, cleaning business

or I'm going to, I mean, if you want to do that, you have to go back to the bottom, which I, you know, didn't necessarily have in my brain. So fortunately at that time, a health system here, Christa Santeroza, pretty prominent. the Texas, you know, Louisiana area, was divesting of a real small patient advocacy, you know, engagement business that they had built kind of around managed care. And they said, hey, it's not strategic to us anymore. We're just going to divest of this. And I looked at that.

And I said, you know, everything I just got kind of see happen in Fortune 500 is now coming probably to health care. You know, we're going to empower the consumer. We're going to use data. and we're going to get a little smarter about the next thing they might want to do. I just was real excited. Technology is going to play a huge role in where the future of the relationship with that health care consumer is going to go. And it, and it was, you know, you know, how entrepreneurs are, the excitement that you have never quite matches the reality.

So several years in, as we are losing lots of lots of money, and, building, you know, a great platform vision idea, well, the health care buyer tends to be very slow. Yeah. So, you know, you can run out of money before you can make it. And we were very, very fortunate there. We're about five years in some very, very, you know, important companies around the country started to think about the kind of things we were doing. And we got some really, really fortunate, great clients that ultimately led to us getting on a very fascinating upgrade in terms of just where the market's going. And I would tell you today,

and maybe it gets into this in the podcast, but the moment we are in today is like nothing I've ever seen. And I can talk about why, but I don't want to, I'll let you get me there. But that's the early days and kind of how I got here. And it wasn't always pretty, but it seemed to go the right way. At what point as you're sort of working your way up the ranks did you think or did you ever think, hmm, maybe I could lead this. I could be CEO. Well, West was fortunate because as a very young guy, they put me in the role of CEO, founder, president of a new business. So it was just me.

So I thought I was really great. And it was just me. And I didn't realize, hey, I was CEO of me. So I got that opportunity as super, you know, young age to then grow the company around me. And then ultimately with that company in a 10-year period, we had 10,000 team members. So I kind of was on the rocket ship and it just sort of lifted me up. So that happened. And then kind of the same thing happened with this company where when we acquired it, it had 20 people. So I was once again going kind of back to that. Yeah, no, that's remarkable.

Yeah, so let's pivot now into KERNet. And you were saying there's no moment like today. So, yeah, tell us what's going on. Like, how are you viewing the world and tell us about Karenet? We feel with our, you know, we're primarily invested in three markets. So very, very excited about the provider space, health systems, really, really big growth area for us. Health plans has always been a cornerstone. and then the technology, health services type companies, you know, the CBS kind of companies of the world.

So we love the places where we're able to come in and be a partner. In any of those verticals, our role is to come in and be the engagement, clinical, non-clinical support for the patients, the members, anything outside of the clinic or anything outside of the hospital. So as you think about our business, think about us as being that group that is walking alongside the patient and really making sure that they're taking the next right action. Maybe they need to be going into the ER. Maybe they don't. Maybe they need to have a primary care physician.

Maybe they don't. Are they taking their medications? Have they gone and picked up? So anything around the health care concern? consumer, we're going to get involved. And so we do that today for about 400 really prominent healthcare customers. And what's really fun is I was sharing with you, there's a couple of things emerging right now that I think are just so fun. One is the healthcare consumer has a voice like they've never had. We're seeing it with, you know, the consumerism that's happening with GOP ones. We're

seeing it with the ability for the exchange to open up, hey, now I have my own policy. It's not just with the employer. We're seeing it with the innovation in the MA plant. So the consumer is at this fascinating moment where they are starting to understand that this is a really important benefit. In fact, I was reading an article on the Wall Street Journal two days ago and it said something to the affect the 25% of employees right now will not leave their company because of the health benefits. So as the consumer is realizing the value of that in their life, they're starting to emerge or want more. What does that mean for me?

In fact, my wife and I were having this conversation yesterday, and the topic was the movement around health care concierge and whether that's interesting or not. And I said, you know, from my perspective, if you will use those. services, probably wonderful. If you don't use them, probably not. It's wonderful. So the moment there, and then the other moment is really around technology. Everything we are seeing with AI and specifically the ability for the LLMs is opening up a world of expertise in the pocket of the consumer that just did not exist. Yes.

My mom went through a new hip 13 days ago, and I took, just because I'm having fun with AI, I'm learning, I took every single snippet of info. And I just fed it into my perplexity. And I just said, tell me what's going on. And images and you name it. And she had some complications and nausea and things. And I just uploaded it. And as that thing started to tell the story, well, all of a sudden now when we go in and

meet with the doctors at an ER or we go in and meet with the other. doctors, well, the story is kind of unfolding in front of us. Yeah. And I don't think that's ever been possible. No. I have a son who's in medical school right now, and it's fun to banter with him, and they're learning, you know, all the conventional things about being a doctor. And I'm kind of like, hey, I don't want to say this, but in my pocket, there's some real power

that wasn't there. So anyway, I just think this moment, if you think about it, and I think we're seeing it where the consumer is being unleashed in a way that is just fascinated. Yeah. No, I agree with you. We're very blessed, you and I and those that we work with to be in a service where we help humanity, help other people. And there's nothing better, more gratifying than that. and then to see kind of the fruition of what we've always wanted, right, was the engagement that you talked about from patients and now with the tech and just the capabilities. We're very

fortunate to see all this action happen, you know, so it's exciting to be in the middle of it. And care net health, you all are helping your companies and hospitals and payers help drive some of that. So that's pretty cool. You're also doing some international growth. So tell us more about that. And then how do you evaluate? Like we were talking off camera about some of the podcast that we listen to. So maybe get some intel from some of those podcasts. But like, how do you make those evaluations and decisions? So thank you for asking about the stuff we're doing around the world. So as we think about health care and some people maybe are closer to this than others, as a country, we're spending about $17,000 per person per year. And I know I will

say that to people, and it's surprising, I guess, to me a little bit, that that's kind of like new information. But it's really not. It's a $5 trillion market, and we have 300 million plus Americans. So it's really clear. And not only we're at $5 trillion, all the smart guys say in the next 10, 12 years, it'll be $9 trillion. And we just throw those numbers around, but the $17,000 to me is really meaningful. If you look at the cost of the system. And our role, we looked at it and we said, can we start delivering really good services

around the world to the U.S. consumer? And so it was funny, I was on a phone last night with Delta Airlines. And as the lady picked up and she had a really fancy kind of British sort of, you know, accent. And I said, well, I think you're in, South Africa. She goes, you got that one right? And then it was KTATO. And I dropped the phone and I said to my wife, I said, you don't really understand this money. But Delta is now able to use those services for 70 or 80% less cost than the U.S. And so we said that's a movement for health care. And so we opened up in the Philippines a few years ago. We made an acquisition in Latin America with, you know,

Spanish being a pretty key importance and also has locations in the U.S. for Spanish there. Then we also opened up in Trinidad and recently, and that's been fantastic. So it's just a two or three hour flight from Miami. And then about, you know, 60 days ago, we made a phenomenal acquisition of a really cool company in South Africa with another 2,500 team members, only servicing U.S. healthcare. So as we unleash that consumer and as we think about where it's going, we want to guys to be the ones that are leading with the tech and leading with the value prop,

where our clients can pay 75% less for services that are outside of the clinic. So if they can save in some of the administrative costs, if they can save in some of the pennies and nickels, well, the idea is invest more in your clinicians, invest more in the, you know, get more people to come into the. So as you think about it, we get to have a pretty cool role to take a burden off of our client, hopefully do it, you know, with really cool tech and really great people. And then all of a sudden, they look at it and then really save. And then we saw that happening with technology probably 30 and 40 years ago. We saw that movement.

It's, I think it's here for health care. It's a good moment for that. And we, once again, as a company that is trying. trying to help a client and to help a client be successful, they can have a United States price point and they can have an international price point. And they might be literally five times different. Yeah. And so we don't honestly tell clients what to do. We just say, hey, here's kind of the options and try what you like. Yeah. Love that. Yeah. And I'm sure we don't have time to go into it. But I'm guessing, because I've done a little bit of this myself in the past as a

I'm guessing that the quality, there's not a difference in the quality. You know, we're part of the richest country in the world. And what's important here and what we're willing to get excited about, if you go to South Africa, you know, and you have the same role, you might have a hundred people wanting that. And the U.S. you might have tech. Right. Yeah, it's pretty fascinating. Yeah, that's great.

So you mentioned tech. So I'll have to ask, you know, we're digital voices. and were categorized under tech. So I have to ask you one sort of tech question. So yeah, you alluded to it already, AI and other capabilities. What's one like tech capability that you're particularly proud of that Karen Ann Health has, you know, grabbed onto to help clients or help internally? I think our secret sauce on tech is all around the CRL.

So we invested and have 200 technology professionals. We invested very early and continued to invest in. the idea that we have our own version of Salesforce, if you will, that brings in a very robust all 400 clients sit on the same platform. It allows shared services. We've made 10 acquisitions. We allow those to be weaved into the tech platform in a very unified way. So our secret sauce is really around do we have the right CRM, customer relationship

management platform so that when we get more insights, we get more data, you know, the APIs that our clients have, the partners that they have, how can we integrate it? Because our vision is really how do we put a unified picture of the healthcare patient consumer, you know, including things in the EMR, how do we speak to them and how do we touch them? So it's really important that, you know, we know what's going on. Do they need a primary care physician? Are they taking their medications? Is there things on the health plan that they are eligible for that they haven't signed up for?

Do they have an emergency at 3 in the morning and need to speak with one of our clinicians? And then can we connect them to their own doctor? So as you think about it, for us, it's how does technology enter into that journey with that health? Right. And we've all seen it with Amazon and with eBay and it's gotten to be where it's just so fun. You know, I'm like the other day I had an epiphany. We ran out of something at the house and I was like in 10 seconds, I can order it on Amazon. And I have to think about it. I don't have to put it on a grocery list. It's here. That's that. That, and then telehealth was a big moment. I think for for the country with COVID, where everybody realized do I need to go into the to the office or can I I just, can you just call me?

So we, we feel like we're a gateway to that patient's journey. And it's, it's just starting. I think it's just in the early innings, you start thinking about, you know, stuff that you know very well, things like simple things like price transparency. Great idea. But if it's not served up at the right time with the right discussion, it doesn't help. Right. So that's, that's, that's, that's, that's our.

That's our one tech thing. So, John, we've gone through this where your career and you've done great, you gave us great examples, how especially early in your career, you took these businesses and you really grew them. What would your advice be? Like, what are one or two skills that you think helped you the most? So people listening, you know, maybe early in their career or mid career. And they're like, man, someday I want to be like John Irwin. I want to be leading companies or experience this type of growth. What are one or two key skills that you think? enabled your success. Two things. One, never underestimate the need to be in front of customers and be talking to them. Never underestimate that because at the end of the day, no business has anything going on if customers aren't excited and happy and wanting to do more stuff with you. So always put that as a, and my kids, you know, they're always coming to this new idea. And I'm like, well, go try to sell it. If you can sell it, that'll help, right? I mean,

Good news. And then number two, I'm a super big believer in the power of suggestion. So as you're charting your career and you want to be an entrepreneur, you want to grow, you want to do this, you know, I think and believe in the idea that plant the seed that you can actually get much, much further than you ever thought. Yes. Yes. dream so, so big that you don't even want to tell people you're doing it because it's like, it's too crazy. And the reason I believe so much in that is I think there's there's things in us that actually get in our way. And we have to give ourselves permission to be okay that that could be possible. So those are two. I mean, to me, it's, I have, there's so many executives I've worked with over the years and there are

so far ahead of me in so many ways. But rarely do you run into people who are thinking big enough. Yeah. No, I love that. That's great advice, especially being in front of customers as well. I think as we grow in our careers, we tend to forget that and lose focus. And I think that's very hurtful. This has been amazing conversation, John, learning so much about you, what makes you work,

and also quite a bit about KareNet Health. What did we miss? Or anything you want to double down on, I'll give you the. the last word. I think we covered everything. I think you did a great job of just kind of outlining the ideas. I think, you know, one simple thing that I've used in the many, many years, and since we just finished the NBA finals and everybody in the country, I think, was rooting for the Spurs. I will say, one of my lines that I like to use in our company for the last, who knows how long, is I say, you know what, we're building a version of the Spurs. So how do we put the performers and

and get ourselves positioned to where the magic can happen. How do we add those right pieces and how does that chemistry come together? And it's really fun to me to kind of think about business and sort of the Spurs in the same way because, you know, we're going to be doing better. We're going to have more success if this is fun. And I think the Spurs showed us that this last year. I woke up, but I wasn't paying attention. Honestly, to the team, I had lost touch from Tim Duncan and all three.

years and my kids said Dan Gini started watching this is really good. And then everybody got caught up in the magic. But just recognizing that this whole journey we're on in the business world isn't that different. You know, let's get some great people. Let's let them see where that goes. And there's good and bad. And you know, we're going to have rough seasons. We're going to have things where we can't even believe this was possible.

But that's one of the things I've enjoyed. Love that. John, Irwin. Thank you for being a guest on Digital Voices. Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection, and connection. Subscribe on YouTube, Apple, and Spotify Podcasts so you don't miss an episode.