This Week in Startups - Meta cuts 11K employees, Binance/FTX fallout + Homeward CEO Dr. Jenny Schneider | E1608

Episode Date: November 10, 2022

J+M start the show by breaking down the two biggest stories in tech: Meta's 13% RIF, impacting 11K employees (1:23) and the Binance/FTX fallout (19:21). Then, Homeward CEO Jenny Schneider joins Molly ...Wood for another edition of The Next Unicorns! (40:35) (0:00) J+M tee up today's topics! (1:23) Meta lays off 11K employees (13% of the company) (14:20) LinkedIn Jobs - Post your first job for free at https://linkedIn.com/unicorn (15:45) Alternative strategies for Meta (19:21) Binance/FTX fallout (28:14) OpenPhone - Get an extra 20% off any plan for your first 6 months at https://openphone.com/twist  (29:40) Impact on crypto VC (39:13) Coda - The all-in-one doc for teams, sign up for free at https://coda.io/twist (40:35) Homeward CEO Jenny Schneider joins Molly Wood to break down why she started a company that provides healthcare services to rural areas in America (49:15) Challenges for Homeward (57:42) Breaking down Homeward's business model FOLLOW Jenny: https://twitter.com/dr_jschneider FOLLOW Jason: https://linktr.ee/calacanis FOLLOW Molly: https://twitter.com/mollywood Subscribe to our YouTube to watch all full episodes: https://www.youtube.com/channel/UCkkhmBWfS7pILYIk0izkc3A?sub_confirmation=1

Transcript
Discussion (0)
Starting point is 00:00:00 Okay, everybody, it's Wednesday. We have big news, massive layoffs at Meta, and then a ton of drama between Binance and FTX, the saga continues. And on the second half of the show, Molly. And on the second half of the show, we have a phenomenal builder creating real solutions with real value in the world that people really want. It's like a little bit of a yin-yang situation. We have another segment of The Next Unicorns with Jenny Schneider of Homeward,
Starting point is 00:00:26 which is a startup bringing healthcare to underserved. rural parts of America. It's going to be a great show. Stick with us. This week in startups is brought to you by LinkedIn Jobs. A business is only as strong as its people and every hire matters. Post your first job for free at LinkedIn.com slash unicorn. Open phone. As a startup founder, a lot of mistakes are easy to roll back, but using your personal cell phone number as your company number isn't one of them. Open phone makes it easy to get business phone numbers for you and your team. right on top of your existing devices. Visit openphone.com slash twist to get 20% off your first six months.
Starting point is 00:01:08 And Coda is the all-in-one doc for teams. If you've got a stack of niche workflow tools or if you're buried in docs and spreadsheets, Coda is the dock that brings it all together. Startups can sign up for free at coda.io slash twist. Good morning, Molly. It is Wednesday. It is Wednesday. Yeah. Um, hey, how about that election night?
Starting point is 00:01:32 I know it's just. The word bloodbath has never been thrown around so flagrantly and with so little meaning, it seems. I mean, what, who's having a worse time right now? Republicans, people being laid off for crypto. I mean, it is chaotic out there. It is absolute chaos. Well, that's- Absolute chaos.
Starting point is 00:01:56 Or Putin. He's having a terrible day, too. Yeah. You'll see retreating or something. I mean, I can't even keep up with the news cycle. They're retreating from like the only capital that they managed to claim. Well, here's what happened. I woke up.
Starting point is 00:02:09 And the first thing I see across the newswire, of course, is meta, the Facebook corporation doing a massive amount of layoffs, as everybody knows, on Sunday night, based on the news that massive layoffs were coming, I put in a J-trade at a market order up to 5%. So it was at $91, I think. and I closed at $49, $95. Today, I think it's the best short-term J-trade of me because it's gone up $7. On the very sad news, but very pragmatic
Starting point is 00:02:41 and healthy news that meta has laid off. I saw two different numbers now, $11,000 and $16,000. We'll go with the $11,000 number for now. Yeah. Maybe you could queue up for the audience what Zuckerberg said since he was never going to do this, and then he's definitely going to do it and now he's done it.
Starting point is 00:03:02 Was he never going to do this? People, I mean, that was why Brad wrote his letter, right? Like he's not listening, he keeps hiring, and he's got his head in the sand. And then two weeks after, maybe three weeks after Brad wrote that letter, here we are. This is one of the largest layoffs I've seen in the history of tech.
Starting point is 00:03:17 I don't know if I've ever seen a bigger layoff from a company that didn't shut down. Yeah. So Meta laid off a little over 11,000 people according to the letter, the most recent version of this letter that was posted. There was some confusion. We should clarify what we're talking about here. There was some confusion because Brad Gersner, who authored that letter from the open letter
Starting point is 00:03:38 from the shareholders, posted what was probably an early draft of this internal Facebook note. And it said 16,000 employees. So that's where this confusion is coming from. But the latest number that is in the news is about 11,000. And we should say that this is significantly. more, I think, than even you predicted, Jason, and that, you know, we had heard it would be sort of many thousands.
Starting point is 00:04:01 It's 13%, I think, of employees. But there were 86,000 employees when we talked on Monday, I believe. Yeah. So you were like, they might do five percent? Five to seven. I was like, 10% would be 8600, obviously. I was like, that's a large number. This is over 10%.
Starting point is 00:04:18 Yeah. 13%. It's bananas. So the letter says from, Mark Zuckerberg, today I'm sharing some of the most difficult changes we've made in meta's history. I've decided to reduce the size of our team by about 13% and let more than 11,000 of our talented employees go. We are also taking a number of additional steps to become a leaner and more efficient company by cutting discretionary spending and extending our hiring
Starting point is 00:04:41 freeze through Q1. I want to take accountability for these decisions and for how we got here. I know this is tough for everyone and I'm especially sorry to those impacted meta stock. as you mentioned is up about 8% on the news. And there are a couple, I don't know, I thought there were a couple of notable things here and probably the most notable is that this is not a, in no way does this letter signal any shift in direction for the company. Right?
Starting point is 00:05:12 Like he talks about how they're going to spend less, but also quite specifically says, fundamentally we're making these changes for two reasons. Our revenue outlook is lower than we expected at the beginning of the year. and we want to make sure we're operating efficiently across both family of apps and reality labs. Right. So it seems as if, you know, the two divisions, if you will, the two companies within a company are being impacted relatively equally.
Starting point is 00:05:36 There were reports of a decrease in overall spend that was not super significant. So there are tons of expenses outside of employees that can be cut at these companies, obviously. And he did tip his cards there. So if we look at what's happening here, Molly, I think we talked about how startups would make the cuts first. You know, later stage startups would go next. And then we wondered, Apple, Google, Facebook, meta, you know, Google, who's going to take the medicine next? Or if they will even need to because they have so much cash that they can ride this out. But the stock market has said we're not interested in companies with declining earnings.
Starting point is 00:06:19 profits. So you got to, if you can't make the money you said you were going to make, the top line, you're going to have to cut the bottom line. So here we are. All these hiring freezes were talked about. We didn't actually see them in the numbers. And it's pretty clear to me that when the stock dipped below $100 that Zuckerberg was going to do something. I didn't think he would be able to maintain his team and the enthusiasm of the team if that stock kept going down. And I think that is what shook up his reality, is that the people around him, who's net worth, you know, probably instead of his going from whatever, $75 billion to $25 billion, it's still over a billion dollars, who cares? Right, right. But if you were somebody working for him who's an important person who's got a million dollars or $3 million and your $3 million turned into $500K, like it just materially changes your entire life and your entire planning of your life, you might have been thinking about retiring at 60 and now you're thinking about working to 72. And I know these are big numbers, so I'm not like unaware of that fact. But here's the next piece. So we always try to look at what happens next. The next piece is going to be massive austerity measures.
Starting point is 00:07:30 There are people in rooms at Facebook right now, Google, Microsoft, who are saying, bring me every expense in this business. And they say, oh, we got this retreat. We got this sales conference. We have this travel policy, business class, first class, five-star hotels, four-star hotels, depending what city you're going to, depending on what level you're on. We have free food,
Starting point is 00:07:51 we got lots of real estate, you know, we do your laundry, all that stuff is in the process of being ripped out right now. Yeah. And that's, you know,
Starting point is 00:08:01 a bummer for people, but it's not as big of a bummer is losing your job. And then as I've said, we'll know that this is a seriously acute situation. When Zuck looks at the salaries of people
Starting point is 00:08:14 that were ballooning over the last couple years, and he just starts resetting salaries. That's very hard to do. You hire somebody at X price. You tell him, hey, listen, the reality is I can hire two of you for X price or reality is now there's those laid off people.
Starting point is 00:08:28 You're going to have to work harder to earn that salary. And that's the process that we're going to see next. I predict is this doesn't turn around. Salary cuts are next. And that is, I have not seen, I'm trying to remember when I left. You've brought up salary cuts a bunch of time, but I've never seen that. dot comera.
Starting point is 00:08:48 I mean, doccomera in tech. Yeah. In tech. In dot comera and tech, a bunch of people were brought into rooms and said, listen, we're cutting salaries across the board,
Starting point is 00:08:58 25% for the top people and everybody below this, you know, threshold of comp is going to be cut 10%. You know, so usually like the top folks get hit harder at the bottom folks that are yada yada. And it's a way of doing like a final riff. It's the, it's the final riff.
Starting point is 00:09:14 It's the, you know, sorry, but there's no more people we can cut or this business is not functional so all we can do is now make cuts to people's benefits real estate, whatever it happens to be. I'm not saying that's guaranteed
Starting point is 00:09:27 because I didn't see that in 2008. I think people are very... Yeah. That's like the last ditch effort, but what people might do in this situation, you might cut deeper and then hire people for positions at what will be the new reality
Starting point is 00:09:40 in Silicon Valley. If they're not great. So now it's up to every employee and team member to look at this like you're on some ship in the middle of the ocean. There's a limited amount of provisions, and everybody's going to have to do more for less. And this is when things can get really ugly.
Starting point is 00:09:59 Like it makes it really gnarly to run these companies. And I saw it during the dot-com era. Unquestionably, tech recession. Unquestionably, these layoffs are going to continue. But I think increasingly what you're going to see is the profound difference between the companies that, you know, you don't see Apple having to do this. You see Microsoft making a targeted small number of layoffs that are probably performance-based.
Starting point is 00:10:20 You see Salesforce laid off a few hundred people and specifically said, this is for performance. Like they're taking, you know, they're taking the wave of downturn as an opportunity to get rid of their low performers. But then you have meta and then you have, let's say Twitter, which has a bunch of bills to pay that it didn't have to pay before. And meta is a company that has plowed a bunch of money into a pivot. and has to make these cuts and shows no sign of backing away from the pivot. So what we're really going to see with any downturns is all a long way of saying, with any downturn, you see whose strategy is working. Like there are companies who are bloated and who are having to lay people off.
Starting point is 00:10:59 And the, you know, CEOs are apologizing for that. And they're saying we didn't totally see the growth. I see no sign. Jack said I hired way too many people. Jack did that. Patrick Collison did it at Stripe. They, you know, they really were like humble about these layoffs. Yeah, I will say, I see.
Starting point is 00:11:15 no sign of Zuck taking the medicine here, and I see all these employees suffering as a result. Like nothing about this. Even the stock pop, I'm like, I don't know why you guys are buying this. He is going to continue to plow money into the metaverse. And reality labs, and I see no sign that he has been humbled in any way.
Starting point is 00:11:34 I think he is making a large sacrifice to try to keep his godkingdom alive. Gosh, you know, you sound like me. I actually think. I know. now you're a shareholder and you're like, no, I never give him, I very rarely give him any credit. I actually think 11,000 was more than I expected him to do. I thought he was going to do five or six. Yeah, because he's trying to get these, he's trying to get Gersoner off his back.
Starting point is 00:11:56 Or just being, so he can go right back to doing the same stuff. Yeah. No, I'm going to take a different, I'm going to take a different view. I think what happened to him is like, he just is going to have a hard time keeping people motivated, if that stock price keeps going down. So I think this is very simple. If your stock price is going way down and the people who work for you who are talented, did start looking at other options like starting a startup or just retiring rich. That's the big issue here. And people were hiring, I think actually Airbnb did the same thing.
Starting point is 00:12:25 People were hiring with expectations of colossal growth for two years. And whether it's the pandemic or the market downturn and this recession, people got in the habit of hiring two years out. We've talked about this before. And if you were hiring for two years out, you might have had twice as many people as you need. You might have had three times as many people as you need. man, that is hard to digest.
Starting point is 00:12:46 And that means, you know, these 10, 15% rifts are just not going to get it done. And I actually will predict Apple has the hiring freeze in place now. They got pretty serious about that. When people do these performance-based things, that's a way to get rid of five to 10% of people. I talked about this many times. And this isn't like, I'm some Machiavellian guy, like suggesting this. But I do think the reason why some people are doing these moves to, hey, come back to office, is as a loyalty test
Starting point is 00:13:15 or a gentleman's riff. As I've said, like the performance stuff, come back to the office. Some of these have, you know, loyalty tests as gentlemen's rifts vibes to them for me.
Starting point is 00:13:27 And I think it's a way to just get an extra three to five percent to opt out, right? Or just making people work harder. That's the other thing. This town has never worked so little in my experience of 30 years in Techmen.
Starting point is 00:13:40 The last 10 years people have been phoning it in in large part. This industry, 20 years ago, people were in on the weekends, people were in at night. I know it's like a different generation now, but I think that's what we might be heading back to. And that's another discussion
Starting point is 00:13:56 people haven't started having yet is what happened to like the 60, 70 hour crazy maniacal tech industry? It's like, oh. You'll never get me to co-sign that. Like, I don't think that's healthy. You were here for it. Yeah, you were here for 20 years ago.
Starting point is 00:14:10 Yeah. I'm not necessarily endorsing it. But I'm just saying people are going to be. A lot of those executives like had heart attacks in their 60s after doing all of that. So like, nah. All right, everybody, LinkedIn jobs. We have to talk about the downturn right now. There is one silver lining for all of us running businesses, especially small businesses or nascent companies. You know, when you got that half dozen dozen people, the talent pool is getting stronger and stronger. And people are looking for interesting companies to go work for. And that's where you come in. And that's where LinkedIn's going to solve. all your problems. When you run a startup, you run a small business, you know every single new hire is high stakes. So you have to ask yourself, what if I hire the wrong person? What is that going to do to my team? My team dynamics? Well, that's why you have to check out LinkedIn jobs. There's so much great talent out there right now, and LinkedIn jobs helps you find the right people for your team, and they help you do it faster. Now, you want to be 100% certain you have the right candidate
Starting point is 00:15:07 pool that you're looking at. Well, that's LinkedIn. You're talking about over 800 million people are there. use screening questions. Ask people thoughtful questions. Hey, what do you, if you were a podcasting company? What do you love about podcasting? What are your top three podcasters? And why? Hey, if you're an app company, have you downloaded our app and what do you think of it? And maybe give me some feedback. So that will help you filter the people who really want to come work for you, who have that passion. LinkedIn jobs helps you find the qualified candidates you want to talk to faster. Post your job for free at LinkedIn.com slash unicorn. That's LinkedIn.com slash unicorn to post your job. for free. Terms and conditions do apply. I want to go back to the original point though about
Starting point is 00:15:46 meta, which is like I'm not sure, like, yes, 100%, but is stock price the same as strategy in the long term? No. Like stock price, it gets investors off your back. If the stock price goes up, you get a little extra capital to keep doing what you're doing. But I do not see a strategy change from meta specifically right now. Is the reason you believe that's because he didn't specifically say we're cutting this amount from the lab's portion of the business. Because he wasn't like, I'm going to, we're going to, you know, we're going to refocus energy on the core part of the business that makes us all the money, know that we're going to have. Like, if there had been a spinoff, if he was like, this is now our R&D division or like labeled it in some way like X and made it its own business division that was, but instead, you know, he's like we've shifted more of our researches. I'm reading from the letter onto a smaller number of high priority growth areas like our AI discovery engine, our ads and business platforms and our long term vision for the metaverse.
Starting point is 00:16:40 Those two out of three are the legacy business now or the existing business Well, yeah. Yeah. I mean, actually, maybe I give him credit for that too. That sounds like actually when they wrote that, they were thinking of Wall Street or, you know, the Brad Gershner's of the world. Like, let's give them their raw meat.
Starting point is 00:16:57 Two out of three things here are going to be about the things you're talking about. There's an argument if you believe that Facebook and Instagram are not going to be growing businesses and they can't compete. There's an argument to cut really deep there and manage. them for profits, just like squeeze every ounce out of that business, which is what AOL wound up doing eventually with the dial-up business. They couldn't make it grow as a broadband. And they were just like, you know what, cut the 10,000 support operators, cut as many people who are involved in the dial-up business. And then they used all that funding to try to build the content
Starting point is 00:17:30 business, which the company Weblogs Inc that they bought of mine was part of, right? So that was, I actually watched that up front. They took that, wow, I never even thought about that. what if they just said we're going to keep cutting even harder on Facebook and the Instagram businesses to just run them for profit, right? And just throw off profit. So you're right. That's what they've been doing. That's what they've always done. And the margins were insane. Facebook, like, this is why the stock was so high in the first place is that Facebook and Instagram throw off profit like crazy. And the only reason they don't now is because of the huge increase in spending $15 billion, I will remind you, on reality labs.
Starting point is 00:18:06 Yeah. This is the other thought test that people are having right now. Silicon Valley, what would be the minimum amount of people to run WhatsApp? And when WhatsApp was a private company, there was something like 50 engineers working on it for 500 million users. It turns out, like some of these apps, you could literally run one engineer per 10 million people with the right engineers. And so these companies have gotten hugely bloated. And I think that's going to be, if this gets really acute over the next six months,
Starting point is 00:18:34 I think you're going to see some people even move to that. This could get even darker. This may not be the end. This may be the beginning. We agree there. Absolutely. Sorry to the people who lost their gigs and again, usually they land on their feet. Will this time be any different?
Starting point is 00:18:53 I mean, now you're talking about potentially, you're talking about tens of thousands of people coming out of work at the same time. Like landing on your feet. Let's just say there's going to be some real painful roles in between. Do you know people in your circle who have been laid off right now for many of the, no? If anybody wants that, you know. know, let us know anecdotally, like, what they're seeing. Because, yeah, it used to be if you left a company, you had three other options. I'm wondering are the three other options.
Starting point is 00:19:18 Yeah. Molly at launch.com. You can email you. All right. And we, I mean, we were beating that finance story to death yesterday. I thought. And yet it keeps getting more interesting. And what is, I mean, this is going to zero?
Starting point is 00:19:34 You called this. I did. L-O-I. Remember. Binance signed a non-binding, a letter of intent to purchase FTX, or as Jason calls them, letters of nothing.
Starting point is 00:19:48 And now it's being... It is being whispered that Binance is, quote, strongly leaning towards scrapping FTX rescue takeover after first glance at books. Whoa. This is being reported on Coin Desk, according to a person familiar
Starting point is 00:20:08 with the matter. So take this, you know, with the appropriate size grain of salt, backing out, writes the publication would be one more stunning development in the collapse of Sam Bankman-Freed's
Starting point is 00:20:19 crypto empire. Matt Levine had a piece that was written sort of yesterday as this or right before. It must have been Sunday night, as this was sort of all unfolding. What day is it? Must have been Monday night. And was like,
Starting point is 00:20:32 the value of FTCX, kind of logically at this point, must be zero. Yeah. And it appears that Binance got in there, maybe, looked at those books. According to CoinDusk's source, quote, roughly half a day into the process of reviewing FTC's internal data and loan commitments has led Binance to strongly lean against completing the transaction. Seems like leverage loans. Yes.
Starting point is 00:20:57 And a lack of financial discipline was a major story in the operations of these exchanges and crypto projects. because they financially were so clever that they created margin-based programs, I think they started to behave. And we were kind of wondering from the outside, like, how are these companies this big? Yep. We're like, wait a second.
Starting point is 00:21:18 You know, I don't know, Dropbox is worth $10 billion. Box, Zendes. You companies with real revenue. We're like, well, they're worth $10 billion and those things worth $30 billion? Like, how? And I think what we're finding is a lot of this stuff was propped up by leverage
Starting point is 00:21:33 where people would take some asset they have and get two or three times that to go make other investments. So this would be as if, you know, I don't know, let's pick a company. Facebook had 50 billion in the bank and they turned it into 200 billion with leverage and started buying up a bunch of stuff
Starting point is 00:21:51 and their company had the risk if that, you know, whatever underlying asset, let's say equity in companies, went down, they'd have to pay it and you get that what's called a margin call. And so this seems to have been super widespread in a way of doing business. And I can't help but think, Molly, that because these people were such financial wizards, my eyebrows are going way up. Like, I got two wizards.
Starting point is 00:22:17 Somebody tells me the Rock does what I do at my eyebrow as well. The people's eyebrow. Is that what they called the people's eyebrow? That's what he called. Yeah. This was back from his wrestling days. You have to be 50 an old stocker like me to know about people's eyebrow. So anyway, listen, my knowledge of the rock.
Starting point is 00:22:33 starts at Black Adam. Which I loved. And I know people hate it, but yeah, I have no idea who this guy is. I know, like, I know he was a wrestler and then maybe in Fast and Furious. And then he did like, there's something, that's all I know. It may be something, you know what the Rock is cooking. Do you smell what the Rock is cooking? He's got to catch race.
Starting point is 00:22:51 Can you smell what the Rock is cooking? Seriously? Honestly, you know, I got, I have pop culture blind spots. When he came back to WrestleMania after he had already left to go Fast and Furious, like my brother and I lost our minds. I literally, one of my big pop culture blind spots is professional wrestling and fast and furious. I don't have time for this nonsense. I'm sorry that you all love it.
Starting point is 00:23:10 I'm busy with Andor, Star Wars, Marvel, and Lord of the Rings and House of the Dragon. I got other things on my docket. I can't be involved in everything, people. Biggest mistake I ever made was not going to WrestleMania at Levi Stadium right after Levi opened. I have literally never gone to any wrestling event. Oh, you and I are going to go to WrestleMania one year, Because it is, and all other sports will be ruined for you. Because like a guy comes flying and hits somebody with like a chair and then like jumps off of a scaffolding on to somebody else.
Starting point is 00:23:43 It's all fake. It doesn't matter. It is acts of insane acrobatics. And it ends, it does not matter. It is literally the most exciting thing you'll ever watch. So it's Cirque or Soleil. You'll be like, it's Cirque or Soleil with people on steroids is what you're telling me. Yeah.
Starting point is 00:23:59 They get pretty messed up though. I mean, it's like, it's a real. It's a. It takes a terrible physical toll. Like, I don't want to downplay that, but it is pretty awesome. So, Binance CEO, CZ. Yes. I love how these geniuses are also brilliant that they have to have acronyms, SBF, CZ.
Starting point is 00:24:18 Nobody could just be Chuck or Susan, right? It's everybody, can't be just like Steve or Bill, you know, can't be Travis. In the one case, like, his name is John. It's like a Chinese name. The supervillains, Legion. Anyway, the super villains all, exactly. They have to have their, like, their actions. He wrote a memo to his team.
Starting point is 00:24:38 And the thing I found interesting about this, if this is true, this is the quote we have in our notes here. I don't know, I guess this thing got leaked. As the due diligence for the deal is ongoing, I want to remind everyone, do not trade FTT tokens. If you have a bag, you have a bag, do not buy herself. I guess insider trading is now what they're concerned with. Is that what that means? He doesn't want them trading their tokens while they're doing this. So?
Starting point is 00:25:00 Yeah. And then he says. But that's okay. More importantly, we need to hold ourselves to higher standards than even in banks. To me, it's like something you say when you have not been holding yourself to high standards in banks. Like, there should be compliance. This is where I've wound up, Molly. I want to know where you wound up.
Starting point is 00:25:17 Original set of technologies, Ethereum, Bitcoin, you know, blockchain, NFT stuff, smart contracts, core technologies, code written by, you know, pirate hackers. All this stuff was super dope. brilliant like total mind F you know like whoa man this stuff is radically freaking cool if this gets executed
Starting point is 00:25:41 and done well it's going to change everything then a bunch of like grifters shisters criminals delusional people
Starting point is 00:25:56 talkers Legit. Deforminous. I don't know if this is where the genius exists. It's like you gotta be, you gotta be pretty smart to, you know, if you look at the people
Starting point is 00:26:07 who were able to understand this all the way down. Okay. Financialize it. Like, you know, it's everything you said. I think I put this in our group chat, our crypto chat at one point.
Starting point is 00:26:18 It's like, look, every utopia starts out, great. And then somebody comes in who wants all the money and all the power. Yeah. And in this case,
Starting point is 00:26:27 the people came in who wanted all the money and all the power were also the ones who were like the only people smart enough to understand it. And it ended up the same as it ever has. Like, you know, Matt, there's been a clip going around of Matt Levine asking SBF to define yield farming. Matt Levine was like, I'm really cynical about this and you just defined a Ponzi scheme in an even more cynical way than I ever could. And so it sounds like what you're saying is you're effectively running a Ponzi and you're fine with that. And SBF was like, I mean, that's a fair statement. Right. Like, Wow.
Starting point is 00:27:00 So people came along, financialized this, to their own benefit, because somebody always wants all the money and all the power. And then the whole thing, and then they built centralized exchanges, and then it wasn't enough to just take people's deposits and then buy coins for them. It wasn't enough to invest. It's the bare sterns all over against every freaking, you know, financial manipulation thing. It's not enough to just take deposits and invest on their behalf.
Starting point is 00:27:23 Then they would also be like, well, take your deposit and then I'll invest. And then I'll also take your collateral. and I'll invest that. And then I'll issue you a 20 to one margin loan to keep investing on your behalf. Or give you some other isch coin. I don't want to say the S word here. But that was the thing that was weird. It's like, hey, and here's some of these coins.
Starting point is 00:27:42 So it's like, give us your coins that have some value. We loan them out. We get some margin on that. You get some. They get some extra to. And we're just giving you some extra funny money. Here's some extra monopoly money on top of the imaginary money. And it's just like layers of imaginary money being flipped and loaned.
Starting point is 00:27:58 And no core value. I think all this stuff gets washed. And then what's left is whatever the original decentralized technology was, that can't be stopped, apparently. Or it's hard to stop, you know, like Bitcoin and Ethereum. Yeah, maybe. This feels like the end to me. Listen, a lot of founders are Lucy Goosey with their personal phone numbers.
Starting point is 00:28:18 You know that can cause chaos. Why? Because now you've got somebody's phone number in some sales documents, in some corporate emails. And then they leave your company. And then what happens? One of your great clients looks in their email, They look in their docs folder.
Starting point is 00:28:31 They find the document. They call that person. Now they've left your company. They're working for a competitor. Or the number doesn't pick up. And you look super unprofessional. And listen, you got to grow up as a startup. Nobody wants to spend $100,000 on a phone system in an office somewhere.
Starting point is 00:28:44 No. You want flexibility. You want that number to be provisioned quickly and digitally. And that's what Open Phone does so well. It's pretty simple. We all understand that. So here's what you do. You get open phone.
Starting point is 00:28:55 You create business numbers for your team. It just works like an app on your smartphone. It is an app on your smartphone or on your desktop. You pick a number, you install the app, you're done. Easy, peasy, lemon, squeasy. We use open phone in our sales team every day in and day out. It's amazing. It's flawless.
Starting point is 00:29:08 It's stable. And it, dare I say, it's affordable. Open phone. absurdly affordable. I'm going to say it at $10 a month. But Twist listeners can get an extra 20% off any plan for the first six months because they love startups. Sign up at openphone.com slash twist.
Starting point is 00:29:22 If you want that discount, please do it so that they know we sent you. Openphone.com slash twist. You got other numbers that you're paying a whole bunch of money for? They'll take them over, right? you can port them over for the cost of $0.0.0 for free. I want you to head over to O-P-E-H-O-N-E.com slash twist today. Openphone.com slash twist. Go do it right now.
Starting point is 00:29:40 If you're an LP in a fund that's in crypto, you know, what in Andreessen Horowitz raised, like some crazy multi-billion dollars is a $3 billion crypto fund? I want to say. Yeah, four? The latest in Dr.in-Haw-Haw-I-Haw-I-T-W-I-T-R-O-T-Haw-I-W-T-E-R-E-Haw-T-E-L-E-Haw-E-E-Haw-T-E. And their total funds raised for crypto were $7.6 billion. Okay. Whatever's not deployed.
Starting point is 00:30:06 And I'm not saying this because, like, I'm trying to throw shade at them. The logical thing to do here is to give back 90% of that money and just dissolve that fund or reduce the fund down to 10% or 20% and make it commiser it with the opportunity. Because the opportunity that they started putting hundreds of millions of dollars into were all frauds, Ponzi schemes or houses of cards. You know, the most, the best way you could frame this was a house of cards or incompetence. And at worst, it was a Ponzi and a fraud. If that's your biggest investments fall into those categories, it's time to close up shop folks. Or it's time to greatly reduce this and say, you know what, we're going to start making
Starting point is 00:30:48 5, 10 million investments in Series A companies that are building actual products. We're not going to be layering 100 million, 500 million slugs into giant companies. that we didn't diligence. I mean, that's the other piece that's got to come out here is who's on the board of FTX. Listen, it might be some of my friends that might be people I'm friendly with,
Starting point is 00:31:10 but this is where diligence matters and governance matters. We've seen this over and over again, but with crypto, because of the layers of Mushugana and, you know, fraud and risk being taken, there needed to be many more controls here. Who's responsible for the controls in a private company?
Starting point is 00:31:31 Management in the board. Investors. And so who was steering the ship? Who knew what, when? This is going to be the lawsuit of lawsuits. This is like Theranos level. I mean, could this be even bigger than Theranos in terms of the amount of money raised? It probably is.
Starting point is 00:31:51 In terms of the ecosystem overall, this is a trillion dollar asset class. This isn't just so like a bunch of money raised. Like a bunch of VCs are going to lose a lot of money. Sure. Without a doubt, you're absolutely right that at this point. I mean, and that's not going to happen, right? A16 has been super firm. I mean, it might happen.
Starting point is 00:32:09 But, you know, I've seen them on stage multiple times at various events being like, where this is a long-term play, we're committed to the long-term, like, we're not going to, you know, and so it's possible that they'll keep. But yeah, in terms of the overall impact of what is imploding, right? It's not like one project is imploding or, and that's going to happen to, right? One coin goes to zero. This is the exchanges. This is the financialization layer that institutional investors have been a part of.
Starting point is 00:32:41 That, like, this is a big octopus. Like, this is going to have, this has fingers and everything. Well, and also, if they deployed, you know, five, six, seven billion, who knows where they are on the deployment of all this capital, but let's pick a number four. Let's pick a management fee. 2.5%. It means they were pulling down $100 million for the last five years.
Starting point is 00:33:05 They pulled out $500 million in management fees to then incinerate all this money. I mean, these LPs are going to be so underwater. If they lose all their money, and Andreessen Harowitz swept a half billion dollars in fees while they were losing it,
Starting point is 00:33:21 I mean, there's got to be some sort of a clawback or something here. Yeah. You know, and who knows? Maybe there's some rebound here, but the scale of this is what I find. It's astonishing. I saw a quote,
Starting point is 00:33:32 I saw a thing today, Bloomberg. Scale was just too crazy. Yeah. I never understood it when I was looking at all these opportunities. And you and I have been having this discussion with climate startups and people in ESG and stuff like that. Hey, sometimes we had this discussion on VC Sunday school two weeks ago, I think, like, hey, the valuation pretty high.
Starting point is 00:33:48 Rents too damn high. Yeah. These rents and valuations are nothing. These people were investing. in companies for hundreds of millions to billions of dollars when they had just nascent revenue or house of card revenue. This is like they want six months ago. You know, they're like, they're still at 20x and we're like talking 10x.
Starting point is 00:34:09 It's not like an ocean apart. Bloomberg is estimating that FTX, which was worth $32 billion on Monday, is now estimated to be worth one single dollar. Crazy. dollar and SBF himself lost 95 or 96% of his personal wealth overnight and according to Bloomberg at least has personal debt totaling about $650 million. I mean, Bernie Madoff was tens of billions of dollars lost. Now, some of it was paper. So there's also a little bit of that going on here. People made a bunch of paper gains. So who knows what the cash in was. You know, with Bernie Madoff, it was 20 billion cash in and like 80 billion. and some amount of it was on paper. So, you know, this is, I think...
Starting point is 00:34:56 This is bigger than that. Yeah. $17.5 billion, they estimate, was stolen from investors in the Madoff scandal. And if FTX just went from $32 billion to $1. Yeah. Some of that is investor money. Some of that is, I think,
Starting point is 00:35:11 bag holders who had accounts there, like people have, if I'm understanding it's correctly, people who had deposits there are going to lose their deposits, right? That's... They didn't get their deposits out in time. I mean, this is even more reason to that adage about like, hey, not your keys, not your coins kind of thing that they talk about a lot. Like the idea of keeping your cryptocurrency on an exchange unless it's maybe Coinbase and it's here in the United States and it's regulated in public and, you know, and they actually did under pressure because of all of this make their balance sheets public. So you can at least see that.
Starting point is 00:35:44 But yeah, I mean, look, as soon as you're participating in this brand new thing at the level of effective. gambling and you're just trying to get in on the get rich quick scheme and you don't like you said own your keys and you don't understand the underlying technology. Just assume you're the mark. Anyway, and there's
Starting point is 00:36:05 a whole sub-story here which we won't get into but Alameda the trading the trading firm not the platform FTX seems like there was some insider dealing there. Yeah. And Vinny talked about that
Starting point is 00:36:21 yesterday. You go back to listeners, if you go back to our crypto roundtable, you can hear Vinny try to explain a little bit about how these sister companies were clearly dealing with each other, that, you know, FTX, SBF was using the FTT token to bail out Alameda, but that may have left a huge hole in its balance sheet that maybe CZ knew about and exploited to cause this run. Like, it's all, again, it's all very complicated, but I am with you. I think this is a full-on Lehman Brothers Bear Stearns moment. Like this is a huge collapse.
Starting point is 00:36:54 And of course, collateral damage. Bitcoin down to 17K, down 15% in past 24 hours. Ethereum down 24% last 24 hours. Salana down 46%, I think also in the last 24, 48 hours. This stuff is just going to, we're in full on contagion mode. Yeah.
Starting point is 00:37:09 My tiny little Are you looking at your $400? I am. So, okay, you remember, I put a grand total of $1,300 into crypto. Just so I could be the guinea pig for the world. It's a nice weekend away. It's a little weekend getaway. I was like, okay, like you never know.
Starting point is 00:37:25 I don't know. Gave up a weekend getaway. To the moon, I gave up a really nice weekend getaway. And my current portfolio is worth $386. And 55 cents. Moving into Facebook. We should see who can lose more money faster, like J-trades or. Well, I mean, I'm down like 50% of that.
Starting point is 00:37:43 Sounds like you're down to 80 or something. About 80%. Yeah. Yeah. Just sell it all. Put it in Facebook. Trust and suck. You know.
Starting point is 00:37:51 You haven't lost until you sell. Wow. I'm a hoddler. Okay. I'm a hoddler. All right. Next up is the next unicorns. While people are playing,
Starting point is 00:38:01 what is this new expression everybody loves? If you F around, you find out. Exactly. Here, our next unicorn is out here, like, literally saving lives. So like, reminder. Build real businesses. Build real products. What you could be doing with your life,
Starting point is 00:38:16 just as one example, is founding a health care company that brings high-quality health care to rural parts of America that literally don't have it. Like, you could be keeping people alive. Like Jenny Schneider, the CEO of Homeward, which is a technology-enabled health care provider delivering care, like I said, to these rural communities, which have a 23% higher mortality rate compared to urban ones, which is appalling. And it's just a super interesting conversation about how to get doctors and high-quality
Starting point is 00:38:45 health care to the parts of America that just are not, don't have it. Literally don't have it. All right. Enjoy another amazing next unicorn series. And if you have ideas for our next unicorn, just email producers at this week in startups.com. We're always looking for that company that's, you know, in that 100 to 500 million range and doing something really interesting, maybe under the radar because we're talking about FDX and Facebook so much.
Starting point is 00:39:09 Exactly. But enjoy the interview. Well done. Enjoy. Hey, listen, if you're trying to get your startup off the ground, trying to run it more efficiently, which I know you need to do right now. You've got to do more with less. You're going to need tools to do it.
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Starting point is 00:40:35 Jenny Schneider is the CEO of Homeward, a technology-enabled health care provider delivering care to those who don't have it. And we hope a next unicorn. Jenny, welcome to our series. Thanks so much, Molly. Delighted to get to be here. Tell me, I guess in your own words, I gave the tagline version, but tell me what you're working on. Right now, I am working on a company called Homeward Health, and what we're doing is we're re-architecting health and care delivery in rural America. I have family in rural America, grew up in Montana and North Dakota, and have all too good an idea of why this is so necessary.
Starting point is 00:41:10 But lay it out for us. What is missing that you're trying to solve? Well, lucky for you to have family in rural markets because there are so many small towns in America that are absolutely wonderful with great character and wonderful people. What we know is that delivery of health care and rural markets is not at high enough quality as compared to urban markets. So if you live in an area that's designated as rural by the last three numbers of your zip code, your rates of mortality are 23% higher. And that's independent of socioeconomic status. And so really the big issue is there's not enough health care providers in rural markets to provide the type of health care that people need and people deserve.
Starting point is 00:41:52 And so we're taking a different approach rather than asking people in rural markets to drive hours for a few minutes of health care services in a city. We're actually trying to flip the model on its head and bring health care to people through the use of things such as mobile vans, home visits, and technology services. So it's not all just telemedicine. It's literally sometimes a doctor will come to your town. That's right. And so, you know, one of the big things that I've learned and my co-founder, Mark Hendale,
Starting point is 00:42:21 from our various journeys prior to Homeward Health, is that telehealth is an incredible asset. Telehealth alone will not solve a crisis. So telehealth has been in existence for 10 plus years, and yet health care outcomes in rural markets have continued to worsen. What we know is that health care is very personal, and you need to have an established relationship built off of trust prior to leveraging some of the other tools and techniques that might be helpful. So telehealth alone will not fix health care delivery in rural markets, telehealth plus some other combinations of in person and frankly, ways to build trust and make health care more convenient will.
Starting point is 00:43:01 So how does it work in terms of, let's say, a mobile van or a traveling doctor and building that trust? Is it the same, is it ideally the same doctor who comes? comes to visit a town over and over? I think the biggest thing to learn to earn trust is getting to know people and getting to know communities. And so when we launch in a specific county in a specific state, we hire people from that county. We hire people to help us, you know, to figure out the routes that we're going to use for our mobile van, help us as we go into a home to visit with a person to set up the technology components that can then go on and monitor people throughout the rest of, of their time with us as their health care provider.
Starting point is 00:43:44 What do you mean when you say you hire people? You mean you hire doctors in that area or you hire like logistic support staff? Yes and yes. And so one of the big questions I often get asked is if there's not enough doctors today in rural America, how are you going to create enough doctors? I'm not saying that was my question, but that was. Well, I'm giving you, I'm giving you credit for that question. And the answer is we're not, right?
Starting point is 00:44:07 But we are going to do something different, which is we're going to allow people to work at the top of their license. So we start with the team of medical assistance, nurses, nurse practitioners, physician assistants, and doctors. And it's a combination of teams in different locations that provide the optimal care as a team. And so when we look at these rural markets, there are logistics people, there are medical professionals that live there at various levels of training. We just talked about some of them medical assistant, et cetera. And so we actually to help employ these people to deliver the care in that local ecosystem. What that does is gives us an incredible insight as to the nuances and the delightful characteristics of each small town and
Starting point is 00:44:48 each population of people whom we're caring for. What would those people otherwise be doing? Like, might they be employed by a local clinic or a hospital or leaving? Yeah, what we find is that there's huge rates of hospital closures in states that are designated as rural or areas that are designated as rural within a state. There's a lot of people who actually don't have employment, who have these skill sets who live in these small towns or frankly have to drive many hours to an urban environment to be able to find a job. We are not stealing health care providers that are in existence today. That's not the model. In fact, we partner with people. And we believe that in order to drive sustainable health care outcomes in an economically sustainable fashion, we need to
Starting point is 00:45:33 work deeply to partner and not compete in these rural markets. I mean, if I'm being honest, the hospital that my mom keeps ending up in, like, I would prefer that you just steal. I'm sure there are good people there. Anyway, different topic. Quickly, though, will you give us that definition of rural? Like, what population are we talking about? Yeah. So if you look at the U.S. Census map, there's nine different cutoffs that have from the very tip top of urban to the very bottom of rural. and they have to do with population density. I haven't committed all of those different nine cutoffs to memory, so I'm going to have to punt on that one.
Starting point is 00:46:10 But as we really are looking at the bottom three, so really areas that are very remote, often lack infrastructure. And by infrastructure, I mean public transportation, lack of internet connectivity, and sometimes even poor road access. How did you get interested in this?
Starting point is 00:46:27 Well, similar to you, I have roots or family roots in rural America. So I grew up in a small town in Minnesota called Winona, Minnesota. And I don't come. Yeah, right. So I spent every summer we would vacation in North Dakota. That was like the gold country for us. In fact, I actually went back two summers ago with my children and my dad and we did a nice road trip.
Starting point is 00:46:49 It was a super fun time. Oh, lovely. Yeah, it was really great. But I grew up in a family that is not medically trained. My dad owns the local auto parts store in Winona and services many of the surrounding in very rural towns in Minnesota, lots of tractors, lots of, you know, car, car mechanic and fixes type of work. And I was diagnosed with type 1 diabetes when I was 12. And at that time, I didn't know any different, but I was, I was not able to see an endocrinologist, a specialist
Starting point is 00:47:22 who helps deal with type 1 diabetes in young children until about three weeks later. And that just felt normal because I didn't have anything else to compare it to, until I went to Johns Hopkins for medical school and realized that that first time after diagnosis is super critical. And that's where things kind of go awry, either really low blood sugar or really high blood sugar as you're starting to figure out your regimen. And that that was not the normal or not the recommended care pathway. And it started to peak my interest and think about what are the outcomes for people who live in areas where there are health deserts and there are not as many health care providers and put me down this road to understand more deeply the nuances of what's
Starting point is 00:48:03 driving worse outcomes in these areas. Well, it sounds like you are, I'm making a more explicit connection, but it sounds like you also are informed by this idea of your father's business and the fact that service can happen in a mobile way. Yes, and it's actually kind of incredible. So growing up myself, my two brothers, most of our friends, worked for my dad at some point during high school. And usually the job was to be a driver.
Starting point is 00:48:33 And what that meant is you were in a white MPE truck, motor parts and equipment. And someone would call in and say, hey, look, I need a spark plug or a rotator belt. And they would give you the part. You'd get in the car and you'd go drive it over to the business. Happened the whole day. And it occurred to me that, you know, we think of those, these businesses is very important and can actually get parts to the businesses when the part. are broken. But when people break, we don't bring parts to people. We instead ask people,
Starting point is 00:49:02 broken people, to come to a certain location. The service level differentiation between the car business in rural Minnesota versus the health care business was really striking for me. Okay. So how hard is this logistically to pull up? I assume that might be part of the reason why that doesn't, hasn't existed yet. Yeah. So it's hard. Yeah. Again, I'm not, I'm not, It's not an easy problem or we probably would not still be a problem. But I would say that there's a couple of things that we're approaching it with that are different and I think are really important. One is that if you look at why are there so few providers in rural markets, it's because the way that the economics of reimbursement work for health care, it really doesn't make it sustainable. So today, we have a fee-for-service world, which is I fill up my docket from eight to five with visits.
Starting point is 00:49:56 if you're sicker, I can charge more money and get reimbursed at a higher rate. That's not actually economic alignment for, there's no real economic incentive for me to keep you healthier, right? It gets really tricky in these areas where it's hard to fill the docket from eight to five because people are dispersed throughout. And I don't know, you hit a pothole or the tractor breaks. You're waiting for a part from my dad's store to show up and you miss your time slot. And so it becomes really difficult for providers in a fee-for-service world to stay afloat. And so we've taken a different approach for that concept around total capitation or owning the entire cost of what it takes to deliver service to somebody.
Starting point is 00:50:38 The other part, the other key pillar for us is really understanding what it takes to deliver and build a set of solutions on technology. So you can't mythically or magically create more providers to live in these rural small towns, but instead you can leverage some technology to actually take things to a different level. Allow people to practice at the true top of their licensure, what they're totally trained to do, and then take away as many of those administrative tasks as you can. And then by putting those two together, it really changes the healthcare paradigm and healthcare delivery system. So it's this combination of efficiency that makes it easier to be a practitioner in these areas
Starting point is 00:51:19 and a fee model that means that you don't have to worry so much about economies of scale. Like, the easy assumption would be, well, it's hard to make a living as a doctor in a small town because there aren't enough patients. But it sounds like you're saying that's not really the problem. It's actually how we charge that makes it unsustainable. That's not the problem. Yeah. It's not that there's enough patients. It's truly how we charge and how we reimburse for those services.
Starting point is 00:51:44 And the technology is both to make providers more efficient, but actually to deliver a lot of the care that can be done more remotely. So telehealth is one piece of that. But there are things such as remote patient monitoring where I can track if you have high blood pressure, how your blood pressure is doing, adjust your medications remotely, get those medications delivered to your door. Your chance of following through on that is much higher than if I ask you to come in every other week to drive four hours for 15 minutes and then send you to a different pharmacy, two hours, the other direction. And so a lot of this is truly just understanding what is it like and where people live? What does their day-to-day existence look like? So when we start our service, we first
Starting point is 00:52:24 meet people in their home. And what that does is it allows us to understand people in a totally different way. We prefer to call people members rather than patients because we're actually just taking care of people. So we understand who they are, what's afflicting them from their health care status in their home. It also helps us build trust so that we can deploy some of these technology. We can put our cell phone number into their phone so that they can call us when something's needed. It's a very different relationship than handing someone a flyer or sending a flyer to someone and being asked to call. And so we understand trust is important, technology and economic alignment of incentives. So break down a little bit for me that the first part of that,
Starting point is 00:53:07 the re-overhauling the fee structure by kind of owning the whole stack, as we might say in the software world. How does that literally work? Yeah. So there are some, there are a majority of health care today is still a fee for service. Every time you go in, you get charged for what happened. There are a couple models and a couple populations where that's changed. And most of that has been in government. And so that's in Medicare and in Medicaid. And the government says, I will take care of Molly. And Molly will, you know, is allowed to spend, I'm going to make up a number here, $10,000 because Molly has hypertension and she has recurring urinary tract infections and she's of this. age. So she, on, you know, give or take, it'll cost about $10,000 a year to take care of Molly. You can actually, can you, can you provide that care at that cost or even better? Can you provide better care at a lower cost? And then actually keep, keep the dollars that you overachieve on. All of a sudden, as a provider, I'm not trying to get Molly in to see me as many times as I can. I'm actually trying to think, okay, how can I make Molly better and reduce the recurrence of the
Starting point is 00:54:14 urinary tract infections. How can I manage her blood pressure so I can give her a remote, you know, a remote blood pressure cuff that every time she puts it on, I upload up, the data is uploaded and I can change what kind of medication she has. We can talk about some preventive measures so that I'm actually proactively taking care of her health care needs, rather than having her come back to me so that I can bill every single time I get her. The change is very different in terms of the care you're providing to think thoroughly around preventing items versus reacting to items. Yeah. It's so interesting. We have talked before to other health care providers about this concept of how health care has the worst, like effectively customer service. It's a customer service question.
Starting point is 00:55:02 And any description that it's startling, how startling it is, whenever you do. describe a patient as a person. It is amazing to me even now when we talk about people like, why are you not calling them a patient? And I'm like, well, see, like something happens to a patient. You know, if you call them a person, you think about them differently. You think about how hard it was for them to get here versus why they didn't take their medications.
Starting point is 00:55:26 You start to view the world very different. And for me, for full disclosure, when I was diagnosed with diabetes, it was the number one thing that bothered me that people would say, oh, oh, I see. Oh, you're a diabetic. I'm like, actually, actually, that is a piece of what made, but like, I'm actually a really great basketball player. I think I'm kind of funny. I like to dance. I ride my bicycle.
Starting point is 00:55:47 I love to run. Like, why am I this one thing to you? Right. And it's, and I think that changing that, that the nomenclature, the words really changes the paradigm of how we think about providing care for people. Yeah, absolutely. So far what you've described as is fairly general practitioner. Where do or could specialists come in? Or is that an option?
Starting point is 00:56:10 Well, it's a very important option. So when we look at access to health care in rural markets, rural markets have half the number of primary care doctors per head, per head count as urban markets. And 10% of all rural counties have no health care provider. Like one out of 10 rural counties have zero health care providers. It gets worse when you talk about specialists. So in rural compared to urban, there's one eighth the number of specialists in rural as compared to urban.
Starting point is 00:56:39 So absolutely, this model has to include and has to involve specialists. And as we launch into our providing of care, the common specialties, there's a number of them that work really well from a technology and a remote monitoring component, such as cardiology. There's a lot of diagnostic and maintenance work you can do in this environment. And then again, back to talking about partnering. And we partner very closely with the existing health systems for things such, as a cardiac cathartization or a new valve where you have to go in for a surgery or a more
Starting point is 00:57:13 extensive procedure. Those are not things that we do, but there are centers that do those and do those very well. But a lot of the upfront work can be done so that those cardiologists practicing in those centers can do the things they're most specifically trained to do. Right. So you could do a lot of that before you have to go to the center if you were a member here. Yes. And how great for everybody. Great for the docs. Great for the member. You know, reduces costs, reduces complications, and it makes it a ton easier for everybody. Yeah. All right.
Starting point is 00:57:42 Well, talk to me about the business. Is it B2B? Is it direct to consumer? It sounds like you're talking about a partnership model. Help me break down how you get paid. Sure. So we launched our business in March. We are status post series B fundraising now.
Starting point is 00:57:58 We've announced a partnership with Priority Health, which is a large health insurance company in the state of Michigan. and we will be providing care for 30,000 Medicare-eligible individuals. So we come in as an in-network provider, and we're responsible for their clinical outcomes and their total cost of care, and we do that through our partnership with them. What that means is because they're Medicare eligible. I was giving you a $10,000 cost per year, just kind of making something up. But each of these individuals, given their own comorbidities, will cost the government
Starting point is 00:58:36 a certain amount and the government allocates that amount of money to priority health. Priority health will then give it to us and we're on the hook to provide care for that individual. Got it. Okay. And then is it a, they'll just, it will be that whole amount. It's not a revenue share. It's sort of a straightforward like this is the amount. Yeah. So the way these typically work is. It's very tricky. Yeah. So at the end of the day, our goal is to provide better care and that's very clearly documented through clinical metrics at a lower cost. And then there's a component of the sharing of that, when we're able to do that, that is a revenue reimburse reimbursement for us and for our partner at priority health. And then do the doctors actually work for you? Do you
Starting point is 00:59:20 manage the fleet? Like how much they do. Yes. Yes. We have our own set of, as we talked about medical assistance, RNs, physician assistants, MDs, medical doctors. And we also work with many of those care providers in the ecosystem as well. So we have our own that work for us, and we partner with ones that work in the ecosystem. Again, it'd be really difficult across a population of 30,000 people to own all of the different care providers. But we manage a lot of the upfront care and then work and refer our members to the specialists when needed within the ecosystem. Right. So it ends up being the bulk of the care, if not the most expensive care. That's right. You make it up in volume, so to speak. Yeah. And
Starting point is 01:00:02 then on this sort of path to next unicorn, at least within this framework, what do your margins look like? Well, we're just in the process of launching the company. We've only been alive and launched for just about six months. So it's really difficult, I think, at this stage to talk about margins. And the world of margins has shifted. But we are building a product solution set that has a path to profitability for any cohort we have in a state within 18 months. And there's large numbers of dollars involved for taking care of sick people in rural America. And we believe that we can do it in a very cost-efficient way. But more than that, in a way that really means something to people and is a very different
Starting point is 01:00:42 experience and drives much better at clinical outcomes. Yeah. And then what is the market size for this? How many of these communities are there that you would want to reach? So if you're looking just in America, and that's the country where we live and the country where we're starting, this is 20% of the entire U.S. population. So one out of five people. So it's not small.
Starting point is 01:01:04 It's not a small market. You know, sometimes I'll hear people say, oh, it's so great that you're doing something so niche in rural. What a tiny market. And I'm thinking to myself, when we launched Livongo, which was a unicorn, people said diabetes is huge. Well, diabetes is about half the market of rural. Yeah.
Starting point is 01:01:23 So, so in rural market, there's a very large tam here. That is remarkable. So how do people access this case? So today people will access the care as we're an in-network provider for their insurance company in the rural markets where we're launching. We're starting. Again, as I mentioned, we've only been a company for a few months here, but we're starting in the state of Michigan. And about 40% of the entire population in the state of Michigan lives in what's designated as a rural market. It's a high-volume rural state, if you will.
Starting point is 01:01:59 So you just launched six months ago, as you've said, and raised a $50 million series B. Healthcare is a space that BCs can be a little scared of. Is what do you think, I mean, aside from you and your expertise and, you know, domain expertise really matters. You're a doctor. But like, what do you think it is that has made this click for your investors? I think it's a couple things. One is the opportunity we talked a little bit around the size of the population. right? So 60, 60 plus million people in rural markets. That's a large population. The second is the
Starting point is 01:02:36 timing around technology assets to deliver the care here is critical. I think the third is real recognition across the ecosystem about how broken health care is in rural markets. This is a bipartisan issue. You're starting to see a lot of focus in delivery of health care and rural markets. And I think the last is there aren't a lot of people here fixing it because it has been traditionally very hard to do. And so there's a first mover advantage. And we've assembled an incredibly strong team to help deliver on that promise. What does it take for you to grow? Like, you have to sort of, do you have to make these partnerships with insurance companies one by one? We do. And I'll be honest, the, you know, kind of the top of the funnel partnerships,
Starting point is 01:03:21 because of the size of the problem in rural America has not been as difficult as I would have thought. there's there's a real eagerness to try something new and try something different. Our next stage of the business is heads down building and showing that our model is successful. And so we're really excited to get to do that in Michigan with an incredible partner in priority health. I mean, I cannot help but sort of fast forward to broad adoption of this and imagine that the other thing it does is help keep these communities viable. Yes, and we're hoping to get to Montana and North Dakota to help your family, Molly. Yes, please. my mom is also a type 1 diabetic. That would be amazing. I appreciate it.
Starting point is 01:04:00 Jenny Schneider is the CEO of Homeward. Thanks so much. Hopefully, an ex-unicorn will be watching. Thank you. Thanks for all the excitement. All right, everybody. That's it for us today. It's Wednesday. We made it to the middle of the week. A couple more days to go, Molly. This has been a heck of a week. We're just crawling toward the finish. We do not, by the way, have Friday off. We are not one of those companies that takes the three-day veterans day weekend. So we will be with you day after day tomorrow.
Starting point is 01:04:26 We got Lon Harris for another episode of this week in streaming. Oh, yeah. Disney results are out. Plus Andor is rocking lots to talk about. And I'd like to get a startup of the day and a we live in the future. And can we get some stuff other than this chaos and this news that are just too big to not focus on? Anyway, I'm going to see you tomorrow. All right.
Starting point is 01:04:47 Take it. Bye.

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