Your Next Move - Innovating Industries—How These Entrepreneurs Are Addressing Pain Points

Episode Date: May 6, 2025

The health care industry is full of challenges, from inefficiencies in data usage to gaps in patient care and accessibility. How are entrepreneurs tackling these pain points and driving meaningful change?   At our recent Inc. Founders House in Philadelphia, Inc. editor-in-chief Mike Hofman sat down with Brigham Hyde of Atropos Health, Anne Fulenwider of Alloy Health, and Amer Alnajar of Vytalize to discuss how they are identifying and addressing critical pain points in health care. They chatted about how they leverage innovative approaches, integrate patient insights, and transform challenges into opportunities to enhance the overall customer experience. They’re identifying critical industry needs while building smart, scalable solutions.

With the Venture X Business Card from Capital One, you earn unlimited double miles on every purchase. Plus, the Venture X Business Card has no preset spending limit, so your purchasing power can adapt to meet your business needs. Capital One, what's in your wallet? I'm Sarah Lynch and you are listening to Your Next Move, audio edition, produced by Inc. and Capital One Business. In this episode, you'll hear from Inc. editor-in-chief Mike Hoffman as he chats with Dr. Brigham

Hyde from Atropos Health, Anne Follinwider from Alloy Health, and Amir Al-Najjar from Vitalize, to discuss how they are identifying and addressing critical pain points in health care. At our recent Inc. Founders House in Philadelphia, they chatted about how they can leverage innovative approaches, integrate patient insights, and transform challenges into opportunities to enhance the overall customer experience. Hear how they have identified critical industry needs while building smart scalable solutions and learn how to apply their strategies to your own business and drive innovation. How are you guys doing? How's Philadelphia today? Thank you for the beautiful weather and I'm glad we're all in here together

although maybe at some point like sneak out to the patio and get a beverage and enjoy the beautiful sunshine But we've got a great program here today. We're really excited to have so many company founders in the room representing so many companies I'm Mike Hoffman, Aaron Chief of Inc. as I said And you know, I'm really delighted to get together with you because I feel like when we're together with founders There's so many interesting ideas that come forth There's so much great knowledge that folks can share, whether it's about how to deal with difficult employees or how to deal with difficult investors.

Sometimes you deal with difficult employees and investors at the same time. I don't know if that resonates with anyone. But also best practices about things like marketing and HR and managing growth and managing through growing pains. Now on behalf of everyone at Inc. and our partners at Capital One Business,

we're really delighted to have you here. So please give yourselves a round of applause for coming out today. And now let's get things started. We're going to have our first panel again, which is on healthcare. So I'm really excited about this panel because we have lots of great growth companies who have lots of amazing experiences. And we also, Amir is the co-founder of the number one Inc 5000 company for 2024. So big round of applause for Amir. And remind me, what was the revenue for the company? From a million to like over 4 billion in a few years. Over 4 billion for a few years. So real amazing growth story, which

we're excited to tell here. But first, we'll start with Ann. Ann, why don't you tell us about your company, Alloy Health, and what the market you serve is and sort of what the main trend that you see right now in your space. Thank you. And thank you so much for having me. It's really nice to be here on the stage. Alloy Women's Health is a menopause digital health platform. We connect the 55 million women in menopause to the 2000 or fewer menopause

specialist practitioners in the country. And we deliver theause to the 2,000 or fewer menopause specialist practitioners in the country. And we deliver the care, the questions, the education, and the actual prescription solutions sent right to your door. Thank you. Round of applause. I would say the biggest trend that we're seeing, and I think we have a lot to do with it,

is the demand for better menopause care. We started the company in 2000. And in 2023, I believe, we were part of a New York Times Magazine cover story. So women have been misled about menopause. And it talked about the fact that 20 years ago, there was some faulty data put out there in the world that really went from 40% of menopausal women

getting the prescribed first-line care to 4%, and that number has actually declined since 2000 when we started, so 2020. So- Less than 4%? Less than 4% of that number has actually declined since 2000 when we started. So 2020. Less than 4%? Less than 4% of menopausal women are getting the first line care recommended by all of the medical establishments. And so the longer and more that we've talked about it and generated the education and the

really have created the demand. Every room we go into, women are surprised and shocked to hear how badly they have been served if at all at this stage of life. And we've really generated the demand to the point where the estrogen patch, which is one of the FDA-approved generic solutions that's out there, has actually, we've seen shortages, and this is before the current administration. And so that's been exciting to see, and it's sort of hard to see all the vast sort of suffering and misinformation that's been out there for so long, but it's really encouraging to see women getting the information and education that they need to have the agency to demand these very simple

solutions. So, Ian, if your audience is consumers, Brigham, your audience is clinical trials and clinicians. Can you tell us about your company and also what the biggest trend you're seeing in your spaces? Yeah, I love Anne's comments. trials and clinicians, can you tell us about your company and also what the biggest trend you're seeing in your space is? Yeah, I love Anne's comments. I almost think Anne should be a customer. What we focus on is- Going to do a deal right here on Steadicam.

Live deal. We focus on personalized evidence for care for everyone. And the story she tells highlights this. We don't have enough evidence for what to do for the average patient. Even worse when we get into certain underrepresented populations. The stat we use is only about 14% of daily medical decisions have any high quality evidence behind them at all. That leaves our clinicians in a position where they have to do their best.

This is maybe the art of medicine, but we think we can solve that evidence gap problem. And what we build is automation for producing high quality evidence on real patient data from all the data we've created over the last 15 years in health care. Taking that from an average study, an observation or research study, whether it's a researcher at Stanford or at a pharma company, usually take months.

We can do it in under three minutes now at the point of care. So you could be in your doctor's office. They could say for, okay, patient with this background, treatment A, treatment B. We'll run a study on tens of thousands of people just like you. That is brand new. That's possible in the last year. It's one of the exciting things about this broader automation wave to trends.

Clinical trials were how we classically generated evidence. The gold standard, double-blind placebo-controlled randomized. And we still think that's the top of the pyramid. But observational research and the methods behind it, if done properly, can actually supplement and help the underrepresented groups. You know, 70% of clinical trials systematically exclude everybody with comorbidities, let alone other underrepresented groups. So we're running these trials on healthy male triathletes

at Memorial Sloan Kettering, and then taking them out and trying to treat everybody with it. So I just think there's a role to supplement that, and again, bring that dream of personalized medicine to bear. It also matters when we talk about research funding. NIH, been a lot of discussion of what's going on there. My spouse is at Columbia University as a researcher. So we're seeing it on the ground. You know, I think one of the things we're trying to do is help

supplement in this time or basic science research is being challenged and bring the ability to do those types of studies and publications quickly and cheaply and democratize them to more people, get the young faculty going now. We also have more out of DC, there's not just that going on. The broader moves of the FDA and the Maha movement, while there's maybe some good areas of focus there, I think the air is a disruption or a concern. You're pharma, how are you going to come up with the next cure if you're not sure about your regulatory timelines? Is there a role for some of this automation

that companies like Astor Building to help speed that up, make it more efficient? Maybe it's a win for both. And then in the broader Maha conversation, while I think we're all happy about Red Di 40, let's talk about evidence again. I think this is a moment where really well-done, well-crafted evidence that is really clear is really needed

to remove some of the buzzword of what's going on in health. I also think it's an opportunity to open up that personalization of care into new venues. Maybe there should be evidence that certain supplements work really well in certain groups or that certain people should get this treatment without a prior auth. Like why can't we do that now if this automation using generative AI tools like ours has created that abundance.

So that's what we're hopeful about dealing with the challenges in the meantime. It's sort of this interesting moment right where the technology and the science is advancing at this incredibly rapid rate and then at the same time the policy framework that has been in place for the last 20 years is also changing in a really dynamic way with potentially a lot of harm. The change is good. Sometimes change has to happen quickly. Let's just hope we don't break all of it. And I think that's what we're all hopeful about while remaining optimistic about what

could emerge. Amir, I was bragging on you a minute ago about having the number one Inc 5000 company, Vitalize Health, based in New Jersey, so just across the river. I'm sort of curious, can you tell us a little bit about your company and what you do and then what the biggest trend is that you see in your space? Yeah, absolutely. Thank you for having me again. So my company, Vitalize Health, we're in the value-based healthcare space.

So we always keep hearing about healthcare costs going up. We don't necessarily have a lot of quality to show for it in the United States. And what we do, we work closely with primary care docs, other providers, in order to deliver better care. We work directly with the federal government, Medicare, and other private insurers to help cut healthcare costs while improving quality. You may think, how is that possible? How are you cutting costs and improving quality? Well, healthcare is that bad in this country that you could do both. And that's really where we're coming at it from. And you know, we're very fortunate where we're in an environment where we're able to generate

win, win, win, wins. You know, like vitalize my company, we get paid when patients are doing better, when our providers are able to earn, you know, shared savings checks by saving the health system money and by the health system money and by the taxpayer saving money. So it's sort of fully aligned incentives. And we work closely with our primary care providers. So a lot of the stuff we know is helpful

and beneficial in healthcare, but doesn't happen. Everyone knows a patient should have a followup after they've been hospitalized for a week by their primary care doctor. It only happens 40% of the time nationwide. 40% of the time? 40% of the time, so 60% of the time. That's not half, yeah.

Yeah, it's not happening. Well, why? There's a million reasons why, and that's what we try to solve with our primary care partners one by one. They may not have the data or the feeds to let them know that, hey, Mrs. Smith just left the hospital. So we provide that. They may not have enough staffing the data or the feeds to let him know that, hey, Mrs. Smith just left the hospital.

So we provide that. They may not have enough staffing to proactively call patients. So we provide either funding or staffing resources for our primary care clinic. And a lot of what we do is just listen, listen, because honestly, like if you just listen to people, you usually get the answer. It's not really that hard. And I always say, like every one of our problems that we're dealing with is very easy. It's just that we just have a million of them and they're all sort of stacked up on

top of each other. And you don't have to solve all million day one. You just work at a couple at a time, keep moving forward. So, you know, what we're seeing is people are beginning to believe in value based care. You know, Medicare came out and said by 2030, every Medicare patient needs to be in a value based care program. The data is conclusive that whether they're called ACOs, the mechanism that delivers value based care, accountable care organizations, they deliver savings. They generate savings for Medicare, better outcomes for patients.

And you know, the example, you know, I give is it better to ignore a Medicare patient in the home for two, three weeks, couple months go by and they end up in the hospital for a $20,000 admission or is it better to proactively send the nurse practitioner to the home that may only cost the system $200 and they're able to get their needs addressed right off the bat. So obviously, you know, $200 a care is a lot better than $20,000 a care, you know, we're not buying cars here, you know, so So, a ventative is the way to go. And I appreciate what my co-panelists are doing. I think what you're doing with clinical-based evidence

is huge. That's something that we could also potentially be a client as well, looking into. You said win-win-win. That's what we're seeing in the data. You could have better evidence-based treatments that actually reduce drug costs and improve total cost of care. What we see is you know the clinical content doubles every 72 days so like every 72 days double the amount of research papers existed. I'm lucky to

increase my knowledge like half a percent a year let alone double every 72 days so like how do these providers keep up they don't and what we see is trends like oh if you're a doctor and you graduate in the 1980s You typically prescribe a certain way versus someone that may have graduated in 2000 you prescribe a different way And you know and there's evidence so you know why can't we tee it up? You know and I guess that's what you guys are trying to solve and we're all trying to solve so I'm here You're a medical doctor. Do I have that right? Yeah, yeah internal medicine physician primary care Yeah, so for all of us here as we think about our doctors and the practices that we go to, what are the pressures on those practices?

And then how does that create opportunity for your business? A lot of people sometimes, especially with COVID, and they're beginning to view doctors not as favorably as maybe 10, 15 years ago. And the reality is they're just human beings, and they're being asked to see more patients every day. They're being asked to see more patients every day They're being given more administrative paperwork every day So they would love to spend the time and really get to understand what's driving the issue But unfortunately the way the system is set up

It's set up in a way where if they don't just check the box and move on They're gonna get backed up and they'll get fired from their job. And if they're running their own private practice They won't make enough money to cover their expenses That's the problem with a lot of what's going on and what we're trying to help is bring additional resources You know a lot of our practices that are able to add an extra Several thousand dollars a month from these, you know bonus payments in order to maybe slow things down a bit There's a lot of new tools like AI scribing which is able to write the notes on behalf of the doctor so that way they're able to focus.

Ultimately what we believe at Vitalize, our job is to get as much off their plate as possible to just focus on the patient in front of them. And I believe that's where all the magic will happen. We just have to sort of like cut the noise. And they're just human beings that want to do the right thing, but they're just sort of overwhelmed

by a very cumbersome system. And you came into the healthcare space as an outsider. You were a media executive for many years. Fans of Project Runway may recognize Anne. But I'm sort of curious, as you started to get involved in the healthcare space, what were some of the biggest surprises that you learned about how it works and what opportunities came out of the biggest surprises that you learned about how it works and what opportunities came out of discovering those surprises?

So I left my whole previous career, 25 years in magazines, because I believed that serving women in menopause is a good idea. The biggest surprise to me is how bad the problem was, even though I had already decided to really take a giant risk in fixing it. The doctors, to your point, have not received medical training. Only 20% of OB-GYN residents have even heard about menopause for one hour, and often it's a lunch and learn in medical school. And so, again, they can't be blamed for what they don't know,

but the result is that women are getting completely ignored, dismissed. Our average patient has spent three years trying to get care, and that's those people who can find care. We have also found that building a business that works for the doctors and the patients and the business is a win-win-win that actually provides the good old-fashioned continuous relationship with one health care provider who really knows your health history but also your menopause care. I couldn't believe how bad the system was and how misaligned the incentives were. So we're cash pay and we tried to build something that worked for the insurance and there was also a business that was viable.

And we also went through the employer route and we finally realized that there were about 11 different middlemen taking a cut between the doctor and the patient and the business. And there was so little care under 2000 providers certified in menopause that we just actually had to use technology, AI, to build this digital system, basically build our own lane. We had to just completely scrap the system that existed and we're actually providing care that costs $50 a year for the doctor care plus the price of our mostly generic FDA approved prescriptions. So it's affordable. We have 30 doctors who are working on our platform, all been working in OB-GYN for decades, mission-driven to help menopausal

women. We have zero doctor-atrician in three years. No one has ever heard of that, and the doctors are saying this is their favorite way to practice medicine that they've ever practiced. We're the only ones in the digital health space in menopause also providing only access to physicians. So many other companies have to try to save costs because of the various players taking a cut that they actually are trying to save money on the thing that matters most, which is the medical expertise. So they're doing low-cost providers, trying to train them up really quickly on what takes

really a whole career to learn because it's not, again, a medical school. And so I've just been so amazed, and everyone out there is saying it, for better or for worse, that the system is broken, but it was broken to the point where no one was winning except for a couple of the middlemen, and women were dying of UTIs in hospitals. I mean, it's really dire out there, and yet the solutions are actually so simple,

and when we actually just focus on the patient and the doctor and building a business that works, everyone wins. And I'm curious, are you seeing consumer behavior change? Oh, absolutely. I mean, I think not just in the menopause phase, right? I was just talking about this earlier where my mother was like, you've got to be friends with your doctor, because that person's going to take care of you

your whole life, right? And then I grew up, I'm a Gen X, so I've got to be friends with your doctor because that person's going to take care of you your whole life, right? And then I grew up, I'm a Gen X, so I've learned to find solutions online. I'm not digital native, but I'm digital fluent, right? So when I had my babies, I was going on Baby Center and crowdsourcing information. But the millennials and below, they have experienced the health care system

from the point of view of digital driven point solutions at every stage, from mental health to fertility to breastfeeding support to menopausal care. They're not there yet, but they're almost there. The oldest millennials are in perimenopause. And they, frankly, are just going to demand this change. And they're not, they've never experienced or even expect to experience the fact

that they'll have a doctor for a long period of time who will know them and be able to refer them to other experts based on their network. That doesn't exist anymore. I mean, it's, a lot of people are getting really good care at one medical, but that is based on the entire, completely opposite, right? Centralize the care and just have people come in.

The behavior really, really was changed before we got here and then COVID of course completely accelerated the shift and the acceptance of digital solutions. I'm interested, let's talk a little bit about sort of growing a business and, of course, completely accelerated this shift and the acceptance of digital solutions. I'm interested. Let's talk a little bit about sort of growing a business and, you know, healthcare is a $4.9 trillion industry. Investors are always very hungry for fast growth, healthcare startups. And yet I think in every case, I think all of your companies have raised money, but I

also think that you've been wary of raising too much or, you know, been thoughtful about the sources of funding that you have. So Brigham, can you tell us a little bit about your philosophy of raising money and what you raised and how that has shaped your company over time? So we raised a Series B last year, 34 million. We've raised about 60 million to date through three rounds or about four years old. Great group of investors. I would actually say on themes and maybe just things people think about, thinking about the mission of our company, which we think of as very broad. I want everybody to have access to this personalized evidence.

That's in the world. So that's a big goal. You have to have the right investor set to do that. And that's people with maybe a longer vision. So we work with people like Jim Breyer of Breyer Capital, led the A-Round investment in Facebook, the Yosemite Ventures, which is the jobs family, Reed Jobs, big mission, obviously, focus firm in oncology. Choosing investors that have that long view is important.

Later on, we've added a lot of strategic partners because I think the way to navigate healthcare is to understand the institutions within it and be able to work within that system. There's always the epic side of this when we talk about EMR and distribution, and there's different dynamics, obviously, in pharmacy and payments. For us, McKesson, Sincora, two very large sort of distributors

between pharma and provider were good alignments for us. We also work with Merck. So I've built a big community of investors. That, I think, is something that I wanted to do here because of the size that we're trying to do and to help us navigate it. In terms of just thinking about fundraising amounts, every one of my peers who took big rounds in 20 and 21

are miserable right now if they're still employed. And their jobs day to day as founders turned into firing people real fast. So I think the lesson for our community, particularly for healthcare, has been tried in different cycles. You can't buy the market the same way you might do if you're trying to be a category winner and direct to consumer. I'd say consumer healthcare is testing that now. It's actually getting interesting.

But broadly in B2B or B2B to C health tech, you have to be careful with that ethos, even if it's tempting to get that great valuation or to have so much money, you can throw big company parties or whatever, or even spend it on marketing. You want to make sure that's effective. So I try and be really thoughtful about that. At our B round, I turned down an additional $40 million and pissed some people off, frankly. But they can always invest later and add a higher valuation,

of course. Through their anger, they can write a check. The other part of this, just to say, and if people are in the early stages here, and we may talk a bit more about tech, with the toolkit we all now have with AI, LLMs, and generative AI technology, everything that's come out of the cloud layer, you should

be able to build a more capital efficient startup. And while every part of health tech still requires talent, domain knowledge, and relationships, you should go LLM first, AI first within your company from day one. Our big focus, and I know we talked about this a bit off stage, we have to build a profitable business to do this at scale. And our gross margins are way ahead of where our peers are at this stage because we made that decision early.

And I just think that's a new model. And your company is fully remote, is that right? Yeah, we're 100% remote. We're a COVID company. Spent on Stanford. I've got 50 employees in 14 states, which is its own headache. If anybody's solving virtual HR, please talk to me afterwards.

But we deal with that. And that efficiency lets me get great talent for the right price, regardless of where it is. There's advantages all over the place to build a more capital efficient business. I think that's kind of what investors are demanding a little bit. You two probably have experiences that are similar. Well, I come from media and I covered female entrepreneurs as editor in chief of Marie Claire Magazine.

I believed then and I see it now from the other side that a big raise was a big success. We did stories, a big amount of money is a very exciting story for journalists and for the reader or the audience. What I understand now as a founder is that, you know, and the other reason that that is like big names with big amounts of money, validating an idea seems like almost, it sort of helps the journalists validate this is a good thing to write about. But now I see from the other side that those big amounts of money, validating an idea seems like almost, it sort of helps the journalist validate, this is a good thing to write about. But now I see from the other side that those people are just giving away more of their company,

have more people to report to, and more pressure to deliver a certain return in a certain amount of time. And so it's been completely, for me, flipped on its head to raise the least amount of money to be able to grow responsibly and quickly, and to find investors who, first of all, its head to raise the least amount of money to be able to grow responsibly and quickly and to find investors who, first of all, don't think they know your business better than

you do and who have this timeline of like this healthcare, this is not crypto. And yes, AI is helping us be a lot more efficient and a lot more quick and being able to deliver care at scale. But that sense of like, we know what we're doing, we want as little involvement as possible, and we don't want to be rushed in the timeline for the return. Yeah. And Amir, you got shot down by a strategic, a would-be potential strategic investor and ended up funding the company in its early days through friends and family money from

your friends and family and your co-founders friends and family. In the end, was that sort of a blessing in disguise? Here's a tip for growing your business get the Venture X business card from Capital One and start earning unlimited double miles on every purchase. That's right with unlimited double miles the more your business spends the more miles you earn plus the Venture X business card has no preset spending limit, so your purchasing power can adapt to meet your business needs. The Venture X Business Card also includes access to over a thousand airport lounges. Just imagine where the Venture X Business Card from Capital One can take your business.

Capital One. What's in your wallet? Terms and conditions apply. Find out more at CapitalOne.com slash Venture X Business. Yeah, absolutely. You know, a lot of things didn't happen. And you know, some of the things that didn't happen ended up being the best things that happened to you.

You know, we've been at this for 11 years. We started the company in 2014. And you know, the first few years it was friends and family because who else is going to invest in you other than your friends and family? The first couple of years when it's just you and your co-founders. But you know, as the business has grown and evolved

and we're able to bring in angel investors, then smaller seed around investors, Series A, it's interesting. A lot of it is maintaining the relationship and having sort of clear lines of communication with your investors. Like, you know, one of the things, you know, my co-founder, the CEO Faris, he does a lot of the investment side of things. And he's very close with our board and our investors. He speaks to them on a regular basis. And we've never had a situation where we had a vote in a board meeting where we had to go one way or the other. It was always sort of unanimous because we're always on the same page at all given times.

And I hear what some of my colleagues are here. We did in the last couple of years raise a lot of money and grew pretty fast fast and we're dealing with some of the pain there as well. So I completely agree. You know, you don't want to overdo it with growth, you know. What's the biggest pain point? Well, in 23 to 24, we made up roughly 40% of the growth in value-based care nationwide. If you compare all the health systems, everyone out there in the, you know, we had 200,000 lives, Medicare lives, the whole group was 450,000. So we ended up adding a lot of practices that were primary care practices that we partnered

with that were not good fits, that were maybe less inclined to practice value-based care. And, you know, so that ended up leading to a little bit of some pain points in 24. And then we had to separate from 24 to 25 but you learn you learn and you know absolutely you know there's always a middle road and ultimately I agree like ultimately the goal is not to lose rather than to gain more quickly so going slow has its benefits and but at the same time you know everything's a balancing act you don't want to go too slow either so it's I think that's one of the hardest things of startups is everything's in a shade of gray in the middle and it's hard.

It's hard to know whether you're on one extreme or another. And you were saying that between you and your co-founder and your board, you've made it a real focus this year on improving EBITDA. Is that right? EBITDA, yeah. So in 21, 22, when we were going for the rapid growth, everyone was like top line revenue, growth, growth, growth, land grab,

that's what everyone wanted, including our investors. And a year, a year and a half goes by, we get the fastest growing company in the world with Inc. Magazine, and they're like, all right, it's no longer growth, guys, it's profitability, we don't care about your growth anymore. Check that off and go on to the next thing. It makes sense, we're running a business, not a growth Check that off and go on to the next thing. It makes sense.

We're running a business, not a growth engine. I think that's the goal of a business. You're supposed to make money at some point. It's a transition, but it's been a good journey. We're just very fortunate. The one positive thing of growth is it enables you to attract talent and people that you normally wouldn't have been able to attract. Our current COO was the COO of UnitedHealthcare. That wouldn't have been able to attract. Our current COO was the COO of United Healthcare.

That wouldn't have been able to happen. He's managing 400,000 employees, now he works at Vitalize. It wouldn't have happened if we were still a tiny startup. But it's a double-edged sword. You want to be careful. You want to be able to walk that middle lane, which is I think one of the hardest parts of a startup is knowing if you're on one extreme or the other. Yeah.

So this is obviously our Your Next Move session, which Inc. produces in partnership with Capital One Business. And so let me ask the very obvious question. Brigham, what's your next move? What I'm really focused on right now is distribution in the provider market. I think we've got the product, we've got the product market fit, we've got the users that love it. The reality getting down to providers is if you're in startup in the room,

trying to figure out well, okay, so I just like put up a website and send the provider so it's like no, we have a big announcement coming this week, which I'll bring them out to preview ambient let's make some news AI scribes a lot over the last year. It's been one of the big success stories. We're going to be announcing ambient integration at Stanford University, our home university. So imagine you're a physician, your visit gets recorded,

your note gets automatically generated, and then there's a personalized evidence study for that patient on what to do. They don't have to do anything. So we're really focused on that. I'd say a bigger idea that I'm interested in that we'll see if it's time for this, but it's really feeling like prior authorization might be having a moment. I also think the efficiency of it and the potential win-win, if we can remove some of

the administrative burden there, add to that what's starting to look like a potentially really thoughtful and aggressive CMS. So we're watching that closely. I would love it if we could all be talking a year from now and saying, there's a path to removing prior auth and evidence based prior auth playing a really key part of that. So that's what's up for us. Great, great. And what's your next move? We are exploring drug to consumer we first tried and did

sort of conquer and get the woman to come straight to us. And that's been our biggest source, obviously of business. But we are also having built this reputation among doctors and having happy doctors who work for us are now about to launch HCP, like basically getting doctors to refer their patients to us because none of them actually want to do menopausal care

because they don't get reimbursed at a high enough rate. The OB-GYNs really want to deliver babies. That's what they went into this for. And then also we're at the stage, we were encouraged by an investor we did not take on early to do this very early, but we are now at a revenue stage where we can think about vertical integration of our doctor network and our pharmacy. Yeah. You were saying earlier that even though menopause is like a very hot area in healthcare right

now, the total market is still, well, the addressable market is huge, but the total market is still small. Is that right? Yeah, I think if you took all the menopause companies out there and there are about five of us, then some of the bigger players have said over the years that they're getting into menopause but just haven't been able to conquer it because it's complicated and there are not enough providers for all the reasons I've been talking about. I think if you, you know, 55 million menopause, if you include perimenopause is 83 million. And I think I would say, if you take all of us together, we've probably cornered one 50th of the market.

And so we have a lot, and still the demand is so high. And again, recent, the Menopause Society this past fall gave that 4% stat of women in menopause seeking help. That's the number of women going to get help who don't receive it, or who do receive it. that 4% stat of women in menopause seeking help. That's the number of women going to get help who don't receive it, or who do receive it. So that leaves 96% of that, 55 to 83 million, looking for help and not getting it yet.

Wow, wow. And Amir, having run the number one company, healthcare or not, in America, in terms of revenue growth over the past couple of years, what's your next move? So we've been historically focused on the primary care, doctor, patients directly. We're gonna we're expanding working more with specialists, skilled nursing facilities, other people in the health

care space. It's not enough to make sure that you know the primary care is where we started because we do use them as sort of the quarterback where it all sort of starts from but obviously specialists, health systems, skilled nursing facilities, they all have a role to improve patient outcomes. And we're also trying to craft ways how we could win-win. How can an ophthalmologist serve better care for a Medicare patient while profiting their clinic more and while helping the taxpayer save money?

So it's not always straightforward, but I really do believe in the majority of things. If you really spend the time, you could figure out win-win-win-wins. And I do believe it's not a zero-sum game in the world, so you are able to structure a lot of that. So expand outside of the primary care. We're beginning to do some of that,

but go a lot deeper into the network play. Great. Well, Brigham Hyatt of Atropo Health, Anne Flomweiler of Alloy Health, and Amir Al-Najjar of Vitalize Health. Thank you so much for being with us here today. Thank you. Thank you. Thank you, everybody. Al Najar of Vitalize Health. And already, subscribe to Your Next Move on Apple Podcasts, Spotify, or wherever you listen. Your Next Move is a production of Inc. and Capital One Business.