Latest / StartUp Health NOW Podcast / Dr. Toyin Ajayi, Cityblock Health: Building and Scaling a Company With an Impactful Mission

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Dr. Toyin Ajayi, Cityblock Health: Building and Scaling a Company With an Impactful Mission · StartUp Health NOW Podcast

• 0:00
  [on hold music] Probably the key things that I would, would remind myself of is that time really flies, and establishing solid foundations for the business upfront and taking the time to do that intentionally will always yield dividends, even though you're, you're feeling under pressure to move and to grow.
• 0:23
  [upbeat music] Welcome to Startup Health Now, the podcast where we celebrate the entrepreneurs and innovators reimagining the future of health.
• 0:34
  Toyin Ajayi co-founded Cityblock Health in twenty seventeen with the goal of meeting patients where they are.
• 0:40
  Cityblock Health, which joined Startup Health in twenty nineteen, provides patients with twenty four/seven support and care that is affordable and fits their complex needs.
• 0:50
  Their mission is not just to improve quality of care, but to improve the health of whole communities.
• 0:55
  In this conversation, Toyin, who stepped into the role of CEO this year, shares how their high touch care concept adapted to COVID.
• 1:02
  She also explains how their unique model has specialists collaborating on patient care plans and gives some hard-earned leadership advice to founders. Let's get into the conversation. [upbeat music] Dr.
• 1:17
  Ajayi, thanks for joining us today for this fireside chat. Thanks for having me, Logan.
• 1:24
  So I think people can get, uh, distracted by the big fundraise headlines and evaluations and end up not seeing past a company's mission statement.
• 1:34
  And so as I mentioned, we know that Cityblock, uh, works to address the health needs of low-income communities, communities that have been overlooked, uh, by other health systems.
• 1:44
  Um, but let's level set and give you a chance to explain exactly what Cityblock is, what the care model is, and how you're deploying it today. Sure. Um, so thank you again for having us.
• 1:56
  Um, uh, so Cityblock is a value-based provider, um, that's rooted in community-based, um, primary care, behavioral health, and social care.
• 2:05
  We primarily serve Medicaid and dually eligible populations, so ind-individuals with the most complex needs in the healthcare ecosystem, folks who are most likely to kind of fall through the cracks and get left behind by the frustrating, confusing existing healthcare system, um, and, and folks who have the, like, the most to lose from the deficits of our, of our existing sy- status quo.
• 2:27
  Um, we, uh, partner with managed care organizations, um, in geographies where they have significant, um, concentrations of individuals with these complex needs who are living with sequelae of poverty.
• 2:39
  And we take financial risk and provide care in the community that drives health outcomes that are improved off of baseline, reduces acute utilization by, um, by proactively and in a more cost-effective way, bringing care to people in their homes, and, um, and improves overall health quality and, and engagement.
• 2:58
  Um, we, we now operate in, in five markets, um, across the Northeast, coming further down into the, the Mid-Atlantic region. We're continuing to expand and grow.
• 3:07
  Um, but, uh, but our, our sort of overall thesis and, and, and we're proving out the thesis is, is that there's sustainable business case for delivering high quality, personalized, um, integrated care that meets people where they are and avoids the, the, the needless morbidity, illness, and utilization that comes from unmet healthcare needs, particularly in low income populations.
• 3:32
  I wonder if we could get into any details around some of those strategies. You talked about personalization, personalized care.
• 3:39
  You talked about integrated care, and I know you've put a lot of time and energy into figuring out, well, what does that really look like, uh, patient by patient?
• 3:47
  So what are some of the actual strategies you've used, uh, to accomplish those goals? And the first thing is about engagement. So, um, when you look at the data, this is pre-pandemic.
• 3:58
  It's much, much worse post-pandemic, right?
• 4:00
  When you look at, um, individuals with the most significant healthcare needs, people with multiple chronic conditions, people struggling with mental health or addiction, people with high utilization patterns of the emergency room and the, the hospital setting, um, very few of them, typically on the order of about fifty percent, have meaningful primary care relationships that you can see in the data.
• 4:20
  And by that I mean that they've seen the same doctor or the same advanced practice clinician in a practice more than once in the pre-preceding twelve months, like a real relationship.
• 4:29
  And when you think about that, when you think this person's struggling with diabetes and high blood pressure and heart failure, they were in the hospital three times last year.
• 4:37
  The threshold of saying, "Did you see a doctor in the primary care setting in-- at least once in the prior twelve months, ideally two or three times, and it was the same person, and maybe it's a person you actually have a relationship with?"
• 4:48
  Um, very few people actually have that, can say that.
• 4:50
  Um, and they're using, and they're sort of almost defaulting to the acute system, um, because there's such so many barriers to accessing care, transportation, childcare, um, uh, the telephone to make an appointment, sit on the, sit on the phone and reschedule.
• 5:06
  Um, you know, the, the, the cash that there's effectively out-of-pocket spending, um, in, in the form of lost wages for the day they took off to go see the doctor.
• 5:14
  There's so many barriers to accessing a healthcare system that for many people doesn't feel like it meets their needs.
• 5:20
  'Cause ultimately, when you get in front of the clinician, you get ten minutes, and maybe they're distracted with the EHR or with something else, and you're not even able to begin to tell your story.
• 5:28
  And so we focus very much on, on, on bridging the access gap, not in the traditional way. We're not building more clinics and thinking that's somebody-- somehow gonna solve the problem.
• 5:38
  We're not giving everybody an app in the App Store and pushing out, you know, text messages and thinking that's gonna solve the problem.
• 5:44
  We're actually going to people, finding them, um, be it in a shelter, on a park bench, on a street corner, or in their home, and ensuring that they have a trusted relationship that is their entry point into the care model that we can then provide primary care and mental health and social services around and address the social, the, the social barriers to them accessing care on their own terms.That's one of the key pieces of the model.
• 6:08
  It's, it's that relationship, that engagement model, that trust-based, um, unlock that enables people to kind of access services that they're entitled to, that are there for them, that would make a difference for them, but they have historically not been able to address and to access.
• 6:22
  The second piece is, is around integration of care services at the point of need.
• 6:26
  So physical health and behavioral health, and making sure that people really do, um, uh, re-receive a holistic experience of care, which for many is a novel experience, right?
• 6:37
  Most health centers, many practices really think of physical health as very separate from behavioral health and mental health and social and, and, um, and, uh, substance use disorder treatment.
• 6:46
  And that means that people need to make separate appointments and that their clinicians can't see or talk to each other, that there's no sense of cohesion across those two spaces.
• 6:54
  And so for us, that next p-sort of key component of the model is that integration at the point of need of physical and behavioral health.
• 7:01
  And then the third key unlock for us is, is addressing social barriers, which we call social care, but providing social care.
• 7:08
  It's recognizing that, um, you know, there are the traditional so-social drivers of, of health that we talk about, um, many of which are almost geographically defined, place-based.
• 7:18
  Um, our people, our members live in communities that are hard to access through transportation, where they don't have great access to healthy, nutritious, and affordable food, um, where they may not have, you know, green, leafy, safe spaces to exercise outside, um, where they may not have access to great data coverage or to the, the, the income to buy, um, internet and, and access services in those ways.
• 7:41
  But they're also struggling from loneliness, from trauma, from, um, the, the consequences of a life lived with, you know, exposure to systemic racism and all this, um, all this sequelae as well.
• 7:52
  And so addressing those social needs, understanding them first and then addressing them is another key point of leverage for us.
• 7:58
  And, um, we find a lot of value through, um, through closing those social gaps with individuals as a means to help them, um, achieve better health. Uh, let's talk about that social care piece for a minute.
• 8:10
  There's many, many people on this call who are, are passionate about addressing just what you described, all the elements of life that really feed into health beyond just a visit with a doctor.
• 8:21
  And you've had the benefit of really being on the front lines of delivering this kind of social care and seeing what really moves the needle.
• 8:30
  And so I wonder if you could give us any of your thoughts on, on that piece, moving from the theories of social care to, to action and what really, what really matters to people, to patients on the ground. Yeah. Yeah.
• 8:43
  I mean, I think the first thing is to acknowledge that we are all, I think collectively the communities, right, say Cityblock, but also all of us in this work, we're on a learning journey, right?
• 8:51
  Like, the level of science and, um, and best practice around social care is still very nascent.
• 8:58
  And so we all have to think of ourselves as innovating here and contributing to a body of work that will enable us to better understand what I like to describe as the sort of the dose-dependent relationship between social interventions and health outcomes.
• 9:10
  Um, and so when you take it from the sort of the meta level, right, like we all know and recognize that in order to thrive and in order to live healthy lives, individuals need, um, basic services.
• 9:21
  They need the basic needs that need-- must be met. Warm, safe place to sleep at night. Um, sufficient, nutritious, healthy food to eat. Um, uh, the ability to move around your environment to access additional services.
• 9:34
  Sufficient income that you can pay for all of the things that you need in order to be healthy. Um, education such that you can understand health information and make reasoned choices for yourself.
• 9:45
  There's a whole host of social needs that enable health.
• 9:48
  What we also know is that, um, those, those needs are, um, very unequally met by a society that does not prioritize investment or historically hasn't universally prioritized investment in these common social goods.
• 10:03
  And as healthcare professionals and as healthcare organizations, we see the consequences of this most acutely and most expensively in the healthcare system. And I, you know, I say that this is anecdote, you know, to...
• 10:15
  And it's not to be trite, but, you know, if you're, if you're one of our, our members and you're struggling with marginally hou-- being marginally housed, you're, you know, every Friday night, not sure where you're gonna sleep.
• 10:25
  Um, uh, it's if you have enough money for a motel, is dependent on whether you're able to raise that money through sex work or through, um, panhandling or, um, just a stroke of luck.
• 10:36
  Um, at ten o'clock or at midnight on a Friday night, there's only one place really you can go where you are guaranteed that someone's gonna act like you matter for a minute, and you may get a place to sleep and a sandwich, and that's the emergency room.
• 10:49
  And so, so there's the most extreme example, which is a, a massive, like, lack of a social need directly translates into healthcare cost and health utilization.
• 10:58
  But then you, you sort of-- you can map it all back, you know, even in less extreme circumstances.
• 11:03
  If you're a person who struggles with, you know, three or four chronic conditions, one of which is diabetes, another which is, is high blood pressure or, um, or heart failure, and you've got to eat a specialized diet, but your ten dollars, um, in, in disposable income for the next two days isn't sufficient to buy you a healthy homemade meal.
• 11:22
  It's enough to get you a fast food, um, uh, Happy Meal that has way more salt than you probably should, should have or more sugar, and you find yourself in the emergency room as a result, right?
• 11:32
  These are social problems that translate into healthcare, right?
• 11:35
  Um, the question, however, is not as simple when you look backwards and say, okay, does that mean that healthcare dollars should pay for healthy, nutritious food for everyone? It should pay for housing for everyone.
• 11:47
  Um, in theory, yes, but in practice, we do not have the resources distributed in that way, right?
• 11:52
  So you then have to ask yourself, what are the interventions that we can pay for with healthcare resources that will make the most impact for people on the, on, on the healthcare side of their lives, recognizing that it leaves still gaps unmetAnd that we have to partner more holistically and more broadly with, um, social services organizations, with government, if we're really trying to sort of prevent as opposed to treat.
• 12:16
  And, um, and that's where, you know, we are learning and innovating at Cityblock. And the first recognizing that understanding where those gaps exist for our members, that's key. That's the first step.
• 12:26
  You gotta understand, you gotta measure it, and really see it in order to then intervene, and then you have to test and iterate.
• 12:32
  Um, for some folks who are struggling with marginal housing, um, supporting them to get access to a benefit that they qualify for, Section 8 as an example, or, um, supportive housing if they're struggling with mental illness is, is a sufficient and, and actually very, um, uh, efficient and effective use of healthcare dollars.
• 12:51
  For others, it might be putting them up in an emergency, um, respite unit, um, that we actually pay for. For others yet, it might be helping them repair a relationship with a loved one so they can move in with them.
• 13:02
  Um, and so thinking about the ways that we sort of titrate the dosing of social interventions to get the maximum outcome for the people whom we're serving, while recognizing that we exist in an ecosystem that, that ultimately entirely has to be reformed in order to get upstream enough to prevent the issues that we're treating, um, is, is a really nuanced and I think important part of the way we approach the work.
• 13:24
  Very interesting. Um, I, I wanna spend a little bit more time talking about the care model a little later, but, uh, for now, I want to shift over to talking about Cityblock, the business.
• 13:33
  Uh, but I also wanna invite everybody who's on the call to, uh, drop your questions in the chat.
• 13:38
  We're gonna leave time on this call, uh, for all of your questions, and you can start leaving them now, and once we get to that portion, I will call on you and ask you to come off mute and ask it yourself.
• 13:48
  So be ready for that, so you can start leaving your questions now.
• 13:52
  Uh, my question is, when we were talking before this call, you mentioned that Cityblock has grown, uh, s- a lot, and I think has more than a thousand employees, you said? But you started- That's correct. Yeah...
• 14:04
  I believe, with three co-founders, uh, back in the day. Uh, and, you know, I kind of...
• 14:11
  I wonder if you-- Th- that's some rapid growth, and I wonder if you could go back to, to when it was just the three of you and give yourself a piece of advice now knowing what you know, uh, looking from a, from a business standpoint, um, what would you tell yourself?
• 14:27
  Oh my goodness. I mean, the... as, as you all know, the road to being a founder or, or the path of being a founder is littered with woulda, coulda, shouldas, right? Like there's a million-- I, I could write a book.
• 14:38
  There's a million things that I would wish I knew now-- then that I know now. Um, you know, I think the, um,
• 14:48
  probably the key things that I would, would remind myself of is that time really flies, and, um, establishing solid foundations for the business upfront and taking the time to do that intentionally will always yield dividends even though you're, you're feeling under pressure to move and to grow.
• 15:06
  Um, you know, one of the most valuable things we did, and it came a little bit later in our lifecycle as a company, was to spend time, um, on a company-wide exercise where we built our values, and, um, and that has been
• 15:21
  so valuable. But it was, it was months of workshopping and wordsmithing and town halls and real conversations with people that we did not do, you know, in the first six months or year of the company's founding.
• 15:35
  Um, but then when we got to, it was like just so foundational and so valuable, and so things like that. I think recognizing that, um, we are not all...
• 15:43
  w- as we're not ever, and certainly I could in the future not be as fortunate as to, as to have the success that we've had. You never know, but build as though you're gonna be wildly successful.
• 15:52
  Build as though you're gonna exceed your wildest dreams, and that means that you need to be prepared to, to endure, and you need to be prepared to have, um, uh, artifacts and institutions and systems and processes and structures that can grow with you.
• 16:06
  Um, that would be the biggest piece of advice at every point is to, is to really do this as though it's gonna be here for a long time. And that's hard when, when we...
• 16:13
  many of, many folks, like I can't include myself, I'm not a Silicon Valley-ite really, but, you know, sort of move fast and break things is the sort of the, the, the quintessential adage.
• 16:23
  I, I, I don't actually subscribe to that.
• 16:25
  Um, and I would really, um, I think urge folks to, to really think about the places where you want to, in some instances, overbuild relative to your stage, um, in order to, to create the foundations that you can, you can grow with.
• 16:38
  I'm sure you're being pulled in a thousand different directions with your current role as CEO.
• 16:42
  How do you build in the time to make sure you still are using that thinking, that you are building s- solid foundations and not just, uh, working and doing now that you're in such a high pressure role?
• 16:55
  Um, for me, it's, it's about two things. It's about sort of managing myself, um, just sort of personally, internally, like making sure that I'm like well rested, that I have, you know, I opt... I know how I work.
• 17:07
  I'm much better in the mornings, that I really am very, uh, very careful and sort of guard quite closely my morning time so that I can use that as productive thinking and working time.
• 17:17
  So really understanding your rhythms, um, and making sure that you're effectively optimizing yourself for the work, um, is, is thing number one.
• 17:24
  Um, you know, the sleep, exercise, food, all those things are really, really, really important, um, in the self-care.
• 17:30
  And then the other thing is, um, is being really, really, um, intentional about, not just for myself, but for my team, carving out, um, real time to think and to, to, to, to be strategic.
• 17:41
  Um, and that requires being exposed to new ideas. It requires being exposed to old ideas.
• 17:46
  It re- requires being exposed to the business, um, to seeing what happens on the ground, making sure you're really connected to the team and what the tone and tenor and energy of the organization is, and where you're having impact, that you're rooted in the data on performance, because that is all fodderFor strategic thinking, and so making sure that you're sort of constantly, you know, being exposed to stimuli, both external and internal, that will, um, that will promote strategic thinking.
• 18:11
  Um, and then having the time to actually do it is, has been really key. And so, you know, I, I often will roll my eyes when I get asked to go to a conference or something. I never wanna go.
• 18:21
  I would much rather stay and, you know, work, work with my team and focus looking inwards.
• 18:27
  But every time I do, you, you get exposed to new ideas, to new people, to new, um, to a sense of what's happening in the broader ecosystem.
• 18:34
  Like making sure to have that both external and internal stimuli really well-balanced I think is critical to ensure that you have the right ingredients for, for good decision-making. When you came over...
• 18:46
  When you took over as CEO, you penned an editorial that I, I read on, on Medium, and you said that in, uh, 2020 hit you like a ton of bricks, that COVID-19 really, uh, caused you to have to really rethink, um, CityBlock Health, kind of, uh, your, your care models, et cetera, and kinda recalibrate, and I wonder if you could sort of talk about what you observed and kind of how you went about recalibrating due to the pandemic.
• 19:14
  Yeah. I mean, who here didn't feel hit by a ton of bricks, like, [laughs] in 2020? Um, it was, it was really trying times, you know, and I think, um, uh, on many levels, um, not to mention the personal levels.
• 19:25
  Um, but for us, it was a really humbling and also very transformational moment for our business. Um, at the time, our largest market and our largest, um, population of membership was in Brooklyn, New York.
• 19:38
  Um, those of you who are in or around New York remember what it was like in March of 2020 in New York. Um, uh, we were just completely overwhelmed immediately.
• 19:48
  And, you know, as a physician, first and foremost, who's been serving marginalized populations my whole career, um, as a person of color living in a, you know, majority low-income community in Crown Heights where I live, it was very clear from day one that this pandemic was gonna disproportionately impact the, the marginalized and the disenfranchised who happen to be our members.
• 20:12
  And so we, we knew we had an imperative to, like, really, really rethink our clinical model to make sure we could almost stand in the way, um, and, and prevent some of the, just the suffering that we knew was gonna happen to our members, um, to identify those who are most vulnerable as quickly as possible, to get to them as quickly as possible, to stay on top of the literature and the learnings, to make sure we had access to PPE and oxygen, that we were having the right conversations with family members, that we were equipping them with the tools to keep their loved ones healthy and safe while our hospitals were overflowing.
• 20:46
  Um, we, we were just, like, just fully focused on saying, "We see this avalanche coming, and we know that our folks are the most vulnerable people that, that exist in our society.
• 20:56
  How do we get to them first, and how do we wrap around them as much as possible?"
• 21:00
  And then at the, at the sort of the company level, you know, as, as a, as a healthcare company whose, um, uh, entire outcomes and business model is predicated on taking care of people and keeping them safe and out of the hospital, sick people, keeping them safe and out of the hospital, what did that mean for us when our key kind of modes of deployment were still very much in person, um, and very much hands-on, and continue to be to this day?
• 21:25
  Where we had healthcare workers who were potentially putting themselves in the line of fire, um, so to speak, um, in their duty to care for our members, when we had members who were too afraid or too frail or vulnerable to leave their homes and really shouldn't take visitors, when we had other members who were unable to socially distance 'cause they were essential workers who needed to get on the bus or the subway and go to their job every day to keep our system and our society still going, even despite all of this.
• 21:50
  So what does it mean for us from a business perspective was a really big question, and we, I think in the, in, in the beginning, sensed and were geared for the idea that, um, that a model like ours and a company like ours that pr- disproportionately focuses on, on marginalized communities and that has a, the ability to pivot and innovate very quickly would find itself in, in much higher demand, even than it was before in the pandemic.
• 22:14
  Um, but I don't know that we were prepared for just how much higher demand, right? And so, um, you know, it was... uh, 2020 was really transformational for CityBlock. We grew significantly.
• 22:24
  Um, we saw the, the value that a, that a value-based primary care community-oriented provider has in an ecosystem where other primary care practices were shutting down. They were worried about making payroll.
• 22:37
  They couldn't keep their doors open because their entire business model was predicated on people coming to them, sitting in a room full of other sick people to get care, and absent that, they couldn't make their business work, whereas we were, we're value based.
• 22:51
  We're oriented around a population. We have the resources to say, "Okay, they can't come to us. We're gonna go to them." We need to deliver tablets to people so they can get on online and, and video visit.
• 23:01
  We can do that. We need to invest in, in a whole new clinical delivery system with paramedics and EMTs in people's homes. We can do that too.
• 23:09
  Um, and so we were really, I think, very well positioned to grow and to, to take on the care of more people in the midst of the pandemic.
• 23:16
  Um, but, um, but it was, it was really, really, um, it was really a challenge, and we, I think, rose to that challenge very much, um, driven by our commitment to serving our members and to ensuring that we were providing the very best possible care for them at one of the hardest times for, for our society.
• 23:32
  Yeah. That's fascinating. Uh, let's go to a couple questions from the audience. We've got a, a couple that have come in. Let's start with, uh, Bentley Adams.
• 23:40
  Uh, well, you can come off mute, give us 30 seconds about, uh, your business, and then ask your question. Great. Thanks. Thanks, Leon, and, and thanks, Dr. Ajayi. I, I think it's...
• 23:51
  Or do you go by Toyin, or is Toyin better? You tell me. Toyin's good. Toyin's good. You're good. [laughs] Just wanna always be respectful of those positions in our world. But, um- I appreciate that...
• 23:58
  I, I love the story and, and, and I love your purpose and I love your passion, and I always, I always think with founders, one of the most important things to me... Oh, I guess first, what Waye is.
• 24:06
  Waye is a mindful eating app that helps people find peace in their relationship with food and their body.
• 24:11
  Um, so with founders, I'm always curious, you know, what was the original vision of what you set out to do?How specific was it? And how did that come to be? Or how did that change along the way?
• 24:26
  And I think you answered it a little bit in there, but I'd love to hear kind of what the, the human experience of being a founder of this amazing company has been, 'cause I think that you're, you're definitely making impact.
• 24:35
  So I'm curious how you-- where you started from and where you're at now in your own words. Thank you.
• 24:40
  Um, you know, the, the vision was actually very specific, partly 'cause, you know, I, I grew up in healthcare, not in a venture. This is my first startup. I'm a total novice to that side.
• 24:52
  But, um, but I spent many years, you know, providing care in safety net hospitals and community health centers and, um, you know, doing street homeless work, um, really just seeing the ways in which our system fails to meet the needs of, of people who need it the most.
• 25:06
  And the vision was to create a scalable business case for providing a dignified and respectful experience of care for the most marginalized in our communities, and to start that in Medicaid.
• 25:18
  So build a company that was fit for purpose for people who struggle with low income in addition to all the other things that they have going on. Um, and, and, you know, it, it, it evolves.
• 25:28
  Certainly, it's evolved to much more specificity on the care model, to much more specificity in the ways in which social and behavioral and physical come together, um, to a much deeper understanding of what, you know, the healthcare ecosystem wants to purchase.
• 25:43
  Um, so there's a lot of, like, growth and learning that's occurred. But the vision was very specific about, you know, anchored in that experience. Like, I want people...
• 25:51
  I want to, to prove-- We still to this day wanna prove that it's possible to do things radically different and do it at scale, um, because we believe that our true impact is gonna be achieved when everyone else in the healthcare system behaves differently because we finally, like, call the lie.
• 26:09
  Like, we call the lie. It is not... You know, the best we can do is not a ten-minute visit that feels it's dismissive of a person who's in distress.
• 26:19
  The best we can do is not an emergency room that will see you when your foot needs to be amputated, but where you can't afford insulin to prevent the amputation. Like, that is not the best we can do.
• 26:30
  We can do better than that, and, like, we wanna prove that we can do better than that. Not, like, out of the generosity of someone's sort of philanthropic giving, but actually with a business that can scale and sustain.
• 26:42
  Um, and so that, that ultimately is the thing for us.
• 26:46
  And, um, and we continue to just eat away at this, you know, with a, with a just a, a sort of, like, maniacal focus on the population and the experience that our members have of, of the care they receive with us in order to prove that, that we can do way better for these folks.
• 27:02
  Thanks for the question, Bentley. I love that, that maniacal focus at, at we can do better. Uh, let's go to David Sarabia, uh, his question. He's from In Recovery. So come off mute, David. Hey, guys. How are you?
• 27:15
  Hi, Taryn. Nice to meet you. I'm a big fan of Cityblock. Thank you.
• 27:19
  Um, yeah, and, you know, having been in New York-- having been homeless in New York, actually, um, completely very much connected to your mission, and, and I appreciate everything you guys do.
• 27:28
  Um, yeah, that revolving door is so true and, you know, you, you hack things out when you're homeless. I was, uh, taking the A train 'cause- Mm-hmm...
• 27:35
  you know, long as, long as red you can take to sleep like an hour and a half uninterrupted all the way to Far Rockaway. Um, so my question really is, you know, how do you, how do you continue to be so high touch?
• 27:47
  I'm sorry, my, my company In Recovery, um, just in a quick nutshell, uh, we are helping treatment providers or treatment-- the treatment industry become more data-driven and really create a, a much more, uh, scalable path to reintegration for people.
• 28:01
  Um, so for, for your company and, and how you guys are so high touch, how do you continue to be like this when, when, you know, you obviously have to answer to investors, you now have to scale the company, you have to eventually be more systematic, right?
• 28:15
  Versus like you said, you know, sometimes you, you, you don't need a ten-minute visit, you need a one-hour conversation about that person's issues.
• 28:22
  And how do you guys leverage government relationships as well for, for something like this? It seems like really, really critical, right? To, to engage with social services and government services, so on with this. Yeah.
• 28:33
  Thank you so much for the question, and thank you for sharing your experience. Um, I just...
• 28:36
  And, you know, I think, I think that obviously your experience will inform so much of how you build, and so I just love that you bring that into your story as well. Um, you know,
• 28:47
  the how do you scale the high touch has been the key question for us and the key unlock, right? It's not... We, we... And that's where technology is so valuable.
• 28:55
  Tech doesn't replace the human contact, but tech can make it so much more efficient and, and effective and valuable. And so here are some examples.
• 29:04
  Um, if I'm going to do outreach to do-- try to find somebody and try to engage them in, in the healthcare, um, system that we're providing, um, if I'm armed with information about what their needs might be, with suggested guidelines about how I might interact with them, with, um, the intelligence that they may not be home to answer the phone, you know, at four o'clock in the afternoon 'cause they're working, um, that enables me to be way more targeted and way more effective in the way that I outreach a member.
• 29:32
  The next thing, of course, is then, like, what do I do for people and with people? How do we, um, essentially scale, uh, you know, mo-most of the most high-performing... We still do this at Cityblock.
• 29:41
  The most high-performing interdisciplinary teams do what we call case conferencing or huddling, where we get an interdisciplinary team together, um, the best minds possible of our, you know, nurse practitioner or physician assistant, our community health partner, our, um, behavioral health specialist, our physician or medical director.
• 29:57
  Everybody gets in the room and talks about what's going on for a specific member and tries to figure out and prioritize what we can do to help improve their health outcomes, and then bring that member into the conversation as we kind of build their, um, uh, personalized care plan.
• 30:13
  And oftentimes it feels like you're bouncing. You know, it's like it's a trial and error. This is a person, they're always in the emergency room, they're always struggling, their blood sugar is always super high.
• 30:21
  Okay, well, let's try a home visit. Let's try getting them home-delivered meals that have, you know, less carbs. Let's try this information thing. Let's try connecting them to so and so. There's actually like...
• 30:32
  We can start to aggregate best practices and-...
• 30:35
  shortcut some of the, the, the wrong doors we go down when we're trying to figure out what, what the most high value set of interventions would be for a person, and in what sequence.
• 30:44
  And so how do you use data and our experiences and our care pathways and our tooling to create decision support for team members so that they don't have to try every idea that everyone else has tried before, um, before they get to the right one?
• 31:00
  That's another example of the ways in which you can scale high touch. The final piece is, of course, just recognizing that, um, that even at maturity, some people need an hour-long visit.
• 31:12
  And if that hour-long visit with a therapist or with a community health partner prevents one hospitalization, you've paid for it 20 times, 40 times over.
• 31:23
  Um, and so there is a real, like, ROI on time in the community, um, time spent on preventive care, time spent on care coordination, time invested in primary care, time invested in mental health and addiction treatment services.
• 31:38
  Like, the ROI is immense because the counterfactual is the emergency room, which also doesn't solve the problem. It just creates a, you know, a short-term band-aid that is incredibly expensive.
• 31:50
  Um, and we really recognize that and, and really strive to make sure that our members, um, get access to the time, the time that they need as well. Appreciate the question, David.
• 32:00
  Uh, you mentioned something, Toyin, uh, about the huddle, which is such a, a- an awesome idea of just being able to bring in these, this multip- multidisciplinary team to address a whole person, and it made me think of a question I had, which was about CityBlock, um, uh, evolving to, to virtual, to moving to virtual, uh, which I know happened through COVID.
• 32:22
  You had major offices in Brooklyn, and now I believe you're all virtual.
• 32:26
  And I, and I wonder if you could maybe t-t-tell us a little bit about that journey and about some of the, the challenges, maybe some of the strategies you've employed to make that work within the model and culture of your company.
• 32:40
  Yeah.
• 32:41
  So our care team, um, uh, members, and so folks who are providing direct care to our members, um, continue to huddle, um, uh, often in person, um, but also virtually, and then we continue to see our members in person.
• 32:52
  So we retained, you know, our bricks-and-mortar hubs, our community hubs, um, in, in the markets that we operate in that members can come in and receive care at, that our team members can, um, you know, spend time, time together with.
• 33:04
  But our corporate office, um, closed during the pandemic and has remained closed. Um, and that has created a, as a whole...
• 33:11
  Again, I'm, like, we're certainly not unique in experiencing this, um, uh, a whole set of both challenges and opportunities for sure as we, as we've sought to, to ensure that that, like, high touch, um, interpersonal, um, uh, set of relationships are preserved throughout the team.
• 33:28
  Um, and so, so we, we continue to, of course, um, like, like most companies use, use a lot on, um, uh, of, of, of virtual interaction, um, uh, with our members and with our team members.
• 33:41
  We, we give them the opportunity to, to be in person as well as to, to engage virtually, um, depending on what folks need. And, um, and it's been a g- a learning journey for sure.
• 33:50
  Um, but I think we've, we've really demonstrated, like many have, that, that we can do a lot, um, virtually, and we can, um, and we can certainly, certainly, uh, collaborate, partner, communicate well in really effective and efficient ways using virtual modalities.
• 34:04
  And so that continues to be something that we've really taken advantage of.
• 34:08
  Uh, what's unique about your, your situation, like you said, everyone's dealing with this same situation, but, uh, you're dealing with it at a, a level and scale that is unique and maybe has given you a chance to learn new lessons more quickly maybe.
• 34:21
  Uh, if you were to give advice to a founder on this call who maybe was struggling with, um, uh, running virtual teams, keeping, keeping a team's culture strong in the face of, um, remote work, uh, virtual teams, any advice you'd give?
• 34:39
  Um, I think, uh, start building opportunities for, um, for asyn- not... For, for non-meeting related connections.
• 34:50
  Um, and so we, we use, uh, um, an a- add-on or an app in, in Slack, um, to create donuts, like little virtual kind of coffees, um, for people.
• 35:01
  Um, whatever the, the, the tools are that you seek to use, make sure to, to incorporate them, um, and, and give people an opportunity to just get to know each other, um, get to bond, get to hear each other's story, um, uh, build relationships.
• 35:15
  I think that's key. I think the other is, um, is the flip of that, I think, is don't ol- don't underestimate the value of in-person time in the midst of virtual, right?
• 35:26
  And so trying to create opportunities for off-sites, opportunities for people to really get together in person, um, uh, is so important.
• 35:35
  And sometimes I've, I've experienced where, where it just feels like we're kind of, everything's kind of funky and things feel kind of hard.
• 35:41
  Um, sometimes just getting together and, like, at CityBlock, we, we tend to dance and eat and have fun together, and, like, having a little party or having a little gathering just changes the energy, um, and, and gets people kind of back into this, uh, appreciation, um, and the gratitude that we feel for getting to work with such incredible people.
• 36:01
  Um, and, and that can get, can get worn off if you're constantly, you know, in these transactional meetings, um, without the opportunity to really build those relationships around them. I think that's very wise.
• 36:15
  Uh, let's go to another question from the chat. Uh, Marco Paschina from Akenta, if you can come off mute, uh, tell us what you do in a sentence, and then ask your question. Hi, Toyin.
• 36:25
  Well, thanks so much for finding the time to, to chat with us. I really appreciate it. And so I'm, I'm Marco Paschina. I'm the founder of Akenta Health.
• 36:35
  We are a virtual clinic specialized in cardiovascular disease prevention.For underserved communities. So I think it's-- I, I really appreciate what you did with Cityblock. We mainly focus on the Hispanic community.
• 36:46
  We're based out of Los Angeles. And I have a couple of questions for you. Some of them you answered, but the main question is, what was your initial go-to-market strategy?
• 36:57
  I know that you told me that you were working with especially Medicaid. That's, that's something we're really interested in doing. And how did you, how did you get to working with them in the beginning?
• 37:08
  And also, how do you then also got the, the attention of managed care organizations with that, which I know that sometimes they tend to be a bit close with the network they have. Yeah.
• 37:21
  So we started, um, uh, going directly to managed care organizations, um, and, and to your point, really seeking to prove the value prop to them of contracting with us and of partnering with us, um, to care for their members.
• 37:36
  Um, I think it helped a lot that, you know, if when you're, when you're focusing on, um, members with the most complex needs, um, and folks who have not historically had access to care, um, it helps a lot because very few payers, even today, you know, they get their doors pounded down on solutions for X or Y, but very, very rarely do they experience, you know, uh, an organization, a venture-backed startup saying, "No, no, we wanna go care for the folks that nobody else wants to care for, the folks who are really, really struggling, who may be hard to engage and hard to reach, but we really believe we can do something different there."
• 38:13
  Um, and so, so really, you know, just, just focusing on that value proposition to, to managed care organization is key. And then recognizing that it takes time.
• 38:21
  I mean, the deal cycle for a, for a, you know, a value-based managed care contract is a long time. And so you have to be patient.
• 38:29
  You have to have many, many sort of irons in the fire, um, working on a number of different sort of paths. Um, uh, but, but they do eventually convert. It just takes time.
• 38:40
  Um, and so those are the, those are the kind of big things that I would, um, that I would sort of flag, you know, flag for you. Thanks. And I have just one quick follow-up question on that.
• 38:51
  It's how-- in your first meetings with investors when you were early on, right? How do you... I know-- I mean, I experienced some with some investors that they're-- you're like, you know, there's,
• 39:01
  I don't know, some investors are like, "Is this venture back, backable, yes or no?"
• 39:06
  And I feel like they're like, they, they kind of get confused on the fact that, yes, it's a company that does have a big social impact, but it also has like a valuable business model behind it.
• 39:17
  So how did you kind of approach this, these conversations with very early stage investors? Because we are pre-seed, seed stage, so we're just starting out. Yeah. I think a couple of things.
• 39:29
  I think, um, you know, showing the, showing the business model and showing, showing how the economics scale over time, um, is really important. I think the second thing is, is the TAM.
• 39:39
  Um, so many, particularly non-healthcare investors are not used to the TAM, like how, just how big the market is in healthcare and how big the market specifically is in, in, you know, government programs and underserved communities.
• 39:53
  Um, there is just a massive, massive opportunity to scale businesses that are focused on, you know, folks on Medicaid, folks who are dually eligible for Medicaid and Medicaid across the country.
• 40:02
  And so those two, I think, key points are really important.
• 40:05
  Um, and, you know, the, I think the final piece is, is, is giving them, you know, some visibility and confidence that, that there is not a conflict between your social mission and your business.
• 40:16
  And I think for us, that alignment between our social mission and the business is so critical. Um, we don't make money at Cityblock.
• 40:25
  We are not successful unless we're able to meaningfully improve costs in the healthcare system by improving healthcare, um, and the healthcare experiences and the healthcare outcomes of our members.
• 40:34
  And so, you know, I think one of the things that I think sometimes gives investors pause is, is there gonna be a trade-off between making money and, you know, doing the social thing?
• 40:43
  And to, to, to create the right alignment in your business as you think about your go-to-market strategy, as you think about your overall corporate strategy between doing the right thing for the, for the cause and the population whom you serve and creating margin is so important.
• 40:58
  And you have to have that, like, locked and loaded from the outset, um, in these businesses.
• 41:03
  And there's a real opportunity, I think, to, to sell and to, to make a case for, for why these are accretive venture businesses, um, uh, if you can get those things right. All right. Thanks so much.
• 41:14
  Appreciate that, Marco. Uh, let's go to another question. Let's go to one from Eliana Goldstein. Um, and she asks-- Oh, she says that her camera's cutting out. No problem, Eliana.
• 41:27
  She says, um, "What's your mindset on building versus partnering when it comes to new healthcare service offerings for your members?" Yeah, it depends on, on what the, what the services are.
• 41:38
  It's a great question, Eliana. I think the first question I would ask myself is, is this core? Is this a core capability for our business? Um, and is this differentiating or differentiated?
• 41:50
  Um, and if the answer is yes, then I would build, right?
• 41:53
  Um, uh, if this is core to the experience that your members have, it's core to your service offering, it's differentiating or differentiated, um, it's a key point of leverage I would build.
• 42:03
  Um, however, you know, as you know, there are so many other services that people need and access, and some of these are commodities today in the ecosystem, um, or they're not, they're specialized, but there's four or five people who've been doing this for a while, and they do it really well.
• 42:18
  Um, I think being focused enough to know exactly when you ought to build, um, which is, you know, sort of the criteria I described earlier, and also humble enough to not think you can build everything and that-- and to learn to partner is, is a really important lesson to learn in healthcare because there are so many adjacencies.
• 42:37
  You could provide, you know, a wonderful, um, you know, peer, uh, data-informed coaching experience forUm, I think, I think somebody earlier was working on, on, on helping people with healthy weight.
• 42:50
  And your folks are gonna, at some point, see a primary care doctor. They may see a therapist. They may, um, you know, need a teeth-- tooth pulled at the dentist.
• 42:59
  Like, there's-- we touch the healthcare system in so many different ways that it would be ludicrous to try to own every step of the journey.
• 43:07
  Um, but recognizing where to partner and, and doing so well, um, and discerningly, I think is really important.
• 43:13
  And then owning and really optimizing the places where you have to be differentiated, I think is just a key discipline. I love it. I love it. Let's go to Robbie Bustami from, uh, Biotics.ai.
• 43:26
  Robbie, you can come off mute. Hi, Toyin. Thanks. Uh, thank you so much for, uh, talking to us. [clears throat] Sorry, I'm a little sick, so, uh, my voice is a little out of it.
• 43:36
  But, um, so, uh, so m-my question is, so here at Biotics.ai,
• 43:42
  uh, we've developed an AI-powered platform to help reduce the one out of two structural anomaly, uh, misdiagnosis rate, um, by providing automated quality assurance, risk mitigation, um, AI-powered diagnostics, and, um, time-saving, uh, reporting-based capabilities.
• 44:01
  Um,
• 44:02
  at, at Cityblock, uh, you know, it seems like there's such a huge focus on quality and, and risk mitigation, um, both on the patient side and, and on the, on the payer side, uh, with making sure that, uh, the best possible quality of care is provided back to patients and,
• 44:22
  and that they have trust in their, uh, in their health systems. Uh, have you seen use cases where AI technologies have been used to
• 44:29
  help provide and monitor and validate, uh, the quality of care for patients and also for, for payers as well? Yeah, I think that's a, that's a really interesting question.
• 44:39
  I mean, we certainly see use cases for AI in our, um, uh, in our model, um, you know, in helping us even just, uh, segment and identify the different risk profiles of the members whom we serve.
• 44:50
  It's been really, really interesting for us to start to model out in much more, um, with much more nuance and, um, and focus around who, who those high-risk folks are, um, and then making sure that they're getting what they need.
• 45:04
  Um, I'm very interested, I think it's to the earlier question about how do you scale, um, high touch is, you know, how do you automate the things that are not,
• 45:14
  not important necessarily uses of, of people's time, but that need to, to happen? And how do you surface up, um, the right next, best next step in terms of the care that people ought to receive?
• 45:26
  Um, so those are areas that we continue to see as potential for, um, for continuing to explore the value and the, um, opportunity to, to invest in AI. I appreciate the question, Robbie.
• 45:38
  Um, we're getting towards the top of the hour. I wanna give people a chance to share a, an insight.
• 45:43
  Uh, if you'd like to, to reflect back to, to Toyin and the group, something that you've learned, that you appreciated, you can drop that, uh, or your name into the chat. I wanna make sure we have time.
• 45:54
  Uh, Toyin, um, I, I'd love for you to share kinda what's next for Cityblock Health.
• 45:59
  You've, you've given us sort of the, the recent traction a-and what you're excited about, but, but what's coming in the next, uh, year or two? Yeah.
• 46:07
  I think it's, um, you know, you-you've heard the, the big picture, um, and, um, and, you know, our mission and our vision is really to prove that you can do this at scale.
• 46:17
  And so what's next, no surprise, is that we continue to grow, um, we continue to scale our impact, um, entering new markets, new partnerships, serving more members, um, continuing to iterate on our learning and understanding about, you know, what all the, the right, the right ingredients are to drive better outcomes for people, um, and, and partnering in really thoughtful and creative ways with both managed care organizations as well as with other healthcare organizations to, to, um, optimize the value that we can drive for our members.
• 46:44
  So, um, so continuing to disrupt and continuing to grow really is what's next for us. Um, I'm hoping you can give some advice to founders since I know you invest as well.
• 46:56
  Uh, I know you, you evaluate early-stage startups, and you really, you meet, uh, and mentor founders and CEOs.
• 47:03
  I'm gonna try to wrap up-- I'm gonna try to roll up two of the questions in the chat and see what advice you might have for founders in terms of caring for their own mental health, looking at Yair Saperstein's question from EvoMD.
• 47:18
  And then secondarily, um, Ismail's, uh, question from Innovarex Global around early-stage recruiting, recruiting top talent, uh, early in the game, really getting them on board with your mission.
• 47:30
  So any advice for founders first about kind of, um, taking care of themselves personally, mentally? Yeah. I think, um, I think a lot of it sort of pieces of advice maybe I sprinkled along earlier.
• 47:43
  First is like, you know, upfront, build as though you're gonna be doing this for a long time. Again, build as though you're gonna be wildly successful, right?
• 47:50
  And what does that mean to sustain yourself not through one, two, three, four sprints when you're kind of flat out getting no sleep, but, like, what if this is a marathon?
• 47:58
  What if you get to keep doing this for a while and, um, and you get to continue to build and grow? Like, what does it look like to be sustainable for yourself?
• 48:06
  And it's gonna be different for everyone, but I actually think that there are some key ingredients that are kind of universal. Um, first is really understand your own patterns.
• 48:14
  Know when you work well, know how much sleep you need, make sure you get it. Um, really carve out time for thinking. Um, exercise is key.
• 48:24
  Whatever you need to do to maintain your mental health and your poise, people will be looking to you to set the tone for the company.
• 48:29
  And so being able to just, like, keep balanced and maintain your, sort of your, your equipoise is so critical. Um, those, those are just, just key.
• 48:39
  And no matter what happens, you know, there, there will be ups, there will be downs.
• 48:44
  Um, you know, don't, don't get too, too, too down about the downs and too up about the ups, I think helps a lot in maintaining that sort of balanced focus.
• 48:51
  This, this is gonna be a long haul for sure.Um, and then in terms of building the team, I think, you know, looking for, um, especially in the early teams, people, again, who you can envision being on the journey a long time with.
• 49:03
  Um, so folks who are committed, who have high integrity, who are great communicators, who are committed to the mission and the vision, um, who are proven leaders and builders.
• 49:14
  Um, I would look for people who can scale with you and who you can scale with and who you wanna spend many hours. Um, sometimes, you know, when you're, when you're on a, on a, on a down swing working really hard with.
• 49:28
  Um, and so I think that, that... those are the sort of key things, um, I think that, that have really been helpful, um, that I would recommend folks doing as they, as you pursue your journey. Very nice.
• 49:39
  Um, there's enough time for a couple of greatest insights you can share, uh, back to the group, kind of what you're hearing, what you're learning.
• 49:46
  And I wanna call on, on Ismael from, uh, InnoVerex Global because, uh, he brings a, an interesting, uh, perspective to this. So, uh, you can go ahead and come off mute and share. No, thank you, Logan.
• 49:59
  Uh, and really thank you, Dr. Ajayi, for sharing a lot of r- thoughts that really resonated.
• 50:04
  As a company, uh, my background as a healthcare provider in the US, there's a lot of parallels that you mentioned in terms of marginalized groups or even in rural communities in America that we saw an opportunity or, I guess, similarities in Africa in terms of, you mentioned the 10 minutes that you might spend in a, you know, emergency doctor's office.
• 50:24
  Well, most people on the continent never make it to the doctor's office- Mm-hmm...
• 50:29
  in general because of barriers to care and a lot of challenges that, you know, I'm glad that a lot of the strategies that you're mentioning, leveraging technology, because there's not a lot of doctors that are available.
• 50:40
  A lot of those things that we're, we are now trying to implement on the continent, and I think it helps that the USA has a safety net of being able to do business with government and agencies, which is a barrier in Africa.
• 50:53
  Uh, but I just wanted to say thank you 'cause I think so much of what you said is relatable on the continent, uh, and it allows us to just kind of bridge that gap and transfer best ideas. So thank you. Thank you.
• 51:05
  And congrats on your startup. It sounds amazing. Uh, I mean, on that topic, Toyin, obviously you are hyper local with your focus. How do you think about, do you think about global impact and global health?
• 51:20
  You know, I grew up in global health, right? Um, I, I grew up actually in East Africa. My parents are from Nigeria.
• 51:26
  I spent most of, um, my med school years thinking I was gonna, um, you know, live and practice in, in, in, uh, the developing world and probably in Sub-Saharan Africa.
• 51:37
  Um, and it sort of built a lot of my skills, um, and certainly my understanding and recognition and respect for community health workers and, um, and community-based models of care and participatory, um, models of care, the understanding of the social drivers.
• 51:54
  Like, I learned all of that in, in global health settings.
• 51:58
  Um, and, and I actually think that the, the lessons we can learn from other countries about how to, um, transform our healthcare system here are profound, um, if we can look past the sort of hubris and, um, and some of the, the stigma associated with that.
• 52:13
  Um, and so, you know, I do think about global impact, actually, in some ways think about the reverse global impact. There's so many things that I learned working in Sierra Leone, um, you know,
• 52:23
  ironically, that are valuable and translatable to, um, to serving Brooklyn communities.
• 52:30
  Um, and so I'm really interested in understanding how we, again, um, uh, prove it out here, and then I think we can scale from there.
• 52:37
  Um, but, but really figuring out how to make this thing scale and, um, and consistent, um, and, and truly sort of disruptive to our healthcare ecosystem in the US is a plenty big job for now.
• 52:50
  Um, and I think that there are lessons to be learned when we crack that nut and can, can continue to scale beyond that. I love it. I love it. Um, we are getting close to the top of the hour.
• 53:01
  I wanna make sure I give you the final word here, Toyin.
• 53:04
  Any final, uh, parting advice for a panel of founders who really look up to the work you're doing, who are trying to innovate in health, uh, or at various stages of development facing some of these challenges?
• 53:15
  Uh, what are your, what are your parting words? Well, thank you. Um, uh, you know, I think, I think folks are, I'm sure, feeling and, um, and experiencing some apprehension about this moment in time.
• 53:28
  You know, we're seeing the data about funding being down for early-stage startups across all the ecosystems. Um, uh, you know, the, the sort of global economic, um, climate I think can be daunting for many.
• 53:41
  And I would just say the best possible startups, um, the best startups will thrive in moments like this, right? Like- Mm.
• 53:48
  And the, um, the work that you all do here will be really, really profound, um, uh, in addressing a need in a market that will always have needs, um, always have needs. And that's critical, right?
• 54:03
  Like, healthcare is one of those spaces that, um, that, where there will always be demand. Um, and so you're, you're in the right sector.
• 54:10
  Um, you're actually in a moment in time that will push you to be better, um, and to be more, um, uh, more effective and more rigorous, and that's a good thing because we'll emerge out of this stronger.
• 54:20
  And so I would say keep your head up and, you know, continue to, to, to, to build, continue to listen to the feedback that you're getting from the market more broadly, and, um, and I know that that success will come your way, no doubt.
• 54:33
  I appreciate that. Dr. Toyin Ajayi, I think I speak for the group when I say we really appreciate your time today.
• 54:39
  Even more, we appreciate the time you've spent in building Cityblock Health, a company that we admire and, uh, which we know is gonna do a lot of good in the future. So we appreciate you, and thanks for joining us today.
• 54:52
  [upbeat music] Thanks for listening to "Startup Health Now." Startup Health invest in health transformers around the world who are dedicated to achieving audacious health moonshots.
• 55:03
  If you wanna learn how you can join this community of entrepreneurs, or if you wanna connect with one of our four hundred companies, go to startuphealth.com.
• 55:10
  If you'd like to learn how you can invest in our Health Moonshot Impact Fund, go to healthmoonshots.com. Thanks for listening to "Startup Health Now." We'll be back again with another episode next week. [upbeat music]