Neil Patel

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Vijay Kedar has gone from being an investor to the founder of his own health tech startup. His venture has attracted the backing of some of the most respected investors while raising $100M over the past five years. Tomorrow Health has acquired funding from top-tier financiers like Obvious Ventures, Andreessen Horowitz, Sound Ventures, and Bond.

In this episode, you will learn:

  • Fundraising by each round
  • How healthcare is changing
  • The difference between good and great companies
  • Vijay’s top advice for other aspiring entrepreneurs

 

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    Moreover, I also provided a commentary on a pitch deck from an Uber competitor that has raised over $400 million (see it here).

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    About Vijay Kedar:

    Vijay Kedar, the CEO, and founder of Tomorrow Health, began his career on the investing side with Goldman Sachs but left to join Josh Kushner and Mario Schlosser as an early employee of Oscar Health. At Oscar, Vijay spent time around case management for the most challenged patients within their network and learned first-hand about the transition of care to the home.

    From an investor and builder perspective, Vijay recognized the supply and reimbursement challenges of providing durable medical equipment (DME) – respirators, mobility devices, etc. – to patients in need. A family health experience, however, inspired Vijay to leave Oscar to launch Tomorrow Health to serve millions of Americans in need of healthcare at home. Vijay is educated at Harvard Business School.

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    Connect with Vijay Kedar:

    Read the Full Transcription of the Interview:

    Alejandro Cremades: Alrighty hello everyone and welcome to the deal maker show. So today. We have a very exciting founder. You know a founder that is going to walk us you know through the journey you know through the incredible journey and and through what he’s building building financing scaling I mean you name it. And I think we’re gonna really find this story very inspiring so without further. Do let’s welcome our guest today vj kidar welcome to the show.

    Vijay Kedar: Um, thank you all Ajandro It’s a pleasure to be here with you.

    Alejandro Cremades: So originally born in Pittsburgh Pennsylvania so give us a letter of a walk through memory lane. How was life growing up.

    Vijay Kedar: Ah, you know Pittsburgh is an amazing place to grow up. So I I was born and raised there. My parents originally emigrated from South India from a town called Chennai and.

    Vijay Kedar: I come from a big family of physicians. So my my father was a cardiologist and after doing his residency in Chicago moved to Pittsburgh to start ah to start ah a practice there and you know I’ve always found Pittsburgh to be ah the perfect balance between. A big city in a small town. It has you know everything? you’d want ah ah gray restaurants. Great sports teams fun neighborhoods but always has that small town pride and it’s ah it’s certainly a city that that bleeds black and gold when it comes to the Pittsburgh steelers. So. Overall, a great a great place to grow up.

    Alejandro Cremades: How do you think that obviously you know your parents coming from India where education is so important where you need to be a doctor or you need to be. You know an engineer you know like. Education is everything. How do you think that that has also influenced your path because you know certainly you went to the best schools.

    Vijay Kedar: Ah, you know I appreciate that and I think there’s there’s no question my parents and and my family’s focus on education early on has ah certainly had a tremendous impact on on my life And. Ah, my my father is ah is a doctor and my mother actually is a computer engineer so we have all the bases covered and ah you know, growing up more than anything. They just pushed my brother and I yeah to be deeply deeply intellectually curious. And to just have a passion and a love for learning. Whatever whatever the subject was whether it was history or literature or science. Um, and I think more than anything when I think about some of the foundations. To Entrepreneurship. It’s It’s really that it’s a thirst for Knowledge. It’s a deep intellectual curiosity to understand a space customers. Ah a new vertical. Um, and so that that certainly was a big part of of my foundation and ah. You know more broadly growing up. They were always encouraging ah more than anything of us finding that which we were most passionate about and and early on for me. Um it was. It was the medical field and I was certainly on that path to become a clinician.

    Vijay Kedar: Ah, but over time realized that while I loved that direct impact that Medicine Medicine could have ah you know I wondered if there were were better ways to scale that impact at the end of the day. My father as a clinician could only impact as many patients as he had hours in a day. And so I began to shift my focus to to other ways to address that but certainly that focus on on education and that thirst for learning has remained since then.

    Alejandro Cremades: So then tell us about you know going, you know because obviously you did a little bit of um of you know when it comes to the um to the studies you know I mean you did hbas you know you also did you know like the um, you also did the University Of Ghana what was that.

    Vijay Kedar: You know that that was ah my my junior year of college. Um I had been fortunate. You know, growing up um to do quite a lot of traveling with my family. My my grandfather who was also a clinician um. Practiced until ah, his his mid 80 s when he retired had this vision of stepping on all 7 continents with all of his grandkids and so since I was very young. You know we were taking. Trips around the world. Um from Asia to Latin America and and beyond and it it instilled in me just ah, an absolute love of um, experiencing new cultures learning new languages new cuisines new ways of thinking and and so when I was in college I I wanted to take that opportunity to study elsewhere and ah to study in a place that I felt was you know, fundamentally different from from where I had grown up and um. Had the opportunity to study at the University Of Ghana um just outside of the capital city of akra and it was an incredible experience for me. It was everything from studying international politics.

    Vijay Kedar: Ah, working at an ngo in ah a town called abablosi which was Ghana’s largest slum and and then um, taking motorcycle trips around the country to to explore new areas and. Ah, made some amazing friends. There certainly opened my eyes to um, really the the richness of of cultures throughout West Africa and overall was was a tremendous amount of fun.

    Alejandro Cremades: And I mean obviously see there. You have an itch because you know your parents from India you know you’ve traveled around the world. You’ve experienced different cultures. You were raised here in the us what kind of advantage. Do you think that gives you when it comes to tackling problems.

    Vijay Kedar: Um I think it’s incumbentent upon all of us in many ways to expand our worldviews and our purviews as much as we can right at the end of the day. It just enables us to understand. Problems to understand markets to understand people in just so much of a more diverse way. Um, and you know I think whether it is ah traveling to a new country or having a new experience more than I think it just. It broadens your your worldview it broadens your scope of thinking and takes you out of what can otherwise be a naturally narrow and and myopic way of thinking and you know I think when it comes to starting a business and and really attacking a problem at the end of the day you’re trying to change the status Quo. You’re trying to change an ecosystem or a market that has been operating a certain way for a very long time and the only way to do that is with fresh perspectives and always by recognizing that there is always a different approach that can be taken and So. Ah, when you approach a problem or along the way is you start to hit roadblocks along the way to recognize that there’s a wider vantage point that can be taken um and and certainly ah building that resilience in many ways to to do that I you know I will say.

    Vijay Kedar: Just on the note of my upbringing I mean there’s no question growing up in an immigrant household ah in many ways that that immigrant hustle was was born into to my brother and I very early on and my father.

    Vijay Kedar: Come to this country really without any relatives with not very much money and was nineteen years old at graduated medical school was coming to build a life and um I think there was just so many principles that that he learned through that process of certainly never taking anything for granted. Ah, the critical importance of of hard work and focus and dedication. Ah that have really become pillars of of how my brother and I have have always operated and certainly have been a big part of of my journey throughout my career and and starting tomorrow health.

    Alejandro Cremades: Now obviously now you are on the on the founder side of the table but you’ve also been on the investor side of the table I mean after your studies you you went to Goldman Sachs and you were doing private equity there for a few years so what did you learn there about pattern recognition perhaps about. Companies that you know were working better than others and what were some of those trades that they you know trigger that or or or made that happen.

    Vijay Kedar: You know, learned a tremendous amount during my years as an investor and ah you know I think what one of the benefits of that vantage point is really back to some of my earlier comments just the the the breath of purview that you get right? seeing? Ah, ah. 1 the opportunity to work across a number of different industries but but seeing from a bird’s eye view. You know, different business models across verticals and and how they are resilient or not towards market changes and and and dynamics and yeah I think. With the the lens of of private equity was fortunate to have the opportunity to work closely with a number of really fantastic management teams um to understand how they translated strategy to execution how they ah Tackled. Market opportunities and really brought them to life. Um, and in many ways while I certainly had the the analytical perspective of an investor at that point it also kindled my passion and my interest to get closer to operations to get closer to building. The other thing that happened during my years at Goldman was some fundamental shifts in the health care market. Um, while I was there Obama had just been reelected. It was the tying of the bow that obamacare was going to be taking effect and.

    Vijay Kedar: I was staffed on ah on a pretty small cross-functional team across the firm to really? ah 1 understand the tenets of the legislation um chronicle how it was going to impact different subsectors and health care and then you know what were the opportunities for us. Ah, to effectively position ourselves from an investment standpoint. Ah, and so during that time you know sat down and read the law end to end ah and it was just incredibly eye-opening as to the breath of change that was going to be taking place in every subsector. Within a healthcare and they’re taking and an innovator’s lens to it. You could think of you know, multiple companies to be created with every chapter of of that law and so it really sparked my interest in in getting a deeper understanding of. The companies and the founders that were out there really trying to drive that change and to bring that innovation to life.

    Alejandro Cremades: And now in your case I mean you went from Goldman Sachs to Oscar Health obviously you know like in in Goldman Sachs there I mean you were quite busy. You evaluated about a billion across you know what you were saying healthcare technology energy. Ah, definitely healthcare seemed to be the um, the segment that really caught your attention to really go into the operation on the ah on the on the ah kind of like operations and and and business side of things. So how was that change. How did that change come about to say hey you know what I’m going to go. More on the operator ah type of approach here.

    Vijay Kedar: Um, you know what? Well I Well I loved ah the analytical perspective investor found it incredibly intellectually stimulating extremely learned a tremendous amount what was increasingly exciting to me was was was really how operators and executives. Um, we’re building and scaling their businesses and and and that’s where I felt I had the greatest opportunity to learn was was working with many of the management teams we supported towards doing that. Um, and in particular having seen just the precipice of change in the Healthcare ecosystem. Um I was just really eager to to to be a part of that change to be a part of the action and and so as part of that um was pretty deliberate in ah building. Ah ah, a list of of companies that I thought were doing. Just incredibly innovative things in the space talking to friends in the industry talking to um other investors bankers etc and really developing a perspective on on those businesses that I thought I thought were were best points to drive real change in Healthcare And. Um, networked my way in to a bunch of different founders. Um and cold emailed a number of of folks. Um and just had a really fascinating wrath of conversations on on you know how different founders were approaching the space and.

    Vijay Kedar: Ah, you know, looking back on this over a decade later It’s really fascinating because you know many of these folks have since built amazing businesses and have become good friends. You know Sean Duffy at Omata was one of the folks I reached out to when Omada was a 10 person company I know he’s been here on the on the podcast as well. Ah, Zach ah and nat from flat iron health who are now angel investors and and partners of ours were were just getting things going. Ah and so was incredible to see kind of how that health tech ecosystem was really getting off the ground and how it’s flourished since then. Um, but it was also during that process I got connected to Josh Kushner and Marius losser at at Oscar and from my earliest conversations was just blown away by the scale of the vision that they had outlined and really believed in the opportunity for. Um, a technology for much more consumer focused insurer to play a much larger role in the ecosystem than health insurers had previously played and in much more effectively constructing. Ah, optimized networks for care and from engaging and guiding members through their healthcare journeys and so um, as soon as I got connected with them ah was was really excited about the opportunity to build and.

    Vijay Kedar: Ah, was able to join that team in the first few dozen folks.

    Alejandro Cremades: So then so then tell us because obviously Oscar Health was a pivotal moment for you. You know? now you’re on the operator side. You’re able to really see what’s going on. So I guess you know question is at what point in the mix. That’s the idea of maybe venturing on your own and. And starting you know tomorrow health at what point does that come does that idea come knocking and at what point do you realize hey I think I’m ready I’m ready for this and and I’m ready to go at it on my own.

    Vijay Kedar: Um, you know I I had always had a bit of an entrepreneurial bug when I was in college had worked to start a few ventures with with friends and in different areas. Ah but to me it was It was really always about. Ah.

    Vijay Kedar: Identifying a problem which I really really cared about enough to to to focus really all of my attention and my energy on on solving and ah you know the time at Oscar was certainly pivotal in a number of different ways. You know one was. Really kind of learning the brass tacks of what it took to drive change in the healthcare ecosystem right? and ah it was 1 thing for us to look at at those kind of high-level overarching trends and macro dynamics. Around the investment committee table. Ah as an investor. Ah and I found that it was very different to actually be on the ground right? I mean we could wax and weigh in all, we wanted about you know value based care and and and how its advent in health care was going to. Ah, drive certain macro trends. It was very different when I found myself you know boots on the ground negotiating with ah a large you know hospital system Cfo ah to try to get them to accept a value-based arrangement and to take a downside risk on their contracts and. Um, you know, just getting into the weeds of the health care ecosystem really opened my eyes to um, what was actually needed to to drive change and certainly just a tremendous amount of learnings there both from.

    Vijay Kedar: Ah, things we did right? as as well as from mistakes that I made along the way. Yeah, that that I’ve certainly learned from it. Those are always the ones that are you know, seared into your into your memory and kind of help to inform you know how you can how you can approach a problem different in the future. Ah, so so so you know to getting those operational wraps and and really digging deeper into what it took to drive change in the industry um was a huge piece of it and really understanding the confluence of the regulatory strategic. And financial dynamics at play between insurers um hospital systems providers and and and patients um and and then you know unexpectedly in in many ways it was during that time that. I really became exposed to many of the problems in home based health care and ah that was due to a more personal note about a week after I started at Oscar my mother was unfortunately diagnosed with stage 3 rectal cancer and fortunately is doing well now and in remission. Ah, but had a a really tough journey through it ended up spending a couple of months inpatient in the icu battling a lung disease stemming from her chemotherapy and three months on a ventilator ah and stemming from that needed a year of very intensive.

    Vijay Kedar: Home-based health care everything from 14 literres of oxygen to osamy and wound care supplies and mobility and respiratory equipment and you know candidly we just could not have imagined how challenging it would be to manage that as ah as a patient or a family member despite being. And healthcare care myself despite coming from a family of doctors. Um, you know all lin it took us about six weeks to get everything that she needed and we ended up having to readmit her back to the hospital twice in in that first month ah which was just incredibly eyeopening. Incredibly. Ah, demoralizing to my mother after working so hard to leave the hospital incredibly disruptive to her care. Um, and that was a problem having experienced that. So personally that just really sat with me and from there when I when I went back to my role at Oscar i. Saw the same challenges but from the health plans vantage point as you know as we were certainly a healthur at Oscar um, that every market that I launched we had to contract with you know, hundreds or thousands of different home based care providers to take to to get to adequacy to serve our our members. Driving our care management efforts I’d find myself you know, borrowing the phone from a nurse case manager and literally you know negotiating with some of these home-based care companies to get our patients an oxygen tank or an orhotic brace so we could discharge them out of the hospital and it just became so clear that from every vantage point all of us believed in.

    Vijay Kedar: Shift of Healthcare to the home but the technology and operations infrastructure to enable home based care reliably and at scale was simply lacking and that’s ultimately what inspired me to ultimately make the transition to starting to tomorrow health.

    Alejandro Cremades: So then tell us about the for the people that are listening. You know what were the next steps you know you were like okay, let’s go.

    Vijay Kedar: You know what? I I formally left Oscar spent the first year really just doing deep market research um to really really understand the problem and understand what was broken in the ecosystem and. You know as part of that process ah spoke directly with thousands of ah patients and families on the experiences that they’ve had sat with dozens of hospital discharge managers clicking through their electronic medical records to order. Ah, home medical equipment and supplies for for their patients spoke with ah medical equipment companies distributors health insurers regulators to really understand the different sides of of the ecosystem and and honestly the. The deeper I dug it was clear that the problem was even bigger than than I had experienced either personally with my mother or or from the health cleanse vantage point at Oscar ah that it was something that really touched and impacted the care of hundreds of millions of americans and ah. Was was levying an experience and a status quo that was just really so challenged and so broken. Ah, but the solution was also a complex one. Um, you know I recognized that. Ah, this was an ecosystem that wasn’t working for anyone involved.

    Vijay Kedar: Ah, and that what was needed was really a rewiring of the processes the workflows in many cases, the incentives within this ecosystem in order to deliver much more streamlined much more efficient and ultimately higher quality healthcare to patients. Um. And so from there began ah to really ah identify what that solution could look like and what that early product could look like and as part of that began to build our early team. Ah, and then ultimately raised our our first round of funding to get things off the ground.

    Alejandro Cremades: And and before going and and and digging into the funding I mean for the people that are listening to get it. What ended up being the business model of tomorrow health. How do you guys make money.

    Vijay Kedar: Um, yeah, so you know I mentioned that that this is an ecosystem in home-based Healthcare. That’s not really working for for anyone and specifically that’s you know for health insurers for physicians and hospitals for home-based care suppliers and then most notably for patients. Um. And so what we do towards our vision of of helping to restore the home as a patient’s primary place of care is ah we serve as a technology platform to really coordinate and manage the breadth of of home-based health care needs that patients have and so we partner. With health plans and provider organizations so physicians and hospitals to coordinate the health care that their members receive we streamline the way that home based care is ordered ah delivered and and ultimately paid for and by really. Providing technology to streamline each part of that and each workflow that with it. That’s within that. Ah, we drive a lot greater efficiency. We Also Realign incentives. Ah, towards better quality and better efficiency which is something that that doesn’t really exist in the status quo of of the Market. Um, and so we are ultimately compensated by the health plans and the providers that we work with to coordinate care for their members. Um, and we.

    Vijay Kedar: The the outcomes that we drive are ultimately around the quality and efficiency of that care. So 97% on time starts of care for patients who need care at home and that’s relative to what is a ah network average of between 50 to 60% an over 95 Nps Score across the rat the patients we’ve served really transforming that experience which is unfortunately ranges between 10 and negative 10 in in this side of the industry. Um, and then ultimately just driving much greater efficiency and value to each of the stakeholders involved. So ah so that’s that’s ultimately our model at tomorrow health and by leveraging that end-ten technology platform. We’re ultimately able to provide patients with. The home-based care that they need faster more reliably and more affordably.

    Alejandro Cremades: So then in this case I mean you were alluding to fundraising how much capital have you guys raised to date.

    Vijay Kedar: Um, we’ve raised a little under 100000000 all in through our ah recent series b round.

    Alejandro Cremades: So obviously a company like this is is capital intensive I mean you were alluding to that you guys had to raise some money to get going. So what has been the journey or the experience and also the expectations from going from 1 financing cycle to the next.

    Vijay Kedar: Um, yeah, you know I’d say um, first for our overarching business because it is you know, ultimately a technology forward model. Ah the core model ah scales in a in a fairly capital light way. Ah, is we’ve thought about financing. It’s really been About. You know what’s the combination of the capital and and critically for us the partners that can help us accelerate our our journey and can enable us to invest ahead. In the right team and resources whether that’s on product and engineering whether that’s on business development and growth whether it’s on core operations to really help us continue to bring this platform to life and and Deliver. You know, incredibly strong value to our core customers. Um.

    Vijay Kedar: You know our our first round of funding was seven and a half million that was led by the team at Andreessen Horowitz um and supported by um box group sound ventures and the range of health care and tech angels at. Ceos and founders from ah paypal door dash oscar health flatir and health quartet pullpack and and others all of which who’ve been incredibly helpful in our journey. Um, but you know at the outset the initial ah capital was ah to really. Get things off the ground and and and to to prove out our holistic vision. You know one of the things that is a bit different in healthcare is if you’re serving enterprise customers. You got to get it right out of the gate right? that you don’t quite have that capability to um to to. To to test and iterate. Ah when you know ultimately there is patient care on the line and you’re working with at you know, really meaningful at scale healthcare organizations and so for us it was really about ensuring that. Ah, the platform that we had the product that we were delivering and ultimately the outcomes that we could drive from a service quality standpoint were going to be incredibly strong for our early enterprise customers right? and so that was really the if.

    Vijay Kedar: If I was to describe the most important milestone it was to really have a set of of a very happy enterprise customers and and and demonstrate that model. Um, you know our our series a was raised in. Um, in 2020 ah like late 2020 and that was 25000000 led well also by Andrees Horowitz and supported by obvious ventures and a handful of other folks. Um, and. You know that was really about in many cases kind of broadening the scope of our model and you know early on. We saw the capability to operate in a defined way to um, ultimately. Take accountability for the medical equipment and supplies that patients were receiving and and kind of building that core infrastructure as we scaled up. It was really about broadening the model to that expansive platform vision that I described so so series a was really about platformizing the overarching model. Ah, and then our series b which is 60000000 ah led by bond capital and Recentesen Horowitz growth sound ventures obvious ventures and a range of others ah was really about about taking that model to scale new partnerships at new markets and doubling down on.

    Vijay Kedar: Our core technology platform to really bring our vision of of more effective and more efficient home-based Healthcare to more of the country.

    Alejandro Cremades: So talking about vision there. Let’s double click on that imagine you go to bed tonight and you wake up in a world. You know a few years later where the vision of tomorrow Health is fully realized what does that world look like.

    Vijay Kedar: Um, you know, ultimately, um, we think about it as a world in which um, patients turn to tomorrow health for the full breath of their healthcare needs at home and so. Today in the same way that ah you know we walk outside of our homes and we need to get from point a to point b and we pull out the uber app and it’s given us all these modes of transportation that.

    Vijay Kedar: We know we can trust ah to to reliably and transparently get us from point a to point b the same way that we you know, ah, any time we want anything ordered to our doorsteps pull out our Amazon app and. You know, push a couple of buttons and and know with visibility that products are going to arrive on our doorstep with defined prices with a high level of quality. Um, we want folks to turn to tomorrow health when they think about healthcare at home and that can be whether they or family members are recovering from. Ah, acute health episodes coming out of surgery managing diseases like covid and others or managing ongoing chronic conditions like diabetes or cancer cardiovascular disease and coordinating the breath of the equipment supplies and services that they need um and ultimately that vision is is. That a patient like my mother with the wide breadth of of home-based care needs that she has um the fourteen liters of oxygen you know the ostomy and wound care supplies. The respiratory therapist coming to her home to adjust her ventilator settings the pulse oximmetry. Remote monitoring device measuring her oxygen saturation levels does not have to work with a dozen different vendors and and home-based care companies as we did but can work with 1 seamless platform and tomorrow health that is coordinating the breath of of home-based healthcare needs that she has reliably.

    Vijay Kedar: With efficiency and critically that it’s all embedded within her insurance benefits ah to be reimbursed affordable and to keep her healthy and safe at home.

    Alejandro Cremades: So now vja you been for about 5 years you know with tomorrow health you know, pushing things. You know if you had obviously a ton of lessons learned you know along the way. So if you had the opportunity of going back in time and. And having a chat with your younger self. You know, maybe that day vj that is still at Goldman Sachs and you know looking at those companies doing great things in healthcare and you know the other industries that you were involved in and if you were able to have a sit down right now with that younger vj and and giving that. Younger vj 1 piece of advice before launching a business. What would that be and why given what you know now.

    Vijay Kedar: Um, you know I I think it would be um, one to to have the conviction and the resilience that you know whatever the problems that came our way to just really really. Remain laser focused on that end State Vision. Ah and to recognize when it makes sense to keep you know barreling against that wall to try to break it down and when it makes sense to start thinking about you know how you climb. That wall or how you scale under it. Ah because you know at at every journey along the way of building a business. Um, you know there. There are always roadblocks. There are always punches in the face as as we like to say there’s always unexpected things. Um. And so much of ah what makes in my opinion. Ah a business, an organization a culture one that can deliver true impact at scale is that grit is that resilience ah to constantly work through those obstacles to constantly. Ah, be iterating the approach and the focus um to always get to to that end state. Um, there is always a path forward and ultimately um, iterating on the approach to Identify. You know what it is that makes the most sense.

    Vijay Kedar: What it is that will get you to the other side in my opinion is is what separates great companies from from good ones and is an important lesson and Tenet certainly for me and and us to think about consistently.

    Alejandro Cremades: I Love it vj So for the folks that are listening. What is the best way for them to reach out and say hi.

    Vijay Kedar: Yeah, they can reach out to me directly. My email is [email protected] I’m also on Twitter at at the jkeda r ah, and love to love to hear from folks. So I would encourage them to get in touch.

    Alejandro Cremades: Amazing. Well video. Thank you so much for being on the deal maker show. It has been an honor to have you with us and amazing. Thank you so much with j.

    Vijay Kedar: Um, really enjoyed it all Andra thanks for having me on.

     

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