01 Sep 2018
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Case Study: A Good Fit

A startup focused on worker wellness considers new markets
Re: Harry McCracken (AMP 114); J.W. Penland (MBA 1996); Lisa Putukian (MBA 1988); Katherine Kalin (MBA 1990); Lindsay Jurist-Rosner (MBA 2009)
by Jen McFarland Flint

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Illustration by Matt Chinworth

Every year, millions of Americans resolve to lose weight, but few sustain their loss over time, according to a report in the New England Journal of Medicine. The reason lies in the gap between initiating a change in behavior—joining the gym, for example—and sustaining it over time, says Sean Eldridge (MBA 2009). He and his cofounders at Gain Life, an early-stage startup based at the Harvard Launch Lab, have an app for that. By combining behavioral science and marketing best practices with the personalization that web and mobile apps allow, the team discovered a way to guide people through behavior changes with results that stick. Individuals using Gain Life’s weight loss apps achieve results that double the one-year benchmark for other methods, Eldridge says.

The startup has built a nice book of business within the $9 billion corporate wellness market by partnering with health plans and employers, and has expanded into more general health and wellness areas, with apps for people who want to eat better, for instance, or be more fit. After discovering that their technology could help individuals manage Type 2 diabetes, the team started exploring chronic disease management, with a launch slated for later this year. But now that they’ve “bottled” the process, their technology could be applied to almost any area of behavior change—financial savings, relationships, you name it, Eldridge says.

The Question:

Last year, on a lark, Gain Life partnered with an insurance company to see if its apps could help people who are out of work on shortor long-term disability or workers’ compensation. This market has only a handful of competitors and big bottom-line dollars at stake: One insurance company alone could pay out $4 billion in disability benefits a year, Eldridge says. Gain Life’s existing wellness market has good prospects, although it’s highly competitive, “almost to the point of commoditization,” he adds, and the sales cycles can last up to a year. Should Gain Life focus on this new return-to-work market, where there may be a more favorable business model in the near term, or should it double down in the established wellness space? Or should the team continue to explore how their technology could be used in other markets for even broader applicability?

The Answers:

They must at least explore this new market. Apart from insurance claims, there is the productivity value of getting people back to work sooner. If the average absenteeism across corporate America is about 4 to 5 percent, then the value of saving a fraction of this would be huge. If the app is truly effective, I would think any sizable employer would be interested.
—Harry McCracken (AMP 114, 1994)

A highly competitive market with one-year sales cycles on the one hand; a pilot customer in a less-competitive niche with a massive opportunity to create value for insurers on the other. If Gain Life can negotiate an attractive initial vendor agreement with a compelling business model, I suspect the superior path is the new opportunity.
—J.W. Penland (MBA 1996)

Definitely branch out beyond wellness, which is full of hype and competitors. Preferably go with a few apps that might tap into the same channels for marketing and payment (insurance, employers, health professionals, or individuals, for example) to build momentum within the channel. Exploit it as a platform instead of just an app.
—Lisa Putukian (MBA 1988)

With significant opportunity in two distinct markets, it would be a disservice to potential customers not to pursue both (and eventually broader applications). However, trying to pursue two different strategies for different markets simultaneously may eventually jeopardize the success of both. At such an early stage in the company’s life cycle, focus will likely yield better results than dividing management’s attention and resources. Are the potential of the disability market and the proven success in wellness sufficient to enable the company to raise funds and apply separate leadership to the additional market opportunities, to mitigate the risk of diluting the focus on one strategy by the other?
—Katherine Bach Kalin (MBA 1990)

Got a case? To take part in a future “Case Study,” send an outline of your company’s challenge to bulletin@hbs.edu

Case Study Update: Wellthy

Wellthy is a software-enabled service for coordinating complex family care issues. Cofounder Lindsay Jurist-Rosner’s (MBA 2009) question for Bulletin readers in 2016 went to the issue of pricing: Eldercare and EAP benefit offerings tend to charge according to a per-employee, per-month (PEPM) pricing, often $0.30 or less. Should Wellthy adopt this standard structure—or differentiate the value proposition and pricing because its solution is more robust?

How they answered the question: “Being flexible proved to be the most effective path forward for us,” Jurist-Rosner says. Wellthy offers a range of pricing models—all informed by utilization data. The PEPM pricing for large companies, as a result, is higher than $0.30. For smaller companies, Wellthy sends a monthly invoice covering those employees using the service. When massive companies prefer a lump sum upfront, Wellthy gladly adjusts.

Where they are today: Employees at 385 organizations now have access to Wellthy’s support as a covered employee benefit.

New challenges: Competitors have emerged and are helping establish the new category. But one company in particular seems to copy Wellthy’s every move, from pricing to strategy. “What’s the best way for an early-stage company to respond?” Jurist-Rosner asks. “Should we ignore it or react? That’s the very real challenge that keeps me up at night.”

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