A great lesson I’ve learned, both as a surgeon and as an entrepreneur, is that medical expertise alone is not enough to connect patients to the best care as effectively as possible. Technology is just as important, and applying that technology in context is critical.
One of the reasons I love writing this column is that I can interview people with stories like mine who have achieved amazing things. dr Jennifer Schneider is Co-Founder and Chief Executive Officer of Homeward, a company focused on transforming the delivery of health and care in partnership with communities around the world, beginning in rural America. She was previously the Chief Medical Officer of Castlight, the President of Livongo, and is an internist by training.
dr Schneider is a great role model for men and women who want to recombine their skills, prioritize the right things at the right time, and develop the vision to seize opportunities. dr Schneider zoomed in with me one morning from her beautiful, cabin-like Napa Valley home. Her relatable insights into motherhood, healthcare, and entrepreneurship speak to me, and I’m excited to share them here.
What made you decide to go into the healthcare field?
I come from a Midwest family where my father runs the local auto parts store. It is the lifeblood of my family, who are still very involved in the local community of my hometown of Winona, Minnesota.
I was diagnosed with type 1 diabetes when I was 12 years old and that sparked my interest in healthcare. Being able to deal with my condition was very empowering. From that day on, I started telling people I wanted to be an endocrinologist, and most people didn’t know what that was.
After entering medicine, what made you decide to switch to healthcare?
After receiving my medical degree from Johns Hopkins University School of Medicine and my Masters in Health Services Research from Stanford University, I worked as an internist. I later became Chief Medical Officer of Castlight Health and eventually Chief Medical Officer and President of Livongo, where I led the company through a successful IPO and the industry’s largest merger with Teladoc Health.
I stopped clinical practice when we decided to take Castlight public. I had just had my third baby and realized that it was a challenge breastfeeding one child, giving birth to another, publicizing Castlight and moonlighting as a hospital doctor. I’m happiest when I’m busy.
I am firmly convinced that the combination of both training courses, both as a doctor and as a manager, was very important for my career development. One of my favorite stories is that one day we had a very bad meeting at Castlight and everyone was very upset. Later that evening I went to the hospital for my shift and I literally coded someone seconds after I parked my car at the hospital. And I thought, the care I’m giving actually counts in the context of that person’s life. It really puts things in perspective.
I like difficult problems and I like solving them. When we launched Castlight, the question was: how do we create a free market in healthcare? There are people who spend $200 on a barber but struggle to pay the $20 co-payment for their doctor’s appointment. Building on that concept, Livongo looked at how we make it easier for people with chronic conditions to manage their health. We’ve combined data science with a deep empathy for people living with chronic conditions to enhance that experience.
Homeward Health is a very different company to Castlight and Livongo, but I’ve built on many of the lessons learned from my previous companies to carefully use technology to scale access to clinical services. At Homeward, we are focused on expanding access to health care in a system that is tragically broken for people living in rural communities. It’s not a little broken, it’s broken a lot. In fact, there is a 23% higher mortality rate if the last 3 digits of your zip code are marked as rural.
Ever since Homeward started, I’ve heard people say, great, you’re going into a niche space. And I answer: 60 million people live in rural communities. Homeward’s total addressable market is actually twice the size of Livongo. This is a very big problem.
What is Homeward and why did you decide to tackle rural healthcare as your newest project?
Homeward is a company focused on transforming the delivery of health and care in partnership with communities around the world, beginning in rural America. We enter the marketplace as an in-network healthcare plan provider and partner to serve Medicare beneficiaries. We are a values-based care provider, which means we take full risk for our members’ entire cost of care. We believe this approach effectively aligns incentives for all stakeholders by incentivizing health outcomes rather than being paid for total visits.
By assuming full risk for the entire supply, we can also be more flexible in deploying technology-enabled services in rural markets that are often not reimbursed in a fee model. Finally, care models and technology are implemented in a manner that ensures practitioners are operating at the peak of their credential, meaning they can do what they were ultimately trained to do.
How does Homeward fit into the current healthcare market and what sets it apart from other companies?
We differentiate ourselves firstly by being an in-network provider and secondly by building a technology platform that helps scale access to providers. Our technology is able to connect to our members via cellular rather than relying on WiFi or broadband access which is often unavailable in the communities where we operate. This has been extremely helpful in contacting people in rural areas where internet access may be limited. Additionally, in rural markets, building trust with our members is crucial and so we often start our care journey with a home visit. Our providers physically enter their phone number into the person’s phone, which helps establish a connection and builds trust. Many people in rural markets have family members who have moved to urban areas to work, so support from the younger generations may not always be physically present.
How has Homeward been received by health plans?
It is generally accepted that healthcare in rural markets underperforms in terms of outcomes, cost and experience. Homeward has had success partnering with health plans to serve Medicare and MA plan beneficiaries in these areas because there is clearly room for improvement. They love how Homeward can help on their behalf to manage challenging populations, improve key healthcare plan metrics like HEDIS and CAHPS measures by improving the member experience, and help improve Medicare Advantage penetration.
You have championed women in leadership positions throughout your career. Why is this so important to you?
Women are the dominant buyers in healthcare, so it is important to represent and understand the perspectives of women in leadership positions. As a wife and mother of two daughters, I firmly believe in the value of diverse leadership styles and the empowerment of women to take on leadership roles. Women have different approaches and leadership styles that tend to be more inquisitive. To bend the curve, you need to understand who the decision makers are. I serve on the boards of several companies with female founders, including Cityblock Health’s Toyin Ajayi and Maven’s Kate Ryder, and believe it is critical to support and mentor the next generation of women leaders.
What advice would you give to the next generation of women leaders?
I think it’s simple: bet on yourself. And that’s what I tell my kids too: you never say ‘I can’t’, you say ‘I can’. Part of growing and learning is making mistakes. Enjoy the process and double your strengths.
What challenges did you face and how did you master them during your transition from a doctor in private practice to an entrepreneur?
One challenge I faced was shifting the mindset from a hierarchical medical education environment to a more team-oriented and collaborative business environment. In a healthtech company, we create something new and novel, and there are elements of each person’s unique skills that are critical to the company’s success, from technology to sales to clinical expertise.
I also sometimes had the feeling, “If you don’t see me, then I don’t matter.” But I’ve learned that sometimes it’s important to try things a little differently. After Livongo, I joined General Catalyst as Executive-in-Residence and stayed out of the spotlight for a while. This experience gave me time to reflect on what was most important to me and what I really wanted from my next business. It led me to start Homeward which was an amazing experience.
Likewise, leaning in and out was very important to me as my children were different ages. I worked more when they were younger because I believe the impact I have on them varies over the years. I’ve been leaning towards it more lately as my children become more independent as they progress through their teenage years.
Click here to learn more about Homeward Health Here.