Violet & Everside: Putting Patients First to Transform Care Delivery and Improve Outcomes

Episode Overview

On this episode, Gaurang Choksi, Founder and CEO of Violet, the first cultural competence credentialing and upskilling platform for clinicians, speaks with host Kate Barrett about the importance of inclusive care in generating better health outcomes, how data can be used to build health equity, and the powerful role mission can play in all aspects of company building. Throughout the conversation, Everside Health CEO Chris Miller and NEA Co-President Mohamad Makhzoumi share insights and advice gleaned in building one of the nation's largest providers of direct primary and mental health care--from the benefits of increased access to care, to how CEOs can vet potential investors to find the best long-term partner for their business. Listen to find out what inspired Gaurang and Chris to build transformational healthcare companies and how prioritizing patient outcomes is reshaping a massive industry.

"The three boxes I always try to check when I'm a hiring—hungry, humble, and smart. And if I can find those three boxes, the level of expertise, oftentimes, doesn't matter."

Chris Miller CEO, Everside


  • Why healthcare companies are treating patients more like customers
  • How the right data can drive better health outcomes
  • How value-based care is reshaping a massive ecosystem
  • Building a team (and board) around a shared mission

On this Episode

Gaurang Choksi

Gaurang Choksi is the Founder & CEO of Violet, a health equity platform that benchmarks inclusive providers, encourages growth, and promotes inclusive care across the healthcare industry. On this episode, Gaurang chats with host, Kate Barrett, about the importance of inclusive care in generating better health outcomes and building health equity for all.

Chris Miller

Co-President, NEA

Chris Miller is the CEO of Everside Health, one of the largest direct primary care providers in the U.S., integrating primary, mental and occupational healthcare into one holistic solution. On this episode, Chris and Everside board member, Mohamad Makhzoumi, discuss approaching the massive healthcare market, building a team with diverse expertise, and empowering patients to have more control over their care.


Kate Barrett (00:06):

This is Founder Forward, the podcast from NEA, where we explore the company-building journey with candid commentary from founders and investors, some legendary, some just getting started, all moving forward. I'm Kate Barrett.


On this episode of Founder Forward, I spoke to Gaurang Choksi, Founder and CEO of Violet, the first cultural competence credentialing and upskilling platform for clinicians. Gaurang shared the importance of inclusive care in generating better health outcomes and building health equity for all.

Gaurang Choksi (00:47):

My name is Gaurang. I'm the founder here at a company called Violet. We're essentially building the first-ever platform dedicated to building health equity with education and data.

Kate Barrett (00:56):

And on every episode of Founder Forward, we like to fast-forward to get some insights from a founder and investor who are walking this road together. Today, we'll hear from Chris Miller, CEO of Everside Health, one of the nation's largest providers of direct, primary, and mental health care, and Mohamad Makhzoumi, NEA managing general partner and head of Healthcare Investing. Chris and Mo talked about how Everside is approaching the massive healthcare market, building a team with diverse expertise, and empowering patients to have more control over their care.

Mohamad Makhzoumi (01:28):

My name is Mo Makhzoumi. I'm managing general partner and lucky enough to run NEA's Global Healthcare Investing practice in my 21st year.

Chris Miller (01:36):

So, I'm Chris Miller, CEO of Everside, formerly Paladina. I have been CEO now for, this is my seventh year. So, just over six years.

Kate Barrett (01:46):

Transforming an industry that has served consumers one way for so long isn't easy. But when founders and CEOs prioritize patient outcomes, we can begin building toward a healthier and more inclusive future. Let's dive in.


Gaurang, I actually want to start our discussion hearing a little bit about your journey before founding Violet. What it was that set you on the path to entrepreneurship? And then, what compelled you to actually take that leap and found a company?

Gaurang Choksi (02:20):

Great question. I grew up in India in a pretty small town. I moved to the US when I was 10 and got to see what life is like for the 80 million Americans that are on Medicaid. My mom worked at a Wendy's, my dad worked at a factory, and then I'm a gay man, as well. So, really seeing how our healthcare system works and doesn't work through the lens of being a part of the LGBT community. And then, professionally, I started my career in consulting. I have always been very entrepreneurial. At 23, I remember I wanted to start an insurance company, and so I actually got a job at Oscar. I was in the first few hundred employees there, and what was fascinating was they were an insurance company and they built an amazing insurance company. But through my journey at Oscar, and really taking my passion of building Brew Health Equity, what I found was there was a unique opportunity to build health equity with education and data and technology.


So, in 2019, I'm based in New York City, which is where Oscar was headquartered. I went to a primary care doctor at a digital health company. So, this was a primary care clinic that had venture funding. And even though I had been on PrEP, which is a preventative drug recommended for especially members of the LGBT community to prevent HIV, the physician I was sent to at this digital health company didn't know what PrEP was when I asked for a refill. And that was an incredibly upsetting and jarring experience. And at the same time, I was leading Oscar as LGBT Affinity Group, and what we would hear a lot is people would call in and say, "I'm a mother. My 8-year-old is navigating gender. I want a doctor that understands how to work with gender." And as an insurance company, we were kind of blind.


What we wanted was a clear indicator that said this doctor is objectively inclusive with gender or race, or really any core cultural competencies or cultural humilities, but that data doesn't exist. So, at Violet, what we're building, it's something quite novel. We're building the first ever credit agency for cultural competence, and we intentionally use that analogy. What we really believe is that the ability to be inclusive by clinicians, it's a skill. It's a skill everybody could fine tune, but what you need is clarity on how are you doing, what do you need to do to be better? We get to know care delivery teams, we upskill them to be more inclusive, and then we use data to power their directories to make it easier for the one out of two Americans that are LGBT or BIPOC to get to the right person faster.

Kate Barrett (04:42):

Improving access to care is such an important mission, Gaurang. And it's a core focus of Everside's business, too. Chris and Mohamad talked about what it was like tackling that mission in the early days just as the global pandemic was accelerating.

Mohamad Makhzoumi (05:02):

We've been fortunate enough to work together, Chris, now, for almost four years. And not much has happened in those four years. You've only 10 Xed a business, spun it out of a large public company, folded in multiple acquisitions, and then tangled with a once in a generation health pandemic as a healthcare company sitting at the focal point of return to work for hundreds of thousands of Americans. So, it's a unique story, Chris, because most investments, at least in a venture world, you have a firm, like NEA, and we partner with an entrepreneur and a founder early in the company build. We partnered together to spin out a division of a $15 billion public company, stand it up as an independent business, and then build it standalone, doing some really disruptive things.

Chris Miller (05:53):

I'm fortunate to be at the helm of this business. As you mentioned, it's a transformational company here. And our mission is to really transform the way the US healthcare system is evolving, enabling patients in our care to lead their healthiest lives, and we're fortunate to do that, now, for about 600,000 patients across the United States.

Mohamad Makhzoumi (06:11):

Chris, our journey together as partners was accelerated by all the common connectivity that we share, really, through the NEA network. So, I feel like, at the time, DaVita was selling Paladina. We, NEA, had a thesis around primary care for employers, but I feel like our relationship just accelerated so dramatically given all the shared points of connectivity. And I don't know that it would've worked so well if we hadn't come in with all of those shared connections.

Chris Miller (06:39):

Yeah, I think that's right. We collectively decided to spin out, what was then, Paladina of DaVita with the blessing of Kent and Joe and the board, given some of the changes they were making, as well, given some of their non-core assets. And so, we went through a process and brought in the bank, and met with a number of different potential investors/acquirers. NEA emerged very quickly as the leader given expertise in healthcare technology and connectivity. And I'd heard the legend of this gentleman named Mo. And when, I finally got to meet Mohamad in person, it was pretty clear that this was the right place for us to land. And I like to tease Mo a little bit about this because we actually got a couple of other bids that offered us a little bit more from a cash perspective, but NEA clearly was the right place for us to land regardless. And it was great because Kent and the team gave me the leeway to make sure this was landing in the right spot.

Mohamad Makhzoumi (07:38):

And I remember being together in that big conference room in Denver in July of 2018 when we announced the deal to the entire Paladina team.

Chris Miller (07:48):


Mohamad Makhzoumi (07:49):

And I mean, the business is dramatically different today in a whole number of positive ways. I think it'd be great for the listeners to really understand what the Everside model is, what you are delivering for your customers, the employers and their employees, the members and the dependents? And how that has changed over time? And how you think it'll change going forward? Because I know one of the things you and I talked frequently about is what the next iteration of our company is going to look like.

Chris Miller (08:19):

Yeah. We are a direct to employer, value-based care company built on the foundation of primary care. And so, what we do is we build and staff onsite and near site health centers, and then we staff them with PCPs, and we funnel as much care as we can through those health centers. So, what that means is the employee, it's typically free for the employee, it's paid for by employer. They, then, have 24/7 access to that provider. And what that better access to care, then, does is drive great results. So, amazing patient satisfaction scores, much better clinical outcomes, better than 90th percentile in terms of HEDIS measurements, and then tremendous cost savings for the clients we serve because their employees have access to care.


So, that's the nature of what we do. And again, the results have been pretty dramatic in terms of the cost savings, typically 17% by year three, and 51% by year five for the clients that we're serving. So, where we're moving, the foundation has been primary care. But we want to be, and are now, but we're moving more in this direction, a total cost of care saving solution for the clients that we're serving. And that means building on the foundation of primary care, but adding more and more ancillary services, like mental health solutions, physical therapy, occupational health, pharma, labs. The more services we can provide for the clients, the more that we can save them.

Mohamad Makhzoumi (09:39):

Chris, the way I think about it, because a lot of our partners focus in tech and entrepreneurs, it's going full stack and the opportunity to own the entire journey and patient experience beyond primary care. But knowing that primary care is the front door through which every one of us has to walk through to access the downstream specialists and labs and pharmacy and outpatient resources, I don't know that there's another opportunity like that that we see in healthcare or even in consumer e-commerce. I mean, it's just a massive, massive market, and you've built a great business on a tiny speck of it.

Kate Barrett (10:19):

So, at the end of the day, Gaurang, I mean, Everside, Violet, and thousands of other companies are essentially trying to democratize access to quality care. I read a comment that you made somewhere that, "Empathy is not inclusivity." What do people need to know about the distinction between the two?

Gaurang Choksi (10:35):

Great question. You could be filled with empathy when it comes to working with black patients or LGBT patients, like myself. But it doesn't necessarily mean you'll have the expertise or the skillset to actually know what I need to know based on my identities. Gay men in America have 20 times the rate of colorectal cancer, and if clinicians appropriately taught about HPV vaccine, that rate could be drastically reduced. But what we're seeing is, a lot of times, clinicians are, one, overwhelmed. Two, they're often not easily taught or provided the tools they need to know about these inequities and what they could do about it. And three, we don't use data in an efficient way. So, we really believe that by recognizing cultural competence as a skill, we could use that data to meaningfully deliver better outcomes.


And what we're seeing is so many of our partners, the care delivery organizations, they're excited. Because now, for the first time ever, they're able to objectively see a scorecard almost that says, "My team is doing really, really well working with this community, but we have room for growth working with gender identity or sexual orientation." And what that does is, now, that transparency yields accountability. The learning and development leadership, the chief medical officer, the CEO of these organizations, now they know what they need to invest in, and that's really been a powerful unlock.

Kate Barrett (12:00):

That's interesting. Everside has emphasized education as a key component of democratizing healthcare, too. It's had a lot to do with how they've responded to the challenges presented by the pandemic. Let's take a listen.

Mohamad Makhzoumi (12:17):

You, Chris, and the team, I felt like, had the perfect balance between playing offense and defense at the same time and covering your flank, but also thinking, as you said, about opportunities because, no doubt, the pandemic has created enormous opportunity in healthcare, in technology enabled healthcare, and candidly, most specifically, in primary care as the front door.

Chris Miller (12:40):

We started every day with asking ourselves two questions. In the midst of a crisis, question number one was how can we continue to serve our patients? How can we continue to serve them well? And question number two is how can we serve them better than the way we did before? So, never waste a good crisis. You've heard that quoted many, many times. So, the answer to the first question was we need to keep our health centers open. And we kept 100% of them open throughout the pandemic. The second question of how can we serve our patients even better was let's switch to do more virtual care. And so, we had the virtual piece in place. We were doing just a small percentage of our patient visits were done virtually. And at the height of the pandemic, we were doing as many as 75% of our patient visits done virtually.


And so ,it's actually been a really positive movement for us. These are not typically early adopters that we serve, but now they're getting on their phone and dialing in their providers by video. And so, look, this didn't escape us. This is an opportunity for us and it really propelled our growth in a much different way. One of our challenges is continuing to educate the public, educate the types of clients we serve about the value of direct primary care and value-based care. And look, let's not ignore some of the facts in the United States. You've got about 25% of Americans don't have a primary care physician. Almost half of Americans choose not to go to see their doctor because they can't afford it. And so, we have figured out a way to deliver better healthcare through the employers and deliver much better outcomes for patients. And this education piece has been really, again, propelled by some of the downside effects of the pandemic. It's actually helped us to continue the education throughout this country.

Kate Barrett (14:20):

Hearing all that, those are some alarming statistics. And Gaurang, I think you probably have a few of your own specific to the population or populations that Violet serves.

Gaurang Choksi (14:31):

Yeah, and there's so many studies about this, but by 2045, one out of two Americans will be a part of the LGBT or BIPOC communities. Meaning, one out of two Americans will be culturally diverse. And yet, our healthcare system, the tools, and the technology, and the employees in the healthcare system are not able to actually serve the communities that they want to serve to the capacity that they want to. And what we're seeing is these disparities and these inequities will not get better until we actually invest in helping everybody access the right education at the right time and actually upskill themselves. As a company, we intentionally use the word upskill because we deeply believe that the ability to be inclusive, it's not just about memorizing facts. Clinicians and care delivery professionals are amazing at memorizing facts. That's not the problem here. The problem is a lot of times you may know the importance of bringing in race into a conversation, but as a clinician, you may not still feel comfortable saying the word black or bringing in race into a care delivery interaction when you know want to to actually teach about disparities.


In the past few years, we've seen a huge verticalization of healthcare. We've seen many care delivery companies focus on specific conditions, like Equip app for eating disorders, or focusing on communities, like the folks of the world focusing on the LGBT community. At Violet, what we're doing is taking a horizontal approach. Which is, I deeply believe in as a human, I do believe this, we can unlock a lot of inclusive care if we look at existing care delivery organizations. And then, on top of that, what we're seeing is humans are intersectional. As a human, I don't think about me being a gay man as a really greater degree of importance than me being an Indian immigrant.


What I know is I'm both, both of those identities that make up me. And similarly, what we're seeing is as America, as a country, continues to get more diverse and intersectional, people don't want to pick one identity or one condition. What they want is one doctor that can really see their whole person, see all of the identities that they have, all of the conditions they're processing and navigating. And what we're able to do is, as we have partnerships with care delivery organizations, we can help them make sure that they have the data they need to get every single patient, based on all of their identities and conditions, to the best possible person for them internally. And that really is how we'll build health equity together.

Kate Barrett (17:01):

It seems clear that what patients want is easier access to more personalized care. But change is slow to come in an industry that's as sprawling and complicated as healthcare. I want to share some of Mohamad and Chris's conversation about this.

Mohamad Makhzoumi (17:20):

Healthcare is so fascinating because you have these massive incumbents that sit across the landscape. And it's crazy to say that Everside, as a $300 million business, is still infinitesimally small in the grand scheme of a four and a half trillion-dollar industry. How do you navigate a competitive landscape that has these behemoths in it? And not to mention the Amazons and the Walmarts and these non-healthcare behemoths wanting to get into this really attractive market segment. How much time do you worry about that? How do you navigate that?

Chris Miller (17:54):

Yeah, another great question. So, look, we are very intentional about our differentiation. That's the first point I'll make, and I'll talk a little bit about that to illustrate it. And so, what's the lovely outcome of all this is we have gotten the attention of those behemoths, and they're talking to us about partnerships now. And I think that's a great tribute to how we've differentiated ourselves. But it all starts with the results. And we haven't talked about this as much, but that's the real differentiator for Everside. And we deliver significantly better clinical outcomes, we deliver significant cost savings for the clients we're serving, and fantastic net promoter scores. So, patient satisfaction scores are really, really high. I mean, our latest NPS score is 85, and you think about some of those that lead the way typically in the healthcare industry-

Mohamad Makhzoumi (18:36):

It's higher than Netflix. Forget about healthcare industry.

Chris Miller (18:38):

Yeah, we're up there with the Netflix and Apple and Trader Joe's and Ritz-Carlton. And look, the average net promoter score for a primary care physician is negative. It's negative 1.7 and we're 85. So, it tells you that we're delivering a great service for both our clients and the patients that we serve. And because of that, we do get that attention from some of the behemoths that are saying, "Hey, whoa, what's going on here?" And we have figured out a way to deliver much better healthcare through the employer to these patients who desperately need it, and the results speak for themselves. So, because of that, I think, even though we are much smaller than some of these behemoths, we have attracted their attention.

Mohamad Makhzoumi (19:13):

Yes, quite captivated on every side. And I would say, Chris, there's a good lesson in there in the sense that I think it's really easy for entrepreneurs, for CEOs, for investors to get caught up in what the competitive landscape looks like and who's doing what. And oh, this firm made an investment here, and this big tech company's trying to enter the category. And in the sense that, usually, when something doesn't work, it's because you, the company, didn't succeed, not because of what someone outside the company did. And I think your and the team's maniacal focus on operating excellence, on the product, on the patients and the member experience, and blocking out all the other noise, it's hard to do, but you've done it, and that's been a key ingredient to your success.

Chris Miller (20:01):

Well, I appreciate that. It is a focus and it's a maniacal focus, as you mentioned, on making sure we're seeing things through the lens of patients first. If we're taking care of our patients and delivering great outcomes to patient satisfaction scores, we know that's going to lead to better cost savings for the clients we serve, too. And to your point earlier, look, there's 110 million Americans right now that get their insurance through self-insured employers. We're serving about 600,000 of those. So, there's lots and lots of white space for us to grow ahead. And so, because of that, and I don't mean for this to sound loof in any way, but we're not terribly worried about competition. There's a lot of patients who need our service, a lot of employers who need to save money, healthcare spend increasing six, 7% year over year, and we've reduced that spend to 1.1% so we can deliver great outcomes to these clients. So, because of that, we don't really spend sleepless nights thinking about competition. We know if we're going to execute well, business is going to grow.

Kate Barrett (20:59):

How did you think about that as you were forming Violet and figuring out how you were going to operate?

Gaurang Choksi (21:04):

Kate, what I believe is that the future of healthcare, like every industry, is going to be personalized care. And tactically, what does personalization look like? It means you do your best to use technology to actually deliver quality healthcare where there is meaningfully better health outcomes. And one of the core pillars of health outcomes is patient and provider trust. Does that patient actually believe that the provider you are going to connect them with will understand them, will advocate for them, will actually build a lasting relationship? And what we believe is that whether you're a behemoth in healthcare, or you're a nascent startup that's doing verticalized care delivery, everybody wants to focus on delivering the highest quality care. And what we're starting to see is we see partners across the spectrum. We see large systems coming to us saying, "I really want to make sure I'm building health equity." And similarly, we see verticalized care delivery companies coming to us saying, "I'm an expert in a certain community, but I know my patients are intersectional." And what I want is to be sure that I can connect them to the best possible person internally.

Kate Barrett (22:11):

All right. So what's your NPS? Or more seriously, what are the metrics that matter?

Gaurang Choksi (22:16):

Yeah, we think a lot about metrics being a startup. What we look at are, really, three key pillars of metrics. One is how much are the clinicians learning on our platform? Two is what is the impact we're having on every single organization? And three is clinical outcomes, which we're working on. For us, we're seeing a lot of engagement, more than anybody else has seen, for our care delivery focused learning platform. To give a data point, right now, on average, 86% of the providers join our platform when we invite them, which is huge because what that shows you is providers want to learn. It's just they don't want to learn with a low quality compliance-like training. They want to learn with quality education. On the outcomes itself, we're actually conducting research with a few other organizations to look at as they use our data about their own care delivery teams for care coordination, do they build better relationships?


And then, for the secondary bullet around the impact we have on organizations that we partner with, we just published a great case study with this company called Brightline, where they are an industry leader on adolescent behavioral healthcare. But what they were able to do within a span of a year, which is super impressive, they quickly were able to identify an area of growth for their team. For them, it just so happened that it was gender identity and youth. And they upskilled themselves drastically. So, when we first benchmarked the team, only 4% of the team had cultural competencies with working with gender and youth. And within the course of one year, they completed over 900 hours of training, and more importantly, they grew that 4% to 19%. And Kate, what they did in that year was they meaningfully, they invested in their team. And to us, that's how we build health equity, which is we create systems that meaningfully teach people how to be inclusive, and then we celebrate that inclusivity.

Kate Barrett (24:07):

So, we know that in order to provide that training and education externally, you have to have a strong, well-trained internal team. I want to talk about your hiring process, but first let's hear an excerpt from Chris and Mohamad's conversation about Everside's approach.

Mohamad Makhzoumi (24:28):

Everside is blended. If you look at the executive leadership team, you've got tech companies, you've got marketing companies, like Clear, you've got retail companies, like Walgreens, and then really hardcore healthcare companies, like DaVita and CareMore. How do you blend a team from such diverse backgrounds and get them to buy into that shared mission and values?

Chris Miller (24:49):

It helps by making sure you're doing the right kind of hiring. So, the three boxes I always try to check when I'm a hiring--

Mohamad Makhzoumi (24:54):

I know what you're going to say, and I love it. Go ahead.

Chris Miller (24:54):

You know what I'm going to say. You've heard me say this a lot, but it's hungry, humble, and smart. And if I can find those three boxes, the level of expertise, oftentimes, doesn't matter. I want somebody who is really hungry to change the way the healthcare system is evolving and wants to make a big impact. I need humility because that's really a key part of our culture. We're servant leaders, and we want to make sure that that's instilled and what we do each day. And, look, smart never hurts. Hiring people that are smart who've done this before.


You look at some of the logos on my executive team now. I mean, we've got ChenMed, we've got Walgreens, we've got all sorts of payer expertise. And so, it's really been wonderful to bring individuals who've seen successes, failures, and they're bringing those best practices to the table now and can blend that big company expertise along with aggressive growth expertise. This team is executing extremely well right now. So, I'm very fortunate to have been able to attract the type of teammates that I've been able to attract, especially within the last 18 months, and build a world-class team.

Mohamad Makhzoumi (25:54):

It's remarkable. And I think, Chris, there's a great lesson embedded in there for other founders and entrepreneurs because some of it's been planned, but some of it's also been serendipity. We had a CFO who decided to walk out in the middle of the pandemic, and that wasn't planned. But you look at where we landed with one of the most talented CFOs I've ever worked with who came out of Walgreens Boots Alliance. And so, talk a little bit about planned versus unplanned and how to roll the punches, so to speak.

Chris Miller (26:20):

So, one advice I'd give to earlier stage entrepreneurs is to start to build a pipeline very early in terms of just relationship building, connectivity. Not necessarily to hire those people, but who do they know, as well? Look, this happens with investors, but it also happens with leaders of big and small companies, too. And so, I'm fortunate to have a bit of a global pipeline that I can tap into, not only to define leads, but really to due diligence on some of these people too, which is really critical.

Kate Barrett (26:48):

So Gaurang, what is your approach when it comes to constructing the right team to build and grow the business?

Gaurang Choksi (26:55):

I love the way Chris framed it up. What I look for is two core things. One is humility, and two is a deep desire to build health equity. And what we've been able to do is attract people that have built high growth startups before. And for us, our executive leadership and the full team, it's a mix of individuals that, one, every single person cares about health equity. But two, people either have educational and ed tech backgrounds or health tech backgrounds. So, quite a few of the team members, including myself, came from Oscar and other health plans. But collectively, when we have to dig deep and sometimes dig deeper into healthcare concepts or education concepts, those are amazing conversations because now we have the right people around the table really advocating from their point of view and why there are certain decisions we need to make to make learning in healthcare as easy as possible.

Kate Barrett (27:47):

And you're a first time founder, despite having long been entrepreneurial. And you've founded this company, really, right as the pandemic was accelerating, right? So, how did you recruit people?

Gaurang Choksi (28:01):

So, my approach to hiring is really finding top talent and sending them notes, working with amazing recruiters that are focused on mission driven early stage startups, and then having honest conversations with people. Letting them know exactly what the state of affairs are with your organization, and what you're marching towards, and then giving them the opportunity to say, "Is this aligned to your goals? Do you want to build health equity? And do you want to use education and data as the vehicle for building health equity? If yes, then join our team."

Kate Barrett (28:30):

So, we've talked a lot about building a team, but what about building a team of investors? I want to share some of Mohamad and Chris's conversation about Everside's approach to this, and how Chris ended up partnering with NEA.

Mohamad Makhzoumi (28:46):

If I were a founder, an entrepreneur, a CEO then I'd want to kind of understand is what advice you have for them around what to look for when raising capital, when seeking a partner, either in things to avoid or things to run toward. And you've seen it, because I think it's unique at the venture stage, the growth stage. And with all the inbounds that you've gotten from strategics and public investors, how do you cut through the noise? And what advice do you have for other founders?

Chris Miller (29:17):

So, a couple of things. So, when looking for the right kind of investor partner, the first thing I look for is a track record of success. And so, that's really meaningful. That track record of success brings a pattern of recognition. And if you can see pattern recognition, then those investors are going to be really helpful in taking you from one stage to the next. They see things before you do and can give you a heads-up for that sort of thing. And so, the wonderful thing about bringing on an investor with a track record of success is you can reach out to those CEOs, those executives, before you do a deal with them and really get the true story.


And so, I called a number of CEOs, and they all told me what a wonderful partner the NEA was. So, that track record of success is really critical. I mentioned NEA had the expertise in both healthcare and technology, and we really wanted to move into more of a tech enabled delivery of services. And so, that was key to have that expertise. And the third thing I looked at, too, was that hold pattern. And so, bringing on an investor whose average hold time is nine years is really meaningful and allows you to grow the business at the pace which makes the most sense. So, I don't have to make any hasty decisions to flip this and deliver returns to LPs in two or three years. It helps you to run the business much more differently. And so, that was a key piece of what I look for.

Mohamad Makhzoumi (30:34):

And look, I think that it's mutual in the sense that I feel like we were, and still are, totally aligned, and I knew the ways that I could support you, and I knew they were going to change, right? Because the stuff that you need from our team is very different now than it was when we first started together. And I feel like the hallmark of a great relationship between a CEO and an investing partner is that you can adapt and change as the dynamics, as the company, as the market changes, so that we're both hitting the right notes as the company changes.

Chris Miller (31:10):

Yeah, but the important thing is to keep the dialogue going throughout each stage. And so, look, the wonderful thing about you all is that you respect the fact that I don't need to have somebody advise on the day-to-day operations, the company you trust that's going to happen because I'm fairly seasoned executive, fortunately, by now. But it is, it's important to just keep the dialogue going throughout each stage of the company. And so, you and I talk a lot. I talk to a number of my investors a lot, and there's always aspects of strategy, growth, personnel that I need help with. But to your point, they're very different from where they were four years ago. And so, it's a different kind of help, but the key pieces are always there in terms of how I can help you and you me.

Kate Barrett (31:48):

So, what do you think Gaurang? Is that the best way to diligence a potential investor?

Gaurang Choksi (31:57):

Absolutely. Kate, I have done ref countless reference calls on all of my investors, all of my advisors, all of my employees. And frankly, I absolutely love hearing other founders and other partners experiences with potential partners. And for us, and for me personally, the more data points I have, the more helpful it is to know that that is the investor I really want to work with long term. One of my favorite interview or reference call questions to ask is asking about a time that the specific individual had to apologize. And that question generally unearths a lot of hidden truths.

Kate Barrett (32:31):

That's fascinating. Did anybody ever say the person has never apologized? Because I would think that would be a really good leading indicator, too.

Gaurang Choksi (32:39):

There's been a few times specific founders have shared that. "Oh, this investor never has quite apologized." And to me, then, there's a secondary question of, "Did it ever warrant an apology where you felt that it just wasn't received?"

Kate Barrett (32:51):

As you approach two years, I guess, on the job as a founder here, what advice would you offer to aspiring or emerging founders? Are there lessons that you learned that you wish you hadn't? Or advice that you didn't get but wish you had?

Gaurang Choksi (33:06):

For me, staying humble, continuing to work hard and actually prioritizing honest relationships has been a huge value add. There's been so many investors, so many advisors, individuals that I've met, that sometimes they gave me feedback that, at the time, maybe I didn't want to quite hear. But thematically, what you often find is, as themes emerge, that feedback has merit. And so, my word of wisdom, really, would be keep working hard and keep building honest relationships.

Kate Barrett (33:36):

I really, really enjoyed hearing about what you're building. I really enjoyed hearing about your perspective and even just what led you to found the company. I think you have a really powerful story, and I'm really grateful that you decided to share some of that with us today. So, thank you.

Gaurang Choksi (33:52):

No, thank you for having me. This has been really lovely, and I have appreciated hearing the snippets from Chris and Mohamad's conversation, as well. It was fun to hear about their approach to building quality care.

Mohamad Makhzoumi (34:04):

I don't want to take another minute away from you running our very important business, and I can't thank you enough for sharing your thoughts here today.

Chris Miller (34:12):

Thanks for giving me the opportunity. I'm grateful for it and happy to be of continued help, as needed. Thank you.

Kate Barrett (34:25):

It's always inspiring to hear a founder share their journey. It's inspiring and instructive to hear about a company's mission to ensure all patients have access to effective inclusive care. And I think understanding how those goals infuse every aspect of company building offers a lot to any founder that they can take away and apply in their own journey. I'd like to thank Gaurang, Chris, and Mohamad for sharing their incredible stories with us. It's been a pleasure to hear about their journeys and learn from their experiences. I hope you learned a lot, too. Thank you for joining us.


Founder Forward is a production from NEA, made in partnership with Frequency Media. From NEA, I'm your host and executive producer, Kate Barrett, with support from Ashley Mitchell, Erica Sunkin, and Shanna Hendriks. From Frequency Media, Michelle Khouri is our executive producer, Enna Garkusha is our supervising producer, Jordan Rizzieri is our producer, and Catherine Devine and Emily Krumberger are our associate producers. Our mixer and sound designer is Claire Bidigare-Curtis, with dialogue editing by Sydnee Evans. For more on NEA, visit You can subscribe to Founder Forward on Apple Podcasts, Spotify, and wherever you get your favorite podcasts.

The information provided in this podcast is for educational and illustrative purposes only and is not intended to be an offer of securities, investments, investment advice or recommendations. New Enterprise Associates (NEA) is a registered investment adviser with the Securities and Exchange Commission. However, nothing in this communication should be interpreted to suggest that the SEC has endorsed or approved the contents of the podcast. Any offering of securities by NEA is restricted to qualified investors and is made pursuant to offering documents that contain important disclosures concerning risk, fees, conflicts, and other important information. The company founders or other executives featured in the podcast are not compensated, directly or indirectly, by NEA but may be founders or executives of portfolio companies NEA has invested in through funds managed by NEA and its affiliates. The host of the podcast is an employee of NEA and is compensated in her role as a NEA employee. NEA has paid to optimize the placement of this podcast on certain online search platforms.

NEA makes no assurance that investment results obtained historically can be obtained in the future, or that any investments managed by NEA will be profitable. The statements made by the founders, investors and the presenters in the podcast are their own, and are not intended to be an endorsement of the investment advisory services offered by NEA. NEA has no obligation to update, modify, or amend the contents of the podcast nor to notify the listeners in the event that any information, opinion, projection, forecast or estimate included changes or subsequently becomes inaccurate or outdated. To the extent the founders and investors featured in the podcast discuss hypotheticals, projections, or forecasts to illustrate their views, such views are their own and are not verified or adopted by NEA, nor has NEA tested the validity of the assumptions that underlie these opinions. The companies featured in the podcast are not a representative sample of all current or former NEA portfolio companies. Listeners of the information contained in the podcast should consult their own legal, tax, and financial advisers because the contents are not intended by NEA to be used as part of the investment decision making process related to any investment managed by NEA.

About Founder Forward

Founder Forward is a new podcast from NEA that explores the company building journey with candid commentary and useful insights from entrepreneurs and investors at every stage of growth.

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