#130: Steve Gutentag, Co-founder of Thirty Madison

In this episode, I’m joined by Steve Gutentag, co-founder and CEO of Thirty Madison, a human-centered healthcare company.

Thirty Madison is focused on becoming the premier healthcare company for people living with chronic conditions. Its innovative model delivers better patient experiences and superior health outcomes through specialist-level offerings on a singular platform. Its product portfolio includes Keeps for men’s hair loss, Evens for gastrointestinal conditions, Cove for migraines, and Picnic for allergies.

On today’s podcast, we discuss the company’s recent $140M funding round, its merger with women’s healthcare company Nurx, and Steve’s plan for becoming the leading platform for specialty healthcare offerings.

In this episode, you’ll learn:

  • Strategies for building and managing multiple brands
  • How Thirty Madison is scaling access to digital healthcare
  • Tips for setting up self-sustaining teams in your business

Links & Resources

Steve Gutentag’s Links

Episode Transcript

This is a machine-generated transcript. Please excuse any errors.

[00:00:00] Steve:
When we build our offerings we’re not trying to provide access to healthcare. That’s not enough. We want to provide access to a better health outcome.

[00:00:18] Joe:
Welcome back to the Fitt Insider podcast. I’m your host, Joe Vennare.

Today I’m joined by Steve Gutentag, Co-Founder and CEO of Thirty Madison, a human-centered healthcare company.

In this episode we discuss the company’s recent $140 million funding round, it’s merger with women’s healthcare company, Nurix, and Steve shares his plan for becoming the leading platform for specialty healthcare offerings.

Let’s get into it.

Hi, Steve, welcome to Fitt Insider. Thanks for joining us.

[00:00:41] Steve:
Thanks so much for having me.

[00:00:42] Joe:
I’m looking forward to the conversation here today.

To kick things off, can you introduce yourself and tell us about Thirty Madison?

[00:00:50] Steve:

I’m Steve Gutentag. I’m one of the Co-Founders and CEO of Thirty Madison. We’re a healthcare company that has just hit its fifth birthday yesterday since we started Thirty Madison.

We’re focused on becoming the premier healthcare company for people living with chronic conditions.

Many people know us by some of our offerings that are consumer facing, like Keeps for hair loss, Cove for migraine, and others. But really what we’ve built is a new and innovative care model that delivers better patient experiences and superior health outcomes at scale.

We do that through specialist-level offerings and a singular platform and infrastructure.

[00:01:35] Joe:
Yeah, I think it’s really interesting.

Having both followed the company in the space, and then of course digging in preparing for this company, you talk about it as a human-first or human-centered healthcare company. Can you expand on that? What you mean by that, and what it actually looks like in practice.

[00:01:54] Steve:
Yeah, absolutely. So, you know, I think, I think if you talk to the average person who has a healthcare experience, with the traditional system, usually the word enjoyable is not how it’s described. and, being built around the patient, people say patient centered all the time. but at the end of the day, the experience itself often, is lacking.

And, and so we got our roots. In building experiences for, for patients directly, we went, with our Keeps offering and our co offering. And, you know, we say that we are building the premier healthcare company for, for people living with chronic conditions. And one of the biggest and most important words there is people.

That is our north star, the people who are suffering from different health issues or who have specific chronic needs, that they’re not able to satisfy elsewhere. And when we are. Serving those, those people as our Northstar, it brings a lot of clarity as to how do we make sure that what we’re building is built for them at the center. and you know, we work with so many other constituents and stakeholders within the healthcare industry, providers, payers, pharma company is you name it. but I think is so. We work with them to bring them into this model to better serve patients and in service of patients and, and, and service of those people.

And so everything that we do, we start with this first principle of, how do we create a better patient experience, an incredible enjoyable patient experience. That’s really delightful. And we build an entire brand eco system around. That, you know, the set of chronic conditions and the set of health issues that, that patient is really trying to address.

And we really think about it from that principled consumer centric approach, but then we apply that and marry that with our outcome centric. Patient model that is really designed to help support a patient from start to ongoing care and . From a lens of what does the patient need to get to the best health outcome.

[00:04:02] Joe:
Yeah, I think it’s really important. And I want to definitely want to dig in a little bit more to, you know, how you approach the different, Kind of conditions that you are tackling and then expand those over time. But I was just curious in terms of, you know, structure, we’ve seen a lot of different companies emerging in the kind of digital health direct to consumer healthcare that are, you know, a adventure studio, some are holding companies, some are, you know, launching the companies and spinning them out.

What is the structure? a of Thirty Madison. And how did you arrive at that?

[00:04:33] Steve:
I think a lot of people assume that we had different companies and were kind a studio, or we, spin out these independent.

That that’s not, that’s not actually what it is. So the, the brand is part of that model that I said that was this really human centered built for the, the patient who has the person who has chronic conditions. And so we marry that brand. With our longitudinal, our care, you know, our patient journey that I talked about.

So the company is one company and the way we’re able to deliver our model to patients, at scale is we’ve built a central platform and infrastructure, the spans technology and data spans, medical service and it spans physical infrastructure and supply chain, capabilities. And this platform is what powers that, that care model.

And it’s not specific to any one chronic condition, but it’s all the pieces that, you know, think about this as, APIs or software that a patient will, complete their consultation with, or a physician will use to see a patient or the actual physician group and the network of physicians and the care team that supports them or the pharmacy that supports all of our offerings.

And then we build these dedicated brands and experiences on top of this platform targeting specific chronic conditions. and so they’re all interconnect. They’re all designed to be essentially like a, I think like a virtual center of excellence, like a

[00:06:05] Joe:

[00:06:05] Steve:
Specialist practice around that set of health issues.

But with the scale and infrastructure behind it, of our platform and the ability to serve patients across a variety of.

[00:06:19] Joe:
Yeah, for sure. I think, you know, basically improving. All of the not only experience, but the, like you said, the infrastructure is, is central to, and key both to improving the, the consumer experience, but also the, the healthcare system, which in and up itself is broken on, on different levels. so it makes sense that you would approach it that way.

You kind of, you mentioned some of the conditions and, and, and brands from Keeps to Cove. I think Even, and Picnic other ones, Covering everything from kind of the, the hair loss, migraines, GI issues, allergies. can you talk about the, the vision and go to market in terms of how you approach, which conditions you are serving, how you spin up those brands and ultimately get them launched in this platform?

[00:07:07] Steve:
Yeah, absolutely. Great question. So first and foremost, when we think about, I think it’s helpful to understand how do we get here and then a little bit about where are we going? So we started with Keeps, which is focused on men loss. And the reason being is we’re building our platform. We’re building our infrastructure, all the, those pieces that I talked about, just a, at our core, what we said we’re building is this care model.

And the platform serves that it powers that, and what’s so special about the care model is that it’s not built for a specific chronic condition. It is built for better serving patients across so many types of chronic conditions. It’s really designed to work for almost any chronic condition over time.

And that’s a pretty tall statement. Right. and we, we had to prove that out. And so we said, well, let’s start with something on the lighter side of healthcare, you know, more low acuity, less complex health issue. And, hair loss was a really good chronic condition for us to get started. And so we, that was the first application of our care model, where we built this dedicated brand, this dedicated experience.

And then we invest and specialist level telemedicine, personalizing treatment options, and. ongoing condition management and care for patients all through keeps. And so we started there, and saw really great success. We saw that We were both delivering on that promise of a better patient experience.

Patients loved us, you know, we were growing and still growing very, very, but we were also delivering on that promise of actually helping guys. Keep their hair. And we were driving to really good health outcomes and making them really happy. And so as we saw success, we said, great, first proof point. So now we want to think about what was the next one.

And we. Okay. We’re seeing a really great success with Keeps. We could let’s do another condition like keeps or let’s focus on another area like that and just keep growing that way. But again, with our core being our care model and our promise being that we can serve a whole host of chronic conditions.

We said, we need to go with something much more serious. You know, and, and pick a much higher acuity, more complex condition where we can still serve patients where we can still, build that dedicated experience. And so we went and, selected migraine as that, that second, condition. And we built this Cove brand.

It’s a very different patient. We had to go and really understand, who, you know, what is their core need? What’s the challenges that they’re facing. And we had to approach building it differently because not only is migraine a much more complex condition. Than men’s hair loss, but the spectrum of care required for migraine is also very different.

So whereas hair loss, our average guy typically is not using treatments today. Like we’re introducing them and helping them keep their hairstyle hair loss. For the first time, our migraine patient is very different. The vast majority are women. but more importantly than their gender is the fact of their severe migraine suffers.

So they are on average coming in with nine or more migraine per month. they, most of them have seen a physician before most of them have suffered for many years. And a third of them before coming to co have just have gone in the months proceedings either to the, to urgent care in a quarter to the ER, just for their migraines.

So they’re deeply suffering and we really had to build our model to serve this much higher acuity, much more complex patient population and show that the model worked there. And we’ve been really fortunate over the last couple of years to demonstrate and prove out that our model works for a really low acuity health issue, a really high acuity health issue.

And it works at scale. We’re the largest provider of migraine care in the country. We’re the largest, hair loss business as well. Like we have built real scale in these areas, serving hundreds of thousands of patients. actively like on an ongoing basis. And, and so we, those, those. not at bookends, but we saw those on very different ends of that spectrum. and so we started to build, into our next set of conditions with GI and allergy being focused and having that, continuing to build out both capabilities at our core platform with, with very specific use cases for those chronic conditions.

And as we think about those going forward, Our ambition is not to just have one or two or, or low to high, but one, whenever we enter into a condition area, we want to be able to serve the full spectrum of those patients. So from the first line treatment to some of the more serious therapies and helping patients get to a better outcome, regardless of where they are in their journey.

Two, we want to go for, broad. So we want to have at least one offering relevant for every person in our country in the next few years. So we, we are not trying to just, bring a patient in and figure out, okay, well, like is, the only way this works is, by like continuing to serve you here, or we have to go and serve you elsewhere, but really we want to be the best place for a host of conditions and at least one of them be relevant for everyone in the country.

[00:12:19] Joe:
Yeah, I think that’s really, really powerful. And I think seeing that expand over time, I’d be curious to know as you’re going through. This process, have there been any conditions, brands that you’ve, you’ve gone down the path of, of starting to launch, but hasn’t worked for one reason or another, or have you not encountered that as much thus far?

[00:12:37] Steve:
We have been really, we, we, we’ve only launched. We’ve started to work on and we launched four to date. Right. That are out in the market. All four are there, we’ve seen all four of them have success, which is fantastic. but it hasn’t always been right outta the gate. we’ve had to, to learn and adapt and iterate and evolve as we’ve done that.

You know, when we, first launched our evens offering, we really launched it with this one narrow focus of, acid reflux curve. And, as we, as we started to do that, we weren’t meeting the needs of patients. And what we realized was we were seeing incredible demand and interest, but we weren’t able actually serve the patient because they often, you know, acid reflex or UR was just one of the symptoms of a broader GI issue or, or vice versa.

They had multiple GI issues. And so, we’ve had a step back. And, and we started to expand and, and, and, and really see ourselves less about one condition within GI, but a, a set of interrelated GI conditions as a starting point. And so we had to learn that, you know, we think of ourselves as building these specialist level offerings.

Like we want to be the, the center of excellence for these, the different areas where we operate in. And we started with one condition. Per brand and that’s, you know, keeps just was men hair loss COVID was just migraine. So even was just acid reflux and ger. And we, we realize that it sometimes is, you know, we want to be more of a GI specialist.

So that means we’re not going to so broad, but we gotta go a little bit broader than one condition to serve the patient. Properly. And so we started to add IBS and other conditions alongside that were interrelated so that we were holistic.

[00:14:34] Joe:
Yeah, it makes sense that it’s kind of, you’re, you’re evolving that offering as you get more and more feedback and engage with more customers, patients to make sure that you are serving them to your point. the other thing is you’re explaining. Both the platform and the structure that comes to mind is how are the, the, how are you structuring and how are you, kind of setting up the teams to be both interconnected, but be able to work independently to serve the different kind of brands.

So you have that central tie in right with the infrastructure, but these teams have to be able to kind of be self-sustaining on their own. Can you just talk about that? A little, a.

[00:15:06] Steve:
We’re about 350 ish people today, overall, working across all of our offerings, as well as all the central pieces. And I think it’s important to note that when you’re growing really quickly, you’re not going to, it’s not static, right. The structure and how we operate is not static. We’re 350 people, you know, today, maybe a little over 300.

When we started 20, 22, we were like a, just over a hundred people when we started 20 in. and. The structure and the team has had to evolve. Not only has our business has changed and grown, but also the team has. And so I’ll tell you what we look like today. but the reality is if you were to speak with me six months from now, or six months ago, I would say something very different. and I think it’s important to kinda, to, to say, and we’ve ebbed and flowed between more in teams working on, individual brands without.

And he needs to switch contexts and smaller teams working centrally on the things that everyone has to use, like pharmacy or medical groups and so on, to more central and larger teams working centrally. So we can share knowledge and share learnings and, and, and create that fluidity that really sparks innovation.

And, today we, we have a, I think a really interesting mix, so. Dedicated teams with leaders for each of the brands that are, they tend to be pretty tight, in size. So typically sub 30 people, for the individual teams. And so we have four brands. And so if you just did the math there about a, you a hundred to 120 people are going to be independent just within their business.

And then, the rest and the majority of the company work centrally. Now, that doesn’t mean that there aren’t people in those central organizations who only focus on one of our offerings, but they operate centrally. And this really helps for both career pathing and growth opportunities, but also the ability for someone to work across, the offerings and take learning from one to the next, so that they better, we can, you know, if we learn something from co and our patients for code that would be relevant for picnic.

We want to be able to seamlessly and quickly implement that. and vice versa.

[00:17:31] Joe:
Yeah, I think it, it, it’s really interesting to think about how that is also evolving, right? As you both the, the platform and the offerings and the, the customer experience itself is. so I appreciate you, you know, shedding some light on that for us. changing gears a little bit, I wanted to get your thoughts on the, the overall kind of, Explosion right of telehealth in general, digital health in recent years, the kind of direct to consumer model has been very powerful in de-stigmatizing certain conditions and increasing access and hopefully right in improving outcomes as well.

But then you get kind of the other side where it’s like, Are there drawbacks related to self diagnosis or certain situations where people should be seeking out care in person. How do you think about the, the pros and cons on that front?

[00:18:22] Steve:
Great question. So I think, I think look by and large, the, and digital health is incredibly impactful for patients.

[00:18:29] Joe:

[00:18:29] Steve:
And, and certainly in that positive, I think in any industry where there’s something new, there’s always going to be, folks who are, who are doing better jobs or worse jobs in it.

I think as it comes back to the patient though, you know, one CR early on just creating more options for patients to get access us to healthcare, is a good thing. Right. I think you said you’re, you’re in Pennsylvania, I’m in New York, we’re in or near major cities. And so we’re fortunate that there are even if it one we’re fortunate, there are physicians in care, nearby, many places in the country.

There aren’t two, I’m incredibly the. Have insurance and afford that care. many people in the country aren’t. And so when you think about the offerings, there’s so much room for the ability to provide more access to care and to treatment. I think we’re what you’re seeing though.

And what I’m. Is, that’s not enough. And people are realizing that and you need to go beyond that. you know, when we, when we build our offerings, we say, it’s not, we’re not trying to provide access to healthcare actually anymore. Like, that’s not enough. We want to say we want to access to a better health outcome. and that’s, that’s the mantra and the mindset that we take. And, you know, it’s not about getting a medication delivered or seeing a doctor online.

It’s about how do those things fit together to drive to a better health outcome for a patient? How do they come together and how does digital health and technology drive on the cost to deliver those better outcomes? how does it drive up the actual experience, I started this by saying, a few people would describe their healthcare experiences as enjoyable. and you know, . I think the net promoter score in, in the average healthcare experience, the single digits, which is, you know, on a scale from negative 100 to 100 being the best, like being in the single digits is.

Awful. and you know, we’re, we’re seeing ourselves that we can do that. So I’ll use co as a quick example here, to the point around better serving patients, you know, first and foremost, our patients coming in have often had. Healthcare experiences for their migraine. I told you they’re deeply suffering.

Oftentimes for years, and the system frankly, has failed, more often than not, they’re not able to see a specialist. Part of that is because there’s just not enough out there. So there’s 40 million people in the United States who suffer from migraine. There’s about 500 physic who are head specialists.

You can’t pop like in the, like, there’s no way to provide access to that type of care without using some form of technology or a different way to, to help patients get that specialist level care. And so, patients are coming in, they’re deeply frustrated. They’re suffering. if you have nine or more mega in a month, you know, and many of our patients are more than half of the month have a migraine.

You can’t live easily that way. Or some people you can’t, you just can’t live that way. Like that’s not, that’s, that’s terrible. And so we’re able to create, this specialist level. Telemedicine experience recommend them, work with using heart and data, working with what they, provide their physician and working with their physician.

They got a personalized plan. That’s, you know, mix of sometimes it’s a medication sometimes it’s, coaching, digital therapeutic coaching. Sometimes it’s a supplement. It’s a. But then, we provide them with this ongoing continuous access to their physician, to their care team, migraine tracking tools.

And we work with them to help them get to a better outcome. And what’s really powerful is that we’re showing for patients who are with us, you know, after three to six months, but 80% of patients, experience reduction in migraine severity. about a third reduction in migraine days per month. so if you can, you know, get four or five, six days of your month back, and when you even have a migraine it’s less severe that’s life changing.

And so we’re reducing ER visits and these other things. And so when I think about the ability for digital health to help patients, you know, and the last one, which is going back to the NPS score, we have roughly an 80 NPS. and, and we’re doing that at scale.

Like if you think about that for a second, being able to deliver incredibly enjoyable patient experiences at lower prices that actually deliver a better health outcome. And we can do for tens or hundreds of thousands of patients already, and its of. there’s nothing like that.

And that’s the promise and the potential of digital health, but there hasn’t delivered on that just yet, but we’re, we’re starting to see that happening and that’s really powerful.

[00:23:29] Joe:
Yeah, I think you, you paint a really, you use the word powerful. I I’ll echo that, picture of what can be when it comes to the opportunity and, and how we’re going about it in the digital health space. I’d be curious to hear your thoughts on, you know, when we think about the different companies that have emerged in this space, in addition to, to Thirty Madison, you have like the, him of the world and row and.

Even maybe like a redesign health, which is more of like the venture studio model that we talked about. And then the consolidation, the M and a, the, you know, even to point, Thirty Madison and NEX, the, the women’s kind of digital health company, announcing, the merger there. How do you see it playing out in terms of the platforms, the models, the, the competitors, the M and a, all the pieces that go into that.

Do you have a sense of where that’s going, how you’d like to play out.

[00:24:20] Steve:
Yeah. So, I mean, I think, I think the promise of digital health has yet to be realized. And, the promise of it is that we can deliver, better patient experiences that we can put more control into the patient’s hands.

The we can deliver better outcomes, more access to better outcomes, to more people at scale. And that we can do it more affordably and cut costs, not just from a patient more affordably, but actually put costs from the system unnecessary costs from the healthcare system. you know, I think what’s, you’re seeing is that, it’s gone in waves.

Right. you start with, I think telemedicine or digital health, 1.0 was kind of like this, just instead of me talking with you, I’d be talking with a doctor, right? Like it’s like, how do we just put the doctor visit on the internet? and it was typically more for like an urgent care setting or with your existing physician, you know, and you really want to think about it.

Like could have just been a phone call back in the day was a similar type experience. but that was that first wave and. You’re starting to see shifts happening. And part of this is through consolidation and M and a part of this is just through patient comfort and technology. Like why now? you have, hundreds of millions of people who have experienced telemedicine for the first time and realize what the, and not just the patients, but. Tens of thousands or hundreds of thousands of physicians and, and care, providers. And so you’re starting to see a, at least understanding of it. You know, I, I don’t have to tell my parents, like, what is telemedicine anymore? They know. and that’s really powerful when you think about the, shift that you’re starting to see.

So then you’re starting to see now people saying, well, what if. This was a starting point. And so there’s so much investment in virtual urgent care offerings and now virtual primary care offerings. we’re really excited cause what we really believe we’re building is virtual specialists, right? Virtual specialty care. And we, you know, when you look at the, Costs in the healthcare system and patients there, you know, the majority of costs are in treating chronic conditions and for specialists, and, and also that’s where the majority of the shortages, in terms of providers.

And so as we grow and get to scale, and, and frankly with our combination, you know, if we think that, scale means serving patients, right. And how many patients can we impact to drive change in healthcare? Well, what’s one of the, there’s many things that are exciting about our combination with NX, but I think one of the most exciting things is that on day one will be the largest player in our space by patient cap.

You know, we will serve more patients, 750,000 patients. than anyone else and, you know, pretty soon a million and that in healthcare is real, real scale. And that allows you to really, you know, I think a lot of the times it’s really hard to, quote unquote, transform an industry. when you are certain only when you’re small, but even when you get to a large scale, it’s hard to transform an industry.

If you’re either only working inside the system, Or only working outside the system. and I think something for us that we’re excited about is that we work and serve patients directly. But we also work with payers. We work with providers, we work with employers, we work with others within the healthcare system and bring them into our model and we found a way to do that, to better serve patients.

And I think that’s when the, the promise of digital health will hopefully be delivered in the future is when we’re. delivering on those three things I said earlier, which is better patient experiences and more control in the patient’s hands, but it’s not, that’s not enough. You gotta also deliver better outcomes and you gotta do it in a way that, reduces cost in the system and works and brings the system forward.

[00:28:32] Joe:
For sure. Yeah. And I think in wrapping up, maybe one more question for you, looking ahead. I think it was last summer, you guys raised like 140 million round valued it, you know, well, over a billion dollars at this point. And of course talking about. Both the, the vision, the opportunity, but also the mission to improve access and, and bring costs down and, and serve more people.

Ultimately, as you think about, you know, continuing to navigate that course, is there anything on the roadmap or anything that you’re excited about? We should be on the lookout for, looking ahead here.

[00:29:06] Steve:
We did just announce a pretty transformational deal and merging with Nurix. I’m really excited about what that’s going to mean for patients. I’m really excited for what that level of scale can mean in terms of how we better serve patients, and how we deliver the better outcomes to them.

The other piece is we are already on a path where we want to have at least one offering for everyone in the country in the next couple years. We also expect to introduce additional brands and offerings targeting other chronic conditions, and have reach in terms of what we can do to serve patients. But also continue to deliver on the promise of delivering better outcomes and experiences for patients with chronic conditions, at scale.

[00:30:04] Joe:

What’s the best way for people to learn more, or engage with the different brands, or apply?

Where would you point them?

[00:30:16] Steve:
Yeah. We list all of our offerings on ThirtyMadison.com. If you’re suffering from hair loss and you want men’s hair loss services you can go to Keeps.com. Migraine is with Cove.com. GI is Evens.com, and allergy PicnicAllergy.com.

[00:30:37] Joe:

Steve, thanks so much for joining us today. It was great learning more about everything that you have going on, and I’m very excited to share the conversation.

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