In this Q&A, you’ll hear from Rob Sebastian, co-founder of Forward, a network of insurance-free healthcare clinics. Rob discusses his personalized, data-driven, and proactive solution to a broken US healthcare system and explains why healthcare is a product, not a service.
Can you tell us about what you’re working on at Forward?
Rob Sebastian: Forward is a startup building insurance-free healthcare from the ground up — combining top-rated doctors with advanced technology to provide personalized, data-driven, proactive care. Forward’s mission is to build the world’s best healthcare for billions of people, for free.
It’s important to highlight that Forward is different because we’re laser-focused on preventative care. In other doctor’s offices, you might come in for a rash, they treat the rash, then send you on your way. But this doesn’t actually address any root cause; it just treats symptoms instead of finding a long-term solution for your overall health.
Thinking beyond Band-Aids, rashes, or colds, we look for the problems that are going to cause problems down the road, namely heart disease, cancer, and high blood pressure. At Forward, we want to discover those issues early so we can treat them sooner — before they’re fatal.
When you walk into a Forward location, you quickly see how this is an entirely different healthcare experience.
In your first baseline visit, which lasts 45 minutes with a doctor, we collect up to 500 biometric points—most of which are not commonly screened for—to develop an extremely comprehensive and precise view of your health, which includes comprehensive metabolic, lipid, and hemoglobin panels.
We also give you the option to do genetic screening, which is a follow-up appointment that allows us to dive even deeper into your health. Forward is $149/month, a flat fee (with no co-pays, ever) which includes access to everyday primary care in addition to our doctor-led programs and always-on support.
Our membership shows exactly who we work for — people like you and me, not Big Medicine.
How did you come up with the idea? What key insight led you to pursue this opportunity?
RS: Nearly one-third of all bankruptcies are tied to medical issues, and costs and premiums have risen 100% over the last decade. The average employee pays around $428 per month in premiums even though claim denial rates are up 23% since 2016, forcing more people to pay out of pocket for the same care or less.
Our health is one of the most foundational aspects of our lives, but the system we have today is fundamentally broken because 1.) It’s the wrong product, and 2.) has the wrong incentives.
And when an entire industry is totally corrupt and consumer-hostile, you can’t just chip away at the problem. The only reasonable solution is to break everything down to the studs and rebuild on top of clean incentives.
It needs to be inherently preventative; it needs to leverage technology for rapid results and improvements; and it needs to be cheaper than the current system, working for patients, not insurance companies.
To achieve our model, we took two big bets: First, we cut ties with a broken product. We’re built from the ground up, vertically integrated, and a “full-stack” solution — meaning we build hardware and software, construct physical locations and hire doctors, and build front-ends and back-ends.
Second, we cut ties with broken incentives by removing insurance altogether. We get paid directly by our members, not some financial middlemen. Which means you pay us so that you can live healthier for longer. With the right incentives, everything changes for the better.
That’s why we built Forward.
How big can this get? What’s the addressable market and how do you go about capturing it?
RS: If you work backward from our mission of building the world’s best healthcare for billions of people for free, I’d say the goal is to be everywhere.
Remember: Healthcare should be a product, not a service. When you think of a service, you think by market. When you think of a product, you want to be everywhere. Apple doesn’t ask what markets it should launch the iPhone in; it should be everywhere, just like Forward.
Who is the core customer? How are you acquiring customers? And how will you grow the customer base?
RS: We have over 20 locations and serve thousands of members around the country ranging from 18–93 years old. Forward is for anyone, and we’re showing our members how healthcare should work — focused on prevention and keeping you healthy, not just treating you when you’re sick.
In terms of our members’ profiles, one-third of them aren’t insured, and we expect that number to keep growing as we continue to expand. Some because people can’t wait for an insurance-free world. Others because they’re barely making ends meet and have no choice but to go insurance-free. In either case, they’re demanding change, and it’s why we’re rebuilding healthcare.
The other portion of our members are insured but still choose Forward — they want true preventative care from a long-term doctor who works for them, not their insurance.
We believe that showing members our value and the future of healthcare is an excellent way to expand our customer base. We lead with product any chance we get, showing how it’ll help you.
And that’s different from how it currently operates. When was the last time a health plan advertisement showed you how their cancer prevention works? They don’t, because they’re not betting on it.
I want people signing up for Forward because we have the best cancer prevention… the best heart disease program… not because it’s one of the two options their employer gives them.
Looking at your road map, what are some of the milestones you’re targeting over the next 3-6 months?
RS: Every day we are driven to continue building a high-quality healthcare system where care is affordable and accessible to all. We’re constantly adding more services and features to improve our membership, using technology to improve care while decreasing price.
Anything else you’d like to share with readers?
RS: We challenge you to join us and stop following the status quo society has come to accept in healthcare. We challenge you to stop allowing insurers to take the driver’s seat of your health. And we challenge you to dream about a world where you don’t have to sacrifice care for cost.
Because when built right, a system rooted in long-term care, empowered by technology, has the power to change the world.
Related reading from Fitt Insider:
Fitt Insider Podcast #126: Adrian Aoun, Founder and CEO of Forward
Issue No. 141: High-Performance Health
If you’re interested in having your company featured in our Startup Q&A series, send an email to firstname.lastname@example.org.