There's a specific flavor of hubris that shows up when a tech founder enters healthcare. It sounds like: "Brokers are just middlemen getting rich off of a broken system. We'll go direct to the employer." Nick Soman spent years building Decent, a health plan designed around direct primary care, and he watched a lot of smart people make this exact mistake. He also made some of them himself. This episode is the map of those wrong turns. Nick is the former founder and CEO of Decent, now Chief Commercial Officer at Nice Healthcare (Decent and Nice, Nice and Decent). I can happily say that Nick lives up to his two companies' names.
Start with brokers, not against them. The typical "tech disruption" approach frames brokers as rent-seeking middlemen.
Nick's counterargument:
If you don't have rate relief, you have nothing. Rate relief is the one question brokers are being asked by their clients, day in and day out. If you can't show that your plan is cheaper for at least 40% of groups, the conversation doesn't start. Nick's heuristic: if the broker doesn't have price, they have nothing to sell, no matter how elegant the technology.
Therefore: focus on steerage. The difference between the cheapest and most expensive MRI in Austin, TX is roughly 8x. If you can build a plan that guides people to the lower-cost option for non-emergency shoppable services, you've found the actual lever. Nick's starter heuristic: for all non-emergency hospital claims, do you have an alternative good spot to send members to next time?
Then simplify until it hurts. Decent spent four years before it could credibly sell the Zero Plan: “if you do what the plan wants you to do, it costs you $0 outside your monthly contribution.” That is the level of simplicity you need to actually break through to the decision maker at your prospects. The HR person who has to make this decision once a year and really doesn't want to be in this conversation needs a message that lands in one sentence. This also helps brokers sell (remember rule number one).
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00:00 Intro: Why Tech People Fail in Healthcare (With Nick Soman, Former CEO of Decent)
09:47 Tip #1 — If You Can't Sell to Brokers, You Have Nothing
19:17 Reframe Brokers as Channel Partners, Not Middlemen
29:06 Make It Simpler. Then Simpler Again. (The Story of the Zero Plan)
34:53 The Secret Weapon: Steerage (And Why an 8x Price Spread Changes Everything)
43:56 Narrow Networks, Broker Trust, and Building Something You'd Put Your Own Family On