Interview With Ankit Gupta
Describe your product or service:
“Bicycle Health is the leading provider of virtual opioid addiction recovery treatment, helping patients rebuild their lives through a personalized, outcomes-based platform and evidence-based care model. It provides empathetic, affordable, person-to-person care at scale, with medication management, behavioral health treatment, support groups, and care coordination to deliver the highest quality recovery experience through telehealth.”
Describe your company values and mission:
“Bicycle Health is committed to helping patients live fulfilling lives free from opioid addiction and aims to reach patients wherever they are on their recovery journey. Bicycle’s mission is to bridge the gap between cost and convenience for patients with opioid use disorders (OUD) by providing high-quality, affordable virtual care that makes recovery simple and effective – safely from home.”
How are you funded? I.e. type of funding, number of funding rounds, total funding amount.
“In June 2021, Bicycle Health announced its $27 Million Series A investment led by Questa Capital with participation from City Light Capital, Emily Melton, and previous investor SignalFire. Since the start of the pandemic, Bicycle Health has grown 30% month over month and is now the largest virtual care platform for OUD by geographic footprint and insurance coverage. The company will use the capital to expand its rapidly growing clinician network, partner with additional payers, invest in research and continue building local community partnerships to reach those without other treatment options.”
How big is your team? Tell us a little about them (I.e. co-founders, freelancers, etc.)
“Bicycle Health’s leadership team is composed of eight people, but it was primarily Dr. Brian Clear, Chris Turitzin, and I who pioneered the launch of Bicycle Health’s platform. Dr. Brian Clear, medical director, ensures that clinicians have the training, resources, and support needed to provide evidence-based and high-quality care to all patients. More broadly, he focuses on improving the quality of care for those experiencing problems related to opioid use. Chris Turitzin, head of product, has always been fascinated by applying technology to building better experiences in healthcare. His experience includes founding Momentus Media, a social media consulting firm that was later acquired by Facebook. After serving as a product manager at Facebook, he turned his focus to building healthcare technology services. Others on the leadership team include: LuAnn Aaukus, chief operating officer, brings 40 years of experience in healthcare management, operations and business development, physician and health plan partnerships, strategic planning, entrepreneurship, patient and caregiver education programs, as well as hospital device and medical products sales and services. Sarah Howroyd, director of behavioral health, has extensive experience in the mental health and addictions arena helping create, design, and implement numerous programs over the years, including Bicycle Health’s. Sarah's expertise is often tapped nationally at conferences, colleges, and in the media, but her focus has always been to create meaningful social change and use her hope, strength, and experience to shatter stigma. Bryan Hayes, head of enrollment, brought more than 20 years of leadership and contact center experience to Bicycle Health, focusing on scaling the company’s ability to have a dramatic and lasting impact on its fight against the opioid epidemic. Liza Hoffman, head of UX research, leads research initiatives to improve the patient and provider experience. Throughout her career, she has spearheaded efforts to expand access to behavioral health treatment that is evidence-based and rooted in shared-decision making. Loni Sabo, VP of talent and culture, is passionate about building a culture that attracts, engages, develops, and retains the best talent focused on fighting the battle against opioids. She brings experience in leading large change management initiatives to include culture, engagement, mergers and acquisitions, HR technology, and has led and built numerous programs to include onboarding, talent acquisition, performance management, engagement, career and manager development, and leadership development.”
How did you come up with and validate your startup idea? Tell us the story!
“I have always been passionate about using the power of technology to create patient-centered experiences that can deliver high-quality outcomes at scale. I first started this career by founding Pulse, a news platform that was eventually bought by LinkedIn (you may have heard of LinkedIn Pulse!). I then spent some time traveling in India, where I came across the raging problem of opioid addiction. After spending some time in an orthopedic clinic to learn more about pain management and opioids, I founded Bicycle Health in 2017 to increase access to high-quality, integrated medical and behavioral healthcare for people with opioid use disorder.
After speaking with many patients, I learned that people were prescribed opioids for pain by doctors. However, many of these doctors were unaware of how addictive and problematic opioids are, and most patients described how opioids negatively affected their lives over time. I soon realized that opioids are overprescribed and under-managed in the United States, impacting far more people than most realize. And further, I found that medication for opioid use disorder to be severely lacking.
Bicycle Health began with just one in-person clinic in Redwood City, California, but I realized I could reach even more people with opioid use disorder if the services were available online. During the pandemic, the company transitioned from one in-person clinic to delivering its services through telemedicine, rapidly scaling its operations and now serving thousands of people across the country.
I was nervous to be an outsider to the healthcare world, but helping people take back control of their life is what gave me the confidence to know that I was on the right track. More often than not, patients discussed with me feelings of shame and stigma, ultimately hindering them from getting the care they desperately want and need. I didn’t care that I was new to the healthcare world – I simply wanted to provide people with empathetic, affordable, person-to-person care — supporting patients wherever they’re at in their recovery journey.”
How did you come up with your startup's name? Did you have other names you considered?
“One of the biggest reasons many people do not access traditional care models for addiction treatment is because of the stigma and feelings of judgment when seeking treatment. In order to combat that, I brainstormed names that refer to addiction treatment and recovery but don’t add to the stigma, which is how I landed on Bicycle Health. The name Bicycle Health is a good metaphor for recovery – just as a bike does, recovery gives you a sense of freedom and independence.
I learned how to ride a bike as a kid, and it’s a skill that has stayed with me and will continue to stay with me for the rest of my life. Similarly, that’s what recovery is for many people – a new skill that you learn, use, and that stays with you throughout your life. Relapse is a part of recovery, just as falling off a bike is a part of riding. If you fall off a bike, you can quickly hop back on, just like you can with recovery.
When I initially started Bicycle Health, I’d given up my car and was riding my bike everywhere – to meet friends, to buy groceries – and I appreciated the feelings of freedom, being able to go places really easily. And these are the things we want for Bicycle Health patients – agency, to be free.”
Did you always want to start your own business? What made you want to become an entrepreneur?
“From a young age, I have always dreamt of being like my father, who inspired my entrepreneurial journey. My mother always encouraged my father to be an entrepreneur, so early on in my childhood, he quit his job to start multiple businesses. He taught me that you don’t have to follow a traditional career path. Rather, it’s important to take risks and no matter what it is you are doing, do it passionately. From that moment forward, I have always strived towards a career that has a lot of impact within my community.”
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Did you encounter any roadblocks when launching your startup? If so, what were they and what did you do to solve them?
“Before starting Bicycle Health, I had only ever gone to the doctor a few times throughout my life – I was a complete stranger to the healthcare industry. My career first started when I founded Pulse News, so my entire network was almost entirely based in the technology world. And like me, a lot of people from tech want to break into healthcare, but it’s difficult – they have no contacts or context on the landscape of the industry. The way I view it: those in healthcare know the problems they want to solve but don’t have the time or resources to address it, and comparably, those in tech may not know the problem but have the knowledge and experience to create the tools necessary to solve it.
To help bridge this knowledge gap, I created a meetup called Docs and Hackers to bring together a “group of medical practitioners and software builders who aim to improve the practice of medicine with technology.” Both those in healthcare and those in tech were struggling with the same problem because there was such a stark knowledge gap. Before the pandemic, Docs and Hackers had meetups in Boston, New York, India, among many, to bring together over 3,000 members. Docs and Hackers is sponsored by Harvard Medical School and Flare Capital Partners, allowing the meetups to bring people from different cities together to share new ideas, get feedback, and foster relationships between technology and healthcare.”
Who is your target market? How did you establish the right market for your startup?
“Traditional treatment for OUD comes with many roadblocks – it requires extensive time off, a luxury many Americans cannot afford; it often demands leaving behind family and household duties; and it comes with a high price tag that’s unaffordable for most, with in-patient rehabilitation starting at $15,000 per month. Further, the societal stigma surrounding addiction induces feelings of isolation and judgment, preventing many with addiction from seeking help.
Bicycle Health was developed for those overcoming opioid use disorder and are in need of convenient, affordable, and private treatment options. Addiction does not discriminate, and neither does Bicycle Health – we are passionate about helping anyone who needs addiction treatment.”
What's your marketing strategy?
“Bicycle Health wants to meet patients wherever they are on their recovery journey, and this includes how they market to current and prospective patients. They utilize direct-to-consumer channels, such as Google and social media. For example, Bicycle Health hosted an AMA session in September 2021 to give folks in the addiction community the chance to anonymously ask questions about addiction, different treatment methods, etc. and organically see the value in its treatment model rather than focusing on traditional marketing tactics, such as paid ads.”
How did you acquire your first 100 customers?
“When I first started Bicycle Health, I set out to find a medical provider that I could build the clinic around. I connected with an SF-based nurse practitioner who had been practicing for many years and was interested in working together. Conveniently, the owner of the practice she had been working for was retiring and actively looking for someone who was dedicated to serving the community to take over. So when Bicycle Health took over the Redwood City clinic in 2017, it adopted most of its patients, too.”
What are the key customer metrics / unit economics / KPIs you pay attention to to monitor the health of your business?
“Bicycle Health’s platform is built on data-driven decision making. A part of its telehealth model is using tech-enabled systems and resources to support patients’ needs and treatment goals, as well as monitor the health of the business. Bicycle Health’s biggest KPI is patient retention. The company examines customer metrics by looking at the percentage of patients that are overcoming problematic opioid use in their first week. [We] analyze the number of engaged patients by comparing no-show rates, meaning those who successfully completed an appointment versus those who did not show up. Additionally, we look at financial hardship to understand what percentage of patients could no longer continue treatment due to financial insecurities. Bicycle Health analyzes patient retention at 30, 90, and 360 days into the treatment process to understand how its treatment model is working for its patients, ultimately uncovering the health of the business.”
What's your favorite startup book and podcast?
“One of my favorite books on entrepreneurship is ‘The Hard Thing About Hard Things’ by Ben Horowitz, co-founder of Andreessen Horowitz, a private American venture capital firm – and one of Silicon Valley's most respected and experienced entrepreneurs. His book offers practical wisdom about the tough decisions all CEOs face and how to build a great organization that many want to learn from. I have read this book cover to cover many times and applied its insights to my decision-making throughout my entrepreneurial journey.
The biggest takeaway from this book is that things are difficult for all sorts of reasons – there is no one black-and-white answer to solving the world’s problems. Throughout the book, Horowitz talks about his journey and its hardships and how he works through difficult decisions he has to make. This book offered me some great insights as a ‘look-ahead.’ As I read, I ask myself questions like, ‘what problem did this renowned entrepreneur solve, and how can I apply this to me?’
I feel great comfort applying his learnings to my career knowing this entrepreneur has achieved so much by applying these insights to his everyday decisions. One way I have applied Horowitz’s teachings to Bicycle Health is being strategic about who I work with and asking: do they understand the goals and mission of this company? Do they have the right intention working for me? Can I depend on them to understand the messaging of this company? I apply questions like these to vet the right people who will contribute to Bicycle Health’s impact on the community while optimizing financial return.
My favorite business podcast is called ‘a16z,’ a show produced by (shocker!) Andreessen Horowitz. The podcast discusses tech and culture trends, news, and the future, featuring industry experts, business leaders, and other interesting thinkers and voices from around the world. Beyond learning about industry news as it relates to Bicycle Health, I appreciate the broad range of topics and intelligent people that speak on the podcast.”
What is something that surprised you about entrepreneurship?
“Every day, I am surprised by how quickly the role of a CEO changes. When I reflect on how much Bicycle Health and I have grown, I notice that my day-to-day responsibilities are rarely the same as they were two or three months ago. At the beginning of my career with Bicycle Health, my mission was to hone in on the problem I was trying to solve: who exactly the platform is targeting, and what value is the company providing them. In this stage, I was very hands-on, primarily focused on developing Bicycle Health’s services and acquiring patients.
Immediately, I watched the role transition from building the platform to scaling it, which requires a well-thought-out leadership team. As the platform was growing, I recognized that in order to assume the higher-level responsibilities of a CEO, I, myself, had to create a reliable and principled team that I could trust and delegate tasks to. And quickly, my role moved from hiring the right team to diverting my attention to raising $27 million through a Series A funding round to rapidly grow a clinician network and expand access to opioid use disorder treatment. To date, Bicycle Health has about 200 people working for the company, and one of my core responsibilities is to foster a company culture that has a purpose, one that is proud to be curbing opioid addiction, and one that is excited to teach and learn from each other. Every day, I strive to coach and inspire my colleagues to solve problems, whether a small one that arose at work or a large-scale project, such as Bicycle Health.”
How do you achieve work/life balance as a founder?
“I achieve work/life balance by nurturing a strong team of individuals who want to solve problems. Hiring the right people may be time-consuming, but it is very critical for long-term success. In order to create a team that aligns with Bicycle Health’s values and goals, as well as would contribute to the platform's rapid growth and financial return, I have read many books on recruitment and conducted research to optimize results. When hiring someone, I look for individuals that align with Bicycle Health’s vision and are eager to learn but most importantly, someone who is humble enough to let someone challenge their views without taking it personally. Both in terms of patient care plans and in company culture, Bicycle Health fosters a collaborative work environment, and in order to successfully run the platform, I need someone I can successfully cooperate with.”
What is a strategy you use to stay productive and focused?
“It isn’t the money or media coverage that motivates my work – it’s hearing the success stories from patients. Learning that a mother got their child back from Child Protective Services. Hearing about a patient’s promotion at their job. Discovering that someone got married and started their own business. At a humanistic level, I am motivated by the fact that this work is changing people’s lives for the better. Without Bicycle Health, patients may have never gotten the opportunity to be a parent, get promoted, get married, or start a business. Every day, I am motivated to give back patients control of their lives, and finding meaning in my work is how I stay focused and engaged.”
Did you have to develop any habits that helped lead you to success? If so, what are they?
“I think my love of learning has been instrumental in my success. I am constantly reading, researching, listening, trying new things, and seeking out new people to learn from. For instance, just recently, I finished a LinkedIn learning course by Jeff Weiner, CEO of LinkedIn, on ‘Leading like a CEO.’ In this online learning course, Jeff discusses the ‘importance of maintaining awareness of yourself, your team, your industry, and the world at large.’ He also teaches how to ‘learn about the role of inspiration in leadership, both in terms of being true to your own values and motivating others.’
Another habit I have developed is staying organized. Each morning, I create daily to-do lists, as well as schedule unstructured time throughout the day. It sounds counterintuitive that unstructured time would keep me organized, but I block off three different time slots daily that are dedicated to free-form thinking and writing. Since I am online virtually all day, slotted times devoted to thinking and writing is what fuels my creativity and keeps my mind refreshed.”
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