Patrick Henshaw, left, CEO of Louisville Enterprise Acceleration Partnership, poses a question to a panel about how health care startups can connect with big companies. The panel included, from left, Angelique Johnson, CEO and co-founder of MEMStim; Praveen Thadani, senior vice president of growth strategy and trend at Humana; and Kevin Bramer, CEO of Lucina. | Courtesy of LEAP

Louisville must undergo a cultural shift toward greater inclusivity and support of entrepreneurship if it wants to successfully compete with faster-growing peers such as Austin, Texas, and Nashville, Tenn., said Lucina Health CEO Kevin Bramer.

Parts of the community root for others to fail and display arrogance toward them, he said, and those attitudes are holding back the city’s drive toward innovation-fueled growth.

Bramer made the comments last week at a panel discussion about how to improve collaboration between startups and big businesses. The panel was organized by the HealthEnterprisesNetwork, which is an affiliate of Greater Louisville Inc., the local chamber of commerce.

Kevin Bramer

“There are folks in this room that want to see me fail,” Bramer said. “There are folks in this room that want to see a lot of folks fail. … The reason that is is because it’s a small pond. There is only so much money in this city. There’s only so much … talent. There’s only so much energy that goes around the world of entrepreneurship that it’s a bit scary and it’s sad, to be quite frank.” 

Bramer said that if Louisville wants to compete with more successful peers, all Louisvillians have to root for everyone here to succeed.

“We’ve got to decide, at some point, that we’re going to become a town that’s inclusive of entrepreneurship, inclusive of new money coming in, inclusive of new talent coming in, talent that may be brighter, sharper, faster than we are in certain cases. And we’ve got to be willing to face the fact that maybe we don’t know everything.”

Other panel participants included Angelique Johnson, CEO and co-founder of MEMStim, which makes implantable electrode leads used for nerve stimulation; Praveen Thadani, senior vice president of growth strategy and trend at Humana; and, as moderator, Patrick Henshaw, CEO of Louisville Entrepreneurship Acceleration Partnership.

Bramer leads Lucina, which is based in Louisville and analyzes insurance claims and other data to identify mothers at risk of preterm delivery to enable early intervention and improved outcomes. He previously worked for Norton Healthcare.

“Louisville is … a bit of an insular town,” Bramer said. “And to be quite frank, you know, we’ve got to grow our wealth, we’ve got to grow our entrepreneurship, and we’ve got to grow our talent base. But I think it all is based on our behaviors. … I think our behaviors have got to be open to allow other folks to come into this city, and not be so insular.

“One of the things I see often, and I hate to say this, but we have … kind of a sense of arrogance that needs to be … dropped to be more humble about the fact that we’ve got … to bring in other talent and be welcoming of that talent,” he added.

Changing how to think about startups
Angelique Johnson

Johnson said that part of the shift that’s required in Louisville relates to how people determine when to invest in startups.

“I think we’re a bit too harsh for the startup community,” she said.

Many people view investing in startups like they do investing in a business, by asking whether the startups are generating revenue. That measure generally does not provide a lot of insight into a startup’s potential, Johnson said.

Instead, investors should focus on the startup’s technology and innovation.

“Just because you’re generating revenue today at the start of your company doesn’t make you a really big company at the end of your company,” she said. “It just means that you could … make something today you could sell today, and didn’t take that much time to sell because it probably wasn’t as innovative as it could have been.”

The focus on revenue has resulted in many potential entrepreneurs remaining on the sidelines.

“The undergraduate students (in Louisville) are not actively engaged in entrepreneurship,” said Johnson. “And we have several undergraduate universities right here in the city.”

How to get Humana’s attention
Praveen Thadani

Thadani said he has interacted with about 2,000 startups in the last three years, as Humana continually looks for innovative partners. However, he said, connecting with Humana may be difficult for startups if they don’t put in some effort.

When Thadani gives presentations, startup CEOs sometimes ask whether he will respond to a LinkedIn email.

“I’m pretty blatantly honest, and I say that I don’t think I will, because I really want you to expend some time and energy into getting to know us and to understand our issues,” he said.

Humana frequently interacts with entrepreneurs who talk about how their solution is better than anybody else’s, but Thadani said he often asks them very basic but fundamental questions, such as whether they’ve thought about not just whether their product works but how they put it in front of a physician, how a physician can access the information, whether that access is part of the workflow and, if it isn’t, how the entrepreneur expects to get utilization beyond 2% or 3%.

The critical question entrepreneurs have to answer, Thadani said, is whether the users of the solution actually will use it.

“That’s more important to us than anything else,” he said.

Humana interacts with startups in multiple ways, at forums and through incubators, but if startups want to get the insurer’s attention, they have to diversify their client base beyond Louisville and diversify their exposure, Thadani said. Humana is much more likely to reach out to a startup if the insurer hears about the startup through multiple avenues, including board members and Humana employees.

“That persistence and … your ability to connect with a very diverse audience matters a lot,” he said.

Thadani also warned that even if startups get to interact with big companies, collaborations may not happen or may take a long time to develop, which can be frustrating for entrepreneurs.

A few months ago, Humana was close to signing a contract with a startup, but the insurer’s priorities changed and the deal fell through, Thadani said. However, he stayed in touch with the company’s CEO and a few months later showcased the startup to a new leader in Humana’s digital health organization. The parties are now close to signing a national contract.

“Patience is incredibly important,” said Thadani.

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Boris Ladwig
Boris Ladwig is a reporter with more than 20 years of experience and has won awards from multiple journalism organizations in Indiana and Kentucky for feature series, news, First Amendment/community affairs, nondeadline news, criminal justice, business and investigative reporting. As part of The (Columbus, Indiana) Republic’s staff, he also won the Kent Cooper award, the top honor given by the Associated Press Managing Editors for the best overall news writing in the state. A graduate of Indiana State University, he is a soccer aficionado (Borussia Dortmund and 1. FC Köln), singer and travel enthusiast who has visited countries on five continents. He speaks fluent German, rudimentary French and bits of Spanish, Italian, Khmer and Mandarin.