In this episode, Thad Davis, Senior Managing Director, interviews Caitlin Donovan, Global Head of Uber Health, where they discuss the importance of mentorship, having a strong opinion, and knowing your value.Read Transcript
Welcome to Perspectives, Leerink Partners’ signature podcast, where we share our insights and interview leaders across the industry to get their perspective on how they’re driving innovation. We’ll also be digging into the backstory to learn more about what has most influenced their success. Be sure to check out all episodes by Leerink Partners.
Thad Davis: I’m Thad Davis. I’m a senior managing director here at Leerink Partners. It’s my pleasure here to be joined by Caitlin, who’s the global head of Uber Health, a very important title and a very important sounding title. And also, I am being joined with one of the 100 most powerful people in all of healthcare. Congratulations on your nomination to that list. But it’s good to have you here with us on the podcast, Caitlin.
Caitlin Donovan: Thank you so much for having me, Thad. Excited to be here.
Thad Davis: It’s been a while. I think the last time I saw you, we were on, talking about our own conference talking about AI.
Caitlin Donovan: That’s right, it was all about big tech and healthcare.
Thad Davis: Oh, yeah. Big tech and healthcare. So, you’re back to talk about big tech and healthcare, except now it’s just focused on you.
Caitlin Donovan: Exactly, and a little bit less AI.
Thad Davis: Yeah. A little less AI, a little bit more about delivery. I think that the listeners here would love to just hear a little bit about yourself. Kind of what, just a brief introduction. We’ll, obviously go through, uh, your past, Whole point of kind of what we tried to focus on getting inside the heads of leading executives inside of healthcare. But maybe just talk a little bit, do a quick introduction, your role at Uber, and then, uh, what, what you’re trying to accomplish, your agenda. And then we’ll come back to that also at the end of the podcast.
Caitlin Donovan: Sure. Happy to. So, like you said, I’m the global head of health at Uber. Yes, work in big tech, but background is much more in healthcare than it is in tech, so really trying to marry those two worlds. For those who don’t know what Uber Health is, I think most folks think you take out your Uber app, you use it to get to and from doctor’s appointments. But it’s actually a completely separate software platform that’s intended to help those that wouldn’t otherwise have access, whether to technology, rides or deliveries themselves, or the ability to navigate their benefits alone, to be able to navigate four different supplemental benefits. Rides, to and from doctor’s appointments, grocery delivery, over the counter delivery, and prescription delivery. And the key is that we allow a provider, a care coordinator, a social worker, someone else to book those things on behalf of a patient so that we can solve for that gap of patients that really don’t have, yes, the physical access, but also the figurative ability to navigate the system to get those things they need.
Thad Davis: I was doing the pre work looking at the time when you came on to Uber. And then kind of where you are on the platform now, and probably towards the end, I’d like to actually burrow in that quite a bit, because I do think that I do think that actually, because of your clinical background and all the things that you’ve done in healthcare, I think you’ve had a quite a bit of, quite a bit of a handprint on kind of the shape of what that delivery that four pillar delivery model has become at Uber. But before we get into that, we want to talk about young Cate. So, let’s just go back to the beginning. Where are you from? Are you a Bostonite by, by intention? Or where are you from originally? What’s the backdrop there?
Caitlin Donovan: I am from Boston originally, and I still live in Boston today. And I think, like most folks from Massachusetts, I think we have a hard time leaving. I found that a lot of folks that grew up in Boston stay in Boston. Um, for me, I happen to be very close with my family, so even if I intended to leave for, a little bit of time, uh, was never successful at that. I always knew I wanted to end up back here, close by to where I grew up, my family, et cetera.
Thad Davis: And your parents are still nearby, and do you have siblings, et cetera, that you grew up with?
Caitlin Donovan: I do. You know, very close with my parents, both physically and in general, and then very, very close with my younger sister.
Thad Davis: In Boston as well?
Caitlin Donovan: In Boston as well, five minutes down the street, we tend to follow each other.
Thad Davis: Oh, wow. Okay. Okay. Okay. I was like, “we’re both physically close. They’re next door.”
Caitlin Donovan: That’s exactly right. The furthest apart we ever lived was 30 minutes and it felt like long distance.
Thad Davis: I mean, that’s very good having a close family like that. Obviously, you, you took that and, you know brought that through. Obviously, I’m not even going to hit the high school years because it’s clearly, you landed at Harvard. So, unless you were like a delinquent who just happened to luck out, I think you probably did well to high school to Harvard. Which again, a well-known vocational institution in, in the Boston area.
Caitlin Donovan: Had trouble leaving. Had trouble leaving.
Thad Davis: Yeah, that’s actually I think that that’s actually an interesting note that there’s a lot of different versions of Harvard, but you went through the honors undergrad economics program, which, at time you’re there was no schluff program. And with a lot of sort of very hardcore professors. What was it like going through the program and what has that done? I think economics is an educational background always hones people’s thinking to a degree, but what did you focus on in the program? And how has that kind of, what things have you taken from that forward?
Caitlin Donovan: Oh, good question. When I showed up at school, I actually had no intention of being an economics major. I thought I wanted to be a chemistry major. I am way too social to spend a lot of time in a lab.
Thad Davis: I’ll pass that onto my, I’ll pass that onto my bio pharma partners up here.
Caitlin Donovan: I’m so happy that others do that because it produces such important research, but I much preferred, to your point, thinking through problems, less doing research on my own, and more applying concepts to real life, and to your point, felt very, very lucky that just the, the strength of the faculty there, I probably didn’t even appreciate it at the time, really allowed to focus on the specific things that I found interesting. So, you know, for me it was a lot of game theory and, and microeconomics and applied economics.
Thad Davis: Yeah, the mid two thousands, I was doing my MBA Chicago Booth, and that was the time of the, the era of Freakonomics around both very fundamental micro econ theory, as well as applied economic theory or empirical field work that was being done. And so, like, I was around, like, I had the fortune to be exposed to, like, Stephen Levitt and folks like that, you know, people that win people that win Nobels and Clark medals. Versus. Yeah, yeah, exactly. You’re like, you’re like, “is anybody here not have a Clark medal?” You’re like, “okay, yeah.”
Caitlin Donovan: Exactly. I feel very lucky just to be exposed.
Thad Davis: Yeah. I mean, it sounds like that. I mean, it sounds like you, you sort of dipped yourself in that economics, which, which is funny, because if you look at look at, like, where you’ve ended up, I found this kind of interesting where you started out in economics program and in probably what you do and what you’ve a couple of the other background things, very unit economic micro oriented type models.
Caitlin Donovan: I think that’s right. Although I was talking to someone the other day around how those basic principles and the way you think through problems certainly applies. I have absolutely lost my ability to do multivariable calculus.
Thad Davis: Yeah. You could have gone on to linear algebra in the AI world. You know, it’s like just a continuation.
Caitlin Donovan: Oh my gosh. Completely agreed. And given how much I did not like linear algebra, I’m very happy that I do not touch AI.
Thad Davis: There’s only a handful of people that can even know the math, let alone design that math. Better to go do something applied. It’s more, more, more steady in a commercial basis. See, you came out, came out of Harvard and then went to, went to the world of leveraged finance actually. So leveraged debt at Sankaty, which is obviously Bain Capital Credit now. I just want to take a moment for the listenership to appreciate that somebody else also got their start in a debt trained environment, such as myself. So, I mean, again, another, another very specific form of training around mind and unit modeling and sort of things like that.
Caitlin Donovan: And almost the what do you need to believe to make sure that nothing bad happens and still have upside as opposed to only focusing on the growth and the upside, just totally different way of thinking. And especially in 2008 during the financial crisis, really interesting time to be in leveraged.
Thad Davis: Yeah. It’s a workout job. Yeah, it’s all work. It was work out. You’re like it, we’re like, “we’re hiring you.” You’re like, “Oh, what am I investing in investing?” I mean, you’re not investing in anything like you’re gonna you’re gonna save our investments.
Caitlin Donovan: You know what was interesting though? That was true for most high yield funds at the time, but Sankaty had just raised a new fund, so we were very lucky and had a lot of dry powder.
Thad Davis: Oh, that’s good.
Caitlin Donovan: So, we were one of the few shops that could pick up some of the distressed assets, which again was very, very fun to see both how you protect a portfolio as well as how you pick the right spots to redeploy.
Thad Davis: Yeah, that, that picking the right spots. Especially if you go through a time where you’re doing like, you’re like, “is that even a good idea type thing?” You’re like, “does this is a company need to exist.” Is it just a good idea and a broken model, or is this something to do? I mean, I do think that that underpins a lot of actual core thinking around, you know, identification, you’re like. Listen, I’ve been, I’ve seen a lot of bad stuff. I know what to invest in that’s good. And I know what good looks like and then you took that and transform that you, you left the world of downside protection. And then you went to Summit, which is about as growthy as you can get right there.
Caitlin Donovan: Yeah, and you know what’s funny is I actually left Sankaty because someone on our investment committee who’s a fabulous mentor, told me that I showed up to every investment committee with a business plan for the companies that I was investing in, to, to really contextualize what the investment recommendation was. And I remember telling her, “No, everyone does that.” And she said, “they absolutely do not.”
Thad Davis: You’re like, they’re like, “no, no, no, it’s not correct.” You’re like, “why doesn’t everybody act like the way I’m acting?” Yeah, exactly. Like they don’t.
Caitlin Donovan: You know, and so that’s honestly part of the reason I went to Summit. I was part of their portfolio operations team, so I could still keep a foot in the door of investing if I didn’t like operating but try and see as many growth phase companies as possible to see if I liked operating, learn from as many different business models as possible to, to then ultimately switch from investing altogether to truly being an operator.
Thad Davis: That’s actually interesting where you have economic training. You went through two different to basically two different elements of the capital structure where you’re an investor. And then a lot of people will make the transition to go, you know, create value in a corporate dev role, you went down the hardcore clinical route and in clinical ops. And not only that, you went to CareCentrix, which is a paragon of infusion, et cetera, to go run ops. What possessed you to get your hands dirty?
Caitlin Donovan: Oh, that’s a good question. The pieces of investing that I always liked was understanding the core components of in the context of an industry, in the context of a company, what should this company do to grow, become more profitable, whatever the goal was. And I realized thanks to a lot of really good mentors that I had perspective of their ability to pull that off. So wanted to be in a position where I had full ownership of not just making the bet, but being able to set up the operations and run them to pull off whatever that bet was. CareCentrix, I thought was a really great place to do it. One, because I was very lucky to work with an amazing management team that didn’t just know how to run a company, but how to teach others that were new to the field. So, so had the pleasure of learning from them and it was such an interesting time in that company. To your point, there was, at the time in the industry, there was a lot of uh, focus on home infusion and redirecting from ambulatory infusion suites to home infusion, which created interesting network effects for payers. So had to, had to deal with all of that. And at the same time, home care models were migrating from primarily fee for service to, to really being full risk, both with upside and downside.
Thad Davis: It’s a time a model transition is what that was like a model, a lot of model transitions going on new ways to deliver care, new modalities for care delivery.
Caitlin Donovan: Exactly. And so it was very fun to be able to think outside the box on what is the goal if you had a blank piece of paper, how would you spin this up and then help the company migrate from the way it had spun up, which was contract by contract, call center by call center, which is so common for specialty benefit managers to a more scalable approach.
Thad Davis: Do you consider this, a side question that just kind of came out as I was listening to you, but do you consider yourself anybody transition to ops, generally, there’s a couple of different sort of thinking patterns. Do you consider yourself a control-oriented person? You’re like, going back kind of what you were a couple of things you were saying. Like, “I went in, I did two levels of investing. I was constantly thinking about business plans. I underwrote ownership models and I said, no, no, no, no. I want to be in charge. I want to control what occurs here.” Is that an underlying thing? Are you a fundamental, I don’t want to call you control freak, but are you a fundamental control freak?
Caitlin Donovan: Oh, that’s a good question. I think about certain things, but not about others.I think I come in with a strong opinion loosely held.
Thad Davis: A strong, a strong opinion that must be adhered to.
Caitlin Donovan: Exactly, exactly. It takes a lot of convincing. Um, no, no, but I do think it’s important to have perspective, because indecision stalls businesses. And so having strong perspective I think is important. But, having enough leeway to be able to delegate not just tasks but decision making to a team is critical to get anything done. Because otherwise you are the single point of failure, you are the bottleneck and you cannot move as fast as you need to, to achieve anything beyond the incremental.
Thad Davis: Otherwise, it’s too micro at that point. You’re like, “I can be very controlling over a very specific role, or I can have a vision that I want to see. And then through operational delivery, I can, bring that vision to bear.” Obviously, it requires a lot of fortitude to control the vision and to make sure things are in the right places. But I mean, I think that that seems to characterize your time in the CareCentrix. your role there. I mean, you, you wrapped up with a very, a very specific role, which then it kind of led you to LogistiCare. For the listening audience. LogistiCare is Motive Care now. And is an analogous model in, in certain, in certain ways to what Uber does from a, from a logistics and transport perspective, at the LogistiCare level. I think. Well, there’s a lot of compare and contrast and sort of what Uber is doing in a larger 4 pillar format as we’ll talk about a little bit, but, I mean, that you went from CareCentrix, so LogistiCare, which literally is a logistics model. It does supply chain and logistics model. I mean, so you went from, went from control to logistics control.
Caitlin Donovan: Actually what’s interesting is CareCentrix and LogistiCare, so my path to there was through an acquisition, was at a startup, was COO of the startup. We were acquired and ended management team.
Thad Davis: Oh Okay. Wait, wait. Yeah. You’re like, you’re like, “you’re in charge.” You’re like, “oh, okay.” Yeah. Sounds good.
Caitlin Donovan: Which is very fun to both grow something while fixing something else, um, with, with, you know, Circulation was the name of the startup, and we were growing very quickly, um, and then were acquired by the largest incumbent in the space. So how do you merge those two businesses, I think is, I think is an interesting problem.
Thad Davis: In circulations with healthcare logistics, or healthcare, a healthcare ground game effectively.
Caitlin Donovan: Exactly. And I actually think the way to think about those businesses, they’re shockingly similar to CareCentrix. So if you really think about what both circulation and LogistiCare do. They’re specialty benefit managers. There’s an intake function, high, for CareCentrix, high I need home care, for LogistiCare circulation, high I need transportation. You’ve got to map who has what benefit, can they have this transportation, can they have this home care or not. And then you’ve got to find the appropriate provider, whether that’s a home care provider or a transportation provider, to fulfill the request, if it’s an appropriate request. That’s so very, very similar business models, just different benefits.
Thad Davis: Do you find yourself doing comparisons like that through your career? Like, no, this model is just like that model. Everything that’s applicable over here. What you said is actually, I think that’s an experience, a very experienced point of view, but a lot of people would not equate those two worlds. That’d be like, like, if you, if you spoke inside of inside of our shop, they’d be like, no, no, no. Those are two for two different business. Actually, they’re specialty benefits managers. They were just like it to each other. Do you find yourself trying to break down walls like that around like, no, no, no. These models are not that different. It’s just a fundamental economic model that you’re managing your intaking patients. Like you said, or is that a thinking pattern that you have that you’ve kind of applied through over the years?
Caitlin Donovan: I think so. I think it’s really important to understand, what you can generalize and then where there’s nuance because where you can generalize, you can have perspective into your point lessons learned that let you be better on the first time, and then you can spend your time really diving into the nuance, as opposed to starting from ground zero to recreate the wheel. To me, that’s a really good way to come up to speed and make sure that you’re setting a vision appropriately, operating appropriately, et cetera.
Thad Davis: I meet with a lot of startups out in the healthcare world. As part of, obviously it’s part of my gig, but a lot of people think that they’re actually recreating business models and they, they don’t, they’re like, well, you know, like you’d be surprised the amount of people, and maybe it’s just a comment that I’m adding in, but you’d be surprised. You meet a hundred healthcare startups. 80 of them think that they’re reinventing the, that they’ve invented the wheel when actually they’ve just reinvented the wheel. And so they’re, because they will not do the general, the specificity. You don’t go, what’s this model like? Oh, it’s like this. Oh, okay. Well, I’ll generalize, but then I need to attack the specific details that make my, make what I do different and innovative in the space. And, you know, add value. Now there’s not to say that there’s not truly innovative models, but those are few and far between.
Caitlin Donovan: I think that’s spot on. To me, what I think is very interesting to watch and fun to watch from afar is a lot of startups that talk about their tech platforms but then recognize pretty quickly that tech alone in healthcare without a human touch doesn’t really get you that far, or it certainly doesn’t get you to scale to your point on thinking that there’s a new model that’s going to work than when you have to serve a full patient population need to supplement with tried and true methods.
Thad Davis: Yeah, I’ve had another guest on where we talked a little bit about this around tech versus process tech versus process versus model. And I was never trained that way. So, I went through a consulting. I went through a consulting gig back in the day, James Martin, which was the original sort of IT consulting company out there. And they didn’t even train you on tech. They trained you on process, and then once you understood process modeling, then you got to learn the tech because they were like, there’s no such thing as tech. Tech is just a computer reinforcement of a human process.
Caitlin Donovan: I could not agree with that more.
Thad Davis: If the process is wrong, you’re just going to codify a bad process technologically. So, solve your process problem, figure out what the model is and then involve the tech. Don’t do tech to invent the process. Otherwise, you’re just going to reinvent, or more importantly, you just reinvent a process that somebody’s already, already solved.
Caitlin Donovan: Exactly. Or you implement your tech, and you haven’t fixed your process, so you don’t get the savings that you were expecting. The amount of times at Summit, you know, I was in their portfolio operations group, so did a lot of consulting, and companies would say, “we need new tech”, and we’d lead them through, no, you need a new process, and then we can talk about tech. And you could get, you know, 30 to 50 percent of the savings you were expected just by having that tighter process using people.
Thad Davis: When we get some tech in here, we’re gonna make things much cheaper. You’re like, “Are you? Are you though?”
Caitlin Donovan: Or you’re going to pay a very large licensing fee.
Thad Davis: You’re like, “well, when we put it, when we put in SAP, everything’s gonna be great.” You’re like, if I had a dollar. At this point actually is interesting. This came out because I think this will actually come back when we get to Uber talking about uber and what you’ve done and kind of what uber has done on the health side. I think that that’s been very, I think it’s been, uh, at least from my observation, a very important point to take away is that Uber is a big technology company, but it’s a big process company too. So, but before we get to Uber, you then went to the world of like a completely different world is clinical, which is on the MyOrthos side, which is another great business, but that is it. That’s a straight physician practice management model that’s delivering, delivering a process to support the physicians, which in turn support clinical delivery. So that’s actually down at the clinical level. That’s a little bit of a little bit of a different thread versus some of the other things here.
Caitlin Donovan: The reason for that, so coming back to sort of CareCentrix and, and Circulation LogistiCare were remarkably similar in terms of the goals of those companies, even though the benefits they were managing were quite different. And one of the threads that, I picked up on, on how to drive better clinical results for patients, et cetera, is that involvement of not just patient engagement, but their care team engagement. So, providers specifically really made a massive difference at driving the right adherence, driving the right outcomes. And so wanted to go, even though it’s not my long term passion, I’d much prefer to be, really at those specialty benefit managers that can, affect a lot of lives, wanted to go to a provider group to understand what are their processes, what are their operational workflows, how do they think about, You know, the, the payer who’s giving them all these things to do so that I could build better engagement platforms, processes, etc. to, to really think about how to improve care delivery models.
Thad Davis: Orthodontics has a unique aspect to it, where it has a fairly self-contained clinical episode around it. So, there is some general, I don’t want to, I don’t want to dilute down, you know, orthodontic specialists, etc. that actually has an ability to kind of, you can put your hand around a complete process again. And then manage, manage the outcome, backhaul data, understand what to do, retune, and then also you can get, you can take that because it’s a closed system. You can take that right to the right to the clinician and say, “see, I can, I can work with you to do something to get to a better outcome.” And it’s like, it’s a good, these models are very good for partnership-oriented things, especially with the clinical deliveries involved then, then you’re sitting around at an orthodontic PPM and then Uber calls, which is a significant left turn, which it does make sense. I mean, I would say I was looking at it and I was like, I was like, it would make sense to call you because you have all of the elements that they would want. When you got to Uber, this is my words, not yours or your firm’s, but when you got to Uber, it was like there was Uber health for transport and then there’s been a quite a transition around what Uber health was sort of two plus years ago to like that talk track that you have today, even over the last, like we spoke about a year ago, it’s refined even further over the last year. How did Uber come to you? Or did you come to Uber or vice versa? And then what have you done? Sort of give us the, you know, two minutes sort of Caitlin and Uber story.
Caitlin Donovan: So, you’re right, received a recruiting call from Uber. To your point, knew I wanted to experience the provider world, but didn’t want to stay there forever, had helped MyOrthos set up their, their operations. It was about time to leave. Took that call and I’m very, very happy I did. From, from my standpoint, I was very lucky in that when I was at Circulation LogistiCare, Uber was a vendor of mine. So, I had a very clear perspective to the assets that Uber had, and Uber Health had specifically. And I had a point of view that stringing them together differently could really impact care delivery.
Thad Davis: So basically, Uber was a utility to an actual overlay that you were doing. So, you were providing, you were a value add your prior firm on top of Uber’s logistical capabilities.
Caitlin Donovan: It gave me a great perspective to see what Uber had that was different and unique to the market that could really change care delivery. And what I saw was a couple things. One was typically if patients needed transportation, they needed other things because they didn’t have access, they were homebound, et cetera. And Uber’s the only player that I can think of that has both a very large independent network of drivers and an independent network of couriers so that you could physically get patients where they needed, get things to patients. The second thing that I found really important was thinking about not just how you physically move patients and make their experience better, but how do you solve some ecosystem problems that don’t allow for access to these supplemental benefits that the data is pretty clear, drive better health outcomes. And just so folks understand what those issues are in my mind, supplemental benefits are typically thought of in silos. So, a health plan picks a point solution and then you as the poor patient have to call somewhere between 10 and 20 different places to organize your own care. So, you’d have to call a transportation vendor. You’d have to use a flexible spending card to get your over-the-counter goods. You might have a post-acute meal. You might have a grocery store allowance. You might have both. And so, figuring out how to navigate the system to get what you need is quite difficult. And on top of that, your care team has no idea what benefits are available to you. These supplemental benefits are not, the information is not available in the change healthcare’s abilities of the world. It is a complete black box. And so, when we came to Uber, the thought was, aggregate the benefits that Uber can service, and do it in a way that makes transparent that black box. So, patient can access, care team can access, and the traditional methods of health plan call center, etc. can access. So that you’re not just connecting patients to the services they need, you’re allowing providers, call centers, social workers, care coordinators to take that next best action.
Thad Davis: That’s led into this, the four-pillar format that for my own part, I’ve not really heard you talk about this in a material way for at least my, how and why be organized around this sort of four pillar format? What’s the, what’s the process designed to let you there?
Caitlin Donovan: A couple principles. One was Can Uber do it using our core competencies? And so, all of the four pillars that we picked have a component of either rides or deliveries. The second was, would it make the ecosystem better on day one? And so just to give an example, the four pillars that we now offer are transportation, prescription delivery, grocery delivery, and over the counter good delivery. So, from a patient point of view, I think it makes delivery better day one because now you have to call one place instead of four to receive those services. From a provider point of view, can talk into some of the data that justifies this, makes it better because you now have visibility into my patient has these benefits. which historically was a black box. From a payer point of view, better day one because I now have to contract with a single entity, not four. I don’t have to pay for four different call centers, my providers have visibility and are driving the right marginal action on behalf of the patient versus giving the patient homework and sending them to multiple different call centers to organize their care on their own.
Thad Davis: How have you seen payers react to this? Because you’re, you’re pushing into, uh, there’s some bundling, bundling and other payment models that could be aggregated under that. There’s certain things around certain populations where, you know, you can get into around, like, well, you have to have a sophisticated payer that is going to involve themselves in that. I mean, the getting somebody to a clinical appointment is a very clear sort of value proposition because I, I think most healthcare participants in the ecosystem understand that delivering prescriptions to enhance adherence, but kind of beginning to bundle that for payers is sort of, those are disparate processes being bundled and the value is one provider. But one data backhaul as well. I mean, what, what success have you had in terms of connecting up with the payer side?
Caitlin Donovan: I’d say the reception has been incredible actually. The reason I think that is a lot of these supplemental benefits and the way they’re offered today.
Thad Davis: It’s a haphazard quilt.
Caitlin Donovan: Exactly. There’s opportunity for improvement.
Thad Davis: Process issue.
Caitlin Donovan: Exactly, exactly, it comes back to the process issue. The second place I think that fits in, so, so from a payer’s lens, as a stand-alone, just using us to connect your point solutions goes quite far, and you think about who’s making those decisions, there’s, for Medicare, there’s typically a product team, files supplemental benefits, we’re a way to improve quality, keep costs down. Then you think about who’s the advent of value-based care and especially with some of the risk adjustment changes that are coming up, you have to migrate from coding appropriately to truly driving the right action for the right patient at the right time. And so, thinking about how to do things like carve supplemental benefits into a capitated rate, which historically doesn’t happen, is a really interesting premise for payers and at-risk providers where we’ve found a lot of other successes. Because I, I do think that’s ultimately the right model that historically has not happened just because of the prevalence of point solutions and lack of consistent technology to allow these value-based providers to tap into benefits that they don’t want to manage but do want to access.
Thad Davis: The evolution of this, going back to kind of my lead into this line of discussion, like, this was not in place when you came on board. I mean, you had a person, but you came with a perspective. So, I’m sure you in a joke way. I’m sure you slayed the interview because you’re like, “here’s what you need to do.” And they’re like, “oh, we found our person.” The, but I mean, overlaying this and organizing around this, how, how did you do that? I find this to be fascinating. Like, Uber Health just moving people around to Uber Health, like actually talking about participation in value-based bundles where you’re, you know, enabling, enabling quality delivery is quite a transformation. What can you say about the last kind of two years of the work you’ve done? Like, it’s amazing. It’s sounds good here at the end, but as I’ve said before, it’s like, Shawshank, you had to go through this pipe to get here. Like what? I mean, what? What was like the work? How did you organize to get here? Like, how did you break down or eat the elephant?
Caitlin Donovan: So, I was very lucky to have known the product before, so came in with very strong perspective, both about what Uber should do, and given my experience at CareCentrix, LogistiCare, et cetera, understood what the industry was asking for, and so viewed it as my job to marry the two. From a, how did we organize standpoint, I think the math sort of speaks for itself, where if you are only focused on the end patient, which is incredibly important and table stakes, but without thinking about the way the ecosystem is designed and works, you’re building for your user, not for your buyer.
Thad Davis: Going back to understanding the process. We could have applied a tech stack to all this, but if you don’t understand how things are actually done out there, which you just happen to have a little background on, whatever you attempt to do with the tools you have is not destined for failure.
Caitlin Donovan: I think that’s right, and I actually think that’s where a lot of big tech makes missteps in the healthcare space.
Thad Davis: No, no, no, they’re going to reinvent everything. So that’s correct. Yeah.
Caitlin Donovan: Exactly. Exactly. And by the way, that’s rational, but not thinking to your point about the process to get there and what the bar is and what good looks like and I need to make it just better tomorrow to inch the ecosystem along.
Thad Davis: Well, you’ll have the sector talk about, like, you’ll have a tech, like just pure tech talk about tech debt in like, legacy tech debt, but they won’t talk about something equivalent on a business model side, which is just simple legacy business models. And you’re like, I know, I know we, we would all love if we could take a whiteboard out here and, and in the middle of a podcast redesign the US healthcare system. That’d be pretty sweet, but you have to deal with what it is. And there are, you can enhance and deliver that tech value and what we do at Uber to the whole, to the whole concept, but you have to have a little bit of respect on how to actually get it done, otherwise nobody’s going to pay for it.
Caitlin Donovan: Exactly. To me, that was sort of the most critical piece is understand that the buyer and the user are different, and we have to live up to our Uber name by keeping that end user experience. Having Uber magic, but really need to focus on who is the buyer? How do we affect the ecosystem? How do we fit in to be able to really impact patients individually and care delivery holistically?
Thad Davis: So, going back to control versus team for a second here. So, when you came to Uber health, I mean, what was the scale of the team then versus what’s the scale of the team now? And it maybe a head count or capabilities. Like what have you, what have you done? And what, what has the team done to kind of transform itself over the last two years?
Caitlin Donovan: You’re completely right when we joined, think of us as basic ability to book a ride on behalf of someone else in a HIPAA enabled way. And since then, we’ve layered on, I view it as sort of as three phases, right? First was, let’s do the things that will enable a payer to actually buy from us. So, we have to accept an eligibility file. We have to be able to be paid the way payers pay. Then we layered on all of the four pillars as you described them. Cause to me, that’s really the value prop of, why Uber? Uber’s in a unique position to, to be a platform, whereas others, I think must be a point solution, because there’s need for point solutions in healthcare. And then phase three is, is really gonna be all about how to connect the ecosystem together, how to make sure that when a payer has a benefit, a provider can access it, a caregiver can access it, et cetera. And I think that’s what you’ll see from us in the future.
Thad: Davis How do you stay disciplined around this? If I had the power of a delivery network that is touching participants directly, independently, I would go bonkers. I would begin to be like, “I know what I’m gonna do home health, buddy.” I think this is a broader sort of Uber thing, but I find it to be impressive that it’s actually been as disciplined to the core competencies as it has, there’s a lot, a lot of opportunity for adventurism here.
Caitlin Donovan: I think you’re right, and I think, to me it’s, would I degrade my core asset by making a choice? So, for example, on home health. We do a lot of movement of nurses, right? You need to have a HIPAA enabled way to move. Once you’re in the home, you can see gaps in care. You can close them on the spot. That’s a big piece of who we sell to. But turning your Uber driver into the nurse that goes into the home, that makes no sense to me because all of a sudden, this massive network, I won’t have anymore, because folks will have to be credentialed and it really will restrict the power of the scale of Uber. And so that was really how we made a lot of choices around where we started focusing, what we purposely paused on to really drive forward in a, in a very quick manner. And I think because we did that, not only, to your point, have we released this new product that now is not just one pillar, but four. The public numbers we’ve given is, we’ve two years in a row, grown over 70 percent year over year. So almost tripled in two years. which is exciting.
Thad Davis: Yeah, it’s fast result. I mean, discipline drives fast results in that regard. I mean, that’s been that’s sort of the benefit of being focused. Like I said, if we can leverage what we have in place quickly and, and not try to distort that and then do the do the core things around kind of going back to not try to affect what core things that we do and not try to necessarily totally affect what the core things that the market does. We can, you know, add a lot of value and take and get a lot of revenue ramp from just doing that. And very quickly as well versus like going down a you know, experimental rabbit hole, I guess would be a way to put it. As we’re kind of turning to the end, we’ll now transition out of your highly successful outcome here or ongoing outcome.
Caitlin Donovan: Fingers crossed there’s more to come.
Thad Davis: Yeah, we are. We are very hopeful about that. Now is the stage of experimentation. You mentioned a few people that have been mentors to you, et cetera. Everybody has folks that have been influential, but you actually call them mentors. How important has that aspect been where you go backwards and speak to them and say, you know, “here’s where I’m at now. What do you think? What is your perspective?” Like, how are you building and utilizing mentors?
Caitlin Donovan: Yeah. I find it incredibly important. And it’s something that I think is really hard to find. Yes, I’m quite social and I come off as extroverted. I’m also very shy. I know it’s an enigma.
Thad Davis: Yeah, it’s like, what? It makes no sense. I’ve only known you as an extrovert. So, yeah, this is good.
Caitlin Donovan: Exactly. But when it comes personally, I think it’s really hard to ask for help, but is one of the most important things you can do, especially with people you trust.
Thad Davis: It’s because you’re a control-oriented person. People that want fundamental control and have strong visions have a hard time changing their, or opening up to perspectives. So, yeah, it’s like, oh, you’re like, “oh, I should listen to that person.” Yeah, yeah.
Caitlin Donovan: So, feel very lucky that I, that I lucked into that, um, with people I trust and respect and shared their perspective so that I avoided mistakes and now keep their nuggets as if they are my own. To your point, yes, that is, I do not think that that is a one-time thing. There are several people that anytime I have an idea, I want to make sure that I bounce it off others because otherwise you have blind spots and, and it’s really important in my mind, especially when you tend to have strong opinions, to make sure to take the time to round them out, with other folks thoughts, perspectives, lessons learned, etc. and I’m very, very lucky to have many people that I can call and do that for. And try and pay it forward, to be honest.
Thad Davis: There’s an interweaving probably two words popped mind there, which is, high confidence in oneself. So, know thyself is, they would say, and then a certain level of, like, just vulnerability to be able to say, you know, trust and vulnerability to allow feedback to allowed feedback and a perspective to, you know, adjust your own perspective. So it’s both like, that’s unique in finding a mentor that dovetails into that I agree with you, is a very unique, a unique and difficult thing. And it’s also requires a lot of cultivation by the, the mentee themselves. ’cause usually, usually the mentors got a rather rigid perspective, but sometimes there’s a, you know, like, “oh, I’m gonna listen to them.” Okay, now I’m gonna go transmogrify that.
Caitlin Donovan: It’s when you find people who are almost always right, and so you learn your lesson to just take their advice.
Thad Davis: Yeah, exactly. And then what are you? Uh, what are you doing? Uh, interest, hobbies, charities? What? What are you into these days? What? What? What would you tell people to be into these days?
Caitlin Donovan: Oh good question. Honestly, um, mostly my children. As much as I love what I do, I, uh, also love being done at the end of the day so I can play with them. And I think my hobbies tend to match theirs. So, uh, uh, so I’ve moonlighted as a paleontologist and recently I’m a Lego master. So if anyone,
Thad Davis: You know what? You definitely know you’re a process person because you brought up Legos.
Caitlin Donovan: Honestly, they’re the best. The directions. It’s very satisfying when you’re done. You know, my son’s much more creative than I am and can build out of his own mind, but that is definitely not me.
Thad Davis: That’s interesting thing because people now like you see that Lego this is like Lego for adults is like a big thing now because you go to like Technica and all the things that they have where they build visions for you. But as a kid, it’s actually they’re like I can ground up create without any rigidity. Here so I can form it my mind. Yeah, it’s the Legos. Yeah, I actually I’m gonna go buy, I’m gonna go by Lego set. And finally, I’ve had the fortune on the podcast to have several very strong woman executives through here, but I find it to be very inspirational. And I could probably along with probably handing it over to one of my one of my colleagues here. Probably we could drive a whole women’s executive podcast. There’s plenty of that, but some perspectives you’ve been very fortunate and have had a very strong trajectory, not every woman has the opportunities. I mean, what has been the key things about you? Motherhood is, is no small aspect of both being executive as well as mother, et cetera. I mean, what, what are some observations that you’ve had along the way?
Caitlin Donovan: Oh, that’s a good question.
Thad Davis: I’m the guy. So, I’m not gonna, I’m not gonna try to, I’m not gonna try to pervade any opinions here.
Caitlin Donovan: I was very lucky early on, and also quite lucky that my personality naturally is, I do not have a problem saying my opinion in a room, which I’ve learned is sometimes rare. And I think that has, been very lucky in terms of giving me more opportunity than others might have. What I’ve observed and I think is really important is, and again this was advice I got very early on when I was fresh out of college and I did not understand it. I was told by, again a mentor, Caitlin, know your value. When you decide to have kids, meanwhile I’m 22 and not even thinking about having kids,
Thad Davis: You’re like, you’re like, “what?” Yeah.
Caitlin Donovan: You decide when you’re gonna leave. You decide this, and you know your value. And that stuck with me. So, when it was time to have kids, I had no problem, designing the way I worked and the way I was at home so that I had sort of fulfilling life. And I don’t think others are given that advice early enough on to think in advance about what knowing your value means. And then the second thing that’s really resonated with me is knowing how to try new things, have an opinion, but do it in a way that resonates with your personality as opposed to what is what is traditionally expected, I think is a really important thing, especially for women. So, I have been, have been thinking about both of those things a lot recently.
Thad Davis: That last point. I’ve not heard that said that quite that way before. It’s like, being able to find your own voice versus trying to conform or have a voice that’s supposed to fit into a pre-designed world for you. So very good. Excellent. Well, that is that is all the points that I had here. Caitlin. Congratulations on everything you’ve done. the velocity here, especially at Uber has just been amazing. No wonder you’re one of the top 100 people in healthcare.
Caitlin Donovan: Well, thank you, and thank you so much for having me, Thad. This was a really fun conversation.
Thad Davis: Excellent. Thank you. And we’ll talk again soon.
Caitlin Donovan: Awesome.
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