Startup Teams: Twentyeight Health

Why did you choose to be an entrepreneur, and how did your company come together?

Amy: I started off my career as a consultant at Bain, and most recently, I was the general manager of a skincare startup in NYC. I loved how consumer-centric beauty is. Everything is created with a deep qualitative and quantitative insight of the user. Simultaneously, I lived in the US for the first time and experienced firsthand how difficult it is to get care even with insurance. I wanted to bring the consumer-centric approach from beauty to healthcare to build dignified patient experiences, which led me to start Twentyeight Health.

Bruno: Prior to Twentyeight Health, I spent eight years at Boston Consulting Group. During this time, I worked with the Gates Foundation to improve access to healthcare in developing countries. I deeply care about improving access to healthcare and think that there is still a lot of work to be done. Through my experience at Gates, I realized the potential that telemedicine could have in improving access to care, particularly when it comes to women’s health. Shortly after, I met Amy through a friend and colleague from BCG, and we decided to form & launch Twentyeight Health. 

What are your favorite startups?

Amy and Bruno: Through our work at Twentyeight Health, we’ve built close relationships with other organizations focused on providing underserved women with sexual and reproductive healthcare, such Healthify and ICAN!. Additionally, we are excited to work with innovative players rethinking the women's health experience including Ovia Health. 

Why did you start your current company?

Amy and Bruno: Today, low-income women are three times more likely to have an unintended pregnancy than the average woman in the US, and nearly one-third of physicians nationwide aren’t accepting new Medicaid patients. These devastating statistics underscore why offering high-quality reproductive care, inclusive of people across race, income bracket, or health insurance status is more important than ever.

Twentyeight Health launched in December 2018. As we enter our third year in business, we look forward to increasing access to high-quality sexual and reproductive care for women across the United States. Over the last three months, we’ve launched in six new states across the U.S., effectively doubling our footprint, and plan to be available to more than 80% of the U.S. population by this summer.

What's most frustrating and rewarding about entrepreneurship/innovation?

Amy: The most frustrating part is not having enough time! There are many ways we want to expand how we serve our users, and we are eager to grow. 

The most rewarding part is hearing from our users about the impact we’ve made. During our all-hands meeting every Friday, the customer experience team shares user feedback. What started out as a way for the whole team to stay connected with our users has quickly become one of the highlights of my week.

What's the No. 1 mistake entrepreneurs make?

Bruno: Not enough focus on what truly differentiates them from other players. Most startups have competitors when they launch or see competitors joining their market along the way. An easy mistake is to think that the market is large enough and that many players will succeed. While that might be true, the most successful startups have a clear differentiation and moat that enables them to attract customers at low cost and build barriers for their competitors to copy them.

What are the top three lessons you've learned as an entrepreneur?

Amy: First is resilience. Especially in the early stages, there are many people who will doubt you. It’s also important to stay curious, and understand the “why” behind the “no’s”. It doesn’t mean you have to agree, but it helps you gain another perspective. Third, is to find a cofounder that shares not only your vision but also your values. It’s easy to agree when things are going well, and when obstacles arise, Bruno and I go back to our values of treating others with kindness, questioning the status quo, and embracing a growth mindset to have difficult conversations, challenge our thinking, and arrive at a solution that’s better than what either one of us could have thought of individually.

What are the complementary skills you each bring to the table?

Amy: When I moved to New York City in 2014, I joined a venture studio to build a telemedicine platform for dietitians, and later led Onomie Beauty, where our team developed and launched Allure Best of Beauty-winning products. These experiences taught me a lot about what it took to succeed as a startup, and how to build a consumer business that truly put the customer first.

Bruno: From my work with the Gates Foundation to improve access to healthcare in developing countries, I learned a lot about what it takes to bring healthcare to underserved populations. Additionally, I developed a strong network in the healthcare space which was helpful to meet our early investors, advisors, and team members. 

What are the characteristics/qualities you look for in a founding partner? 

Amy: Most importantly, you have to find a founding partner who is just as passionate about the idea for the business as you are. When I met Bruno, it quickly became clear that we both cared deeply about increasing access to sexual and reproductive care for underserved communities.

Bruno: I completely agree with Amy, and in terms of skill sets, it’s incredibly valuable to find a founding partner with complementary skills. Amy’s experience in the consumer startup world, and the work I did with the Gates Foundation expanding access to healthcare for underserved communities, have served Twentyeight Health well.

How do you make sure you don’t get on each other’s nerves?

Amy: Bruno and I come from management consulting backgrounds, and really value the investment in teams that a lot of consulting firms have.

We want to make sure that everyone feels supported and even though we might be working on different things, at the end of the day, we’re working towards a bigger goal. And that means that whenever we can help one another, we should. I think our commitment to helping one another — regardless of the situation — helps ensure that we don’t get on each other’s nerves.

What are some lessons learned about working together?

Amy: Since our earliest days working together, Bruno and I were very clear on which decisions we should align on before making, and which decisions we should feel empowered to make independently. We learned it’s incredibly important to be aligned on decision-making processes at Twentyeight Health, particularly as our company has experienced exponential growth over the last year.

Twentyeight doubled the number of states it’s available in in the first three months of 2021 alone and plans on being available to women in more than 20 states by the summer. This type of rapid growth requires both of us to make a lot of timely decisions about customer support, sales, financing, operations, marketing, and more. I’m glad we learned early on the importance of being aligned on decision-making processes, as it’s allowed us to scale.

What’s your advice about teams and founding partners to entrepreneurs looking to start a company?

Amy: It’s important to be aligned with your cofounder not just about the vision of your company, but also how to get there. Very early on, Bruno and I spent a lot of time discussing our personal values and the culture we wanted to create at Twentyeight. This process is an important step - even before the first employee joins - because it becomes a lens for cultural fit for building the team.

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