By helping hundreds of hospitals like HCA Healthcare hire nurses faster and with less hassle, Iman Abuzeid has built a rare venture-backed company that is already profitable. It probably won't be long before she turns into a unicorn.
EUThe Abuzeid Man walked into Andreessen Horowitz's annual barbecue in the summer of 2019 with two term sheets from other venture capital firms already in hand, but was determined to leave with a third. The co-founder and CEO of Incredible Health was sure she wanted a16z managing partner Jeff Jordan, former CEO of online restaurant reservation marketplace OpenTable and senior vice president of eBay, to help grow her recruiting startup. of nurses.
What he didn't realize was that he would land not only a major investor that night, but also one of his firm's top customers. Amid endless platters of burgers and ribs at the home of Ben and Felicia Horowitz, Abuzeid, 36, moved past Tina Knowles (Beyoncé's mother) and CBS host Gayle King, zeroing in on Bernard Tyson, the late CEO of Kaiser Permanente. Abuzeid says he started the conversation with Tyson the same way he does with all the hospital executives he's introducing. “We have a huge shortage of nurses,” she says. "I think their units are understaffed and they don't have enough nurses."
A month after that barbecue, San Francisco-based Incredible Health, which Abuzeid co-founded with 41-year-old CTO Rome Portlock, landed Jordan's company as lead investor in its $15 Series A round. . Soon after, he also signed an agreement to work with Kaiser, which spans 39 hospitals and is now one of his company's biggest customers.
To help hospitals find nurses, San Francisco-based Incredible Health reverses traditional hiring, with hospital customers essentially paying to introduce themselves to nurses who sign up for free. “The biggest challenge right now is meeting the demand for nurses,” says Jordan, who sits on Incredible Health's board of directors.
Since launching in California in 2017, more than 500 hospitals have signed with Incredible Health, including HCA Healthcare and Stanford Health Care, as well as Kaiser. The company focuses on filling permanent jobs rather than short-term nursing trips or work contracts. Hospital customers pay annual subscriptions at tiered prices based on the number of nurses they plan to hire. Revenue is expected to top $16 million this year, triple last year's $5 million. That growth helped Incredible Health earn a spot on this year's Next Billion-Dollar Startups list, one of the 25 companies we believe are most likely to reach a $1 billion valuation.
Unlike most venture-backed startups, Incredible Health is profitable — "accidentally profitable," as Abuzeid is fond of saying. Each state has its own rules about health care licensing, making the expansion of this business slower than it would in a less regulated one, and Incredible Health is careful to line up enough employers and nurses to make the market work in each state before move on. for the next. This slow and steady strategy has helped the company move to 21 states at a profit, and Abuzeid plans to go national in 2022.
Nurses are just a starting point, explains Abuzeid, with the long-term goal of being the "market leader in the healthcare workforce." The company intends to expand to customers beyond hospitals in the future for urgent care, operating rooms, skilled nursing facilities and home healthcare. Abuzeid hopes the company will eventually serve doctors, physiotherapists and pharmacists.
“I wanted to build and create things that had a large-scale impact. Not just one-on-one with patients.”
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HeUS Bureau of Labor Statisticsprojects that health care and social care will "add the most jobs of any industry sector" (about 3.3 million over the next ten years) as aging baby boomers need more care and the number of Americans with chronic conditions continues to rise. Rather than being a one-stop solution for job seekers, Incredible Health is adopting a LinkedIn page, which Microsoft bought for $26 billion in 2016, creating a social network of nurses and tools like salary estimates and free education credits. continued. Abuzeid says there are hundreds of thousands of nurses on the platform and hospitals have hired thousands (he declined to provide specific numbers). The average salary for a Registered Nurse in the US is around $90,000 (although there is significant regional variation). Nurses who use Incredible Health see an average pay increase of 17% when they change jobs, says Abuzeid. “It allows us to not only be the place where a nurse and eventually all healthcare professionals find their jobs,” she says, “but also where they manage their careers.”
ABuzeid was born to Sudanese parents in Saudi Arabia, where his father, an ear, nose and throat surgeon, got a job. While his grandparents in Sudan started transport, agriculture and real estate businesses, his two older brothers became doctors like their father. One brother is an ear, nose and throat surgeon in Seattle, while the other is a trauma surgeon in Atlanta. Abuzeid started out on the same path, earning his undergraduate and medical degrees at University College London. But it was the influence of his grandparents that gave him the courage to give up the daily practice of medicine. “It made me feel very comfortable with risk,” she recalls.
At the age of 24, Abuzeid skipped his medical residency program in the UK and moved to the US to work in healthcare consultancy. It was the start of a decade-long journey to become his own boss. “I wanted to build and create things that had a large-scale impact,” he says. “Not just one-on-one with patients.”
failing
Even before the pandemic, some states were experiencing shortages of registered nurses. These six states will have the biggest gaps through 2030.
Source: National Center for Health Workforce Analysis, July 2017
In 2009, she joined Booz & Co. in New York City as a hospital strategy and operations consultant. He then earned his MBA from Wharton and became a product manager at San Francisco-based digital health company AliveCor, which was developing a personal heart-monitoring device connected to a smartphone. It was there that he met co-founder Portlock. With a degree from MIT in computer science, Portlock had previously worked for Linden Lab (creators of the video game Second Life) and EventBrite before becoming one of the first engineers hired by AliveCor. After two years of working together, the duo struck out on their own. "I knew [Iman] the type of person who makes things happen and does them," says Portlock.
In 2015, they began work on Lift League, customer retention software for small and medium-sized healthcare companies, which was accepted into an accelerator program run by venture capital firm NFX. But after several strategy sessions trying to figure out how to grow, they scrapped the concept. For their second venture, Abuzeid and Portlock decided to apply the Hired.com concept, originally a recruiting tool for software engineers, to healthcare. “That's when we saw the model of employers asking for talent,” says Abuzeid. Many hospitals were still stuck in the dark ages, selling paper and taking months to hire nurses and other staff, even as healthcare spending approached 18% of US GDP while technology hovered around 10%.
Portlock's sister, brother-in-law and sister-in-law were all nurses, so they discussed the idea with the family before pitching it to potential hospital clients. In January 2017, with less than two months to go until NFX demo day, they dug in, Portlock wrote the code, and Abuzeid called hospitals and came up with the business plan. Portlock was also juggling a newborn baby. Now count the age of the company (four years old) by the age of your first child. In March, Incredible Health was in contractual negotiations with HCA Healthcare, one of the nation's largest hospital systems. The first check (which is framed on the wall of the company's San Francisco office) arrived a few weeks later, as did an initial $2.4 million investment led by James Joaquin of Obvious Ventures.
CWhen the pandemic hit in March 2020 and cases overwhelmed hospital ICUs, hospitals focused more on surviving than recruiting. Now, 18 months later, hospitals face a different challenge: staff burnout. David Jones, director of human resources at Stanford Health Care, says the number of nurses furloughing the health care system increased 312% last year due to pandemic-related burnout and stress. As the demand for nurses increases, job seekers have more power in the face of growing shortages, he adds. This means that employers who make the first offer are more likely to close the deal. “Right now, velocity is probably the biggest variable in how nurses decide where they want to work if given multiple opportunities,” says Jones. Even before the pandemic, California was predicted to have a shortage of 44,500 nurses by 2030.according to federal estimates. Incredible Health's software, Jones says, "really helped us get in line first and be able to present our opportunities and try to close deals much faster."
Incredible Health estimates that the average hospital customer can save at least $2 million that would otherwise go towards traveling nurses, human resources or other administrative costs. (Neither Stanford nor Kaiser have confirmed the financial outcome of their deals with Incredible Health.)
For job seekers, it is also a much faster and more transparent system. Shenita Anderson, an emergency room nurse, says she received several job offers within two weeks of creating what she calls a "power profile" at Incredible Health. He landed two in Los Angeles: a full-time job at Cedars-Sinai and a pay-a-day opportunity at Glendale Adventist. Compared to filling out tons of online forms and never getting a response, Incredible Health's process was not only easier, but it let you know where you stood because you could see which recruiters were looking at your profile. “[It took] some of that angst out of the equation,” says Anderson, who is now pursuing a doctorate in nursing at UCLA, where she is researching how to help African-American smokers quit while working full-time. .
For Abuzeid, the success of Anderson and the other nurses is personal. After all, the odds were stacked against him, at least on paper. “Raising money as a black founder is obviously a challenge. The statistics are against you in many ways,” says Abuzeid, who points out that only 1% of VC money goes to Black founders and even less to Black female founders. Knowing the possibilities, she sought out mentors and applied her fundraising skills. It worked for her in an industry dominated by white men, and she hopes the same will be true for the tens of thousands of nurses her company seeks to train. “You just have to go for it,” says Abuzeid. "You just need to be as assertive as possible."
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