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Strategic Communications Advisory For Visionary Founders
Actionable
Takeaways
Validate payment willingness before product-market fit:
Axenya spent $1 million on a prototype, then $2 million more building what they believed was market-ready. They ran a year of proof-of-concepts in Brazil without generating one dollar in revenue. Doctors wouldn't pay (not their job), patients were too fragmented to understand the purchase, and health plans had misaligned time horizons—employees churn before preventive investments pay off. Only after exhausting their capital did they discover companies would pay because employees stay longer than health plan contracts. The brutal lesson: technical validation means nothing without a buyer who has budget authority, procurement access, and economic incentive to pay your price.
Restructure your entire business model to align with buyer economics:
When Axenya finally identified companies as buyers, they still faced a problem—HR and finance teams couldn't evaluate complex healthcare products and traditional brokers charge 3-5% regardless of outcomes. Mariano's team acquired a 25,000-life broker and rebuilt as a zero-fee model, earning solely from cost savings they generate. This wasn't a pricing tactic—it was a complete business model redesign that required broker licensing, insurance expertise, and risk assumption. The result: they quadrupled to 100,000+ lives in two years. The insight for founders: when buyer incentives don't align with your value delivery, repricing won't fix it—you need structural model innovation.
Map regulatory constraints before market size in expansion planning:
Brazil and Mexico represent 85% of Latin America's addressable market, but Axenya won't enter Argentina despite proximity because regulated health plan pricing prevents capturing cost savings—the foundation of their model. Europe requires a completely different revenue model since employers don't pay for healthcare. Even US expansion targets Florida specifically because Brazilian companies operate there, reducing friction. Mariano's framework: clinical efficacy travels, but business model viability depends entirely on regulatory structure and payment norms. For B2B founders in regulated industries, TAM analysis without regulatory mapping is fiction.
Design compensation to operationalize referrals, not just request them:
Axenya's referral engine breakthrough wasn't sophisticated—they started asking customers for introductions and built CS team incentives for successful referrals. The implementation detail that matters: clients readily refer within their own industry, but those referrals often aren't ideal-fit prospects. Rather than generic "would you refer us" requests, their CS team now qualifies referral targets before making asks, ensuring introduced companies match their enterprise profile. The lesson isn't "just ask"—it's structuring your CS compensation and qualification process to generate qualified pipeline, not just introductions.
Prove unit economics and recontract capability to cross the Series A threshold:
Mariano identified two factors that separated their Series A success from the seed-to-A crunch: achieving cash flow positive and demonstrating full-cycle customer proof—initial sale, retention, and recontract of the same accounts. This wasn't about hitting ARR milestones but proving economic sustainability that could survive 6-9 month fundraising cycles. For founders approaching Series A, the bar isn't growth velocity alone—it's evidence that your sales motion is repeatable, your unit economics work without endless capital, and customers renew because you deliver measurable value.
Conversation
Highlights
Axenya is rebuilding healthcare around chronic disease prevention through AI-powered continuous monitoring. Covering 100,000 lives in Brazil and processing 95 million clinical inferences monthly, the company pivoted from clinical technology provider to healthcare broker – achieving cash flow positive status before their Series A. In this episode of BUILDERS, I sat down with Mariano García-Valiño, CEO and Founder of Axenya, to learn how they spent $3 million building the “perfect product” before discovering no one would pay for it, why they acquired a small broker to unlock their revenue model, and their regulatory-constrained approach to geographic expansion.
Topics Discussed:
- Axenya’s shift from infectious disease to chronic disease management through wearables and AI The 12-month zero-revenue period after spending $3 million on product development
- Why doctors, patients, and health plans all failed as buyers despite clinical validation
- The broker acquisition that unlocked their business model Performance-based pricing: zero fees upfront, revenue from cost savings only Regulatory barriers determining expansion (Mexico viable, Argentina impossible, Europe requires model redesign)
- Field-force-driven GTM with 30+ salespeople for complex, high-ACV enterprise deals Path to cash flow positive before Series A and scaling playbook for 2026
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Don’t Miss: New Podcast Series — How I Hire Senior GTM leaders share the tactical hiring frameworks they use to build winning revenue teams. Hosted by Andy Mowat, who scaled 4 unicorns from $10M to $100M+ ARR and launched Whispered to help executives find their next role. Subscribe here: https://open.spotify.com/show/53yCHlPfLSMFimtv0riPyM
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