Listen Here

| |

Conversation
Highlights

 

When Tech Meets Rural Healthcare: How Homeward Redefined Product-Market Fit

Most healthcare technology companies start by building solutions. Homeward started by making mistakes.

In a recent episode of Category Visionaries, Amar Kendale, President and Co-founder of Homeward, shared how his $70M-backed healthcare technology company is addressing the 23% higher mortality rate in rural America. But their path to success required completely rethinking their initial go-to-market approach.

 

The False Start

“We went on to rapidly make a series of mistakes,” Amar candidly shares. “Our intent was to make our mistakes quickly, when they were of the least consequence.”

Their initial hypothesis seemed logical: rural areas have half as many primary care doctors as urban areas, so they should provide comprehensive primary care services. They launched with multiple access points – home visits, mobile clinics, and pop-up facilities.

But patients weren’t interested.

 

The Counterintuitive Discovery

When they investigated why, they uncovered something surprising. “About a third of people hadn’t seen a doctor in over two years,” Amar explains. But when asked why they wouldn’t try Homeward’s services, patients responded: “I have a doctor… I’m not dying, I’m not bleeding, I don’t have any broken bones… if I really am in trouble, that’s when I’ll see my doctor.”

This insight revealed a crucial misunderstanding about rural healthcare consumption. The problem wasn’t a lack of doctors – it was how those doctors’ time was being used. Rural physicians were overwhelmed with acute care, leaving no capacity for preventive services like “making sure you’re getting your colonoscopy and getting your blood pressure checked and managing your diabetes.”

 

The Technology Trap

Many founders would have responded by building more technology. Homeward did the opposite.

“There’s a trap a lot of technologists fall into,” Amar notes. “You have a vision for the way that technology can play a role, and you decide to start building first before you really know whether it’s exactly the right problem or not. And then you take it to market and you’re a little bit in love with your idea.”

Instead, Homeward built minimal technology initially. Their tech team embedded with clinicians, learning the workflows firsthand. This approach allowed them to understand the real operational challenges before writing a single line of code.

 

The Pivot to Partnership

Rather than competing with existing providers, Homeward repositioned as a supplemental service. “Our role in the market is to supplement the existing provider, not to displace them and not to create abrasion or confusion for the patient,” Amar explains.

This pivot required building trust through multiple stakeholder relationships. They hired local medical assistants and community health workers who understood their communities. They formed partnerships with health plans and local health systems. Most importantly, they focused on delivering consistent, reliable service.

 

The Results

The strategy is working. Homeward achieved an 80 NPS score – higher than any of their previous ventures – and is growing 3-4x annually. But perhaps most telling is their impact on rural healthcare delivery.

“We’re growing at a rate that’s probably double the rate that [other value-based care companies] grew at,” Amar shares. “In part that’s us standing on their shoulders… they’ve done a lot of the hard work for us.”

 

Lessons for B2B Founders

Homeward’s journey offers valuable insights for B2B technology founders:

  • Make your mistakes early and cheaply
  • Challenge your initial assumptions through direct market interaction
  • Resist the urge to build technology before understanding workflows
  • Build trust through local presence and partnerships
  • Design solutions that complement rather than replace existing systems

 

As Amar summarizes: “Get close to the workflows… get close to the patient. But don’t neglect other stakeholders – the provider, the payer. Because that’s going to be your Achilles heel.”

 

Actionable
Takeaways

Start with Operations, Not Technology:

Amar emphasizes the importance of avoiding the "technologist's trap" of building before understanding. As he notes, "There's a trap a lot of technologists fall into... you have a vision for the way that technology can play a role, and you decide to start building first before you really know whether it's exactly the right problem or not." Instead, Homeward built minimal technology initially, embedding their tech team with clinicians to understand workflows before building solutions.

Challenge Initial Assumptions Through Market Testing:

Homeward's early hypothesis about rural healthcare needs was incorrect. They assumed people without regular doctor visits needed primary care, but discovered that rural patients had doctors for acute care—they needed supplemental services for preventive care. As Amar explains, "What's different about the way people are consuming healthcare in rural is the thing we have to pay attention to."

Build Trust Through Local Presence:

In healthcare, trust is paramount and historically local. Homeward succeeded by hiring local medical assistants and community health workers who understand the communities. "They have a really high degree of cultural competency. They are ambassadors for the Homeward brand... who can help us to spread that message," Amar shares.

Choose Strategic Markets for Scale:

When selecting initial markets, Homeward focused on states with large Medicare populations to ensure sufficient scale. "You could easily die by a thousand cuts if you go after too small a market," Amar explains. Their success in Michigan and Minnesota created a template for future market expansion.

Design for Multiple Stakeholders:

Healthcare technology requires satisfying multiple stakeholders—patients, providers, and payers. Amar warns, "If you focus on the patient and the payer and you leave out the provider, well, you may never get prescribed and you may never show up in the provider workflow." Successfully navigating this complexity creates defensive moats against competitors.

Partner with Long-Term Vision Aligned Investors:

Homeward chose investors who shared their vision for transforming rural healthcare. Their lead investor, General Catalyst, pushed them to think bigger: "We were sheepishly sketching out the path to being a billion dollar business. And Hemant added the zero. He said this is easily a $10 billion business."

Focus on Early Validation and Responsible Growth:

Despite rapid expansion (3-4x annual growth), Homeward maintains disciplined growth. Their approach is validated by an 80 NPS score, which Amar notes is "better than we ever did at Livongo or any other place we've been."

Recommended Founder
Interviews

Joseph Schneier

CEO of Trusty Care

Joseph Schneier, CEO of Trusty Care: $13+ Million Raised to Shape the Future of Medicare

Joshua Miller

CEO and Co-Founder of Gradient Health

Joshua Miller, CEO & Co-Founder of Gradient Health: $5.7 Million Raised to Build the Future of Medical Imaging

David King Lassman

Founder of GigXR

David King Lassman, Founder of GigXR: $7 Million Raised to Bring Immersive Learning to Healthcare

Andreas Cleve

CEO and Co-Founder of Corti

Andreas Cleve, CEO and Co-Founder of Corti: $32 Million Raised to Power the Future of Patient Consultations

James Bates

CEO and Founder of AdviNOW Medical

James Bates, CEO and Founder of AdviNOW Medical: $24 Million Raised to Build the Future of AI-Powered Healthcare

Dimitrios Skaltsas

CEO & Co-Founder of Intelligencia AI

Dimitrios Skaltsas, CEO & Co-Founder of Intelligencia AI: $15.5 Million Raised to Build the Future of Drug Development

Senan Ebrahim

CEO & Founder of Delfina

Senan Ebrahim, CEO & Founder of Delfina: $10 Million Raised to Build the Future of Intelligent Pregnancy Care

Brock Leonti

CEO & Co-Founder of Prescribe FIT

Brock Leonti, CEO & Co-Founder of Prescribe FIT: $15 Million Raised to Build the Future of Orthopedic Care

Daniel West

CEO of Prospection

Daniel West, CEO of Prospection: $36 Million Raised to Build the Future of Patient-Centric Intelligence

Ben Albert

CEO & Co-Founder of Upfront Healthcare

Ben Albert, CEO & Co-Founder of Upfront Healthcare: $30 Million Raised to Power the Future of Patient Engagement

Rafid Fadul

CEO and Co-Founder of Zivian Health

Rafid Fadul, CEO and Co-Founder of Zivian Health: $3 Million Raised to Power the Future of Compliant Healthcare Collaborations

Itzik Cohen

Co-Founder and CEO of PayZen

Itzik Cohen, Co-Founder and CEO of PayZen: $240 Million Raised to Build the Future of Affordable Health Care

Elad Ferber

CEO & Co-Founder of Synthpop

Elad Ferber, CEO & Co-Founder of Synthpop: $8 Million Raised to Build the Future of Healthcare Administration with AI

Michael Gorton

Founder of Teladoc

Teladoc Founder Michael Gorton on the Early Days of Pioneering the Telemedicine Category (And What’s He’s Up to Next)

Joe Gagnon

CEO of 1upHealth

Joe Gagnon, CEO at 1upHealth: Over $75 Million Raised to Build the Future of Healthcare Data

Samson Magid

Co-Founder and CEO of HealthSnap

Samson Magid, Co-Founder and CEO of HealthSnap: Over $12 Million Raised to Build the Future of Remote Patient Monitoring

Henry O’Connell

CEO & Founder of Canary Speech

Henry O’Connell, CEO & Founder of Canary Speech: $26 Million Raised to Build the Future of Vocal Biomarker Technology

Justin Dearborn

Founder & CEO of Praia Health

Justin Dearborn, Founder & CEO of Praia Health: $20 Million Raised to Build the Future of Consumer Experience in Healthcare

Derek Streat

Co-Founder & Chief Executive Officer of Dexcare

Derek Streat, CEO of Dexcare: $110 Million Raised to Help Health Systems to Find Time for the Best Care

Amy Brown

CEO and Founder of Authenticx

Amy Brown, CEO and Founder of Authenticx: $28 Million Raised to Build the Future of Listening AI

Matthew Stoudt

CEO and Founder of AppliedVR

Matthew Stoudt, CEO and Founder of AppliedVR: Over $70 Million Raised to Build the Future of Chronic Pain Relief

Matt Renfro

Co-Founder & CEO of Lynx

Matt Renfro, CEO of Lynx: $17.5 Million raised to Bring Modern Fintech to Healthcare

Kevin Flyangolts

CEO and Founder of Aclid

Kevin Flyangolts, CEO & Founder of Aclid: $4 Million Raised to Build the Future of Biosecurity

Alfred Griffin

CEO and Co-Founder of CEO and Co-Founder

Alfred Griffin, CEO and Co-Founder of LightForce: $150 Million Raised to Power the Future of Orthodontics

Trenor Williams

CEO and Co-Founder of Socially Determined

Trenor Williams, CEO and Co-Founder of Socially Determined: $34 Million Raised to Build the Social Risk Intelligence Category

Hala Borno

Founder and CEO of Trial Library

Hala Borno, Founder and CEO of Trial Library: $5M Raised to Improve Patient Recruitment and Diversity in Oncology Clinical Trials

Kristen Valdes

CEO & Founder of B.well

Kristen Valdes, CEO & Founder of B.well: $100 Million Raised to Reimagine the Healthcare Experience

Ty Allen

CEO of SocialClimb

Ty Allen, CEO of SocialClimb: $12 Million Raised to Power the Future of Healthcare Marketing

Stacy Edgar

CEO and Co-Founder of Venteur

Stacy Edgar, CEO & Co-Founder of Venteur: $7.6 Million Raised to Build the Future of Health Insurance

Dilpreet Sahota

CEO of Trek Health

Dilpreet Sahota, CEO of Trek Health: $3 Million Raised to Help Mental Health Providers Accept Insurance

Viral Patel

Founder and CEO of Radish Health

Viral Patel, CEO of Radish Health: $5 Million Raised to Connect Employees with a Better Healthcare Experience

Brad Kittredge

CEO & Co-Founder of Brightside

Brad Kittredge, CEO & Co-Founder of Brightside: $150 Million Raised to Build the Future of Mental Healthcare

Dr Thomas Oakley

CEO of Feedback PLC

Dr Thomas Oakley, CEO of Feedback PLC: £20 Million Raised to Build the Future of Patient Data Sharing

Dr. Nan-Wei Gong

CEO and Founder of FIGUR8

Dr. Nan-Wei Gong, CEO & Founder of FIGUR8: $40 Million Raised to Build the Future of Musculoskeletal Health and Injury Data Solutions

Khaled Boukadoum

Founder of Torch Dental

Khaled Boukadoum, Founder of Torch Dental: $49.5 Million Raised to Transform Dental Supply Management Through Digital Innovation

Rishi Nayyar

CEO and Co-Founder of PocketHealth

Rishi Nayyar, CEO and Co-Founder of PocketHealth: $22.5 Million Raised to Power the Future of Medical Image Sharing

Mark Lehmkuhle

CEO & Founder of Epitel

Mark Lehmkuhle, CEO & Founder of Epitel: $20 Million Raised to Build the Future of Brain Health Monitoring

Vicky Demas

CEO of Identifeye Health

Vicky Demas, CEO of identifeye HEALTH: $90 Million Raised to Power the Future of Retinal Imaging

Brett Kleger

CEO of Datacubed Health

Brett Kleger, CEO of Datacubed Health: $43 Million Raised to Revolutionize Clinical Trial Data Collection

Aasim Saeed

CEO and Founder of Amenities Health

Aasim Saeed, CEO and Founder of Amenities Health: $10 Million Raised to Build the Future of Patient Engagement

Austin McChord

CEO of Casana

Austin McChord, CEO of Casana: Over $46 Million Raised to Create the Future of In-Home Health Monitoring

Kourosh Davarpanah

Co-Founder and CEO of Inato

Kourosh Davarpanah, Co-Founder and CEO of Inato: Over $35 Million Raised to Build the Future of Clinical Trials

Cesar Herrera

CEO and Co-Founder of Yuvo Health

Cesar Herrera, CEO and Co-Founder of Yuvo Health: $28 Million Raised to Revolutionize Healthcare Access

Dipanwita Das

CEO and Co-Founder of Sorcero

Dipanwita Das, CEO and Co-Founder of Sorcero: Over $20 Million Raised to Power Medical Affairs Teams of the Future

Danny Freed

CEO & Founder of Blueprint

Danny Freed, CEO & Founder of Blueprint: $13.7 Million Raised to Build the Future of Therapist Enablement

Daniel Lambert

CEO of PathologyWatch

Daniel Lambert, CEO of PathologyWatch: Over $50 Million Raised to Build the Future of Digital Pathology

Kyle Kiser

CEO of Arrive Health

Kyle Kiser, CEO of Arrive Health: Over $40 Million Raised to Improve the Value of Healthcare Through Informed Decision-Making

Armon Sharei

CEO & Founder of Portal

Armon Sharei, CEO & Founder of Portal: $5 Million Raised to Power the Future of Cell Engineering

Richard Queen

CEO and Co-Founder of DignifiHealth

Richard Queen, CEO and Co-Founder of DignifiHealth: $7 Million Raised to Drive Better Patient Outcomes in Rural Healthcare and Beyond

David Berry

CEO and Founder of Valo

David Berry, CEO and Founder of Valo: Over $500 Million Raised to Build the Future of Drug Discovery

Nick Soman

CEO & Founder of Decent

Nick Soman, CEO & Founder of Decent: $43 Million Raised to Build the Future of Direct Primary Care

Alex Zekoff

CEO and Co-Founder of Thoughtful AI

Alex Zekoff, CEO and Co-Founder of Thoughtful AI: $21 Million Raised to Power the Future of Healthcare Automation