An early Sesame team member explains how the healthcare marketplace started as a local Kansas City service, pivoted to telehealth in two weeks during COVID, then expanded nationwide when pandemic licensing waivers made it possible to operate across states like Florida and Texas.
Chapters
So you did mention that you have the telehealth and the in-person, right? So was that from the beginning or?
No. So in the beginning it was all in-person. So, you know, this was a little bit before I joined, but I'll tell the story anyway. So Sesame started off, you know, like many of you who are founders and co-founders, you try to pick a market. So they picked Kansas City. They chose Kansas City for a number of reasons, actually, because it's a more innovative healthcare city than people might realize. They have a large direct-to-consumer patient sort of bunch of doctors who are there, including some that are still on our board, like Allison Edwards, who's our medical director, who had her own practice where she got people to sign up for her practice, pay her a monthly subscription to keep them healthy instead of treat them when they get sick, which is a— big difference in how you think about stuff. And anyway, so they went to one city and they tried to figure out how to sell in that city. And that's when I joined. That was about that point. And they were figuring it out and then, uh-oh, COVID happened and in-person doctor's appointments stopped and everybody went to telehealth. So Sesame didn't have a telehealth platform. And being good startup people that we are, we launched it in 2 weeks. We launched a telehealth platform using all the things that we could, Google Cloud and all the tools and tricks of the trade that we still have today. And doctors couldn't do in person, so we started doing telehealth. And that led to a lot of our growth. It still is a lot of our growth. We thought of ourselves, we still do think of ourselves as a hyper-local marketplace, right? How far are you willing to travel to see a doctor? Not very far, right? When it comes down to it, you're willing to travel further for a specialist. But all of a sudden when COVID hit around and then the COVID waivers happened, not only could you see a doctor if you were in Kansas City, you could see it if you were in Wichita, Kansas, but all of a sudden actually doctors were licensed across states. So we had no desire to launch in Florida until actually they made it— most of our doctors were eligible to practice in Florida. And we said, well, why are we not launching in Florida? And then all of a sudden Texas became a COVID waiver state. Well, we can launch in Texas. My home state of New Hampshire accepted people from out of state. And all of a sudden we launched in New Hampshire. I didn't expect us to launch in New Hampshire in the first 6 months that I was there, but all of a sudden we did. And so the marketplace grew from being in one city to being national within weeks. And our marketing changed and everything we did changed from being hyperlocal to saying, no, actually we can, we can go broad. That, that, that was a godsend in some ways because, you know, not that I was rooting for the pandemic or things like that, the pandemic was a godsend. It certainly wasn't. It was awful for millions of people, but it allows us to expand in a way that, that we wouldn't have expanded so quickly. So when those waiver wires expired, when those waivers expired, you know, we had actually recruited more actual doctors in Florida and in Nebraska and in New Hampshire and in Texas and in Alabama and in Arkansas and everywhere else. So when the waivers expired, we had already built up a marketplace that cold start problem, that helped us get over it.
