Cofounder of She Leads Africa, Lagos, Nigeria
The Challenge: In the United States, career advice and networking opportunities for women entering the workforce are plentiful. In many places across Africa, the situation is quite different. Afua Osei discovered, while she was completing an internship in Lagos, Nigeria, that young women there had limited access to both. “I saw that there was an opportunity to create content and experiences that were really focused on helping young women understand the nuances and find success in the professional world,” Osei said.
“The main component was: How am I going to make sure that it’s always a value-added service for our audience?”
The Strategy: In 2012, she started to research her potential customer and the extent of the problem facing millennial African women seeking career advice. Her plan was to build an online content platform where women could share advice, resources, and opportunities to be successful in their chosen professional path. She wanted She Leads Africa to be a business and not a nonprofit, so she built a team to determine the angle and the goals for the company. In the early stages, there was a lot of testing, evaluating, and listening to user feedback to create a sustainable business, she said. “The main component was: How am I going to make sure that it’s always a value-added service for our audience? . . . How can we be flexible in terms of changing our model and evolving and growing with our audience?” Osei said. The current iteration of She Leads Africa launched in 2014. The site reaches 500,000 women in 35 countries and has hosted events in 10 countries on three continents.
The Takeaway: Starting a business takes not only knowing how to address an existing problem, but understanding that to be successful the business model may need to change based on customer feedback.
Founder and CEO of HealthEngine, Chicago
The Challenge: In the United States, costs for medical services are nearly impossible for patients to ascertain before getting care. Moreover, health insurers typically only renegotiate with clinical providers once every five to seven years and not concurrently with their local competitors. The lack of transparency and competitive tension results in inefficiencies and severe dislocations—meaning the economy’s largest sector is also perhaps the only one in which market forces are absent.
“This gets the focus back on reestablishing the doctor-patient relationship.”
The Strategy: It’s a challenge that has long fascinated Jonathan Weiss, who founded and successfully sold three international health-care companies between 2000 and 2012. The first, Nations Healthcare, became the largest private-sector hospital organization partnered with the British National Health Service (NHS). The NHS guaranteed millions of cases under multiyear agreements to hospital groups, such as Nations Healthcare, which vied for the opportunity to build, staff, operate, and own these centers of excellence. In the United States, health-care providers for the most part are paid based upon inputs rather than quality of care, Weiss said. By contrast, the public-private initiative that the NHS sponsored first required hospitals to warranty high standards of clinical outcomes and then set them to compete based on a single and easily comparable variable: price. Having been on the provider side, Weiss recognized that competition and marginal pricing could be harnessed to great effect in the health-care industry, and so founded Endeavour Health and Premier Health Partners, marketplace platforms in which health-care providers competed on cost and clinical quality in real time to attract consumers. “This gets the focus back on reestablishing the doctor-patient relationship whereby facilities and systems exist to serve the patient through serving the clinician, rather than vice versa,” Weiss said.
Weiss realized that such a solution could powerfully address many of the problems plaguing the US health-care system and returned to the States to replicate the model, founding Chicago-based HealthEngine in 2012. When patient-consumers use the platform to enjoin health-care providers to compete and a cost-savings results, these individuals receive a rebate, which can reduce their out-of-pocket costs. Under HealthEngine’s Get Paid to Save program, once a patient’s deductible is met, the patient is paid when he or she saves money on behalf of a third-party payer—often his or her self-insured employer—thereby maintaining elasticity of demand.
For health-care professionals, HealthEngine’s Clinician Shared Savings Program is a state-by-state pool that receives 10 percent of all HealthEngine savings. Any doctor or clinical professional can enroll and win economically whenever he or she facilitates savings on behalf of patients and their third-party payers through helping competition among facilities, which on average comprise 90 percent of the standard cost of a case.
Having worked diligently since the outset to ensure that its marketplace platform and model remained compliant with laws and regulations in one of the most heavily regulated industries, the HealthEngine platform is delivering prices that, on average, are an additional 52 percent below those achieved by the largest health insurers. Weiss shared that last year, a bipartisan cohort from Congress visited Chicago in order to learn just how HealthEngine was uniquely able to bend the curve to such an extent, culminating in HealthEngine recently being invited to implement the platform for the benefit of members enrolled in the Blue Cross health plan serving members and staff of Congress and the Supreme Court.
The Takeaway: In a complex and entrenched industry, starting with a specific consumer pain point, while at the same time architecting alignment among key stakeholders, is critical in order to have the best opportunity to succeed in establishing a successful, innovative solution.
Partner at Keller Lenkner, Chicago, and Senior Advisor at Burford Capital, New York
The Challenge: It’s expensive for a company to pursue a lawsuit for breach of contract or other commercial claim. Even if the firm has a good case, paying lawyers and their staff is costly and takes money and effort away from running the business. Ashley Keller thought there had to be a more rational way for companies to fund these suits.
“The fact that I have a JD and an MBA from UChicago was not lost on people as a reason to entrust us.”
The Strategy: While working at Chicago-based hedge fund Alyeska Investment Group, he saw how some public securities had their asset values determined largely based on legal or regulatory outcomes. He realized the potential for a firm that could provide the capital to pursue commercial litigation in exchange for part of whatever monetary judgment a company received. So, in 2013, he and two others founded litigation finance firm Gerchen Keller Capital.
For a company pursuing litigation, Gerchen Keller offered nonrecourse financing secured by the proceeds of a successful case, essentially de-risking the suit. For investors, it was an opportunity to add an uncorrelated asset to their portfolios, as a breach-of-contract case has no correlation to the stock market. When raising capital, Keller and his cofounders explained to investors that their backgrounds in both law and finance would help them choose the lawsuits that would be most likely to succeed. “The fact that I have a JD and an MBA from the University of Chicago was not lost on people as a reason to entrust us with their capital,” Keller said. In late 2016, Burford Capital—a publicly traded, New York–based firm and one of the biggest players in the space—bought Gerchen Keller for $175 million in cash, stock, and incentives.
Keller remains a senior advisor at Burford. He and his partners recently launched Keller Lenkner, a law firm that represents plaintiffs in complex litigation. The team’s experience managing litigation-related investments allows Keller Lenkner to focus on capital-intensive lawsuits where it is acting on an alternative-fee basis and only receiving compensation or reimbursement for expenses if a case is successful.
The Takeaway: There are many ways to look at something as an asset—and if something is an asset, it can attract financing. Just because an industry is long established doesn’t mean there isn’t an opportunity for significant disruption in a positive way.
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