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Why Startups DIE | 🚨 911 Emergency Care Shutdown?

There are thousands of reasons why a startup/firm will go 6-ft under...sometimes on arrival, on the runway, or even at a state of launch. What I'd like to focus on in this blog-series are the organic reasons that leads a company to its resting place (RIP)


Today's Zombie is...

Company Name: CALL9

Year of Birth: 2015

Year of Death: 2019

Sector: Emergency/Nursing Care

Funding: $34M (USD)

Workforce: 100-250

What was Call9?

The genuine idea behind Call9 was to eliminate time wasted in emergency waiting rooms and instead bridge the gap between emergency first responders in Skilled Nursing Facilities (SNFs) on call to staff nurses on hospital settings. By facilitating this channel, immediate care to patients will be conduced on "time" given that Call9 provided adequate diagnostic tools and telemedicine capabilities for patient-doctor interaction.

Call9 claims that they were able to operate 142,000 telemedicine visits and 11,000 patients who used the services. Not bad for a health tech startup, I might say!

They have also solidified partnerships with crucial nursing homes around NYC metro-area such as CareRite, ArchCare, and Central Island Healthcare, let alone a Lyft deal for medical transportation. 🔥

So what really happened?🔍

I will have to firstly introduce the notion of value-based care so to give more context as to why Call9 met its demise. US-based Value-Based Care is all about paying the healthcare providers once the patient got better. Meanwhile, the healthcare facility may get penalties IF the same patient gets readmitted. So no more fee-for-service revenue model and more of the perception of a long-term patient care continuum. It is highly complicated but allow me to zoom in to the challenge that Call9 faced: they are thriving to lower the ER admissions of patients coming from nursing care which is a double-edge sword in its own merit. IF the patient is a recurring visitor to the ER then the hospital will be flagged and IF the patient is a new incomer, Call9 telemedicine services, the money maker feature, is compromised. Now, telemedicine visits requires healthcare providers to provide services through a platform, which is Call9 in this case, and since it is following the value-based care model, healthcare providers are not compensated for their hours consulting, diagnosing, and providing on-call support...but rather the results of such effort. Often than not, patients in SNFs do have health comorbidity due to advanced often requires multi-layered level of patient care.

Needless to say, long-term value-based care is difficult to prove in this patient segment. Call9 attempted to bridge the gap and satisfy both sides of the supply and demand but the fundamental healthcare revenue model is not compatible with either the healthcare provider, ER admissions, or their core telemedicine service.

So what can we deduct from the Call9 experience?

Here are my humble thoughts on this:

  • They scaled TOO fast – expanded to new adjacent services too early as well – validate and sustain the core business first before any grandiose risky endeavors – Call9 was literally expanding to another city (Albany, NY) prior business / revenue model validation.

  • There was an insufficient customer-feedback and since this is following a B2B2C model, it is wiser to know if the healthcare providers are OK with the overall "deal" , patient first is a cool concept but service providers are vital in this equation. They are at the end of the day are Call9 users as well...

  • Recommendation: Deep market research prior launching... telemedicine was definitely on fire back in 2015 but was it really compatible to the healthcare environment at that time? let alone a niche area of nursing care?

RIP Call9... I feel truly sorry for your loss.



Successful people don’t fear failure but understand that it’s necessary to learn and grow from.” -Robert Kiyosaki

One Step Further? Armor thy mind with the power of knowledge 👇


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