For this issue of the Fintech Explorer, I had the pleasure of interviewing my former Goldman colleague Steven Greene, a co-founder of Nibble Health, a startup that provides a “healthcare safety net” as a financial employer benefit. We had an interesting Q&A covering Steven’s entrepreneurial journey, his company’s business model, and the company’s coming roadmap and plans. Enjoy!
Thanks for taking some time to answer questions, Steven! To start off, can you speak a little bit about your entrepreneurial journey and what led you to start Nibble Health?
Steven: First - thank you for having me, Ravi. I was lucky to start my journey right alongside yours in a large, fluorescently lit conference room during Goldman Sachs Investment Banking training in 2012!
I started my career in Restructuring at GS and then after business school re-joined the firm in Healthcare M&A, where I covered large biopharma, healthcare services, and healthcare IT clients. Through that role, I really fell in love with the healthcare space, but knew I wanted to be an operator. I then went to Thirty Madison, a telemedicine startup focused on treating chronic conditions, as the chief of staff to the co-founders. I was at Thirty Madison for almost three years and had a front row seat to the good and the sometimes not-so-good of scaling a unicorn digital health business.
Last summer my wife woke up one morning thinking she was having a heart attack. We went to the ER and after a brief stay where the hospital took basic bloodwork, gave her a COVID test, and performed a chest scan, we found out she luckily only had a bad case of bacterial pneumonia. We were in the hospital for two hours, did the absolute minimum in terms of treatment, and still received an invoice a month later for $8,000 - and she has insurance. We’re still litigating that bill.
This happens in the US every day at an unimaginable scale. In the past five years, more than half of American adults report they’ve gone into debt because of medical bills. This debt not only cripples them financially, but it deters or completely prevents them from seeking care when they need it most. Given my background in finance and healthcare, I began to think about how we could use financial services to change how people access and afford care. That was the start of Nibble Health.
What does Nibble Health do and what customer problems does Nibble Health solve for consumers and businesses?
Steven: Nibble Health enables leading organizations to provide zero-interest, zero-fee healthcare financing as an employee benefit. Employees can use their Nibble Health card to pay for out-of-pocket healthcare expenses in free installments over time, creating a healthcare safety net that removes financial barriers to care, and companies can lower overall insurance costs while increasing employee satisfaction.
More broadly, our goal is to empower patients through financial technology. Healthcare financing will be one of several fintech-related tools we use to help patients better access and navigate the healthcare system.
What type of traction have you seen so far? Can you give an example of a real customer you have, and how they are using the service?
Steven: We’re pre-launch, but we’ve spent a lot of our time in deep diligence with employers, employees, and distribution partners who are excited about what we’re building.
We’re getting interest from employers who span the spectrum from small private equity backed businesses to multi-billion dollar public companies, and from industrial to tech. They see Nibble Health as a solution to problems that are critical to their businesses. Whether it’s related to productivity, employee retention, financial wellness, employee NPS, health plan optimization, or bottom line healthcare cost improvements, Nibble Health is a platform that can be used by any employer to solve important pain points, and can also be used by everyone within a given workforce regardless of age, role, location, or demographic.
Can you speak about Nibble Health’s business model? How does the company generate revenue while avoiding predatory lending?
Steven: We provide zero-cost (no fees, no interest) healthcare financing to employees, for which employers pay us a fee. The credit limit we offer is dynamic depending on the employer and the broader employee pool, but is designed such that we don’t allow employees to shoulder overly burdensome balances based on their income.
Contrary to traditional BNPL that lives at checkout and charges providers a fee in exchange for increasing conversion and transaction size, our goal is to live at a completely different part of the healthcare decision making process - before someone chooses to seek care.
What we’re really doing is providing patients with a healthcare safety net - a line of credit which lives in their wallet, and which they know is there to protect them if they want or need to access care. That’s a powerful tool for getting people to take action. Nibble isn’t specific to any individual type of procedure, limited to a single use, or limited to a provider - we run on Visa rails, so patients don’t need to restrict themselves to a certain network or doctor.
Are there special regulatory considerations you have to take into account given your place in the healthcare payments space?
Steven: Privacy, security, and regulatory compliance guide everything we do. We’ve exerted a tremendous amount of effort to put infrastructure guardrails in place to ensure transactions are confidential and secure, and will comply with KYC/KYB, AML, HIPAA, SOC, and the comprehensive list of consumer payments regulations. This is a critical part of our business and we’ve invested accordingly.
Congrats on the recent fundraising round! What are your top priorities for the next 12-18 months now that you’ve closed the round?
Steven: We’re focused on providing world-class service to our first cohort of employers and continuing to build our team. On the hiring front, Patrick Collison used to talk about how when you hire the first 10 people you’re not really hiring the first 10, you’re hiring the first 100, as those people will either directly hire others or indirectly act as attractors/repellers of certain types of talent. Now that we have new capital, we’re looking to add to our team and make hires who can lay the foundation for the future of our business. As you can imagine, we’re super protective of those roles, so hiring is difficult but exciting. Everyone who comes in really has to raise the bar. If your readers know anyone who could be a fit for our mission, send them our way! https://jobs.lever.co/NibbleHealth