As a spine surgeon, my job requires me to make split second decisions with life-changing consequences for the patient on the operating table. When the anesthesiologist tells me that my patient’s blood pressure is plummeting, do I close them up or take the extra minute to drill the spine and save them from lifelong paralysis? When there are nerves blocking my view of a safe path for placing an implant, do I risk stretching the nerve or stop what I’m doing and disrupt the patient’s life with a second surgery?
These high-stakes decisions lead to what many surgeons call “decision fatigue.” Going out to dinner after a day in the operating room, I have no interest in choosing my meal from a menu. That’s why I’m so awe-struck by Dr. Danish Nagda and Dylan Slattery. Danish is a former surgeon and CEO and founder of Rezilient Health, and Dylan is the CEO and co-founder of Excel Health Plans. As entrepreneurs seeking to change the way we practice healthcare, both Danish and Dylan take risks and make critical split-second decisions that are a constant part of day-to-day operations.
Rezilient Health and Excel Health Plans have recently announced their new partnership. Flushed from their pre-announcement photo shoot, Danish and Dylan sat down with me to talk about how their own experiences with healthcare have shaped their vision to deliver more effective, efficient, and value-based healthcare.
Dylan and Danish, describe each of your organizations.
Dylan: We [Excel Health Plans] are more of a managed care organization. We bring all of the pieces together. We pull together vendor partners to deliver a high performing health plan to small and mid-market employers and their benefit consultants. We are like a general contractor. Normally the broker is tasked with architecting the health plan, building it, servicing it. That is a tall ask for anyone. Every single self-funded employer normally customizes their own plan, which is very resource intensive, and not a scalable business model for benefit consultants. Building a plan is like building a house. Imagine every house being custom built. Instead, we have developed a standardized way to build that house – like a track home instead of a custom home.
Danish: Rezilient offers care at CloudClinics, physical locations where doctors are on screen and routine tools are wifi-connected and stream to the Rezilient doctor remotely. With this technology, Rezilient is building a health system where every doctor of every specialty is available at every location for every patient.
Dylan, what prompted you to start Excel?
Dylan: We realized that brokers were being asked to do a lot. When everything is customized, it leaves a lot of room for error. We found a huge need to develop a blue ocean strategy for small to mid-sized employers. If you are a company that has 25 lives, your broker likely doesn’t have the team, knowledge, or resources to bring a high performing health plan solution to the table, compared to a broker working with a company that has 5000 lives. Excel solves that problem.
What brought you two together?
Danish: We met at Health Rosetta, a community of people focused on reducing the total cost of care. We immediately had early alignment, as we both shared personal stories of challenges in the healthcare journey. I told Dylan about my dad, he told me about his own personal journey with cancer. For both of us, this is personal. We share the same goals to better healthcare: get in early and guide patients to the right doctor, which automatically reduces the cost of care. That was how it started, and now we are both growing at a crazy exponential rate next to each other.
Tell me about the partnership between Excel and Rezilient.
Danish: With this partnership, Rezilient will be offered as a benefit for every member on the Excel Health Plans. We are becoming their healthcare delivery partner. The employer offers Excel, and their members now have access to Rezilient’s services. For members that are outside of our CloudClinic service areas, they will have access to a virtual-first option. We are entering 5 new markets in the next 12 months, so all members in those markets will have access to full services.
Dylan: In many of the markets, especially in rural areas, access to primary care is severely limited, and it can take months to schedule a visit. We lower the cost of care from a risk management point – we want members to get the care they want, where they want it, at a price they can afford.
Danish, you left your career as a surgeon, invested a lot of your own personal money into your idea for Rezilient, and then spent two years in stealth mode building technology before ever seeing a patient. Tell me what that kind of risk-taking feels like.
Danish: People thought I was nuts. When you have the ability to make income at a very high level, people think that moving away from that is ludicrous. But for me it was existential. My dad worked so hard to give his kids the best life, and he never got to see it, and I watched him wither away. I joke with founders – you have to burn the boats and take the plunge. And I have found this to be the best decision I have ever made in my career. It also could have been the worst. But you don’t know until you try. When you burn the boats, it makes you realize that you have to succeed.
Dylan, Tell me what it was like to start Excel.
Dylan: Two years ago this was just an idea. I was just working another job until spring of last year. I walked away from a great career in sales, making a lot of money. I didn’t have a full time job until I was 27 because of my cancer, and with that job, I had initially thought that I had “made it.” But I found that it was still unfulfilling. I thought, there has to be more. From an income standpoint, it was all I ever wanted. But I feel like cancer influenced my life in so many different ways – it feels like I am living with house money because I am not supposed to be here.
I am a quick learner and I get bored easily. It is not a good recipe for being an employee.I saw an opportunity that wasn’t being addressed, to help the small employer. I would rather go all in on something that I am passionate about than sit behind a desk punching numbers. Yes it was tough – we didn’t pay ourselves for the 6 months. But we kept the long-term vision in mind.
You briefly mentioned the mentality of a founder – tell me about that.
Danish: I have found that a lot of successful founders have a point in their lives where they say “I am going to go all in.” Once you make that decision, the difference between entrepreneurs who are successful vs. those who are not is that even in moments of doubt, which everyone has, they convince themselves that there is no going back. When you are building something, and you have seen something, you can’t unsee it. So when you’re meeting with investors or partners, there needs to be clear alignment on what the world will look like. They’re either on board or need to get out of the way.
Dylan: Entrepreneurs are not satisfied with the status quo – so much so that they are willing to bet everything they have to change reality. In that way cancer prepared me to be a founder – there were points where people said how do you do it? And I thought: What alternative is there? There is no plan B. You either win or you die.
What is one piece of advice you have for founders?
Danish: Investors get to invest in one hundred companies, founders invest everything they have in one. Make sure you have the right one. If you have a spouse, talk to them before you do it and make sure they are on board.
Dylan: Stack the deck in your favor before you go all in, acquire the skills you need – education, experience, mentorship. Once you have something that you are so passionate about that you are willing to burn the boats, THEN go do it.