May 18, 2023
Nathan Bays: Hello, everyone. Nathan Bays here with a good friend of mine, Dan Brillman. Dan, welcome to the Gary Bisbee Show. Obviously I’m not Gary and filling in for him in in his passing, but but we’re happy that you’re here, Dan, and I know you knew Gary as well. So he would enjoy the fact that you are a, you’re a guest on the show and we’re looking forward to the conversation today. Welcome.
Dan Brillman: Thanks for having me, Nathan. And obviously we sorely miss Gary, who’s such a great mentor and. Leader and, left such a great impression on so many, including us too. It’s a pleasure to do this. And we’ll, I’ll continue to be sorely missed.
Nathan Bays: No, absolutely. Dan for the audience, certainly you and I have known each other for many years, and I, part of, I’ve been fortunate you. Ask me to join your board. Full transparency, but also but also it’s been a great run. So the questions will be will be certainly from an insider’s perspective, but just for the purpose of the audience, just tell us a little bit about, the founding of the company, yourself, Taylor Justice, your co-founder, where did the idea from the comp, for Unite Us come from? And tell us about those early days.
Dan Brillman: Sure. So my background, I’ll start with mine and how I. At Taylor many years into into my life. But 2013 was when we incorporated the company. So we’re about 10 years old now. But leading up to that was a long journey in how I got to this place. A little bit by luck, a little bit by a lot of entrepreneurs, right? See a problem they really care about that problem and see a way to fix that and lead that in a country. And so my background, I went to Yale undergrad. I worked in financing consulting before joining the military as a pilot, and I’ve been in the Air Force now for 17 years. I still serve today and have a couple years left. But couple years in I did a lot of deployments in the Middle East in my early career as a lieutenant and a captain, and then came back from my first deployment and went to business school at Columbia. Thought I was gonna go back into finance. And at that point, veterans that I served with started calling me with their medical issues, government issues, and social service issues. A lot of these things I had no idea about didn’t have any background on I wasn’t an expert in these things even though my family comes from medicine in a different way. And they came to me cuz they trusted me. And they had these issues and there were always a multitude of issues. And there were just one thing. It was, I wanna get access to government benefits. I don’t know how I need a myriad of social services like housing or post-traumatic stress support, or I’m not eligible for the va. How do I get healthcare and health insurance? And I couldn’t solve one of those things. And so I. Just like everyone in the military, these are your brothers and sisters. You care about them and so you try to help them. And in 2010, I was in, in the middle business school and I started searching for services myself for on behalf of these folks and saw how fragmented it was in communities between all of these different agencies that serve the same person, just across a myriad of services. And the veteran didn’t care. They just wanted services. They didn’t care. It was a separate, these are separate sectors. They just wanted these services and they were impacting their lives. And I looked at Google searches and, directories online and started calling these agencies. And the real thing that really was the light bulb was every time they said no to me on behalf of someone else, they would say, but I think I know someone down the street. That can do it. And so they had these kind of little referrals in their head of who I should also go to, but they had no idea of their capacity if they could actually serve the person and the programmatic eligibility. And so what did I end up doing because I became so frustrated about is I wrote a paper about it in business school that got in the hands of a venture capitalist. Through the Dean who came to me and happened to be a West Point graduate and said, you should really build this out. This is a problem of bringing sectors together to really support the individual in need in a more efficient way as a, as an infrastructure technology. And luckily I got to meet Taylor Justice, my co-founder as he was applying to business school, and we got randomly paired as a mentor in business school and someone that was applying he’s a West Point graduate. An army veteran and he was doing this from a different world. He was in the private sector, had was doing sales, but in his philanthropic world, was leading a nonprofit that brought together civilians and military members in communities through physical activity and camaraderie. And that’s where people presented needs. So he was running this on an Excel sheet of, people were going in the jail system, but there was a veteran treatment court and they wanted to get them services from other services. And all of these people had multiple needs and that’s where they presented their needs. And it was really fragmented. And so that’s where the story of Unite Us started, was the fragmentation that existed across all of these sectors. And how do we bring them together for, to better service and improve the health of the veteran. And now obviously 10 years later, same problem. Many. Different iterations of that solution, but same problem we solve today with a bunch of amazing products that are out across the country.
Nathan Bays: Yeah. Whether it’s healthcare or social care one of the. The, the biggest challenges within the United States and really globally is the fragmentation that occurs. There’s just so much fragmentation and, United US uses technology to bridge that. So maybe talk a little bit about, the technology solution. How did you take this, these ad hoc networks of, Dan knows this person, Taylor knows this person that are occurring all over the country and compress that down and create a technology solution to to help solve the
Dan Brillman: Yep. Yeah. And fast forward 10 years, right? We’re doing a lot on top of that infrastructure, like predicting needs and now reimbursing for these services. That were never reimbursed before, but it had to start with the connectivity that was required to even get organizations together to simultaneously serve the same person with the thesis of we are doing, we will be better together if we’re actually serving the person together. And so what this took 10 years ago was not just technology, it was standardization. It was getting people to agree on things that I’ve never been agreed to before that lived in technology. How, these organizations would talk to each other. What response back did they want when they sent something out to another agency? What did they want to get back in a standardized way across 150 different types of services, both medical, governmental, social service issues housing, food, employment, substance use, mental health. And we had to create a standard over the last 10 years on how that data is exchanged securely, how the person is protected in our system, how it’s permissioned, who can see what and who can’t see what and not duplicate services, reduce silos of information. And we had to start small and, but We started in New York City, which is not so small. And, but we also started with the veteran population, which is also not so small. It is everyone. It is not just, everyone thinks veterans are just the va. It’s actually only a small component of veterans that actually are using the va. And so the 22 million veterans of, even a small percentage use that. So veterans are everyone, right? They’re Medicaid, they’re Medicare, they’re uninsured. Some of them are va. And so we start, I think, going back, we start with the heart of population in probably the craziest city to do that. A very competitive city around nonprofits and things like that. But we got them to agree.
Nathan Bays: If we rolled back to 2013 when you and Taylor founded the business until today, w would love to hear your take just about some of really the maturation of kind of thinking around, social determinants from policy makers, from, business leaders, community leaders, from others from healthcare, organizations. How have you seen, because you’ve had a front row seat at all of this. H how have you seen that? Change that awareness change, over the last decade.
Dan Brillman: Yeah, so you know, over the last decade there’s no one that’s arguing that we’re spending more across the board and not getting any better outcomes for it. And so that’s come to almost a tipping point probably in the last five. Years of, okay, this can’t happen in a silo. I think that’s probably what most people will say and that silo is, typically sometimes referred to as the medical silo, but really it’s the silo across all three of those sectors of medical government and social services. And then also just the proliferation of technology has changed the landscape in what we’re able to do around aggregating information, being able to better understand a person. And what their needs are. And it comes back to the general, basic building blocks of I go to the doctor once or twice a year, that’s not driving my health. What’s, what are the actual drivers that are impeding my health or improving my health? And it’s happening everything outside. And so that’s the larger market, 50,000 foot view is. It’s no long things are no longer determined in the hospital. It’s actually determined everywhere else. And healthcare moving there with home-based care and clinics in the community. And can I go just, within a mile to get whatever I need regardless if that’s food or medicine or whatever that is. And so that’s happened a lot on, I think on the technology side. We saw the entrance of EHRs, right? Not so long ago. This is not talking like five decades ago. We’re still on its, rounding first base in, in how long that’s really been around, and that’s almost created new silos just inside the medical world in itself. And that’s really shown a light or shined a light on. There’s many more gaps, not just in the medical data silos of sharing information to better service someone, but all these other gaps that are exposed around all the different governmental programs and social service programs that people are getting simultaneously and now that’s even further fragmented when you start bringing these sectors together to say, what are we actually doing? We’re all serving the same person at different times in their life. And so where government has really come in over this time, and I think it’s been exacerbated, I think Covid exacerbated it because in a positive light shedding that, covid was not just a medical issue and a medical pandemic, it shed light on all these other underlying issues that were gonna affect people’s health over time. And so you saw people getting evicted or you don’t have housing, right? You don’t have access to healthy food. You’re in a much different place medically than you’re ever gonna be. And so that’s been the manifestation of that. Where it’s driven at a 50,000 foot view is more policy for sure at all levels. And those levels have become starting at. The CMS level of call it mandates, or call it pushing states or pushing different entities to do their work differently, to think about social needs or other factors that are impeding health. And then it’s also been I would just say invested in at the state levels of moving to manage care, moving to value-based care, meaning now I’m responsible financially. And if these things are happening outside my four walls, I better be connecting with them and understanding what’s happening. Otherwise, I don’t really have control of costs.
Nathan Bays: Yeah. Do you see, when you look out, into the future do you see the healthcare ecosystem? Owning more of the social determinant social care space, do you think it stays fragmented? And I mean that not just from a kinda a hospital health system managed care plan, but even from a kinda a policy perspective, at the highest level, do you think, are you seeing policymakers say, Hey, these two go more closely together. Maybe we used to have kind of social services here, healthcare here, now we’re bringing those two together and thinking about them more holistically. Do you see that?
Dan Brillman: I’m seeing it happen rapidly in the last 24 months. And it’s really tying all these different pieces together pretty quickly. And the dollars coming together in different places. If you think about the where, like the dollars that we’re investing in people, it’s medical dollars. It’s government dollars, right? It’s Phil philanthropic dollars which typically go to the kind of the social service agencies. And you think about how they’re funded as well. And there’s a lot of that now coming together and braiding in a way saying, why are we doing this in silos? And we think about what HHS is. It’s, we always talk about the Big H, but probably not the other H, which is the human service component. And so I think governments are realizing. We shouldn’t be doing these things in silos. How do we bring funding together? How do we make things more efficient in the delivery of services for our people? Typically, benefits are underutilized in communities. Has nothing to do with medical services. So to your question, I think back to the point is it really just the medical world, coming into this, the answer is no. I think the, some of the mandates and some of the pushes to hospitals and payers, Are making them realize how quickly they need to move into a more integrated approach. For sure. But the long tail is, it is not a healthcare approach to address social determinants or social drivers of health. It can’t be it cannot be a medicalized approach. It can’t, we can’t put all the burden on health plans and health systems to address these factors because there’s the other side of the government, which is just as big. And so it’s really around bringing that together.
Nathan Bays: How do you see and not to go into the political weeds but my, my perception is that really this focus, on, on the importance of social care and solving it is really not a partisan. Political issue. Maybe there’s some difference in, in how, those on the right and those on the left may, may look at the issue, at least at a high level. But everyone wants to solve these, these problems. But tell me, perspective boots agree.
Dan Brillman: Everyone cares about it. There’s no question. When we turned on the news during Covid, it was people getting evicted, people not having access to food, people having mental health issues, and people. While having medical issues related to covid, right? These are all things that have every stakeholder and legislator, I think understands that needs to be brought together. They may think about it differently, but at the 50,000 foot view, everyone wants a better and efficient. System of delivery of services, right? I didn’t say care or medical care or social care. They just want a better system of delivering services to people in need. And so whose job is that, to come into that game? It’s all of those sectors to be able to do that. They talk about it maybe differently in the way they want to solve it, but the end point of it is a more efficient. Delivery of services for me as a constituent for my, the state I live in or the city I live in for my healthcare provider. They want better for me, of course. They don’t want me less healthy. And for the community when I need support, they wanna help me. So all of these things are bridging together. I.
Nathan Bays: That makes complete sense. So tell me not necessarily from a unit perspective, but from a macro perspective, when you ahead, call it 10 years or. What are you most excited about? What are you seeing now that gives you the most kinda excitement about, where the space is going and what’s happening, around social care and social?
Dan Brillman: Yeah, so I, there’s a couple things that I think are happening. One is health as it’s defined, is just blurring, which is a good thing. What is health and what are health services that improve my health as a constituent? And I say constituent because if I say patient, it’s very medical. If I say clients very social, but as a constituent and American, how am I getting services? And Those funding streams are being blurred more and more in, in a good way as well of how governments are taking a stance on this at the city level, at the county level, at the state level, to say we need to do better for our people. What are the ways in which we do better for our people? Thinking five to 10 years out. This technology is going to be a normal day-to-day exercise for us and for and how we connect people to services. And for the person in need today. We, again, we don’t really care if I need housing. That housing organization is run by X, Y, Z and it’s funded by X, Y, Z, and I go to the hospital and it’s this entity. We don’t care as consumers, we want services. And five to 10 years now, we’re not gonna really kn know. Who’s funding what? It’s all gonna be really integrated from a delivery perspective and from a funding perspective. And for me, I tell my story one time. Because it’s all really connected. And so do I know technologies behind the scenes? May maybe not, but ultimately I’m not gonna have to navigate myself through crisis, right? Individually with my own self. It’s gonna be the supply side that’s fully connected. Think, and you think about other industries that have done this, like Amazon and the supply chain, right? You don’t really know where it’s coming from and where the shipment is before you order it, but it’s there in two days and you don’t really care. Where it’s coming from, as long as that has, pretty good refuse. But it gets there and it gets there on time, right? And so that’s really the ecosystem that’s starting to be created now at scale. And that’s really exciting for, I think all of us as consumers of care that I think we all agree is beyond fragmented even in just one of those sectors. But that’s, five to 10 years out, that’s very doable.
Nathan Bays: That’s exciting. Let me ask you a question just about, your experience as a leader, right? And a lot of, the audience for, for Gary’s show is about leadership and also, healthcare but really around leadership. So you’ve taken, a company literally from zero employees, you and Taylor up to many, hundreds of employees. Now, what are some of your key. Lessons learned, a, as a leader and what are, maybe what’s something maybe you would’ve done different? Looking back, hindsight’s always
Dan Brillman: Yeah, I love, I’m, you know me well, but I love reflecting back on the stuff I did not do well. Cause that’s the stuff I I love to change and not make mistakes. Again, of course. I also use some of my military kind of ethos in how we run the company. Some folks think about just cause I’m in the military, I’m like very structured and it’s very hierarchical. But actually it’s not how flying works in the military. It’s a really, a team doesn’t matter if it’s someone’s next to you, that’s maybe a different rank, right? You’re all one team in battle. And that’s how we operate really as a company. And we really care about meeting the end result and the impact that’s needed and what are the different ways to get to the end mission and successfully do that. I had to learn that early on by not taking on everything myself as the C E O I tried to do that. And I always. Stop myself even today with, hundreds and hundreds of employees. Because you hire people that are smarter and better and have more expertise than you. And part back to the military is you trust, right? Like you trust the people that are gonna execute you, support them. And it comes back to servant leadership. Ultimately my philosophy and Taylors too is we feel more successful as leaders. When others in our company succeed, not when we succeed, right? That’s an expectation. We should always succeed and win. But when others do well, that’s what we’re here to do. So it all comes back to being a servant leader to those folks and also taking more off your plate. Not for the sake of doing work, but because you’re not the best at it.
Nathan Bays: When you look out at, kind of everything that you. You’ve done as a company, and I’m sure there’s, many things you are, you’re proud of. Probably some things, again, you’d say I would do it different, most proud of as it relates to what the company to.
Dan Brillman: Yeah, so I think. Being a learning based company is probably the most, the biggest thing I’m proud of. And the reason I say that’s cuz it’s manifested into our products. And we were a single product for many years and how to connect all of these nodes together to securely communicate, to track the last mile and ensure we close the loop and we’re getting people to, services faster than ever and anyone else. Which is great. And so we’re driving an amazing impact and we’re driving cost utilization decreases. We’re. Improving people’s health and their measures and their trust in this network that we’ve created. But the most, the biggest thing I’m proud of is we learn very quickly and we continue to adapt very quickly, which has brought our new products to the market where our customers said, wow, for the first time, I’ve see where my patients are going, or my clients are going. I see how fast they’re getting there. Who should I put in this? And how do I know before they’re in crisis? How can I get in front of people faster? And that’s where the market is going too. So we’ve invested tons in predictive analytics to be able to better understand populations, to better get in front of me and offer me services before I need them. And that’s really where the world is going. That’s what I deserve. That’s what I want to as a consumer. I’d love to be offered services by my government by my city, by my hospital, by my health plan and offer me these things ahead of time throughout my life from when I’m a child to elderly. And then also as we’ve made an impact, the biggest thing I’m proud of is really aligning the incentives between the government world, the medical world, and the community world through. Dollars. And so showing the impact of the community, they work so hard. They drive such amazing impact for people in need every single day. And now being able to reimburse them in a way that’s effective, that is recurring for them and building really strong organizations out of that is the biggest thing I’m proud of. And it took, it’s very complex behind the scenes. We make it easy for them to be able to do it, but it’s never happened before.
Nathan Bays: Dan, thanks so much for joining us on the show today. It’s been fantastic. And we look forward to seeing how the company continues to grow and evolve and serve more and more people across the country.
Dan Brillman: Great. Thank you Nathan.
Nathan Bays: Yep.