Venture Everywhere Podcast: Joseph Schneier with Jenny Fielding
Joseph Schneier, founder and CEO of Circle chats with Jenny Fielding, Managing Partner of Everywhere Ventures on episode 91: Healthcare Comes Full Circle.
In episode 91 of Venture Everywhere, host Jenny Fielding, co-founder and Managing Partner at Everywhere Ventures, chats with Joseph Schneier, founder and CEO of Circle, a healthcare data analytics and automation platform. Inspired by a personal family crisis, Joseph shares the personal story behind Circle’s founding and his mission to bridge the communication gap between healthcare stakeholders and consumers. Joseph also discusses Circle’s evolution from a B2B SaaS platform to a consumer-facing brand, how the company is leveraging AI to simplify communication, and its role in helping millions better understand, access, and manage their healthcare.
In this episode, you will hear:
Circle’s role in enabling compliant collaboration between hospitals and insurers
Navigating constant regulatory changes that can impact customer viability
How Circle’s AI integration reduces full-day workflows to 20-minute tasks
Tracking consumers from the first touchpoint through their healthcare journey
Maintaining compliance while removing jargon from healthcare communications
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TRANSCRIPT
00:00:04 VO: Everywhere Podcast Network.
00:00:14 Jenny Fielding: Hi, and welcome to the Everywhere Podcast. We’re a global community of founders and operators who’ve come together to support the next generation of builders. So the premise of the podcast is just that, founders interviewing other founders about the trials and tribulations of building a company. I hope you enjoy the episode.
00:00:34 Jenny: Hello, everybody. Welcome to Venture Everywhere, where today I am so excited to be talking to Joseph, who’s the founder and CEO of Circle, which is a healthcare data analytics company and automation company as well.
00:00:49 Jenny: And we’re going to hear a little bit more about why Jo started this, how Jo started this, really the mission behind it, and where the platform is actually going. So welcome, Jo.
00:01:01 Jo: I’m so glad to be here.
00:01:03 Jenny: Awesome. Let’s kick it off because you and I have actually known each other for quite a long time, which is really fun. I’d love to just start with the inspiration for Circle. It’s had a few iterations as most great founders do. So maybe you could start with what was the initial spark that got you to do this crazy thing of starting a startup.
00:01:23 Jo: Absolutely. So around a decade ago, my younger brother got into a really bad car accident and he was in the ICU for about six weeks. He had done this thing where he had been working in corporate America, but his dream was to be a chef. So he had left his job to follow his dream. But what that meant was he didn’t have any health insurance at the time.
00:01:44 Jo: So he gets into this car accident and I had been working in healthcare for a long time up until then. I show up and immediately what I’m thinking about is “Oh, my God, how are we gonna pay for this?” I’m just seeing millions of dollars right in front of me.
00:01:58 Jo: And I knew enough about health insurance and healthcare from my previous companies to help walk him through it, but it was still incredibly challenging. And he was able to get signed up for Medicaid, which is health insurance for low income individuals.
00:02:13 Jo: But there was this moment where I was walking around the hospital and peeking into the other rooms and thinking to myself, how are these people figuring out all of this? Are they just getting the bill for a million dollars or... what’s happening to them?
00:02:28 Jo: That was really the reason that we got the company started was this information asymmetry between consumers and the healthcare industry that results in financial problems for individuals, emotional problems, just a whole cascading range of issues. So that’s how we got started.
00:02:48 Jenny: It is amazing just how transparency doesn’t really factor into our healthcare system. It doesn’t seem like something that should be that complicated. Now, yes, I understand all the codes and all these things. It’s a complicated system.
00:03:04 Jenny: But it seems like now, especially with AI, there should be this translation layer for us. And so I am hoping that we’re moving towards something a little better. And I think what you’ve built is pretty amazing. You’ve been working at it for a number of years. So tell us a little bit more about Circle and the impact you hope to make with it.
00:03:24 Jo: So when we started, we were really consumer facing and thankfully we’ve been able to come full circle. We started the company, my brother being this North Star, how do we solve problems for this individual.
00:03:36 Jo: And we quickly realized that the reason why things are not working for him are because of data pipelines in the system. Just all these disparate institutions that don’t have ways to easily speak to each other and have different incentive structures and compliance structures.
00:03:53 Jo: So we developed a platform that allows a lot of healthcare stakeholders to work together around challenges related to onboarding and communicating with either patients or members.
00:04:06 Jo: Up until a year ago, all of our products were used by people who work at health insurance companies or healthcare providers. Just in this last year, we finally launched our direct to consumer version of the product.
00:04:18 Jenny: That is full circle.
00:04:19 Jo: Yes, exactly.
00:04:20 Jenny: So can I ask you a basic question, which is how come the electronic medical record groups, when you talk about bringing data together, we always think about EMRs, but that’s something different. So for the audience, especially, can you give us a quick where the EMRs drop off and where Circle comes in?
00:04:38 Jo: Sure. So EMRs are used for two really core reasons. One, they’re used to collect all of the data on you as a healthcare consumer, as a patient. And then two, to provide a way for your provider, your doctor, nurse, whatever, to be able to bill an insurer. So it’s really dealing with a very specific portion.
00:05:01 Jo: But like anything you do with any other company, it’s not just about that experience. There’s all sorts of supporting pieces that need to be in place. The industry has not focused on things like, how do we as health insurers communicate with consumers in ways that they’ll understand?
00:05:21 Jo: And not around things like what your A1C levels are, but, hey, you need to get into the doctor and get your annual checkup because if you don’t, you have this risk because of your family history.
00:05:35 Jo: It’s a different process and it’s run by different portions of the business. That portion of the business has not had a lot of technology investment. Hence, no one liking their insurance company.
00:05:45 Jenny: All right. So tell us now how Circle comes in at that moment.
00:05:49 Jo: Just to clarify, we work in the Medicare, Medicaid, and marketplace sectors. So those are Obamacare, Medicare, which is mostly for seniors or people with chronic illnesses or low income individuals who have Medicaid. And the reason for that is unlike employer-based insurance, people need to contact their insurer directly. So they don’t have like a HR department to help them out.
00:06:09 Jo: So we start with a program. We work with provider groups to communicate out to their patients, hey, you as patients need to do something about your health insurance. So we started at the very, very beginning, very first touch points, which already, people are getting upset.
00:06:26 Jo: And then we move them into the onboarding process, which is really a sales process. So the product is very much a CRM quoting sales system, a Shopify plus a Bill.com with a backend of Amazon to help people on the front end to understand what decision they need to make.
00:06:45 Jo: And then we do a lot of extremely boring stuff like commission reconciliation and policy reconciliation and all of these things. But the reason that we do all of them is we want to track the entire journey from the first touch point a consumer has with either a healthcare provider or an insurer all the way through how do I choose Aetna Health Group, this plan, that plan, whatever.
00:07:10 Jo: And then as I move through the year, how do I know what I’m supposed to be doing? How do I understand what bill I should be paying, which one I shouldn’t be paying? How do I know if I’m supposed to be going to the doctor, actually do this check and all of that type of stuff? So the system supports communication in the beginning and then communication throughout the year.
00:07:29 Jenny: Very cool. Sounds seamless. So tell us about some of the challenges that you’ve had, because I imagine anything dealing with healthcare, regulated industries and just complex ecosystems is never straightforward. Where should we start?
00:07:42 Jo: The deepest side from the bottom of my soul. None of the systems are set up in a way that makes this an easy process to solve. If it was easy, it would be solved already.
00:07:54 Jo: So there are different incentives structures for all these different groups that make it complex for them to work together. There are compliance issues that make it complex to work together.
00:08:03 Jo: So we’re acting as like a go-between system that can allow hospital system to work with a health insurer more compliantly by sitting in the middle. But that requires us getting the hospital system on board and the health insurer on board. So that in and of itself is extremely complicated and challenging.
00:08:24 Jo: That would be challenging enough if we lived in a static world where policy never changed. Reality world, we live in where every day I wake up and I’m like, what happened yesterday? We have to really stay on top of an ever shifting landscape of regulations that change what our core products can and cannot do and what our customers can and cannot do.
00:08:47 Jenny: Makes sense. I imagine you’ve had some people help you along the way. So maybe you can talk about some of the influences that have encouraged you to go down such a tricky path.
00:08:58 Jenny: I definitely think, especially in regulated industries, when you have those mentors that have helped pull you in those bad moments, that can be so important. So I love to hear about some of those inspirational people.
00:09:09 Jo: Yeah, I’ll mention one. There was a woman named Nancy Cocozza who came on early with the company and she ran Aetna’s whole Medicare division. She’s a brilliant, smart, strong, just tough person, very honest, which is what you really want in a mentor.
00:09:29 Jo: The thing that was encouraging about working with her is even though she had lived in this industry for such a long time, she hadn’t lost faith that things couldn’t be improved. But she knew down to a lot of the technical levels what can and cannot be done. I keep her in the back of my mind. Would Nancy agree that we can do this or not?
00:09:49 Jenny: I love that. She’s your little guardian angel Nancy.
00:09:53 Jo: Yes, and also rapping me hand and knuckles if I’m not doing things correctly, but in a loving good way. And just across my career, I think it is underestimated by founders how important it is to have mentors who will challenge you and be there for you when you’re really hurting but also push you in the ways that you need to be pushed. So I do try to look for those. But in this industry, Nancy has been one of the biggest ones.
00:10:20 Jenny: That’s great. As you look holistically at the industry and specifically data and automation as a catalyst for improving healthcare over the last decade and then looking forward, where do you see the opportunities?
00:10:35 Jenny: It seems like we’re at this moment where I feel like things could really benefit consumers or we could just become riddled in paperwork and regulation and just stay static. And it’s how I felt during the pandemic.
00:10:50 Jenny: All of a sudden telemedicine and my doctor was seeing people on Zoom. And we’ve gone backwards a little bit since then. And I think because incentives maybe weren’t aligned. So how do you see the future on that front?
00:11:01 Jo: So I will start with the optimistic view. I have worked with AI for my entire career. So I’m one of those people that’s seen many waves of AI. But healthcare creates the vast majority of data that’s created worldwide.
00:11:19 Jo: From what we see, 99% of it is put on a shelf and never touched. One of the biggest frustrations in healthcare in America is information asymmetry and communication issue that is so easily solved with AI. It’s maybe one of the best use cases out there.
00:11:37 Jo: On the flip side, the industry in its implementations of AI, the first things they did was optimize how do we just make more money off of people. And so that’s created a lot of mistrust. So looking at how guardrails can be put in place is, I think, the most critical thing moving forward over the next 10 years.
00:11:58 Jo: There are infinite number of workflows that we could be improving. We just had to build out a product to take in paper applications and use OCR technology to put them into a CRM system. That’s crazy that this is still a thing that has to be done. So that one hand, the industry is there. On the other hand, once that data goes into that system...
00:12:20 Jenny: So much you can do.
00:12:21 Jo: Yeah, you could do so much with it to help somebody. Not just with how do you get your insurance, but maybe that person has mobility issues or food insecurity. There’s so much more that can be done with the data that we have.
00:12:34 Jo: I do think that there’s going to be a push at least for workflows to be improved. There’s a lot more reticence around things that are consumer facing, but hopefully that’ll shift over time.
00:12:46 Jenny: All right. Well, good segue into if you could wave your magic wand and solve one challenge in healthcare data today, what would it be? It sounds like there’s a lot of opportunity for improvement. So what would you pick first?
00:12:58 Jo: This is a very boring answer, but it is the first thing that I would solve. If all health insurers, whether or not they’re government related or not, were required to submit claims data to the Center for Medicare and Medicaid Services, it would be transformative on so many levels.
00:13:18 Jo: There’s so much we could be learning about why employees are getting their premiums jacked up when that’s not happening on the Medicare side and start to rationalize some of this data. It’s not an exciting answer, but it is the answer. Please, please make that happen.
00:13:35 Jenny: Be amazing. How does Circle help providers and insurers not just grow their business, but also improve communication? Which seems to be full circle, what you started talking about at the beginning of this so improving patient and member communication.
00:13:49 Jo: One of the things that we’re really working on now is how to take the jargon out of the communication while remaining compliant. It’s a tough road and we are using a lot of AI in this portion of the business.
00:14:03 Jo: The average American reads at about a fifth grade level. The average healthcare piece that gets put out is 12th grade or above. So that’s really the merging of that gap, connecting those two points.
00:14:14 Jo: Just as an example, if I told you, okay, you’ve got co-insurance of this and your copay is that and your deductible is this, most people glaze over and I have no idea what you’re talking about.
00:14:24 Jenny: That’s me and I read above the 12th grade level. But I’m HR at our firm and I have to do our healthcare policy. And this woman, bless her heart, was so nice and she was explaining this to me.
00:14:36 Jenny: I literally could not focus on what she was saying. It was so convoluted with the co-pays and the this and that. She’s rattling it off and she’s like, you got that, Jenny? I’m like, I literally did not understand what she was saying.
00:14:48 Jo: Yes. I believe that you should not have to understand that. Why should you have to become an insurance expert?
00:14:54 Jenny: It’s so complex though.
00:14:56 Jo: I think things need to be translated into things that are meaningful for the audience, which what people want to know is how do I get to a doctor and am I going to get a surprise bill?
00:15:08 Jenny: And how much do I have to freaking pay without this copay, co-insurance? I don’t care how you guys are doing it. That’s your business. Just tell me how much I need to pay.
00:15:17 Jo: Yeah. I keep telling people it’s like as if airlines were saying, “Well, the coding for you going to St. Louis...” And you’re like, what?...
00:15:27 Jenny: Exactly. Just take me there.
00:15:28 Jo: That is possible. Some things need to change on a regulatory level. But it was almost impossible to change all of this before generative AI. Now I just feel like we’re at a tipping point where we really could rebuild trust with the healthcare system if we were to start to lean on some more technology. Technology doesn’t solve everything, but in this instance, it really could solve a lot for consumers.
00:15:53 Jenny: I love that. And I love that you’ve been at the intersection of machine learning, or whatever we used to call it, for so long. So this must be such a amazing moment to see it come to fruition after all these years.
00:16:06 Jenny: Okay, let’s look a little bit future-forward for Circle. So tell us where things are going and a little bit about how you plan to orchestrate not just the mission there, but the team. Is this a type of business where you’re going to need to hire a lot of people? Tell us a little bit about what you’ve built and how you scale this.
00:16:26 Jo: So we are at a really critical junction. So up until this last year, we were just a SaaS company, pure SaaS company. We sold software. We buy the software. We support the software. That’s it. We were able to have a team of 20 people supporting multi-billion dollar companies and not a problem.
00:16:46 Jo: With going direct to consumer, where we are going out into the world, for the first time, we need to be building out a consumer presence and build trust in us, Circle, with the greater world.
00:17:01 Jo: That does mean we need to have more bodies at the company than we had in the past. So I anticipate over the next year, we’ll likely need to hire between 50 to 75 people, which is for us is a huge shift in the way we’ve been operating as a company.
00:17:19 Jo: This portion of the business runs much faster. It’s not RFPs that take six months for them to decide to release. All these organizations want to grow in some capacity. So the speed of the company is 100 times faster than it was a year ago.
00:17:35 Jo: So that combination are two big shifts for our company. It’s just a real inflection point for us. So I foresee that in the next year or two, we’ll be a really radically different company than its current position.
00:17:48 Jenny: That’s exciting. And then just give us a quick peek, if you can, on maybe some of the products or things that we should look forward to in Circle being able to unlock for your customers.
00:17:59 Jo: So for our customers, we have moved from saying, “Here is a platform, go and implement whatever your business strategy is” to working with our customers and saying,
“What is your business strategy and how do we help you to get there?” That is a really big difference.
00:18:15 Jo: So instead of just leaving them to their own devices, our system, we say, okay. If you want to grow in Tulsa, but you can’t grow in Oklahoma City or whatever, we can help them to really organize their business and their communication strategy on the ground all the way through the process. So that makes a big difference for them.
00:18:38 Jo: We’ve been able to integrate AI into the product in a way where it makes workflows that even in our system, which was great, that much better. So things that were still taking them a full day to complete, they can now complete in 20 minutes.
00:18:52 Jenny: What’s keeping you up at night?
00:18:53 Jo: The changing regulatory market is pretty intense. We really do have to pay attention on a daily basis and typically, know where the wind’s going. So that’s been a bit challenging.
00:19:07 Jenny: Is that based on current administration and just how they’re operating or that’s just healthcare in general right now?
00:19:14 Jo: Actually, honestly, this administration and the last administration. Both were making such radical pulls in different directions that it’s hard to anticipate, okay, things are moving this way, but what if there’s a change in three years and then they pull this way?
00:19:30 Jo: So making sure what we build can accommodate shifts is a critical component. But some of these things can make a big difference in whether or not our customers even can grow. We have customers who are shutting down whole lines of business because it’s no longer profitable. So it’s because of just a small shift in policy. So that does keep me up.
00:19:56 Jenny: It’s interesting. At our firm when people are like, “Well, what do you invest in?” We’re like, “Well, we try to invest in the software layer that’s making industries, including regulated ones, more resilient or fortifying them.”
00:20:07 Jenny: And I feel like that’s exactly what you’re doing. You guys are in this shifting landscape, but the service that you provide, it’s your job to make sure that’s bulletproof, regardless of where the winds go. But that’s obviously really tough.
00:20:21 Jenny: So outside of specifically as a company, but just more holistically, what does success look like for you, for Circle, in general?
00:20:31 Jo: For me, what I would really like to do down the road is to be able to have a bigger impact on policy and legislation around healthcare. I’ve, over the course of my career, been able to work in almost every arena of healthcare. So I’d love to be able to take some of the tons of information I’ve amassed and apply that at a larger scale.
00:20:58 Jo: As a company, we want to be touching the vast majority of lives of people who are low-income seniors or self-employed. We want to become the trusted name for them.
00:21:11 Jo: “I don’t know where to turn to. I’m going to turn to Circle because that’s the group that is going to give me the honest answer. Even if it’s not the answer I want to hear, even if it’s my health insurance not covering this, at least I know that I got the right answer.”
00:21:24 Jenny: All right, we’re almost towards the end, but I always love this question. What’s one idea that experts in your field say that you disagree with? I feel like you just have so much experience in healthcare and you’ve seen so many ups and downs. What’s something that people always say that you roll your eye at and like, mm, not really true?
00:21:43 Jo: I could give a 10 hour talk. But I will speak directly to something that I think a lot of people think. So a lot of people in America do not understand why insurance exists and they think it is basically the devil. That if we just got rid of insurance, healthcare would be fixed.
00:22:00 Jo: I think the thing that people don’t understand is that the way that insurance should work... and this is how it works all over the world, European countries have a version of insurance, it’s collective bargaining. That’s what it is. It’s the same as a union that’s representing a group of people. And the larger that group of people is, the more power they have.
00:22:20 Jo: European countries have private insurers and public insurers. They have a mix of all of these things. We assume that the problem is really just very simplistic when it’s not as simplistic as just get rid of insurance and then everything’s better. So people don’t usually like that.
00:22:37 Jenny: Yes. It is interesting because as screwed up as our system as I spend a lot of time in Europe and other places and it seems universally people think their systems are screwed up.
00:22:46 Jo: That is true.
00:22:47 Jenny: There’s also that. Okay, this has been so fun. We’re gonna do a quick speed round. So these are just quick answers. Is there a book or some type of media podcast, etcetera that you’ve been enjoying recently?
00:22:59 Jo: So I always recommend to everyone that if you are interested in healthcare, you should read The Social Transformation of American Medicine. It is maybe not a fun thing, but it is the most informative thing.
00:23:10 Jo: But I did recently read a book called Endurance, and I really recommend it. It’s a story of bravery and overcoming obstacles. As a founder, I was like, oh, these are people having other obstacles that they overcame. It was encouraging.
00:23:26 Jenny: I love it. Okay, if you could live anywhere in the world for just one year, where would it be and why?
00:23:32 Jo: This would entail me agreeing to leave New York City, which would be challenging. I would like to spend a year in Germany learning more about their health system. I’ve spent a lot of time there, but if I could spend a year just really digging in deep there, that’s probably where I would be.
00:23:47 Jenny: Awesome. And favorite productivity hack, something that keeps you moving fast?
00:23:53 Jo: More and more, I think my best productivity hack is just hiring the right people so that I’m not doing everybody’s job, which is, I think, a problem I’ve run into in the past.
00:24:07 Jenny: Well, if you’re going to scale up another 75 people in the next year, we’re going to have to figure that out. All right. And then where can listeners find you?
00:24:15 Jo: I don’t do a lot of social media, but I am pretty active on LinkedIn. There only two Joseph Schneier’s. Pretty easy to figure out which one I am. But also feel free to email me directly. It’s joseph@circleengaged.ai.
00:24:28 Jenny: Jo, it’s been such a pleasure. It’s been just personally rewarding for me to have been in your orbit for so long and seeing your evolution and your passion towards healthcare and really just helping people more generally. So thank you so much. This was great.
00:24:42 Jo: It was really great to talk to you. Thanks so much for doing this.
00:24:46 Scott Hartley: Thanks for joining us and hope you enjoyed today’s episode. For those of you listening, you might also be interested to learn more about Everywhere. We’re a first-check pre-seed fund that does exactly that, invests everywhere. We’re a community of 500 founders and operators, and we’ve invested in over 250 companies around the globe. Find us at our website, everywhere.vc, on LinkedIn, and through our regular founder spotlights on Substack. Be sure to subscribe, and we’ll catch you on the next episode.
Read more from Joseph Schneier in Founders Everywhere.