The secret to health care entrepreneur Brad Smith’s success is a measured one.
First: He makes sure patient care and experience is top-of-mind. Then he finds gaps in the health care industry and develops solutions. Finally, he makes sure his startups stay small until things have been perfected.
“I really like finding hard problems and running after them and seeing if you can make them better,” Smith said. “What we’re learning over time is how to scale after we have a good model that’s working in a small place.”
Smith’s two-year-old Nashville startup, value-based health care firm Main Street Health, closed a $315 million round of funding this week. The money will be used to expand their operations from 18 states to 26 next year.
This is Smith’s second startup to break a ten-figure valuation in the past two years, the first of which was CareBridge, which vaulted to a $1 billion valuation last year and ranked No 1. in this year’s Inc. 5000 fastest-growing companies list. Reaching this threshold is considered “unicorn territory” and is a notable number for Nashville’s startup community.
For both companies, Smith said he established key partnerships early on so that when it was time to expand, it was able to happen quickly.
And making Nashville his home base has made recruiting workers and creating investor relationships easier, according to Smith.
Prior to CareBridge and Main Street, Smith — former Director of the Center for Medicare and Medicaid Innovation — and former U.S. Senate Majority Leader Bill Frist co-founded Aspire Health in 2013. They sold it to insurance company Anthem Inc. (now Elevance Health) in 2018. Frist, Smith and other former Aspire executives were involved in the creation of both Main Street Health and CareBridge.
A passion for rural health care
Main Street partners with rural primary care clinics to provide health care services to seniors. The company has a proprietary care management platform that integrates with a doctor’s electronic medical record. Patients are helped by “health navigators,” who work inside the startup’s partner clinics to coordinate care.
Smith’s passion for rural health care stems partially from his family’s experiences. His mother’s family is from Spring City, a small town halfway between Nashville and Knoxville. His wife’s family is from small town Abbeville, Alabama, where her father works as a peanut farmer.
“I just spent a lot of time in rural America and one, love the culture, and love how it feels being in rural America and the community focus,” Smith said.
A lot of the innovation he was seeing with his work at the Center for Medicare and Medicaid Innovation were in suburban and urban areas, not rural areas. In fact, he said trends in rural health care have been challenging over the past decade.
“Over 100 rural hospitals have closed. The number of primary care providers and specialists, especially in rural areas, is declining,” Smith said. “I think there’s an opportunity to really think about ways to transform rural health care.”
Because of his passion for the work he’s doing, Smith said Main Street is a company he can see running for “a really long time.”
“The need and the opportunity is really large and that makes it something that can be really fun to do for a long time,” he said.
