Trevor Price, CEO and Founder, Oxeon Holdings

Oxeon is a professional services and investments firm driven by the mission of making people healthier. The company includes three distinct business units: Oxeon Partners, Oxeon Venture Studio, and Town Hall Ventures. Oxeon Partners is a retained executive search firm. Oxeon Venture Studio builds and launches healthcare companies, and Town Hall Ventures is a venture capital firm that invests in innovative healthcare companies. Pulse writer Jamie Marvil sat down with CEO and Founder Trevor Price to discuss Oxeon and their endeavors.

The Pulse: Can you please provide an overview of your background and how you came to found Oxeon?

Trevor Price: I am an entrepreneur. I started my first business when I was ten years old, selling vegetables I had grown out of a red wagon on Rip Road in Hanover, NH. I contributed to my college education as an entrepreneur, and following college, I started a software company in India.

Throughout my career, it has become clear that people are more important than products and markets. Great teams figure their way out of inferior products and small markets, while poor teams ruin great products and huge markets. I had been exposed to executive search through my mother who is an accomplished executive search consultant, but as an entrepreneur, I didn’t love the traditional executive search model. Furthermore, as a venture-backed entrepreneur, I thought there was room to bring more value from the investing side as well. What came out of these experiences and feelings was the convergence of three things: executive search and investing from an entrepreneurial lens.

“People are more important than products and markets. Great teams figure their way out of inferior products and small markets, while poor teams ruin great products and huge markets.”

At the start of Oxeon, we were breaking down the executive search industry, getting rid of the traditional commission-based compensation and transaction-based culture. From there, we began to look at how we could leverage the relationships and information being built on the executive search side to be better investors and entrepreneurs. For example, when we run a CFO search for a hospital provider, I see it as an opportunity to talk to all the CFOs in the space and learn about the toughest problems these individuals are trying to solve. In the end, this information all feeds into the businesses that we are funding through Town Hall Ventures or that we are creating through our Venture Studio. Ultimately, the founding of Oxeon was an entrepreneurial exercise in thinking differently about building teams, thinking differently about investing, and thinking fundamentally differently about building healthcare companies.

The Pulse: As the founder of an executive search firm, you and your team support companies in identifying and attracting highly successful leadership. How do you think about building a management team that works well together and is set up to drive value?

TP: There is an infinite number of scenarios that a company might be faced with, so there is no straightforward, one-size-fits-all answer. The management team for an early-stage startup without product-market fit will be totally different from that of a highly specialized growth equity company. Our job as executive search consultants is not to define what a company needs, but to help our clients commit to an intellectually engaged search process. We need to help them think through the archetypes of executives that might match and actively calibrate on the role. At the end of the day, a successful executive search is not about dictating an outcome and really is not that different from consulting. In some ways, we view ourselves as strategic consultants, just with organizational design and human capital at the core of what we do.

The Pulse: COVID-19 has dramatically changed the way people work and could transform the workplace long-term. When recruiting leaders through Oxeon Partners, how do you think about identifying leaders who are best suited to lead in a radically different, and often virtual, workplace environment?

TP: It starts with the culture of the organization. If the company has a culture that emphasizes virtual communication and a distributed workforce, then COVID-19 has not really changed the thinking in terms of leadership recruitment. If the company has traditionally had an in-person culture, then it becomes a matter of gauging an executive’s ability to bridge this period of remote work. In the end, we are not doing a substantially different assessment.

The Pulse: Oxeon was founded on the mission “to make people healthier.” Within your portfolio, what have you found to be some of the more exciting innovations in healthcare that get at this very mission?

TP: We will not take on a client unless we fundamentally believe they are making people healthier. Each one of us has a different passion, but for me, my passion is around value-based, risk based care for vulnerable populations. Whether it’s companies focused on complex conditions or substance abuse disorders, I am passionate about businesses that take marginalized, complex populations with a chronic, high-cost condition and create a whole-person, value-based method to delivering care.

Overall, I think there is systemic racism in our healthcare system. You really don’t need to look much further than the differences between Medicare, Medicaid, and commercial insurance to see the problem. Oxeon has always been very passionate about those areas.

The Pulse: What do you see as being some of the biggest challenges that your portfolio companies face, both broadly and as a result of COVID-19?

TP: The first challenge is really getting the team right. Before Town Hall Ventures, Oxeon made twenty investments between $100K and $2M off our balance sheet. We built the leadership teams for each of these companies, and not a single one has declined in value since. In fact, nine of the twenty have achieved unicorn status, and that’s all in technology-enabled healthcare services. If that’s not a screaming indication for great teams, I don’t know what is.

Secondly, product-market fit is crucial and not just from the perspective of engaging and retaining a consumer. It’s really about following the money and figuring out the perverse incentives in healthcare. Having an organization that is sophisticated enough to navigate the misalignment of incentives in healthcare is important. Ultimately, team, product-market fit, the implications of product-market fit in sales cycles, and capitalization are the pieces that are very hard for seed and early-stage healthcare companies.

The Pulse: Many trends in healthcare, such as the transition to virtual primary care, have been accelerated by COVID-19. Of these trends and transformations, which do you see as being here to stay for the long haul?

TP: I think telehealth is here to stay, but to what extent remains to be seen. Most of the businesses we work with have gone from low-to-mid double-digit percentages for virtual health visits to 95% in April and May of 2020. I think the pendulum will swing back on those numbers, but only time will tell by how much. One of our mental health companies surveyed their doctors, and 80-90% of the
doctors want to go back to substantial in-person care. They also surveyed their patients, and the results were not that far off from those numbers. Right now, the company is probably at north of 90% virtual care. Yes, I think telemedicine is here to stay, but I think reimbursements are going to get cut significantly, and I think the pendulum will swing back at least some of the way.

Right now, many healthcare companies in the virtual provider space are feasting on very high margins in telehealth care delivery, and I think the industry is in for a bit of a reckoning on that. I think the government and health plans are going to drive down reimbursements for telehealth, and it will be interesting to see how those businesses adapt.

I think value-based care is here to stay. I think in-home care is here to stay. I also think COVID-19 is showing even more than before the impact of social determinants of health including housing insecurity, food insecurity, job insecurity, and transportation. The pandemic has shown a spotlight on much of the innovation that was validated through the first-generation of value-based primary care companies and companies focused on mental health and social determinants of health.

The Pulse: You’ve mentioned that Oxeon aims to help underserved populations. As an investor, what is the opportunity there, and why is it an area you are so excited about?

TP: The easiest way to frame the opportunity is through those served by Medicare and those served by Medicaid. Pre-COVID-19, over 135 million Americans participated in those two programs, and now the number is closer to 140 million Americans. Collectively, these populations consume over $1.4T of healthcare every year. At the end of 2020, almost 40% of all Medicare beneficiaries were enrolled in Medicare Advantage plans. You have almost 25 million people under managed care. Yet, if you were to aggregate Iora, Oak Street, Landmark, etc., you are probably under 2.5% market penetration. It’s crazy when you think about it.

On the Medicaid side, it is much harder to make money because of reimbursement rates. Post COVID 19, you will likely have north of 75 million Americans on Medicaid and almost 37 million children enrolled in Medicaid and CHIP. Can you think of many innovative private-equity or venture-backed companies that are actively disrupting risk-based Medicaid? The ROI is not there right now, but it is getting there. You tell me whether there are any other industries that are as underpenetrated as technology-enabled healthcare services focused on risk-based and complex care for people enrolled in managed care programs within Medicare and Medicaid. It’s a massive market that is totally underpenetrated.

The Pulse: In 2016, Oxeon partnered with Deerfield to launch the “Break into the Boardroom” initiative to drive greater representation of female healthcare executives in the boardroom. Can you talk a bit about how this initiative came to be and how this initiative is progressing?

TP: “Break into the Boardroom” was a brainchild of my partner Mia Jung, who is an incredible force. I have two daughters, and I am married to an incredible woman. I am the son of an incredible woman, and my employee base is at least a 50/50 gender split. It is unacceptable that our governance structures in our country are so lacking in diversity. Within the first fifteen seconds of her elevator pitch on the idea, I was like “Yes, let’s do it.”

“I am the son of an incredible woman, and my employee base is at least a 50/50 gender split. It is unacceptable that our governance structures in our country are so lacking in diversity.”

Mia has led the initiative, partnered with Leslie Henshaw at Deerfield. We identify high potential female executives working in healthcare and bring them together into a peer group. There is mentoring, development, and preparation to take on independent board seats at venture-backed, private-equity backed, and public companies. We then actively connect these women with those people making decisions about the board seats, whether it’s investors or nominating committee chairs. We have placed nearly forty women on boards in the past couple years.

We are also launching an initiative called the Mosaic Initiative in partnership with my friend Renee DeSilva at the Health Management Academy. The program will be similar but focused on BIPOC healthcare executives.
Overall, these efforts are a source of immense pride within the organization. At the end of the day, there are things that are just more important than revenue and profits.

Interviewed by Jamie Marvil in January 2021