Joshua Silver discusses his entrepreneurial journey, including co-founding Patientco and its eventual exit for $450 million.
Joshua Silver discusses his entrepreneurial journey, including co-founding Patientco and its eventual exit for $450 million. He shares insights on building a business for over a decade and the secrets to a successful entrepreneurial exit.
How do you figure out if someone's going to be a good fit for your startup or not? And that's probably the biggest mistake that I've made and the biggest mistake I see other founders make is not getting the right people on the bus at the right time. And it it costs you not only a lot of money, but it just it costs you a lot of opportunity. All righty. Hello everyone and welcome to the dealmaker show. So today we have a another repeated founder, you know, joining us. You know, we're going to be talking about all the good stuff that we like to hear obviously, you know, the building, the the financing, the scaling, the exiting. Uh also we're going to be talking about like how, you know, he got started with his first company. You know, they ended up having a really nice transaction there, 450 million that was disclosed. And then also we're going to be talking about how he used consulting as
the transition bridge in order to get to the next business. So again we're going to be talking to about good stuff like challenges experiencing experiencing growth today you know the world of AI how that is impacting you know certain certain aspects as you're thinking about the operational you know structure of your business and other really good stuff. So, brace yourself for a very impactful conversation today. Very inspiring, too. And without further ado, let's welcome our guest today, Joshua Silver. Welcome to the show. >> Thanks so much for having me. Appreciate it. >> So, originally born in Boston, but grew up in Atlanta. Give us a walk through Memory Lane. How was life growing up for you, Joshua? >> You know, it was uh it was good. I moved uh from Boston down to Atlanta uh when I was in middle school and then stayed in middle school uh stayed in Atlanta. um
through high school and college went to uh Georgia Tech uh studied computer science there. So pretty technical background by training and that has certainly come in handy uh over the last almost two decades now of of building fintech companies. >> How did you get into the world of computers to begin with? >> You know as a kid I was just always a tinkerer. Uh you know loved building things uh whether it was Legos or connects or robotics things like that. um and just really carried that through and pretty early on figured out that uh technology and engineering would make a pretty good career and I enjoyed doing it. So stuck with it uh you know starting really in middle school uh all the way till now. And how was that moment where you decided to go at it as an entrepreneur? Because I mean it took no time right out of uh college. You I'm sure that your parents were probably like,
"Hey Joshua, why don't you do a few years at least of uh corporate?" >> You know, it was a a big kind of existential debate I was having. Uh when I graduated from school, I had offers from a lot of the top consulting firms, some of the the major technology companies at the time. um and you know really had to figure out what I wanted to do with my life whether I wanted to go more of a traditional path and go work for someone or start my own thing and ultimately of course decided to go down the path of entrepreneurship. I've thought a lot about there's probably no better time in my life than after I graduated college because I had really no expenses at the time. Um, you know, no fam, you know, family commitments or anything like that. And so it was a relatively low risk time actually to start and I figured look if if it didn't work out, I could always go back to corporate America.
Um, but luckily uh it worked out very well. And uh here I am almost 20 years later still doing entrepreneurship. >> And we'll talk about your latest baby too. Now for this one, for the first one for patient call, how was that? How did you guys get the band together, you know, and how did you get going? I mean, tell us about the origins. >> Yeah, so I partnered with uh another serial entrepreneur actually. Um, we really split the world almost in half. I took uh product and engineering and operations. He took the the go to market and sales uh side of things. And he had also gone to Georgia Tech, although a number of years before myself. So, we had had known each other from the the Georgia Tech alumni network and had been talking for years throughout my college experience about different ideas and it it kind of finally came time that I was graduating and said, "All right, it's
time to do this. Let's go." Uh, and at that point, we got into, you know, deep idea search mode where we really spent a lot of time thinking about what would be a good idea. And you know unlike a lot of other entrepreneurs that are really kind of missiondriven or solving some personal problem, we took a much more engineering ccentric approach to it in terms of not the technology but in finding the problem and we looked at what were the trends uh what were actual problems and most importantly how can we make money for someone. That's been a recurring theme in my business career is always how can we help a company make money. It's not about time savings. It's not about efficiency. um when you help a company make more money, I've found that it becomes a must-have product and and all of my companies uh all three of them now have have kind of shared that same theme. So, for example, with
patient collab, what were the uh ingredients that made it the idea that you all ended up, you know, thinking like, hey, this is worth pursuing. >> Well, when we started, we actually thought we were going to go out and solve the problem of hospitals and doctor's offices at the time didn't have online bill pay. And this was in the mid200s. And so today online bill pay is commonplace, but back then almost every healthcare payment came through a check. And so the initial idea was let's just electronify all these payments. As we got into it, we quickly realized that the electronification wasn't the core essence of the problem. The core essence of the problem was that most hospitals are only collecting 50 cents on the dollar of every patient bill they send out. So imagine a grocery store. This is the example I like to give people. and in the checkout line, every other person just doesn't
pay and they walk out with their groceries. What do you think would happen to the price of groceries? Well, it would have to double because every other person wasn't paying. Well, guess what? That's exactly what happens in the healthcare realm. And so, when we realized that 50% of patients weren't paying their bills and many of them had the financial capacity to do so, there were other reasons they weren't paying. That's when we pivoted and realized now we can go deep dive on the real problem which is collectibility in in healthcare. >> Now talk to us about the early days. What did they look like and how did you guys go about shaping up to the MVP until you were like I think I think that this is this is heading somewhere. >> Yeah. You know it's really tough because my original company Patient Co. was at the intersection of two of the most regulated industries. on the one hand
financial services and on the other hand healthcare IT so you think about things like PCI and HIPPA and compliance uh it's very very challenging in both of these spaces to get something going from scratch because unlike for example vertical software where you can spin up an MVP and it maybe sort of kind of works there's really no room for error when you're moving people's money and dealing with healthcare data and so it turns out that it's a relatively big build to even get your very first customer and then convincing uh a customer to be the very first one in these highly regulated industries um was really really challenging. Uh luckily we were able to kind of work our way into it by going to friends of friends of friends who owned small doctor's offices and you know then you work your way up to rural uh hospitals that are more like clinics and then you kind of work your way up to
regional facilities and then you know by exit we were working with some of the largest healthcare organizations in the country including BJC Healthcare out of St. Louis and Piedmont out of Atlanta. Um, you know, facilities that had 25 and 30 major hospitals and then thousands and thousands of doctors. So, it's really about just chiseling your way in, wedging your way into that very first one and then working your way up um to bigger and bigger uh clients until you till you've kind of reached um the the type of client you want to work with long term. >> And how were you guys monetizing there? So we were aligning ourselves primarily with the collections. And so we took a piece of every transaction that that came through and we went and we told the hospitals, look, you're leaving 50 cents on the dollar today on the table. If we can help you improve that and collect more, we can take a
piece of it.…