Homeward, a healthcare technology company that's raised over $70M, is pioneering a new approach to rural healthcare delivery by combining technology with in-person care. In this episode of Category Visionaries, Amar Kendale, President and Co-Founder of Homeward shares how the company is addressing the 23% higher mortality rate in rural America through an innovative care delivery model and technology platform.

Topics Discussed:

• Homeward's evolution from initial hypothesis to market-validated solution
• The unique challenges of healthcare delivery in rural communities
• Building trust in healthcare through local partnerships
• Technology's role in scaling healthcare access
• Value-based care implementation and criticism
• Market entry strategy for healthcare technology companies

GTM Lessons For B2B Founders:

1. Start with Operations, Not Technology: Amar emphasizes the importance of avoiding the "technologist's trap" of building before understanding. As he notes, "There's a trap a lot of technologists fall into... you have a vision for the way that technology can play a role, and you decide to start building first before you really know whether it's exactly the right problem or not." Instead, Homeward built minimal technology initially, embedding their tech team with clinicians to understand workflows before building solutions.
2. Challenge Initial Assumptions Through Market Testing: Homeward's early hypothesis about rural healthcare needs was incorrect. They assumed people without regular doctor visits needed primary care, but discovered that rural patients had doctors for acute care—they needed supplemental services for preventive care. As Amar explains, "What's different about the way people are consuming healthcare in rural is the thing we have to pay attention to."
3. Build Trust Through Local Presence: In healthcare, trust is paramount and historically local. Homeward succeeded by hiring local medical assistants and community health workers who understand the communities. "They have a really high degree of cultural competency. They are ambassadors for the Homeward brand... who can help us to spread that message," Amar shares.
4. Choose Strategic Markets for Scale: When selecting initial markets, Homeward focused on states with large Medicare populations to ensure sufficient scale. "You could easily die by a thousand cuts if you go after too small a market," Amar explains. Their success in Michigan and Minnesota created a template for future market expansion.
5. Design for Multiple Stakeholders: Healthcare technology requires satisfying multiple stakeholders—patients, providers, and payers. Amar warns, "If you focus on the patient and the payer and you leave out the provider, well, you may never get prescribed and you may never show up in the provider workflow." Successfully navigating this complexity creates defensive moats against competitors.
6. Partner with Long-Term Vision Aligned Investors: Homeward chose investors who shared their vision for transforming rural healthcare. Their lead investor, General Catalyst, pushed them to think bigger: "We were sheepishly sketching out the path to being a billion dollar business. And Hemant added the zero. He said this is easily a $10 billion business."
7. Focus on Early Validation and Responsible Growth: Despite rapid expansion (3-4x annual growth), Homeward maintains disciplined growth. Their approach is validated by an 80 NPS score, which Amar notes is "better than we ever did at Livongo or any other place we've been."

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