An exclusive Tech Tribune Q&A with Stephanie Strong (founder and CEO) of Boulder Care, which was honored in our:
Tell us the origin story of Boulder Care – what problem were you trying to solve and why?
Before starting Boulder, I was at a venture capital firm investing in healthcare services & technology innovations. One of our portfolio companies was a group of brick-and-mortar addiction treatment clinics. Immersed in these centers, I saw firsthand the lifesaving power of medications for addiction and how the right treatment could truly help transform the lives of people with opioid use disorder (OUD). But I also met patients who were facing immense barriers, both in the midst of their treatment, and directly because of it.
In-person care demands frequent trips to the clinic, counselor, and pharmacy, often with long commutes with limited transportation, while juggling work and childcare. It was pretty clear that telehealth could solve a lot of these problems. The trouble was, existing clinics were financially incentivized not to invest in telehealth, instead making money by demanding more in-person visits and more drug testing, despite worse outcomes. It became clear that we needed to build a new model from the ground up, one that realigned incentives between health plans and providers around keeping patients well. That’s when I decided to build a virtual treatment company that was built to address these barriers head-on, using technology, multidisciplinary care teams, and value-based payment models to improve the patient experience, while decreasing costs to the system.
What was the biggest hurdle you encountered in your journey?
When we started Boulder in 2017, there was a lot of cynicism about telemedicine for addiction treatment. Investors and incumbent institutions said people in the throes of addiction weren’t capable of using technology or making their own care decisions, that low-income, rural Americans weren’t consumers VC-backed companies build products for, and that Medicaid was not a viable customer to realize ROI.
We were fortunate to have a health plan partner who believed in our vision and became our first customer, enabling us to design a payment model grounded in value and outcomes. This all predates the COVID-19 pandemic, but as soon as the pandemic began, things really accelerated. Clinics had to close, but we stayed open, and the rules around remote addiction care changed significantly with the declaration of the public health emergency in 2020. These regulatory changes removed additional barriers for our patients, and helped us prove how effective our remote treatment model could be. We have been able to focus on working with underserved and vulnerable populations and still get retention and success rates that are more than double the industry average. Having the time to prove what we knew to be true (that people could thrive in a supportive, low-barrier recovery environment) has really helped us change hearts and minds.
What does the future hold for Boulder Care?
Boulder has had a lot of success serving thousands of patients in Oregon, Washington, and other core markets like Ohio, North Carolina, and Colorado. As we expand nationally, we stay true to our mission and ensure we really become a part of the local community each time we enter a new state. We might be a company driven by technology, but we know our people and their connection to communities is key. Having a local focus allows us to partner with other organizations on the ground (including primary care, health systems, and social services organizations) and offer our patients whole-person care. We’re very focused on serving low-income Americans (80% of our patients are on Medicaid), a population that many other treatment options turn away. And we can continue to do that at no cost to the patient by showing health plan partners how Boulder’s program reduces costs by shifting their spend from expensive rehabs or emergency care to preventive, evidence-based care at home. Because the truth is, continuing to achieve great patient outcomes not only helps us save lives, it is also the best way to prove to our partners that quality, patient-first treatment is good business.
What are your thoughts on the local tech startup scene in Portland?
Portland is a really supportive community with such a vibrant, innovative spirit. In 2019, we relocated the company’s headquarters from Brooklyn, NY to Portland, where we currently have an office downtown. Portlanders are thoughtful, creative, and mission-driven, excited about dedicating their talents to social impact at scale. That’s the recipe for a successful startup.
Many of Boulder’s patients live in rural or frontier Oregon, an extremely different culture than Portland. It is deeply fulfilling to bridge some of these gaps, geographically and philosophically, recognizing that addiction wounds all of our families and communities equally, and we must come together and unite around solutions that help people get better.
What’s your best advice for aspiring entrepreneurs?
I love Michelle Obama’s notion that we must see the world not only for what it is, but what it should be. That’s where you might focus. What would you change about the world? Then unpack the evolution of an industry or problem – how did we get where we are, and what might we do differently? I also encourage founders to think critically about how you will align your business and your values. Once companies get big, they often lose sight of what’s important, stop responding to critical feedback from their customers, or fail to do the right thing because they’re prioritizing near-term revenue over long-term value. At Boulder, doing the right thing for our patients with unconditional support is our North Star. Finally, surround yourself with great people who understand your vision and share your values, and empower them. I attribute Boulder’s success to our diverse teams of caregivers, technologists, and builders, and see my role as keeping them feeling supported, inspired, and aligned on a shared vision.