[Editor’s Note: This story is part of a “Where Are They Now” series on startups named to NC TECH’s annual Top 10 Startups To Watch list from 2014 to the present. You can find the main story here. There are also six other feature stories on startups from the NC TECH lists that are no longer active standalone companies: Organic Transit (2014 list); Tiger Eye Sensor (2015); Tourpedo (2015); EmployUs (2016); Cultivate (2017); and myBeeHyve (2018).]
When Durham-based Forecast Health was named to NC TECH’s Top 10 Startups To Watch list in 2016, the startup had no plans of being acquired, said Forecast Health’s Co-Founder and chief analytics officer Michael Cousins.
But in 2017, it was official: St. Louis-based Lumeris had fully acquired the company and suddenly had a new branch office in Durham courtesy of the Forecast Health team.
Forecast Health began in 2014 out of a desire to help hospital systems improve patient outcomes and increase revenue with advanced analytics. The startup’s tools enabled hospital systems to incorporate more specific personal data on top of health or claims data to improve predictive ability. With Forecast Health, healthcare companies could better identify and manage a population’s health risks and see if a patient’s profile matched those who had success rates with specific programs.
While Cousins has a PhD in neuroscience, he jokingly said that he got an MBA from watching Shark Tank. So the transition to running a business after being used to solely focusing on the science side of healthcare predictive models was challenging.
Even so, Forecast Health grew to 11 clients and received valuable external recognition from the Society of Actuaries and from NC TECH. They also had successfully raised $5 million in a Series A round.
“We were really hustling,” Cousins said, “and so having frankly any validation was really a shot in the arm.”
Though at the time, Cousins said, Forecast Health was still mostly just a group of people who believed they could use the mining of personal data to create a more accurate method of predictive analytics for the healthcare industry, helping both patients and hospital systems.
“We honestly had modest goals,” Cousins said. “We weren’t trying to take a bite out of the $4 trillion healthcare [market] or all the platitudes that come out of Silicon Valley. We were a lot more blue-collar about it. We just wanted to get some clients and help them improve patient outcomes.”
By 2016, Cousins and his team had begun asking themselves what race they wanted to run. The choices were clear: stay independent, or grow bigger much faster as part of a larger company. The first path still seemed fully viable given that Forecast Health had already picked up momentum—they had secured funding and grown a client base. Still, they were realistic about how much further they had to go.
“As good as we were feeling in 2016 about our progress,” Cousins said, “we also knew we were a dinky little player.”
Lumeris was supposed to be a potential client for Forecast Health, but the more they got to know them, the more they discovered they could be a great fit, Cousins said. The reality check was that Forecast Health simply didn’t have the depth of relationships in health systems across the country that Lumeris did. Lumeris was the perfect, more mature company to bring Forecast’s capabilities and tools into hospitals nationwide.
Since the acquisition, Cousins transitioned into the role of Chief Analytics Officer at Lumeris. He is honest about the difficulties in getting to this point: “Trying to break into healthcare and change health care is freaking ridiculously hard.”
There is a tendency among hospital systems to not want to change, and a host of lobbying issues at play. If he had known what he would face, Cousins said he probably would never have started Forecast Health in the first place.
Going from zero to one
But in some ways, ignorance is bliss. And to this day, he’s so glad he did start Forecast Health because it changed his life.
“To go from nothing to creating something, it just feels so good,” Cousins said. “That really helped me feel like, not that my work here on Earth is done, but really helped me feel like I was making a positive impact.”
Cousins added, “I’m glad no one could really ever paint the picture of how hard it would be for me. People tried, but they couldn’t have done it. It is impossible.”
Still, he encourages other entrepreneurs to go for it. Life is short. But he advises them to reflect deeply on whether their product ideas are truly differentiated.
“Don’t kid yourself on that,” Cousins said. “And the reason you don’t kid yourself is because you have to have the conviction on what you’re doing, because the challenges are so great and you’ll need to stick to it.”
Since working at Lumeris and leaving the startup grind, Cousins no longer works constantly, seven days a week. He is able to focus on what he does best—concentrating on the science behind the analytics as opposed to running an entire business operation. He has zero regrets about the acquisition.
He’s proud of the work the Forecast Health team did to get to this point. Now, Cousins spends 80 percent of his time thinking about succession planning and staff development, he said. As he looks ahead, through Forecast Health and now Lumeris, Cousins said he has found a more fulfilled life.
“Every day is not a walk in the park,” Cousins said. “Of course, it’s not. But I do feel like we’re able to fulfill our mission that we started at Forecast Health.”