A Founder's Guide to Finding Focus in Turbulent Markets: Lessons from Nirvana

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In the ever-changing landscape of the technology industry, where market conditions shift rapidly and (somewhat) unpredictably, finding and maintaining focus is essential for the success of any company.

This rings particularly true for early to growth-stage startups, where resource constraints and intense competition necessitate a strategic approach to growth. In a recent interview with Urvish, Co-founder and CTO of Nirvana Health, we delved into their journey of navigating turbulent markets and the strategies they employed to not only survive but thrive.

Introducing Nirvana

Nirvana, led by Urvish Parikh and his co-founders Kelvin Chan, and Akshay Venkitasubramanian, embarked on a mission four years ago to address the critical issue of accessibility in healthcare. Initially, Nirvana aimed to bring cost and coverage transparency to mental health care by streamlining the entire insurance process, from coverage checks to claims filing and payment statuses.

Nirvana raised a seed extension at the tail end of 2021, where deals peaked in volume and value (according to Pitchbook/nvca).

In February 2022, the Fed started raising interest rates, and twelve months later, the effective rate had reached 5% (the last time it had reached that level was 2006). The amount of capital deployed to early-stage companies dropped by 60+%.

The funding freeze sent shockwaves through the industry, leaving many startups adrift. But for Urvish and his team, it was a defining moment— "We knew we had to make a choice," he reflects.

"Before, when we raised money and before that freeze in funding, we had this really large objective... there was a lot of product-market fit, discovery, understanding the problem domain by trying out different products. And then, as soon as the freeze happened, we realized that we need to really choose which problem we want to solve."

The Power of Focus

Amidst the uncertainty, Nirvana narrowed its focus to a single core problem: coverage checks (checking a patient's coverage/verifying benefits). Urvish emphasizes the importance of focus in driving strategic decisions, stating, "The key insight that we had was like, okay, we can try to traverse the problem domain from all of the directions of the problem... Or we can really deeply look at the problem itself and understand if there are key problems that are propagating the larger issue."

By honing in on the coverage check process, Nirvana Health was able to identify the root cause of many downstream errors in their data and workflow. This laser focus allowed them to innovate rapidly, developing sophisticated models to enhance accuracy and efficiency. Urvish explains, "We ended up creating a lot of synergies... So as soon as you have focus, then you're also identifying the problem at its core and then building up the solution with synergies."

For context, this coverage check helps patients avoid surprise bills and make better-informed decisions—and for providers, it helps eliminate the time-consuming and costly work of checking patient coverage and financial details.

Trade-Offs and Sequencing

Urvish's main takeaway from the market turndown: "When the market was really great, it wasn't about sequencing. Let's just conquer the world... But as soon as you have to choose, sequence matters."

Focus may sound obvious, but Nirvana's focus on the core issue of coverage checks narrowed their Total Addressable Market—for the short-term. As soon as they decided to zero in on the core issue of coverage checks, they could model a narrative around the interconnectedness of errors in the insurance process. Urvish explains, "We showed how errors and coverage checks lead to errors in claims filing, that lead to errors in payment status, that lead to money on the table for the customer. And we were able to show this story clearly with every customer. Everyone was on board. You can be very empirical about convincing people."

"I know on the books it looks like we are cutting our TAM [today]... but it's a sequencing thing...we're not saying we're shutting the door. We're cutting our TAM now so we can focus, really get to the heart of the problem. And then as that problem gets fixed at the heart, there's obviously other modifications that are upstream of the problem that we can get to." He explains, "as soon as we set it up as a sequencing thing, it was okay."

Strategic Adaptation in Action

Nirvana Health's success wasn't solely attributed to focus; it was also marked by strategic adaptation and innovation. Recognizing the need to optimize operations, they invested heavily in automation and AI, leveraging technology to streamline processes and reduce manual errors. Additionally, they prioritized building strong relationships with clients and partners, adopting a customer-centric approach to tailor solutions to their specific needs.

"When you start to identify your problem as a complex system where there's a bunch of different actors with different intentions and different objectives, you as a company, it's your job to find some way to order that complexity. And the only way to order complexity is by building feedback loops," Urvish explains.

Looking Ahead

As Nirvana Health continues to chart its course in the dynamic healthcare landscape, the lessons learned from their journey serve as a beacon for other founders. In an era characterized by market volatility and uncertainty, finding focus amidst chaos is not just a luxury—it's a necessity for survival and growth.

In summary, Nirvana Health's story underscores the power of focus, strategic adaptation, and innovation in driving success in turbulent markets. By embracing these principles and remaining committed to delivering value to their clients, they have not only weathered the storm but emerged stronger and more resilient than ever.