Which health care startups will succeed? Which ones will fail? Disruptive Innovation Theory provides one lens to help us predict the answer, and Jobs to Be Done Theory provides another. Disruptive Innovation describes a process by which a product or service initially takes root at the bottom of a market – typically by being less expensive, more accessible, or targeting nonconsumers – and then relentlessly moves upmarket, eventually displacing established competitors. Many new entrants in health care are not disruptive by this definition, but does that mean they won’t successfully out compete the incumbents? Not necessarily.
Jobs Theory helps explain why. Jobs is a framework to better understand customer behavior. While conventional marketing segments a market by demographics and product attributes, Jobs focuses on the functional, social, and emotional drivers that explain why customers make the choices they do. People pull products and services into their lives to achieve their desired progress, and this progress is the job someone is trying to get done.
Organizing a new business model around a customer’s job gives companies a competitive advantage and fuels its growth. Understanding the job allows the company to more effectively develop solutions that match the progress people seek. Taking a Jobs approach is especially effective in markets where existing solutions are misaligned with customers’ priorities. In his book, Competing Against Luck, Clay Christensen shares how companies that organize their business models around serving a job to be done have a competitive advantage over those who do not. Without understanding the job, and organizing around it, organizations are effectively “competing against luck.”
Many new entrants have a competitive advantage without being disruptive. They gain this advantage from their decision to build highly focused business models around a job to be done. By addressing the job better than incumbent offerings, these new entrants win with consumers, make the market larger, and grow rapidly as a result.
Women’s health startups are organizing around the job to be done for competitive advantage
Two startups organizing around a job to be done are Tia and Parsley Health. For the sake of this analysis, we will use a simplified job statement to describe the job to be done these models serve. The statement looks something like, “When I’m exhausted by seeing multiple doctors to address my health concerns, help me get to the root cause of my issues in one place, so I can feel like myself again.” Let’s look at each one’s approach to organizing around this job.
Women make the vast majority of family health care decisions, yet most health care solutions are built by males. Tia, a hybrid and whole-person health solution built for women by women, is seeking to change that. Through their virtual and in-person approach they offer primary care, mental health services, gynecology, and wellness offerings such as acupuncture. Tia seeks to care for women across their lifespan through relationship-based – not transactional – care.
In September 2021, they received $100 million in a Series B round to expand their model, with a stated goal of serving 100,000 women by 2023. As there are key women’s health services – such as obstetrics and cardiology – that are outside of Tia’s scope, the start-up is forging partnerships with health systems to provide these services along with care continuity.
When women visit their primary care provider and gynecologist through traditional avenues, they have to visit two different doctor’s offices and see two different providers. Most internal medicine or family medicine practices do not provide complete gynecological care, and thus the woman must go to one doctor for her reproductive health needs and another for general preventive care and acute health issues. Additionally, should they need mental health services for anxiety or depression, many GYNs and PCPs would refer them to a mental health provider.
This is not an optimal solution for the job to be done listed above. Seeing multiple disconnected providers requires many visits and retelling of one’s personal history. Without clear interfaces between specialists and primary providers, details fall through the cracks and solutions are often suboptimal. Tia is integrating these services under one business model to address these pain points and better serve the job to be done.
Parsley Health is a holistic women’s health practice that addresses the root cause of chronic conditions. Melding traditional and functional medicine approaches, a care team of doctors and health coaches partners with patients to uncover and address the root cause of their conditions. With a full picture of the patient’s health history, providers create a plan for long-term health and healing. Their offering to receive care in-person or online was in motion pre-pandemic, and it fueled Parsley’s extreme growth in 2020. Membership grew 20x between February and December of that year.
Now six years after its founding, Parsley is one of the national leaders in holistic health and is available nationwide via telehealth. While their approach is more convenient and accessible than the disconnected offerings of traditional primary and specialty care, it is potentially less affordable. As so many of its resources – like health coaches – and processes – like longer visits – run counter to existing health care business models, Parsley must operate within a different value network. Instead of accepting insurance, Parsley members pay $175/month out of pocket. They are able to submit this to their insurance company for out-of-network reimbursement, but unlike traditional doctors, Parsley doesn’t handle this step.
Given their growth, it appears Parsley is addressing the job better than many incumbent alternatives. Their outcomes support this position as well. Within a year, 80% of their members see improvement in their symptoms and feel better, and 77% reduce the number of medications they are taking. Lastly, they claim to provide 22 times the support of a traditional PCP, though it’s unclear how this is calculated.
Both organizations are growing as a result of organizing their business models around a job to be done. Because of how they’ve organized their resources, processes, and priorities, they deliver on the job better than incumbents. As a result, they’ll be able to outcompete those who can’t – or don’t – pivot their models to address the job.
How should incumbents respond?
The answer to this question was best stated by Clay Christensen when he wrote, “What matters is not the product attributes you rope together, but the experiences you enable to help your customers make the progress they want to make.”
Focusing on improving the patient experience within an incumbent’s existing model of care is the wrong place for leaders to place their attention. To stop competing against luck and win the hearts and minds of consumers, it’s critical to uncover the progress they seek. Then leaders must reorganize their resources, processes, and priorities in a way that enables them to effectively serve the job to be done. Organizing around the job includes creating measures of success that matter to the consumer, not just focusing on historical measures associated with the traditional business. For most incumbents, organizing around the job is best tackled through the creation of an autonomous business unit, separate from the core operations.
Deciding to organize one’s business model around consumers’ jobs to be done is a strategic choice. One could also choose to continue competing against luck. It just might leave them without the ability to compete for very long.