Read the full transcript here:

Meena 0:00

So, we’ve always, from day one, said that the pricing has to be affordable, the pricing has to be in line with what they may have thought they had gone to hospital or otherwise. So pricing has always been middle of the road. We don’t do premium pricing that only a few people can afford. And that’s the reason why we have a fairly large customer base across the country. However, we’ve also ensured that from day one, unit margins are maintained and we never lose money for anything that we do. So that is something which has always been our objective. So the models that we have created are such that gross margins are always solid, the pricing is good for the patient. And we need to work backwards to see how we get the right kind of supply mix and utilization and technology such that we are able to meet our objectives.

Nansi 1:06

Hi, everyone. Before we begin, I would like to share that this podcast is brought to you by Prime Venture Partners. An early stage VC fund led by Amit Somani, Shripati Acharya and Sanjay Swami. Prime is often the first institutional investor in category defining tech startups in FinTech, SAS, healthcare and education, such as Mygate, Quizizz, PlanetSpark, Bolt and Glip. To know more about Prime, visit https://primevp.in/

Siddhartha 1:38

Hi, this is Siddhartha Ahaluwalia. Welcome to 100x Entrepreneur Podcast. Today I have with me Meena Ganesh, Chairperson of Portea. Portea is the largest outside of hospital care startups for patients in India. Meena has been a serial entrepreneur. Meena, Welcome to 100x Entrepreneur podcast.

Meena 1:59

Hi Siddhartha, it’s a pleasure to be here with you today. Thank you for having me.

Siddhartha 2:04

Meena, I would love to know your journey. Your journey has been very diverse. You have been a founder multiple times and you have been an investor. So I would love to know, for our readers, for our listeners, how did you start in your life, what led you to entrepreneurship and about your family background?

Meena 2:23

Sure, happy to share my own journey. Starting with a family background, I come from a middle class services background. My father was in the railways. My mother was a housewife. So that was the background. I grew up with the assumption that I would build a career and in a corporation that was really the understanding, especially after I went to IIM and graduated, that was the real plan. And we set out on that, in the year 2000. I had been working for some years before that. I was with Microsoft at that time. And I had a lot of interactions with a number of software startups. At Microsoft, my role was to work with them to see how we could encourage them to use the Microsoft Back Office platform for the products that they were creating. And in the process, I got quite interested in how startups were being built. In the meantime, my husband, also 10 years prior to that, had already started his first startup. So I had an experience of how it is to build businesses in the days before VC monies and all of that.

So in 2000, the whole bug bit me that I wanted to do my own startup and I looked at what were the interesting areas and found that creating a startup in the BPO customer service space would be an interesting opportunity for us to go after. So that was the genesis of my startup journey. So that was a customer asset that we built. There were other co-founders and jointly we built that and we sold it to ICICI OneSource thereafter I was working with Tesco, which is the UK’s largest retailer, as their founding CEO for setting up their back office and the tech Center in India. I did that for five years, and then became co-founder for TutorVista which was into the, as you termed it earlier as Edtech. It was an online tutoring program for the global markets using Indian talent.

And when we started with that, and then when we looked at India, we saw what we should be doing in India. We realized it was way too early from our proliferation of the internet in India for us to offer online tutoring to the Indian students. So instead we looked at how we could use technology to improve the quality of teaching in schools. So the digital classrooms were created. And thereafter, we moved on to post school tutoring. And then at the end of the, towards the second half of the journey, we started to build schools and actually had 35 schools that we either built from scratch or acquired as a part of the overall TutorVista offering.

So, globally, we were an online tutoring company, in India we were a school’s digital for schools and schools management company. We sold that company to Pearson, in 2011. And from 2011 to 2013, I was still with Pearson, helping them do the transition and integration into the large Pearson environment. Also, we had started our journey on creating other startups. So that’s when we co-founded Bigbasket and promoted Bigbasket with other founders, with the ones that are running Bigbasket on a day to day basis today, Hari Menon and the whole team, they joined us and joined hands with us, and we created that.

In 2013, we had a complete exit from TutorVista-Pearson. And that’s when I started to look at what I want to do over and beyond the other startups that we started to create. So both Bigbasket and BlueStone were launched, even while we were in the transition period. And 2013, when the transition was completed, I wanted to look at the healthcare space. And I felt that there was an opportunity to create something exciting in the healthcare space. And that’s how Portea came about.

Since then, since 2011, we created a portfolio of a dozen startup that we have promoted in and all of them are in some kind of consumer facing businesses, whether it is Bigbasket, BlueStone, HomeLane, or TutorVista or Portea, all these are in various forms of consumer tech in various domains. That’s been the journey. It’s always been, I’ve always looked at where the gaps are in this country, in terms of challenges that we face, or products and services that we wish we had, which would make our life easier and better. And that’s been the motivating factor to identify these various opportunities.

Siddhartha 7:35

And I had previously interacted with Ganesh. So he said that he always likes to start in three domains, which will never go out of fashion in India, Roti, Kapda and Makaan.

Meena 7:46

Roti, Kapda, Makaan, healthcare and education, I would say. Those are the five spaces which will always remain evergreen in this country. There is always something exciting to do in these businesses.

Siddhartha 8:01

And can you share the conception of Portea? What are the different ideas that you brainstormed during that time when you decided that you wanted to start in healthcare? And why outside healthcare care based services that you only focused on? How did you decide that it was like an extremely large market to disrupt? And second, the first steps that you took in zero to one journey?

Meena 8:27

Sure. So like I said, in 2013, I was very keen to explore a new area that I wanted to build a business in. And healthcare was always something of great interest to me. So I looked at the healthcare space and examined where the issues were, where the gaps were. And it was apparent to me that while there has been a lot of investment in the facility based care, and perhaps to some degree in the diagnostic space, the outside of hospital health care is not an area where much investment has happened. Also, it was very apparent, and various studies have also shown that 70% of the healthcare needs of people, citizens are actually to be fulfilled outside of hospitals. But even though such a large quantum of healthcare needs to happen outside of hospitals, it is not there. It is not much that has happened there.

And from my own personal experience dealing with healthcare challenges of my parents, I realized that I had access to excellent hospital facilities for surgeries for large interventions, but when I got them home for managing the day to day care or post operative care, it was a real challenge. There was just nothing of quality and reliability that I could go with. And every day was a struggle to see whether I could really provide the basic needs that my parents had. So part of it was experience, part of it was just seeing the space, and I spent a lot of time talking to a number of people in the space. And people who understand the healthcare ecosystem, people who have worked in this, people who know what works and what doesn’t work. And that sort of informed where we wanted to go. And that’s how we started in 2013.

So in July of 2013, we started the journey. And we started to put together a sort of proof of concept, trying out various models of both acquiring patients and acquiring the manpower. One thing was very clear in our head from day one, that this was going to be a very large scalable business. It is something the whole country would need, there’s an opportunity to create a brand which is recognised for itself. And it could potentially be a pan India brand. Unlike hospital brands, which tend to be more regional in nature, because of the nature of outside of hospital healthcare, it actually is possible to do it as a pan India brand. So to be able to do that, technology was going to be a very important contributor, and literally the foundation to build this business. So these were some things which were very apparent to us. So we started the journey.

End of 2013, we raised our Series A and started to build out the business. And we started with one or two services in one location, and then slowly understood what the customer needs were. And we also realize that healthcare is a very different industry as is education. But healthcare requires you to find ways to cooperate with the rest of the ecosystem, you cannot do it in isolation. So understanding the needs of hospitals, doctors, how you can cooperate with them, how you make sure that they don’t feel that you’re competing and trying to take away their patients, but really extending their care and making their patients better at home. And how do you actually showcase? So while we started by acquiring patients directly through our digital marketing etc, we also right upfront, tied up with some hospitals and doctors, so that we could provide care to their patients. And in that process, we tried out both the models and we started by exploring both these ways of customer acquisition.

Siddhartha 12:46

And can you describe from then, after raising your series A to the journey till now. What have been the various milestones, till now? The number of patients served, the number of homes served, the number of cities you operate in and the number of services that Portea does today?

Meena 13:04

Yeah, so like I said, we started by exploring physiotherapy and doctor on call those kinds of services initially. And if you fast forward today, we are a full service provider, which means that we provide services for primary care, for chronic disease management, for elder care, for post operative care, and postoperative ranging from simple support for patients who just recovered from, from surgeries all the way up to providing ICU at home kind of services. So it’s a fairly broad range of services that we offer. Along with the services, we also provide all the medical equipment that patients might need. So whether it is hospital beds, or mobility, or respiratory, or ICU support services that you need, which requires very, very high end ventilators and multipara monitors and different kinds of beds.

So creating a complete solution for a patient so that they don’t have to run to multiple places to assemble what they need. So that one is the breadth of services. The other thing that we understood over a period of time is that it is important to have solutions. So we started to create solutions for like I said, for patients who are, let’s say recovering from stroke and need a complete ICU kind of setup, which then slowly means some away and gets them back into mobility. For patients with cancer, we have created specialized solutions, for patients who are recovering from cardiac issues or patients with pulmonary disorders. So each of these areas have taken and see what is the full service that they need and make that available to them.

The other thing that we’ve tried very hard is to see how we can improve the payer interface for this. As of now, till perhaps fairly recently, most of the outside of hospital healthcare is private pay, so people have to pay out of their pocket. We have tried to work with insurers and now we are seeing some good movement and some of the leading healthcare insurance and GIC companies have also started to cover home Healthcare also as a part of the insurance offerings. It’s still early days, it’s nascent, but I think people are starting to cover.

The other thing that happened during COVID Was that suddenly there was the whole home health care services or health care services through digital and outside of hospital, suddenly took prominence, because that was the only way that you could treat the huge number of COVID patients through digital or at home, because it was impossible to get hospital beds at many points in time. And some of the conditions did not require hospitalization. So both for people who are mild as well as moderate. And in some cases, people with some degree of criticality, care at home became the only way to support them. But not just for COVID patients.

What also happened, as I’m sure you know Siddhartha, is that hospital beds were just not available for non COVID patients literally all hospitals shut shop for anything that was not an emergency. So even any kind of electives or regular follow ups, or treatments, which ideally they would have gone to hospital, they were not able to go. So many of that also came to the notice of home health care companies and the health setup. For instance, there’s a lot of cancer care that took prominence at home, in which patients may have gone for some of those to hospitals, but decided to stay at home and take the support because there was in some cases, no choice. And in some cases, there was reluctance to go to the hospital.

So all of that has transformed the industry itself. And of course, for us the journey has been interesting. And we are now present in 40 cities. We have served about 12 lakh patients so far in our journey, including a number of patients that we served for the various state governments during the COVID.

Siddhartha 17:40

And how big is the Portea team today?

Meena 17:44

We have close to 4500 people across.

Siddhartha 17:46

And that includes the medical staff as well?

Meena 17:53

Yes, that is Correct.

Siddhartha, 17:54

So, I have been a healthcare entrepreneur Meena from 2012 to 2017. And I think there’s still the notion that continues today that it’s very difficult to make money in healthcare-tech in India, healthcare and healthcare-tech both. Why is the notion that and I’ve seen startups struggle

Extremely badly in healthcare to make money. There is user adoption, but the ability to pay money both from the institution side and the user side is not so high.

Meena 18:27

Well, I don’t know if I necessarily agree with you. I think the problem can be that if there is not a very clear set in requirements for the offer that you’re creating, then people’s willingness to pay becomes always a challenge.

So if, for instance, there are a lot of point of care devices, and I love them, they are very, very nifty. They measure a lot of nice parameters. But the question then comes up in the patient’s mind is, why do I need to do that? Indians don’t very easily look at preventive care. We are far from doing regular checkups and diagnostics to make sure that we are in good shape. Perhaps it’s picked up a lot more in the last decade. But still, we don’t do that. Even people who are very well educated, they have access, have money, they still hesitate to get checkups done, or to measure vitals or do anything that they don’t think is essential.

So what happens is you may have very good devices, you may have very good products, but the customers don’t see the need for it and they don’t understand how it’s going to help them. So that’s a part of the journey and learning. The second part is that some of the products that are created are meant to be replacement for Healthcare Professionals for instance. So instead of sending a nurse to check on you, take this device and you check yourself. Now the cost differential for getting a nurse versus getting a device is still not so high in India, and especially in India, we do have a lot of stay at home nursing, stay at home attendance which are available. So then you have those and you say that they will measure you don’t need a device. So that’s also something that comes into play.

The third is that things like teleconsultations and quote unquote digital health, by themselves find it difficult to monetize. They need to have something more than that to monetize. And that’s why you see them pairing up or adding on services such as labs and pharma, etc, so that there is an ongoing monetization. Otherwise your cost of acquisition does not get covered by just the teleconsultation solutions that you may offer. So it’s a part of evolution.

However, companies like Portia, and other home healthcare companies, we use technology to support a core requirement of healthcare, which is that people, either they go to the hospital or they do it at home, but it is essential and it’s something that is required and they need to do. The issue comes in as if you’re trying to do something which is nice to have rather than just compulsory or which is really essential, and makes a difference to the health of people. That’s where the problem comes in.

Siddhartha 21:36

Dear listeners, before we dive further into the podcast, I would like to welcome Prashant Ganti, Head of Product Management at Zoho payroll and Zoho Books. Prashant, what does Zoho payroll do? And what is the story behind it?

Prashant Kunti 21:48

Zoho payroll is a Payroll solution from the Zoho suite of products. It’s designed from the ground up to completely abstract the payroll complexity and put your payroll compliance on autopilot. So what do I mean by this? So when we talk about abstracting payroll complexity, it means that a business needs to know just who their employees are that they work and how much they get paid. And on putting your payroll compliance on autopilot mode. What we mean is that there are ever changing rules and regulations that affect your payroll, and Zoho payroll takes care of all those things, Business need not worry about all those things.

Siddhartha 22:28

Thank you, Prashant. Dear listeners, you will find more about Zoho payroll in the show notes. Now, let’s further continue with the podcast.

And you think that people still will pay for necessary health care services in India? Which complement a hospital or a doctor, but especially do not replace them?

Meena 22:48

Yes, correct. That’s what our journey has been.

Siddhartha 22:53

And how is the pricing model changed at Portea? Can you share that journey as well?

Meena 23:00

So we’ve always said from day one, that the pricing has to be affordable, the pricing has to be in line with what they may have got if they had gone to hospital or otherwise. So pricing has always been middle of the road, it’s not that we don’t do premium pricing that only a few people can afford. And that’s the reason why we have a fairly large customer base across the country. However, we’ve also ensured that from day one, we make unit margins are maintained, and they never lose money for anything that we do. So that is something which has always been our

objective. So the models that we have created are such that gross margins are always solid.

The pricing is good for the patient. And we need to work backwards to see how do we get the right kind of supply mix and utilization and technology such that we are able to meet our objectives to do this.

Siddhartha 24:06

And what would have been your unique learning building in the healthcare space in India?

Meena 24:12

So like I said, first and foremost, my learning was that healthcare is very different. A lot of people wonder, and it’s difficult to cooperate in healthcare. Perhaps now there’s a lot more cooperation that’s coming in, but there is always a degree of discomfort about what will happen to my patient if my patient will remain solid with me or not. So making sure that those kinds of concerns that people may have about the ownership of patients was something that I had to learn and I had to deal with that. Second is as an outsider there is coming into the healthcare space. Of course I brought in experts right upfront, very senior doctors who had their own brand and were able to open doors, otherwise people wouldn’t talk to you. Because there is, there’s a belief that others outside the industry may or may not understand what really goes into providing good quality healthcare.

So that insularity, the little bit of suspicion, those were things that we had to overcome initially. But once having overcome that, it has been a phenomenal learning journey, just to understand how the customer needs have been changing over time, how it is possible to, to follow the customer, understand their needs, and build a business, which is very meaningful. It’s not just something which makes money or is economically viable, it is extremely meaningful. No other work that I have done so far gives me the same level of satisfaction that I get out of this.

I’ve realized that there’s a huge gap in healthcare services for seniors, Children, and maybe people who are in the working field, get a lot more attention. But the senior citizens, many times they don’t have insurance coverage, they don’t wish to burden their family members, they keep quiet, they don’t take care and when things become really bad, then that’s when they come into the fold. So how do you make sure that they are provided the same level of health care as is provided to other parts of the demographic is something which has been on my mind, and I think we are doing a lot of work to attend to that.

The other area which is coming to the top of my mind, I can’t say I’ve done much on that as yet, which is on mental health. There is very, very clear indication that there is a huge amount of requirement for support in the mental health space. And we need to find solutions, which will help support this requirement and it has become even more acute during the COVID period.

Siddhartha 27:14

And how have you grown as a founder at Portea? What are the things as a founder, because you have been a founder multiple times that you have learned and unlearned at Portea.

Meena 27:24

So Well, every startup that you do, teaches you something new, when of course you learn more about the domain. Portea has taught me patience. Portea has taught me the need to pivot, learn constantly. Portea has taught me that healthcare is a long lead business. You have to really work on it over a period of time before you can start to see real benefits. But once it is well established, the kind of respect and the kind of support that you get from your customer base is substantial. I’ve also learned the importance of cooperating with the ecosystem, working with regulators. All of those are new things which I hadn’t done earlier. And I’ve had to do that now.

Siddhartha 28:20

And what are the leadership principles that you operate by that you believe in at Portea.

Meena 28:26

So my leadership principles, whether Portea or otherwise, remain pretty much similar. I’ve always believed that you lead with head and heart, you don’t just lead with your mind and your intellect, but you also bring in your whole self, you show your passion, you be very clear to people what this actually means to you. And they come along with you because they see your authentic self and your whole self there. Second is that there is always so much to learn in every journey. So as a leader, you need to have the humility to accept that there are many things you may not know. You may not have the answers for that. There might be people in your own teams who know better than you about what’s going on on the ground and we have the solutions. So do you have the ability to listen to them to take insights from what’s coming from them and actually apply that to make your business better.

The third is that remembering that your investors or your board members or others are there to support you and you’re having a win-win relationship with them, especially with your investors is very, very important. Sometimes there are founders who sort of feel that they are on two different sides of the table. I believe that we need to make it as the same side of the table so that we can all work together towards a good outcome.

Siddhartha 30:03

Meena, Can you share your fundraising journey at Portea? Who did you raise your various rounds from and who came on board?

Meena 30:12

So our investor base includes Axel partners, both India and the US venture East. We have IFC and Qualcomm. And in the final round, we had Manipal, CDC and Saber partners.

Siddhartha 30:33

And right now, because you have been on both sides, both being an investor and a founder multiple times. So for a founder at this scale, how hard it is to balance the investor-founder relationship in the long run, because investors might expect a different kind of return when they enter in. But, as things progress might deliver, or might not deliver on the expectation, how do you balance that?

Meena 31:02

Absolutely, Yeah, no, it is, it’s a reality, no investor will believe that everything is gonna go exactly as planned and it never does. They know that as well. The important thing is to be honest, and to share where you stand, and take help in getting to the right place rather than to hide or to not be totally transparent. And that has been my learning. Because at the end of the day, like I said, we have to be on the same side of the table. So how do you make them feel that they are on the same side of the table, so that we can all work together towards a good outcome that has to be the mindset and with which you have to go.

I believe that right at the time you take the investment, making the right choice is important that you have found, you have investors and board members who are aligned with you rather than those that are giving you the best valuation? So that is important.

Siddhartha 32:06

And Meena, my last question to you is, how do you balance your time between Growth Story portea and your home? And how has that changed over a period of time? Were you initially very aggressive as an entrepreneur, like dedicating plus more than 12 hours a day? And has it become more balanced? Or has it remained the same?

Meena 32:32

So yes, every company or every business that I’ve started has said there are times when you have to be 19 hours, I wouldn’t say not even 12 hours, completely committed and dedicated. And it can have a lot of challenges, not just with Portea, but with some of my other startups. Also, I’ve had very, very difficult times and sometimes things are not so challenging. So I believe that work and life have to flow. There is no, there is no balance that you can always be, they are both at the same level. Sometimes one takes up residence while sometimes something else. So you need to see how to make that flow keep going on. And how do you take support from the rest of your ecosystem to ensure that you’re able to do what is right for whichever it is at that point in time.

That said, obviously, from our personal front, my life is a little different now with grown up children. My parents are no more so I have elderly mother in law who I have to take care of. But my discretionary time is more now than it ever was before. So I use it in different ways, though. It’s not just Portea. I’m on the boards of some listed companies, including Axis bank, PNG and Pfizer limited. And I also have a foundation. So those are the other interests which take up my time over and beyond whatever I need to do for Portea and, of course, my other startups.

Siddhartha 34:14

And what has helped you the most to grow as an entrepreneur during the last 20 years?

Meena 34:21

Portea by a long stretch. It’s been transformative for me as an individual.

Siddhartha 34:30

Thank you so much, Meena. It’s been a pleasure having you on the podcast. Thank you so much for sharing your experience, insights. It’s really wonderful. I personally learned a lot and I hope you know my listeners feel the same way.

Siddhartha 34:42

Thank you, Siddhartha. It was lovely talking to you.

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