A.G. Breitenstein stands as a legendary figure in the arena of healthcare innovation - a visionary entrepreneur with a deep commitment to inclusivity and equity. Her journey from an advocate for LGBTQIA+ youth to a pioneering force in health technology showcases a dynamic career built on the principles of accessible and equitable healthcare. A five-time founder, a few of A.G.'s most notable ventures include the creation of Humedica, which became a linchpin in health analytics, and Folx Health, a groundbreaking telehealth platform catering to the LGBTQIA+ community. Her roles have spanned from Chief Product Officer of Optum Analytics to founding partner at Optum Ventures and Venture Partner at the largest digital health VC fund in the US, Define Ventures.
A.G.'s work transcends entrepreneurship; she has been a fervent advocate for privacy and digital health innovation, contributing to policy and governance through significant roles. With an educational background from Yale, the University of Connecticut School of Law, and Harvard’s School of Public Health, A.G. embodies the spirit of a trailblazer whose efforts have not only advanced healthcare technology but ensured it serves the needs of all, especially the underserved and marginalized. As we delve into A.G.'s story, her journey from a legal advocate to a healthcare innovator reflects a relentless pursuit of a more inclusive and equitable healthcare system.
Formative Years
In the quiet suburbs of Connecticut, amidst the idyllic sprawl of bedroom communities, A.G. Breitenstein's formative years unfolded far from the complexities of the LGBTQIA+ community's struggles and triumphs. A self-described tomboy, A.G.'s childhood was marked by a spirited freedom, exploring the woods and embodying the untamed curiosity of youth. This early life, rich with outdoor adventures and absent of any open discussions on queer identities, encapsulated a world where LGBTQIA+ topics were invisible, seemingly nonexistent to A.G.’s young and adventurous spirit.
High school brought with it a burgeoning awareness and a profound sense of isolation. No one around her was openly gay, and the silence around queer identities only intensified her feeling of being an outlier, of possessing an unspoken difference that could not yet be named. It was a 1983 horror film, "The Hunger," starring Susan Sarandon and Catherine Deneuve, that cracked open a window to a world A.G. had never imagined - one where her nascent understanding of her own identity found a flicker of recognition. The film, with its depiction of a complex, queer relationship, was a revelation, marking the beginning of A.G.'s journey towards self-discovery, a path that would only truly unfold in her college years.
The Streets of Boston
The path to finding her place in the world was not straightforward. A.G.'s mother was a scientist at Yale and A.G. initially explored following in her scientific footsteps. Yet, it was the crisis unfolding at the height of the AIDS epidemic that would ultimately call her to action. A.G.’s foray into healthcare was not born out of ambition alone but from a deeply personal confrontation with the realities of the AIDS epidemic during her college years. Coming out at a time when the LGBTQIA+ community was embroiled in a life-or-death battle for recognition and rights, A.G. was driven by a fervent desire to enact change. "It was very different from today," A.G. reflects, "there was no gay marriage, and queer and trans folks didn't have many rights. It was still very much about activism, saving our lives and taking care of our bodies." This period of activism was not just a backdrop for A.G.'s future endeavors but the crucible that forged her path.
After graduating from law school, A.G. was moved by the plight of those around her. She ventured to Boston, a city that would become the crucible for her activism and entrepreneurial spirit. In 1994, at the apex of the HIV crisis, she founded a nonprofit, the Health Law Institute, dedicated to the welfare of queer and trans kids navigating the harsh realities of street life.
The coming out process for LGBTQIA+ individuals is fraught with the fear of rejection, a fear compounded by the potential loss of family, home and community. The experience of sudden, life-altering rejection, cutting across lines of race, ethnicity, and income, remains a poignant reminder of the ongoing struggles within the LGBTQIA+ community. For many young people, the act of revealing their true selves can precipitate a cascade of consequences, stripping away the veneer of safety and belonging that every child deserves. This stark reality was vividly observed by A.G. in Boston, where the absence of a support system for these individuals was not just a failure of family or friends but a systemic issue that demanded urgent attention. The situation impacted A.G. deeply, driving her commitment to advocacy and support for those cast aside by the very structures meant to protect them. Her efforts shone a light on the essential humanity and dignity of every individual, advocating for a world where coming out is not met with loss but with love and acceptance.
Moved by the plight of these young individuals, A.G. took action. Collaborating with passionate allies, she worked to provide not just the basics of food and housing but also medical care and legal support - a recognition that the challenges faced by these youth were complex and intertwined with legalities often beyond their control.
This endeavor quickly became part of a larger effort, providing A.G. with a front-row seat to the healthcare system's stark inequities. The experience was eye-opening, revealing a healthcare landscape that was not only inhospitable but often downright adversarial to those on the margins. "Trying to help them get access to health care was a nightmare," A.G. recalls, highlighting the systemic barriers that obstructed even the most basic care for these vulnerable populations. It was a realization that the law, with its slow machinery of justice and reform, might not be the most effective tool for the kind of immediate, systemic change she envisioned.
Pivoting from Law to Public Health
The challenges that unfolded before A.G.’s eyes on the streets of Boston caused her to reconsider her career. The decision to leave law and pursue a degree in public health was not taken lightly. It represented a significant pivot, driven by the recognition that the complexities of healthcare access and equity required not just legal advocacy but a deep understanding of public health dynamics. A.G. matriculated at Harvard to pursue a degree in Public Health.
During her studies, A.G. found herself at the intersection of healthcare and law once again, this time tasked with drafting health privacy legislation for Massachusetts. Despite feeling unprepared - "I was a 24-year-old who totally didn't know what the hell I was doing," as she humorously put it - this experience offered her invaluable insights into the healthcare industry's inner workings and the critical importance of data in shaping health outcomes and policies. The experience also allowed her to meet “all of the leaders of the hospitals and plans and major delivery organizations. I was embedded in the whole tapestry of the provider industry in Massachusetts. One of the things we heard resoundingly across all those constituencies was the need for data.”
A.G.'s work on privacy legislation underscored a pivotal gap in the healthcare system: the lack of comprehensive, actionable data. It was a revelation that spurred her interest in data analytics and its potential to transform healthcare delivery and outcomes. "So while I was writing privacy legislation, I was also getting really immersed in data and being able to use the data to tell the story of what was going on," A.G. explains. This dual exposure to the legal and data-centric aspects of healthcare crystallized her entrepreneurial vision, igniting an idea to leverage technology and data analytics to address the systemic flaws she had witnessed firsthand.
The Entrepreneurial Bug
Reflecting on the motivation behind her entrepreneurial ventures, A.G. recounts, "nonprofits were great, but then we had to do the bidding of the state or the federal government. That's when I fell in love with building companies because it was a fast, direct way to make a lot of change." This sentiment encapsulates A.G.'s approach to entrepreneurship: as a means to effectuate rapid, impactful change in a broken healthcare system.
Embarking on the entrepreneurial path, A.G. ventured into the world of startups with a keen interest in data and analytics, despite her own admission of having no clear roadmap. This leap into the unknown was not just a career change but a commitment to exploring innovative solutions to entrenched healthcare problems.
Recruited during her MPH studies at Harvard by a group of Boston entrepreneurs, A.G. embarked on a journey that would fundamentally alter her career trajectory and the landscape of healthcare data utilization. With no prior experience in the startup world, or nuanced understanding of business dynamics, A.G. quickly became enamored with the rapid pace of development and the immediate impact possible through innovative approaches to healthcare data.
The early years at Humedica were characterized by a synergy of minds between A.G. and her co-founders. Initially met with skepticism, Humedica's journey was one of overcoming doubts and demonstrating the untapped potential of healthcare data. The prevailing belief that no one would be willing to share their data with Humedica was quickly dispelled as the company managed to secure information representing 10% of the American population. This achievement underscored a critical insight: the healthcare industry was not resistant to change but was in desperate need of innovative solutions that could unlock new value streams and improve care delivery.
Humedica's success lay in its ability to rewire the industry's approach to data, moving beyond the limitations of existing practices to introduce models that showcased the benefits of data analytics in driving value-based care. Before Humedica, the utilization of Electronic Medical Records (EMR) data was minimal, with only a 5% penetration rate in 2008. The company's bet on the future of EMRs, and its pioneering work in EMR data analytics, set it apart from contemporaries focused solely on claims analytics.
Within four years, Humedica built a formidable data asset encompassing approximately 25 million lives and was purchased by UnitedHealthGroup. When combined with Optum's claims data, the platform offered a comprehensive view of patient care spanning over 130 million lives. This merger of EMR and claims data was a cornerstone in the evolution of value-based care, showcasing the critical role of data in transforming healthcare delivery and outcomes.
Revitalizing Healthcare.gov
The crisis surrounding Healthcare.gov served as a unique proving ground for A.G.. "About nine months after we sold Humedica to Optum, Healthcare.gov fell apart," A.G. recalled, highlighting the urgency that led to her involvement in Washington, D.C. Amidst national media attention and Senate hearings, the project was a pressure cooker, demanding not just technical expertise but unparalleled leadership and problem-solving skills. A.G. was among the few chosen by Optum to tackle this colossal challenge, joining a small, elite team thrust into the spotlight with a clear mandate: “fix Healthcare.gov, no matter what it takes.”
The approach to solving the Healthcare.gov debacle was as innovative as it was effective. Faced with a complex puzzle exacerbated by the involvement of six different agencies, each with its legal and administrative responsibilities, A.G. and her team employed a radical strategy. "We actually took all of the people who had legal responsibility and we put them in rooms in a hallway," she explained. This unconventional method - literally corralling decision-makers into a single space to expedite approvals - epitomized the kind of bold, outside-the-box thinking that A.G. had come to embrace. It was a testament to the power of direct action and clear goals in navigating bureaucratic complexities.
This chapter in A.G.'s career not only showcased her ability to steer through a high-stakes crisis but also solidified her belief in the potential of targeted, entrepreneurial solutions to "tame a big beast." The experience at Healthcare.gov illustrated that with the right resources, a clear objective, and the freedom to act decisively, transformative change is achievable. It was a lesson in the efficacy of combining entrepreneurial zeal with the scale and scope of government projects - a blend that would come to define much of A.G.'s subsequent ventures and her approach to healthcare innovation. The complexities of the healthcare system, formidable though they may be, are not insurmountable with the right impetus and strategy. This realization would continue to influence A.G.'s career, driving her towards endeavors that marry the efficiency and innovation of the private sector with the scale and impact of public health initiatives.
The Optum Octopus
Following the resurrection of Healthcare.gov., A.G. embarked on a new chapter with Optum, stepping into the role of Chief Product Officer for Optum Analytics. This position presented her with the formidable challenge of navigating an organization she likened to a "giant octopus," a testament to Optum's vast and multifaceted engagement across the healthcare sector. Optum, known for its extensive reach - spanning payer, provider, and virtually every other aspect of the healthcare system - offered A.G. a unique vantage point from which to understand and influence the industry's inner workings.
However, A.G.'s entrepreneurial spirit and preference for agility over the inherent inertia of large organizations led her to contemplate departure. It was during this period of transition that she was presented with the opportunity to shape and lead Optum Ventures. Tasked with establishing Optum's venture fund as a wholly independent entity, A.G. crafted the fund's originating thesis and spearheaded its initial years. This venture fund represented a novel approach for Optum, strategically positioning it to invest in and nurture healthcare innovations with the potential to significantly impact the industry.
A.G.'s journey through the ranks of Optum and her leadership within Optum Ventures underscore her unparalleled ability to navigate, influence and innovate within the healthcare industry's most influential circles. Yet, it also reaffirms her fundamental drive toward entrepreneurship and her commitment to advancing healthcare through more nimble, impactful ventures. After a brief "time on the beach," as she wittily noted, A.G.'s relentless pursuit of innovation and impact continued, underscoring her indelible mark on the healthcare innovation landscape.
The Birth of Folx Health
The inception of Folx Health was rooted in A.G.’s own experiences and a clear recognition of the unmet healthcare needs within the LGBTQIA+ community. The concept was straightforward, almost intuitive, born from a lifetime spent navigating the edges of a healthcare system that consistently failed to recognize or address the specific needs of queer and trans individuals. The venture into founding Folx Health was catalyzed by a simple yet profound conversation with Lynne Chou O’Keefe, the Founder and Managing Partner of Define Ventures. Lynne was immediately on board, which prompted A.G. to leap into action. As COVID-19 began reshaping the world, A.G. closed Folx Health's seed round, setting the stage for a venture that would swiftly gain momentum.
Folx Health emerged not just as a healthcare provider but as a revolutionary platform designed by, and for, the LGBTQIA+ community. It sought to dismantle the barriers to access and care that had long plagued queer and trans individuals, offering services such as hormone replacement therapy (HRT) and pre-exposure prophylaxis (PrEP) through a virtual model that meets patients where they are - both geographically and in their personal healthcare journeys. This approach was particularly vital during the pandemic, underscoring the flexibility and resilience of virtual healthcare.
A.G.'s leadership at Folx Health was driven by a vision to provide healthcare that was not only accessible and competent but also affirming and celebratory of the queer and trans experience. She understood firsthand the dismissive and often discriminatory treatment faced by LGBTQIA+ individuals within traditional healthcare settings. These experiences solidified her resolve to create a healthcare environment where queer and trans people were not merely tolerated but seen, heard and celebrated.
Under A.G.'s guidance, Folx Health rapidly expanded, offering its services in numerous states and working towards nationwide coverage. The emphasis on affordability and accessibility addressed the significant challenge of healthcare access for uninsured or underinsured members of the LGBTQIA+ community, making crucial treatments like HRT and PrEP more attainable.
More than just a healthcare provider, A.G. has transformed the healthcare experience into one that enhances the quality of life and joy for the patient. By placing healthcare directly in the hands of those it serves, Folx Health has taken a bold step towards a future where healthcare is fully inclusive, affirming, and supportive of the goals and identities of every individual it touches.
Expanding Personal Freedom Through Health
Throughout her illustrious career at the nexus of healthcare and technology, A.G. has been driven by a singular, profound philosophy: “the expansion of personal freedom through health”. This guiding principle, while seemingly broad, encapsulates her deep-seated belief in the power of healthcare to enhance our ability to engage with the world, realize our potential, and express our true selves. "It's always been about expanding the zone of freedom for people," A.G. asserts, reflecting on her journey. This ethos has not only shaped her professional endeavors but also the very essence of her contributions to healthcare innovation.
A.G.'s approach is rooted in the understanding that health is fundamental to personal autonomy and self-actualization. "When we are healthy, when we have the ability to be in our bodies and to be healthy, it expands the range of what we can experience in the world," she explains. Her work, particularly with Folx Health, exemplifies this conviction, aiming to open the aperture of healthcare to support individuals in becoming the fullest expression of themselves.
For A.G., the ultimate goal is to dismantle the barriers that prevent people from seeking care, whether due to fear of judgment or the healthcare system's inherent biases. She champions a model where individuals can approach healthcare providers without hesitation, asking questions and seeking care without fear of discrimination. This vision was partly inspired by the success of platforms like Hims, which addressed erectile dysfunction openly, challenging the stigma of discussing such issues with healthcare providers.
At the heart of A.G.'s philosophy is the conviction that health equates to freedom. By broadening the definition of health, she believes we can similarly expand the definition of freedom, creating a world where healthcare is a catalyst for personal liberation and societal transformation. Through her work, A.G. Breitenstein continues to challenge the status quo, advocating for a healthcare system that not only treats but empowers, celebrates and truly sees the individuals it serves. Her journey and achievements underscore a relentless pursuit of a more inclusive, equitable healthcare landscape, where every individual has the freedom to be their most authentic self.
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