The summer between my first and second year at HBS I had the opportunity to intern at Main Street Health, a Nashville-based startup focused on facilitating value-based care for rural Medicare populations. Main Street Health works to bridge the gap in health care access for rural communities by establishing partnerships that help Medicare companies implement more patient-centered, outcome-driven care models.

Pivoting into a Startup

Before attending HBS, I worked in consulting, where I focused on health care payer/provider clients. While consulting gave me a strong analytical and industry foundation, I wanted to pivot for the summer and gain hands-on operational experience at a startup. Main Street Health provided the perfect opportunity to do just that—working in a fast-paced, early-stage environment where I could see the direct impact of my work.

Learning About the Challenges in Rural Health Care

During the internship, I had the opportunity to interview 30+ employees from their on-the-ground workforce to better understand their drivers of satisfaction and opportunities to improve efficiency. Through this, I gained insight into the unique challenges and rewards of rural health care. Hiring health care professionals, finding transportation, and even getting an appointment at an overbooked clinic are just a few challenges disproportionately impacting rural communities.

Why Value-Based Care?

I was drawn to this role out of a passion for value-based care, a model that prioritizes patient outcomes rather than volume of services. This model is still evolving, and I wanted to gain firsthand experience with how it functions on a practical level.

Surprising Realities and Key Takeaways

My internship gave me the opportunity to work at an early-stage company for the first time in my career, and I came away with three major lessons:

  1. Pilots are an opportunity to test hypothesis – and gather data to validate their success (or failure). Pivot quickly depending on the results.
  2. It is vital to foster a culture encouraging open and upward feedback in a startup setting. This will instill a value of continuous improvement across the organization.
  3. Know your core value proposition to your customers. You may be tempted to stray from these values at some point and having them continuously in mind can help you avoid pivoting in the wrong strategic direction.

Advice for Aspiring Value-Based Care Professionals

For students considering a career in value-based care, my advice is simple: dive in as soon as you can. This field is intricate and rapidly evolving, so early exposure is invaluable. The sooner you understand the payment models, incentive structures, and operational hurdles, the better prepared you’ll be to make a meaningful impact.

Looking back, my time with Main Street Health was a deeply rewarding experience that reinforced my commitment to health care innovation. I’m excited to bring these insights into my future career and to continue exploring ways to improve health care accessibility.