Lessons from April Koh, the Youngest Female Unicorn Founder and CEO of Spring Health

I’ve had a lot of non-consensus convos these past couple weeks that have left me wanting more for society but not know how that will transpire in reality.

I’m big on celebrating wins for any marginalized individual but in the same vein I’m never wanted to be known as the first women or first South Asian or first first-gen American accomplishing something. I want to known by name as the best end of story. I understand that’s not what all of us want and that it’s also important to acknowledge the progress that is made within our communities. I believe there will be a new wave of entrepreneurs, investors, artists, filmmakers/producers, creators, intellectuals, etc. that will not sell out and be one of many holding the highest positions in an organization/company. Shout out to my brown girls for this one - Vaneezeh and Bhargavi (more to come on Brown Girl Angels)

Major thanks to my friend Edwin Ong and the Asian Hustle Network for today’s interview!

Born in a Yale coffee shop from a groundbreaking research paper, Spring Health is a comprehensive mental health solution for employers and health plans. Unlike any other solution, Spring Health uses Precision Mental Healthcare to seamlessly pinpoint and deliver exactly the right fit for each person — whether that’s digital support, meditation exercises, coaching, therapy, medication, and beyond.

At just 29, April Koh led Spring Health to unicorn status with a $2 billion valuation, transforming her own experiences with mental healthcare into a revolutionary platform that matches employees with personalized mental healthcare solutions. Earlier in 2024, April and her team raised a $100M Series E at a $3.3B valuation. The company now connects 13,000 providers with patients worldwide through its team of 1,300 employees.

We are excited to share six hidden lessons for founders that we learned from our research and exclusive interview with April Koh, founder and CEO of Spring Health.

1. Driving profits is not mutually exclusive with driving positive social impact at scale.

Spring Health’s mission is to eliminate every barrier to mental health, something that squarely fits the description of positive social impact, and yet, they are incorporated as a for-profit. April explains that financial success and the mission can act in alignment to drive large-scale impact.

“We built Spring Health as a for-profit company because we believe that's the most effective way to drive large-scale impact in mental healthcare. Our goal has always been to eliminate barriers to mental health, and our for-profit model allows us to attract top talent, scale rapidly, and continuously innovate… One of the rewarding things about our business is that our impact and financial success are correlated. That’s one of the reasons we recently announced an industry-first performance guarantee on our mental health services, promising that for every dollar spent on clinical care services, customers save more than a dollar in overall health plan costs.”

2. If you are a minority founder, leverage your lived experiences to your advantage.

The usual discussion around being a minority founder is how being a minority puts you at a disadvantage. Less commonly discussed is how your experiences can precipitate as qualities that make you a better founder. For example, April’s experiences as an Asian woman have helped her be a more empathetic leader–a trait that is especially important to have in the healthcare industry. 

“My identity as an Asian woman has made me a more empathetic, innovative, and determined healthcare founder. Have there been moments where my race or culture has presented challenges? Sure. But I’m also a better and more empathetic CEO because of my background. I follow so many founders from non-traditional backgrounds who faced tremendous obstacles, and I’m so grateful to them.”

3. Co-Founder Relationships are Dynamic Partnerships

When you decide to start a startup with someone, you are committing to a serious relationship. The average startup takes around 8 years to reach an IPO, which is also the average length of marriage in the US. Thus, it is crucial to understand how your skill sets mesh and your visions for the company align before saying yes to a co-founder. For April and Adam, this approach is what led them to building a long-standing partnership. 

“My co-founder, Dr. Adam Chekroud, is the world's leading computational psychiatrist. When we first met, he was working on research to prove that we could use machine learning to outperform the average psychiatrist in matching someone to the right treatment for them. I convinced him [to work with me] by showing him that I could translate his research into something that could have a real impact on real lives. I created a website that hosted his algorithm and allowed people to take a questionnaire, and it would spit out what medication at what dosage would be most effective for that person. We turned it around in a week and he was so impressed that I think he just rode the wave of curiosity. We were just building things so quickly and one thing led to another and we started the company together.” -From April Koh on the Stigma Podcast

4. Go-To-Market Fit is imperative for enterprise sales.

Lots of people talk about Product Market Fit (PMF) but for enterprise sales, Go-To-Market (GTM) Fit is just as important. GTM Fit is the next step after PMF, where you take your product and figure out a repeatable and predictable way to sell your product to as many people as possible. GTM Fit is so important to get right because founder-led sales don't scale forever. Without the founder pitching each customer individually, it is important that a repeatable, predictable process is in place to enable your sales team to generate revenue at scale. Here is how April got to GTM Fit:

“We got to GTM Fit by reviewing all the sales conversations that we had every month. We would do a retrospective for every conversation, and we would ask: Who did we talk to? Which conversations did we have? What worked? What didn’t work? We tried to glean patterns from every single conversation. What we were especially looking for was the “Wow”. When in the sales conversation or when in the sales process does the prospect kind of like have that “Wow” moment? It took a few quarters to establish our process, and then once we got it was like 🚀.” - From April’s interview for Slush

5. Finding the right customer is a crucial component of PMF

If your product isn’t gaining traction, it is worth rethinking who you are selling to before giving up on the idea. Initially, Spring Health focused on selling a clinical decision support tool to primary care providers but quickly pivoted when they realized that a different customer, HR and benefits leaders, had a much greater appetite for their product. This shift led them to PMF without changing the core idea behind their product.

“We sold software into health systems, but it wasn’t landing - people were not interested in sales pitches. In one pitch, the decision-maker said ‘You really should talk to our HR department because our physicians and nurses are burned out and we have a mental health crisis.’ At the time, we knew we didn't have a product-market fit because there was no momentum behind the business. We were open to anything, so we took the HR meeting. It was the first time in any sales pitch where they listened and leaned in. Very quickly, it was clear that there was a tremendous need among employees for better mental health care. So we pivoted to focusing on employers, immediately saw the results, and our business took off.” - From April’s interview for Slush

6. You don’t need to sacrifice mental health for hypergrowth.

It’s often believed that hyper-growth and mental health are mutually exclusive. However, April postulates that hyper-growth and mental health can feed into each other positively. If your mental health is good, you’ll likely be more effective at work, and if you’re being more effective at work, you’ll likely feel more positive. To achieve this, April orients Spring Health’s employee policies around this framework:

"We explicitly stated two ambitious goals: to be the mentally healthiest company in the world and the highest performing company in the world. Unlike other companies that treat these as separate objectives, we've developed a new framework around people operations that marries these goals together. For every people policy, process, or benefit, we ask three critical questions:

1. Does it advance both mental health and organizational performance?

2. Does it advance performance while accidentally hurting mental health?

3. Does it advance mental health while inadvertently hurting performance?

This framework has transformed how we make decisions. For example, when we recently revised our parental leave policy, we examined both the mental health impact of different leave durations and their effects on performance and turnover. It's about creating systems that support both individual wellbeing and organizational success, recognizing that these goals can and should be mutually reinforcing rather than competing priorities." - From April’s interview for Slush

Conclusion

Thank you to April Koh and her team for the interview! If you are an employer or a healthcare provider looking to ensure that your employees/patients can get personalized and efficient mental health treatment, please reach out to Spring Health to see what they can do for you.

This interview was done in collaboration with my good friend, Edwin Ong and Asian Hustle Network.

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