Loiacono: Healthcare startups face no shortcuts due to strict enterprise reference requirements
AJ Loiacono · He spent $0 on marketing—raised $400M at $3.25B valuation | Judi Health · Aug 24, 2026 · at 2:22
AJ Loiacono, founder and CEO of pharmacy benefits platform Judi Health, explains why enterprise healthcare go-to-market requires climbing through small account sizes rather than relying on high-level relationships.
0:00 / 0:31exact quote · 31.2s
▶ Watch the full episode on YouTube → 720p mp4 · rendered on demand · StarZero watermark
“When you're in healthcare, I often say there are no shortcuts because Even if your brother or sister was the CEO of a large Fortune 500 company, and they have a 100,000 employees, and you say, hey, I could service your company, someone in compliance or legal, someone is going to put a check in balance and say, can you give me a reference of another company that's a 100,000 lives, someone who's our stature, someone who's our scale. And if you can't, you're right back to the beginning.”
quote is from the automated transcript, cleaned for reading: filler sounds and stutters are removed, nothing is rephrased. names can be misheard (the analysis reads context, assessments check outside sources). how →
More from AJ Loiacono
Loiacono: Competing PBMs Faked Mandatory Federal Compensation Disclosures in 2023
“23 people needed to start reporting this information, people being pharmacy benefit managers and administrators like ourselves, Had to start reporting this information. And what we realized is people were faking it. They either weren't doing it or they were pr…”
Loiacono: Traditional PBMs have a 'horrible conflict of interest'
“I felt this was a horrible conflict of interest. The conflict of interest is, think about it, if you're asking someone to manage your benefit plan, and the more expensive the medication, the more money they make, that doesn't sound like a recipe for good outco…”
Loiacono: Smaller Employers Suffer From Shadier, Highly Commissioned Brokers
“The smaller the employer group, usually the shadier the broker. And what I mean by this is they're going to be like, I'm going to get paid on everything and anything. The larger the client, you start to see, I would say some professional behavior here and some…”
Loiacono: A $10M ARR startup is nothing in consolidated healthcare markets
“Healthcare is highly consolidated. CVS, Cigna, and United Healthcare. Three publicly traded companies, all of which are I'm gonna say Fortune eight, Fortune 10, Fortune 14, respectively, in that range. And so when you're battling with titans, yeah, ten million…”
Loiacono: Traditional PBMs Charge Hundreds of Different Prices for Same Drug
“You know, so if a traditional pharmacy benefit manager, someone we compete with, they'll have hundreds of different prices for the same drug, same day, same pharmacy for different customers.”
Loiacono: Capital Rx won Fortune 500s by operating 70% more efficiently
“So if you read my business plan at the start, it was, we need to operate 70% more efficient than three fortune 15 companies. Now, their purchasing power was higher, but if we operated that at that efficiency, we could beat them head to head and we could do som…”