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Dec 20, 2020 · 15m · top-founders

OnCallHealth Grows 150% to $3m Run Rate for Virtual Patient Care HealthTech

Nicholas Chupswick · 8m spoken Nathan Latka · 5m spoken
0:00 / 0:00

gold bands on the timeline = statements, start to end. Hover to read, click to jump. CC turns on captions

In this interview with Nathan Latka, OnCall Health founder and CEO Nicholas Chupswick discusses scaling his virtual care SaaS platform past $3 million in ARR, leveraging a $6 million Series A round, and optimizing enterprise unit economics across healthcare networks.

How this conversation actually went

Every chapter scored 0–10 on four independent dynamics. Hover any point for the reasoning behind the score. Nathan holds 36.8% of the talking time here. How this is scored →

Nathan as informed peer 5.6 Guest teaching 3.8 Guest disagreement 1.4 Nathan pushing back 3.6
05100:0010:000:13–2:58 · Nathan as informed peer 3/10 Latka Platform Subscription Pitch and Premium Access The segment starts with Nathan's standard platform promotional intro, followed by general exploratory questions about OnCall Health's virtual care solution and market timing during the COVID-19 pandemic.2:58–5:41 · Nathan as informed peer 6/10 Customer Segmentation, Tiered Pricing, and Revenue Metrics Nicholas outlines their customer tiers and ARR growth from under $1M to over $3M. Nathan quickly extrapolates valuation ranges from typical Series A dilution percentages.5:41–9:24 · Nathan as informed peer 7/10 Sales Compensation, Customer Success, and Net Revenue Retention Nathan presses on how account executives can be effective without hard quotas and probes the team structure and upsell mechanics across customer success.9:25–12:41 · Nathan as informed peer 7/10 Strategic Focus: Enterprise Prioritization vs. SMB Long Tail Nathan challenges the strategic value of servicing 600 SMBs at $75 per month when they only represent 15% of revenue. Nicholas concedes the point and explains the pivot toward self-serve automation alongside enterprise focus.12:42–15:20 · Nathan as informed peer 5/10 Burn Rate Tolerance and Customer Acquisition Payback Periods Nathan models monthly cash burn scenarios against the Series A cash cushion before asking about payback periods and concluding with the Famous Five questions.0:13–2:58 · Guest teaching 3/10 Latka Platform Subscription Pitch and Premium Access The segment starts with Nathan's standard platform promotional intro, followed by general exploratory questions about OnCall Health's virtual care solution and market timing during the COVID-19 pandemic.2:58–5:41 · Guest teaching 4/10 Customer Segmentation, Tiered Pricing, and Revenue Metrics Nicholas outlines their customer tiers and ARR growth from under $1M to over $3M. Nathan quickly extrapolates valuation ranges from typical Series A dilution percentages.5:41–9:24 · Guest teaching 5/10 Sales Compensation, Customer Success, and Net Revenue Retention Nathan presses on how account executives can be effective without hard quotas and probes the team structure and upsell mechanics across customer success.9:25–12:41 · Guest teaching 4/10 Strategic Focus: Enterprise Prioritization vs. SMB Long Tail Nathan challenges the strategic value of servicing 600 SMBs at $75 per month when they only represent 15% of revenue. Nicholas concedes the point and explains the pivot toward self-serve automation alongside enterprise focus.12:42–15:20 · Guest teaching 3/10 Burn Rate Tolerance and Customer Acquisition Payback Periods Nathan models monthly cash burn scenarios against the Series A cash cushion before asking about payback periods and concluding with the Famous Five questions.0:13–2:58 · Guest disagreement 1/10 Latka Platform Subscription Pitch and Premium Access The segment starts with Nathan's standard platform promotional intro, followed by general exploratory questions about OnCall Health's virtual care solution and market timing during the COVID-19 pandemic.2:58–5:41 · Guest disagreement 1/10 Customer Segmentation, Tiered Pricing, and Revenue Metrics Nicholas outlines their customer tiers and ARR growth from under $1M to over $3M. Nathan quickly extrapolates valuation ranges from typical Series A dilution percentages.5:41–9:24 · Guest disagreement 2/10 Sales Compensation, Customer Success, and Net Revenue Retention Nathan presses on how account executives can be effective without hard quotas and probes the team structure and upsell mechanics across customer success.9:25–12:41 · Guest disagreement 2/10 Strategic Focus: Enterprise Prioritization vs. SMB Long Tail Nathan challenges the strategic value of servicing 600 SMBs at $75 per month when they only represent 15% of revenue. Nicholas concedes the point and explains the pivot toward self-serve automation alongside enterprise focus.12:42–15:20 · Guest disagreement 1/10 Burn Rate Tolerance and Customer Acquisition Payback Periods Nathan models monthly cash burn scenarios against the Series A cash cushion before asking about payback periods and concluding with the Famous Five questions.0:13–2:58 · Nathan pushing back 1/10 Latka Platform Subscription Pitch and Premium Access The segment starts with Nathan's standard platform promotional intro, followed by general exploratory questions about OnCall Health's virtual care solution and market timing during the COVID-19 pandemic.2:58–5:41 · Nathan pushing back 3/10 Customer Segmentation, Tiered Pricing, and Revenue Metrics Nicholas outlines their customer tiers and ARR growth from under $1M to over $3M. Nathan quickly extrapolates valuation ranges from typical Series A dilution percentages.5:41–9:24 · Nathan pushing back 5/10 Sales Compensation, Customer Success, and Net Revenue Retention Nathan presses on how account executives can be effective without hard quotas and probes the team structure and upsell mechanics across customer success.9:25–12:41 · Nathan pushing back 6/10 Strategic Focus: Enterprise Prioritization vs. SMB Long Tail Nathan challenges the strategic value of servicing 600 SMBs at $75 per month when they only represent 15% of revenue. Nicholas concedes the point and explains the pivot toward self-serve automation alongside enterprise focus.12:42–15:20 · Nathan pushing back 3/10 Burn Rate Tolerance and Customer Acquisition Payback Periods Nathan models monthly cash burn scenarios against the Series A cash cushion before asking about payback periods and concluding with the Famous Five questions.

speaking balance: gold is Nathan, purple is the guest (3 minute bins)

0:00 · Nathan 54.3% · guest 45.7%0:00 · Nathan 54.3% · guest 45.7%3:00 · Nathan 28.8% · guest 71.2%3:00 · Nathan 28.8% · guest 71.2%6:00 · Nathan 28.4% · guest 71.6%6:00 · Nathan 28.4% · guest 71.6%9:00 · Nathan 28.9% · guest 71.1%9:00 · Nathan 28.9% · guest 71.1%12:00 · Nathan 29.2% · guest 70.8%12:00 · Nathan 29.2% · guest 70.8%15:00 · Nathan 84.5% · guest 15.5%15:00 · Nathan 84.5% · guest 15.5%
Sharpest disagreement ▶ 5:52 Defending quota-free uncapped commission structure

Nicholas firmly clarifies that account executives have uncapped commission incentives even if hard quotas are not rigidly enforced yet.

 Hardest push from Nathan ▶ 9:25 Challenging resource allocation to small practices

Nathan does the math showing small practices generate under 15% of revenue and questions why Nicholas spends any engineering or customer focus on them.

 Biggest teaching moment ▶ 8:31 Explaining pharma and insurer network enterprise model

Nicholas educates Nathan on how non-traditional enterprise clients like insurers and pharma monetize provider networks without directly employing practitioners.

 Nathan holds their own ▶ 9:25 Deconstructing ARR contribution from low ACV tier

Nathan rapidly calculates the exact monthly contribution of the 600 SMB clients ($45k out of $250k) to demonstrate their limited strategic value.
the scores for every segment, with the reasoning behind each
ChapterTopicNathan as informed peerGuest teachingGuest disagreementNathan pushing backWhy
Latka Platform Subscription Pitch and Premium Access 3311 The segment starts with Nathan's standard platform promotional intro, followed by general exploratory questions about OnCall Health's virtual care solution and market timing during the COVID-19 pandemic.
Customer Segmentation, Tiered Pricing, and Revenue Metrics 6413 Nicholas outlines their customer tiers and ARR growth from under $1M to over $3M. Nathan quickly extrapolates valuation ranges from typical Series A dilution percentages.
Sales Compensation, Customer Success, and Net Revenue Retention 7525 Nathan presses on how account executives can be effective without hard quotas and probes the team structure and upsell mechanics across customer success.
Strategic Focus: Enterprise Prioritization vs. SMB Long Tail 7426 Nathan challenges the strategic value of servicing 600 SMBs at $75 per month when they only represent 15% of revenue. Nicholas concedes the point and explains the pivot toward self-serve automation alongside enterprise focus.
Burn Rate Tolerance and Customer Acquisition Payback Periods 5313 Nathan models monthly cash burn scenarios against the Series A cash cushion before asking about payback periods and concluding with the Famous Five questions.

Statements from this episode (14)

Assertion Not checkable as stated
Chupswick breaks down OnCall Health's 700 customers and pricing tiers
“We have we have about 700 customers. About 600 of them are small practices, paying us about 75 dollars a month on average. And then we have over a hundred customers that we put into our enterprise sort of bracket, which has more more advanced kind of branding …”
Nicholas Chupswick Dec 20, 2020 ▶ 3:04
Assertion Not checkable as stated
Chupswick: OnCall Health ARR is well over $3 million
“We're around we're well over three million ARR now.”
Nicholas Chupswick Dec 20, 2020 ▶ 3:40
Assertion Not checkable as stated
Chupswick: OnCall Health was below $1M ARR one year prior
“Less than a million.”
Nicholas Chupswick Dec 20, 2020 ▶ 3:47
Disclosure
Chupswick: OnCall Health raised a $6 million Series A
“We raised six million USD.”
Nicholas Chupswick Dec 20, 2020 ▶ 4:28
Disclosure
Chupswick: Base10 led OnCall Health's Series A to drive US expansion
“Base 10 is our series, a lead investor. They're San Francisco based and they've been amazing in terms of helping us push into the U S more.”
Nicholas Chupswick Dec 20, 2020 ▶ 4:34
Disclosure
Chupswick: OnCall Health Offers Uncapped Sales Commission Without Hard Quotas
“We have uncapped commission, but just not enforcing, you know, hard.”
Nicholas Chupswick Dec 20, 2020 ▶ 6:01
Assertion Not checkable as stated
OnCall Health allocates one-third of its headcount to customer success
“I think close to 10 right now. ... 30.”
Nicholas Chupswick Dec 20, 2020 ▶ 6:42
Assertion Not checkable as stated
Chupswick: OnCall Health's Net Revenue Retention Is Well Over 100%
“We've been well over a hundred for as long as I can remember just especially because of a lot of that account expansion.”
Nicholas Chupswick Dec 20, 2020 ▶ 7:22
Disclosure
Chupswick: OnCall Health charges enterprise white-label package plus per-provider seat fees
“So there's two components to our pricing. We charge for our enterprise package, which includes our like fully branded apps. The customers get to become the publisher of their own virtual care apps that we help them create. And then it's essentially like a whit…”
Nicholas Chupswick Dec 20, 2020 ▶ 7:46
Assertion Not checkable as stated
Chupswick: Pharma companies and insurers are OnCall Health's largest customers
“The interesting thing is, you know, we do work with some kind of conventional hospital systems, but the larger, like our largest customers are, like I said, pharma companies and insurers that don't directly employ healthcare providers, but they have networks o…”
Nicholas Chupswick Dec 20, 2020 ▶ 8:37
Disclosure
OnCall Health CEO shifts focus from capital efficiency to growth spending
“I think now in this next phase of the business that's becoming less important to me. I'm trying to optimize more for growth at this stage and be a little bit more liberal with spending.”
Nicholas Chupswick Dec 20, 2020 ▶ 11:56
Assertion Not checkable as stated
OnCall Health reached $1M ARR with roughly $1M raised
“We were able to reach kind of a million ARR with only about a million raised.”
Nicholas Chupswick Dec 20, 2020 ▶ 12:09
Disclosure
OnCall Health CEO Is Comfortable Scaling Monthly Expenses to $500K
“I think we will have to get up to that for a while. And yes, I would be comfortable with that.”
Nicholas Chupswick Dec 20, 2020 ▶ 13:35
Assertion Not checkable as stated
OnCall Health Reports 6-Month SMB and 2-Month Enterprise CAC Paybacks
“I think our payback period is a few months for, Or six months for an SMB and two months for an enterprise.”
Nicholas Chupswick Dec 20, 2020 ▶ 14:20
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