Mark Arnoldy, CEO of Possible, is helping to change the world -- by bringing high-quality, low-cost healthcare to the poor in Nepal. Arnoldy and his team work within the Nepali government’s existing infrastructure to deliver free healthcare for the poor using a hub and spoke model through a hospital, a network of clinics and community health workers. Possible also crowdfunds the cost of more complex cases and refers these patients to its network of urban partner hospitals. Using this model, Possible has treated more than 235,000 patients in rural Nepal since 2008.
Working in an area with limited infrastructure and technology, Possible strives to make the impossible possible. Below, Arnoldy shares four critical insights for entrepreneurs on similar missions.
- People are your greatest asset, but can also be your biggest challenge.
Arnoldy says Possible’s “forever challenge” is attracting top-notch talent to work for more than 1-2 years on the ground in challenging and often isolated settings, where it can be difficult to raise a family and frequent travel is part of the job. (Possible’s HQ is in NYC, but most of the ground work is done in rural Nepal.)
“In this work, failure is frequent, hits hard and has real life-changing implications for people,” says Arnoldy. “We are always seeking people who are dedicated to the battle irrespective of outcome, and our favorite quote comes from The Gita: ‘You’re obligated to the battle, but not entitled to its fruits.’ We look for people who are going to execute against all odds.”
- Hire for grit and humility.
To lower employee turnover, hiring managers are urged to compare candidates to the best people they’ve ever worked with, so as not to hire “the best of the worst.”
“We do everything in our power to make Possible a great place to work and to give ground to retain people for the longer term,” says Arnoldy. “For example, we are building Nepal’s first rural teaching hospital to provide great infrastructure, and we’ve focused intensely on building a culture that’s going to attract remarkable people through our For-Impact Culture Code.”
Possible’s For-Impact Culture Code includes 10 values, such as: 1. We put our patients first, 4. We think big, 8. We are transparent until it hurts, and 10. We believe everything is possible, until it isn’t.
- Learn how to leverage partnerships.
Possible’s partnerships aim to heighten healthcare quality without any excess. Possible’s partnership with the Nepali government, which includes a unique performance-based financing system, is a great example of this. In order to get paid, Possible must hit six impact-driven KPIs, which includes Surgery Access (% of days when surgical services are fully available to patients) and Safe Birth (% of women giving birth in a healthcare facility with a trained clinician).
“Nepal's government also grants universal healthcare to all its citizens. However, 30% of its national health budget is left unspent,” says Arnoldy. “Through this financing model, we are able to channel public-sector money more effectively, while providing overall greater impact for the communities we serve.”
They’ve deemed this public-private partnership Durable Healthcare, which transforms the status quo by expanding access to care and protecting against excess.
“We are simultaneously building a model that can be replicated throughout the country at scale, while contributing to data on policy on healthcare systems development in emerging economies around the world,” says Arnoldy.
- To create impact, you must first experience the problem.
To make a dent in healthcare, absolute commitment is a must.
“You can’t do this as an armchair change-maker. If you’re so compelled by what you experience that you can’t imagine doing anything else but starting and dedicating 10-plus years of your life to building an organization, know that the real gap in this kind of work isn’t innovations and tools, it’s people who are willing to put boots on the ground and build great organizations to close the ‘delivery gap’ between the medical diagnostics and therapeutics we have, and the poor who need them,” says Arnoldy.
“At the end of the day, we need people building massive, extraordinarily well-run healthcare companies that can succeed in these environments. We need an army of Kaiser Permanentes built for the world's most impossible places.”
For more information, check out possiblehealth.org. All images courtesy of Possible.
This feature originally appeared in our Spring 2015 issue of YEC Quarterly, our print magazine for YEC members.