The loneliness epidemic is more than an emotion, it’s a public health crisis with devastating effects on mental and physical well-being. Cindy Jordan, CEO of Pyx Health, shares how her personal tragedy led to founding a company dedicated to tackling loneliness and its companion challenges, from food insecurity to transportation barriers.

She reveals how evidence-based screenings, personalized outreach, and a blend of technology and human connection are transforming care for Medicaid, Medicare, and exchange populations, proving that addressing social determinants of health can change lives and communities.

Check out the full series of “Career Sessions, Career Lessons” podcasts here or visit pathwise.io/podcast/. A full written transcript of this episode is also available at https://pathwise.io/podcasts/cindy-jordan

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Addressing The Epidemic Of Loneliness, With Cindy Jordan

CEO Of Pyx Health

I’m J.R. Lowry. This is Career Sessions, Career Lessons, which is brought to you by PathWise.io. If you want to take control of your career, join the PathWise community. Basic membership is free. My guest is Cindy Jordan, the CEO of Pyx Health, which she founded in 2017 to address loneliness and its negative impact on wellbeing, particularly in the most vulnerable, hard-to-reach populations.

Pyx’s founding was motivated by Cindy’s daughter’s struggle with a mental health crisis. Sadly, her daughter lost her personal battle in 2021, but her memory lives on in Pyx’s mission today. In our discussion, we’re going to be talking about Pyx Health, its growth journey, the role it plays in battling loneliness and other mental and related health issues, and Cindy’s role as an entrepreneur and leader. Let’s get going.

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Cindy, welcome. Thank you for joining me on the show. I appreciate you making time.

Of course. Thanks for having me.

Beyond Loneliness: Addressing Social Determinants Of Health

Tell us about Pyx Health.

Much like children, as we were talking about before the show went on. It has grown into something way beyond what it was born to do. It was born out of a need to solve loneliness. This was pre-pandemic. This is actually my second healthcare IT startup company, and I was not interested in doing another one. It’s a hard industry to thrive in, etc. I was like, “No, once was enough after I sold it.”

My stepdaughter in 2018-ish ended up having like a really terrible year. She ended up in an inpatient facility and was diagnosed with a behavioral health condition, bipolar disorder. Riddled in all of that was substance abuse. All the stories we’ve seen a million times are just a real, honest-to-goodness decline that we had the unfortunate front-row seat to witness. When we got through it as a family, I asked her, “Could you tell me what comes first, because I want us to get ahead of it. I’m a fixer. If we can see the early detection warning sign, then maybe there’s something we can do, etc.”

She said, “You’ll never understand, but I’m alone in this journey. I’m lonely.” I was like, “That makes no sense. You live with a roommate, and you come to the family dinner. Why do you feel alone?” She said, “It’s because no one and nothing can understand what I’m going through.” The reason I mentioned that this was pre-pandemic is that it’s important to understand that we didn’t research loneliness as a country before everybody became lonely during the pandemic.

It turns out that it actually is just like any other diagnosable, treatable mental health condition. There is an effect in the brain, which is what makes it more deadly than obesity and alcoholism put together. The brain starts to mistrust, disbelieve, and truly believe that you’re alone in your plight. You stop taking care of yourself. You stop having the will to go on. You stop believing that there’s an answer. That’s what Rylie suffered with.

We started Pyx Health in 2018, really on a mission to figure out where loneliness was the most prevalent, and it led us to Medicaid and Medicare. We deliberately built an innovative tech platform. Of course, we have humans as well, but geared it toward folks who are often ignored by innovation. It’s really cool to build the best piece of tech you can build and market it directly to a consumer, but to take it to folks who are living at or below the poverty line and have many comorbidities between mental health and physical health.

No one was doing it when we went after that in 2018. That’s how Pyx was born. The way it’s evolved is that we realized that when we were helping folks with loneliness, we had to help them with so much more. Now the industry will call them social determinants of health or non-medical barriers to health, but think of any and everything that can contribute to your health declining and/or having a bad health episode that is not clinical.

You don’t have a ride to the doctor. You don’t have enough food in your refrigerator. You have health literacy issues, and that doesn’t mean you cannot read. That just means that you don’t understand what’s happening to you, and it hasn’t been explained well to you, and you don’t understand how to navigate the system, etc. That’s when we grew up as a company. I would say this is when we went into our young adulthood, and we started treating everything that was associated with loneliness, which led us to the social determinants of health.

Now we’re in every state in the country, we’re contracted to serve over eight million people, and we make almost 10,000 calls a day. Of course, we have the platform where we’re helping folks navigate the system, and to its core, really still trying to tackle loneliness, which ultimately ended up basically killing Rylie. She ended up dying in 2020. I think that she just never ever got through the dark side of feeling like nothing was ever going to help her.

I’m very sorry for that.

Thank you. That was a long explanation.

Unmasking Loneliness: A Treatable Condition

I think with good reason. What are some of the other misconceptions? You’ve talked a little bit about this, Cindy, but what are some of the other misconceptions that people have about loneliness and the magnitude of it in the US, since that’s your market of focus?

I do think there’s a better understanding because, just like anything in the world, you understand it better when you experience it. The thing about loneliness, when I said diagnosable, treatable condition, there are a few things that have to happen. Number one, there has to be a widely accepted, clinically proven, evidence-based screening that can diagnose a mental health condition. There’s one for depression, there’s one for anxiety, and there’s one for loneliness.

Just like depression and anxiety, loneliness has degrees. I think all of us, after the pandemic, can say to some degree or another, we felt lonely. Chronic loneliness, which is the highest degree, like severe depression, severe anxiety, chronic loneliness is when it starts to basically cripple your physical health. That is the niche I think that Pyx Health built in the early days. What we have learned is that it is never alone.

It always lives with some other distress. In the markets that we serve, food insecurity, imagine you are lonely, imagine it’s very bad, and it’s affecting your health, but you don’t even have enough food in the refrigerator to keep yourself healthy enough to muster the energy to try to address your chronic loneliness. You haven’t seen a doctor in two years, and you aren’t able to get into a PCP for eight months. There are all of these issues that surround the fact that, sure, we can go out and find folks who have it.

We can help them identify it, but the misconception is that if you simply give somebody company, they’re going to feel better. That is not true. There is no prescription for loneliness at this point in time. You have to actually do some very intentional therapeutic work. You have to take care of all the other things that are contributing to it. Again, if you’re food insecure and you don’t have food to eat, you don’t have healthy food to eat. It’s like feeding the beast.

The way you’re describing it reminds me of a conversation I had many years ago with somebody about the homelessness problem in the United States. It’s one thing to get people off the streets and into a shelter, but it’s another thing to figure out why they’re homeless in the first place and what you can do about that. Those are two completely different things.

JR, we’ve been in this for eight years, and it was considered very progressive if you were a health plan and you combined what behavioral health and physical health, meaning mental health and physical health. Until eight years ago, Nary and the Two never met. The homelessness problem is a great example. How can somebody physically be better if they’re suffering from a mental health condition and vice versa? That was considered cutting-edge. It just goes to show you that, unfortunately and or fortunately, because there’s been some amazing strides made in keeping folks alive. If there isn’t a pharmaceutical, we as a healthcare industry don’t know how to tackle certain problems. There are no pharmaceuticals for non-medical barriers to health, including loneliness.

Cracking The Code: Holistic Care And Food Acquisition

What are some of the ways that you crack through that problem?

Again, we start to treat the whole person. We assess them. Not just ask them a question, “How are you feeling? What can I do for you today?” Literally using evidence-based screenings to assess not only their behavioral health, but also their physical health, and then their non-barriers. For example, are they in crisis? Do they have a place to sleep? Do they have food to eat?

That’s what actually led Pyx in May. We made a very large acquisition and purchased a food company because we realized that we cannot just point people to resources. We’ve got to try to solve as much as we can when we have the trust of the member that we’re serving in order to actually start improving outcomes. When you think about outcomes, too, they’re not just that the person feels better. They’re getting healthier, they’re doing therapeutic intervention. Health outcomes are also, you don’t go to the emergency room every single week when you don’t need to be there, because that’s the only way you can be fed and/or get company and/or get a therapist to pay attention to you.

One of the biggest problems we have in this country is the burden of the emergency health system. People in emergency rooms who don’t need to be there. The system is stretched thin. Those are outcomes that we also consider to be good. Health plans that pay us for our service are what they’re driven by. Making sure that folks are getting the help for the things that they need and not accessing the system in ways that are expensive and/or not good for anyone, including the member.

FarmboxRX: Bridging Food Insecurity And Engagement

I’m curious about the food acquisition you’ve done, FarmboxRx. How does that fit into your delivery model, and how do the payers look at that as part of what they are or aren’t responsible for?

Let’s look at it from two perspectives. Number one would be that they believe that food insecurity contributes to very poor health outcomes, which is expensive. Just like, let’s just call it out. It’s expensive. With SNAP benefits being cut in the One Big Beautiful Bill and just the cost of nutritious food being unaffordable to many people, they do see what Pyx is doing as solving two things. One, addressing all those social determinants of health needs, including loneliness.

Two, solving food insecurity. If you look at the market of Medicaid and Medicare, 78% of folks are either food insecure or lonely or both. It’s a huge swath. The other way they look at it is we cannot help people unless we can engage them, get them activated into their health, into wanting to do better, feed their family, do the whole thing, and feel better.

Cindy Jordan: Look at the Medicaid and Medicare market: 78% of folks are either food insecure or lonely, or both. That’s a huge swath.

What we have found, even when Pyx pays for it, when we send a box of food to someone’s home, rather than calling them a hundred times, texting them, sending them a voice message, sending an email, doing whatever, our engagement rate triples. You can imagine. Just like me and you, to meet someone in their home, and I always say, at the dining room table or at the kitchen table, and I use this word deliberately in an intimate way, it knocks down all these barriers and creates an avenue for us to build trust and really get in there and help people.

Are you still focusing primarily on the Medicaid and Medicare population?

Yeah, that was the exchange. The exchange would be a commercial population. Those are folks who don’t qualify for Medicaid, but are living just barely above the poverty line. I hate this term, but it is a term that’s used. It’s the working poor, three jobs, and their insurance is almost unaffordable. Believe it or not, they have 2.5 times more social determinants of health needs than a member on Medicaid. We serve those folks, too. Those folks are actually in limbo right now. Congress hasn’t approved the subsidies to keep the exchange going. If they don’t, health plans aren’t going to invest in it. All of those folks are going to be uninsured and hungry and candidly not well.

When you think about it, as much as everybody fought Obamacare, as everybody’s called it, the Affordable Care Act back in 10, or 12 years ago, it pulled millions of people out of the uninsured ranks. It feels like we’re going to take a big step backward there. Obviously, that’s a population that really just cannot afford for that to happen.

What’s unfortunate is that it’ll be years before we see something like the actual, where we look back and be like, for example, rural hospitals closing. I guess what folks don’t make the connection to, because if you’re not on Medicaid or you’re not on Medicare or you’re not on the exchange, remember we talked about shared experience early on? You don’t have that shared experience. Here’s the truth. When someone shows up in the emergency room and they don’t have insurance, that is paid for by the states and the federal government, and that comes out of taxes, and we pay for that.

Cindy Jordan: When someone shows up in the emergency room without insurance, that’s paid for by the States and federal government out of our taxes. At some point that money runs out, and then rural hospitals, in particular, can’t serve anymore.

Everyone pays for that. At some point, that money runs out, and then rural hospitals in particular cannot serve anymore. I don’t want to blow this out of proportion, but it is going to be as good as what Obamacare did for putting people on insurance. It’s going to be equally, if not worse, for what’s going to happen to folks without insurance. Insurance has just gotten more expensive since that bill passed. I haven’t seen this recently, but I can tell you as an employer who employs almost 300 people, we’re paying twice as much as we did seven years ago for our folks.

Price inflation and insurance are through the roof, and it’s just making it a bigger and bigger problem. It’s funny, I remember being in graduate school talking about this back in the early 1990s, and obviously, that’s 30 years ago, and saying that it was on track to be the biggest part of GDP for the United States back then. I think it was second only to defense, and I don’t know, we were spending a ton more money on defense. I say that as a former military officer, but we’re spending probably even more in terms of percentage increase on healthcare.

It cannot solve this problem. I literally just bought health insurance. I live in the UK and need to set up an individual plan, and even living here and having a backstop program, it’s not cheap when you want to add the United States as somebody who goes back and forth regularly. It’s like the costs just go up by like 4 or 5 X. It’s just crazy how much adding that market into a plan costs. That’s for the vast majority of people, anybody who’s having to buy their own insurance or fund their own care. It’s just it’s completely unmanageable.

My mother-in-law worked for a municipality for twenty years or whatever, and then retired and has lifelong health insurance. Name me one company at all that does that anymore. Not fire, not police. I was a police officer for five years right out of college, and part of the draw was the benefits. That’s not there anymore. What are we going to do as insurance becomes so unaffordable that it’s even going to impact retirement, and like what you said?

Here’s what I do know. The Kaiser Family Foundation put out a study about how many folks on Medicaid are actually working, part-time to full-time, and it’s over 65%. These are folks that are working, and a lot of them are working, but it is either that the employer they work for cannot afford to provide benefits, or they cannot afford even the exchange. What’s happening is that the haves and have-nots, and health insurance is getting wider and wider in a huge acceleration.

From Dining Room Table To National Scale: Pyx’s Early Days

Let’s shift gears. Let’s go back a little bit to the early days of Pyx. This wasn’t your first rodeo. You’d done a healthcare IT company, as you mentioned before, but what were the first 6 to 12 months of building Pyx like for you and the team?

It was completely different than building the first one, where we had to build the software and then go out and prove it. I sold my first company to the advisory board. At the time, I think they were the largest publicly traded health company in the country. I’m not made for corporate America, but if there was a corporate America to work in that way, it was a great experience.

What that did was give me contacts. When we started Pyx, when I was formulating the idea, I deliberately went to some CEOs of big Medicaid plans that I had relationships with and said, “I have this idea, what do you think?” One of them, Kathy Oestreich, for a Banner Health Plan, I’ll never forget her. She’s like, “Cindy, your timing is impeccable. I’m in the middle of a bid.” What I don’t think people know about Medicaid is that it’s a competitive bid process every five years, and all states conduct it differently.

What you have to do is you might’ve served members for five years, but then you have to rebid in order to have the privilege of serving them again. Anyway, long story longer, she said that this idea of loneliness in the Medicaid market was cutting-edge at the time. We had a contract before I had a product. That was the huge difference between the first company and the second company.

Obviously, that was a pivotal moment. What were some of the other pivotal moments that shaped the trajectory in the first couple of years?

One of them, in this story, is in folklore, but we started picking up steam. We were just following the bid process, and we’d find places that were in competitive bids and show them the Pyx and show them the early outcomes, which were very good. We were picking up steam. When you enter the market as a point solution and you’re doing well, your customers inevitably will come to you and say, “Can you do more?”

You, as a company, have to make that decision on whether you’re going to expand your offering and maybe dilute your offering, or whether you’re going to remain a point solution. That happened to us quickly because when you have Medicaid members engaged in particular, there are a lot of things that the health plan wants you to do. We were in a room, and it was my co-founder and me, two women who were basically our first two employees.

We were probably in that room for six hours. What I mean to tell you in the most loving way is that it was a knockdown, drag-out fight on whether or not we would remain a loneliness company, because we were creating a category and everyone wanted to acquiesce. “If we do loneliness, or if we do this, or if we can do one more thing, or if we can do this, we can sell.” One of the women in the room, Rachel, who’s still with us, was our first employee, and she was our lead salesperson.

Of course, she’s advocating to be able to sell more. I just said, “Look, we’re a loneliness company right now. This is who we are. This is our identity. We are going to stay steadfast to it.” It meant that we turned some business away. Six months later, the whole world shut down. It turned out that, unfortunately, that was the right bet. Now, I will tell you, we had that discussion again about three years ago, and it was time to be more than a loneliness company.

That was obvious. Our footprint was big. Our offering was out there. We were engaging so many folks, and the health plans needed us. Now the market’s consolidating. It’s not frothy like it was when we went into the market. The market’s consolidating, so they need one vendor to do more, and Point Solutions were quickly becoming passe.

Pandemic Pivot: Scaling Up To Meet Unprecedented Needs

Go back to the pandemic. How did that affect the business? Obviously, we had an epidemic of loneliness made worse at that point, but how did it affect you positively or negatively?

We haven’t taken any money up until then. It was basically self-funded with the founding group. We were actually out of the country on a glamping trip. I didn’t have any cell service, and we were on a boat one day. By this point, the world is shutting down, and I have literally no idea. We must’ve floated into cell service cause my phone blows up. Hundreds of messages. I knew something was up when a good portion of those messages were from CEOs of health plans. Here’s the world shutting down, and I’m getting text messages from CEOs of health plans.

My first call was to Christina, who’s the president of our company, and I said, “Please buy me toilet paper and chicken.” My second call was to the CEO of our largest client, and I said, “What can I do?” They said, “You guys have to figure out how to serve our members, all of them, and you have to figure it out in a week.” It changed the business because I had to take money. As you can imagine, I would not have been able to serve the magnitude of business that came in in such a short period of time if I didn’t have the cash to scale up.

It was certainly one of the things when I was looking at just the growth of your business before we set this up, I was really impressed with how quickly you had grown, and was curious what the turning point was. Sounds like that pandemic, for better or worse, and a bunch of outside cash to grow really quickly was the key.

We took in ten million. I’m also old school. I just don’t believe in raising money on outside valuation. We raised money on the valuation of the contracts we had. I’ve never chased the valuation of Pyx, thankfully, knock on wood. If you had asked me, J.R., back in the day when I was sitting at my dining room table and thinking only about Rylie, I would have told you I was going to sell it in three years, like I did the other company for no money, like I did the other company.

Once I took that money, I changed, really, now we’re private equity backed. We did a $41 million acquisition where I changed who I am as a leader. Being the CEO of a company of 300 people was not on my bucket list. I don’t understand the magnitude of what I did in that moment, but I can tell you that it was spurred by a very visceral need to serve people.

Triggering Service: Reaching High-Risk Populations

You have millions of people who are in the plans that are contracting with you. How do people trigger the service? If I have a physical ailment, I go to the doctor. If I have a diagnosable mental ailment, I may go to the doctor. It may come up through my primary care doctor, I’ll say, on the physical side. As you said, there wasn’t really a diagnosis here in the early going. How does that service delivery model start?

It can be triggered in one of two ways. One would be that we serve populations that we know are going to be more likely to have a lot of social determinants of health, including food insecurity and loneliness. It’s going to impact them in major ways, like high-risk pregnant moms, for example. If a health plan contracts with us, they’ll say, ‘We’re going to send you a list on a daily or weekly basis of our high-risk pregnant mom population.

It’s your job to engage them and get them to, first of all, fix all the stuff that we’ve talked about already. Secondly, get them in for their prenatal visit, make sure they have food, and make sure they’re eating the right food. After they have the baby, make sure they have diapers and wipes.” We will do the whole trajectory. That way of reaching out is by population. The second way is by need. Health plans screen all the time, and we do the same.

We’ve gotten to the point where you, as a health plan, can send us a list of people. If we know just the smallest amount about them, we can run them through an algorithm, and it will actually tell us who is very likely to be suffering from food insecurity, loneliness, or another urgent SDOH need, and we will prioritize reaching out to those folks.

We can be as specific as, like we serve a plan in North Carolina that had a lot of SMI population. That means severely mentally ill. When a SMI population, when someone ends up in an inpatient facility, they are obligated by the state to get into an appointment within seven days. We have been serving that population for years. They send us the list of folks that end up, but it could also be where someone says, “Look, I’m having a super hard time with almost everyone. I cannot figure out who has what SDOH needs. I cannot get them to engage with us. Here’s the list.” You tell me who we should be focused on, and we can do that for them.

You were trucking along on your own trajectory, and then you had this clear need to massively accelerate. You took funding from our private equity back, and you talked about how you’ve changed who you are. How else has being in a much bigger nationally scaled organization been a challenge for you as a leader? You started around your dining room table, as you said, and now you’ve got millions of people who rely on your support.

The candid answer to that is that I feel like I manage primarily through a spreadsheet now. That’s my job. That’s what I’m being paid to do. We’re a business, and it’s okay. I often feel like women in particular feel bad about saying this, but it’s okay to do something super good for the world and make money. Now, I think the biggest challenge is keeping us grounded as to who we are and why we’re here.

Cindy Jordan: It’s okay to do something super good for the world and make money. The biggest challenge is keeping us grounded, who we are and why we’re here.

Our conference room in our Tucson building is called Rylie’s room. We never forget, I don’t forget. I mean, obviously, and my co-founder doesn’t forget what it’s like to lose a kid. To keep that passion and see through all the noise of what your EBITDA margin is and how your top line growth is looking and all that stuff, and remember why you’re here, that’s the challenge as you grow.

There are folks in this company that I have never met. That is so foreign to me. It has not been my entrepreneurial journey, but now I owe it to all these folks who rely on Pyx for employment. We really are a very generous company when it comes to options and ownership, and that thing. I owe it to them now to make sure that this company stays true to itself, but is also successful.

How do you measure outcomes with your patients? You talked a lot about evidence-based approaches. How do you measure all that?

You can measure it by obviously re-screening from an evidence-based perspective. You can see when people improve. Number two, we measure quality outcomes. The whole industry, Medicaid and Medicare, thrives around quality outcomes. I’m sure you’ve heard STARS ratings for Medicare before. Those are linked to quality outcomes.

Quality would be like, are you getting folks into their preventative care screenings? Are you lowering A1C? Are you keeping people out of the emergency room? Are you with high-risk pregnant moms, impacting the need for the NICU? We have gotten to the point in the sophistication level where we can prove that our intervention and what we were able to do are linked to improved outcomes, like I mentioned.

Tech-Driven Impact: Algorithms And Member Platforms

You talked earlier about the algorithm that you use to look at these populations. What are some of the other ways that you’re applying technology in the business?

We do have a member-facing platform. It’s an app. It’s also web-based. That has become critically important because what we do, you cannot do at scale unless folks can self-serve inside the platform, whether it’s we have a loneliness program called Thrive whether it’s using the Thrive program through the platform and/or resource navigating and/or given all of the new requirements that are coming out for the One Big Beautiful Bill, like we’ll be able to help people fill out work requirements through the platform.

The platform has to be engaging. Inevitably, healthcare technology is greedy. Think about every time you engage with healthcare tech, like if you’re going to go to a doctor’s appointment. All they want is your information, your insurance, your this. You answer the same questions a hundred times, and it gives nothing back to you. We’ve gone to great lengths to make sure that the experience inside that platform is individualized. We use an AI light model for that. For example, JR, if you and I talked on the phone, if you talk to a Pyx like a care coordinator on the phone, all of those conversations get transcribed by the AI in real time.

That turns into the experience you’ll have inside the platform. It knows exactly what you need, exactly when you need it, and helps you get there. You cannot free-text or talk with the platform, but we use it to make sure that you are getting what you need. It’s not just that we didn’t build it for a hundred thousand people. We built it for you. We also still have the bot, and that’s who’s behind me. His name is Pixar and he’ll tell jokes and enter levity and try to make the experience of engaging with technology more personable.

Just thinking about running a business that was meant to help people with their career journeys, not quite as I’ll say, socially important, maybe as helping people with loneliness, but certainly a contributor to the sense of happiness and fulfillment that people need. How do you get people onto the platform? How do you engage them? The nudge theory, all of that stuff, that was part of what fascinated me about your story when it was pitched by Mia.

The nudge theory is true. We all know how people engage with technology, but I would argue that the reason Pyx is winning on the technology front is that I’ll give you an example. Remember how I told you we’ll use the box as our first engagement, the box of food. By the way, it’s a beautiful box of food. It’s packed like a company called Harry and David. It does not come rotten. We are not just sending you food to send you food or sending you really good food.

It’s an experience, but on top will be a QR code, and it’ll say, “Get some recipes for this food here,” or “Learn more.” When you scan that QR code, we are instantly able to help you with other needs. It comes back to solving a pain point for the member before the member will actually trust your technology. Linking the food, linking the human, and the tech together and making them inseparable, I think, is what makes the tech work.

We’ve got people pouring their deepest, darkest secrets into all these gen AI tools right now. What’s your take on where this is going to go? Is all of this going to be taken over by the machines, or what’s your vision in terms of how you see the mix of man and machine, human and machine playing out in your own delivery model?

I will be long gone by the time that happens. Healthcare is always last to innovate. We know that. I really appreciate that Dr. Oz and CMS are really pushing AI, but the truth of the matter is, it is not sophisticated enough to handle the complexities of mental health and social health. I almost see it having a play in clinical health first because it is so nuanced the way that people manage through depression, loneliness, food insecurity, etc.

By the way, health plans are not on board. They will legislate within their contracts what you can do from an AI or machine learning perspective until the day is long. Part of it is that they’re so protective of their data. They don’t want you using data to train a model. I think we’re years away in healthcare in particular. I think I’ll be long gone before we’re seeing AI write your emails. Now I don’t know how it’s going to impact healthcare unless there is also a human involved.

Not to be too self-promotional here about Pyx, but that’s what I think Pyx did right. Our technology is 100% reliant on the fact that we’ve had contact with you in some way or form. You’ve talked to one of our humans and/or we’ve assessed you, whether it was through the QR code or something. We’re not just trusting an AI bot to figure out what you need.

I live in London and ride the tube regularly and see the ads on the tube cars, the train cars advertising these AI-based therapy apps, which presumably are subscription-based, privately funded directly by the consumer. A different business model than what you’re talking about. I just wonder where that’s really going to go. I guess if you think about it in the context of your business, your desire was to solve a loneliness problem. It seems massively ironic to solve a loneliness problem by telling somebody that you just get to talk to a computer.

They’ve popped up in the market in the US, and we’ve actually tried them because you could consider them to be somewhat of a competitor. I say that their quotes, but there was one that we tried, and you could instantly confuse the bot, and you start talking about things like suicide, because you don’t say suicide. Nobody who is thinking of ending their world generally says, “I want to commit suicide.”

They say, “I don’t want to live anymore. I feel like there’s no reason for me to go on.” This confuses the AI. Actually, I think this was a well-documented story. I actually do think it was in the UK where the bot got so frustrated with a suicidal person on one of these that the bot got so frustrated that it threw up its virtual arms and said, “I cannot help you anymore, you should just go kill yourself.” The person did. We are eons away from figuring that out or trusting it. How about that?

It just strikes me that it’s great to have tools to help you with all the analysis, but it’s like, as soon as we start undermining our species’ basic need for human connection and trying to substitute in a machine. I feel like we’ve lost the plot completely, but it does feel like that’s where certainly some companies are headed.

Yes, I get it. What’s the AI that Elon Musk has or something?

Grok.

If that guy cannot figure it out, like who’s going to be able to? They made some tweaks to it, released it anew, and then it came out of the gate anti-semitic.

I hear the new version is actually really good. I have not tried it.

I haven’t tried it either.

Maybe he has finally gotten it.

My point is, it seems to me that the last place that we should be interjecting that technology is when we’re talking about the fragility of mental health.

Cultivating Culture: Leading A Growing Enterprise

I completely agree. Let’s talk a little bit more about the company. You’re at 300 people now. You said you haven’t met everybody. How do you maintain that culture and mission as you scale?

I don’t anymore. I need my team, particularly my senior leadership team, to do that. That was an interesting thing with that money that we took early on. It was from a firm called Rallyday, and they were new to us in their first fund, and it was all founders. If you think about private equity, generally speaking, the private equity folks are not entrepreneurs. They’ve come up from the banking side of the house or the investment side of the house or whatever.

These four folks were all founders. One of the things that they really did for me personally, but also for our company, is that we did training on how to define your culture in a way that is digestible and not just words up on a wall somewhere or on a background. Two, how to live that culture? I think that actually was one of the most powerful things that happened to Pyx Health. They’re called BBOs, Beliefs, Behaviors, and Objectives. You figure out what your beliefs are.

You figure out 2 or 3 behaviors that you want your company to do as associated with those beliefs, and what’s the outcome that you want from them? When you make it easily digestible like that, like we believe people come first or human connection comes first. One of our behaviors is, unless it’s unavoidable, you are on camera in meetings, because we all cannot be in the same place. You see what I mean? There were ways for us to codify this. They really taught me about how to train leaders of leaders. At this point, the culture in Pyx is way beyond me.

What were some of the things that you particularly took away from that experience personally?

For anybody who does what I do to say that there’s no ego involved would be lying. There’s ego involved in this. Sometimes, to my detriment, particularly in the first company, my whole existence was centered around being successful. I had to let go of that. I had to find gratification. I had to find self-fulfillment by watching other folks do. It couldn’t just be about me anymore. At this point in time, it’s really not about me to be candid.

Of course, you’re talking to me, and I’m the one who will do calls like this, but in the end, I don’t sell anymore, really. I’ll show up on some calls occasionally. I’ve got this senior group of leaders that are phenomenal. I think that the hardest lesson and/or the most important lesson I learned was to find a different way to be fulfilled that wasn’t about it all being centered around Cindy.

Everybody goes through that. I remember one of my very first podcast interviewees was a guy who had started a company on his second time around. It was growing like crazy, and he said it got to be 150 people, and he realized, which I think is that tipping point of whatever that scientist was who studied that, where it’s like, no longer can you know everybody personally. Therefore, you have to start putting in those systems and have to start divorcing yourself from the day-to-day. You cannot have roads coming through you, but it sounds like you’ve done that. At the end of the day, that’s what builds lasting enterprises. It is when the founders can leave, and it goes on successfully without them. Too many founded enterprises never get past that point.

I think you’re right. It’s because the founder and I’ve known many of them, like their entire existence and ego are tied into it, and they don’t let it happen. Look, it’s no secret, obviously, because we were just in the 50 over 50, but I’m over 50. I actually am finding gratification or career satisfaction in watching some folks grow into these incredible leaders. I mentioned the woman who’s the president of the company. She was in her early thirties when she started working for us. She had a career.

She was a VP at a health plan, but what she’s become like in how she leads, now here comes my ego back in. Take a little credit for that. It is so gratifying. Almost more than when it was like all about me. Honestly, if I were not leading this company tomorrow, this company would still thrive under whoever took control of it. It would go on and it would succeed and it would do well. There’s also some peace in that.

That’s the sign of a lasting enterprise. Kudos to you for creating that. Last question, I know we’re running up against time. What’s ahead for Pyx? What are the goals over the next 12 to 24 months?

I think that Pyx has to solve a lot of these problems that are going to be created around people losing health insurance. I do think food insecurity is going to become a national epidemic. I don’t think it’s going to cut the ways that we’re used to seeing. We just think that people who live below the poverty line are food insecure, and everyone else isn’t. That’s not true. I think that these are the big things that Pyx is going to have to tackle.

Cindy Jordan: Food insecurity is going to become a national epidemic.

We’re going to have to figure out how to feed people, how to do it efficiently, and make sure that they’re getting nutritious food that actually is good for them and for their families. We’re going to have to help them navigate what’s soon going to become a super cumbersome system because people are going to lose health insurance, which means that they’re going to get sick, and bad things are going to happen all the way down the chain, like we talked about, if they cannot administratively figure out how to navigate the system.

I worry about that, as we talked about, and I wish you well in helping to solve that problem.

Thank you so much.

On that, we will close. Thank you for doing this with me, Cindy. It’s really informative. It’s phenomenal what you’ve built, and a huge congratulations on that end on the 50 over 50 list.

Thanks, J.R. I really appreciate it. It was really nice to meet you, J.R. Take care.

—

Thanks to Cindy for joining me to discuss her company, Pyx Health, its growth journey, the role it plays in battling loneliness and other mental health issues, and also the things that surround them, as well as her role as an entrepreneur and a leader. As a reminder, our podcast was brought to you by Pathwise.io. If you’re ready to take control of your career, join the Pathwise community. Basic membership is free. You can also sign up on the website for the Pathwise newsletter. Follow us onLinkedIn,Facebook,YouTube,Instagram, and TikTok. Thanks. Have a great day.

Important Links

• Pyx Health
• Cindy on LinkedIn
• Kaiser Family Foundation
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About Cindy Jordan

Cindy Jordan is the CEO of Pyx Health, which she founded in 2017 to address loneliness and its negative impact on well-being, particularly in the most vulnerable, hard-to-reach populations. Today Pyx Health is looking beyond loneliness to members’ and health plans’ evolving needs to imagine new solutions and create new programs that impact process and outcomes, while remaining mission focused. This expansion includes their recent acquisition of FarmboxRx. They’re using what they’ve learned about connection to redefine engagement and create trusted relationships that truly activate members.

Cindy was not the idealized ‘start a company from your Harvard dorm room’ entrepreneur. She was previously a police officer, presidential campaign fundraiser, and marketing strategist before she founded her first health IT company in the wake of the 2008 recession, a proprietary referral marketing tool for physicians called Medical Referral Source (MRS) When MRS was acquired by The Advisory Board Company about 4 years later, Cindy exited as CEO and continued to work on growing MRS, now known as Crimson Medical Referrals, as managing director for a short time.

Pyx’s founding was motivated by Cindy’s daughter’s struggle with a mental health crisis. Cindy and her wife (and Pyx co-founder) Anne became aware of gaps in healthcare and the pervasive loneliness and social isolation epidemic affecting vulnerable populations. They delved into healthcare research about loneliness only to find that little was being actively done to identify and address its negative mental and physical health effects. And Pyx Health was born – to focus on identifying and providing support and resources to individuals experiencing the negative health and social effects of loneliness. Sadly, Cindy’s daughter lost her personal battle in 2021 but her memory continues to fuel Pyx’s mission.

What began as a focus on treating loneliness evolved into the ability to impact other potentially deadly barriers to health, and in turn, improve member outcomes for Pyx’s health plan clients. Pyx now serves Medicaid and Medicare members from nearly 100 health plans in 30+ states (representing over 10 million covered lives).