A big leap to a health-promoting start-up

Tom Spann left a management job at Accenture to become founding CEO of Accolade.

When investors first called Tom Spann with their idea of making health care more accessible, he thought they were nuts, to put it politely.

No way was he going to leave a senior management job - leading a $2 billion unit of the consulting group Accenture, for "the most cockamamie thing I ever heard," Spann said.

Even so, in 2007, Spann did just that, leaving Accenture to become founding chief executive of Accolade Inc. in Plymouth Meeting.

The cockamamie idea was to create a concierge business, hired by companies such as Lowe's and Comcast to help their employees navigate the health-care system. Nurses and counselors, reached by phone, would give advice on treatment, find doctors, and straighten out insurance problems.

Accolade would get paid based, in part, on what it saved employers in health costs.

"The more I thought about it, I thought, 'This is the right thing for patients,' " Spann said. "Everybody knows people struggle with the health-care system."

Question: In your Accenture job, you spoke with employers who told you that providing health coverage for employees was one of their biggest challenges. Explain.

Answer: Costs are unbearably high and growing out of control. Then their employees aren't satisfied with it anyway. It's such a challenging experience for them. It's an unbelievably complex and fragmented system. [Patients] are making very important decisions under a lot of stress, and all of us make bad decisions under stress.

Q: Any other issues?

A: It matters to them on more than just the cost, because there's a lot of studies that show that for every dollar they are spending on health care, they are losing another two dollars on productivity.

Q: To me, there seems to be an inherent conflict - wouldn't employers want to keep costs down by limiting access, even if individuals need help?

A: If you get the right care the first time, it will cost less. Maybe not every single case, but over a big enough population, given enough time, it'll be that way. As soon as our clients sense we're trying to save money in the short term, they won't trust us, they won't talk to us, and we'll be out of business.

Q: Has Accolade always saved companies money?

A: Yes. Not every month, not every quarter. The first quarter with our first customer, we saved money. The second quarter, we lost it all back. That was a scary time. Then the third quarter we saved money and the fourth. We've never had a population that lost money.

Q: You rose through the ranks of an established company. What was it like to shift to a start-up?

A: When you first start a new company, it's like, 'Let's try this and see if it works.' Then [you realize], 'Oh my gosh, this really works.' If it doesn't work out, it's because I screwed it up.

Q: Is it hard to delegate?

A: When I left Accenture, I was running a business with 10,000 people. Of course, I delegated. It's been a harder process for me to delegate as this company has grown. It's harder for me to give up some things. I have to not take everything personally.

Q: What did you want to be when you grew up?

A: A Supreme Court justice, because it was a job for life, and I thought law was interesting.

Q: Do you like to argue?

A: I like data, and I like to argue. I try to be a data-driven guy for such a relationship-based company.



Title: Chief executive.

Home: Plymouth Meeting.

Family: Wife, Nancy; daughters, Jennifer, 26; Meredith, 20.

Resumé: Spent 26 years at Accenture.

Diplomas: Hatboro Horsham High School, Univ. of Pennsylvania, Wharton, economics.

Love story: Married his high school sweetheart.  

Saturday morning: Coffee, then 90 minutes of power yoga with his wife, using a video.

In the glass: Dad's Hat Rye Whiskey.

High school reunions? Used to go. "I haven't done them in 15 or 20 years."


Where: Plymouth Meeting.

Business: Companies pay Accolade's nurses and health assistants to help employees find health care, hoping that will lower costs.

Customers: 500,000 employees and family members from Comcast Corp., Lowe's, 43 firms.

New: Now serving individual Independence Blue Cross subscribers.

Revenue: More than $60 million.

Employees: 592.


Tom Spann on hiring, nurturing health counselors. www.philly.com/jobbing

Interview questions and answers have been edited for space.