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When Tech Meets Rural Healthcare: How Homeward Redefined Product-Market Fit

Most healthcare technology companies start by building solutions. Homeward started by making mistakes.

In a recent episode of Category Visionaries, Amar Kendale, President and Co-founder of Homeward, shared how his $70M-backed healthcare technology company is addressing the 23% higher mortality rate in rural America. But their path to success required completely rethinking their initial go-to-market approach.

The False Start

“We went on to rapidly make a series of mistakes,” Amar candidly shares. “Our intent was to make our mistakes quickly, when they were of the least consequence.”

Their initial hypothesis seemed logical: rural areas have half as many primary care doctors as urban areas, so they should provide comprehensive primary care services. They launched with multiple access points – home visits, mobile clinics, and pop-up facilities.

But patients weren’t interested.

The Counterintuitive Discovery

When they investigated why, they uncovered something surprising. “About a third of people hadn’t seen a doctor in over two years,” Amar explains. But when asked why they wouldn’t try Homeward’s services, patients responded: “I have a doctor… I’m not dying, I’m not bleeding, I don’t have any broken bones… if I really am in trouble, that’s when I’ll see my doctor.”

This insight revealed a crucial misunderstanding about rural healthcare consumption. The problem wasn’t a lack of doctors – it was how those doctors’ time was being used. Rural physicians were overwhelmed with acute care, leaving no capacity for preventive services like “making sure you’re getting your colonoscopy and getting your blood pressure checked and managing your diabetes.”

The Technology Trap

Many founders would have responded by building more technology. Homeward did the opposite.

“There’s a trap a lot of technologists fall into,” Amar notes. “You have a vision for the way that technology can play a role, and you decide to start building first before you really know whether it’s exactly the right problem or not. And then you take it to market and you’re a little bit in love with your idea.”

Instead, Homeward built minimal technology initially. Their tech team embedded with clinicians, learning the workflows firsthand. This approach allowed them to understand the real operational challenges before writing a single line of code.

The Pivot to Partnership

Rather than competing with existing providers, Homeward repositioned as a supplemental service. “Our role in the market is to supplement the existing provider, not to displace them and not to create abrasion or confusion for the patient,” Amar explains.

This pivot required building trust through multiple stakeholder relationships. They hired local medical assistants and community health workers who understood their communities. They formed partnerships with health plans and local health systems. Most importantly, they focused on delivering consistent, reliable service.

The Results

The strategy is working. Homeward achieved an 80 NPS score – higher than any of their previous ventures – and is growing 3-4x annually. But perhaps most telling is their impact on rural healthcare delivery.

“We’re growing at a rate that’s probably double the rate that [other value-based care companies] grew at,” Amar shares. “In part that’s us standing on their shoulders… they’ve done a lot of the hard work for us.”

Lessons for B2B Founders

Homeward’s journey offers valuable insights for B2B technology founders:

• Make your mistakes early and cheaply
• Challenge your initial assumptions through direct market interaction
• Resist the urge to build technology before understanding workflows
• Build trust through local presence and partnerships
• Design solutions that complement rather than replace existing systems

As Amar summarizes: “Get close to the workflows… get close to the patient. But don’t neglect other stakeholders – the provider, the payer. Because that’s going to be your Achilles heel.”