After eight amazing years at Healthcare Bluebook, it's time for the next chapter in my career. With such a rich history of memories from the time I spent with co-workers, to the patients we helped across the country on a daily basis, I would be remiss to not share one last essay of my time here.

I distinctly remember the small second-floor office at Overlook Circle in Brentwood when I stepped through the front door on Jan 1st, 2014. One conference table to the right in front of an orange accent wall with our blue company logo, flanked with a small receptionist desk to the left. As you navigated past the entry area, a sharp left took you down a corridor of four offices to the right and a narrow kitchen to your left. The end of the corridor led to an open space about twice the size of my living room, and in the corner to the left was an open door to a decent-sized storage room. Wires and extension cords were strewn everywhere, and various mismatched desks were being hastily assembled as part of the company's recent hiring push. I sat down to open my Lenovo laptop freshly delivered from Costco, took a deep breath, and observed my new surroundings. I was equally excited... and nervous.

As I settled in the first couple of weeks at Healthcare Bluebook, the office began to take on a unique personality. More new hires trickled in, and we coined the open space in the back the "Analytics Grotto". The storage area connected to the grotto started as an extra conference room, but was quickly re-purposed a few weeks later to accommodate two more hires on the web development team. The small coffee pot in the morning would signal an awkward fast-walk to the kitchen to avoid being the culprit who poured the last drop and thus had to make a new pot. We didn't have a customer support team yet, so the data team (five of us total) would play hot potato with the cordless phone when somebody called our help line and we had to answer. Every Friday afternoon was happy hour, and like most house parties, we'd somehow all cram into that tiny kitchen shoulder-to-shoulder and share stories from the week.

By the time we maxed out that first office in Overlook Circle, we were literally busting at the seams. The Analytics Grotto had grown to hold over fifteen people, and I'm pretty sure we were twice over fire code capacity. But we didn't care – there was an energetic mood every day, and we welcomed every new hire even as the square footage per employee rapidly declined. When we reached a point where there was literally no desk space available without blocking a hallway or door, we rented an extra and slightly larger office on the first floor, then followed the same trend of taking up every inch of free space.

As the company grew to 20 employees, then 30, we started getting custom swag in the form of hats, cups, and t-shirts, but my favorite item was a custom grey zip-up hoodie with our company logo on the front and a number on the back indicating the the order in which we were hired – mine was "13". To some, this might've been an ominous sign, but I've never been the superstitious type and instead turned the concept on its head, referring to it as my "Lucky Number 13" hoodie. It also became a humbling reminder of my work responsibilities and the level of trust that was given to me, passing along a silent message each day I set foot in the office: don't fuck this up.

We've all experienced that feeling of curiosity in a business setting to consider what's just beyond the horizon. What kind of problems are out there waiting for a better solution? What competitors are ripe for disruption? How big of a risk will we be taking if we start walking in that direction?

For many years, our core product at Bluebook was simple: 1) set your zip code; 2) search for a procedure of interest; 3) view the "fair price" of that procedure in your market; and 4) select from a list of facilities ranked green (below the fair price), yellow (slightly above the fair price), or red (well above the fair price). That was it – no predictive modeling, quality ratings, or even the ability to search for a doctor – and there was a certain elegance to working within those forced constraints in the early days. To be clear, pulling that off behind the scenes took an enormous amount of work for such a small team, but the simple and practical output to our users was a feature, not a bug, and it worked very well for us. Most of our competitors took the kitchen sink approach and shoved every conceivable data point in front of a user, resulting in an overwhelming experience and underwhelming ROI for the employers paying for the actual product. In contrast, Bluebook was easy to use and quickly made a difference in patient behavior, and our outcomes proved it.

As the drum beat of capitalism marched onward, so did we. To sustain our growth and retain our customers, we packed up our metaphorical wagon and headed westward towards that horizon of opportunity and disruption. Much like The Oregon Trail – a reference Gen Xers and Early Millennials will appreciate – we plotted the best path we could, knowing we'd face challenges along the way that could potentially derail our entire business. But instead of bandits, dysentery, and crossing treacherous rivers, we fought against VC-funded competitors, ever-changing regulation, and an industry highly resistant towards the idea of arming patients with any type of transparent info around price and quality. There were times when we plowed right through a certain obstacle, and other times we fell hard on our faces and our founders had to pick us up and infuse that necessary adrenaline to keep us moving forward. It was exciting, exhausting, rewarding, and frustrating. Most importantly, it was absolutely worth it.

Fast forward to today: we still retain our core product offering, which now includes a provider search, network filtering, and incentive programs for members that use our site. We offer a concierge service for complex inpatient procedures, and patients using the program often save tens of thousands of dollars in out-of-pocket costs. We acquired one of the best quality data vendors in the industry and expanded our client base from self-insured employers and third-party administrators to hospitals, provider groups, brokers, and consultants. In reaction to recent transparency regulations by the federal government, we've built a compliance solution that will allow employers to adhere to the requirements of the No Surprises Act and Transparency in Coverage Rule. Our two newest products, a self-service analytics tool for consultants and an Rx solution for employers, are both taking the "substance over splash" approached we embraced with our core solution, giving users the great taste of actionable direction without the added calories of information overload. So many accomplishments in the last decade, and in many ways I feel like we're just getting started – kudos to Jeff and Bill for seeing the potential and giving each of us the opportunity to pursue it.

I don't buy into the notion that work is a family. Instead, I believe work is a supporter of families – a subtle but critical difference. If you hear executive leadership at an all-hands meeting saying, "We're all one big family!", then run far away... fast. Five years into my job, Bluebook never took that stance, and instead endeavored to infuse a culture of work / life balance. If you wanted to grind it out 70+ hours in a week to get ahead on some big project, then go for it, but that was your choice. Otherwise, 40 hours a week was fine, and working smarter was always valued over working longer. Being a recovering addict of the Hustle Culture ™ ethos, I came to appreciate an organization that encouraged social relationships and family time just as much as hitting that quarterly KPI. Little did I realize that I'd soon be leaning heavily into that support system during the most difficult period of my life.

On April 8th, 2019, my daughter Grace was born early at 26 weeks, and she spent the next 97 days fighting for her life in the NICU with three life-threatening conditions, each with a higher probably of mortality than survival. The path of care was so complex and interdependent that treating one condition just slightly the wrong way, or even over-treating it, could have an adverse effect on another condition, worsening her chances of making it out alive. Neonatology, cardiology, pulmonology, ophthalmology, radiology, nursing, and physical therapy became a delicate dance of specialties weaving in and out of her cube each day in the back-right corner of the NICU, the spot reserved for the most severe of premature infants. I struggle to describe the feelings you go through as a parent watching an innocent child brought into the world under such duress, so I won't even try to categorize those emotions. It's easy to collapse under the weight of something like that, and if you linger on it, you will. Instead, my wife and I put our full trust in the medical staff and treated each day Grace remained alive as a victory.

The support from my peers at Bluebook was swift and significant: "Take as much time off as you need, focus on your family, and we'll be waiting for you when you come back." I did take off a lot of time in the beginning, but ask any parent with a child in the NICU longer than a couple of weeks and you quickly find that having some type of daily routine outside of the hospital is not only good for your mental health, it's actively encouraged by the medical staff. Exhausted parents that refuse to leave their child's side in favor of modest level of sleep and outside activity can actually be detrimental to the infant, especially during skin-to-skin Kangaroo care when you need to be focused and breathing normally. When you think about it, your child is under the best medical supervision imaginable, and it's more about overcoming your own fears of being away for a few hours so you can rest and recover until the next visit. For cases that go beyond a month, resuming even part-time work can be a welcome distraction between visits, and we were looking at three months or longer. After initial hesitation, I took this advice.

The routine was always the same: wake up and visit Grace around 8am for 30 minutes before heading to the office, check with my wife around lunchtime when she made a solo visit, pack up around 3pm for another afternoon visit, head back home for dinner and relaxation, then make one last evening trip to the NICU to read Grace a book and tell her goodnight. After adjusting to the new schedule, I found myself recharged to see my daughter each time, and I also realized the importance of how a company's focus on supporting families can make all the difference on your mental health. Everyone at Bluebook was supportive and would occasionally ask how Grace was doing, but they also respected the fact that work was a welcome distraction for me and thus let me stay focused on my day-to-day routine. I rarely showed emotion, but I don't know how I would've coped in the absence of my coworkers maintaining that thread of normalcy with me, even when my world was anything but normal at the time. I'm eternally grateful for their support, and will pay it forward the rest of my life. 

Thankfully, this story has a happy ending. After beating the odds on each complication, our daughter came home with us on July 13th, and by the end of the year was living a healthy and happy life with few signs of the fight she endured just months earlier. The doctors frequently called her a "one in a million" baby because of the complications she had and her odds of survival, and I quickly coined her the "million dollar baby" from the bills that ran far north of seven figures – cue a sigh of relief from having great health insurance.

If there's one force more powerful than Einstein's theory of general relativity, then I'm fairly certain it's the comfort zones we all find ourselves in throughout our careers. Most of those comfort zones are tied to the level of risk we're willing to assume, especially for those with families and mortgages, but I think we sometimes use that perceived risk as a crutch to pass on new opportunities even when the risk is minimal. When paychecks are steady and benefits wide-ranging, it's easy to stay heads down and narrow your peripheral vision.

Breaking out of your comfort zone doesn't always mean looking elsewhere for a new job. It can just as easily be about looking within your own company walls for something different. Individual contributors becoming managers, managers becoming individual contributors, employees switching departments, others moving from a technical to a non-technical position... you get the point. The key is to break free of the gravity created by that comfort zone, and instead of viewing just the horizon arc, put yourself at a vantage point to view the entire circumference. Bluebook was great about encouraging this mode of thinking, and many people in the company switched roles as a result. Others decided to pursue something externally, and they were always treated with support and encouragement from their peers.

As new opportunities started coming up for me last year, I rarely moved past an informal conversation, usually referring the role to someone else in my network. I enjoyed my current job, held a fiercely loyal bond to the team I managed, and had an ever-growing list of projects and goals I still wanted to complete. But the opportunities kept coming, until one day I was presented with one that gave me a spark of excitement I hadn't felt since my original offer at Bluebook. I hesitated at first – that comfort zone gravity was in full effect – and I had to force myself to that higher vantage point of assessment and make a decision. Do I leave a company I love working for that's trying to solve a problem I'm deeply passionate about? Am I just as passionate about the type of problem this new company is trying to solve, so much that I'm willing to give it a shot? After sleeping on it, I decided yes, it was worth pursuing.

We're in the midst of a Great Resignation / Evaluation / Dispersion. Covid and the resulting shift to remote work have completely changed the game for anyone looking for a career change, especially in a technical role that requires minimal face-to-face interactions, and I don't think we're going back. Sure, the social relationships can suffer in a continuous virtual setting, but I would argue that a culture can still be infused across the digital wire if you're willing to put in the work. Like many others, Bluebook quickly mobilized to make that transition minimally awkward, and I appreciate everyone that organized virtual events that could take our minds off the pandemic and allow us to swap stories and let our kids and pets participate in the action. While we lost some great employees looking to pursue their passions elsewhere, we also became a home for just as many new employees who found us for the same reasons. That cathartic journey has been poetic in many ways, and I think we'll look back and acknowledge we all landed in a better spot because of it. 

As I reflect on my time at Bluebook, it's become quite clear to me, aside from the amazing team, what kept me at the company so long. It's the answer to a basic question: How much value am I adding to society?

For those reading this, imagine two dots, one to the left and one to the right. On the left is the dot that represents you, your role, and your responsibilities, and on the right is the dot that represents the societal value of your company. Now visualize the line connecting those two dots. Is it clear how your work translates into that societal value? Can you trace what you do today to a net positive impact made tomorrow? Does a line even exist in the first place?

For many of us, that line is anything but straight. Instead, it's a winding maze of obscurity, and by the time we find the other dot, we're not sure our work even matters. And while it's easy to correlate a line's complexity to the size of a company, I've seen it plague even small startups with just a handful of employees. The simplicity of that line is what matters, and I think it's an underlying factor in the decisions we make even if we don't realize it.

At Bluebook, the line has always remained the same: short and straight. I've seen countless instances where the work of one employee in an afternoon translates to a life-changing event for a family the next day. A data analyst providing a single mother a low-cost option for her daughter's spinal surgery, avoiding the need for the mother to take out a second mortgage on her home. A member services advocate helping a family stave off bankruptcy simply by switching a scheduled joint replacement to a different facility just down the street from the higher cost alternative. A software engineer's discussion outside of work with a family member needing heart surgery, sharing which hospital in the area has the highest quality outcomes in cardiac care. The list goes on. As someone who narrowly avoided financial ruin because of our broken healthcare system, this mission has resonated with me each and every day. The value of my work – the value of everyone's work – at this company has always been clear, concise, and captivating.

To everyone at Healthcare Bluebook I've had the privilege to work with, while I won’t be within your ranks moving forward, I'll be cheering you on as your biggest fan on the sidelines. Keep chipping away at that broken system. Keep your arms locked in that march towards the horizon. Keep picking yourselves up when you fall down. Keep being a great supporter of families. Keep helping patients.

Keep fighting the good fight!

Humbly,

JT