By Beth Houck, CEO, SonarMD
June 2025 – I’m from the part of the country venture firms call “flyover” territory—where they pass over us en route to deals on the coasts.
This isn’t a new concept—plenty has been written about these Midwestern companies that have defied coastal expectations. Here in Columbus, we saw Olive AI and CoverMyMeds hit billion-dollar valuations and several venture firms build their brand story on their investments in this part of the country. (As an aside, Olive AI shut down two years after their peak.)
When the venture firms talk about the characteristics of companies from these areas, they talk about the pragmatism, the solidness, the – well – un-sexiness (is that a word?) of the businesses they back. To way overuse stereotypes, these are companies that quietly solve real problems, spend less, and somehow stay incredibly nice while doing it. Yep, that’s our brand.
What doesn’t get enough attention, though, is the resilience we’ve earned—not just as founders, but as lifelong fans of heartbreak-prone sports teams and how this can translate to our ability to run these new companies in one of the most complicated sectors of our economy: healthcare.
If you’re from New England or Seattle or Los Angeles, you may not know this special talent and the kind of character that Midwestern sports fans develop over decades of disappointment:
1. Consider That It’s a Journey
As a consultant in Chicago in the 90’s, I snuck out of work early during the days I was unassigned to a project. This often meant a quick purchase of Cubs bleacher seats in an effort to avoid the sunburn that would rat us out the next day. The Cubs lost all the time. In that entire decade, they never made a playoff. I don’t remember the win-loss record—but I remember the journey, the camaraderie, and the loyalty.
I counsel many people early in their career who have romanticized the idea of working for a start-up, imagining the unicorns and the accompanying financial gains. Instead, imagine the colorful winding journey. At a start-up in a regulatory-influenced industry, that path will include dead-ends and bumpy roads. It will also include interesting people and unexpected views.
Those of us who are okay with the outcome being the journey can weather the inevitable disappointments that come along the way. My second start-up zero-ed in on serving the pain points made bare by the Meaningful Use/MIPS/MACRA program(s). We were a must-have and then a nice-to-have and then found ourselves serving an entirely new market. And honestly? The journey was incredible.
2. Be Irrationally Persistent
Starting a company is not rational. Healthcare doesn’t behave rationally. Going back to the same prospect multiple times is irrational. Do it anyway. Show up like a team rebuilding for the 10th time—plans and all. It’s not the irrational part I’m emphasizing, it’s the persistence.
In the early years of a start-up, everyone is a salesperson. I worked incredibly hard to convince a marquee health system that our solution solved their problem. I knew that it did, and I also knew how badly we needed that logo. And then they said no. Against all conventional advice, I stayed irrationally persistent, asking more questions and surfacing more problems. Eventually, I heard the wall crack: “Beth, I can’t find a reason to say no anymore.” The buyer was a Cardinals fan. I didn’t mention my Cubs allegiance.
Our company now sells to payers, working to convince them that they need to set aside their entrenched systems to benefit a small but expensive segment of their population. We need every bit of this persistence to withstand the changes in leadership and priorities.
3. And Unreasonably Optimistic
The club of long-time Browns fans starts each season believing that This is the Year. Given the track record, there’s no reason to call this anything other than unreasonable optimism.
When I’ve joined each of my start-ups as part of the founding team, I’ve done so with absolute unbridled optimism. The market will love it. Investors will line up. We’ll crush our targets.
I’d argue that this optimism isn’t naivete. When it’s real, that optimism can build stronger teams, inspire early adopters, and fuel you through the tough patches. We’re a proudly resilient bunch, earned through years of disappointing outcomes.
4. Against All Odds, You Still Might Win
I’m a lifelong Browns fan and my husband a Bears fan. In 2001, we cheered for our respective sides at the ill-fated (for Browns fans) head-to-head game. With 32 seconds left in the game, the Bears were down by 14 points. At the time-out, my husband turned to me and told me the improbable path that could happen that would allow his team to come out on top. And, then that’s what happened. And now it’s listed as one of the biggest comebacks in NFL history.
I’m not suggesting that all companies need to be brought to the brink and that you need to orchestrate a perfect and – lucky – comeback. I’m just saying – it does happen.
There are number of incredibly rational reasons to invest in Midwest companies run by Midwesterners and I’ll be proud of the day that I won’t need the resilience earned through years of sports disappointment. Until then, I’ll happily play the role of the sneaky underdog.
About the Author
Beth Houck has more than 25 years of experience in the healthcare industry. Before joining SonarMD, she led customer experience for SA Ignite, a cloud-based healthcare technology company helping provider organizations manage performance and compliance with their MACRA initiatives. Prior to SA Ignite, Beth held positions in strategy, business development and operations in several healthcare organizations, including a startup focused on patient experience measurement and at health systems and payer organizations. Beth earned an MBA with a Health Services Management concentration from the Duke University Fuqua School of Business and a bachelor’s degree in industrial engineering from Northwestern University
