An Interview with Bill Snyder, CEO of Cylinder Health

Cylinder delivers personalized, clinician-backed care to those suffering from digestive issues through its virtual health platform. Cylinder’s tech-forward, human-first program connects members to the right level of support at the right time through an easy interface, bringing the healthcare ecosystem together to align around member needs. Cylinder’s dedicated care teams help members proactively address their gut health from every angle – decreasing costs, reducing absenteeism, and improving their quality of life, at scale. Cylinder’s vision is to create a world where people receive convenient, personalized, and affordable access to the quality digestive healthcare they need to improve their overall health. 

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Tim Gordon: You've been on quite a journey for the last five plus years with the company's first iteration as Vivante Health and now Cylinder. Tell us a bit about the origin story and your vision from here forward.

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Bill Snyder: We founded Cylinder in 2021 with the mission to revolutionize digital health, gut first. So we're working with individuals who suffer from chronic digestive conditions and their related symptoms. It was always a passion project for me because I had seen the toll that digestive health conditions take on people from physical, emotional, and mental perspectives. I knew that this was a big problem that needed an innovative solution to ensure that people are getting the right care at the right time. Since then, we've built an incredible solution. We've been serving members across the country and in every state and it's been really exciting to see us be able to improve the lives of the members we serve and generate incredible outcomes for our patients and for our partners.

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TG: The company has grown a lot in the last few years. Tell us a little bit about that growth and its drivers.

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BS: Cylinder is a B2B2C model, meaning that we sell to large self-funded employers and to health plans, and we’ve seen incredible growth in both segments. I think there's three main reasons for that. The first is, we've been able to generate incredible outcomes at scale. We've shown great clinical outcomes for our patients, cost reductions, and an incredible patient experience. The second is our ability to work within the care ecosystem. We're actively billing through claims with several major health plans, and we're also working in collaboration with the brick-and-mortar providers, ensuring there's no siloed care. The third is just the recognition of the scope and the seriousness of this problem. More and more employers and health plans are seeing this as a major cost driver and they understand they need something innovative to help reduce costs and improve the care for their employees and plan members.

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TG: You successfully raised a pretty substantial Series B at a time when it was nearly impossible to do that. What do you attribute that positive outcome to?

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BS: We were really fortunate - we had an oversubscribed Series B and competing term sheets. I think that it comes down to the fundamentals of the business. We are tackling a massive problem. $136 billion are spent in digestive health in the U.S. every year alone. We are building something innovative and have seen incredible engagement rates with employers and health plans that we're working with. This translated to a really good revenue profile and really strong unit economics, as well as great gross margins because we're really leveraging technology to optimize the care that we deliver. And then I always go back to the team that we've been able to build - it's all about surrounding yourself with the right people. And we've done that in every role in the organization. We're really proud of the team that we've been able to put together.

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TG: I've had a front row seat to some of the “access to care” issues that we see in the GI space. About a year and a half ago, I needed a GI appointment because I was concerned about something, and one place couldn't see me for three months and the other one couldn't see me for 15 months. These are the two major systems in Philadelphia. It was eye-opening and I thought about Cylinder a lot while all this was happening. Can you speak about some of the systemic issues that make a platform like Cylinder so critical for those who are struggling with access to care, regardless of how acute their condition might be?

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BS: Unfortunately, your story is so common. I think part of this is the makeup of digestive health itself, which is an umbrella term that covers a lot of different conditions, such as ulcerative colitis, Crohn's Disease, irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and a whole host of other conditions. There's also a big population out there who are symptomatic but are looking for care like you were in your scenario and, but don't know where to even begin.

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I think that’s what's really difficult -  there's no novel biomarker. There's no singular way to tell how a patient is doing quickly and effectively. It takes time. It takes spending time with the patient and getting to know what's going on in their life. And unfortunately, the doctors out in the brick-and-mortar setting are doing the best they can, but they have limited time. They can only see patients for short periods of time and they're inundated with patients in need.

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That is a big opportunity for us at Cylinder and why we've had so much success because we can immediately understand the patient, build an evidence-based clinical pathway based on their personal need, and then wrap them with a coordinated care team of health coaches, registered dieticians, gastroenterologists, and internal medicine specialists. And so I do think that that immediate access is really important.

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TG: At the tail end of both of those conversations with those health systems, I immediately saw the Cylinder value proposition to a payer and an employer. Can you guess what they told me to do?

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BS: Write down what you're eating and come back in 90 days?

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TG: Worse. They said, “go to the emergency room.”

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BS: <laughs> Oh my gosh.

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TG: Right? Can you imagine how often someone calls like I did? And the front desk of these places says, “well, if you really don't feel well, go to the ER.” How many payers are eating ER bills from people who have no business being there? I obviously did not go to the ER, but that was what both of them said. That's not the answer.

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BS: That is so common and it's validated in third party literature. You see digestive issues as a leading cause for emergency room admissions across the country. And even the gastroenterologists, a lot of them will tell you when patients come into their doors, they're either way too early or way too late. And understanding that time where the care can be most effective is very important. You're absolutely right in terms of our value proposition and what we're trying to do to fix the system.

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TG: I guess the answer should have been “call Cylinder, right?”

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BS: Right <laugh>.

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TG: We've obviously been privileged in getting to know you along this whole journey and have really appreciated your approach to people and culture. What's important to you and the company in any leader who joins Cylinder?

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BS: There's a reason why we've enjoyed partnering with you and your team so much, because I think we're very aligned with how specific we are about the people that we bring into the organization. We're really fortunate that we are a mission-driven company. So people who come to Cylinder are often passionate about the problem that we're trying to solve. They themselves, or a loved one, has usually been impacted by a digestive health condition. They understand that it's a massive problem and they come ready to dive in. I think at a company level, we really focus on transparency, accountability and collaboration throughout our organization. That starts with the people.

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You know, we're looking for people that are going to come in who are going to hold themselves and others accountable. They're transparent about areas where they do really well and where they can either learn or develop along the way. They're collaborative - they're coming in with no ego and instead are focused on the mission and looking forward to collaborating with other, like-minded professionals who are dedicated to helping those in need. That's the baseline of what we look for.

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We do a rigorous screening for every potential new associate at Cylinder. That's why we've enjoyed partnering with you and your team so much because we're very aligned in terms of how we think about that process. And you all have been great partners in that work, which has led to some incredible senior leadership team members that we've been able to bring into Cylinder.

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TG: Thank you for that. The recent rebrand to Cylinder was a seminal moment for the company. What was important for you to capture in the new brand to help define the next chapter?

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BS: We wanted to showcase the work that we're doing for our members and for our partners. So we wanted the brand to be consistent throughout every touchpoint that we have within the care ecosystem. As we thought about what was important to us, we talked often about the fact that we are delivering something that is innovative, new, and unique, but we also wanted to make sure it was accessible because this is a set of conditions that impacts a huge number of individuals. It's every demographic, it's every age group. We wanted to make sure that we were accessible to everyone.

That led us to the name “Cylinder.” We thought of the cylinder shape - it is dynamic and relatively innovative as a shape itself, but everyone knows what a cylinder is, so it is accessible. We wanted to focus on the fact that we were available on demand and that we were going to be there for individuals who are suffering from these very personal conditions. And that's what we tried to pull through with the new branding.

It was an incredible job by everyone at the company. And we're really excited with the finished version. Our members and partners have told us that they love the new brand. So we feel like we did a really nice job on that.

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TG: Being a CEO, founder, and entrepreneur is a challenging role. What keeps you up at night?

BS: It can be a lonely job. The things that you're always thinking about are your people. Are your people feeling fulfilled? Are they doing everything that we need to be doing in order to achieve our mission? Am I supporting them the right way and making sure that they have the space to be empowered and then the drive to accomplish the goals that we’ve set out and co-created together? It's a lot of time spent thinking about the people and the team, and ensuring that you're setting them up for success, because I think that's the biggest, most important aspect of being a founder and CEO.

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Once you build a great team, you start to think more of the dynamics of the business and market. What are we thinking about, not only for the next six months, but what's happening for the next three years, next five years, next 10 years. A great example of this is the onset of GLP-1 - that changed the market and it changed it in a way that I don't think anybody could really have foreseen for us. Fortunately, that ended up being a tailwind because the number one side effect of GLP-1’s is digestive health issues. So we're seeing more members in need of our services. For me it is always thinking about the future state now that we've built such an incredible team and what's our next step as an organization to achieve our mission and vision?

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TG: What are you most excited about right now?

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BS: We've got a lot to be excited about. What I'm most excited about, honestly, is the team that we've built. We do have an incredible group of people who are dedicated to our mission and are working really hard to bring this innovative solution to market. And it's absolutely exciting.

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The other thing that I'm really excited about is the feedback from our members. We are impacting members' lives every single day, and it’s pretty great to be able to hear those patient stories.

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The future is really bright for the company. We're seeing continued growth, continued partnerships, and a lot of interest in what we're doing and what we've built.

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TG: Thank you for spending the time with us!