An Interview with David Stein, Co-Founder & CEO of Ash

Ash is revolutionizing how providers and patients access at-home health testing with a mission to enable accessible healthcare for all. With one integration with the Ash platform, clients unlock a full suite of services required to deliver customized testing programs to their unique patient populations. Ash’s proven approach is fully white label, creating a cohesive at-home testing program, from multi-channel outreach to test kits to connecting members to follow-up care. With Ash, patients have better access to healthcare and better outcomes. Our Founder, Tim Gordon, sat down with the Co-Founder and CEO of Ash, David Stein for a chat about where Ash has been, where they’re going, and what he’s most excited about right now.

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Tim Gordon: It's common to see in healthcare that Founders have a personal tie to the mission that their company is on. What led you to co-found Ash?

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David Stein: We're an at-home health testing platform that partners with digital health companies and health plans to turn on their at-home testing programs. Our belief is that by bringing at-home health testing to wherever is most convenient for patients, we're making healthcare more inclusive and accessible. And I lead with this because we started Ash on the consumer side to make sexually transmitted infection  (STI) testing, specifically for the LGBTQ+ community, more inclusive and accessible. 

The genesis of Ash came from personal pain points in accessing testing in an easy and convenient way, and to be honest, I could not move on from how hard it was to conveniently get tested. I ended up going back to grad school to launch Ash on the consumer side to make STI testing from home convenient and inclusive. As we launched, COVID-19 hit, and it made sense to start selling on the B2B side and that business took off. Shortly after, we completely retired the consumer side and have been working with partners to launch white-labeled at-home testing programs for the last four and a half years.

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Tim G: Expanding on that, what's the big picture vision for what you're building?

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David S: We’ve expanded from just doing sexual health testing, selling directly to consumers, to now running over 150 different biomarkers in all 50 states. And we do absolutely everything for our partners to turn white labeled at-home health testing for their specific patient populations.

One of our core differentiators is that we drive higher adherence and completion rates around our testing programs. And the reason for that is our engagement technology, the white-labeled aspect, and our optimized user experience that is tailored to each specific population. We spend a lot of time thinking about what is appropriate engagement for each population type. This means spending time both on the physical testing kits, and even more so on actually engaging patients to get through the testing process… thinking about how best to reach them, how best to support them and speak to them. This is critically important because 70% of medical decisions or diagnoses are made using laboratory results, and so the data that we're ultimately providing to our partners is extremely important in that continuum of care.

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Tim G: It's a business with a fair amount of complexity as a result. You are dealing with supply chain considerations and regulatory complexities that some don't have to deal with. How have you navigated through some of those hurdles?

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David S: First and foremost, there is no cutting corners. I think we've watched a lot of big players and small players try to cut corners, get penalized for it, and ultimately have it really affect their brand and their ability to grow. We pride ourselves on our quality and efficacy around everything we do and touch. And even if it means we can't win every client and serve every testing program, we're doing everything by the book. 

Second, is that we considered trying to change healthcare from the outside in - like a direct to consumer approach, but the path that has worked for Ash, is changing healthcare from within. This means working with instead of against existing healthcare systems and structures to change how people receive healthcare and bring it into the home. Our entire strategy is to go after the biggest players, be it national healthcare payers, regional health care payers, major enterprise digital health companies, employers, public health departments, etc., to work within these existing systems to get Americans convenient, accessible healthcare from wherever is most convenient.

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Tim G: What surprised you the most in the early years of building a healthcare startup?

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David S: What surprised me most is that from the outside, healthcare appears incredibly complex—but you assume that everyone working within it must understand what’s going on and how to fix what’s broken. But the deeper you go, the more you realize that’s often not the case. Much of the system is fractured, and the solutions are far from obvious.

One of the most important lessons we’ve learned is that in many of the rooms we enter, we’re expected to be the experts in our area of healthcare and in general as well, even when we were newer players in the field. That means doing our homework and taking real pride in being deeply knowledgeable about what we say we do best.

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Tim G: When you were thinking this through, what entry point did you see that gave you the belief that you could upend a complex segment like this that has large old incumbents, as well as established newcomers.

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David S: For me personally, the clearest indicator has been the consistently subpar user experiences offered by many of our competitors. These experiences often fail to make healthcare more convenient or accessible for patients—and that gap has been one of our biggest motivators. It's something we continue to push on.

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Tim G: Ash is in its early innings here and has already found some pretty significant success. And you've done that without raising a ton of capital or hiring a ton of people. Can you share more about the company's growth and then in light of those aspects, what do you attribute the success to?

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David S: We've had really great growth over the last couple of years. We went from doing $6.5 million in revenue in 2023 to $16 million last year and planning to continue to grow in that way. The biggest reason for the growth rate is our perseverance. We've reimagined how to go about this space in a less capital intensive way - and our timing was right. 

Many of our competitors were around well before COVID and experienced explosive growth when they pivoted to COVID testing—sometimes seeing their revenues increase 100-fold. While that surge was beneficial in the short term, it also led to massive fundraising at inflated valuations that weren't sustainable once testing demand disappeared.

In contrast, although we’re venture-backed and have grown quickly, we’ve always prioritized sustainability. We’ve been intentional about building with profitability in mind, resisting the temptation to raise excessive capital at valuations we couldn’t justify. As a result, we’ve built a fundamentally sound and resilient business.

Unlike many of our competitors, we don’t own or operate our lab partners. Instead, our value lies in the technology infrastructure that connects all the moving parts. That strategic choice allows us to focus on delivering best-in-class user experiences, software, and engagement tools. Operationally, this has enabled us to offer the largest testing menu, widest geographic reach, fastest turnaround times, lowest rejection rates, and the most competitive pricing.

In hindsight, building sustainably has been a blessing. It’s not only made us stronger as a business—it’s led to better outcomes and a better product.

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Tim G: In tandem with that, culture and team-building are pretty important. What's been your approach to that and what's worked really well so far?

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David S: I had a few very formative startup experiences before Ash. I was at a company that got acquired by WeWork in the heyday and heights of all that. I was then at another company where there was a solo founder and it grew from one to 40 employees in about a year. Those two experiences really formed how I think about building a company and a startup culture specifically. 

And I think the biggest thing, and I say this in every external and internal interaction about the topic, is that if I have the privilege of starting and building a company, I really only want to work with nice and kind people. And that's the line in the sand for me and I'd say we've been true to that so far. We also don't care for smart assholes. So even if there's someone that is doing an incredible job as far as results are concerned, they have to do it in a kind and nice way.

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Tim G: What do you wish you had done sooner?

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David S: Not a truly nuanced answer here, unfortunately, but putting stuff out in the market before we were really ready. Even if it's in version 0.0001, just getting it to market and seeing if people actually sign the dotted line is something that I think we continue to push to see how soon we can test and deploy. And so more of a general lesson than something specific on that side.

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Tim G: The old “don't let perfect get in the way of good.” What's aspirational on the team and culture side in the next turn of the business?

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David S: I think about it in two ways. One, the talent that we are able to attract currently. I've just been in awe that we've been able to bring in - top players from other amazing companies, both on an employee talent level, but also on a board level. And people are genuinely excited to get involved with what we're doing. 

The other side of it is to reach members where they're at in the way they want it to be spoken to. In the last 12 months, honestly, we went from being able to do that in a pretty good way to being able to do that in an exceptional way. And these are with AI tools that are off the shelf and are easy for us to layer in and use to our advantage.

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Tim G: As you continue to grow and reach new milestones, what do you think is the next big chapter for the business.

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David S: We launched a new vertical in November last year for Health Plans doing gap closure testing. We've really revved up our ability to put together a go-to-market plan and get stuff out there, and with that new opportunities have just come to our doorstep. We're really excited about all the potential avenues where health testing in the home or wherever is most convenient for patients have become something that is the norm and quite popular and a lot of big players are actively looking for solutions. 

I'm most excited about the market forces at play in the digital health space. I think the people who did not build sustainable companies are moving out the way and it's just made a ton of space for us to go and win amazing work and serve amazing populations and help close the gap around all these different healthcare verticals.

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