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C T I N N O V A T O R S , 2 0 2 5 4 7 "Every time the government fixes a problem, it creates 10 new ones." — Michael Waterbury had ruled out for Goodroot. at was before Boyle knocked on the door with a blueprint for a promising approach. From there, it was a straight line to a win-win. In 2024, Goodroot sold RemedyOne. e buyer, Precision Health Group, is a formulary management company under MedImpact, a national pharmacy benefit organization. Precision Health Group and RemedyOne had a strategic partnership and the deal was an extension of that relationship, said Liz Chasse, CEO of SixFold, Goodroot's in-house public relations and marketing firm. However, most of RemedyOne's employees remained within the Goodroot network by joining Navion, a pharmacy benefits consultancy that evolved from the company's former AlignRx brand. Navion incorporates elements of RemedyOne along with Goodroot's merged CoeoRx and Nuwae units. CoeoRx served as a pharmacy benefit navigator for small and midsized employers, while Nuwae worked with drugmakers, payers and patients to promote single, transparent pricing for medications. On the other side of the ledger, Sola, Goodroot's vehicle for helping companies looking for a self-funded health insurance option, failed to survive. Competitors tweaked their approaches to better serve the top end of that market leaving Sola with too many troubled clients, Waterbury explained. "It was the first time I heard the acronym DTQ — decline to quote," he said. Even the best self-funded plans need back-up from a reinsurer. When the risk profile of those plans becomes so tough that reinsurers decline to even quote a price, the path forward can't be found with a GPS. Other Goodroot companies have stayed the course. ey include: • Penstock – Provides payment integrity and reimbursement services for health plans and providers. • Breez – An online financial assistance service that partners with hospitals to manage aid programs. Working directly with patients, Breez prequalifies individuals for reduced-cost or free care at nonprofit hospitals and identifies available assistance options. • Emry – A medical and pharmacy cost-navigation firm that helps employees find affordable care. Its tools include discounted provider pricing, pre-treatment cost comparisons and post-treatment bill review and resolution. And there was a surprise addition. Goodroot's internal public relations and marketing team began attracting attention from outside the company. Clients — and even local Canton businesses — started asking for help. Before long, SixFold became its own startup under the Goodroot umbrella. Chasse, its CEO who has been at Goodroot for about five years, credits Waterbury with much of SixFold's success as well as her own. "Mike is the biggest cheerleader," she said. "He got me to believe in myself." 'Unsustainable' costs While Goodroot's portfolio of firms has shrunk over the past two years, the mission remains ambitious and far-ranging. Still, some churn in the pharmacy benefits space seems natural at a time when PBMs are under renewed scrutiny at both the state and federal level. More than three dozen reform bills have been introduced, but no consensus has emerged beyond the view that the system isn't working as intended. Several major PBMs have voluntarily made changes to improve pricing transparency. at's just one factor feeding Waterbury's growing frustration. "Every time the government fixes a problem, it creates 10 new ones," Waterbury said. He argues the industry needs more than a whack-a-mole response to the problems of a healthcare system most agree is broken. "Healthcare costs are unsustainable," Waterbury said. "We need to bring this back to the top of the agenda and be transparent about the issues, and how to address them." Paul Portsmore, founder and CEO of Greenwich advisory firm Sequoia Health Solutions and a former Blue Cross executive, has noticed his friend's frustration. A customer and frequent golf partner, Portsmore said he takes Waterbury seriously when he talks about convening a summit of insurers, hospitals, PBMs, physicians, foundations and government officials to rethink the system from the ground up. "He has the industry credibility," Portsmore said. Waterbury seems eager to get started. "It's not dependent on who is in office, but rather on aligning the stakeholders, finalizing the plans, and putting the team in place." Still, Portsmore is also realistic. "I doubt he'll get all these people to come to Collinsville," he said with a chuckle, noting that finding a unifying vision will be difficult. But he believes Waterbury is one of the few who could try. And Waterbury knows a bit about hitting long shots. Portsmore notes that Waterbury has hit two holes-in-one during his golfing career. "Each (came) as a guest during a member-guest tournament on our first holes," Waterbury recalls. "I then decided to join each club. Not many people have that golf story to tell." Now, Waterbury is focused on trying to hit a hole-in-one with his bid to rebuild health care from the ground up. I