Fireside Chat, Interview
We Built Our Own Salesforce in Months. Here's Why We're Cancelling the $600K Contract | Curative CEO
- Fred Turner, co-founder and CEO of Curative, pivoted his career from cattle DNA testing to scaling a covert COVID-19 testing operation to $5 billion in revenue, before transitioning the company into a $1.3 billion health insurance provider.
- Turners' first venture, TL Biolabs, focused on sequencing dairy and beef cows to predict traits like musculature and milk yield, but failed to secure US Series A funding because the $1.5 billion total addressable market (TAM) was too small for venture returns.
- The company pivoted to human diagnostics, first launching an at-home STD test to address antibiotic resistance, then moving to sepsis diagnostics under the name "Shield."
- Shield was forced to shut down in late 2019 after a strategic partner killed a signed term sheet due to competitive concerns, despite the company having a lab license that Turner later sold for $150,000 to creditors before buying a replacement license for $27 million during the pandemic.
- When COVID-19 emerged, Curative leveraged a test developed in the Chief Scientific Officer's spare time and acquired a lab license in San Dimas, California, for $27 million using forward revenue from initial government contracts.
- Curative's first major government contract was with the City of Los Angeles, secured after the Deputy Mayor DM'd the CEO's friend following a tweet about available testing capacity.
- The company signed a massive contract with the state of Florida to test every employee at nursing homes across the state once a week for three months, a feat major competitors deemed impossible due to supply chain constraints.
- To achieve scale, Curative built an "orthogonal supply chain," sourcing non-standard consumables like glass filter plates and sterilized electronic swabs to bypass shortages of standard magnetic beads and reagents.
- Peak testing capacity reached 206,000 tests in a single day in December 2020, with the workforce expanding from 7 to 7,000 employees within nine months.
- Total revenue from COVID-19 testing and related services over three years was approximately $5 billion, though the company lost significant money on vaccinations ($2.5 million administered) due to low government reimbursement rates.
- Turner noted that during COVID surges, high utilization made operations profitable, but during lulls, maintaining the peak capacity infrastructure resulted in significant losses on every test.
- Curative pivoted to health insurance in late 2021, deciding against buying hospitals or expanding lab testing because the former had a fragmented payer mix and the latter had a capped market size.
- Turner argues the US healthcare market is inefficient due to extreme consolidation, where massive payers and hospital systems reach a stalemate, driving up costs without improving outcomes.
- The company is cutting approximately 80% of its SaaS spend this year, citing the cancellation of a $600,000/year Salesforce contract after building a superior internal CRM "vibe coded" in two months.
- Curative developed an in-house AI agent named "Gwen" to automate provider network contracting, increasing output from 100 contracts a week to 1,000+ a day (3,500 in eight weeks) while reducing costs from $1,500-$2,000 per contract to $70.
- The credentialing department, which previously took 2-3 months and cost $50 per doctor, is now fully automated using AI, reducing turnaround to 12 hours and costs to 20 cents per doctor.
- Curative is replacing manual underwriting data ingestion by using AI agents to write temporary Python scripts that convert diverse file formats (PDFs, spreadsheets) into standardized internal formats, eliminating the need for manual data cleaning teams.
- The company's spend on Anthropic's AI models has increased six-fold every month over the last six to seven months, rising from tens of thousands to millions of dollars monthly.
- Turner projects that in three years, spending on AI model APIs could reach 2x to 5x the cost of developer salaries as a new workforce architecture emerges where senior engineers manage dozens of unsupervised agents.
- Future staffing will likely shift toward "agent supervisors" and relationship-driven roles, as AI handles repetitive back-office tasks while humans focus on complex negotiations and patient care navigation.
- Turner predicts a future where AI agents act autonomously on behalf of users, such as signing legal contracts or booking travel, though widespread consumer trust in this level of delegation may take years to establish.
- In a secondary bet, Turner co-founded Subcritical, a nuclear energy company, to develop "energy amplifier" reactors that operate safely below criticality to prevent runaway reactions, aiming to solve US regulatory hurdles in the $1.5 trillion energy market.
- Turners believes nuclear is safe and the primary barrier to deployment is restrictive regulation rather than engineering challenges, with the new technology designed to fail-safe by shutting down automatically if the accelerator is turned off.
- Investors in Curative received a 10x return on their initial investment prior to the pivot to insurance and retained their equity in the new $1.3 billion valued company.
- Turner advises entrepreneurs to avoid European-style additive regulation, suggesting penalties for passing new rules to force iterative refinement rather than continuous bureaucratic expansion.
- Turner attributes his success in Silicon Valley to the region's willingness to bet on young founders based on vision, contrasting it with the UK's credential-focused investment culture which initially denied him meetings.