Ancillary Care Management (ACM),
co-founded by CEO
Dave Willcutts and Chief Clinical
Officer Thomas McNulty, was
growing at a steady clip even
through the turn-of-the-century
tech slog. The pair each put up
$50,000 of their own money
to start the company in 1995. They
brainstormed, planned and
consulted from Willcutts’ Pasadena
apartment.
Their first break came in August of
1996 when Blue Cross
of St. Louis asked if they knew of a
company that could
help with the ancillary segment of
its health care spending
(coordinating home infusions or
delivering equipment, such as
a wheelchair, to a patient and
processing it correctly). Willcutts
and McNulty were still just
consulting but had begun a plan
to go into supplying medical
equipment and providing home
infusion coordination - a niche that
had grown largely out of the
HIV/AIDS epidemic. Business at ACM
grew steadily, but it was
manageable.
PUMPED UP WITH CAPITAL
But when three venture capital firms
pumped in a total of
$12 million during 2001 and 2002,
ACM was suddenly soaring
to financial heights the two
founders hadn’t expected – at least
not so quickly. Last year the
company grossed $450 million and
reached No. 9 on
Inc. magazine’s list
of the fastest growing
companies. From 2003 to 2006 ACM
grew 2,942.1 percent.
Willcutts had to make timely
decisions to keep the company
ventilated and paced for growth.
“You’re constantly scrambling,” he
says. There’s the organizing
of the growth, hiring talent, making
sure middle management
does most of the billing at
strategic times. “You’re changing
the
organization structure from a top
level, core executive team that’s
good at executing, to a structure
with multi-layers of middle
management – from 20 employees to
400.”
New York Mayor and business mogul
Michael Bloomberg
had once said the CEO of a
fast-growing company has got to
slow it down because trends come to
an end and curves always
straighten out. But those words
aren’t easy for Willcutts to hear
because in some ways his life is
just beginning. He had just turned
40.
He got married. And he sees ACM
soaring even further than it has.
“I remember when someone said when
we moved past $100
million, ‘Wow, did you ever think
you’d be here?’ and I said, ‘Yeah,
and this isn’t good enough.’”
Those words are also hard for Selina
Lo to hear, although
the CEO of Ruckus Wireless, a
wireless network provider in
Sunnyvale, sees the sense in them.
“I think it is more of an art
than science in terms of when you
let loose the leash and how
much,” she says. “For me in general,
I like three quarters of
accelerated growth. In my business,
I may do well in one quarter,
but I need to see three quarters of
sustainable growth before I
believe it is a trend.”
HITTING A HOME RUN
Drive north 20 miles on Highway 101
up from Sunnyvale to
San Francisco and 32-year-old Jeff
Fluhr, CEO of online ticket
broker StubHub, will tell you that
when he looks behind him
every six to 12 months, his company
looks entirely different.
People have come and gone. He has
moved his offices seven
times from the industrial grit of
the Bayview district to the spit
and polish of downtown’s financial
center.
What suddenly spawned stratospheric
growth at StubHub was
when Fluhr and Major League Baseball
(MLB) signed a contract
giving StubHub the league’s official
ticket exchange business.
Flying back from New York, Fluhr,
with a company that had fewer
than 20 employees, had made promises
StubHub might not have
been able to keep.
“We were pulling all-nighters,
drinking coffee, making changes
to our system, improving software
code to handle the business,”
he says, describing a moment that
forged trust and reliance
among workers. “We didn’t have a lot
of resources to execute, but
had to do the best we could.”
The company succeeded. But as it
grew, (StubHub now has 350 employees
nationally) that intimacy faded.

Ruckus hasn’t faced that problem yet
– even though
CEO Lo was bequeathed with $30
million in venture
capital last year, has the attention
of national media
outlets and is holding meetings with
the likes of media
mogul Rupert Murdoch. Her
three-year-old company
has about 60 employees and
manufactures multiple-
input, multiple-output (MIMO)
antenna boxes that
speed video streaming over Wi-Fi
connections.
What brought the company into
national scrutiny
and board room discomfort was Lo’s
decision
to market Internet Protocol
Televison (IPTV)
distribution. IPTV is pretty much a
Wi-Fi connection
to your TV. Ruckus started letting
its service providers
test the product called MediaFlex in
the first quarter
of 2005. It generated a lot of hype,
but there were no
further deployments until the second
half of 2006
– and that mostly in Europe. To get
anything, Lo had to
time everything.
“By the middle of 2005, I had 80
carriers testing
my stuff,” Lo says. “If I based my
hiring on all those
carriers converting to buying
customers by Q4, then I
would have been bankrupt. In my
business, it’s slow to
acquire a customer. But once you do,
they can really
push your volume – and that’s the
hardest growth to
control.”
She learned that lesson 10 years ago
when she
was with a start-up called Adaptive,
a maker of ATM
local-area networks. There were only
a few companies
that could compete, such as FORE
Systems Inc. the
brainchild of Eric Cooper, a
professor of computer
science at Carnegie Mellon
University. But timely
product deployment was essential.
“Adaptive had the best product, but
it wasn’t ready,”
Lo recalls. “Because of that, FORE
Systems benefited
– and that is something I will
always remember. Timing
is the most critical thing.”
At StubHub, after scoring the MLB
contract, Fluhr
noticed the company was growing in a
business-to-
business trajectory, which at the
time he thought
was fine. The early strategy was
dependent upon
that model, working with teams and
media partners
and leveraging others – not building
a brand. It
was working well, Fluhr recalls, but following that
path would have precluded success
because of the
competition.
“We’re now a more consumer-oriented
company,
getting more consumers to come to
the site, not just
getting customers through other
websites,” he says.
Then there was a second issue behind
the fast
growth – infrastructure. “We were
growing so rapidly
that a lot of the infrastructure,
the people and systems
in some of the less
revenue-generating areas [human
resources, accounting] had been less
mature than a
lot of the revenue-focused areas,”
Fluhr says. “We
always struggled there.”
Quick growth will do that, as
Willcutts attests.
“It does put a strain on an
organization to grow in
$100 million increments annually,”
he says, adding
that it is common to have the
current core team
be completely different from the one
you started
with - founders included. That, he
says, is one of the
greatest challenges in growing, not
just for him but for
employees.
HITS AND MISSES
When the company found clients who
did business
in multiple states, some employees,
who were used to
regional responsibility, couldn’t
take it. “You’ve got to
get someone over me, I can’t handle
this responsibility,”
Willcutts recalls a key employee
saying shortly after
the company doubled in size. His
head of call centers,
for instance, had begun at ACM with
three people
under her and now she’s in charge of
150. “That’s a
great success story,” he says.
Willcutts’ venture board
now helps find employees who are
prepared to grow
alongside the company. ACM now has
350 employees
nationwide and is considering going
public.
Companies experiencing similar
growth, Willcutts
says, should focus on primary goals.
His dad, a
physician in Massachusetts, where
Willcutts spent
his teens and 20s doing home
infusion from dad’s
specialty pharmacy, used to tell his
son to treat his
future business like a residency. So
Willcutts, who majored in
English at Bucknell University in
Lewisburg, Penn., made sure he
worked at an almost “obsessive” rate
to keep his company focused
on infusion, specialty drugs and
related nursing services, and
medical equipment. “Keeping that
focus is important we believe
because it’s then easier to pursue
the next exciting thing.”
In January, Ruckus sold 100,000
MediaFlex systems to 125
customers throughout Europe and the
United States. Lo’s goal
is to take the Wi-Fi solution beyond
TV and establish it throughout
the house, from the kitchen to the
furnace downstairs. She wants
customers on their way home from
work to be able click a few
buttons and be able to preheat their
ovens, turn on the porch
light or program their TIVOs.
“I’ve always been in the enterprise
phase [of a company],” she
says, “and I found it fascinating
that I can build a product I can
use myself. It was pure curiosity
that got me in the door and then
once you’re in, you don’t look
back.”
Also in January, eBay Inc. purchased
StubHub for $310 million,
a deal that will likely close by the
first quarter of 2007. EBay will
fuse StubHub’s technology with its
own tickets business. Neither
Fluhr nor eBay said whether StubHub
employees would lose
their jobs.
ACM, maintains its office in
Pasadena, but has since moved its
headquarters to Minneapolis. It now
serves more than 35 million
people using managed care.
Myke Folger is a contributing editor
to California CEO.
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November 2007 Issue
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