If there was ever a rubber-meets-road moment for six-year-old app Gale Healthcare Solutions, it’s probably right now.
Gale Healthcare Solutions, founded in 2016, matches nurses with available work shifts. A hospital or clinic posts available shifts, then nurses can peruse opportunities, claim open spots and be paid the same day through the platform. This network of nurses now stretches to 40,000, CEO and founder Tony Braswell tells TechCrunch.
Up until this point, Gale Healthcare Solutions has been entirely self funded. But on Wednesday, the company announced a $60 million dollar growth equity investment from FTV Capital.
“They have arguably the largest network of nurses in the United States for this type of platform,” Richard Liu, a partner at FTV Capital, tells TechCrunch. But the firm was also drawn to Gale because of Braswell’s own experience.
"Tony has been doing healthcare staffing for three decades and so he's built up a ton of this industry domain knowledge,” Liu continues.
Braswell comes to Gale Healthcare Solutions after 30 years in healthcare staffing. He made phone calls, sent emails and crafted texts constantly looking to fill temporary nursing shifts. But about six years ago, Braswell realized he was going about things the wrong way. "Amazon comes to my house every day and the typical staffing company calls people every day. That's not efficient. So we built technology," Braswell says.
Adequate nurse staffing is increasingly recognized as a major driver of patient well-being. For instance, one study across acute care hospitals in England, Belgium, Ireland, Spain, Finland and Switzerland found that for every 10% reduction in the proportion of professional nurses at a hospital resulted in an 11% in odds of death. Studies from the U.S. and Korea have also linked higher nursing staff to better patient outcomes.
Findings like this have led to legislation in California, for instance, that actually mandates that hospitals maintain a minimum number of nurses per patient, depending on the type of care being provided.
If you zoom out, there is also a clear shortage of nurses filling shifts in general. A 2017 report by the U.S. Department of Health and Human Services projects that seven states will have significant nursing shortages by 2030. California, for instance, is estimated to have a nursing shortage of over 44,000. Texas will have a shortage of 15,900 and New Jersey will have a shortage of around 11,400 full-time nurses.
COVID-19 has only accelerated things as healthcare workers face immensely heavy patient loads on fewer physical and emotional resources.
There are already staffing agencies geared toward filling the empty nurse shifts (estimates for the temporary healthcare worker market size hover around 19-20 billion). But with a problem as pressing (and large) as nursing shortages, you’re likely to have more than tech-centric startups looking to solve it. And when it comes to matching nurses with shifts, there are other players in the space. Specifically IntelyCare, another app that matches nurses and shifts.
Braswell, through his experience, notes that being able to find positions quickly and easily is a big part of making it work as a temporary nurse. But the company is also looking to create a more stable form of gig work that offers certain perks.
Gale nurses are W-2 employees with the option of a healthcare benefits package. But Gale’s distinguishing characteristic is same-day pay, facilitated through a third party. Nurses can be paid immediately, if they pay a small fee (this, Gale has clarified, does not represent revenue for Gale). Braswell has been fronting the money to enable this feature (“there’s a lot of float there,” he notes). But he sees it as an essential piece of making Gale work for temporary healthcare staff.
“I can’t tell you how many nurses contact me personally, out of 40,000, who need $25 for gas money,” he says. Unfortunately, a lot of nurses are in that situation. This empowers that nurse to work when she wants to work, and get paid when she wants to get paid.”
Despite fronting the money for same-day paychecks, both Liu and Braswell note that Gale Healthcare Solutions is currently profitable. The company earns revenue by charging healthcare facilities for each shift a nurse works. That fee is in line with “industry standard," Liu clarifies.
(That is something to note, as traditional healthcare staffing agencies have been accused by some lawmakers of price-gouging in response to the pandemic. But Liu puts Gale’s position bluntly: “Gale never did that.”)
In terms of Gale’s history and future growth, Braswell, as a founder, wasn’t initially interested in pursuing venture capital. But now, he feels the time is right, largely, for technical expertise and further connections. Liu also notes that FTV has focused on building out the technical capacity of Gale with this current round -- specifically he’s looking to evolve the platform, and provide more tools for hospitals and nurses.
And, with that growing technology, it’s possible Gale might eye more than just nurse staffing. Braswell has his eyes set on expanding the idea of easily accessible, same-day-pay gig work across other jobs in healthcare facilities: like housekeeping, laundry or cooks. Liu, for his part, will also focus on expanding Gale’s network of 40,000 nurses into more states. They’re in about 38 right now.
“With network models, you know, increased density increases the fill rates, right, which are important in this industry,” Liu says.
*This article has been updated to reflect that nurses pay a small fee to receive same day pay. It has also been updated to clarify that Gale's revenue is obtained by charging healthcare facilities for shifts worked by Gale's nurses.