When Madhavi Vemireddy took the reins of Cleo, a benefits platform that provides end-to-end caregiving support to working families, it was because her predecessor was grappling with the very challenge that the company has made central to its mission. In January, former CEO Sarahjane Sacchetti had decided to step down when she realized it was no longer tenable for her to balance her role at Cleo with her own caregiving responsibilities after she lost a parent to a terminal illness.
Since its founding in 2016, Cleo has become the go-to family benefits platform for more than 180 companies that want to help support their employees with their caregiving commitments, from PepsiCo to Salesforce; in 2022, its overall membership increased by 60%. With its acquisition of CareTribe, a digital health platform cofounded by Vemireddy, Cleo expanded its offerings to elder care last year. Since Vemireddy stepped into her new role—first as co-CEO, and more recently as the full-time CEO of Cleo—the company has only deepened that investment, rolling out its caregiving services globally and introducing tools like the Family Health Index, which helps assess whether families and caregivers are at risk of burnout.
Cleo’s focus on caregiving is also personal for Vemireddy, who has an autistic son and, like Sacchetti, faced her own challenges navigating elder care and terminal illness—an experience she found confounding even as a physician.
As Vemireddy wraps up her first year leading Cleo, she talked to Fast Company about what she learned from being a co-CEO, how Cleo is using data to preempt families’ needs, and how AI-powered tools will shape Cleo’s product in the coming year. This interview has been edited and condensed for clarity.
What have you been working on since you became the co-CEO of Cleo back in January?
We launched our full end-to-end platform in January of this year, supporting families across all life stages, from planning parenthood through pregnancy, parenting all ages, and then supporting an adult loved one. [We’re] really seeing it resonate with 40-plus percent of our existing customers; in some cases [we] have pushed out an existing vendor because they saw the value of having it all on one platform, especially as you think about the sandwich generation that [is] supporting adult loved ones and children. We’re really excited about our population health focus and really going beyond concierge care.
I think what we’ve seen in the market is primarily a focus on concierge care, which is obviously a critical component of the support we provide. But given how large this population of caregivers and parents is, you really need a population health approach because this is a segment at very high risk of burnout. If you’re not finding those families who are at highest risk and who have early signs of mental health strain and impact to their own physical well-being, then you’re really missing an opportunity to drive whole person health for that caregiver.
You’re now the sole CEO of Cleo. When we spoke earlier this year, you said the co-CEO arrangement had made it easier to maintain some semblance of work-life balance and manage your caregiving responsibilities. Can you talk about what you learned during that period, and what it’s been like to transition into the full-time role?
I’m very happy that I had that opportunity to work alongside Tsion Lencho as co-CEO. I think it was a really good transition for me, versus being thrown into the full CEO role and having to take on 100% of the responsibilities [on] day one. It really allowed me to focus on my first span of control, which was really more on the product, member operations, clinical analytics, and engineering side of the house. And still obviously very much focused on commercial growth. It was about eight months of that co-CEO role, [and that] really allowed us to just think through the future of the business: strategy, getting teams aligned, and looking at opportunities for more cross-functional collaboration. I think we made a lot of progress during that time. So, when Tsion decided it was time for her to move on, I felt very comfortable taking on the additional responsibilities.
This is obviously an area I’m very much passionate about, just given my own caregiving journey. I think I’ve still been able to kind of maintain work-life balance, and maybe it’s because I had that transition period. I definitely love what I’m doing and love the team.
As you help other families and employees manage their caregiving responsibilities, how do you ensure that ethos is also reflected in the culture you’re building at Cleo?
One thing I really love about our culture is that it’s fostering this culture of care because we come from a place [where] many of us are parents and caregivers. I am so open about my journey and so many individuals within our leadership team and across the company are so open about their own personal journeys, whether it’s a pregnancy loss that may have happened in the recent past, or it’s caregiving for a parent, or you have a child on the autism spectrum. Or it’s just day-to day-parenting—you have a toddler who’s teething and you didn’t sleep well the night before. I commonly see kids on Zoom meetings because they’re sick. This is our reality; let’s not try to hide it. We don’t have to worry about our managers or coworkers thinking we’re distracted. This is our mission.
The first step in getting help is to just raise your hand and say, “This is what I’m going through.” And we know from the data that only 50% of families are telling their managers that they have a caregiving responsibility. I do think, especially as more and more companies add on family support benefits, by definition you’re making it easier for your employees to basically say, “Hey, I need help.”
I feel like we are being more authentic in the workplace because we’re able to talk about the things that are impacting us that might be requiring more flexibility in the workplace, or maybe we’re not having a good day because of the fact that we had a bad day at home. Also just acknowledging the impact that it has on our own mental [and] physical well being; we talk a lot about self care, and how important it is for our employees to have that mindful moment and really ask their teammates how they’re really doing, and spend time on that. I do think that’s a key focus for us—just knowing what we know about the families we support. We’re no different from them.
This year you expanded your caregiving services globally. But the caregiving landscape can be vastly different across countries. How did you get up to speed on that?
When we launched in January of this year, we already had plans around a global rollout, especially given that some of [our] customers wanted to roll out that caregiving support across their global workforce. We started in the U.K. and Canada, and then as of May, we rolled out to all the regions that we support today. We’re definitely seeing good engagement there, as well as just understanding the nuances of supporting families across the globe.
It’s really important for us to understand: What are the different care options in different countries? If you’re doing in-home care, what does that mean? What’s available to members [in Canada] versus in India? So having [local] guides in these regions who are able to provide that culturally competent care and speaking those languages has been really key to [driving] overall adoption.
We’ve started seeing how some of the needs are different. In Canada, some of the top caregiving needs are around healthy aging, planning for the future, and Alzheimer’s disease. Whereas in the U.K., planning for the future and Alzheimer’s disease were in common, but heart failure support was [also] one of the top needs, which is very interesting.
The key part of it is having your experts in these countries. They need to be living there; they need to really understand the different resources that are available [and] the different healthcare systems. In India, most of it is out of pocket, versus in other countries the government is providing a lot of the funding and resources. So, a big part of our go-to-market planning and launch was hiring some of these experts [and] doing the research in each of these regions. [They] were really able to hit the ground running [and have] that cultural understanding. In some places, the expectation is you’re going to take care of your parents in your home, not go find assisted living; India is a great example of that.
You launched the Family Health Index last year, which is designed to evaluate the well-being of caregivers. How has that been a useful tool in terms of guiding Cleo members? What are some of the most interesting findings you’ve compiled from that data?
One thing we saw missing in the market is that no one was risk-stratifying these families and really understanding from an analytics perspective what their needs were. Like I said earlier, the focus is primarily on concierge support—which is critical—but these are also families that are at different stages of burnout, depending on where they are in their caregiving journey.
Some of the initial data that we have suggests 44% are basically failing the PHQ-4, so they have early signs of depression and anxiety. If you don’t give them the support, many of them will go on to develop those conditions, which then obviously has a bigger impact on their productivity [and] on them potentially leaving the workforce. Eighty-three percent are basically telling us they’re feeling burdened from their parenting and caregiving responsibilities, and some of those folks are essentially at the stage of burnout. Sixty-five percent are saying they’re feeling isolated because [they’re] working full-time; they come home and they’ve got responsibilities, especially if they’re dealing with someone with special healthcare needs. So, their own self-care is sort of put to the side. They’re not seeing a physician, and they’re not socializing. They don’t have the time to do that.
Now that we’ve been collecting this data for 10-plus months, we’re seeing some interesting insights by different life stages. We can see the risk level for pregnant women versus parents of teenagers versus [people] in the sandwich generation. Using the Family Health Index, we now have identified who is at high risk for burnout. We see 76% of our parents with teenagers [in] that high-risk cohort because they actually have some of the more severe scores on the PHQ-4, compared to parents of children in other age groups.
When a [Cleo] member takes their assessment in our app, they get a real-time report, so they will actually see where they’re doing well [and] where they need to monitor [and nurture] a specific area. So, that’s been a great call to action for them. We target what we call our high-value interventions around where they need more help. If caregiving burden is the area you need the most help, we look at those responsibilities that you’re doing day to day. What can we take off your plate? Maybe we need to help look for childcare options [or] find in-home care support or set up meal delivery or transportation, so not all of these responsibilities are falling on that caregiver. We can [also] help them engage other family members. With 44% of our families having early signs of mental health strain, we’ll triage them based on their score, and folks with a higher score [will] get referred out to the mental health benefit.
The other great thing is because we’re aggregating these insights across different life stages, it allows us to identify what the common needs are within a cohort. So even if they don’t take [the Family Health Index], we know what types of interventions are likely to benefit a family. We launched support plans a couple of months ago, and that’s specific to the age of your child [and] your caregiving situation. We basically generate a support plan where we’ve identified top areas of education [and] resources and really drive you to a specialist that can help you. Maybe it’s a sleep specialist, maybe it’s a dementia expert, or maybe it’s group coaching.
Looking toward 2024, what are your top priorities at Cleo?
A big focus for us is around leveraging AI and machine learning. We are just about a month away from launching our first product feature under what we call Cleo Assist. That’s our suite of AI-powered capabilities, focused on supporting our parents and caregivers, as well as supporting our guides and helping to automate certain functions, create more structured data, [and] drive more personalization of the support plan and more predictive analytics.
We really want to identify families who are earlier in their caregiving journey but at highest risk for mental health strain [and] burnout, so that we can get them the right support to mitigate that from happening. That’s [also] going to allow us to really drive more cost savings back to our employer. One of the AI applications is benefit recommendations. Because of what we know about families—ages of their children, [or whether] they’re taking care of a parent—we can recommend certain benefits to them. Our goal is to be that one-stop family front door.
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