Creating the 'food as medicine' category with Ashley Tyrner from FarmboxRX

Introduction (00:00:00)

• Ashley Tyrner is the founder and CEO of Farmbox RX, a patient engagement company that uses food as medicine for food as engagement within healthcare.
• Farmbox RX created the category of 'food as medicine' within healthcare.
• Farmbox RX started as a direct-to-consumer (DTC) grocery service.
• Farmbox RX now works with over 90 health plans across the country to bring 'food as medicine' to people in need.
• People with certain chronic diseases can manage their care through their diet.
• Farmbox RX provides people with the healthy produce they need, even if they don't have access or money.
• Health plans are footing the bill for Farmbox RX's services.

Food as medicine (00:02:12)

• FarmboxRX uses food as a tool to engage and incentivize members of health plans to participate in preventative care like diabetic eye exams, mammograms, and colonoscopies.
• Members are typically low-income, food insecure, and have chronic conditions like type 2 diabetes, cardiovascular disease, and hypertension.
• FarmboxRX provides culturally appropriate boxes of food that are tailored to each member's chronic condition and dietary needs.
• Health literacy materials are included in each box to educate members about their condition and how to access care.
• FarmboxRX connects members to other care resources, such as care managers and transportation companies.
• FarmboxRX was founded 10 years ago as a direct-to-consumer entity to address food insecurity and eradicate food deserts.
• In 2020, the company entered the healthcare market after policy changes allowed health plans to offer food and produce to members with certain chronic conditions.
• Health plans are interested in using food as a tool for engagement because it helps them manage the care of their members and get them to participate in preventative care.
• FarmboxRX believes that low-income individuals do want to be healthy, but they often lack the affordability, accessibility, and knowledge to do so.
• By solving these challenges, FarmboxRX empowers members to take control of their health.

Grocery logistics with fresh produce (00:07:07)

• Ashley Tyrner, the co-founder of FarmboxRX, shares her experience of living in a food desert while pregnant 14 years ago.
• She highlights the challenges faced by individuals with limited access to fresh produce due to socioeconomic issues.
• The early days of FarmboxRX involved pioneering the shipping of fresh produce to customers' doorsteps via FedEx or UPS.
• It took about three years to figure out how to ship produce in all seasons while maintaining quality.
• Certain foods cannot be shipped together due to ethylene gas, which can cause faster ripening.
• Shipping fresh produce requires careful consideration of factors such as temperature, packaging, and compatibility of different foods.
• FarmboxRX had to overcome challenges related to shipping produce to different regions during different seasons.
• Some foods, like bananas and oranges, cannot be shipped together as they release ethylene gas, which speeds up ripening.
• The company developed methods to mitigate ethylene gas and ensure the quality of the produce in their boxes.

Working with health plans (00:09:27)

• FarmboxRX aims to eliminate food deserts and provide healthy produce to underserved communities.
• Initially, investors wanted FarmboxRX to become a meal kit service, but the company stayed true to its mission.
• FarmboxRX gained traction by partnering with health plans to offer produce as a benefit to their members, generating revenue solely through health plans.
• The company's success lies in demonstrating positive outcomes, such as driving people into preventative screenings through the use of food as an engagement tool.
• FarmboxRX transitioned from offering direct-to-consumer services to focusing on the 'food as medicine' category, requiring a shift in their revenue model and operational processes.

Bootstrapping a capital-heavy business (00:15:13)

• FarmboxRX, founded by Ashley Tyrner, provides a "food as medicine" program that experienced a surge in its direct-to-consumer business during the COVID-19 pandemic.
• The company transitioned to a B2B model, marketing to health plans and government contracts, requiring a new team and compliance with healthcare regulations.
• Despite challenges in raising capital, FarmboxRX bootstrapped its operations and achieved profitability without external funding.
• FarmboxRX created its own category in healthcare, maintaining control over its vision and direction without investor influence.
• The company generates a return on investment for health plans by engaging patients in quality outcomes like mammograms and diabetic eye exams.
• FarmboxRX seeks investors to support its next phase of growth and expansion.

Distribution and logistics (00:20:48)

• Partnered with one of the largest produce distributors in the country to handle operations.
• Distributor sources all the produce, packs the boxes, and FedEx picks up and delivers the boxes.
• Utilizes the existing food logistics infrastructure for produce in the country.
• Operates eight different distribution centers in different parts of the country to ensure proximity to members.
• FedEx handles all deliveries, ensuring the boxes are out of the cold chain for a maximum of a day and a half before reaching the member's door.
• Ashley Tyrner, the founder of FarmboxRX, came from a unique background as a single mother on food stamps.
• She was inspired to start FarmboxRX to address the problem of food insecurity and lack of access to healthy food.
• Despite her initial concerns and worries about the uncertainty of entrepreneurship, she decided to take the leap and pursue her passion for providing healthy food to those in need.

Ashley’s leadership style (00:22:48)

• Ashley Tyrner, a single mother without a college degree, founded FarmboxRX despite facing challenges.
• Tyrner possesses an entrepreneurial spirit and used creativity to make money, like selling Beanie Babies during the craze.
• She values perseverance and resourcefulness, not letting obstacles hinder her success.
• Tyrner chose New York for FarmboxRX due to its established delivery infrastructure.
• Her fashion industry experience taught her the importance of hard work and independence, which she applied to entrepreneurship.
• As a leader, Tyrner demands excellence but also values diverse backgrounds and skills, prioritizing employee well-being and company success.
• She emphasizes the significance of the "food as medicine" movement in healthcare and acknowledges the potential impact of failure on millions of people.
• Tyrner is open to learning from other food companies and exploring new ideas to enhance her business.

COvid’s impact on online grocery (00:28:15)

• The pandemic pushed people who never shopped online before to shop online.
• Online shopping for groceries has become a vital option for those who lack accessibility, such as the homebound and those without transportation.
• The sudden increase in online grocery shopping led to the allowance of SNAP and EBT cards as a form of payment online.
• There will always be shoppers who prefer to pick out their own groceries, but online shopping has changed the lives of those who need accessibility.
• Access to technology and the internet remains a challenge for some populations.
• FarmboxRX is looking to expand within other health plans, as the big national plans cover a massive percentage of the country and they have only reached a small portion of that market.
• They see themselves as a patient or member engagement company and are expanding their product line to include engagement products such as health risk appraisals and mail-order pharmacy sign-ups.
• Their growth path is expanding in being a member and patient engagement company.

Fundraising challenges (00:31:49)

• Ashley Tyrner, the founder of FarmboxRX, discussed her fundraising journey.
• Investors wanted FarmboxRX to pivot into a meal kit company, but Tyrner refused as she believed in her original vision.
• Tyrner highlighted the importance of finding investors who have experience in the industry you're trying to build in.
• The pandemic shifted the way people get groceries, opening up opportunities for companies like FarmboxRX to provide fresh produce to people in food deserts.
• FarmboxRX accepts SNAP and EBT payments, making it easier for people with low incomes to access healthy food.
• The pandemic accelerated the growth of FarmboxRX by allowing them to adopt a new business model.

Host discussion (00:35:48)

• SNAP can now be used for online groceries, increasing access to marginalized communities.
• Healthcare plans are working with communities to provide affordable and accessible healthcare options, including nudging people to make healthier choices through messaging in food boxes.
• Creative ways of using patient data, such as sending reminders for medical appointments in food boxes, can help people be more proactive about their health.
• FarmboxRX is looking to take on funding and scale up its operations.
• Different foods cannot be shipped at different times of the year due to biological factors, such as the release of gases from bananas.