Spring Health

Instacart

Spring Health

B2B employer benefit — similar model to Lyra Health but with a sharper focus on precision matching. Companies pay Spring Health a per-employee-per-month fee.

Employees take an initial assessment and Spring Health's algorithm recommends a care pathway: therapy, medication management, coaching, digital self-care, or a combination. The key differentiator is the precision — the algorithm claims to reduce treatment time by 50% by getting the right match first instead of cycling through options.

Spring Health also provides a therapist network, psychiatric services, and crisis support. Revenue scales with employer contracts and employee utilization.

Instacart

Instacart operates as a marketplace connecting consumers with personal shoppers and grocery retailers. Revenue comes from multiple streams: delivery fees and service fees charged to consumers (typically $3.99+ per delivery), tips to shoppers (passed through, not revenue), retailer partnerships (grocers pay Instacart for access to the platform and fulfillment services), and advertising.

Advertising has become the crown jewel. Instacart Ads lets consumer packaged goods (CPG) brands like Coca-Cola, Procter & Gamble, and Nestlé pay for sponsored product placements within the Instacart shopping experience.

When someone searches for "chips," Doritos can pay to appear first. This is incredibly valuable because it's advertising at the exact moment of purchase intent.

Ad revenue was $871 million in 2023 and crossed $950 million in 2024.

The retailer partnership model is key. Unlike DoorDash or Uber Eats (which listed restaurants without permission early on), Instacart works with grocers as partners.

Over 1,500 retail banners including Costco, Kroger, Albertsons, and Publix have formal partnerships. Instacart provides the technology and shoppers.

Grocers provide inventory and stores.

Spring Health

April Koh was studying computational neuroscience at Yale when she encountered research on precision medicine for depression — the idea that you could use data to predict which patients would respond to therapy versus medication versus a combination. The existing system was essentially trial and error: try an antidepressant for six weeks, and if it doesn't work, try another one.

Meanwhile, patients suffer. Koh co-founded Spring Health in 2016 with Adam Chekroud, a Yale neuroscience PhD, to build a platform that uses machine learning to match employees to the right mental health treatment on the first try.

They started by publishing peer-reviewed research showing their algorithms could predict treatment response better than chance, then turned that research into a product that employers would pay for.

Instacart

Apoorva Mehta was a 26-year-old Amazon engineer in Seattle who quit his job in 2012 to start a company. The only problem: he had no idea what to build.

Over the next year, he started and abandoned roughly 20 different projects. A social network for lawyers.

A way to track restaurant wait times. Nothing stuck.

Then one day he was too lazy to go grocery shopping. He looked for a service that would shop for him and deliver everything to his door.

Nothing good existed. The existing options were grocery store delivery services that only worked during specific windows, had limited selection, and required ordering days in advance.

Mehta wanted to order groceries the way he ordered everything else online — immediately, from whatever store he wanted.

He built a prototype in 2012 and applied to Y Combinator. The demo was rough — he ordered a six-pack of beer through the app and had it delivered to a YC partner's house during the application process.

It worked. He got in.

Instacart launched in the San Francisco Bay Area in 2013 with a simple promise: order from your favorite local grocery store and have someone shop for you and deliver within an hour.

Spring Health

Enterprise sales to large employers, competing directly with Lyra Health, Headspace Health, and traditional EAP providers. Spring Health leads with outcomes data — publishing research showing faster recovery times and higher clinical improvement rates than industry benchmarks.

Celebrity advisor Apolo Ohno and high-profile board members gave early credibility. Series C at $2.5 billion valuation generated press coverage that opened doors.

International expansion to serve global workforces. Strategic investment from Kinnevik gave European distribution relationships.

Partnership with health plans to offer Spring Health as the behavioral health component within existing benefits.

Instacart

Instacart grew by solving a problem one city at a time. They launched in San Francisco, proved the model, then expanded to other major metros.

Each new market required recruiting shoppers, signing up retailers, and building enough consumer density to make the economics work.

The COVID-19 pandemic was the inflection point. Grocery delivery went from luxury to necessity overnight.

In March 2020 Instacart announced it would add 300,000 shoppers, then raised that by another 250,000 weeks later. Order volume increased 500%.

Years of planned growth happened in weeks. The pandemic proved that grocery delivery wasn't a niche — it was the future of how a significant chunk of the population would shop.

The enterprise play is the long-term moat. By providing white-label technology to grocers, Instacart becomes embedded in their operations.

Even if a grocery chain wanted to build its own delivery service, they'd need years and hundreds of millions to replicate what Instacart provides. The more deeply integrated Instacart becomes in grocery operations, the harder it is to rip out.

Spring Health

Direct competition with Lyra Health, which is larger and better-funded. The employer mental health benefit space is crowded and increasingly commoditized — every startup claims better outcomes and faster ROI.

Therapist supply is the binding constraint across the entire industry. Proving that ML-driven matching actually produces better outcomes than simply having a good therapist network is a difficult clinical claim to substantiate at scale.

Employee engagement is everything — if employees don't take the initial assessment, the precision matching engine can't work. And the macro headwind: employer benefits budgets are under pressure, and mental health benefits are easier to cut than medical benefits when money gets tight.

Instacart

The post-COVID hangover was brutal. After pandemic demand normalized, growth slowed dramatically.

The company's valuation dropped from a peak of $39 billion in early 2021 to about $10 billion at IPO in September 2023. Investors who bought at the peak saw a 75% paper loss.

The narrative shifted from "essential infrastructure" to "nice-to-have luxury."

Unit economics are perpetually tight. Paying a person to walk through a grocery store, pick items, bag them, and drive them to someone's house is expensive.

Unlike meal delivery (one restaurant, one bag), grocery delivery involves dozens of items per order, refrigeration requirements, and substitution decisions. Every order that requires a shopper to call the customer about an out-of-stock item eats into efficiency.

Amazon is the existential threat. Amazon Fresh, Whole Foods delivery, and Amazon's own logistics network represent a competitor with nearly unlimited resources and a Prime membership base of 200+ million.

Amazon has been willing to lose billions on grocery delivery to build market share. Instacart's advantage is retailer partnerships — Kroger and Publix use Instacart specifically because they don't want to help Amazon dominate grocery.

Spring Health

Precision mental health platform — ML-driven assessment that predicts optimal treatment pathway for each individual. Therapist matching engine connecting employees to the right provider by specialty, approach, and predicted fit.

Spring Health Moments — bite-sized digital exercises based on CBT for mild symptoms. Medication management through in-house psychiatric providers.

Manager and HR tools for supporting teams without violating privacy. Work-life coaching for non-clinical needs like stress and work-life balance.

Family support extending benefits to dependents. Crisis support including 24/7 access for emergencies.

Instacart

Instacart Marketplace — the core platform where consumers order groceries from 80,000+ stores for delivery or pickup, with personal shoppers fulfilling orders. Instacart+ — subscription service ($9.99/month) offering free delivery on orders over $35, reduced service fees, and credit back on pickup orders.

Instacart Ads — a retail media platform letting CPG brands run sponsored product listings, display ads, and coupons within the shopping experience. Instacart Platform (Enterprise) — white-label e-commerce technology that lets grocers build their own online ordering and fulfillment powered by Instacart's infrastructure.

Caper Cart — AI-powered smart shopping carts (from the 2021 Caper AI acquisition) with built-in screens, barcode scanners, and payment that let shoppers skip the checkout line.

Spring Health

Investors include Tiger Global Management, Kinnevik, Northzone, William K. Warren Foundation, and Able Partners.

Series C in 2022 valued the company at $2.5 billion.

Instacart

Sequoia Capital was an early and consistent backer. Andreessen Horowitz invested in growth rounds.

D1 Capital Partners led the 2021 round that valued Instacart at $39 billion. Existing investors including Valiant Capital, T.

Rowe Price, Fidelity, and Tiger Global participated across rounds. Y Combinator was the starting point (Summer 2012 batch).

The September 2023 IPO on NASDAQ priced at $30 per share, valuing the company at approximately $10 billion.