🔒2025 Innovator: Goodroot founder Waterbury sets out to confront the inefficiencies, rising costs of U.S. health care

There’s no mistaking the joy in Michael Waterbury’s voice as he recalls his introduction to the world of health insurance. It was 1995 and managed care was just becoming a thing. Oxford Health Plans was gearing up to grab a share of this new market, and Waterbury was among the recent college grads who signed on. From day one, he recalls feeling the energy in the building and the sense of importance in what they were doing. But there was also chaos. He likened it to flying the plane while building it. For the next 20 years, across multiple jobs and employers, he had a front-row seat — and often a hand — as the contours of managed care came into focus. It wasn’t always pretty, efficient or patient-centric. But it was profitable. Very profitable. By the time he set off to build his own healthcare empire in 2015, Waterbury had crystallized a vision of fixes he believed the system needed. He had seen too many middlemen and misaligned incentives, and too little focus on the patient. He believed there was room — and a pressing need — for businesses that could make the system more transparent, efficient and, ultimately, less costly. So he started building. Today, Waterbury is CEO of Canton-based Goodroot, an umbrella company that provides capital, finance, legal, HR, sales and marketing support to scale healthcare technology startups. Goodroot has helped launch 10 companies so far that have offered services ranging from benefit navigation and pharmacy benefit consulting to health engagement. Nearly a decade in, Waterbury said he’s taken on no debt and no outside capital. He also estimates the Goodroot network has saved more than $1 billion for patients and providers, though he concedes that’s just a drop in the bucket compared with the size of the U.S. healthcare market. “It’s time to swing for the fences,” he said, hinting at a new initiative to confront what he calls the unsustainable costs of U.S. health care.

Twist of karma

Waterbury knows about swinging for the fences. At Newtown High School, he was captain of the baseball, basketball and soccer teams. In weighing his options for college, Waterbury bet on his baseball skills and signed on to a Division I scholarship offer from the improving University of Richmond program. What followed, he acknowledges, was his first taste of failure. As a freshman, he rarely played and was schooled in the fine arts of pitching batting practice and manicuring the field. When the incoming class brought even more baseball talent, he saw the handwriting on the wall and turned his attention to the classroom. There, his timing was better. The university was launching a leadership program, which Waterbury describes as a beta version of the entrepreneurship offerings now common on campuses across the country. He focused on finance and marketing. Yet, by graduation day, he didn’t have a firm idea of a future course.

He went home and spent the summer working for a plant nursery owned by his future father-in-law. “It was hard, honest work,” he recalls. And it reminded Waterbury it was time to put his business degree to work. For the next nine years, he helped develop Oxford’s approach — and success — in the New York metropolitan area. When Oxford became a subsidiary of UnitedHealth Group in 2004, Waterbury was responsible for integrating the systems as vice president of network for New York. In 2007, he joined Avon-based Magellan Health — a behavioral and specialty healthcare management company — as senior vice president of medical pharmacy services, and later president of ICORE, its specialty pharmacy unit. In the latter role, he said, revenue grew from $300 million to $500 million, and earnings jumped from $30 million to $50 million. It was a twist of karma that changed his career trajectory. Waterbury prides himself on building relationships but when successfully negotiating a lawsuit settlement for ICORE, he found himself the odd man out. The parties agreed to a merger, as long as the new company didn’t include Waterbury. He left with a check and the thought that it was time to become his own boss. Check out other 2025 Innovator profiles

Evolving portfolio

That was 2015 and within months he’d moved to Collinsville and launched RemedyOne. The pharmacy benefit consulting firm helps employers and health plans lower drug costs and improve results through rebate and formulary management. RemedyOne would eventually become part of Goodroot, which was founded in 2020. Since then, startups have come and gone through the accelerator. For example, in October, Empara — a developer of AI-driven tools that help employers and administrators manage health benefits — was acquired by Pennsylvania-based Opyn Health, a provider of digital tools for healthcare price transparency, virtual care and provider connections. Three of Empara’s founders joined Opyn as part of the deal. Goodroot, a privately held firm, does not disclose terms of any of its transactions. A month earlier, Clearfile — which develops software that streamlines regulatory filings and licensure for health insurers, pharmacy benefit managers and other healthcare organizations — was acquired by Maryland-based Lumelight, a company specializing in compliance and claims technology. Waterbury spoke like a proud parent as Goodroot mentee and Clearfile founder Joe Boyle graduated from the Collinsville accelerator program. “Joe came to Goodroot with a vision to solve a problem most people avoid: regulatory complexity,” Waterbury said. “We backed that vision with capital, talent and infrastructure — and in under two years, he built one of the most respected names in regulatory filing. That’s what we do at Goodroot: champion healthcare leaders and accelerate ideas that can reshape the system.” While glad to take a bow, Waterbury is quick to acknowledge regulatory compliance was an area he initially had ruled out for Goodroot. That was before Boyle knocked on the door with a blueprint for a promising approach. From there, it was a straight line to a win-win. In 2024, Goodroot sold RemedyOne. The buyer, Precision Health Group, is a formulary management company under MedImpact, a national pharmacy benefit organization. Precision Health Group and RemedyOne had a strategic partnership and the deal was an extension of that relationship, said Liz Chasse, CEO of SixFold, Goodroot’s in-house public relations and marketing firm. However, most of RemedyOne’s employees remained within the Goodroot network by joining Navion, a pharmacy benefits consultancy that evolved from the company’s former AlignRx brand. Navion incorporates elements of RemedyOne along with Goodroot’s merged CoeoRx and Nuwae units. CoeoRx served as a pharmacy benefit navigator for small and midsized employers, while Nuwae worked with drugmakers, payers and patients to promote single, transparent pricing for medications. On the other side of the ledger, Sola, Goodroot’s vehicle for helping companies looking for a self-funded health insurance option, failed to survive. Competitors tweaked their approaches to better serve the top end of that market leaving Sola with too many troubled clients, Waterbury explained. “It was the first time I heard the acronym DTQ — decline to quote,” he said. Even the best self-funded plans need back-up from a reinsurer. When the risk profile of those plans becomes so tough that reinsurers decline to even quote a price, the path forward can’t be found with a GPS. Other Goodroot companies have stayed the course. They include:

• Penstock – Provides payment integrity and reimbursement services for health plans and providers.
• Breez – An online financial assistance service that partners with hospitals to manage aid programs. Working directly with patients, Breez prequalifies individuals for reduced-cost or free care at nonprofit hospitals and identifies available assistance options.
• Emry – A medical and pharmacy cost-navigation firm that helps employees find affordable care. Its tools include discounted provider pricing, pre-treatment cost comparisons and post-treatment bill review and resolution.

And there was a surprise addition. Goodroot’s internal public relations and marketing team began attracting attention from outside the company. Clients — and even local Canton businesses — started asking for help. Before long, SixFold became its own startup under the Goodroot umbrella. Chasse, its CEO who has been at Goodroot for about five years, credits Waterbury with much of SixFold’s success as well as her own. “Mike is the biggest cheerleader,” she said. “He got me to believe in myself.”

‘Unsustainable’ costs

While Goodroot’s portfolio of firms has shrunk over the past two years, the mission remains ambitious and far-ranging. Still, some churn in the pharmacy benefits space seems natural at a time when PBMs are under renewed scrutiny at both the state and federal level. More than three dozen reform bills have been introduced, but no consensus has emerged beyond the view that the system isn’t working as intended. Several major PBMs have voluntarily made changes to improve pricing transparency. That’s just one factor feeding Waterbury’s growing frustration. “Every time the government fixes a problem, it creates 10 new ones,” Waterbury said. He argues the industry needs more than a whack-a-mole response to the problems of a healthcare system most agree is broken. “Healthcare costs are unsustainable,” Waterbury said. “We need to bring this back to the top of the agenda and be transparent about the issues, and how to address them.”

“Every time the government fixes a problem, it creates 10 new ones.” — Michael Waterbury

Paul Portsmore, founder and CEO of Greenwich advisory firm Sequoia Health Solutions and a former Blue Cross executive, has noticed his friend’s frustration. A customer and frequent golf partner, Portsmore said he takes Waterbury seriously when he talks about convening a summit of insurers, hospitals, PBMs, physicians, foundations and government officials to rethink the system from the ground up. “He has the industry credibility,” Portsmore said. Waterbury seems eager to get started. “It’s not dependent on who is in office, but rather on aligning the stakeholders, finalizing the plans, and putting the team in place.” Still, Portsmore is also realistic. “I doubt he’ll get all these people to come to Collinsville,” he said with a chuckle, noting that finding a unifying vision will be difficult. But he believes Waterbury is one of the few who could try. And Waterbury knows a bit about hitting long shots. Portsmore notes that Waterbury has hit two holes-in-one during his golfing career. “Each (came) as a guest during a member-guest tournament on our first holes,” Waterbury recalls. “I then decided to join each club. Not many people have that golf story to tell.” Now, Waterbury is focused on trying to hit a hole-in-one with his bid to rebuild health care from the ground up. Check out other 2025 Innovator profiles