TLDR
- Oura sells to people who chose to wear a ring. Most health hardware founders sell into employers, health systems and plans, where the wearer, the operator and the payer are three different people.
- Kinetic co-founder Haytham Elhawary put a belt-worn sensor on warehouse workers, fought churn driven by the prevention paradox, then rebuilt the company as a workers’ comp MGA writing more than $100M in premium this year.
- The operator lessons: design for the involuntary wearer, close the loop at the device, contract for the counterfactual, and stop trying to convince actuaries.
Oura’s IPO will set the terms of the wearables conversation for the rest of the year. Founders will screenshot the S-1, investors will reprice their comps, and every seed deck with a sensor in it will add an Oura logo to the market slide.
For most people building health hardware, that is the wrong comparable. Oura’s buyer is the wearer. They chose the ring, they pay for the subscription, and they open the app because they want to. Almost nobody reading this sells that way. You sell to an employer, a health system or a plan. The person wearing your device was told to wear it, the person watching the dashboard has twenty other priorities, and the person paying for it will never see either of them.
Kinetic built a business in that second world, and Haytham Elhawary, its co-founder and former CEO, has made most of the mistakes available there. We sat down to go through them.
Kinetic in brief
Haytham’s mother is a nurse who was injured on the job more than once. That stayed with him, and roughly twelve years ago he co-founded Kinetic to reduce musculoskeletal injuries at work. The device clips to a worker’s belt, detects a high-risk lift and vibrates so the worker corrects their form. Kinetic sold it to large self-insured employers, the UPS and DHL tier, for years.
In late 2021 it launched an insurance business: a managing general agent selling workers’ comp on Nationwide’s capacity, with the wearables given away free. It sold its first policy about a day after launch. Haytham says Kinetic will write more than $100M in premium this year on roughly $30M of venture capital. He left the company in January.
Design for the wearer who didn’t volunteer
Kinetic’s first device looked like a gun belt, and workers nicknamed it “the bra.” The next version went into a back brace, which got sweaty and was abandoned. The design that stuck clipped to a belt and looked like a pager. Even then, workers wanted to know whether it had a microphone and whether they would be fired for not lifting enough. Kinetic had to standardize how it explained the product on the floor, and still fought every morning over whether people remembered to pick the device up.
So I asked Haytham whether he would put a new device on workers if he started today.
His exceptions are useful. A device the job requires, such as one that clocks you in, gets worn. A sensor on something already mandatory, like a safety vest, gets worn. A new device that nothing depends on gets left in the locker. The question for any B2B hardware founder is what happens the day the wearer leaves your device at home. If the answer is nothing, your adherence curve is already set.
Close the loop at the device
Kinetic built dashboards for managers showing how many high-risk movements workers made and how far that number had fallen. Managers rarely looked. The injury reduction came from the vibration on the belt at the moment of the lift, which pulled workers out of habits they didn’t know they had. Every handoff between detecting a problem and someone acting on it is a place for value to leak. RPM and ambient-sensing founders should map their own handoffs with that in mind.
Contract for the counterfactual
Success created the hardest problem Kinetic had.
Once injuries fall and stay down, buyers stop crediting the device for injuries that no longer happen. Haytham saw churn spike after a year or two, from customers convinced their workers now moved perfectly. The budget structure makes it worse. Actuaries set the injury reserve, the CFO books it with medical inflation, and the safety manager championing your device cannot move that number. A physical therapy product can show a claim that used to cost $50,000 now costs $30,000. Prevention asks a CFO to pay for a claim that never arrived.
DPP, fall-prevention and MSK founders are up against the same wall. Put the baseline and the attribution method in the contract before signing, or move toward the entity that books the savings.
Stop trying to convince actuaries
Kinetic moved toward the savings, and it did so without winning the actuarial argument.
It compared workers who wore the device with workers at the same sites who didn’t, and had an actuarial firm turn the difference into frequency and severity. Then it took the results to business-minded partners. Nationwide, an early investor that had watched the results for years, became its capacity partner.
The policy design removed the need for anyone to believe the device worked. Kinetic priced policies the usual way, gave the devices away and paid customers a dividend at the end of the term when injuries fell. The actuaries were comfortable because pricing assumed nothing. Nationwide was comfortable because the devices cost it nothing. And because Kinetic operates as an MGA, it earns commission without holding the risk.
That also answers the slide every hardware deck carries: “insurers will pay for our data.” Haytham’s experience is that insurers have a pricing method, and new data doesn’t fit into it. The value came from a structure that put the devices inside Nationwide’s distribution, not from licensing a data feed.
Prevention wins the meeting; claims win the renewal
Once Kinetic was in insurance, the change-management problem followed it to smaller customers. Haytham also found that companies switch carriers because of bad claims experiences, not because of prevention. Kinetic now puts much of its investment into claims management: dashboards showing each customer’s loss ratio, next-best actions on open claims, and AI agents that turned a growing data-entry team’s work into pre-filled underwriting files.
What to take from it
Oura will teach founders a lot about consumer subscription hardware. If your wearer, operator and payer are different people, Kinetic’s twelve years are the better syllabus. Before your next pilot, answer four questions. Would the wearer notice if they left your device at home? Does your product act at the moment of detection, or does it produce a report? Who books the savings, and is that person in the room? And what structure would let a partner adopt your product without first believing your outcome data?
The full conversation with Haytham is below.
