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Health
Dec 8, 2021

Levels: A Cultural Anomaly

How the healthcare startup is solving a civilization-scale problem.

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ACTIONABLE INSIGHTS

If you only have a couple of minutes to spare, here's what investors, operators, and founders can learn about Levels.

  • We are in a metabolic health crisis. Nearly 9 out of 10 Americans live with poor metabolic health. That’s significant, as this can contribute to fatigue, brain fog, cardiovascular disease, and cancer. It also costs our healthcare system trillions.
  • Simple devices can help us improve our health. Using a Continuous Glucose Monitor (CGM) opens up a world of data. You can see which foods spike your blood sugar, and using a system like Levels, make healthier decisions. It’s simple but powerful.
  • Building in public has obvious advantages. Levels shares almost all of its thinking publicly. That includes all-hands meetings and working sessions between company founders. Opening its doors has been a sharp move: despite being in beta, Levels has a groundswell of consumer support that’s unusual for a company at its stage.
  • You should protect your team’s “deep work” at all costs. Traditional work environments optimize for rapid-fire communication. Meetings, Slack, text messages, and stand-ups are examples. Levels thinks these defaults are disastrous and reduce the amount of “deep work” its team can do. It does everything possible to protect this time.
  • One CEO’s guide to productivity. Sam Corcos, Levels’ CEO, has been called the  "ultimate optimizer of work, life, the universe, and everything." I studied his productivity playbook and pulled out tactics almost anyone can try for themselves. 

This piece was written as part of The Generalist's partner program. You can read about the ethical guidelines I adhere to in the link above. I always note partnerships transparently, only share my genuine opinion, and commit to working with companies I consider exceptional. Levels is one of them.

There is not a company on earth that runs quite like Levels. 

That may sound hyperbolic, but after two months of following the team's operations, talking with angel and institutional investors, and digging through every crevice and corner of their internal documentation, it is the only conclusion I can come to. 

Other businesses may operate entirely remotely — and do so with great success. A slimmer subset may embrace asynchronous communication, jettisoning tools like Slack in favor of less urgent, more thoughtful discussion. A tiny fragment may have done away with meetings, too. And perhaps, an even smaller number also favor "building in public," transparently sharing their successes and setbacks online. 

All of which is to say, there are probably a handful of businesses that leverage this particular operating system — but I have found none that execute it with the fervor and intensity of Levels. It ratchets each one of these choices up to heights that, at first glance, might look absurd: 

  • Levels is not just remote, the company's CEO, Sam Corcos, is fully nomadic. He moves from city to city, state to state, living out a backpack with a few black t-shirts, a laptop, and his handmade "focus goggles." That sets the tone for the company's commitment to being location agnostic. 
  • Levels is not just asynchronous by default, it "fights" meetings, Slack, and excessive emailing. Though not entirely outlawed, "synchronous" communication is treated warily and often assumed to be counter-productive. 
  • Levels does not just build in public, it shares everything. Really. The company's "Secret Master Plan" is open for anyone to see. Even weekly team forums are posted on YouTube, publicly available to view. 

The sum of these decisions is culturally and operationally profound. At its heart, this approach is designed to optimize for one thing above all others: maximizing deep work. Levels has assembled an elite team unusual for a company its size; it is obsessed with giving that talent the mental space to flourish. 

Operationally, these choices seem to have turned Levels into an executional machine. Though investors are naturally bullish on the companies they back, superlatives are rare. Highlighting one startup can sometimes be seen as implicitly damning others. 

When it comes to Levels' operational excellence, that etiquette is quickly dispensed with. Every investor I spoke to emphasized that this was not just a high-functioning team, but a genuinely exceptional startup, running at a pace that many had never seen before. 

Vijay Pande, a founder of Andreessen Horowitz's Bio Fund, is no stranger to working with healthcare unicorns. He said of Levels, "They just move faster than any other team I've worked with."

In today's piece, we'll try to unpack why that's the case. We'll trace Levels' origins, product innovation, broader strategy and pay particularly close attention to the cultural and operational playbooks that have generated such esteem. We'll make sure to cover: 

  • Inauspicious beginnings. The company that became Levels was just days from being shut down before a new team member delivered a new lease on life. 
  • A colossal problem. Levels is seeking to solve the "metabolic health" crisis. Though you might not be familiar with the term, its impact is immense.
  • Building an "NPS unicorn." What do Peloton and Warby Parker have in common? The answer is fundamental to Levels' growth strategy.
  • A unique culture. How does Levels manage across countries and continents with close to zero meetings? A thoughtful, intentional culture helps. So do dozens of Notion documents and hundreds of Loom videos. 
  • The Sam Corcos Starter Pack. After being dumbfounded by the insane output of the Levels' CEO, I've spent a weird amount of free time watching Loom videos of how he organizes his life. I'll walk through the biggest lessons. 
  • Hiring founders. Levels has a remarkably tenured, high-caliber talent base for an early-stage startup. That's the product of a savvy recruiting playbook. 
  • Grading investors. When it comes to adding value™, VCs have a less than stellar reputation. Levels tracks how its investors perform and rewards those that contribute most effectively. It seems to get much more out of them, as a result. 

By the end of this analysis, you'll not only have an understanding of the opportunity Levels is chasing but what makes it a true cultural anomaly. 

Origins

The path to founding Levels was not a straight one. It involved three different names, two CEOs, a green juice, a road trip, and more than a little luck. 

Magic rodents

The mice had superpowers. There was no other way to say it. 

Josh Clemente, an engineer at SpaceX, was stunned. He'd been spending his time working on a system designed to keep astronauts safe in high-oxygen environments. While most of us that have dreamt about visiting the universe beyond our planet might worry about running out of air, an abundance of oxygen can be equally if not more dangerous. Such an environment is highly flammable for one thing, but just as critically, too much oxygen can essentially poison us, shutting down our central nervous system. 

In thinking through that challenge, Clemente had stumbled upon a paper by Dr. Dominic D'Agostino, an Associate Professor at the University of South Florida, focused on studying metabolic health. In the study, D'Agostino outlined how mice could survive up to 12x longer in a high-oxygen environment if they were in a state called "ketosis," in which your body burns fat to fuel itself. 

To Clemente, such a finding was radical. As an engineer, he'd always seen the body's interaction with food as a relatively simple system with one calorie as good as the next. D'Agostino's work suggested that was far from the case. Eating different types of foods could not only meaningfully change a complex animal's body, it could be the difference between life and death. 

Clemente was particularly primed to find such a message compelling. Despite being young, healthy, and active, he was often exhausted. The long hours at SpaceX were part of the problem — he spent many nights catching a few hours of sleep beneath his desk — but he couldn't shake the feeling that something larger was causing his lethargy. In a pique of concern, he'd even visited a doctor, announcing that he was sure he had a terminal illness; he just needed help finding it. 

Out for blood

D'Agostino's paper proved the spark for an obsession that grew over the following years as Clemente not only digested an increasing volume of research papers but began to experiment with his health more boldly. He tried a ketogenic diet and then a vegan one. 

Soon, he began to prick his finger with a blood glucometer to take different readings. It was an irksome, unpleasant process, but Clemente found it fascinating. In reading Wired to Eat by Robb Wolff, he first heard of a potential upgrade: Continuous Glucose Monitors or CGMs. Once attached to the skin, these devices could track glucose levels automatically, for weeks on end.

Desperate for insights, Clemente asked his doctor for a prescription — and was promptly laughed out of the room. CGMs weren't for young, healthy patients like him. They were for advanced diabetics. If he got sick, then maybe he would become eligible. 

To someone like Clemente, that made no sense. Why would you only start to track a system after it had crashed? Wouldn't it be better to keep an eye on things proactively? 

He decided he would find another way. After failing to find a working CGM on eBay, Clemente relied on a friend smuggling one in from Australia, where they were sold over the counter. Once set up, he was shocked by the data. 

Despite being an extremely conscientious eater — his vegan diet meant he persisted on brown rice, vegetables, and fruit — his blood sugar readings were through the roof. After every meal he ate, he watched as reading spiked, explaining why he often found himself flushed in the aftermath of eating. Then, a few hours later, his blood sugar would crash, sapping his energy. He had never understood why he drank more coffee than anyone he knew — 10 cups a day — and still needed a nap. Finally, he had an explanation. 

Shower thoughts

Using his CGM as a data source, Clemente recalibrated his diet and improved his energy levels. But it wasn't easy. 

In the shower one day, Clemente was thinking through the hoops he had needed to jump through to reach this point. Not only had he needed to learn about CGMs and their purpose, he'd had to illegally import a medical device to reap its benefits. Then, he needed to keep track of it all in an Excel spreadsheet. For something that had been so transformative, it had taken extraordinary effort. Clemente knew that though millions might benefit from this information, almost no one would go to such lengths. 

He stepped out of the shower and told his then-girlfriend that he was starting a company. Ten minutes later, Maple Biometrics had been incorporated as an LLC. 

Frontier Biosciences

One of Clemente's first orders of business was to change the name. After speaking with a couple of friends, he decided that though playful, Maple was not the right name for a company that helped track your blood sugar. It was replaced with the more official-sounding Frontier Biosciences. 

The mission of the rechristened business was simple: bring the benefits of CGM to everyday consumers. Clemente foresaw a company that not only helped you get a device, it explained how to use it and why it mattered. Even better, it would give you actionable information on your data and lifestyle that you could use to make wiser decisions. Now, he just had to build it. 

That proved a formidable task, especially for a first-time entrepreneur. For one thing, CGMs were still Class III medical devices at the time. Even though they barely penetrated the skin, the FDA lumped CGMs into the same category as other "invasive" products, like pacemakers. Getting them into the hands of consumers would be a challenge. 

Clemente found it tough going. Though he had built an impressive career working at SpaceX and Virgin's Hyperloop, he'd never spent time at a startup. As a result, he had little idea of what was needed to raise financing. Rather than turn to venture investors, he decided he would bootstrap the business, only looking for outside capital once he'd established a network of doctors that could prescribe CGMs. Though admirably independent, it was a misguided approach. 

For months, Clemente worked on Frontier, delving into the healthcare industry but making little headway. 

Sleeping by the Rio Grande

A cross-country road trip proved the catalyst for a change in fortune, though it would take a while to register as such. Clemente and his girlfriend had decided to leave the balmy weather of California for the East Coast. She had been accepted to a nursing program in Philadelphia and had gone ahead to settle in. That left Clemente to traverse the country alone in his truck, a journey he hoped would clear his head.

At the last minute, he decided to stop in New Mexico. A group of friends gathered there, and he figured it would make a diverting pitstop. Among those in attendance was an old friend, Sam Corcos. 

Corcos was born and raised in the state Clemente had briefly made his own. The son of local Sacramento entrepreneurs, Corcos grew up watching his parents build businesses. After a brief period writing oncological research papers, Corcos had followed in their shoes. He'd served as CTO of a 3-D printing startup, then reprised the role at a YC company he'd co-founded. 

When Corcos reconnected with Clemente in New Mexico, he was reaching the end of his time at that second business but had yet to step back fully.

Though the men spoke for a few minutes, Clemente left the conversation sensing a kind of understanding. Corcos had shown interest in Clemente's work and the problem he was trying to solve — though not enough to make much of an impression in isolation. That evening Clemente slept in his car by the Rio Grande river, ready to continue East. Little did he know, a new journey was already underway. 

The juice cart pitch

Corcos called out of the blue. 

It had been months since he and Clemente had caught up in New Mexico. Whereas their first conversation had been brief — all broad brushstrokes — now they had the space to truly dig into what Clemente had been building. Throughout their talk, Corcos' interest grew. Not only did he see the potential of Clemente's idea, he thought he might be able to help get it up and running. 

Clemente was "days away" from giving up. He started to look at job boards and prepare his resumé.  

But Corcos made a suggestion: come to New York City. The pair would talk in greater detail, and Corcos would set up conversations with a few friendly investors. While he couldn't promise anything would come from it, Corcos thought it would at least give his friend the chance to build some relationships and start down the path to capitalization. For Clemente, it felt like a lifeline, an offer for support during a journey that had felt lonely at times. He agreed to visit. Within minutes, Corcos had begun sending email introductions to potential investors.  

In the canon of Levels' founding story, few moments have as much weight as the "juice cart moment." In New York, Clemente readied himself to speak with investors at the WeWork, where Corcos had booked a room and set up a day of meetings. Preparing himself for the day, he grabbed a "health drink" from a cart positioned outside the building. It seemed like a virtuous enough breakfast, composed of celery, apple, and carrot. 

Were these supposed to be pitches? Clemente wondered. Or was it just a casual jam session? Any doubts were extinguished when the venture capitalists walked into the room. Yes, this was a pitch. Investors peppered Clemente with questions about the market and his proposed solution. While they seemed excited by his connection to the product, the talk came alive when Clemente showed the sensor's impact. 

It had been about 30 minutes since he'd finished his juice, enough to see a change potentially. So Clemente took a reading. Instead of sitting close to the 120-140 mg/dL one might expect, his blood sugar had hit 217 mg/dL and was continuing to rise. As Clemente remembers it, "everyone's jaw hit the ground." One of them said, "I need this, and my wife needs this, and I want my kids to have this."

If the day's first meeting was cause for optimism, its second prompted reflection. Once again, Clemente made his pitch, and once more, it was well-received. But it was the investor's parting remark that stuck with him. 

"I'll tell you what...you figure out how to get Sam on board, and I'll invest. I've been trying to invest in Sam Corcos for a long time." 

"I want to be the CEO"

Over the next few weeks, Corcos and Clemente were in constant communication. Though he had no formal role in the business, Corcos seemed to be all in, continuing to make introductions, pulling together scopes of work, and outlining the future. His energy had utterly transformed Frontier, taking it from a project on its last legs to a startup, beginning to hit its stride. 

Though he hadn't yet broached the subject, Clemente had spent time thinking about what bringing Corcos aboard might look like. He clearly understood the potential and had already illustrated what he could bring to the table. To continue the conversation, Clemente planned a return trip to New York. 

At the same WeWork, Corcos began the conversation with typical frankness: "I want to be the CEO," he said. 

Clemente was shocked. Though he'd mulled over the idea of them teaming up, he'd never thought about surrendering the CEO position. After all, Frontier was his company, wasn't it? 

Corcos explained why he felt it was the right move. Though an extremely talented engineer and amiable personality, Clemente's "zone of genius" didn't seem to be managerial. Dealing with investors, handling hiring, and taking care of the constant emails that a CEO must manage to keep communication channels clear were certainly within Clemente's abilities ​— but were they really what he enjoyed? Were they where he thrived? 

By contrast, Corcos reveled in such activities. For his pleasure, he had created a database of 1,000 people he wanted to stay in touch with — and actually managed to do so. He was a walking-talking-constantly-thinking web of connections and communication lines. Already, he'd shown how he could get the right people into the room. 

Clemente resolved to think about it. To his immense credit, he realized it was the right move. "It became obvious what the right answer was," he said. "[T]he right answer was to increase the likelihood of success by bringing on people better than me at the things we need to do."

Josh Clemente became Frontier's President, and Sam Corcos began his tenure as the company's CEO. 

Levels

Over the next few months, the company that we see today emerged. The name Frontier was dropped in favor of the simpler, more evocative Levels, and Corcos began putting his formidable Rolodex to good use. 

In short order, Levels' founding team swelled from two to five. David Flinner, a former PM at Google, joined to lead the company's product function. Dr. Casey Means, a Stanford-trained surgeon expert in metabolic health, hopped aboard as Chief Medical Officer. And Andrew Conner, previously a Google engineering lead, bolstered the team's software development. 

Financing followed. Those first "juice cart" pitches converted into funding, and with Corcos at the helm, Levels quickly added firepower. As he unpacks in an appearance on the Funded podcast, Corcos leveraged an unusual playbook to find Levels' market price: "stacking" SAFE notes. 

This practice involves raising multiple rounds in succession, typically at increasing valuation caps. For example, one might raise from an angel investor at an $8 million valuation cap, followed by an investment from another funder at a $10 million valuation cap. Though controversial ​​— some investors balk at paying a higher price for a company that might not have changed much — it allowed Levels to keep bringing in money, build an army of angel investor evangelists, and find a clearing price for its venture round. By taking this approach, Corcos increased the likelihood that Levels would be capitalized fairly and ensured founders did not give up too much equity.

In late 2020, Levels officially announced it had brought aboard institutional funding. Andreessen Horowitz (a16z) led a $12 million seed, with participation from many others. 

What had seemed a fading dream to Josh Clemente a little more than 18 months earlier was now extremely real. He had the team. He had the money. It was time to bring CGM to the rest of the world. 

Opportunity: Improving metabolic health

Though many will know that America's healthcare system is flawed and that its citizenry suffers from numerous ailments at uncommon rates, the extent to which metabolic health factors into the matter is still surprising. Levels is seeking to address this issue with a simple, intuitive solution. 

The problem

The US is in the midst of a metabolic health crisis. Much of the population is overfed damaging foods that spike blood sugar levels, push us past healthy weights, manipulate blood pressure, alter cholesterol, and increase the fat in our blood. 

These changes are not simply statistical or numerical — we feel them. Poor metabolic health can contribute to fatigue, brain fog, anxiety, cardiovascular disease, and cancer. It is linked to many ailments and can affect our existence in ways big and small, from the amount of hair we have on our heads to the length of our lives. 

Large portions of the US populace suffer from such issues. One survey study suggested that 88% of Americans suffered from a metabolic problem, while another showed that more than 33% have prediabetes.

Such percentages amount to hundreds of millions of people in America. While the US is particularly pronounced in this regard, it is certainly not alone. 

Inevitably, these conditions take a toll on our healthcare system. The CDC estimates that diabetes costs $327 billion, including lost productivity. By 2030, the bill is expected to surpass $600 billion. Including other conditions affected by metabolic health quickly pushes costs into the trillions.

As Vijay Pande said in our discussion, "This is a $100 billion-scale problem."

The solution

Framing Levels as a niche business misunderstands the scale of the problem and the ambition of the solution. This company is focused on a civilization-level crisis with life on the line. Everything the team does is geared towards solving this fundamental issue. 

Today, that includes a product that solves the difficulties Clemente faced when trying to duct-tape his own offering together. Specifically, Levels provides access to CGMs through a doctor referral network, and anyone who is approved for a prescription – based on meeting specific health criteria – can access a device. A regulatory change has helped this — CGMs are no longer Class III and are more reasonably categorized as Class II. 

The device itself is not Levels' creation. As you might expect, making a medical sensor from scratch not only takes considerable time but has a lengthy approval process. Part of Levels' innovation is improving the consumer experience by 10 to 100x with software alone. To that end, Levels integrates with pre-existing device makers, bringing the data they collect into its app. 

This is where the magic happens. Via the Levels interface, you can log your food, run "challenges" (e.g., Try eating brown and white rice to see how your body reacts differently), and receive recommendations. Levels' software helps identify which foods may spike your blood sugar and how you might alter your habits to improve your health. It also provides an "overall" daily score of your metabolic health.

As someone that has used the product for the past month, it is a smooth, elegant experience that feels like the future. Even more than many other quantified health products, there's a satisfyingly visual "cause-and-effect" that encourages better decision-making. For example, I know my blood sugar rockets if I eat white rice. Since it's a food I don't care much about, it's become easy to avoid or replace.

The future

Right now, Levels only measures blood sugar. But over time, it's easy to imagine it incorporating much more data. When I asked Pande what indicators he thought it might be interesting for Levels' to monitor down the line, he pointed to serotonin, a hormone that impacts our mood. With that information, you could see how one meal or activity physiologically affects how you feel, with the data to back it up. 

Taylor Sittler, who works on Levels' clinical team, outlined other indicators the company may one day track: 

I think Levels should probably start by continuously measuring the things that will help people change their behavior to avoid metabolic disease: diabetes, cardiovascular disease, Alzheimer's. That will likely include insulin, some kind of cholesterol or triglyceride, perhaps lactate or uric acid. This is likely to change, but I currently think we will add cortisol and perhaps other biomarkers to capture stress and the immune system. This will all need to be put into the context of a larger service that includes periodic blood tests and perhaps imaging.  

While Sittler's delivery might be matter-of-fact, such a platform would be genuinely revolutionary, giving consumers much more information than they have today. Armed with that data, we could take preventative measures earlier and more precisely than is currently possible. 

Sittler summarized this potential, saying, "If we do this correctly, Levels becomes a platform that identifies early risk of disease and helps people live into their 70s and 80s without debilitating disease." 

Growth: Building an "NPS Unicorn"

Levels knows it is tackling a significant problem. It has aspirations to do it while winning over customers' affection and creating a movement around metabolic health. By doing so, it is setting itself up to be one of the most influential purveyors of soft-power in tech

NPS Unicorn

During the Code Conference in 2017, Peloton CEO John Foley pulled up a slide. It showed the net promoter scores (NPS) of some of the world's largest companies and most iconic brands. 

If you're not familiar with NPS, it is effectively a measure of customer satisfaction, collected by asking users how likely they are to recommend a company or product on a scale of 1-10. Those that select a six or lower are considered detractors, while those who choose nine or above are promoters. Anyone that picks seven or eight is excluded. A total score is found by subtracting the percentage of detractors from the percentage of promoters, meaning a detested company could receive as much as -100. At the same time, a beloved product could hit 100. 

Foley's slide showed that Nike had an NPS of 30, about average. Spotify did better at 46, while Netflix posted a solid 54. Apple's NPS was an impressive 66. Only three companies achieved a score above 90: Warby Parker (91), Peloton (91), and Tesla (97). 

Levels' growth strategy orients itself around joining this elite club of "NPS unicorns," a term coined by the team. In every interaction, Levels seeks to serve and fulfill customers, knowing that by doing so, it will create a virtuous flywheel. Happy customers will create user-generated content and recommend Levels to their friends. Those touchpoints help educate the next round of potential users, eventually converting them. If they, too, are well-served, the cycle runs again. 

Internal documentation shows that Levels has routinely surpassed an NPS of 60, putting itself within touching distance of Apple. 

Levels

Such customer affection is already bearing fruit. Maz Brumand recently joined Levels as Head of Business, having worked on strategic health initiatives for eight years at Apple. During his recruitment process, he reached out to a few friends to talk about Levels: 

When I told my network I am joining Levels, there were a number of people, much more than I expected for a small startup, that told me they knew Levels and were incredibly positive about the team, product, and mission! One person even went as far as saying that Levels changed their life...I don't know many other early-stage companies that are in beta that have done that!

From recruiting to customer acquisition, a high NPS makes everything easier. If the company can build on this elevated base, we may one day see it rivaling Tesla's score. 

Creating a movement

The second pivotal part of Levels' strategy is to "create a movement" around metabolic health. Just as Clemente discovered in his days of experimentation, even medical professionals may not realize the value seemingly healthy people can derive from tracking blood sugar and other biometric indicators. 

To change that thinking and popularize its message, Levels seeks to foster a global discussion. It's doing that by winning over influencers and investing in content. 

Look at Levels' advisors and supporters, and you'll find a collection of luminaries from the world of modern fitness and wellness. Dave Asprey of Bulletproof Coffee is a Levels fan; so too, business and marketing guru Seth Godin. Scroll Levels' blog, and you'll find many more from YouTubers to podcasters to writers to doctors — all with large audiences. Many are also Levels advisors. 

Levels

In speaking about Levels ability to execute on its goals, a16z General Partner, and former President of PayPal, Jeff Jordan, recalled how Corcos had explicitly outlined a plan to win over the space's most powerful influencers. When Jordan caught up with the Levels CEO a few months later, Corcos told him, "We're running out of influencers. We've got them all."

That's just one part of Levels' soft power strategy. The other, as suggested above, is building a legitimate content arm. Spend even a few minutes on its blog, and it's clear the company devotes real resources and time to the content it produces. Across an abundance of pieces, Levels unpacks metabolic health, highlights member impact stories, and talks through its progress. It's working — in October, Levels recorded over 160,000 page views on the site. 

Levels

This product is coupled with several other properties. The company's Chief Medical Officer, Dr. Casey Means, sends a weekly email that gets the kind of open rates that would make many media companies jealous. Its podcast, Whole New Level, also has a devoted following. 

Audio is a pillar of Levels' strategy. In a piece for First Round Review, the company's Head of Partnerships, Tom Griffin, explained how he'd set up a "podcast tour" for Levels' founders. Rather than trying to buy 60 seconds worth of airtime, Griffin succeeded in setting up 60-minute conversations, giving his team the space to unpack their work and why metabolic health matters. In total, Levels' founders appeared on more than 100 podcasts in six months, racking up over 1 million hours of listening time in the process. 

These initiatives have helped bolster strong social numbers, with the Levels Instagram at 53,400 followers and its Twitter closing in on 20,000. 

The result is a business that has real distribution channels, though still in beta. Rather than needing to pour money into Facebook or Instagram ads, it can rely on the properties it has built to organically and authentically spread its message. It is a soft-power beast in the making. 

Obvious demand

Perhaps unsurprisingly, Levels has racked up an impressive waitlist of willing customers. Over 150,000 people are on the company's email list, the vast majority of who have yet to try the product. 

Given that Levels is limiting orders, I was genuinely shocked to see the amount of revenue the company is already producing. Over the past year, the company has tripled its monthly income to about $600,000 while keeping burn low. Levels is occasionally profitable, despite not focusing on its financials.

Levels

The company is explicit that it is not prioritizing revenue growth but is already putting up real numbers. Given that Levels intends to grow through external funding, it's unlikely the business will remain profitable in the medium term. Still, it is a fascinating indication of the demand for the product and consumer base Levels has built. In the quest to create a movement, Levels has gotten off to a strong start. 

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Culture: An operational outlier

Though Levels is unusual in several ways, the company truly stands out when it comes to culture. This is a company that constantly examines accepted wisdom. 

Jeff Jordan, chuckling a little as he spoke, talked about how his firm views Levels. He noted that Corcos, in particular, "has a reputation in the [a16z] office of wanting to break with tradition, wanting to trailblaze."

Its decisions might seem unwise to many, but there's a method to it all.

Remote-first

The least contentious of Levels' cultural tenets is its commitment to remote operations. Though still unusual, other companies have embraced the benefits of eschewing office life, particularly during the pandemic. 

For Levels, though, such a decision was not an accident of circumstance but a deliberate choice. Corcos had worked remotely for years and had found it improved his efficacy. It didn't hurt that the available talent pool was much larger by being location-agnostic. 

Of course, it's worth mentioning that Corcos takes the concept of "remote" to the nth degree. He is, literally, nomadic, with no fixed home. Instead, he bounces between city and countryside, coast to coast, living with different friends or staying at Airbnbs. When I spoke to him for the first time, he was holed up in a New York diner, with his slim set of possessions in a backpack. 

If Corcos is tailor-made for remote life, Clemente required a little more convincing. In our exchange, he noted that he had never worked remotely before starting Levels, and in the early days, he and Corcos could be "out of sync on communication." In time, he learned what was necessary to make a remote founding relationship work. In many ways, those early "hurdles" seem to have contributed to creating explicit norms around communication.

Others have also taken time to see the light. Josh Mohrer, previously the General Manager of Uber in New York, had invested in Levels. Over time, he found himself increasingly mesmerized by the quality of the team and its insane shipping speed. He thought about trying to hop aboard but was initially deterred by the fact the team was remote: 

The first time I spoke to Josh Clemente, he told me they were fully remote...I remember thinking to myself that I wish there were a Levels-type company that had a more conventional approach as I was skeptical of pure remote. I've since changed my tune; in fact, I would not work at a company that assembles in an office because the time cost of commuting and office rituals are too high. I can accomplish just as much and reallocate the wasted hours to my wife and children, friends, running in Central Park, playing music, etc.

Corcos concedes that not everyone will find a remote environment right. In one of our discussions, he noted that Levels was not the right company for someone that saw work as a surrogate social home. He cited Airbnb as a successful maximizer of the social approach. Many of his friends that had worked there talked about the strength of the relationships forged. Corcos noted that while these bonds were beneficial during tough times, they came at a cost: the ability to do deep work. 

For the CEO, it's a matter of picking your poison: 

There are trade-offs; everything is trade-offs. The trade-off [in the Airbnb model] is you probably have a much more resilient team. On a remote team, you might not have that same level of resilience...but you do have tremendous agency over how you spend your time. You have unlimited deep work, as much as you want.

Each will appeal to a different kind of person; Levels is happy to expand its scope globally but constrains itself to those keen to work deeply. 

Asynchronous by default

Levels is a vigilant guard against synchronous communication. So determined is it to ensure that its team uses asynchronous channels it has written multiple internal documents outlining the "Principles of Effective Communication." (If you'd like to dig in, there's also a Part 2 here.)

In one of these dossiers, Levels states its case: 

Entropy tends towards synchronous communication. We need to be mindful of how our communication habits might negatively affect others on the team. Overusing synchronous tools like text messaging or Zoom are obvious examples of bad behavior that everyone can relate to, but it's also possible that asynchronous communication that is too rapid can create bad cultural norms.

In its quest to give every employee the maximum time to do deep work, Levels looks to minimize interruptions. In one episode of the Whole New Level podcast, Corcos discusses how he found Slack a "slot machine." Its constant barrage of messages and intermittent reward schedule ("ooh, a funny meme!") give it an addictive, dopamine-harvesting quality. 

Being "asynchronous by default" protects against this. With no expectation to respond immediately, team members can afford to turn on "Do Not Disturb" and focus without fear of impeding progress. 

For this reason, Levels favors tools that are naturally asynchronous and guards against those that lead to rapid back-and-forth. The same document illustrates how the team divides up these tools and highlights a "danger zone": 

Levels

Though Levels is dogmatic about this, it isn't blind to its drawbacks. Again, Corcos is upfront about the trade-off of operating this way. There will be times that moving slower may be to the company's detriment — Levels just believes the benefits of protecting focus will outweigh the negatives. 

This isn't to say that Levels has no meetings. There are occasions in which tight communication loops are desirable. But, by and large, Levels sees them as time-sucks that do not push the company forward. "The Meeeeter" depicts this fear. 

Levels

To date, it seems to have worked. Levels' employees typically have "single-digit hours per week in meetings." It's possible to go days at a time with no interruption to the work you're trying to do. Again, for a certain kind of person — a category in which I include myself — that sounds like paradise. 

Document everything

Jordan joked that Levels had to be Loom's biggest customer. He was only half-kidding. This is a business that documents everything. From a minor workflow to the most significant strategy session, Levels is in a mode of constant content creation and categorization. 

I experienced the power (and whiplash) of this habit first-hand. Within days of working with the Levels team, I was drowned in a torrent of Notion documents, blog posts, YouTube videos, podcasts, and Loom recordings. It is no exaggeration to say that I have never had so much information about a company at my disposal, not only because I had the chance to speak with many team members but because I was granted access to an archive of internal information. 

Levels has documentation for everything. For example, I counted nearly thirty Notion pages that I was given access to — a couple of which are fully public (hyperlinked). That included the following memos: 

The list goes on and on. Any topic you might care to think of — it's almost sure that Levels has already written a detailed guide on it. One of Levels' angel investors, Ellen DaSilva, commented on this documentation's impression on her. In particular, she highlights how Corcos contributes to this process:

One thing that particularly struck me was that Sam wanted to learn about the science behind what he was building. Instead of reading a few papers and having a few conversations, he taught himself the chemistry behind it and ended up writing a 10s-of-pages long whitepaper on the topic, including a legal deep dive. 

Notably, these resources are also in a state of constant revision, making it easy to trace the company's evolution in thinking. For example, "Levels Company Strategy" has seemingly been updated almost quarterly — a perfect record kept. 

It's interesting what kind of impact a database like this can have. Not only does it give a newcomer like me a sense of shock and awe, but it allows potential new hires to get quickly up to speed.

In our discussion, Maz Brumand, Head of Business, mentioned how "when I started talking to Sam he shared ~53 documents and videos with me that outlined how they think and operate." Not only did it demonstrate the depth of the company's thinking, but Brumand noted that such "radical transparency really helped" convince him Levels was the right company for him. He added: 

[Levels] have the culture, talent, systems, capital, and network to make a difference in the world. I have looked at 100s -1000 companies in my professional life in the last two decades, and Levels really stood out. 

Something as seemingly small as documentation contributes to that sense. 

Build-in public

The "radical transparency" Brumand identified extends beyond those within the company's orbit. While many pay lip service to building in public, Levels walks the talk. 

The best example of that is the "Secret Levels Master Plan" published on the company's blog. It is an explicit homage to Elon Musk's famous letter detailing Tesla's approach to world-domination. Sam Corcos summarizes Levels strategy: 

In short, the master plan is:

  1. Build premium software to quantify the effect of diet on metabolic health.
  2. Use that money to expand awareness and scientific understanding of metabolic health; build a more affordable product.
  3. Use that money to build an even more affordable product.

Don't tell anyone.

In isolation, this might look like a cute gimmick. But Levels airs the kind of intimate moments you would expect to occur behind closed doors. The company's "Friday Forum," an all-hands meeting, can be easily found on YouTube. So too, can internal discussions about effective communication, culture, and keyboard shortcuts. 

A Whole New Level, the company's podcast, is another venue for open discussion. In one recent pod, Corcos and Clemente work through some of the company's behavioral tenets, wondering aloud whether it is too "paternalistic" to encourage employees not to answer emails on the weekend. It has the texture of a genuine, unscripted jam session — that's because it is. Just as Levels documents everything internally, it seems to want to share as much as possible with the outside world. No doubt it has contributed to the groundswell Levels has already built. 

While these varied tactics and choices explain how Levels is culturally unique, such a discussion wouldn't be complete without a closer look at CEO Sam Corcos. 

Sam Corcos: A starter pack

The avocados kept coming. Month after month, a new box would arrive. Who was sending them? 

Exotic and delicious, the recipient was grateful for what seemed to be a remarkably tailored gift. A few weeks earlier, at a brunch with friends, he'd offhandedly mentioned how much he enjoyed avocados. Perhaps it had come from one of them? 

He told the story to Julia Lipton, who had been in attendance. Immediately, she knew who it was: Sam Corcos. She had seen him make a note when the topic of avocados had been mentioned, and it was precisely his style to give such a thoughtful gift with no thought of getting credit. 

If anything sums up Corcos, it is this story. He is a person who has the rare ability to think and listen deeply, simultaneously. Across all of our interactions, I sensed that he was both engaged in our conversation while thinking several steps ahead.

I am certainly not the first person to find Corcos exceptional. At different points in my interviews, the discussion would naturally turn to the almost superhuman performance of Levels' CEO. Vijay Pande called him "one of the most remarkable people I've ever met." 

Levels Head of Growth, Ben Grynol, when reflecting on previous venture-backed CEOs he'd worked with, said it was "like trying to compare MJ [Michael Jordan] to not-even-professional basketball players...Not in the same league."

Lenny Rachitsky, an angel investor in the company, mentioned that before meeting him, he "heard from multiple people that Sam was in their top 1% of founders." After getting to know him better, he now sees Corcos as the "ultimate optimizer of work, life, the universe, and everything." 

So, how does he do it? What makes Sam Corcos the MJ of efficiency? 

To try and figure that out, I asked for as much detail as possible on Corcos' favorite tools, habits, and processes. I was not disappointed. After reviewing plenty of Loom videos, here is my Sam Corcos "Starter Pack": 

Imagery from Levels, sterzhakov, War Thunder forum

Let's walk through what this means and how Corcos runs his life. 

Outsource

One of the first parts of Corcos' process is outsourcing. He works with a virtual assistant (VA) to help streamline his processes. This is a perk offered to every Levels employee. The company wants its staff to outsource less cognitively-arduous activities to focus on deep work. Part of onboarding is finding a part of one's job and delegating it to a VA. 

Corcos uses his VA to increase his leverage. A Notion table I reviewed outlines 56 separate processes for Corcos' assistant to handle. It includes rounding up media mentions, reminding engineers of priorities, cleaning LinkedIn messages, and updating the company's investor database. Corcos has outlined a step-by-step walkthrough for each of these, accompanied by detailed Loom videos. There are also explicitly defined cadences for each activity. 

This compendium is constantly being updated and revised.

Automate

Corcos tries to make sure he never does duplicative, unthinking work. For example, whenever he has to write an email more than once, he uses Superhuman to turn it into a snippet. Watching him work through his inbox is like seeing a gamer blitzing through a speedrun: you know what they're doing, but the pace makes it hard to follow.  

Corcos also relies on several different shortcuts and tools designed to save fractions of a second that eventually add up. For example, he is a proponent of Rectangle, which allows you to resize windows on your Mac without relying on your mouse. 

Of course, any time Corcos undertakes a significant new project — like creating a podcast from scratch, for example — he compiles his lessons in a Notion document that he can refer back to and others can benefit from. 

Focus

Julia Lipton mentioned that when Corcos works, he often relies on a pair of "focus goggles," essentially a human version of blinders. Corcos confirmed that this is the case. Particularly on flights, he's prone to being distracted — to make sure he optimizes his time, he took a pair of glasses and spray-painted everything except a small opening black. When wearing them, he can only see what is directly in front of him. 

First, this is hilarious. Second, I sort of want to make a pair. Third, it is just one of the tools Corcos uses to protect his focus relentlessly. 

Earlier this year, in the First Round Review, Corcos detailed how exactly he spends his time. The reason he has that data, to begin with, is because he's an avid user of Rescue Time, an application that tracks what you do on your computer and for how long. Corcos uses it to ensure he's not losing hours to social media or other meaningless sites. 

First Round Review

This is helped by the way he uses his calendar. Rather than saving it for meetings, Corcos treats it like a to-do list, giving virtually every free slot an associated task. He makes sure to set up a dedicated time to handle email so that he doesn't have to hop back and forth to his inbox all day.

First Round Review

To make sure he doesn't miss any meetings, Corcos sets alarms on his phone right after his morning shower. That way, he can stay in the zone without needing to check the time every couple of minutes. 

Say no

Though he enjoys social interactions, Corcos protects his time by saying no to synchronous meetings when possible. As the CEO of a buzzy startup, he naturally receives a high volume of inbound demand. Often, these messages ask for a call of some kind. 

As is company policy, he occasionally accedes to such requests, but more often than not, looks to pivot towards asynchronous communication. In a move I have since copied, he responds to this kind of ask politely but notes his synchronous time is tight at the moment, suggesting that the conversation continues over email. 

More often than not, the requester can make their ask asynchronously, allowing Corcos to respond in writing or via a Loom video. Sometimes, unsure of what they want to talk about, correspondents drop off. Very occasionally, a synchronous meeting is merited.

Stay close

Though hyper-efficient, Corcos still puts a premium on relationships. He sets a goal to stay in touch with 1,000 people per quarter, managed via Airtable.

Corcos' outreach might be simple — just a check-in — but it has proven an effective way to keep tabs on his network. The Levels story exemplifies the impact those connections can have: Josh Clemente was on this list, as was co-founder David Flinner. Dr. Casey Means was introduced to Corcos by her brother, another entrant. Many investors and advisors have come directly from this group or via an introduction. 

Corcos ensures these relationships are not merely transactional. For the last few years, he has run a "Salon" that meets to discuss heady issues from "Boredom" to "What Happened in 1971?" These are hosted in different cities, depending on Corcos' location, offering a chance for participants to converse and learn.

Overall, Corcos is a fascinating character and an extremely effective leader. Like no one else I've met, he has succeeded in constructing a life that is entirely his own without ostracizing a broad network of support. He manages to work where he wants, on his schedule, and still maintains deep ties. It has given him the ability to scale both time and connections in unorthodox ways. 

Recruiting: How to hire founders

A mark of a great startup is its ability to hire ahead of its traction. Convincing elite talent to leave lucrative positions for a new business is not only an indication of your vision's magnetism but a real competitive advantage. The marginal impact of an exceptional early hire for a startup can be the difference between success and failure. 

I'll just say it: Levels is crushing this. I have yet to see a business succeed in hiring so many high performers so early in its life. In particular, Levels has an unusual knack for recruiting founders and investors. Excluding co-founders, ten of the company's employees previously ran businesses of their own, by my count. Four of those went through Y Combinator's prestigious and selective accelerator. 

Indeed, much of the team ran startups at a high level, receiving meaningful validation and raising venture money. Taylor Sittler, for example, previously founded Color Genomics, a company that has raised nearly $500 million in funding. It announced a Series E of $100 million last month. 

How does Levels pull this off? 

It's a result of leveraging its network, making specific asks, showing rather than telling, and letting the hiring flywheel spin. 

Use your investors

In October, Sam Corcos tweeted the following: 

Ninety-four people. And by Jeff Jordan's estimation, thousands of specific asks — the former OpenTable CEO said the company had made "over 2,000 targeted requests for help."

While a16z might get the largest share of such requests, they are by no means alone in receiving regular petitions from Corcos. Everyone on the cap-table — and many outside of it — can expect to hear from the CEO, particularly when it comes to hiring. 

Though it sounds simple, Levels' recruitment strategy starts by asking for help from its backers. 

Make specific asks

That isn't where it ends, though. Almost every startup reaches out to investors for help from time to time. Often, requests are buried in a longer update email sent to multiple parties at once. Vague asks of this kind rarely convert unless VCs are particularly good at taking the initiative. 

To extract more value, Levels aggressively makes direct, specific inquiries. Fidji Simo, CEO of Instacart and one of Levels' investors, explained this strength:

[Corcos] doesn't just send an investor email saying, "If you know any good engineers, send them my way"; instead, he sends every investor an email asking them for the top 3 engineers we've worked with in our career, an intro to all three of them, and a free Levels kit for whoever we refer. This approach has a much higher likelihood of getting the best out of an advisor than a blast email and showcases how intentional this team is.

Corcos keeps track of his requests for investors and notes who delivers. By doing so, he learns which VCs and angels are truly adding value™.

Pop the hood

Once Levels is connected to talented operators, it doesn't try to sell too hard. None of the recruits I spoke to felt as if they got an aggressive pitch. Instead, the relationship developed organically as Levels' explained its mission and culture. 

For many, seeing how the team operated was crucial to their decision. As noted, Josh Mohrer didn't expect to join Levels when he invested as an angel. But seeing the development velocity convinced him that something special was happening. He said that "Levels resonated with me in a way I hadn't felt since I met the Uber team in 2011." 

Dr. Lauren Kelley-Chew had a similar experience. Having previously founded a healthcare business before leading the Verily Life Sciences strategy team, she was well-equipped to assess the company's clinical plans. Her time as an investor gave her the skills to gauge Levels' commercial viability. Digging into the work product convinced her that on both fronts, Levels was impressive:

The team had opened up tons of internal documents for me to check out. I thought the team's transparency said a lot about them — that they believe in what they are doing and stand behind the integrity of their work. I love data, and having worked in private equity in the past, put on my investor hat and started trying to see if I could poke holes in the company.

Rather than finding flaws, she found many more reasons to become part of the team. 

To win over elite talent, Levels lets its work do the talking. 

Let the flywheel spin

In recruiting, success begets success. The final key to Levels' remarkable hiring is simply that adding each new high-performer makes the next such hire progressively easier. The best people want to work with others at their level or above. 

The Levels team is likely to look even more stacked in a year. 

Every Sunday, we unpack the trends, businesses, and leaders shaping the future. Join us today.

Risks: The Levels pre-mortem

"Levels died today. We always knew this was a possibility…"

One of the macabre tasks I enjoyed doing as a venture capitalist was writing out the post-mortems for the companies I invested in. It was a way to think through the points of failure and cut through hazy optimism. 

As it happens, Levels does the same thing. In a Notion document titled "Levels Pre-mortem," the company outlines how it might meet its demise, beginning each section with "Levels died today." 

I'll draw on that document and my analysis to highlight Levels' most significant vulnerabilities. 

Winning over the mainstream

Unless you're Josh Clemente, Continuous Glucose Monitors don't sound like a fun time to most people. Though painless — I can attest from personal experience — there's a psychological wince one experiences from piercing the skin. Putting something into your arm feels disquieting, as do the first few hours of scanning your shoulder with a mobile phone as if you were a bag of bananas passed across a grocery counter.

The strangeness of being just a tiny-bit-cyborg fades quickly. Within a few hours, I'd forgotten about the CGM, and now four weeks in, it's an essential part of my routine. 

Many will struggle with this, though. Sure, tech analysts, startup people, and venture capitalists will be willing to try something new. But what about the rest of the country? Though it may feel massive, our tech-centric bubble is rather small. Will Levels be able to convince mainstream consumers to plug a device into one of their limbs? 

The company is betting that the answer is yes, but nothing is certain. Levels may remain a niche concern rather than a true breakout hit, serving the affluent "worried well." Though that might still produce a large business, it would likely leave Corcos and Co. dissatisfied. Explicitly, this is a team that wants to solve a societal issue, not build a nice-to-have gizmo. 

To penetrate the broader population, Levels will need to educate users and reduce its price. "Metabolic health" is not well-known or understood, and at $399 per month — the company's historic pricing — few have the financial latitude to take a flyer. 

Of course, many tech adoption stories follow the stages outlined by 20th-century labor advocate Nicholas Klein: "First they ignore you, then they laugh at you, then they fight you, then you win."

The idea of the average American wearing a CGM today may seem foreign, but it was not so long ago that tracking one's sleep was an esoteric activity. 

Building membership

When I asked Jeff Jordan where he saw risks in Levels' approach, he pointed to the time horizon that most users engage with the product. Because of the price point, most see Levels as a one-time purchase rather than an ongoing subscription. Individuals may be happy to pay $399 for one month's worth of CGMs, using that timeframe to get a sense of their habits and make adjustments, but forking over more than $2,500 a year is prohibitive. (After the first month, the cost declines to $199 per month.)

Part of the difficulty for Levels is that one could argue the product's marginal utility declines over time. Jordan noted that the "initial insights are off the charts helpful…[but that] the rate of new insights is slowing." He said Levels' real "product opportunity" was to find a way to establish continuous value so that users had a reason to keep using Levels for years to come. 

Levels is taking steps to address this issue. For one thing, it has recently shifted toward a true membership model. Rather than paying once, users are prompted to select what cadence they want to receive CGMs. 

Levels

While this is a subtle shift, it changes the customer relationship from default-off to default-on. 

Simultaneously, Levels is building features to encourage long-term use. For example, users can now connect with a curated supply of nutritionists via the app. It is also rolling out blood testing kits that give users even more information about their bodies, helping them understand their cholesterol. 

The company may add other forms of tracking that don't require hardware changes in the future. For example, it might encourage users to enter their mood or pull in movement data. Both could be interesting when paired with blood glucose data. 

Ultimately, Levels has yet to create a dominant membership product. Grynol outlined how the company is thinking about this: 

The biggest challenge we have to solve is retention and value. How do we create value so that we're like [Amazon] Prime or Costco, where people don't really think about canceling their memberships? 

For now, more work is needed. 

Hardware is hard

An open question is whether Levels should build hardware. Right now, the company uses a product from Abbott called the "Freestyle Libre." Though not beautiful by any means, it is a trustworthy, functional product. But there are three core problems with using an outside provider: 

  1. It's expensive. 
  2. The experience is sub-optimal. 
  3. The data is limited. 

Each Libre two-pack, which lasts 28 days, retails for $199. That means that in hardware alone, Levels costs ~$200 per user per month (assuming the company receives no discount). Even if Levels were to charge nothing for postage, support, technology, and more, it would still be beyond most consumers from a cost perspective. As Jordan said, "Freestyle is not cheap."

Integrating with a legacy player also doesn't lend itself to a magical experience. Though Levels goes to great efforts to make onboarding easy, providing a detailed walkthrough and fast support, it's still a little clunky. You have to get the Libre app set up first, connect it to Levels, get the device set up, and finally begin to use it. Every time you log a reading, you go to Libre's app, which then syncs data across to Levels. 

You stop noticing this after a while, but there's obvious friction in onboarding. Though there may be other ways to address this issue, working with third parties often brings limitations.

Finally, the Freestyle is limited. Designed for people living with diabetes, it tracks blood glucose levels — but nothing else. Levels is building more than just a diabetes diagnostic business; it's trying to give everyone a detailed picture of what's happening in their body. To accommodate that goal, the company is likely to bring in new data types. 

Levels will have to answer in the years ahead whether these impediments make it necessary to build bespoke hardware. Pande believes it may not be required. As he told me, "if these devices are plentiful and can do everything we need, then Levels doesn't have to be a hardware company." 

Given the pain of running a hardware company, especially in the regulated medical device space, Levels will hope that is the case. 

Joyce Carol Oates once wrote that "blood is memory without language." 

Even more than the numbers that illuminate the scale of the metabolic health crisis, it is these words that get to the heart of Levels' challenge. This is a business engrossed with the trickiest of tasks: interpreting the messages and memories of our body. Levels listens as our blood dances with energy and as it lurches in its absence. It sees data and finds the story behind it and the connections between the lives we live and the way we feel. It tracks trends and watches for patterns, and of course — it looks for anomalies. For signs that something is not quite right, something might be improved. 

It is fitting that a company searching for anomalies should be one itself. That should serve it well.

The Generalist’s work is provided for informational purposes only and should not be construed as legal, business, investment, or tax advice. You should always do your own research and consult advisors on these subjects. Our work may feature entities in which Generalist Capital, LLC or the author has invested.