Manoel Lemos

The Brex / Capital One $5.15Bn acquisition is a huge deal and should be celebrated. How did they do it? I've studied their culture by interviewing Henrique Dubugras (Co-founder), Michael B. Tannenbaum (ex-CFO, Employee #1), and Art L. (CBO, Employee #50). These are 10 important lessons I learned from them. Henrique and Pedro built Brex as teenagers from a house in SF to a generational fintech in 9 years. From a startup card to $100B+ in TPV. Along the way, they created a culture that has already spun out dozens of founders who have raised over $800M+. Here's what I learned on our Fintech Leaders episodes: 1. Your first 10 leadership hires matter more than your first 10 employees. Those leaders create processes and structures that outlast them. Some of Brex's first 10 employees didn't become managers, but the leaders they hired early shaped the culture. 2. Great founders get lucky with great mentors. Henrique's first investor was a payments founder who taught him the entire industry before he really understood it. The right early backer can accelerate your learning curve dramatically. 3. Build everything in-house. A major competitive advantage came from building all their software from scratch. Brex built their own issuer processor because Marqeta and Stripe Issuing were not mature when they launched. That proprietary infrastructure enabled deeper integrations than competitors could ever achieve. 4. Your best culture exists in the edges, not the nodes. Henrique used to think companies were 100% about the people. Now he believes the real value is in the processes, systems, and structures people create. Great companies can survive personnel changes because excellence lives in the connections between people. 5. If you have five priorities, you have zero. Every employee and team has a single OKR. The discipline of extreme focus brought them back to hyper growth after a period of growing pains. 6. Move at an unnaturally fast rate. When someone says they will revert next week, ask why not tomorrow. Analysis paralysis kills momentum. Brex leaders operate with urgency that feels uncomfortable to most people. 7. Listen to your customers. Brex built partnerships with Navan and Zip because 87 customers asked about Navan integration in six months. The biggest strategic moves came directly from customer requests. 8. Land and expand is crucial in enterprise. Large customers do not deploy new vendors to everyone at once. They want to try you in one use-case first. Brex restructured sales comp with longer hold periods so reps would land small and expand later. 9. Promoting from within creates loyalty. Behind every internal promotion, a manager is taking a risk on you. The easiest path is always hiring someone who has done the job before. Backing internal talent is harder but builds something lasting. 10. Dream big is not a cliche. Their audacious goal-setting culture produced a generational company in 9 years. Bravo! Link in comments ⤵️

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As we dive deeper in growing our healthcare investing at Bread and Butter Ventures, I'm sharing a few thoughts on the future of healthcare investing in our latest blogpost. I'm excited about several areas: 💡 Democratizing access to quality care for all 💡 Innovation in the fintech and payments layer of healthcare 💡 The potential for AI to optimize and drive efficiency in everything from operations to clinical decision support to care delivery and patient experience 💡 Population health solutions and preventive care The policy headwinds and tailwinds as well as the growing ubiquity of opportunities for AI in healthcare make this a more interesting time than ever to be building in this space. I welcome your thoughts on what you are seeing, what excites you, and what we should be on the lookout for in the months and years ahead! Full post here: https://lnkd.in/gVcRK7CF #digitalhealth #AI #healthcare #investing

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Grateful to join the AlignMNH Real Talk session on a question that continues to shape the future of maternal and newborn health: How do we finance innovation in a way that truly delivers impact at scale? We don’t have a shortage of promising solutions AI and other technologies are already demonstrating what’s possible.What we do have is a gap between piloting and national adoption. That “valley of death” is where many life-saving innovations stall. If we want to change this, we must rethink how we collaborate: - Align governments, funders, and innovators around shared outcomes - Invest in systems, not silos -Build long-term financing pathways that allow proven innovations to scale sustainably This is not just a technical conversation it’s about recognizing the urgency. Every delay has a human cost. #Maternalhealth #GlobalHealth #HealthTech #DigitalHealth

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This week feels like a real inflection point for AI in healthcare—not because of a single breakthrough model, but because the ecosystem is finally ready. After more than a decade working at the intersection of health and tech, I can’t recall another moment when capability, incentives, and trust felt this aligned. We’ve long known healthcare is massive and structurally broken, and that health information is one of technology’s most valuable use cases. The constraint was never opportunity—it was readiness. For the first time, patients and health systems seem prepared to absorb AI in ways that are genuinely useful, responsible, and scalable. With launches spanning both consumer and enterprise, OpenAI isn’t just shipping products; it’s signaling a long-anticipated “slowly, then all at once” shift. I entered healthtech through Google more than a decade ago, working on healthcare knowledge cards in Search, early symptom-to-condition frameworks, and Google’s first HIPAA-compliant product. Even then, the signal was clear: when people have health questions, they turn to tech first—often before they ever touch a health system. Health queries made up roughly 20% of search traffic, yet users were frustrated, forced into fragmented, sideways searches to assemble answers. We even embedded telemedicine directly into Search. Despite strong teams and deep resources, the product ultimately failed. That experience reinforced a lesson that has guided me ever since: insight and talent aren’t enough. Without the right timing and ecosystem, even the best ideas stall. That lesson shapes how I invest at Lux Capital today. We back founders who aren’t just improving access to information, but expanding access to care itself—reducing friction, earning trust, and driving outcomes where the system is hardest to move. What’s different now is that the excuses are gone. Interoperability is real, with most U.S. hospitals exposing FHIR APIs and major EHRs supporting production integrations at scale. Clinical work is digitized enough for AI to live inside daily workflows. And the economic pressure is acute: administrative overhead still consumes 25–30% of spend, margins remain razor-thin, and clinicians generate nearly twice as much EHR data per patient as they did a decade ago. The result is a clear shift from pilots to purchases. We’re seeing rapid enterprise adoption of platforms like Abridge and OpenEvidence, justified by hard metrics—time returned to clinicians, capacity unlocked, and decisions made faster and better. Health systems aren’t adopting AI because it’s exciting; they’re adopting it because it’s one of the last levers left to keep care delivery viable. Healthcare is complex and regulated for good reason. But what stands out right now is alignment. Builders, clinicians, and operators aren’t chasing AI for its own sake—they want tools that work in the messiness of real care delivery. This feels like a genuine step function in both capability and relevance.

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Doximity just released a free AI scribe for US clinicians, accelerating commoditization/the race to the bottom. Their product won’t integrate into the EHR like Abridge, but it’ll be interesting to see how much it impacts their ability to acquire customers, drive usage and maintain retention. This is the start of a trend that will continue across every vertical market. Counterpositioning with free products to undercut upstarts and incumbents alike. Buckle up. Your margin is someone else’s opportunity.

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The hardest companies to build are often the ones the world needs most. Resilience Tech—spanning hardware, software, deep tech, and infrastructure—demands more than just great ideas. The real test isn’t proving the technology works—it’s building it into a company that can scale and last. At B Capital, Karly Wentz and I distilled what we’ve learned into a 10-factor framework for growth investing in this space. It’s how we separate promising pilots from companies that can scale into lasting platforms. Our conviction: the companies that matter most over the next decade will be those that fuse breakthrough science with business fundamentals—and deliver measurable resilience at scale. Read the full article here: https://lnkd.in/gv8jaMPK

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