#271 How to Scale Without Burning Cash with Manu Diwakar, Chief Financial Officer, Virta Health
Access to capital is no longer cheap or guaranteed. Companies that once grew by “buying” growth with aggressive spend are now being forced to prove they can scale in a way that’s sustainable, repeatable, and cash‑efficient.
Kevin Appleby sits down with Manu Diwakar, Chief Financial Officer at Virta Health, to unpack how high‑growth companies can scale aggressively without setting fire to their cash reserves Manu draws on a career that spans Riot Games, the creator economy, AgTech, and now digital health, to show what disciplined, intelligent growth really looks like in practice. This isn’t theory; it’s the lived experience of a CFO who has repeatedly joined businesses in the steep part of the growth curve and helped them mature without losing their edge.
Manu explains how Virta Health is tackling the massive, expensive problem of metabolic disease with a model that reverses conditions like type 2 diabetes while also reducing healthcare costs Along the way, he breaks down how to think about capital efficiency, when to raise versus when to generate and reinvest your own cash, and why talent, culture, and clear unit economics beat vanity metrics every time. For finance leaders and founders who want to scale with ambition—but keep control of the runway—this conversation offers a grounded, experience‑driven playbook.
Key topics covered:
- Manu’s journey from Riot Games to digital health and why he chooses roles where the business is still being built and scaled, not just maintained
- How Virta Health’s model reverses metabolic disease while lowering costs, and what that teaches about aligning mission, product, and economics
- Why scaling without burning cash starts with clear value delivery, not price cuts—especially in tough capital markets
- The importance of hiring for growth: building teams whose capabilities can stretch with the business rather than constantly hiring “the next tier up”
- How a CFO can balance regulation, data security, and innovation in complex sectors like digital healthcare
- Manu’s advice to aspiring CFOs: prioritize environments with steep learning, strong teammates, and real growth, not just impressive titles
Links
Timestamps:
- 0:00 Manu’s career in high‑growth companies – From Riot Games to Virta Health and why he gravitates to businesses that are still being built and scaled
- 4:00 Virta Health’s mission and metabolic disease explained – What metabolic disease really is and how Virta’s approach tackles the root cause, not just symptoms
- 8:20 Business model and unit economics – How partnering with health plans and employers, and charging per engaged patient, underpins a scalable, cash‑efficient model
- 12:10 Regulatory complexity vs. innovation – Balancing cost efficiency, patient outcomes, data security, and compliance in digital healthcare
- 15:40 Scaling without over‑spending – Generating capital internally, reinvesting in growth, and resisting the temptation to chase volume with discounts
- 19:30 Talent and leadership in scaling teams – Lessons from Riot on hiring for potential, designing growth paths, and building a high‑calibre environment
- 30:50 Career advice for future CFOs – Why continuous learning, working in truly growing businesses, and choosing stellar leaders matters more than almost anything else
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