impact 20

Fortune Editors

In business, it doesn’t take a huge company to launch a big idea. The Fortune Impact 20 highlights relatively small enterprises that have built their business models around world-changing ideas, using the profit motive to solve social and environmental problems.

Our list, presented by TPG’s The Rise Fund, showcases venture- and private-equity-backed startups. These companies are typically earlier in their life cycles than the larger companies we feature on our annual <a href="https://fortune.com/ranking/change-the-world/">Change the World list</a>, but they’re deploying the creative tools of capitalism with an outsize positive impact—making people’s lives better even as they road-test and iterate on their innovations.

In compiling the Impact 20, our staff focuses on companies that have already moved past the proof-of-concept phase and are now generating revenue and serving customers. (For more about how we choose the list, read our <a href="https://fortune.com/franchise-list-page/methodology-impact-20-2023/">methodology</a>. TPG is not involved in the selection process.) Some are already “unicorns” with multibillion-dollar valuations; others are smaller outfits with the potential to scale much bigger. But each is pursuing a vision that melds profit and purpose, building businesses that can do good while doing well.

In 2019, the CDC reported that the death rate for people in rural areas of the U.S. was 20% higher than those in cities. Moreover, “inter-facility transfers”—which often involve patients being moved between smaller, more remote hospitals and bigger ones in cities—cost the health care system billions of dollars every year, according to estimates by the Journal of Health and Human Services Administration. 
 
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AmplifyMD, founded in 2018, aims to tackle these disparities, by making it easier for medical specialists to see patients in remote locations. AmplifyMD’s virtual care platform offers more than 15 clinical specialties: Patients and their doctors can access those specialists in a hospital setting, at home, or at a specialty outpatient clinic; it also offers asynchronous help, where specialists record advice for future use. This array of options helps hospitals discharge patients faster: AmplifyMD reports that in 2023, the more than 150 hospitals using the virtual care platform experienced an 80% reduction in referral wait times. In-patient transfer rates, meanwhile, were reduced by 81%. 
 
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Accessibility is the name of the game, so the AmplifyMD software is also designed to be easily implemented for small hospitals with limited staff and tight budgets. The customizable platform also offers up-to-date analytics and insights on care teams’ best practices. The result: significantly improved return on investment for hospitals with limited resources. 
 
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To date, AmplifyMD has raised a total of $23 million from investors.

AmplifyMD

Founded in 2014, Blackbird.AI uses artificial intelligence to detect harmful content online, and then notifies its business clients so they can formulate a response plan. Its Constellation platform analyzes conversations in 25 languages across social media, fringe websites, and the dark web, identifying emerging narratives before they have surfaced. For example, in February and March of 2020, Blackbird analyzed 50 million tweets about COVID-19 and found that 19 million contained “manipulation”—or attempts to shift mindsets by altering context or using influence agents like spamming tools, bots, and deepfakes. The company let its clients know which false narratives were gaining traction online early in the pandemic. 
 
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Blackbird has raised a total of $30.2 million, valuing the company at $80 million. The company says its customers include government organizations and Fortune 500 companies across the e-commerce and internet sectors. If a business suffers from a self-inflicted crisis—say, a cyberattack impacting consumer data—it can rely on Constellation to track responses from individuals and the media during its recovery. While it might take days for a public relations team to pinpoint the various narratives manually, Blackbird can identify them before they become mainstream, freeing up communications employees to strategize responses. To aid in this rapid decision-making, Blackbird’s AI assistant RAV3N Copilot recommends how to respond.

Blackbird.AI

Shopping for a well-rounded medical plan isn’t easy—especially for the older demographic that qualifies for Medicare in the U.S. For the past three years Chapter has had this population covered, helping customers navigate deadlines and eligibility issues and choose, if they desire, from among an array of private Medicare Advantage plans. 
 
Chapter’s platform includes health plans from more than 100 different providers and Medicare plans including Advantage, supplemental, and special needs plans. The company partners with various financial institutions, health systems, and other organizations to help connect it with advice-seekers, offering an array of guidance via webinars and consultations with licensed experts. Chapter has also partnered with Uber Health to help Chapter customers access rides, prescriptions, and grocery deliveries in an easy and affordable way. The company says that its average customer saves more than $2,400 per year in medical costs.

Chapter

Household consumption is the source of around two-thirds of total greenhouse gas emissions, according to a 2020 study. Commons is working to alter that statistic by providing consumers with information about how their spending adds to carbon emissions. The app, available in the U.S. and Canada and free to use, calculates the emissions that go into the making and transportation of each purchase and determines a user’s overall carbon footprint. It also offers personalized recommendations on switching to alternatives that are more earth-friendly, an effort boosted by its August launch of a feature recommending sustainable brands. 
 
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Commons says it has “tens of thousands” of users, including Google cofounder Sergey Brin and Game of Thrones actress Maisie Williams, who has also become an investor. Last year, the average Commons user lowered their emissions by 20% and saved $200 per month, according to the company. If everyone in the U.S. reduced their emissions by the same level, the effect would be the equivalent of taking two-thirds of cars off the road or removing emissions from the entire aviation industry, Commons says. The company has raised $13.9 million, valuing it at $50.4 million. NFL quarterback Colin Kaepernick recently signed on as an advisor.

Commons

Amid a rapidly worsening climate crisis, adopting sustainable alternatives to fossil fuels has become a first priority for the government and businesses. But for the average American, upgrading a home to be fitted with sustainable solutions can be cumbersome and unaffordable. That’s why CEO Hayes Barnard founded GoodLeap, a financial technology platform that connects homeowners with banks and contractors to finance and install clean energy technologies like rooftop solar panels, resilient roofing, and new HVAC systems. Since 2018, the company has helped over 800,000 homeowners save more than $24 billion in utility bills and reduce over 12 million metric tons of carbon dioxide—that’s the equivalent of planting 190 million trees and taking 2.5 million cars off the road. 
 
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GoodLeap was valued at $12 billion in Oct. 2021 after it raised over $800 million in a funding round led by MSD Partners.

GoodLeap

Early-childhood programs can help set young children up for success—but the childcare sector is notoriously underfunded and understaffed. Enter Lillio, the Toronto-based childcare management app that helps support caregivers, parents, and children. (Formerly known as HiMama, the company and app were renamed Lillio in November 2023.) Founded in 2013, Lillio began with communication features to increase family engagement with childcare providers. It has since expanded to provide tools for childcare-center management including daily reports, professional development courses, curriculum materials, and payment management tools. 
 
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The financial impact of pandemic-related closures on childcare centers was stark, and Lillio has played a meaningful role in helping many return to operation quickly. The company says its app is used by more than 10,000 childcare centers and accessed by more than 1.1 million parents. As of December 2023, Lillio’s center management tool is used by over 40,000 educators, with nearly 1 billion moments shared with families through the platform, including photos, videos, and daily reports. 
 
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In November 2021, Lillio raised $56.3 million from five investors including Bain Capital Double Impact, BDC Capital, and Round13 Capital.

Lillio

Saving enough money for retirement feels out of reach for many U.S. workers—and not enough employers are helping them close the gap. According to AARP, in 2022 there were 57 million people between the ages of 18 and 65 in the U.S. working for private-sector employers that don’t offer a traditional pension or a retirement savings plan. 
 
Founded in 2015, Human Interest is trying to address this need. As the fastest-growing 401(k) provider in the U.S—it has tripled its number of customers in less than two years—the company is focused on making it easier for savers and their employers to provide retirement plans. Its platforms eliminate transaction fees, provide cash-back incentives for savers who earn below the national median wage, and make it easy for small businesses to set up and manage retirement plans. Human Interest says it has now given more than half a million people access to a savings plan. The company also offers solo 401(k) plans for self-employed professionals. 
 
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BlackRock led the company’s most recent funding round in January 2023; to date, Human Interest has raised $500 million from investors over eight rounds. As of November 2023, the company is valued at more than $1 billion.

Human Interest

Many green technologies still leave a carbon footprint, but Newlight Technologies is creating one that’s designed to subtract from the global carbon supply. There are microorganisms found in California that eat greenhouse gases, like methane and carbon dioxide, as a food source, and grow a molecule inside their cells called PHB (polyhydroxybutyrate). When purified, PHB becomes meltable and moldable. Newlight is capturing PHB and using it to create “AirCarbon”—a carbon-negative material that can replace synthetic, fossil-based plastics. For every one kilogram of AirCarbon created, at least one kilogram of greenhouse gas is diverted. 
 
Newlight distributes its AirCarbon-based products and materials—including fabrics and compostable drinking straws and cutlery—to over 5,000 locations worldwide, to partners in the fashion, entertainment, food-service, hotel, and auto industries. It has teamed up with companies like Nike to decarbonize their products and launched food-ware products with companies like Shake Shack and Target. Newlight raised $125 million in a funding round in August led by GenZero.

Newlight Technologies

Each year, more than 650,000 people are released from prison in the U.S. When the gates open up, how do these individuals adjust to “normal” life? Orijin aims to empower former inmates by providing essential education and skills training for long-term career sustainability, post-release, to tens of thousands of incarcerated learners. Known until earlier this year as APDS, the organization serves customers across 18 states and the District of Columbia and delivers products and services to hundreds of facilities across the nation. Since 2018 the organization has served over 111,000 incarcerated learners. (Around 15% of Orijin’s own staff are former inmates, making them particularly helpful ambassadors to their clients.) 
 
Orijin provides services and technology, including secure tablet computers connected to cloud-based learning platforms, for free to former incarcerated learners. Orijin’s key partnerships include a contract with the Massachusetts Department of Correction to support 6,000 people with educational and career-readiness courses; and a collaboration with Amazon Web Services (AWS) that enables its students to acquire foundational skills for working in cloud computing.

Orijin

Presence is a leading provider of teletherapy to K–12 schools in the U.S., with a focus on special education, behavioral health, and mental health needs. Post-pandemic, the company finds itself addressing a two-pronged challenge: a national shortage of school clinicians and increased student need. The National Center for Education Statistics reports that the percentage of special education students within the entire K–12 student population has nearly doubled in 45 years—from 8% in 1977 to 15% in 2022. In the past few years, more than two-thirds of public schools have reported large increases in students seeking mental health services. 
 
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Presence has curated the country’s largest network of school-based teletherapists. With the company’s technology, students can access over 2,000 clinicians—including speech-language pathologists, occupational therapists, school psychologists, social workers, and education diagnosticians—regardless of their physical location. 
 
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Since 2009, Presence has delivered over 6 million therapy sessions to students across 47 states. Of the 10,000 schools that partner with Presence, 3,300 are part of the Title I federal education program that supports low-income students.

Presence

RapidSOS helps 911 operators and first responders handle emergencies with speed and efficiency. Covered individuals opt in to RapidSOS on their smartphones, home security systems, apps, and other devices; thereafter, if they contact emergency services like 911, the company transmits life-saving information—like location, vehicle crash data, and health profiles—without the user having to do so. For commercial partners like transportation networks and healthcare systems, RapidSOS automatically gathers and transmits data. In one recent example, RapidSOS helped identify the location of a delivery driver in West Virginia who had driven off the edge of a cliff, using only an emergency SOS notification sent from the driver’s smartwatch. 
 
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RapidSOS operates in the U.S., Mexico, Canada, the U.K., and Brazil. The 11-year-old company has partnered with more than 15,000 public safety agencies, including 95% of emergency communication centers in the U.S., covering 315 million Americans. It also partners with more than 100 tech companies, including Uber, Instacart, and Apple, to gather relevant data. RapidSOS is valued at $573 million after raising a total of $298 million, according to PitchBook.

RapidSOS

Established in 2022, this Brazilian startup uses cutting-edge technology and environmental sciences to restore land and provide jobs in Brazil’s Amazon and Atlantic forests. The company has made significant strides in the restoration of 19,000 hectares of land. Re.green also owns Bioflora, Brazil’s largest native tree nursery, which it operates as a training center for reforestation workers. Through collaboration with other nurseries and Brazil’s indigenous communities, re.green says it has been able to preserve 60 native species and has distributed hundreds of thousands of seedlings for reforestation. 
 
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To gather reliable, timely performance data about existing reforestation projects, and to find suitable land for new ones, re.green also collaborates with drone companies and employs satellite imagery and machine learning. The company has ambitious targets, aiming to restore 75,000 hectares of land by 2025, conserve over 3,000 endangered species, and create 32,000 jobs annually.

re.green

Dental health is a key indicator of overall well-being, and in the case of children, it is especially important to set healthy habits. According to the CDC, complications caused by untreated cavities can have a domino effect, leading to troubles with learning, speaking, and playing. But the dentist’s office is rarely a kid’s favorite destination, not to mention the high cost of dental care: The CDC also reports that kids from low-income families are more than twice as likely to have untreated cavities than those from higher-income households. 
 
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Rodeo Dental, now one of the largest pediatric dental providers in Texas, is curbing cavities and providing dental care to 400,000 patients across three states this year—at low cost and regardless of the customers’ means. The structure of Rodeo Dental aims to reduce missed and delayed appointments by offering specialty services—including wisdom tooth removal and emergency dental care—that are coordinated in-house. Procedures are often completed on the same day. In 2023, the company expects to complete 500,000 preventive services.

Rodeo Dental

AI is creating burgeoning opportunities in health care, with the potential to improve the care of patients in innovative ways. One of those applications is the care of dementia patients. SafelyYou uses AI-enabled video technology and 24/7 remote clinical experts to help detect and prevent falls among senior living residents with dementia. When a patient falls, SafelyYou Respond detects it and alerts the resident’s care staff immediately, who can respond to the event within minutes. The video footage can be reviewed to analyze the cause of the fall and help staff create safer environments for the resident. The technology is currently used in over 300 senior living communities throughout North America. SafelyYou says it detects over 10,000 falls a month and protects more than 9,000 seniors a year; the company says the product helps reduce falls by 40% and fall-related ER visits by 80%. 
 
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SafelyYou announced a $30 million Series B funding round led by Omega Healthcare Investors in 2021.

SafelyYou

Sila Nanotechnologies claims to be the first company to successfully commercialize a silicon anode, replacing graphite as a key material in lithium-ion batteries. Compared to graphite anodes, Sila's Titan Silicon anode delivers up to a 40% boost in energy density and a 15% reduction in weight—which enables longer battery life and reduced charging time. Sila’s production process also reduces carbon emissions by up to 70% compared to graphite anodes—a key point at a time when the energy industry is trying to decarbonize its supply chain. 
 
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Sila already powers consumer electronic devices like the WHOOP 4.0 fitness tracker. It now has set its sights on the auto industry. In May 2022, the company purchased a 600,000-square-foot manufacturing plant in Moses Lake, Wash., with enough production capacity to power 1 million EVs over the next five years. In the same month, Mercedez-Benz tapped Sila to power its G-Class SUV, beginning “mid-decade”—which could make it the first car ever to be powered by batteries with a silicon anode. 
 
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Sila’s Series F round in January 2021 raised $590 million, valuing the company at $3.3 billion. Coatue led the round. 
 
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Sila

Today, U.S. public K–12 schools educate nearly 7.3 million people with learning disabilities—that’s 15% of 2021–22 school year enrollment, according to the National Center for Education Statistics (NCES). Historically, there have been limited curriculum options for special education students and teachers, who often rely on materials teachers adapt on their own from general education content—materials that don’t typically meet the learning needs of students with moderate to severe disabilities. 
 
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Education software company TeachTown aims to provide solutions that better suit these students. Some of these products include play-based learning, life skills for older students, and lessons that help development of speech and language. In November 2019, the company launched enCORE—a general education, standards-based curriculum for students with moderate to severe learning disabilities. EnCORE’s lessons can be tailored to individual needs with different levels of complexity, while all being derived from the same, core content. TeachTown says that on average, the 32,000 students with moderate to severe disabilities currently using the software have demonstrated a 67% improvement in pre- versus post-lesson testing. 
 
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More than 42,000 students overall were using TeachTown’s products at the end of 2022, and the company expects that number to double in 2023. Bain Capital Double Impact, a unit of Bain Capital, invested in TeachTown in 2021.

TeachTown

Think of it as a spillover effect of other kinds of discrimination: Women and people of color routinely receive the lowest quality of feedback at work. In particular, they’re more likely to get personality-based feedback—labeled as “shy,” “passionate,” “abrasive,” “pleasant,” or the like, rather than being given feedback about their actual performance and work output. Black women are three times as likely to get such feedback as other employees, according to Textio. 
 
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Even when that feedback is positive, it isn’t helpful. Textio’s bias interruption and language suggestion platform, called Textio Lift, is designed to break that cycle by helping managers provide specific and actionable feedback. The idea is to limit churn and to create greater opportunites for growth for traditionally underserved workers. The platform identifies exaggerated, non-actionable, and personality-based phrases in performance reviews, and it offers more fair suggestions to replace them with. 
 
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Textio says its customers include 1,300 companies, including one-third of Fortune 1000 companies, with a total of more than 30 million employees. Clients include McDonald’s, Zillow Group, Samsung, Uber, and Hulu. The company has raised $42.5 million, valuing it at $128 million.

Textio

Recruiting diverse populations for clinical trials is a long-standing problem that has limited both the advancement of new medicines and the attainment of equity in health care. White adult males have historically filled most of the roster in clinical trials, while people of color and females have been underrepresented. 
 
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TriNetX, a 10-year-old global health research network, is working to diversify and expand clinical trial enrollment, with the help of an electronic medical record database. The tool includes data from over 30 countries, 250 health care systems, and over 250 million patients worldwide. Since the launch of TriNetX’s Diversity Lens analytic feature in 2021, over 85 companies across life sciences and health care have used the feature to improve the diversity of their test trial populations. TriNetX raised a $40 million Series D funding round in March 2019, led by Merck Global Health Innovation Fund, bringing its total funding to $102 million. In 2020, global investment firm Carlyle Group acquired a majority stake in TriNetX.

TriNetX

Navigating public services can be a daunting task, and the difficulty of getting access through bureaucratic systems can further exacerbate life-threatening issues like food and housing insecurity. New York City–based Unite Us helps people in need access community-based resources—what the company refers to as “social care”—through its national network and software platform. The platform connects health care providers, government agencies, health plans, and nonprofits under one centralized system, allowing providers and social workers to directly connect individuals with essential resources. Unite Us’s approach extends beyond referrals—the platform also provides wraparound support including follow-ups and outcome tracking, ensuring continuous care instead of one-off, Band-Aid services. 
 
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Recently, Unite Us became the first platform to facilitate payment for social care, allowing nonprofits to be reimbursed by Medicaid for the care they provide. With community networks spanning 44 states, Unite Us reaches over 33 million individuals, and has helped meet 88% of all social needs identified. In Q4 of 2023, Unite Us surpassed 1,000 total customers, which include government agencies and community-based organizations. In November 2021, Unite Us raised $185 million from investors including Iconiq Growth, Optum, and Salesforce Ventures.

Unite Us

The retail sector accounts for roughly 25% of global carbon emissions; Vaayu is one of several startups aiming to help it reduce that footprint. Founded during the pandemic, the German software company works with more than 60 brands and businesses within the retail ecosystem to help them trace and cut their carbon and environmental impact, encouraging them to make greener decisions about their supply chains—and, sometimes, to help their customers choose the greenest available products. 
 
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Among its biggest collaborations is with secondhand-clothing retailer Vinted, Europe’s largest consumer-to-consumer platform. In partnership with Swedish fintech company Klarna, Vaayu has produced a carbon emissions tracker that enables over 150 million Klarna shoppers to track an item's CO2 emissions along various stages of its life cycle—empowering them to make more mindful shopping decisions. Vaayu’s other apparel, fashion, and retail partners include Ace &amp; Tate, Veja, Missoma, ASKET, and Otrium.

Vaayu

The Impact 20

Fortune's list of venture- and private-equity-backed startups using the profit motive to solve societal problems.