About
The room came before the company.
m4 builds private rooms where senior healthcare leaders test consequential decisions with peers who understand the weight they carry, and with others who see the same problems from different positions. The first room took shape in 2011, years before m4 became a company.
Where it started
Built for when the rules change
In 2011, while Brian was working in a market-facing strategy role inside a health plan, leaders from three organizations began meeting privately to examine what the Affordable Care Act would mean for their businesses. Within a year, organizations from 31 states had joined. They were insurance executives responsible for financial and operating performance, navigating structural change without clear answers. The value came from testing their thinking with leaders confronting other parts of the same problem.
That is where the idea took shape: work with leaders in private, without a sponsor, alongside people who carry real responsibility. When Brian left to establish m4 innovation in 2014, he envisioned an advisory and analytics practice. Senior leaders encouraged him to make the room itself the work and to open it beyond insurers. The first 4mul8 convened in Austin. In 2018, inspired by the legacy of the Jackson Hole Group, it moved to Jackson Hole, and it has kept evolving alongside its members.
Who leads m4
Small and attentive by design
Brian Melanson
Founder and PresidentBrian spends much of the year composing the rooms. Each morning begins with a review of how the rooms are taking shape, which perspectives are represented and where an important voice may be missing. His work centers on the questions Partners are carrying and on finding the people whose experience can challenge a room in useful and unexpected ways. He spent more than two decades in healthcare and insurance, including roles at Humana, OneDigital and Premera, learning from senior leaders what they need to make consequential decisions well. Often the most valuable voice in a room belongs to the person whose perspective changes how others see the problem. The measure he trusts most is a member calling after a room to say it seemed composed around the very problem they were facing. Outside the rooms, Brian is a photographer, and every photograph on this site is his.
Kristen Melanson
Chief Operating OfficerKristen leads the operational and financial foundation of m4, making sure its private rooms and year-round relationships run with the attention, discretion and consistency members expect. Nurturing Partner relationships is central to her work. She works directly with prospective members, helps identify leaders whose perspectives will strengthen a conversation and guides organizations as they enter the model. She also oversees the many details behind the experience, from venues and suppliers to financial obligations. Her attention to detail was shaped in part by her earlier work in financial services, including Citigroup's mortgage division, where precision and follow-through were essential. Brian and Kristen are married and live in Fairhope, Alabama, with their family. Their shared love of travel and distinctive places shapes the settings they create for members.
How we work
m4 builds the conditions, while you make the call
Every room begins with a core of leaders carrying consequential responsibility. Around them, m4 brings perspectives from other parts of healthcare and insurance, chosen deliberately and in the right proportion, so the discussion gets sharper without losing its center. Years of composing these rooms have taught us that curiosity, discretion and reciprocity matter as much as accomplishment. The right mix changes as the industry does. Finding that balance, and protecting the independence of the conversation, is the work we guard most closely.
What is shared in the room is never attributed outside it. We have no stake in what you decide, and no IP, investment, transaction or implementation upside in the outcome. Our success does not depend on whether you choose A or B.
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