With $24.275M in Series A financing, we are scaling Tia to new markets, new service lines, and new partners. Here’s why we need a new model of women’s care now, more than ever.
By Carolyn Witte & Felicity Yost, Co-Founders of Tia
The U.S. healthcare system was designed to be one-size-fits-all and to treat sickness instead of prevent it. Despite decades of tech-enabled everything, up until two months ago, the iconic image of “healthcare” in the minds of most Americans remained a red cross on a building and a doctor in a white lab coat — a physical place you go to when something bad happens, and to otherwise be avoided at all costs. And then, Covid-19 hit.
While we deeply admire the heroic healthcare workers fighting Covid on the frontlines, this epidemic has also revealed just how broken our healthcare system is. We believe that now, more than ever, there is an imminent need to build a new model of care —one that is personalized and people-based, connects online and offline, and orients patients and providers alike towards prevention.
With $24.275 million in fresh Series A capital — the largest Series A financing led by a female CEO in 2020 — we’re doing just that: building the personalized care delivery model of the future for the most valuable customer in healthcare: women.
The Future is Personalized & People-Based
The Tectonic Shift
Before Covid, the healthcare system was amidst a tectonic shift from specialty-based care to people-based care, with new verticals being built to serve the distinct needs of different populations.
As we adjust to our “new normal” — not a post-Covid world per se, but an honest recognition that we will never really go back to the “old way” of doing things — it’s clear that this tectonic shift to people-based care is only accelerating, and with it, the “unbundling” of primary care and the hospital system as we know it.
So, what is people-based care?
People-based care is the recognition that different populations have different healthcare needs — not just clinically, but experientially and psychosocially — and that successful care models must be designed to serve their unique wants and needs. When we as healthcare entrepreneurs build for people instead of specialties, we are given a wider lens to approach how to deliver healthcare in a way that personalizes the experience, drives higher satisfaction, and leads to better outcomes.
To date, we’ve seen the most innovation in people-based care models with the elderly population — a vertical that houses a multitude of full-stack care delivery companies, from ChenMed to Oak Street Health, built to address the specific needs of the 65+ cohort. By focusing on chronic disease management and the social determinants of health that impact access and outcomes, these companies have pushed the boundaries of where and how care is delivered for the elderly (online, offline, and at-home), inclusive of payment models that incentivize outcomes over volume.
We believe reproductive-aged women deserve a similar focus, and a new model of care designed end-to-end, just for us.
So, why women?
Women control more than 80% of U.S. healthcare dollars. In blunt terms, we use healthcare more, have more doctors, and spend more dollars. Nonetheless, we’ve been under-researched and underserved by a healthcare system that continues to treat us as “small men with different parts” — all-too-often neglecting the complex interplay of hormones, gene regulation, metabolism, and other sex-specific differences that make female health fundamentally distinct from male health. It’s time for that to change.
As dual female founders and female patients, we recognize, deeply, the nuanced ways in which females are different, and that difference doesn’t mean inferiority. By fusing technology, experience design, and the highest quality clinical research and practice, Tia has created a new and distinctly female model of care that’s convenient, collaborative, and connected — one that women don’t just “like,” but love and trust. Through the success of our first brick-and-mortar Tia Clinic in NYC — an integrated gynecology, primary care and evidence-based wellness practice — we’ve shown that the magic formula for people-based care is not just tech, just care, or just brand, but all of it, melded together in a single, unified you-know-it-when-you-feel-it experience.
We’ve proven that the “Tia Way” really, really works. We have a consistent patient Net Promoter Score of 95, which increased to 100 week-over-week since the Covid crisis began. And, with a collaborative care model that empowers Care Teams and not just MDs, we reduce our costs by 40% per service. A tech-enabled care model rooted in trusted relationships and connectivity between providers is where “the magic” happens, and is what makes us ready, now, to scale the “Tia Way” to women everywhere.
The Covid Stress-Test
On March 17th — two days before Shelter-in-Place was instituted in New York, and one day after we chose to temporarily shut the physical doors of the Tia Clinic — we closed our Series A financing, led by Emily Melton at Threshold Ventures with participation from Define Ventures, ACME, Torch Capital, John Doerr, Homebrew and Compound.
As female founders responsible for 3,000 patient lives in NYC, a team of will-do-anything-for-patient-care frontline providers, 50 employees, and a new (amazing) group of investors and board members, the past 90 days have been a rapid-fire stress-test of our vision for people-based care, our values, and our bottom line. We’ve been required to toe-the-line of responding to the crisis while making bets on the future with imperfect information. By necessity, we evolved our service model in-real-time to meet our patients’ needs and questioned many of our core hypotheses, including the unbundling of primary care, and what it means to be the “front door” to the healthcare system. Choosing what to do — and more importantly, what not to do — was the theme of our time in quarantine together as co-founders. As we gear up to reopen the physical Tia Clinic and connect it to our expanded virtual Tia Care offering, we have more conviction than ever on what’s next for Tia, women’s health, and the future of personalized care delivery. Here’s why:
Before Covid, we conducted a patient-wide survey to find out what women love about Tia and what additional services they want from us. We learned that the fusion of OB/GYN and primary care into a singular, integrative model ranked as the number one benefit — outweighing technology, millennial decor, and a slew of other next-gen doctor’s office perks that make up the Tia experience. We also learned that women wanted, quite literally, every service imaginable from Tia — from endocrinology to dermatology to dental care. These findings reinforced a long-held belief we’ve had that women and the healthcare system do not see eye-to-eye on the definition of “women’s health.”
With an infinitely wide mandate to deliver “healthcare for women” vs. “women’s health” as conventionally defined, it’s not surprising that as soon as the epidemic hit, women turned to Tia in droves for all of their disparate needs — Covid-related and otherwise — which fell far outside the bounds of a traditional OB/GYN. In response, we launched Tia Virtual Care to offer Covid screenings, antibody testing, and monitor our patients remotely — keeping them out of NYC’s inundated emergency rooms. In response to a 400% increase in behavioral health-related messages and panicked requests for medication, we rolled out a comprehensive behavioral health program (inclusive of both therapy and medication management), which was immediately 100% booked and has remained at capacity, week-over-week. In response to panicked messages about job losses, we equipped women in our community — in NYC and beyond — with the changing-in-real-time policies on health insurance, helping them get and stay insured during the worst economic crisis since the Great Depression.
Through Covid, Tia has continued to be there for women as their loyal and trusted “medical home,” both online and offline. Not just their OB/GYN or Primary Care Provider or acupuncturist or therapist, but their go-to confidante for care, coordination, translation, and support to make healthcare more human and less complicated. That — all of that — is people-based care.
The Power of Trust
In people-based care and healthcare more broadly, trust is the hardest thing to earn, and the easiest thing to lose. It’s the foundation of everything we do at Tia — past, current, and future. While we are not quite in a post-Covid world just yet, it’s clear that people — and women in particular — will seek to avoid the hospital at all costs, preferring smaller avenues of care that are safer, consumerized, and built “just for them.” While igniting the backlog of elective procedures will provide some revenue recapture for health systems, and for Primary Care Providers, the ability to Zoom with a patient (and get paid for it), it’s clear to us that a much more substantial shift to people-based care and a steadfast obsession with cultivating trust is essential to transforming these all-too-fragile business and service models for the long-haul. We hope that companies like Tia can pave the way.
The Future is Online and Offline Care That Connect
Since Tia’s earliest days as a digital-only app, we’ve operated under the recognition that healthcare is not a once-a-year “checkbox,” but the byproduct of the big and small decisions we make every single day. Accordingly, we’ve invested extensively in our Connected Care technology platform for patients and providers that seamlessly extends a woman’s care journey beyond our exam room walls through asynchronous chat, health tracking, care plans, educational content, and community.
However, until three months ago, the recognition that continuous, connected care was essential to both the experience women want and moving the needle on outcomes was stymied by a major financial constraint: commercial payers refused to pay for it. As a byproduct of this, doctor’s offices like Tia, faced a few options: adopt virtual care and eat the cost, keep doing things the old way and collect what you can of (already diminishing) insurance reimbursements, or find someone else to foot the virtual care bill (for example, consumers willing to pay cash or an innovative employer).
This all changed overnight as Covid-19 triggered a lax in regulation, parity for virtual care reimbursement by commercial payers, and a mass shift in consumer psychology, driving unprecedented utilization of healthcare on the Internet. While the degree to which virtual care reimbursement will hold post-Covid is still in question, it’s clear that the “genie is out of the bottle” and can’t be put back in.
As female entrepreneurs, we’re both excited by the rise of virtual care and the ways in which it unlocks new business and service models, and simultaneously wary of what it could mean for women’s health, if not executed thoughtfully. While it’s rather obvious how we treat a rash or the flu virtually, how to deliver high-quality women’s healthcare — which is inherently more complex, more intimate, and, for obvious reasons, cannot all be done on the Internet — in this new world is less black and white and should not be constrained to a binary video or in-exam room option.
At Tia, we’re committed to thinking beyond a singular form factor like a Zoom call or physical exam room. Instead, we are designing for the full continuum of care in a way that maximizes quality, enhances the patient<>provider relationship, and leverages technology to make the “baton passes” between virtual and in-person care — where healthcare traditionally falters — smooth and seamless.
Rather than a singular visit, we think: care journey.
Rather than online or offline-only, we think: virtually-integrated.
Rather than a video or in-person binary, we think: chat, video, in-person, and remote patient monitoring — all connected.
Rather than healthcare transactions, we think: healthcare relationships.
Rather than tech for tech sake, we think: tech that makes healthcare more convenient, collaborative, and connected.
The Ever Evolving Care Continuum
Over our past ten weeks of temporarily operating in a virtual-only state, it’s been amazing to see our patients and providers rapidly adopt new technology, and fundamentally shift their mental model. We’ve seen an enlightened recognition that virtual care does not have to be a “lesser-than” version of in-person care, or limited to “quick fixes” and prescription refills. When designed with intention to be relationship-based and not transactional, virtual care has the potential to facilitate deep dialogue and human connection — in some regards, more so than an in-person visit, during which an honest hold-up-the-mirror conversation to evaluate your health can be overshadowed by the exam tables, needles, and stirrups.
As we reopen our first brick-and-mortar Tia Clinic on June 1st and expand Tia’s connected virtual and in-clinic care offerings to new markets later this year, we will be further investing in the ever-expanding continuum — a virtually-integrated care model that’s not online or offline-only, but all about delivering the right service in the right place at the right time by the right provider — and using Tia’s technology to connect all of those moments in-between.
The Future is Preventive Care
The Covid fatality data has reinforced a hard truth we’ve known for a long time, but have failed to properly act on: chronic conditions and a lack of focus on preventive care is killing Americans. What we do about it as part of a “Covid-correction” will be a telltale sign of the impact of this crisis on the healthcare system. Unlike with virtual care though, the fix here is not as simple as changing a few laws and billing codes; preventive care requires a fundamental redefinition of what it really means to “be well,” and investments in lifestyle and behavior change required to get and keep people well.
Being a healthy woman is all-too-often reduced to not having an STD or an abnormal Pap, but we know that the leading cause of death for women in America is cardiovascular disease. We also know that women are diagnosed with anxiety and depression at twice the rate of men, and that endocrine and autoimmune disorders are on the rise. In pregnancy, c-section and preterm birth rates continue to go up instead of down, as does maternal mortality, with the U.S. reporting more maternal deaths than any developed country in the world.
We believe that the solution is a preventive “whole women’s health” model that shifts:
From siloed specialists trained in body parts → to integrative Care Teams, who work together to support a woman’s comprehensive physical, mental, and emotional wellbeing.
From cast-typing all women as “hormonal” → to considering, deeply, the implications of the hormonal state in which she is existing (natural cycle, synthetic hormones for contraception, pregnancy, or a period of hormonal deprivation such as postpartum or menopause) in the diagnosis and treatment of a female patient.
From treating symptoms → to “root cause” diagnosis that accounts for the well-studied impact of sleep, nutrition, stress, and other aspects of lifestyle on a woman’s body.
What’s Next: Building Bridges, Not Walls
Equipped with more firepower, we are seizing this opportunity to bring Tia Care to new markets by expanding our virtual and brick-and-mortar footprint and broadening our scope of practice to serve women throughout their reproductive lives. Because every woman deserves healthcare that’s personalized, connects both virtual and in-person care, and helps her get and stay truly well.
We recognize that achieving this vision requires building bridges, not walls, and pushing for evolution within the confines of the current payment and delivery models that dictate access and costs. By partnering with leading health systems, employers, and provider networks to scale our Connected Care Platform, and open new physical and digital Tia doors, we can make “the Tia Way” the new standard of care for women and providers everywhere.
With a laser focus on listening, forever and always, to what women want, we are committed to being a leader in the “Covid-correction” — shaping a new people-based healthcare system that just works and is simple as: “I’m a woman. I have a need. I turn to Tia to take care of the rest.”
