As it hits $100 million run rate, The Pill Club adds former Uber exec Liz Meyerdirk as CEO

Liz Meyerdirk made a name for herself at Uber as the Senior Director & Global Head of Business Development for the company’s Uber Eats business and she’s now turning her attention to women’s health as the new chief executive of The Pill Club.

The move comes at a perilous time for the remote delivery of women’s healthcare as the Supreme Court has taken steps to limit the provision of sexual healthcare to women in recent months.

“Women’s health care has never been more tested than right now,” Meyerdirk noted in a blog post announcing her new role. “COVID-19 has upended access to care; dozens of states have—and continue—to try and limit women’s choice; and last year, the Supreme Court voted to uphold the rollback of the ACA contraceptive mandate decision, a stunning move that could end up impacting as many as 126,000 women who previously received covered contraception through employer-based health insurance.”

A seasoned corporate executive, Meyerdirk is hoping to navigate The Pill Club through these treacherous times. “These events have shown that reliable, safe, and affordable access to women’s health and birth control is
just one more vulnerability in our health care system,” Meyerdirk wrote.

Liz Meyerdirk, chief executive of The Pill Club: Image Credit: The Pill Club

As it faces an uncertain legal environment on some fronts, the company couldn’t be in a better position financially.

The Pill Club, which is profitable and now has a $100 million run rate, is now ready for its closeup with Meyerdirk at the helm.

The company has managed to make its mark in the crowded world of online prescriptions and refill fulfillment by focusing specifically on women’s health and ensuring that those services are available to as many potential patients as possible.

“We’re now serving hundreds of thousands of women nationwide with 20% on Medicaid,” says Meyerdirk. “We prescribe in 43 states and the District of Columbia.”

For Meyerdirk, the background she had in logistics and fulfillment from her time at Uber Eats made the transition to the pill prescription and delivery service natural.

“There is a heavy logistics element to it,” said Meyerdirk.

As Meyerdirk takes the reins of the company, she said there’s a few areas that The Pill Club will expand into beyond its focus on birth control and contraception. “There are areas that our customers are asking for,” Meyerdirk said.

These areas include, initially, dermatology. Last year the company launched a delivery service for contraceptives and women’s hygiene products like pads and tampons.

As it continues to expand its product suite, it’s also growing its executive staff. The company not only added Meyerdirk, but also David Hsu as chief financial officer and Jeremy Downs as senior vice president of growth. Hsu joins the company from Honey, where led the $4 billion acquisition negotiations with PayPal, and Downs comes from Uber Eats, where he spent five years leading growth.

“We need sustained, long-term access to women’s health care, not just a bridge while the pandemic persists; and we need coverage for essential health services like birth control and prenatal care, regardless of whether or not you’re insured,” Meyerdirk wrote. “Reproductive care has and continues to be an essential part of our business, but there are countless opportunities to serve women in all of their life stages from puberty to menopause.”

#articles, #birth-control, #chief-financial-officer, #contraception, #health, #health-care, #health-services, #healthcare, #paypal, #reproductive-health, #supreme-court, #tc, #uber, #uber-eats, #womens-health

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Twentyeight Health is a telemedicine company expanding access to women’s health and reproductive care

New York’s Twentyeight Health is taking the wildly telemedicine services for women’s health popularized by companies like Nurx and bringing them to a patient population that previously hadn’t had access. 

The mission to provide women who are Medicaid or underinsured should not be deprived of the same kinds of care that patients who have more income security or better healthcare coverage enjoy, according to the company’s founder, Amy Fan.

The mission, and the company’s technology, have managed to convince a slew of investors who have poured $5.1 million in seed funding into the new startup. Third Prime led the round, which included investments from Town Hall Ventures, SteelSky Ventures, Aglaé Ventures, GingerBread Capital, Rucker Park Capital, Predictive VC, and angel investors like Stu Libby, Zoe Barry, and Wan Li Zhu.

“Women who are on Medicaid, who are underinsured or without health insurance often struggle to find access to reproductive health services, and these struggles have only increased with COVID-19 pandemic limiting access to in-person appointments,” said Amy Fan, co-founder of Twentyeight Health, in a statement. “We are fighting for healthcare equity, ensuring that all women, particularly BIPOC women and women from low-income backgrounds, can access high quality, dignified and convenient care.”

To ensure that its catering to underserved communities, the company works with Bottomless Closet, a workforce entry program for women, and the 8 colleges in the City University of New York ecosystem including LaGuardia College, which has 45,000 students with 70% coming from families making less than $30,000 in annual income.

The company’s services are currently available across Florida, Maryland, New York, New Jersey, North Carolina and Pennsylvania and it’s the only telemedicine company focused on contraception services to accept Medicaid.

In another example of how awesome this company is, it’s also working to provide free birth control for women who aren’t able to pay out of pocket and are uninsured through a partnership with Bedsider’s Contraceptive Access Fund. The company also donates 2% of its revenue to Bedsider and the National Institute for Reproductive Health. (Y’all, this company is amaze.)

To sign up for the service, new customers fill out a medical questionnaire online. Once the questionnaire is reviewed by a US board-certified doctor within 24 hours customers can access over 100 FDA-approved brands of birth control pills, patches, rings, shots, and emergency contraception and receive a shipment within three days.

Twentyeight Health provides ongoing care through online audio consultations and doctor follow up messages to discuss issues around updating prescriptions or addressing side effects, the company said.

“Today, low-income women are three times more likely to have an unintended pregnancy than the average woman in the U.S., and nearly one-third of physicians nationwide aren’t accepting new Medicaid patients,” said Bruno Van Tuykom, co-founder of Twentyeight Health, in a statement. “This underscores why offering high-quality reproductive care that is inclusive of people across race, income bracket, or health insurance status is more important than ever.”

Launched in 2018, Twentyeight Health said it would use the new cash to continue to expand its services across the U.S.

 

#articles, #birth-control, #co-founder, #contraception, #fda, #florida, #health, #health-insurance, #health-services, #maryland, #medicaid, #new-jersey, #new-york, #north-carolina, #pennsylvania, #tc, #telehealth, #telemedicine, #town-hall-ventures, #united-states

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Nurx has $22.5 million in new money, a path to profitability, and new treatments for migraines on the way

As the COVID-19 epidemic spread across the US earlier this year, Nurx, like most other digital providers of healthcare and prescription services saw a huge spike in demand.

Now, with $22.5 million in new financing and a surging annual run rate that could see the company hit $150 million in revenue, the company is emerging as the largest digital practice for women’s health.

“We saw this tremendous surge in need for our contraception and sensitive health services,” says Nurx chief executive Varsha Rao .

The growth hasn’t come without controversy. Only last year, a New York Times article pointed to corner cutting at the startup which boasts Chelsea Clinton as an investor and advisor.

Undeterred Rao said that the company has now seen tremendous acceleration in all areas of its business. It’s now providing care to over 300,000 patients on a monthly basis, boasts that $150 million run rate and new investors like Comcast Ventures, Trustbridge and Wittington Ventures — the investment arm of one of the largest pharmacy chains in Canada, Shoppers Drug Mart.

The new $22.5 million is an extension on the company’s previous $32 million round and will take the company to profitability by 2021, according to Rao.

And while birth control and contraception are still the largest areas of the company’s business, Nurx is growing its range of services, seeing adoption of its testing for sexually transmitted infections including HPV and herpes and a new treatment area for migraines.

That focus on sexual health and what the company calls sensitive health is different from trying to be a primary care provider says Rao. “Our real focus right now is on our core demographic who are women between the ages of twenty and forty and really focusing on their needs,” she says. “That’s why migraines make a lot of sense. It’s not exclusively hormone related, but it often is… One-in-four women experience migraines and they’re largely from hormonal changes… This is a condition we’re well positioned to address.”

Another way that Nurx differentiates itself from competitors like Hims and Ro, which provide women’s health and contraceptive prescriptions as well, is through its ability to take insurance. “It’s actually pretty challenging to build the system to actually offer insurance,” says Rao. “And yet, we don’t think you can be a true healthcare company if you don’t accept insurance.”

 

#advisor, #canada, #chelsea-clinton, #comcast-ventures, #health-services, #healthcare, #hims, #insurance, #new-york-times, #nurx, #tc, #united-states, #varsha-rao, #wittington-ventures

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Tictrac secures $7.5M to expand employee wellbeing platform as WFH baloons

“Employee Wellbeing” SaaS platforms have been around for some time. Both regulation and increasing stress levels and health problems in the workplace have fed the rise of this sector of tech, and with many corporates painting long-term contracts with providers, it’s a lucrative business. Furthermore, with the COVID-19 pandemic ongoing, large remote-workforces look here to stay for the foreseeable future and are likely to need these platforms more than ever. Notable players in the space include Rally Health, Dacadoo and Virgin Pulse.

Tictrac is a startup in this space that uses a combination of personalized content, lifestyle campaigns and incentivized challenges to motivate staff. It combines this with behavioral science to identify trigger points to egg-on staff to positive behaviors. Existing investors of Tictrac include world-class tennis champion, Andy Murray and American basketball player, Carmelo Anthony who has been named an NBA All-Star 10 times.

Today it secures a £6m ($7.5M) in a funding round led by London-based Puma Private Equity, bringing its total investment to date to £13.5m ($17M). The latest round will allow the company to expand its Employee Wellbeing platform for its thousand-plus customers. It will also now expand its Enterprise platform, which enables insurance companies and health providers to engage their customers in their health and tailor relevant products and services to them.

Tictrac relies heavily on content, contributed by well-known health and fitness influencers, covering fitness, yoga, meditation, mindfulness, recipes and blog posts which provide its users with inspiration and advice on how to improve their lifestyle.

Unlike a lot of other “Employee Welbeing” platforms, users can follow the content or experts that they can relate to (much like with Instagram, Calm or Glo Yoga) powered by a campaign engine that delivers creative themes across Tictrac features, like healthy habit-forming action plans and activity challenges.

Founded in 2010, the company has partnered with healthcare and insurance providers including Aviva, Allianz and Prudential.

In a statement Martin Blinder, CEO and founder of Tictrac, commented: “Now more than ever, companies have a greater role and responsibility in supporting the health of their workforce. And while businesses are focused on sustaining retention and productivity – particularly with so many people working remotely – they are now tasked with trying to navigate health issues such as burn-out and striking a healthy work-life balance.”

Rupert West, Managing Director at Puma Private Equity said: “We have been consistently impressed with Tictrac’s ability to heighten health and wellbeing engagement, which in turn will help alleviate some of the pressures our health services continue to face.”

#allianz, #aviva, #carmelo-anthony, #europe, #health-services, #healthcare, #instagram, #insurance, #london, #national-basketball-association, #nba, #puma-private-equity, #tc

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Building and investing in the ‘human needs economy’

The entrepreneurial and investor focus of the last decade has largely been centered on increased convenience and consumerism, and has encouraged companies to prioritize scaling, with little care for how it affects stakeholders, employees, consumers and even the environment. We have been talking about a shift for some time, but now more than ever, it has become obvious that companies have to take humanity into account as they build and scale in this new paradigm.

The last 10 years of startup growth have been about building and investing in these “nice to haves.” We believe the next 10 years will be focused on building and investing in “need to haves,” and the greatest business opportunities will be found in what we at Human Ventures call The Human Needs Economy — products and services that have material impact on basic needs and livelihoods and address a core draw on a consumer’s time, money or energy. For 2020, we are focusing on solving problems within three categories that we believe will have a huge impact on the Human Needs Economy: health and wellness, the future of work and community.

As the first category of the Human Needs Economy, we outline the opportunity within health and wellness and specific areas in which we are excited to build and invest.

Health and wellness

Looking back at a decade focused on scaling nice to haves, it shouldn’t come as a surprise that we are living with unaddressed health and wellness issues. And the statistics are staggering. In 2019, an estimated 47.6 million adults (19% of the country) had a mental illness, but only 43% received any kind of mental health care. When it comes to sexual and reproductive health, whole populations of minorities and underrepresented groups receive subpar care and face stigma around health issues. And we’re on track for a shortage of 120,000 doctors in the U.S. by 2030, a signal that these issues are set to get worse. (The United States’ response to the COVID-19 pandemic has highlighted how dangerous this is in a crisis.)

These challenges and others represent what we call the wellness deficit — the sum of the human needs that have gone unmet in the areas of health and wellness. And even though it may seem that every block has a new boutique fitness studio popping up or everyone you know has the latest wearable to measure their sleep, we believe we are just at the starting line when it comes to making up ground and building great businesses that tackle these issues.

Below are 10 areas that are poised to make up this wellness deficit:

#column, #consumer-products, #extra-crunch, #femtech, #food, #health, #health-services, #human-ventures, #market-analysis, #mental-health, #social, #startups, #telehealth, #telemedicine, #united-states, #venture-capital

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Pasadena’s petcare financier Scratchpay now offers lending options for human health and wellness

Scratchpay, the Pasadena, Calif.-based provider of petcare financing plans, is now offering lending services for dental, optical and chiropractic care for humans in a broad expansion of its services.

The expansion into human health and wellness was always on the company’s roadmap, according to chief executive John Keatley, but those plans accelerated as the company saw the cresting wave of the COVID-19 pandemic head for the United States.

The company now boasts 7,000 petcare practices and 1,000 human health and wellness practitioners on the company’s financing network.

“We provide short term financing through simple payment plans. We have a product called Take 5 which is a totally free buy-now-pay-later product at the vet or at the dentist,” said Keatley. 

Scratchpay makes its money off of the no-interest Take 5 payment plan by charging a fee to the practices that offer the service. For dentists, vets, optometrists and other service providers the payment plan provides a way to up sell patients on additional services. The company also offers more traditional lending products with interest rates in the high teens, on average, according to Keatley.

For years, the only provider in the patient lending market for pets and people was a company called Care Credit, which offered a high interest credit card, Keatley said.

By contrast, Scratchpay offers a more straightforward approach. Each transaction requires a single approval for a specific dollar amount, instead of the credit line that Care Credit offers, he said.

So far, the company has made around 100,000 loans through its service. Keatley wouldn’t disclose the default rate for the business.

“When we first launched Scratchpay, our goal was to get more pet parents the care they needed using fair, affordable, and transparent payment plans,” said Caleb Morse, co-founder and chief operating officer of Scratchpay, in a statement. “Today, we’re expanding our vision to include other verticals where many patients have historically been underserved in terms of their financing options. We want to help create a world where everyone has access to the health services needed to live healthy, happy lives. The incredible speed of adoption we’re seeing in dental, optometry, and many other sectors in healthcare gives us confidence that we are on a path to make that vision a reality.”

#california, #credit-card, #dentist, #health-services, #healthcare, #tc, #united-states

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Why telehealth can’t significantly flatten the coronavirus curve—yet

The COVID-19 pandemic rages on.

As cases in the United States skyrocket, one of the most foreboding possibilities of COVID-19’s rapid growth is the potential to overwhelm hospital capacity. Hospitals in cities like New York are already underwater, relying on hospital boats (“70,000 ton message[s] of hope and solidarity”) to keep them afloat, and on retired providers as well as prematurely graduated medical students to staff those beds.

In tandem, telehealth has rapidly evolved from a “nice to have” to a “need to have” for U.S. health systems.

Telehealth: from hype to hope to here, overnight

This timing is prescient, as the technologies for telehealth have existed for several decades (at varying levels of sophistication) with modest uptake to-date. From 2005 to 2017, only one out of every 150 doctor visits and one in every 5,000-10,000 specialist visits were conducted via telemedicine.

A major catalyst to uptake was the federal government’s announcement two weeks ago that restrictions on the use of telehealth for Medicare would be temporarily lifted. That policy change included expanding coverage across specialties and settings; waiving co-payments; and loosening HIPAA privacy requirements (such as prohibiting ubiquitous teleconferencing technologies like Apple’s FaceTime).

Accordingly, telehealth—overnight(ish)—is finally mainstream.

At America’s largest health systems, adoption of telehealth has accelerated rapidly: at Massachusetts General Hospital, the weekly number of virtual appointments has multiplied 10-20 times in the past weeks, while at NYU Langone Health, staffing was increased fivefold to handle the rush of new appointments. Teladoc, the U.S.’s largest virtual-care provider, is now reporting over 100,000 appointments weekly.

The diversification of telehealth use cases

The proliferation of telehealth via pioneering health systems has spawned unique use cases rarely seen before in the landscape of U.S. healthcare.

These use cases cut across numerous settings: emergent care, intensive care, triage, and monitoring, to name a few. Outside the hospital setting, domestic initiatives such as Houston’s Project Emergency Telehealth and Navigation (ETHAN) has provided a precedent for the use of telemedicine by paramedics and EMTs in first-response. These sorts of programs have actively been pioneered by startups such as RapidSOS in response to COVID-19.

At the gateway to the hospital (the emergency room), building on work by Jefferson Hospital in Philadelphia, health systems including Kaiser Permanente, Intermountain Health, and Providence Health have adopted programs for tele-intake to minimize contact between providers and patients under investigation (PUIs) for COVID-19.

Upon admission to the hospital, telehealth is being used for monitoring patient status while also ensuring the safety of health providers. Such technologies are proving exceptionally important given wide-scale shortages of personal protective equipment (PPE).

At Washington State’s Providence Regional Medical Center Everett (the site of the first COVID-19 case in America), programs for telemonitoring of ICU patients were built from the ground up in six weeks. Startups like EarlySense are combining multimodal sensors with audiovisual capabilities to enable remote detection and evaluation of clinical deterioration on non-intensive wards.

Following discharge from the emergency room or the inpatient units of the hospital, telescreening tools like TytoCare are enabling physicians to conduct exams and deliver care remotely that previously would have required in-person contact. In the case of discharge from the emergency room—given the volatile clinical course of COVID-19—methods for streamlined and regular check-ins are critical to monitor symptoms and guide the need for more intensive treatment.

Likewise, given recovery from the disease can potentially be tumultuous (especially after ICU care), these technologies are essential for mitigating what has been deemed the “post-hospital syndrome” and ensuring long-term health after discharge from inpatient care.

Here—but there, or everywhere?

While the near-overnight expansion of telehealth in diverse forms is positive news, barriers remain to its widespread dissemination in this country. To move from the prototyping stage at the meccas of modern medicine to a widely useful tool across healthcare settings, telehealth must seek to solve what has been deemed the “last mile problem.”

The last mile refers to the non-technological, practical elements of local care delivery. As with telehealth, when these practical elements of care delivery are inadequately addressed, they inhibit providers from implementing new technologies for patients. In the case of telehealth, the last mile can be grouped into four domains: those related to (a) coverage and reimbursement (b) legal concerns (c) clinical care and (d) social challenges. The federal government’s policy change this month took major steps forward to resolve some legal concerns, including limitation of tort liability and allowing common teleconferencing platforms that may not be strictly HIPAA compliant.

However, considerable obstacles to the uptake of telehealth persist across the other three domains, especially for the 86.5% of Americans not on Medicare. To effectively combat COVID-19, telehealth must also reach these 281 million individuals in the under-resourced nooks and crannies of the U.S. As the virus becomes more pervasive across the country, rural health systems are depending heavily on these technologies to manage the imminent surge of cases.

The essentials to expanding telehealth

In terms of coverage for patients, only 36 states mandated coverage of telehealth services in insurance plans as of April 2019. For those with mandatory coverage, out-of-pocket copays typically ranged $50-80 per appointment. Alternatively, certain plans waived copays, but only following an annual fee for premium services—premiums which may well rise going forward.

All of these costs will hinder the use of telehealth in non-Medicare patients amidst the present outbreak.

While in the past two weeks, some private insurers such as United Healthcare (covering 45 million Americans), Humana (39 million), and Aetna (13 million) waived copays on telehealth services, the privates covering the remaining hundreds of millions of Americans must follow quickly. States can help accelerate this by following the lead of Massachusetts, which last month required all insurers to cover telehealth.

In terms of reimbursement to providers, only 20% of states required payment parity for telehealth to ensure—if telehealth was covered at all—it is remunerated at rates approximating in-person visits for similar diagnoses. This disparity has made adoption of telehealth undesirable and/or untenable for health systems, since the reimbursement rates for telehealth average 20-50% lower than for comparable in-person service.

The challenges to adoption of telehealth are further heightened for independent practices, who must pay subscription fees to use standard telehealth platforms, but simultaneously experience revenue decreases of some 30% upon integrating telehealth. To make adoption of telehealth financially feasible for health systems and individual practices amidst the COVID-19 outbreak, states once again should follow Massachusetts in seizing the opportunity to enforce payment parity by private insurers.

Finally, in terms of clinical care, issues abound in the minutia of how and where telehealth can be performed. In terms of how telehealth is performed: while these services should integrate with the existing workflows of clinical practice, insurance rules currently hinder this. For example, e-visits and check-ups are only permitted for “existing” patients rather than for new patients presenting with mild symptoms or fleeting concerns, who may not require a full work-up (this is the case even under the recent CMS policy).

Moreover, asynchronous methods such as “store-and-forward” consultations and remote patient monitoring—exactly the sort of efficient and highly-scalable pathways integral to the flexible provision of care to the dispersed masses—are restricted in most states.

Additionally, where telehealth can be conducted is hamstrung by “origination site” policies banning these services in patient homes but for a select few conditions (such as stroke assessment and opiate rehabilitation). Such arbitrary, excessive regulations make the widespread utilization of telehealth unrealistic. Also, state-by-state licensing requirements prevent physicians from providing care across borders (for reasons rooted in nineteenth-century concerns of medical quality gaps between states).

To promote the care of COVID-19 patients in epicenter regions, states should follow the lead of New York and Florida to suspend out-of-state licensing bans, allow license transferability, or at least expedite licensing through “licensure compacts” in allied states.

Finally, in terms of social challenges, considerable access disparities exist between demographic groups. For example, according to the National Telecommunications and Information Administration’s 2018 survey, vulnerable populations such as the elderly were 21% less likely to have internet access and almost 50% less likely to conduct videocalls; the poor were 34% less likely to communicate with doctors online; and other demographic minorities (such as Hispanic ethnicity or lower educational attainment) were also less likely to have access to and/or use telehealth technologies.

Since these populations are more likely to face the sorts of comorbid conditions and social determinants of health that heighten mortality from COVID-19—and less likely to have levels of health literacy allowing them to reduce their risk of transmitting infectious diseases like coronavirus—inequalities in telehealth access bear important implications on the country’s ability to flatten the curve of COVID-19.

One of the single best interventions to augment access for these individuals is expanding the scope of practice of non-physician health providers. These providers have their wings clipped by arcane laws fiercely defended by state medical associations that require their “supervision” by physicians for most cases of patient care. This is despite analyses since the 1980s exhibiting the capability for non-physician healthcare providers (such as nurse practitioners and physician assistants) to provide services as high quality as those of physicians.

Liberating various allied health practitioners (including also registered nurses, pharmacists, dentists, paramedics, and social workers) to screen, diagnose, treat, and prescribe with increased autonomy would undergird telehealth’s capabilities as a “force multiplier” in the setting of COVID-19. They can also unleash the potential of startups such as The MAVEN Project which provide platforms for peer-to-peer consults between specialty and generalist health providers in emergency settings.

In geographically dispersed states such as California—where allied health providers are expected to provide half of all primary care appointments by 2030—these policies are especially vital. Bills designed to facilitate these programs like the California Assembly Bill 890 that remains stalled should be endorsed to protect patients across the state from the insidious diffusion of COVID-19.

In summary, the early responses by federal and state agencies to COVID-19 have made progress to promote the uptake of telehealth. However, as the virus expands its siege across the country, more comprehensive solutions are urgently needed to equip the creators, users, and beneficiaries of telehealth with the arsenal they desperately require to vanquish this invisible enemy. Accordingly, pen-and-paper may be the most important technologies for bolstering telehealth today. Letters to senators, in the near-term, may be the most potent ammunition we’ve got.

#column, #coronavirus, #covid-19, #health, #health-services, #telehealth, #telemedicine

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