Joanna Strober
I was around 47 when I stopped sleeping and started waking up every night. What did that do to me? It meant that the next day when I went to work, I was tired, I was having brain fog, I was gaining weight. And I went to a lot of doctors to try to figure out what was going on with me because I felt off and wrong. And what was amazing to me is how every one of these doctors had their own solution, none of which were tied to the fact that I was a woman in this age category.
Narrator
That was Joanna Strober detailing an experience that millions of women face in today’s disjointed healthcare environment. That gap in care led Strober to launch Midi Health in 2021. Midi is a virtual care company focused on women 40 years of age and above going through perimenopause and menopause. But the challenges women face getting quality of care don’t start at 40. There are issues across every age cohort. One-third of women responding to a KFF poll said they had a doctor dismiss their concerns about a healthcare issue. And a recent Gallup survey found that most women said they hadn’t been tested for cancer, diabetes, high blood pressure, or an infection in the past 12 months.
But there are innovators working to break the status quo and improve both access and quality of care for women. In this Oliver Wyman Health Podcast we talk to two such leaders, Strober at Midi Health, and Leah Sparks, CEO and Founder of Wildflower Health, a company that’s focused on value- based maternity care.
Minoo Javanmardian
Hello, my name is Minoo Javanmardian, one of Oliver Wyman partners in the healthcare space. I’m delighted to facilitate the discussion around women’s health today, a topic that has been top of mind for many, including myself as a consumer and industry advisor. We all know that our current healthcare ecosystem is not designed to focus on the needs of more than half of our population. This is even in areas that are specific to women’s anatomy. There are still a lot of unmet needs and gaps in the market. Leah and Joanna, thank you for joining us. Let’s start with a brief discussion of why and how you launched your businesses. Leah, maybe we can start with you.
Leah Sparks
Thank you so much for having me. Probably similar to Joanna, I started this company after a personal journey through my own pregnancy experience and I witnessed firsthand the gaps in the healthcare system. And we have been on a journey for the past decade to change the trajectory of maternal health outcomes by using technology and services to wrap around the existing care ecosystem. And today that principally looks like wrapping around OB and hospital practices throughout the country, enabling them to extend their care into the home through remote monitoring and through nonclinical staff who can better support whole health for pregnant patients and mitigate the complications that drive cost and poor outcomes. And importantly, marrying with that a value-based care model that we can talk about later. But that is quickly how we got started and how we got here.
Minoo
Thank you so much. Very exciting. Looking forward to learning more about it. Joanna, do you want to give us a brief summary of your business?
Joanna
So as Leah says, a lot of these companies are born from women’s personal experiences, and ours was the same. I was around 47 when I stopped sleeping and started waking up every night. What did that do to me? It meant that the next day when I went to work, I was tired. I was having brain fog, I was gaining weight, and I went to a lot of doctors to try to figure out what was going on with me because I felt off and wrong. And what was amazing to me is how every one of these doctors had their own solution, none of which were tied to the fact that I was a woman in this age category. What I learned is that none of them looked at me and said, “Oh, this is just perimenopause.” I eventually paid for a concierge doctor, drove an hour away and got the right care, and my life came back to me after about two weeks.
But it was that realization that very few providers are trained in understanding women’s health issues other than fertility and maternity, that led me to start this company so that we could provide better care to women in their late 30s, 40s, and 50s for all the health issues they’re going through.
Minoo
Thank you. Very exciting, indeed. Let’s now talk about the patient-centered model. As we all know, and you just alluded to it, building a patient-centered model has been a challenge for the industry. How did the two of you think about that idea and what’s proven successful in terms of helping women navigate two very different and complex ends of the spectrum? Joanna, let’s start with you on this one.
Joanna
I think of our entire company as being built around the needs of women. We started with a pilot that we did for nine months where we asked people to give us feedback, like a consumer product, on every part of our model, every part of the care we were offering. We learned from them that someone wanted to have integrated care with both naturopathic medicine and traditional medicine in the same visit. We learned from them how women wanted to be taken care of during this process. We are starting as a consumer experience company and that really educates how we think about providing care. We don’t start from the hospital system, for example. We start from, how do women want to experience care and what will make them feel better fastest?
Minoo
Thank you. Leah, what about you?
Leah
Yeah, it’s an interesting contrast. In our business, of course, in pregnancy, the vast majority of people do deliver their babies in a hospital. And we don’t deliver babies on telehealth, certainly as of yet, probably never. So we have had to take a different approach because of the area that we focus on, which is to say, we work with the care ecosystem of OBs and midwives to help make them more patient centered. The providers we work with are very high quality, great clinicians. They are facing burnout, facing staff shortages, rising wage pressure with their staff.
We help to augment their work, again, by using a virtual technology enabled, nonclinical, complementary staffing model to extend those providers to help do more frequent screening for mental health, for social determinants. Again, do remote monitoring for blood pressure and glucose and do the things that are often not able to be done in the healthcare system the way it is funded and set up today. And those are the things that can move the needle on earlier detection of risk in pregnancy and in better support of health inequities and disparities in care by integrating demographics into that model. It helps to force multiply these clinicians that we work with so that they can have a much more patient-centered model, by using technology enabled services that are integrated into their EHR and integrated into their workflow so it’s complementary to the way they practice medicine.
Joanna
And actually, Leah, we found the same thing. Our women wanted to also be integrated into the healthcare system. We found that women trusted their healthcare system because they delivered a baby there, so they had a relationship with that, and there was a lot of trust. In the same way that you did, we integrate with the EMRs, we integrate with their other doctors. We found that it was very important for women to feel part of the overall ecosystem and not a separate consumer experience that was outside of it.
Minoo
That’s great. So it is complementing the system that we have in place and meeting the unmet needs in the system, which is great. In the same way, let’s talk about what we call, a number of point solutions. There are a lot of solutions out there that have emerged in recent years. In a case like Midi, it seems to be out of necessity because that service offering wasn’t just there adequately. Joanna, can you talk about how platforms like Midi are filling a vacuum in the ecosystem?
Joanna
In most places, to get an insurance-covered visit with an expert in perimenopause or menopause usually takes a minimum of six months. The economics, which everyone listening to this podcast probably knows, don’t urge hospital systems to hire a lot more providers to do this. So instead, it’s fine for them to have a six- to nine-month waiting list for this type of care. But women need to get in sooner. When you’re experiencing these symptoms, you don’t want to wait six to nine months to get care.
What we have found is that we can partner with healthcare systems to add this layer of expertise for them and then refer the more urgent cases in to get the right care. We’re able to do the initial visits with them, take care of their urgent symptoms, and then get the mammograms, get them ultrasounds, get them DEXA scans. We’re able to do blood testing to make sure that there’s nothing else going on in their bodies that need more care. And then we will make sure they get targeted referrals into healthcare systems. We’re able to reduce the unnecessary visits in a healthcare system and enable them to see the patients that really need to be seen in those locations.
Minoo
And along the way, helping tremendously with access, that you mentioned is a big challenge and issue across the industry. Thank you. Leah, from your perspective, how have you been able to build connectivity with payers and providers, since your patients from the beginning need to be connected to the system during pregnancy?
Leah
We have to be highly flexible with the way that we integrate with data and workflows. It can be very low-tech or very high-tech, two-way data integration with Epic. We navigate all of those challenges to make sure we are having data sharing back and forth with the providers, that we have escalation pathways so that if an issue does arise, that we have a seamless way to get back into the care model.
Just as a quick aside, I want to come back to your question, Minoo, about point solutions and listening to Joanna’s answer, because I hear this commentary all the time of point solutions and fragmentation. And I want to make the point, especially listening to Joanna, what you just described, Joanna, is maybe what people perceive as a point solution in Midi actually being much more than that. Actually filling the gaps, not just in menopause, but creating connectivity back into the broader care model. And I think it’s really important for all of us as healthcare innovators and thought leaders to think about the fact that the healthcare system as it operates today feels like a point solution to a lot of people. It’s very transactional. I have something go wrong. I go to my PCP or urgent care, I go to my cervical cancer screening every three years from my OB. It doesn’t feel holistic. It feels like a bunch of point solutions. And so I think the real opportunity for innovators, like I think Joanne and I are both describing, is to not necessarily be conceived as a point solution, but as something that is really helping the existing system to go beyond being transactional and actually meeting broader needs of, in this case, women. And I think that’s a really important distinction that we as an industry need to acknowledge. So I just wanted to get that point in.
Minoo
For what it’s worth, that’s exactly it. The way that you, Leah and Joanna, are approaching this business is taking what could be a point solution to an integrated solution. So that’s exactly the point. But there are still a lot of companies out there that don’t connect with the system the way they should to create an integrated experience for the consumers. The next topic I wanted to touch on is, what role do the focus on cost and movement toward value-based care play in bringing services like yours to the market? There is a lot of conversation around value-based care and managing the cost, et cetera. What is the role of your businesses, if any, in addressing those needs? Leah, do you want to continue?
Leah
We have evolved to root our entire business model in the promise of value-based care. I don’t employ nurses and doctors. I do not, outside of some ancillary services like lactation, we don’t bill a bunch of claims. We provide services that are highly validated for improving cost and quality but are not funded under fee-for-service. And so the way we put our business model together is, we have an actuarial team. We work with payers to analyze their total cost to care claims costs for pregnancy and newborn care. We partner with clinicians to put in place value-based care models for those episodes that result in upside savings based on cost and quality targets, so that Wildflower’s technology and services gets paid out of moving the needle in savings and quality and outcomes.
That’s a pretty fundamental shift for us. We started as a software company selling software. But it has been incredibly gratifying because again, as someone who’s been in this, quote, “digital health space,” for over a decade, I believe that healthcare innovation cannot add cost to the system. It has to figure out how to be funding itself, if you will, through some kind of improvement in access that’s quantitative in certainly cost, quality, and outcomes. And so it is fundamental to our model to support the move to value, for the sustainability and improvement of pregnancy care in a more scalable way.
Minoo
Thank you. Joanna, any comments from you on that space?
Joanna
We think of our value offering differently, although there is some overlap. What we have found is that women often go to the wrong providers and many specialists in their attempts to get care because this is such a fragmented market, and they don’t know where to go and how to get the right care that’s appropriate for them. If they start by coming to Midi, Midi can guide them, give them a lot of advice at a very low cost to the system and minimize the unnecessary visits to the more expensive providers. We are absolutely reducing visits to specialists, reducing visits to psychiatrists. We can take a lot of cost out of the system by getting women, efficiently, the right care that they need. Part of what our value is, is similar to what a primary care doctor would do, but a specialized primary care that’s focused on women.
Minoo
That’s wonderful. So essentially getting the patients to the optimum setting that they can get the care they need versus going and trying multiple different specialties that cost the system a ton, not to mention that provides frustration for the patients.
Thank you both for sharing your insights with us. Clearly this is a very, very important space and one that needs a lot of attention. And congratulations in standing up businesses that are targeted to meet the unmet needs of women. We look forward to other sessions with you all. And again, thanks for participating.
Joanna
Thank you.
Leah
Thank you for having us.
Narrator
The Oliver Wyman Health Podcast is brought to you by the global management consulting firm Oliver Wyman. For more insights on the business of transforming healthcare, visit our online publication, health.oliverwyman.com.
This transcript has been edited for clarity.
