Medical expenditures for heart disease, breast cancer, hip fracture, and stroke dramatically ... [+]
Midi Health, a virtual care clinic making expert care accessible and affordable for women experiencing the hormonal changes of midlife, today announced a $14 million seed investment funding round co-led by Felicis and SemperVirens. Additional investment comes from leading women’s health investors including Emerson Collective, Icon Ventures, Operator Collective, Muse Capital, SteelSky Ventures, and Anne and Susan Wojcicki.
All of Midi’s services are covered by insurance (at the moment available in California only, with plans to expand nationwide in early 2023), and offer convenient access to clinical care through telehealth visits, 24/7 messaging, simplified testing, and home delivery of prescriptions and supplements.
“Our goal is to provide high-quality care that is accessible to all women. Therefore, we have insurance contracts with all of the major carriers in California, including Aetna, Anthem Blue Cross, Blue Shield, Cigna, Health Net, and UnitedHealthcare,” shares Joanna Strober, cofounder and CEO of Midi Health, with me.
Mayo Clinic estimates that approximately 6,000 U.S. women reach menopause every day (over 2 million per year), and although this statistic wouldn’t be alarming if proper health care would be in place for these women, the real problem lies in the fact that a shocking 73% of women aged 40-65 years are not currently treating their menopause symptoms (commonly including hot flashes, vaginal dryness and painful sex, mental health/mood disorders, brain fog, abnormal uterine bleeding, bone loss and more), with further 65% confirming they would not consider HRT (hormone replacement therapy) as a treatment.
To show the size of this alarming state of our healthcare for women in midlife, a Yale University review of insurance claims from more than 500,000 women in various stages of menopause stated that while 60% of women with significant menopausal symptoms seek medical attention, nearly 3/4 of them are left untreated. The downstream effects of untreated symptoms include a higher risk for osteoporosis, heart disease, and cognitive decline. Employees with significant menopause symptoms have 45% higher medical costs and 50% higher pharmacy costs.
Now THAT is a problem.
From Patients To Founders
Like many of the startup founders in the women’s health space who have experienced problems first-hand before embarking on a journey of trying to solve them themselves, Midi Health’s founding team also learned how debilitating menopause symptoms can be—and how hard it is to find care—because they experienced it all themselves, personally.
Midi Health's team - Joanna Strober (CEO), Sharon Meers (COO), Kathleen Jordan, MD (Chief Medical ... [+]
“We opened up about our challenges; then we got curious; then we got angry; then we got energized. Midi is the result,” adds Strober.
Strober stopped sleeping suddenly at age 47 but had no idea her hormones were to blame because she was still getting periods. She visited multiple doctors - some prescribed her sleeping pills, some told her to see a psychiatrist, and some offered nothing and told her to live with it. “It took me a year to find a concierge menopause specialist who linked my issues to hormones in one visit and gave me HRT which solved my problem in a week. This entire time, I was talking to other women with exactly the same problem who were also getting misdiagnosed and finding no relief.”
Midi Health’s CFO and cofounder Sharon Meers was beset by strange symptoms in midlife, from vertigo to osteoporosis to moodiness, and got on the same merry-go-round of specialists before finding doctors who understood they were all linked to menopause in various ways. A combination of HRT, non-hormonal prescriptions, supplements, and lifestyle changes has her feeling even better in her fifties than she has in decades. “But I should have gotten answers and solutions sooner”, she confesses.
Chief Medical Officer Dr. Kathleen Jordan couldn’t access specialized menopause care despite being a top executive in a health system and a prominent physician herself. It took her many months to piece together a care plan for her relatively simple, and common, symptoms. She was sent for a complete cardiac workup for her hot flashes and sweating, plus a host of other specialist visits. “I ultimately had to send medical literature to my doctor with the science-backed and guideline-driven prescriptions I needed, which brought relief in days.”
Chief Brand Officer Jill Herzig went through menopause early, before age 45, and her OB-GYN didn’t even ask her about symptoms, let alone offer solutions. She white-knuckled through hot flashes, night sweats, and urinary symptoms with zero support. “Now I’m dealing with potential osteoporosis which could have been ameliorated with early HRT intervention.”
Chief Commercial Officer Cindy Gentry had no idea what was happening to her when she began to experience sleeplessness and anxiety in her early 50s. She didn’t know she was in menopause, but felt that something was “off.” Gentry was reactive, anxious, and unable to cope with stress in her high-pressure leadership position. She hadn’t discussed menopause, let alone mental health, with the older matriarchs in her Latina family, and her primary care doctors did not recognize that her symptoms were attributable to menopause. So, she suffered through, and feels, looking back, that "if I had been given HRT, all of my issues would have been controlled and my quality of life for more than a decade would have radically improved."
For context, medical expenditures for heart disease, breast cancer, hip fracture, and stroke dramatically decrease when women ages 50-59 take HRT.
Falling Through The Cracks Of The Healthcare System
Once Midi’s founding team learned that menopause care falls through the cracks of multiple different specialties, and lands back in the lap of overworked, under-trained primary care physicians and OB-GYNs, they realized that there were many possible treatments for menopause, but they were rarely discussed by physicians.
Joanna Strober, CEO of Midi Health
“We saw that labs were ordered too infrequently, if at all, but are critical to understanding treatment options and designing a personalized care plan. It was very obvious to us, as potential customers, that a new care model was needed for women in midlife,” adds Strober.
The problem begins with a lack of education, she explains - in the United States, 80% of medical residents reported feeling “barely comfortable” discussing or treating menopause, and only 20% of OB-GYN residency programs provide menopause training, mostly through elective courses, and most focus their practices on pregnancy and delivery.
This year, a survey conducted by Biote found that “25% of women aged 50 to 65 years have never been told by their doctor (primary care physician or OB-GYN) that they were in perimenopause or menopause, even though 92% of the respondents had experienced one or more menopause symptoms in the past year”.
The company operates like a traditional clinic. They see the (female) patient, manage her care and they bill her insurance provider directly. Upon visit, every patient receives a personalized care plan, based on her health history (including any history of breast and other female cancers, because we serve all women), genetic risk factors, ethnicity, and race. Unlike other midlife care companies, the company makes money from care, rather than markups on products and prescriptions.
Transforming Healthcare For Women 40+
Midi’s funding news coincides with the addition of several clinical hires with national prominence: Chief Clinical Officer Mindy Goldman, MD, who has practiced as an OB/GYN at UCSF for three decades and served as the Director of the UCSF Gynecology Center for Cancer Survivors and At-Risk Women; and National Medical Director Heather Hirsch, MD MS NCMP, former lead physician at the Menopause and Midlife Clinic at Brigham and Women’s Hospital, the second largest teaching hospital of Harvard Medical School. They join Chief Medical Officer and Midi cofounder Kathleen Jordan, MD, former SVP of Tia women’s health clinics, in guiding Midi’s protocols, clinician training, and integration with hospital systems.
"Healthcare for women aged 40+ is one of the largest segments of healthcare that has not been transformed by digital health. The power of Midi's B2B2C model is that by partnering with health systems and employers, they can reach tens of thousands of women at scale in rural and urban geographies. We are thrilled to back their team as they expand access to healthcare for women in mid-life," shares Victoria Treyger, General Partner at Felicis, one of the funds that co-led this funding round in Midi Health.
Strober understands that patients are complex and see multiple providers, and knows she and her team must work well with partner organizations to deliver the best care for women in midlife. Recognizing that female midlife care is uniquely suited to telehealth because what women require at this stage, more than anything, is an in-depth conversation with a clinician who has the time to listen to her experience and explore personalized solutions, is imperative for Strober.
“Our founding team started Midi to change the status quo, and change healthcare for a massive demographic—our demographic,” she concludes.
