Perspectives

There has been increasing attention on addressing women’s health needs through digital health solutions. The US healthcare landscape and population trends have created challenges that necessitate a greater focus on meeting women’s health needs within healthcare institutions, particularly to address gaps in access, quality, and affordability of care. Evidenced by the closures of women’s health clinics from reduced public funding[1], insufficient training and protocols for pregnancy complications,[2] and the 56% of OB-GYNs that do not accept Medicaid patients[3], there is a clear opportunity for digital health solutions to address these problems.

Investor interest in the women‘s health market has heightened, with a substantial rise in both total funding and the number of companies tackling women’s health. Through our research, 7wireVentures identified over 200 digital health companies addressing needs throughout a women’s life, with a focus on five categories.

General & Preventative Care: With one-third of women admitting to visiting their provider less than once per year[4], many companies are focusing on addressing gaps in access and education, primarily through general wellness visits, preventative care for women’s diseases, and oncology care. Around 68% of companies in this sector do so by leveraging telehealth or at-home diagnostics technologies to meet patients where they are or to enable self-testing. Given the broad set of services offered, this sector led in total funding, representing 61% of women’s health investments in 2018.[5]

Fertility & Menstruation: As 1 in 6 couples suffer from infertility, a multitude of new entrants have focused on addressing women’s fertility and menstruation needs.[6] Driven by gaps in benefits coverage and outcomes related to fertility treatments (e.g., IVF, egg freezing), digital health companies are focused on educating women about their fertility status, enabling ovulation monitoring, or assessing IVF treatment outcomes. This sector was the second largest category in total funding, representing 31% of women’s health investments in 2018.[7]

Pregnancy: Rising costs and declining outcomes in maternity care, as demonstrated by a 26% increase in maternal morbidity from 2000 to 2014, proved a need to address prenatal care.[8] Companies in this category improve a mother’s education, enable diagnosis, and remotely monitor and intervene in care for high risk patients. While this market is relatively early, the pregnancy care sector is well-positioned for growth with 37 seed and series A stage companies funded in the past 4 years.[9]

Postpartum Care: As 40% of women do not attend a postpartum visit, there is an acute need to address women’s health associated with breastfeeding and Perinatal Mood and Anxiety Disorder (PMAD), which affects 21% of women during pregnancy or the postpartum period.[10] Companies in this space better equip new mothers with nursing education and counseling, access to health professionals, and screening tools for mothers with PMAD symptoms. 80% of total funding in this sector has occurred since 2016.[11] Breastfeeding is currently the most well-funded use case in postpartum care, predominantly in the form of connected breast pumps.[12]

Menopause: While 75% of women of menopausal age experience menopausal symptoms, 55% of these women are untreated today.[13] Companies in this space address gaps in education about symptoms and treatment, improve access to specialized care, and provide menopause-specific products. While this represents the least mature category, with only 4 digital health companies receiving minimal funding, increasing awareness of health concerns and symptoms associated with this life stage will drive digital solutions to address this problem.

PREDICTION 1: WOMEN’S HEALTH STARTUPS WILL MOVE BEYOND B2C MODELS TO DEVELOP PAYER AND PROVIDER RELATIONSHIPS TO EXPAND MARKET ACCESS AND ENHANCE CREDIBILITY.

Considering the relative infancy of the digital women’s health market, 7wireVentures found that 74% of digital health companies in this market leveraged a B2C business model, such as at-home tests, products, or tools for self-care. While much of the overall focus has been on B2C strategies, there are several companies that have gained momentum through partnerships with payers or providers.

Wildflower Health partnered with 7wire SLP Cigna to create the Cigna Healthy Pregnancies application, delivering personalized guidance, experts, and resources for pregnant mothers. Babyscripts partnered with Penn Medicine to enhance their Heart Safe program for hypertensive mothers, demonstrating a 7-day readmissions rate reduction of 5%.[14] Maven Care, which offers consumers access to women’s health professionals, has also started to market their family and fertility benefits services to health plans.

Payers and providers have recognized the cost and outcomes implications of gaps in access to quality of care. Many have started to better provide and manage care through initiating conversations, dedicating resources, or developing partnerships. 7wire SLP Horizon BCBSNJ has done so through programs that offer text-based support, nursing calls, and resources for improved pregnancy care.[15] 7wire SLP Allina Health is enhancing their postpartum care by providing blood pressure checks for new moms and has begun structural work for expanding rural access to services.[16]

Key Implication: 7wireVentures believes that successful companies will offer a clear value proposition for payers and providers and develop strong partnerships with these organizations.

PREDICTION 2: THE SHORTAGE OF OB-GYNS CREATES A GREATER NEED FOR DIGITAL SOLUTIONS TO BRIDGE THE GAP.

The benefits of women’s preventative services are widely accepted, with most women’s wellness visits being provided by an OB-GYN. However, with the population of women growing and supply of OB-GYNs continuing to shrink, a substantial shortage of these providers is forecasted over the next decade. The American College of Obstetrics and Gynecologists estimates that the nationwide shortage of 6,000 to 9,000 OB-GYNs may rise to 22,000 by mid-century.[17] Women have already started to experience the pains of limited access, felt most by those located in rural areas. A symptom of this shortage has been felt through increased wait times, with the average wait for a new patient to see an OB-GYN for an exam increasing 53% from 17 days in 2014 to 26 days in 2017.[18] Given the forecasted increase in gaps to access care, there will be a greater need for digital solutions to meet patients where they are. Digital solutions will have an opportunity to provide access to preventative health services and screening though at-home STI testing, cancer screenings or remote mammograms. Some have already started addressing these issues: EverlyWell provides at-home STI and HPV testing kits; Eva is developing a bra to measure thermal patterns that may detect breast cancer presence with the goal of providing a substitute for annual mammogram screenings.

Key Implication: 7wireVentures is playing close attention to companies that expand access to traditional OB-GYN-delivered services, such as tele-wellness visits or self-screening technologies for STIs and cancer.

PREDICTION 3: IT WILL BE IMPERATIVE FOR EMPLOYERS TO INNOVATE TO INCORPORATE A WIDER VARIETY OF SERVICES TO MEET THE NEEDS OF THE FEMALE WORKFORCE

Employers are well versed in the topics of talent recruitment and retention, having leveraged innovative benefits offerings as a tactic for several years. More recently, leading employers have expanded their suite of benefits to address specific needs of their female workforce, in part to incentivize the 43% of women that leave the workforce after having a baby.[19] 7wire portfolio company Livongo provides such guidance through their recently launched pregnancy and early parenting behavioral health program. This digital tool allows Livongo’s employer clients to support their female employees in addressing the emotional and physical challenges associated with pregnancy and early parenting.

Beginning in 2017 with Apple and Facebook announcing they would cover egg-freezing, fertility benefits have also continued to expand and innovate. Microsoft recently partnered with Progyny to provide a variety of fertility services including IVF, egg-freezing, surrogacy and adoption to their employee base.

Recognizing the need to continuously innovate to remain competitive, other employers have expanded their female health benefits to include maternity care support and family care, such as return to work coaching, breast milk shipping and childcare guides. Frontline companies such as Snap and Bumble partnered with digital health solutions to offer a suite of family benefits to their employees.

Given that the workforce is projected to be increasingly female, and 80% of women in the workforce will have at least one baby during their career, employers will need to implement policies and strategies to better attract and retain the ever-growing female employee base.[20] Employers can also save on health costs for insurance coverage of their employee base by leveraging these tools to support high ticket health events such as pregnancy.

Key Implication: 7wireVentures believes that successful digital solutions will demonstrate clear ROI through reduction in employer health costs and improved attraction and retention of talent.

The five categories of emerging women’s health companies will not only provide needed services where they are lacking today but also provide a competitive force to existing clinics that will force them to be more responsive to the trends of consumerism in health. These trends are what 7wireVentures follows as the cornerstone of its Connected Consumer Health Fund.

[1] Kaiser Family Foundation

[2], COC Data Brief

[3] MDEdge

[4] Yale School of Medicine

[5] Pitchbook Analysis

[6] MobiHealth News

[7] Pitchbook Analysis

[8] American College of Obstetricians and Gynecology

[9] Pitchbook Analysis

[10] American College of Obstetricians and Gynecologists

[11] Pitchbook

[12] Pitchbook Analysis

[13] Ro Health

[14] MedCity news

[15] Horizon BCBSNJ Special Delivery Program

[16] 7wireVentures SLP call, May 31, 2019

[17] ACOG Report: The Obstetrician– Gynecologist Workforce

[18] ME [19] Harvard Business Review

[20] Business Group Health