This startup raised $ 100 million to spice up girls’s well being
Tia co-founders Felicity Yost (L) and Carolyn Witte (R).
About 1 in 10 women in the United States have polycystic ovarian syndrome, but it took Carolyn Witte more than 3 years for a doctor to diagnose the condition – and even then, she did a lot of research on her own. The disease, which sometimes causes hormonal imbalance and affects metabolism, can also lead to fertility problems, diabetes, and mood disorders. After jumping around between different doctors looking for clues, Witte finally sorted all of her symptoms together with the help of a self-help forum in which other women had described their medical path. “That confronted me with the challenges of this fragmented system and how it affects women negatively,” says Witte. And their experience isn’t unique – it’s estimated that around 50-75% of women with the disease don’t know they have it. “How would healthcare look, work, feel if it were actually designed with women at the center?” She wondered. “What if it treated women as a whole people and not as parts?”
Her answer to that question is Tia, a four year old startup that combines face-to-face and virtual mentoring for women that she founded with her best friend from college, Felicity Yost. Witte, 31, and Yost, 31, are both Forbes 30 Under 30 alums. The New York-based company announced Tuesday a $ 100 million Series B led by Lone Pine Capital. Existing investors, including Threshold, Define Ventures, and Torch Capital, took part in the round, which Tia valued at $ 600 million, according to a person familiar with the deal. The capital raised by the company is the latest signal that startups, often marginalized as “women’s health” or “femtech”, are preparing for the mainstream as the wider digital health boom accelerated by the Covid-19 pandemic . Tia has raised $ 132 million to date.
One of the core tenets that made Tia so successful may seem obvious: Women are the most valuable customers in healthcare. 51% of the population are women. They are more involved in their health care than men. They also typically make 80% of health decisions for their family, according to a study in the Journal of Health Care For The Poor And Underserved. Patients can start coming for their annual visit to Tia (which is covered by every insurance plan thanks to the Affordable Care Act) and then come back at least 50% for another preventive service like psychiatry or gynecology. “Women use the healthcare system more often,” says Witte. “This is not rocket science.”
Tia is working on a membership model where members pay around $ 150 a year to access the company’s clinics, the first of which opened in New York City in 2019. All of Tia’s doctors and nurses are white-collar workers, meaning that members see the same care teams who manage everything from annual wellness visits to behavioral health to acupuncture and clinic bills for insurance. Patients have access to an app that they can use to chat with their care team, view their health records or make appointments. For doctors and nurses, Tia has developed an app to support workflows and clinical decisions that Witte compares with a medical version of Asana or G Suite. And the backend software ensures that the entire care team is on the same page.
The company generates most of its revenue from in-person and online visits, which makes the membership fee a tiny fraction, but Witte says it’s an important part of the brand and the experience. Witte likes to say that women “join” Tia, they don’t just “use” Tia. “We are a relationship-based healthcare company,” says Witte. “Our goal is to acquire and retain women for a lifetime. ”
There are moments as an early-stage investor “when you have the opportunity to invest in something that is so obvious to you and for some reason the rest of the world doesn’t see it as obvious,” said Emily Melton, managing partner at Threshold serves on Tia’s board of directors. “When you find these opportunities, run to them because that’s where you can reach this asymmetrical discrepancy where you get the greatest results and the greatest chance of making really meaningful change.” For them, that opportunity is women’s health. And Tia will be proof that “this is not a niche market,” she says. “Nobody questions why Glossier can be worth billions of dollars – women of course buy a lot of makeup. Women also buy a lot of health care, but there is simply no parallel to Estee Lauder. And we have to manage that. ”
“We can’t just put that information out there and then refer women to the health system they hate. That is why they fail. We really need to become the health system and actually change the way care is provided. ”
Carolyn Witte, Tia
Witte and Yost did not want to work in the healthcare sector. After meeting as a student at Cornell, Witte worked in marketing and branding at Google, while Yost moved to a hedge fund and later to product management at a data startup. After Witte’s PCOS health fear, she quit her job and decided to create a Google-like search tool for women’s health that would allow users to make better decisions and not have to travel the rabbit hole of online forums in where misinformation has the potential to run rampant. From this experience, the duo saw that there was a lot of demand, but that providing the information was not really enough. “We can’t just put that information out there and then refer women to the health system they hate. That’s why they fail, ”says Witte. “We really need to become the health system and actually change the way care is provided.”
Tia completed a $ 24 million Series A on the day the Covid-19 lockdown began in New York City. The company already had 3,000 members, but all of its income came from personal services. Policy changes soon followed, allowing doctors to bill for virtual treatments delivery, which meant Tia “essentially reinvented our business and generated revenue online,” says Witte. At the same time, the company decided that the future won’t just be virtual, especially when it comes to treating women. (After all, annual Pap smears won’t go online anytime soon.) Today, Tia delivers 60% of care online (and some services like mental health care are 100% virtual). One of the ways the company can offer care at a lower cost is by focusing on medium-sized providers – 80% of the services are provided by nurses. In combination with the software platform for automating care coordination and administrative tasks, “we can reduce our care costs per service by 40% compared to a digital family doctor’s practice,” says Witte.
Today Tia has clinics in New York City, Los Angeles and Phoenix (opening in October) with plans to expand into San Francisco by the end of the year. The company also plans to open an additional 15 clinics in 2022. If current prices apply, Tia expects to have more than 15,000 members by the end of the year, with a goal of reaching 100,000 members by the end of 2023.
As the company grows, it also begins to work with health systems through joint ventures so that women can receive specialized care that enables services such as obstetrics to be provided in a hospital rather than a clinic. In March, Tia announced an agreement with the national nonprofit Catholic healthcare system CommonSpirit to open a clinic in Arizona. Through the partnership, Tia will refer patients to the hospital’s specialty care and also gain access to CommonSpirit insurance policies. However, given the Catholic values of the health system, it also raised questions about access. CommonSpirit does not perform elective abortions or in vitro fertilization, but told Fast Company that it would “always provide medical care to all patients, including pregnant women” when the deal was announced earlier this year. Witte says that despite the hospital partnerships, Tia has “total control over medical practice and the way we deliver care,” which means women are given choices.
“I think Tia should be everywhere,” said Lynne Chou O’Keefe, founder and managing partner of Define Ventures, who was a seed investor in Tia and sits on the company’s board of directors. “We really offer these services holistically – both stationary and virtual – from puberty to menopause. And so I think we can redefine what women’s health means and what that means for your family later on. “