Midi Health, a virtual care clinic that makes expert care affordable and accessible for women experiencing midlife hormonal changes, today announced a $14 million seed investment 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 Midi services are covered by insurance (currently only available in California, 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. That’s why we have insurance contracts with all the major carriers in California, including Aetna, Anthem Blue Cross, Blue Shield, Cigna, Health Net and UnitedHealthcare,” Joanna Strober, co-founder and CEO of Midi Health, shared with me.
The Mayo Clinic estimates that approximately 6,000 women in the U.S. reach menopause each day (over 2 million per year), and while this statistic would not be alarming if these women were provided with adequate health care, the real problem lies in the fact that a shocking 73% of women aged 40-65 are currently untreated for their menopausal symptoms (commonly including hot flashes, vaginal dryness and painful sex, mental/mood disorders, brain fog, abnormal uterine bleeding, bone loss, and more ), with an additional 65% confirming that they would not consider HRT (hormone replacement therapy) as a treatment.
To show the extent of this alarming state of our health care for middle-aged women, a Yale University review of insurance claims of more than 500,000 women in various stages of menopause stated that while 60% of women with significant menopausal symptoms sought medical help, nearly 3/4 of them are untreated. Consequences of untreated symptoms include a higher risk of osteoporosis, heart disease and cognitive decline. Employees with significant menopausal symptoms had 45% higher medical costs and 50% higher pharmacy costs.
Now THAT is a problem.
From patients to founders
Like many founders of women’s health startups who have experienced problems first-hand before setting out to try to solve them themselves, the Midi Health founding team also learned how debilitating the symptoms of menopause—and how hard it is to find care for them—because they’ve experienced it themselves.
“We talked about our challenges; then we got curious; then we got angry; then we got energized. Midi is the result,” adds Strober.
Strober suddenly stopped sleeping at age 47, but she had no idea her hormones were to blame because she was still getting her period. She visited many doctors – some prescribed sleeping pills, others told her to see a psychiatrist, and others offered nothing and told her to live with it. “It took me a year to find a concierge menopausal specialist who linked my hormone issues in one visit and put me on HRT, which solved my problem in a week. All this time I talked to other women with the same problem who were also misdiagnosed and found no relief.
CFO and co-founder of Midi Health Sharon Mears was beset by strange midlife symptoms, from vertigo to osteoporosis to moodiness, and hit the same merry-go-round of specialists before finding doctors who realized they were all related to menopause in different ways. 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 admits.
The chief medical officer, Dr. Kathleen Jordan, did not have access to specialized menopause care, despite being a senior executive in a health system and a prominent physician herself. It took her many months to put together a care plan for her relatively simple and common symptoms. She was sent for a comprehensive cardiac workup for her hot flashes and sweats, as well as numerous other specialist visits. “I ended up having to send medical literature to my doctor with the science-based and guideline-driven prescriptions I needed, which brought relief in days.”
Chief Brand Officer Jill Herzig went through menopause early, before turning 45, and her OB/GYN didn’t even ask her about symptoms, let alone offer solutions. She was turning white with hot flashes, night sweats, and unsupported urinary symptoms. “Now I’m dealing with potential osteoporosis that could have been alleviated with early HRT intervention.”
Chief Commercial Officer Cindy Gentry had no idea what was happening to her when she began experiencing insomnia and anxiety in her early 50s. She didn’t know she was in menopause, but she felt something was wrong. Gentry was reactive, anxious, and unable to handle the stress of her high-pressure leadership position. She had not discussed menopause, let alone mental health, with the older matriarchs in her Hispanic family, and her primary care physicians did not recognize that her symptoms were due to menopause. So she suffers and feels, looking back, that “if I had I been on HRT all my problems would have been under control and mine the quality of life for more than a decade would be radically improved.”
For context, medical costs for heart disease, breast cancer, hip fracture, and stroke are dramatically reduced when women ages 50-59 take HRT.
Falling through the cracks of the healthcare system
After Midi’s founding team learned that menopause care was slipping through the cracks of multiple different specialties and back into the laps of overworked, undertrained primary care physicians and OB-GYNs, they realized that there are many possible treatments for menopause , but are rarely discussed by doctors.
“We have seen that labs are rarely, if ever, ordered, but are critical to understanding treatment options and developing a personalized care plan. It was very obvious to us as potential customers that a new model of care for midlife women was needed,” adds Strober.
The problem starts with a lack of education, she explains—in the United States, 80 percent of physicians report feeling “barely comfortable” discussing or treating menopause, and only 20 percent of surgery and gynecology programs provide menopause training, mostly through electives. courses and most focus their practices on pregnancy and childbirth.
This year, a study conducted by Biote found that “25% of women aged 50 to 65 have never been told by their doctor (primary care physician or OB-GYN) that they are perimenopausal or menopausal, despite that 92% of female respondents had experienced one or more menopausal symptoms in the past year”.
The company operates as a traditional clinic. They see the patient (woman), manage her care, and bill her insurance provider directly. At the visit, each patient receives a personalized care plan based on her health history (including any history of breast cancer and other cancers in women, as we serve everything women), genetic risk factors, ethnicity and race. Unlike other midlife care companies, the company makes money from care, not markups for products and prescriptions.
Transforming healthcare for women 40+
Midi’s funding news coincides with the addition of several nationally renowned clinical staff: Chief Clinical Officer Mindy Goldman, MD, who practiced as an OB/GYN at UCSF for three decades and served as director of the UCSF Gynecology Center for cancer survivors and Women at Risk; and National Medical Director Heather Hirsch, MD, MS NCMP, former lead physician in the Menopause and Midlife Clinic at Brigham and Women’s Hospital, Harvard Medical School’s second largest teaching hospital. They join Midi Chief Medical Officer and co-founder Kathleen Jordan, MD, former senior vice president of Tia Women’s Health Clinics, in leading Midi’s protocols, clinician training and integration with hospital systems.
“Healthcare for women over 40 is one of the largest segments of healthcare that has not been transformed by digital health. The strength 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 areas. We are excited to support their team as they expand access to healthcare for midlife women,” said Victoria Traeger, General Partner at Felicis, one of the funds leading this funding round at Midi Health.
Strober understands that patients are complex and visit multiple providers, and she knows that she and her team must work well with partner organizations to provide the best care for midlife women. Recognizing that midlife women’s care is uniquely suited to telehealth because what women need at this stage, more than anything, is an in-depth conversation with a clinician who has time to listen to her experience and explore personalized solutions, is imperative for Strober.
“Our founding team launched Midi to change the status quo and transform healthcare for a huge demographic – our demographic,” she concludes.