Key themes for the future of healthtech in 2022 and beyond

Key themes for the future of healthtech in 2022 and beyond

Author: The Carta Team
|
Read time:  27 minutes
Published date:  December 9, 2021
|
Updated date:  September 20, 2023
Since March 2020, we’ve seen the COVID-19 pandemic accelerate the adoption of emerging tech trends. The “new normal” of things like remote work, video

Since March 2020, we’ve seen the COVID-19 pandemic accelerate the adoption of emerging tech trends. The “new normal” of things like remote work, video meetings, and collaboration in the cloud forced companies to adapt. This shift was especially felt in the healthtech space.

“COVID was an interesting stress test for our business,” said Carolyn Witte, co-founder and CEO of Tia. “Pre-COVID, 100% of our services were delivered in the real world. Now it’s a 60/40 split: 60% virtual, 40% in person.” While the past two years have been a challenge, they’ve also created opportunities.

Founders and investors in the healthcare space  shared their thoughts on the changing industry at the 2021 Carta Equity Summit..

The panel:

 

This transcript has been edited and condensed for length and clarity.

Simmone Taitt:I’m Simmone Taitt, I’m the founder and CEO of Poppy Seed Health. And I am as excited as you are to be here with all of these powerhouse women. We are going to be talking about healthcare. Just to set us up, we have a lot to get through. We know the tailwinds of COVID have created such a giant leap forward for us—especially in healthcare. We’re going to chat today about what we think the standard of moving forward looks like, what healthcare looks like today, and also what we’re excited about the future. 

So, let’s get into it. I’m going to throw it to Julie, Deena, Ariela, and Carolyn to do their quick introductions. Julie, why don’t you kick us off?

Julie Yoo:Awesome. Thanks so much, Simone. And thanks, everyone, for being here. Julie Yoo, partner in Andreessen Horowitz, focused on healthcare investing. We invest across all stages. I personally focus on the early-stage side, but we partner with companies who are using technology to transform the way that we access, pay for, and experience healthcare. 

I joined the firm about two years ago after being a co-founder at a company called Kyruus. We had the privilege of being backed by Lux Capital. But we were founded back in the day, before there were such prolific sources of capital available to the digital health market. So it’s just an incredible time to be participating in this space, and I’m really excited for this conversation.

Deena Shakir:Awesome! I can go next. It’s great to be on a panel with some of my favorites in the industry, and what an incredible lineup. Shoutout to Carta for putting together such a wonderful summit. I’m a partner at Lux Capital and we are a multi-stage fund. We do everything from new co-incubation all the way through growth. I joined a little over two years ago and have done a lot in healthtech, although we are generalists and we’ve done everything from fintech to robots to enterprise SaaS. Prior to joining Lux, I had a non-linear path that included a stint in the Obama Administration and many years at Google—including helping build out what became known in later years (RIP) as Google Health, which is part of what led me to my conviction around early-stage innovation and healthtech.

Ariela Safira:Hi, I’m Ariela Safira, I’m the founder and CEO of Real, a mental health care company building a digital solution to care. I feel like Real’s my entire life—but prior to Real, I’ve basically always been working in mental healthcare, largely at IDEO, and after IDEO at City Block. I went to grad school to be a therapist before dropping out to found Real.

Carolyn Witte:Hi, everyone. I’m Carolyn Witte. I’m the co-founder and CEO of Tia. We are a next-gen women’s healthcare platform that provides comprehensive whole-person healthcare, mental, physical, reproductive healthcare for women’s puberty through menopause, both virtually and in the real world. So we’re creating a new paradigm for care delivery for patients and providers alike. And with the goal of making healthcare work better for women, families, communities, for everyone. And really excited to be here and lucky to know all the women on this panel, many of whom I’ve gotten to learn so much from and been mentored and so many things throughout my journey of building Tia and excited to talk about the themes of today’s conversation.

The infrastructure opportunity in healthtech

Simmone:Great, thanks everyone. One of the topics we have been talking about so much in every industry, but especially in healthcare: In the last two years we’ve seen acceleration that would typically take 20 years, right? Not only have we accelerated in healthtech, but Julie and Deena, I would love to hear from you about how you’re thinking about meeting demand and scaling from the investor side. What is interesting to you? What are you looking for when it comes to go-to-market and infrastructure, now that we have accelerated so quickly forward in healthtech? Deena, do you want to kick us off?

Deena:Yeah, absolutely. You know, I try not to say “unprecedented times” now, but it’s been two years of this incredible moment—not only for venture capital, but especially for digital health. As Julie said, for those of us that were working in and around digital health before it was cool, there is definitely a lot that’s very validating, but a lot that’s very exciting about what the next one, five, 10, 20 years will bring. There are a couple of areas in particular that are really exciting. One of them Julia wrote an awesome piece about, which is the infrastructure layer.

As there are so many new opportunities to digitize healthcare delivery, there is an opportunity for players to emerge to power the back end: the plumbing, the picks and shovels. We both have some companies in that space where we’re invested, and I think there’s an opportunity for the Stripe or the AWS, if you will, to power the digital health transformation.

So that’s an area that’s very exciting. And that’s not only on the care delivery side, but also on the R&D side, where there’s a big opportunity to improve the way that clinical innovation takes place. And then beyond that, there are new areas; mental health and women’s health are represented here on this panel. These industries that might have been seen as niche—we have clearly proven they are not, thanks to the great work of founders like Carolyn and Kate Ryder of Maven Clinic in our portfolio. There will be more of those to come, especially as we innovate on the actual technology to not only make it more accessible, but actually improve the outcomes at the end of the day. And that’s what we’re all here for.

Simmone:Julie, I actually had the privilege of listening to your latest podcast episode on go-to-market, B2B2C, and what it actually looks like when it’s time to do that—especially in healthcare, with so many angles in, but where the real priority is better patient care and better outcomes. I’m really curious to know: How do you think about go-to-market and infrastructure?

Julie:Having started a company over 10 years ago and comparing it to now, the analogy that comes to mind is: I was a cave woman with two rocks, rubbing them together trying to make fire, and now these companies are coming out with triple-barrel flamethrowers. They’re able to go out to the market in far more sophisticated ways, which is a testament to just the overall maturity of the space. Part of it is the establishment of these infrastructure players like Deena was describing, but so much of it is actually the forcing function of COVID. On the traditional medicine side, these trad med players, as I like to call them, whether it’s the health systems, the payers, the life sciences companies who historically have relied so heavily on these human labor processes: The pandemic was the light that shone on how fragile that infrastructure was.

So, that’s been wonderful. The way that I describe the various eras of go-to-market in our space: In the first generation, back in my day, really the only viable business model was to sell to trad med, right? It was B2B; the sales cycles were 12 months long. Your financing strategy was literally: You just need to raise enough money to survive at least one or two sales cycles to even get the data point and even get the shot on goal to put your product in front of a user, to then achieve product-market fit. And so it took twice as long at least to kind of go through those motions that it does today.

Then you had the sort of next wave of companies actually competing directly with trad med. Doing full stack models and going directly after consumers and patients. Leveraging the employer chassis as the tip of the spear of new digital health innovations that were not being well served by traditional payers. That’s been the most recent wave that has borne successful companies like you see here. 

And arguably now, we’re entering into this new wave of go-to-market versions that are these re-bundled care models and business models and acquisition models, many of which are represented here. It’s no longer the case that you need to solely rely on a single acquisition channel plus a business model with that same stakeholder.

Simmone alluded some of the pieces that we wrote, one of which was this concept of B2C2B—where, increasingly, digital health companies can actually establish a direct consumer relationship with the end patient and then leverage that data into the evidence generated through that relationship into a very robust B2B motion. They have far more leverage than the historical generations of digital health companies who had to bastardize their products to meet enterprise requirements before they even got the shot to put it in front of an end user. Tia’s actually a phenomenal example of how a direct-to-consumer model can actually create tremendous leverage on the B2B side. So that’s the overall trend that we’ve seen: moving towards these new business models.

One more thing I’ll say that is worth pointing out: Certainly from the investment side, the trope has always been that healthcare is hard, that building companies in this space is hard, and we’ve always blamed it on the regulation or the broader laws of physics in this space. But another reason it’s hard is that to build a truly best-in-class healthcare company, you need pretty much every core competency under the sun to do it well. You need clinical experience, you need regulatory experience, you need consumer experience, you need fintech expertise, you need enterprise muscle, and to have that all under one roof in a single company used to be just untenable.

Now, the volume and robustness of talent available on the market and gravitating toward wanting to be part of the action in the digital health space is creating really sophisticated teams and organizations. All of the companies represented here have this, where you just have an outside number of superpowers that you need to build relative to companies and other verticals.

New business models for delivering healthcare

Simmone:You see all of us founders nodding our heads yes, as we’re all building here. And Carolyn, I would love to get your perspective on the same question from the founder’s perspective, especially with Tia looking at a very successful hybrid model. Also, where are you with Tia today? How are you thinking about your go-to-market in your newest products, or infrastructure—but most of all the hybrid model that Tia has?

Carolyn:It’s so interesting to see so many of the things that Tia has been doing are now becoming healthcare jargon, like B2C2B. I remember getting into a disagreement with one of our board members who used to call, saying, “Oh, you’re pivoting from a B2C model to a B2B model.” Now I’m like, “No, we’re the front door of the healthcare system. We are direct-to-consumer and we acquire, engage, deliver amazing comprehensive women’s healthcare and retain women across the entire healthcare system.” That’s our business. And we really built the business model along the way. I don’t come from healthcare. I have a design brand background from Google before this. I didn’t know what selling to a health system or a payer was like four years ago. And just had this ethos of “build something, reimagine the healthcare system design for women.” 

That’s our north star. From a first principles perspective: Build what women want, and all of us will follow. What we’ve started to see with Tia, and with all the companies here that are delivering personalized care for women, and with so many others in the space, is a recognition—finally—that population-specific care models aren’t niche, but really are the future. The same kind of trends that are enabling infrastructure, that are making it easier to build a healthcare company, have made it harder to create differentiation. Because what differentiates one Zoom with your doctor service from another—if not the care model, if not the brand, if not the experience and so forth?

The next gen, next set of innovations in healthcare: Where we’re going to see it is in care delivery itself, not just the technology that enables access to it, which is table stakes now. That’s my core thesis, where I see a lot of exciting innovation. The second piece of this is really with respect to the concept of the next gen players and the incumbents, and really thinking about how to create that systems-level change. You have to innovate, but also build bridges and not walls in many ways, and work within the confines of the existing system—whether that’s payer contracts and innovating on payment models with a payer, or with the traditional health system like Tia does in our health system partnerships. I think we’ll see a lot more partnerships of these types with all the different types of players, with the goal of making the whole healthcare system innovate in the same direction.

Thinking through the new age of mental health

Simmone:Thanks, Carolyn for that, because I do think that not only are we at the intersection of what it means to be delivering care in a better way, but for patients to be a part of their own care. To really understand what’s happening—in front of them, and also behind the curtain, which sometimes seems to be so out of reach. I think we’re all building in the space to make transparency and accessibility the primary factor. And on that, Ariela, I would love for you to kick us off to talk about one of the biggest things that we’re seeing.

This panel is about trends, but actually healthcare products for consumers have been around forever. But not necessarily in the mental health space. And with Real, you’re very much paving pathways for people to get the kind of mental health support that they need. So let’s talk about how the conversation is changing around building healthcare products for consumers. You want to take us there?

Ariela:I actually don’t know too much about the numbers in gynecology and others, but one of the biggest gaps is that we have more and more generations who are open to work on their mental healthcare. But the issue is that we don’t have nearly enough mental health professionals to treat even the very few who were willing to go to therapy 50 years ago, right? Let alone millennials and Gen Z, who are ready to work on their mental health.

Something I end up spending a whole lot of time on, which is maybe a little less sexy is: We only have enough mental health professionals in this country to offer one-on-one therapy to 7% of Americans. And so we need to start getting a lot more thoughtful, a lot more creative about how we scale care in a way that is not dependent on humans. Often, what happens in healthcare is that in order to reach demand, we lower the quality of the clinician—we end up hiring NPs instead of MDs, and mental health coaches instead of therapists. We’ve already had so many issues in mental healthcare as it relates to not being able to prove clinical efficacy that it’s all the more dramatic if we’re now going to bring on non-licensed individuals and folks who certainly might have kindness and empathy and can solve for loneliness to some extent, but people who weren’t trained to reduce depression or reduce anxiety. What consumerization comes with, in addition to a brand that speaks another language, et cetera, is actually a new model of care.

How can we reach the 93% of the population who will never be able to have consistent therapy? That’s one of the big problem areas we’re tackling. The second is that we’re rolling onto younger demographics. When we think about teens today, kids today, they’re both the most mentally ill populations in terms of depression rates, anxiety rates, et cetera, but they’re also the folks who are born into a digital-first world. They have instilled such different user behaviors. On one hand, they’re the most sick, but on the other hand, they’re the least likely to engage with our traditional understanding of care, inclusive of a one-on-one appointment with an adult who’s going to talk to you about your feelings. It’s so far away from the experience and life of someone who was born into a world of short-form content and user-generated content and every service they’ve used has gathered so much data on them that it’s basically speaking in their accent and their language.

Particularly when I think about younger demographics—not just young adults, but actually teens and kids—we’re going to see that there’s a massive gap in the demand for care and eagerness and openness for care, and then their own definition of what is engaging care. One of the biggest unlocks to consumerization is how to actually build a product that is more scalable in terms of numbers, but also more engaging and proves clinical efficacy for a demographic that has a pretty high bar when it comes to engagement. Those are huge unlocks. Obviously we’re spending a lot of time on it in Real.

I am curious, Julie, Deena, your thoughts here. But when it comes to all the investment coming in, something to note on the mental healthcare side is that because of the massive difference with supply and demand, it takes a very different timeline to bring things to life. I’m going to spend 12 months building a new clinical model, not just putting the system online today. That means a whole additional year of work and time and funds that comes before blowing money on marketing. And particularly as non-healthcare people invest massively into the healthtech space. Obviously there are so many benefits to it and so amazing to see innovation, et cetera, but I’ve found that one of the biggest issues is now that the KPIs are becoming perhaps really not aligned with what a healthcare company’s KPIs should be. 

The evolution of research and development’s role in healthcare

Simmone:Ariela, you hit on so many points that are critical to us, right? Our investors are looking to invest in the most compelling, innovative companies that are moving—I don’t say “the needle forward” any more, but making these big swinging pendulums—because we really do need that kind of innovation in this space. 

You set us up really well there, Ariela, because I know that Deena, you’ve spent some time thinking about R&D. When we think about clinical efficacy, but we also think about what it means to be building something new, we have to think about research and development, what that actually looks like, how we use data to inform our product roadmaps, and how we are actually building for the individual, but also in scale. So, let’s talk about how you’ve been thinking about R&D in healthcare and innovation.

Deena:Absolutely. Ariela really hit the nail on the head. One of the potential risks of the proliferation of companies and capital in healthcare is that at the end of the day, you cannot create clinicians overnight. And when you not only have more demand as a result of the many tailwinds, if you will, of COVID across the consumer side—across the payer side, you still have the provider side to reckon with. We’ve seen some companies, perhaps, take some shortcuts in trying to characterize something as healthcare that’s not healthcare. At the end of the day, the only way you’re going to address that delta between the supply and the demand is through the development of novel care delivery platforms.

A lot of what Ariela and Real are doing, and what Tia is working on as well, are platforms that can also change the delivery dynamic for providers, but fundamentally actually starting earlier around clinical innovation. There are a few key things to think about there. The first is that, as we have more, larger-scale, better-funded, more widely accessible healthcare platforms, we are also generating very meaningful data—across not just the 1% of patients who might have previously used virtual care, but across a much more diverse demographic. How can you translate that into better outcomes at the end of the day? Part of that will be through care delivery. And part of that will also be through the actual act of research.

We have a number of companies in our portfolio like H1 and AllStripes, like Alife on the fertility side, that are using technology to make it not only more efficient, but actually more effective, to discover insights. To enable healthcare providers to partner with pharma researchers to take on rare disease, to actually get meaningfully diverse data into clinical trials, which we have come to realize collectively, as a global population, is essential to quickly discovering insights.

That’s really critical here. It’s unbelievable to me that it was only a few decades ago that women were even included at all in clinical trials, and that to this day it is incredibly Eurocentric, and we do not have data from across the world, including in the continent that you happen to be Zooming in from today, Simmone. So that’s something that we’re really focused on as well. It will be essential ultimately to better outcomes.

Serving a new wave of consumers

Simmone:Before we move on, I definitely want to give Julie and Carolyn an opportunity to jump in here on this point, around how the conversation is changing and building healthcare products for consumers. The key thing there, too, as we talk about consumers, is meeting people where they actually are. A lot of this conversation is around innovation and the digital healthcare landscape, but before we move on, if you want to add anything else to this question, I know it’s a hot topic for founders and investors alike and the folks who are watching us now at the Summit.

Carolyn:I’ll start. So if you don’t know Tia’s evolution story very well, we’ve had quite an evolution from “digital or physical?” to a hybrid model. Really building on that theme of meeting women where they’re at. Our north star the whole time has just been listening to women and responding in real time to their needs. Obviously I have my experience. Now we have tens of thousands of members and patients and respond to their experiences and it turns out that actually, women want different things too. So how do we have a more personalized care delivery model that isn’t one size fits all, even when we’re talking about women?

Meeting women where they’re at means providing as comprehensive a product as possible that can serve as many needs as possible. That means a combination of virtual and in-person. COVID was an interesting stress test for our business. Pre-COVID, 100% of our services were delivered in the real world. Now it’s a 60-40 split: 60 virtua,l 40 in-person. Yet we know that the in-person care is the critical moment—I call it the “like to love moment,” the biggest driver of engagement and retention in our business. Not all healthcare can be delivered on the internet, especially when it comes to women’s health. That’s been really core to meeting women where they’re at with this comprehensive solution.

But I also don’t think it stops there. I like to say that’s just where we’re at today. The challenge as a founder is building for today and tomorrow. Today, that’s a combination of chat, Zoom, and retail-style clinics. In the future, it’s going to be at home and probably other places I don’t even know about. And what we’re in the business of doing is building a platform that can connect all those dots and all those places of care. And as those places of care keep shifting, so too will Tia, as we continue to meet our goal of meeting women where they’re at and providing comprehensive whole-person care.

Deena:It’ll be in the metaverse, Carolyn.

Carolyn:The metaverse, oh, my god, I don’t know about that.

Julie:Good, guys. We’ll be back at this conference five years later, talking about that for real.

Simmone:Totally.

Julie:Yeah.

Simmone:I give it three years, Julie, but go ahead.

Julie:I just want to be conservative. I’ll reinforce and repackage some of what was already said about the investor side. One of the main major differences, certainly, from when I was raising capital back in the day is that we had to pick from either healthcare investors or tech investors. Healthcare investors didn’t really understand what it meant to build a best-in-class technology business. And then vice-versa: Technology firms didn’t understand lots of the physics of healthcare. Now, the great thing is that there are folks like myself and Deena who literally sit at the intersection of not only just tech and healthcare, but also the consumer, the enterprise, the fintech, all the different elements that I described earlier.

So, it’s maybe a call to arms for the space, and it’s going to sound self-serving, but I promise I’m coming from a place of wanting everyone in this market to just do it the right way. In this crazy capital market, you do hear about deals that happen in 24 hours. People getting preempted and not doing any diligence and getting amazing, lucrative offers with very little dilution to the founders. Those seem very tantalizing. But we’ve often walked away from opportunities, even when we get really, really excited about the company, when we’re told, “Hey, you have to make a decision in 24 hours.”  In fact, we actually want to ask the hard questions, and we want the founder to also want to answer the hard questions. About the clinical care model, about all the things that you mentioned earlier, Ariela, that are unique to the way that you guys are building a business—versus some consumer company that is toe-dipping in our domain. It’s been very hard, to be honest, but we try to maintain that high bar of wanting to meet founders in a place where there’s a mutual recognition of the uniqueness of what we’re all building here. And therefore, the need to really dig in and understand all of the factors that are going to contribute to future success with real diligence.

Investors’ outlook on 2022 in healthtech

Simmone:OK, great. We’re going to move on. This was a really wanted part of our conversation, especially hearing from all of you on this. But I want to chat with Julie and Deena for a minute here, just around what you’re excited to see, especially paying attention to 2022. We’re at the end of Q4, at the end of 2021, at the end of another year where we are all together and fighting the pandemic together. So the landscape is still very much shifting underneath our feet, but I am very curious to know what’s exciting you for 2022. Julie, do you want to tell us what that is? Or what those things are? You can have more than one.

Julie:I definitely have more than one. I’ll just highlight a couple. We’ve gone through the first wave of virtual-first care. And I think we’re going to start to see these virtual-only companies really hitting the buzzsaw of how to expand their care models beyond transactional, telemedicine encounters and into real life, where things actually really get super hard—but then get to cut beyond just the early-adopter, low-hanging-fruit set of patients out there. I’m excited about the continued sophistication of care models beyond just urgent care, low-acuity opportunity sets. 

And it goes in both directions, by the way. It’s both higher-end specialty care, SMI-type populations, et cetera. But also the subacute space that is very underserved by the current traditional healthcare system, which is very monolithic. You either have something or you don’t, and there’s not much sort of attention paid to the middle ground. The flattening of the spectrum and granularity of that spectrum is something that we’re really excited about. 

One other thing that relates to earlier what Deena mentioned about the infrastructure layer, plus what we’re talking about on the consumer side, is that one of my big theses for this year was that every healthcare company will become a home health company at some point. Every care model is eventually going to have to extend into the home, whether it’s virtual visits in the home, or actually physically sending people into the home to do various aspects of the care model. Similarly, given the proliferation of the infrastructure layer of the healthcare stack, we will start to see consumer companies become healthcare companies. And in some ways the tip of the spear of this was retail, what Walmart and Walgreens and all those players are doing. 

We saw versions of it with the Lyfts and the Ubers of the world. But I think increasingly, we’ll start to see startups in the consumer space actually view healthcare as an opportunity to expand their LTV, because there are now all of these infrastructure companies available in the market where through turnkey fashion, you can actually turn on various service lines and various services that historically have been very non-trivial to build from the ground up. That is one thing that we are definitely keeping an eye on.

Simmone:Julie, you’re just giving away all of our secrets here, but it is true again: Where does the line of consumer end? Where does it start? And that’s part of the innovation, that’s part of the excitement about where we are with healthcare today. OK, Deena, what’s exciting for you going into 2022?

Deena:Well, also excited about what Julie mentioned. I’m sure we’ll find opportunities to partner in those areas, but I’ll add a couple more to that. The first one is around reaching populations that have not benefited from the wave of the last 12, 18, 24 months. In particular, companies that are innovating in Medicaid, where when it comes to women’s health, as I don’t need to tell you all, half the babies in this country are born under Medicaid and it has been a population that has, for the most part, been difficult to innovate in. Now we have City Block and others that have shown there can be a really valuable, scalable business there, but there are many aspects to care and care delivery and caregiver coordination and infrastructure layers, and payer partnerships in the Medicaid space, that will be really exciting to look at in 2022. So that’s definitely an area of interest.

And then the other one is around the personalization of care. I talked a bit about that on the R&D side: precision care, personalization of care. But looking at that as well on care delivery. Again, it’s not just how we can make it accessible for everyone to Zoom with a doctor, but actually, how we can help clinicians and patients better match with one another. Beyond, “Is this going to be accepted by my insurance?” to actually, “Is this my vibe? Is this going to match my lifestyle, am I going to be able to fit this in?” To Ariela’s earlier point: “Are they going to speak my language?”

At the end of the day, the more expansion of innovation we have here, the more clear it will be what that means in the context of ROI. And I don’t mean ROI for me or for Julie, but ROI to the stakeholders in this industry. So that we can show that this is driving better outcomes and is truly creating value. That it’s contributing to value-based care that is making us all healthier at the end of the day.

The founders’ view of healthtech in 2022

Simmone:I couldn’t agree with both of you more on what we’re looking forward to. Even from the founder’s perspective,, as we are all building in our own bubbles here, I want to give Ariela and Carolyn the opportunity as long as you’d like to tell us what’s exciting for you in 2022. Ariela, why don’t you kick it off with Real? 

Ariela:We’re really expanding demos. We basically spent the past year and a half hyperfocused on the clinical efficacy side. And I think we’ll be investing and expanding those in our platform today. The new demographics we reach are often, most excitingly, demographics that were historically excluded from the mental healthcare system, largely because of costs—and if not because of costs, because there aren’t providers who meet them racially, culturally, et cetera. At scale, that will be super exciting. 

And, wow, I hope we can be in-person again. I basically was born in a pandemic. I’ve never done a round in person at this point. So I have been meeting my investors for the first time in person. I feel like I’m learning. What was fundraising like before when you met in-person? You did full days together, fascinating. But really, I’m excited to scale Real, excited to scale to new demographics. And I love my team so much, I can’t wait to spend more time with them in person.

Simmone:Ariela, could you just quickly tell the people, because I think it’s really fascinating and truly a testament of the time in building during the pandemic, a quick background of Real being brick and mortar, and then that quick and meaningful entry into the digital market?

Ariela:Sure. I’m not good at keeping the story short, as Deena certainly knows, Julie probably too. I’ll try to shorten it. We were set to open our first ever brick-and-mortar location in April 2020. COVID hit. We obviously were not able to do that, but very immediately anticipated mental health needs were going to skyrocket. So, basically within 20 minutes, I hired four of my computer science friends to come on and build a digital platform, which at the time was meant to be a one-month offering of free digital care, purely altruistic, offered in both one-on-one and group format, all themed according to the pandemic. The cut to it is: It was a huge success! In part because it offered free care to thousands of people. It had a wait list of over 10,000, but far more excitingly, we generated learnings we would have never gotten in person, namely that everyone preferred group over one-on-one. Literally every single person who made less than $100,000 in income exclusively chose groups.

But on top of that, about half the people were joining those groups anonymously; videos off, names hidden. Nearly every man was doing that, and nearly every woman of color was doing that. And when we would follow up to ask, “Hey, if you want a more private experience, would you like to join a one-on-one?” Time and time again, folks would share, “No, I want to be in this group because I want a therapist to teach me. I just don’t want anyone to know I’m in a group on exploring your sexuality, or even on loneliness.” And the unlock that it offered—and that we’ve since continued to iterate on and really use as a thesis when it comes to how you we meet people where they’re at and be willing to build an entirely new system—Includes seeing, for so many individuals, that meeting them where they’re at when it comes to mental healthcare is allowing them to reach the system anonymously.

I come from two immigrant parents and can bet my father will never go to therapy. Neither would my Polish mother. It is so beyond our culture. I’ve gone five times in my life and didn’t like it; I get it. But the point is, it really has really iterated on this insight of ,“What does it mean to build a more on-demand asynchronous form of care? How much more data can we generate to optimize on the model? And how much more effective can this be for people when they engage if they can be so more vulnerable given the anonymity?”

Julie:That sounds like a great use case for the metaverse.

Ariela:Oh, god.

Simmone:And also, Ariela, I wanted to give you that opportunity, because I do think asking the forward question doesn’t always cover where we’re coming from. It’s such, not a common story, but for so many companies that started during the pandemic. Carolyn, let’s hear what is exciting for you in 2022 for Tia, or just in general.

Carolyn[sounding like a robot]: Very excited. [Inaudible.]

Simmone:Oh, Carolyn, I’m sorry but when I say, “You’re a robot,” you actually do sound like a robot. I know that you have some exciting things to say. OK, great. She’ll hopefully sign back in and we’ll loop back to Carolyn.

Deena:The metaverse is taking over.

Simmone:I know, but you know what, I’ll give you all a couple of minutes on what I’m excited about in 2022. At the top, I introduced myself: I’m the founder and CEO of Poppy Seed Health. We focus primarily on equity and accessibility to maternal healthcare, specifically focusing on emotional and mental health support. And I’m very excited about what it looks like for us to not only meet people where they are, but very specifically in maternal healthcare. Deena talked about this a bit, which is that about 50% of all of our births in the U.S. are on Medicaid.

But more than that, about 50% of all of the pregnancies in the U.S. are not planned. And in addition to that, what we are very majorly focused on in our telehealth and digital support is where people are, where they are not close to providers or hospitals. And that is in our maternal care desert. So I’m excited to be working on that with Poppy Seed Health at our stage and our team, as we grow in scale to be able to deliver on-demand—truly in just seconds—emotional and mental health support to those folks on their pregnancy and postpartum journeys and beyond. So that’s what I’m excited about. Carolyn, you’re back! Let’s unmute you, and hopefully we can wrap this up.

Carolyn:Am I a robot, am I back?

Simmone:Perfect.

Carolyn:Oh my god. I don’t know what happened.

Simmone:You are perfect.

Carolyn:Thank you for bearing with me.

Simmone:Of course.

Carolyn:A lot of what I’m excited about for next year is growing and expanding our anti-fragmentation model for women in three key ways. The first is expansion and service line and who we serve: focusing on serving women from puberty and menopause. That’s the big piece of us, and you’ll see a lot of service expansion from Tia over the coming months. The second is the other aspect of comprehensive care, whole-person care. Today, we provide that physical, mental, reproductive healthcare. And again, there’s some expansion there in terms of the way we deliver whole-person care. And then lastly, the way we partner and extend that anti-fragmentation model beyond our four walls with integrated specialty care with health system partners. So really excited about kind of really proving that model out and creating more connected-care ecosystems for women and more places. And giving more women access to what we do.

Simmone:Awesome. Thank you. Julie, Deena, Ariela, and Carolyn, thank you so much for your time. This was a lot of fun. I hope that everyone else who joined us today had just as much fun as we did. More than anything, these are the people to watch in this space. And so, continue to join us as we build together and invest together and look forward to healthcare innovation today and beyond. There’s a lot coming and we’re moving fast. So keep up, because we’re really doing our thing here. Thank you all. Thanks so much for your time, Carta. Thank you for having us.

DISCLOSURE: This communication is on behalf of eShares Inc., d/b/a Carta Inc. (“Carta”). This communication is for informational purposes only, and contains general information only. Carta is not, by means of this communication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services.  This publication is not a substitute for such professional advice or services nor should it be used as a basis for any decision or action that may affect your business or interests. Before making any decision or taking any action that may affect your business or interests, you should consult a qualified professional advisor. This communication is not intended as a recommendation, offer or solicitation for the purchase or sale of any security. Carta does not assume any liability for reliance on the information provided herein. ©2021 eShares Inc., d/b/a Carta Inc. (“Carta”). All rights reserved. Reproduction prohibited.

DISCLOSURE: This communication is on behalf of eShares Inc., d/b/a Carta Inc. (“Carta”). This communication is for informational purposes only, and contains general information only. Carta is not, by means of this communication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services.  This publication is not a substitute for such professional advice or services nor should it be used as a basis for any decision or action that may affect your business or interests. Before making any decision or taking any action that may affect your business or interests, you should consult a qualified professional advisor. This communication is not intended as a recommendation, offer or solicitation for the purchase or sale of any security. Carta does not assume any liability for reliance on the information provided herein. ©2021 eShares Inc., d/b/a Carta Inc. (“Carta”). All rights reserved. Reproduction prohibited.