Lessons from Carolyn Witte, Tia, building a holistic home for women’s healthcare
Carolyn Witte, CEO and Co-Founder of Tia, a new paradigm for modern female healthcare.
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Welcome back to the Pear Healthcare Playbook! Every week, we’ll be getting to know trailblazing healthcare leaders and dive into building a digital health business from 0 to 1.
This week, we’re super excited to have Carolyn Witte, CEO and Co-Founder of Tia. Founded in 2017 by Carolyn Witte and Felicity Yost, Tia is blending in-person and virtual care services. Tia’s “Whole Woman, Whole Life” care model fuses gynecology, primary care, mental health and evidence-based wellness services to treat women comprehensively — a stark shift from fragmented care for different "body parts'' or life stages.
Prior to founding Tia, Carolyn was a Team Lead at Google Creative Labs, developing and growing Google’s core mobile consumer products, Search, Maps and Translate.
In September 2021, Tia raised $100M in Series B Round led by Lone Pine Capital, participated by Threshold, Define Ventures, Human Ventures and more.
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Carolyn’s path to entrepreneurship & building Tia:
In her mid-20s, Carolyn worked at the Google Creative Lab, which was at the nexus of storytelling, creativity, and technology and what she thought to be her dream job. She shares that what propelled her into entrepreneurship was her difficult patient experience as a young woman living in New York, making her incredibly frustrated with the US healthcare system.
Like 50% of women in the US, Carolyn didn’t have a primary care provider and went through a 3-year-long diagnosis process for PCOS, a disorder that 1 in 10 women have. Carolyn experienced herself how broken the healthcare system was for women’s health:
“That really exemplifies what happens when we don't understand what women's health is. We treat body parts and ailments and symptoms versus whole people, and women don't have a medical home or a primary care provider who can connect the dots and treat women as people. And because of that, I experienced personally 3 core problems that Tia aims to solve over that 3 year long journey:
The lack of primary care providers (PCPs).
An overuse of specialty care.
The lack of answers given to the patient.
It really exposes a fundamental problem with the US healthcare system, which is that it's designed to treat sickness, not support prevention.”
Women have more frequent and complex healthcare needs than men, Carolyn believes that women bear the brunt of a fragmented, disjointed healthcare system more than men - and this was the genesis of Tia.
Launching Tia’s MVP, a women’s health Q&A app
Carolyn shares that she always had a consistent north star vision: a holistic healthcare system centered around women, oriented around prevention, that treated women as whole people and not parts. The tactics to achieving this vision evolved step-by-step:
Carolyn spent many years Googling her health and working on Google Search, so the first Tia product was a women’s healthcare Q&A app. The app was meant to give women better, more tailored healthcare information to help them make more informed health choices.
“We learned so much that both affirmed the problems we sought to solve, but also informed the evolution of the solution to the full stack care delivery model that we are today.”
Their team had more than 200,000 one-on-one conversations with women about their health through the initial MVP app, learning that:
Just as Carolyn had experienced, women don't put their healthcare into neat boxes that match with specialty medicine.
Women loved the app’s breadth of information, particularly the EQ element that felt relational.
“We were very much like your best friend who was in med school who you could message with your questions and know you could get legit reliable answers to, but also not medical jargon speak.”
Information was only so powerful without a connection to care delivery. That's what Carolyn shares led them to the next chapter— they saw that women would bring the app with them to the doctor's office. ‘Hey Tia, can you explain my insurance?’ ‘Hey Tia, which IUD should I get?’ ‘Can you explain my test results?’
“We were care coordinator, translator, navigator, clinical decision support, your wingwoman for your health in many ways… What I realized was the information we were providing women was powerful, but 10x more powerful connected to care delivery.
If we could not just be an information provider for women, but actually the health care provider for women, that was really the answer to solving the fragmentation problem we set out to solve.”
Tia is a comprehensive whole person care model designed to give women a true medical home, addressing the PCP gap in the market, deepening and integrating primary care with specialty care, and providing women with not only solutions, but a focus on prevention.
Carolyn describes Tia’s model today as a B2C2B play: Tia goes direct to consumers, acting as the front door of the healthcare system for women and routing care across the entire ecosystem, then partners with hospital systems to integrate online and offline care, outpatient and inpatient, etc.
Tia is currently active in four markets: NYC (where they started), Los Angeles, Phoenix, and San Francisco
Tia is a bottom up community membership base model. The typical user journey starts virtually:
When you sign up for Tia, it instantly validates your insurance, which is key to unlocking Tia’s services affordably.
You book your first appointment, which is typically what Carolyn describes as your whole health exam— it's the Tia version of your annual well woman exam that's 100% covered under the ACA for all women every year, under all insurance plans, no matter what. This is Tia’s core preventative health care service.
The first part is a one-on-one virtual consult. Carolyn describes it as a first date experience where they want to get to know you as a whole person— review your health history, identify your health goals, build a care plan for you that's tailored to you and your needs. That may include labs, physical exams, etc. that you need to assess your whole health.
Your care journey continues in the real world at a Tia clinic, a re-imagination of the doctor’s office as a retail style clinic designed to make women feel seen, heard and cared for, that women want to go to and not avoid. You walk into the clinic and hang out in the living room; your insurance is already validated and someone brings you a cup of tea before heading into an exam room.
At that point, you receive critical physical care. Carolyn believes that virtual care is important but can't deliver comprehensive care on its own, and the ability to connect that digital physical experience is key for Tia. That could be a pelvic exam, a breast exam, an ultrasound, or services Tia offers like acupuncture or pelvic floor physical therapy. Your appointment is followed up with a digital care plan, which could be a referral to a therapist or specialist.
A Tia care coordinator guides you through the entire journey, online and offline. Carolyn wants the Tia experience to be the antithesis of the sterile, transactional in-and-out doctor’s office visit, providing a care journey that's rooted in relationships.
The future of Tia
Over the past 5 years, Tia developed a very differentiated care model geared towards helping women want to engage in their health, encouraging preventative health utilization key towards quality outcomes and reducing cost of care. Now that they’ve achieved that, Carolyn’s goal is to scale Tia to more places and to more women, especially across the age spectrum.
When expanding to new markets, Tia takes a geo-specific approach to planting clinics. Carolyn shares that one of their core measurements is providing every woman in their TAM to access a physical Tia clinic within 15-20 minutes of a commute. That differs in SF when compared to NYC or LA— the goal is to ensure that Tia is the first place women turn to and is accessible wherever they work, live, and hang out.
Shifting from femtech to the most valuable customer in healthcare
Tia was one of the first movers in the women’s health tech industry, starting when the term “femtech” was first becoming familiar:
“It's a category or phrase that I think really reinforces something that we've been on a mission to change, which is the misnomer that women fill a niche. I say that Tia is a next-gen primary care business for the most valuable customer in healthcare, which is women,
not a femtech company.”
Carolyn shares that early rounds of financing were difficult as they tried to achieve this mental model shift among investors, convincing them to care that women’s health was not niche, but a massive multi-billion dollar opportunity that they were looking past. More full-stack care delivery companies became more successful, Carolyn saw a shift in investors and also healthcare buyers— there's not just a moral imperative to make healthcare better for women, as they say, but an economic one.
Tia’s raising $100M Series B and showing repeatable success
Tia raised their Series B a few months after opening their Los Angeles clinic, their second market that was wildly successful and continues to be so. It demonstrated 1) that they could repeat their success, 2) the demand for Tia, and 3) their ability to continue to drive engagement.
They'd also unlocked the last portion of the B2C2B playbook after launching their first health system partnership, CommonSpirit in Arizona. This gave them additional leverage in their business to extend the Tia care experience beyond Tia’s clinics.
Carolyn believes that Tia’s “whole woman whole life” perspective clearly positioned Tia as the widest point of entry in women’s health that had the the opportunity to capture the biggest TAM.
Cracking the business model question in healthcare
Focus on the business model, particularly in health care when the business models are so hard to crack. Tia’s 1.0 product, the Q&A app, was wildly successful in proving their team’s brand-building capability and driving demand/engagement. It didn’t, however, prove monetization potential or a scalable business model. Carolyn believes it took opening their first clinic to unlock the system-level business model that could allow Tia to scale.
Figuring out the business model upfront is key to aligning incentives, particularly around financials.
Carolyn suggests to actually delay raising venture capital until you have more clarity and conviction on the business model, which can be key to determining your long term capitalization strategy and the growth of the business.
Owning the relationship with the consumer unlocks the last part of the B2C2B business model — selling to businesses.
Carolyn believes Tia’s business model of partnering directly with the consumer is an advantageous strategy for both product market fit and go to market. Depending on your demographic or the problem you’re trying to solve, selling directly to a health system might be a better go to market strategy, but what Carolyn believes D2C forces you to do is to have a better product. She believes that we’re seeing a next class of consumerized digital health tools where the bar is set higher.
“If consumers are paying for it versus an employer, the level of delight, the level of value that you're forced to demonstrate to your customer in the earliest days… the bar is higher.”
Building an experience that women don't just like, but love, and being able to retain that relationship unlocks the second part of their business model— the B2B piece of how Tia integrates with health systems today.
Find a problem (not the business) you’re obsessed with solving.
"It is the obsession with the problem, not the business model, not the market opportunity, not the term sheet, that I think is the ultimate motivator to get you through.”
Carolyn shares that building a healthcare company specifically is incredibly taxing and difficult, and you might not always know where you're going or how to get there. She’s grateful for her journey being problem first, business second. Not only did it provide continued motivation, it led the Tia team to a better product.
The future of the healthcare system is hybrid care
Carolyn believes it’s increasingly obvious that care can’t be entirely delivered on the internet— despite the spike in virtual care during COVID, telehealth utilization declined significantly over the last year. During the pandemic, their team wasn’t sure whether or not to build out a hybrid model or virtual only model, inherently more scalable but less comprehensive. It was a hard decision, but Carolyn believes their choice to embed Tia on virtually integrated hybrid care was the right one for their bottom line and for providing better healthcare.
Carolyn believes the future of the healthcare system is hybrid and focused on care continuum.
“The real opportunity and next wave of innovation, I believe, is not going to be can you Zoom with your doctor? That's a commodity that anybody can do. It's going to be about how do you actually connect care across these different touch points— chat, video, retail style clinics at home, the hospital. That's really what Tia is super excited to invest in as the future of healthcare for women and for everyone.”
The care continuum will be built through consolidation and re-bundling of solutions.
Carolyn’s excited by a trend she’s seen that some might call consolidation, but she would call re-bundling of solutions. She’s observed a lot of M&A activity among incumbents but also strong new players focused on creating more holistic healthcare solutions, a direction she believes is the right move for consumers.
“If we can move towards the healthcare model that's designed for people and simplicity, and continuity vs. parts… I believe that's really the key to a better experience, to higher quality, to lower costs, and a healthcare system that just works.”
Carolyn shares that healthcare founders often debate what the healthcare system of the future is going to look like: will it be organized by gender, race, ethnicity, location, by payer type, by health condition? Tia demonstrates how organizing the healthcare system by sex and gender can be powerful, delivering personalized care that caters to the distinct needs of the population and bundling solutions for various conditions, specialties, or body parts. However, Carolyn doesn’t believe that’s mutually exclusive from a Medicaid or a Medicare play, etc.
“What I think we're going to see is a mix of different bundles, whether it's population based, location based, payer based, and really start to prove— how do these various approaches to stacking up services and products and experiences drive quality and costs?”
Menopause and mental health, exciting opportunities in women’s health
Carolyn is excited by two areas in particular: menopause and mental health, Tia’s fastest growing service line. Menopause is critical part of women’s lives all too often ignored, and Carolyn believes we're just starting to see excitement and investment and innovation in this space. She’s incredibly excited for Tia to extend their whole person care model to support women in the peri-menopause and menopause journey as well. Additionally, Carolyn believes focusing on sex specific mental health care solutions and therapeutic models is key to addressing mental health issues in the US.
Thank you so much for Carolyn for coming on the podcast!
Interested in Tia or joining their team? Learn more on their website, Twitter, Instagram, and LinkedIn.
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