UNC Professor of Medicine Spencer Dorn

Startups

Oula Lands $28M for Modern Maternity Care

Topping off a week packed with women’s health stories was maternity care startup Oula’s close of $28M in Series B funding.

Oula’s modern maternity centers combine obstetrics with midwifery to ensure expectant mothers receive comprehensive support throughout their reproductive journeys. 

The philosophy behind Oula is that most pregnancy care takes place between visits, so offering in-home support, better education, and virtual access to providers should create a virtuous cycle for improving outcomes.

• Oula also places a heavy emphasis on inclusive care by working with most major payors and Medicaid, as well as its dedicated support for BIPOC parents and families.  

• By finding a middle ground between hypermedicalized and non-medical care, Oula’s pair of New York Clinics have delivered a 26% better C-section rate, a 61% lower preterm birth rate, and a 50% better low birth weight rate compared to the city’s benchmarks. 

The funding arrives as maternal deaths continue to climb in the US, which leads all other high income countries with 23.8 deaths per 100k births (and an abysmal 55.3 deaths per 100k births for Black women).

• A large part of these discrepancies appears to be due to a lack of access to midwives, certified medical practitioners with expertise in low-risk pregnancies, which also see far worse reimbursement than physicians.

• Oula makes the case that the US’ lack of proper reimbursement mechanisms for midwives is a key driver of its poor outcomes, and tackling that issue is a core component of its mission.

The Series B will help Oula round out its platform with services like preconception coaching and enhanced miscarriage support, while also allowing it to scale to more markets to rival established players such as Maven Clinic and Progeny Health.

The Takeaway

Oula is looking to modernize maternity care not only by wrapping a tech-enabled bubble around traditional obstetrics, but also by catering to the specific needs of the mothers and health plans that it serves. It’ll have its work cut out for it scaling from a few New York clinics to a nationwide platform, but it’s hard to ask for better timing or a greater need.

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The Wire

• Health System Lightning Round: US hospitals were reporting plenty of momentum during last week’s Q4 investor calls. CommonSpirit Health reported positive margins on the back of rising patient volumes and an extra $234M from the 340B drug program. Johns Hopkins’ impressive 12% net margin was driven primarily by its rebounding investment portfolio. Sanford Health also looked healthy after the large rural health system reported that its financials surpassed prepandemic levels across the board. A notable straggler was RWJBarnabas, which finished the year in the red after a months-long nurse strike cost the system upwards of $180M.

• Safety of Telehealth Medication Abortion: New research in Nature Medicine brought confirmation that abortion medication prescribed via telehealth is just as safe as in-person care. The study of 6,000+ telehealth patients concluded that both the effectiveness and adverse events were comparable to in-person prescriptions. The news follows the recent retraction of two studies calling out unsubstantiated dangers of abortion meds, and also arrives just before the Supreme Court is scheduled to hear arguments on the access issue next month.

• Dina Series A: Care-at-home software startup Dina closed a $7M Series A round (total funding now $11M) to accelerate the development of its care coordination platform and expand its network of home-based and post-acute providers. Dina’s “Care Traffic Control” platform (…nice) combines its provider network with real-time collaboration and RPM tools to facilitate remote interventions while addressing SDOH needs. The Series A is also earmarked for new chronic condition pathways, including congestive heart failure and COPD.

• KeyCare Moves Into Behavioral Health: Epic-based virtual care platform KeyCare announced WellSpan Health as its inaugural partner for expanding into integrated primary care and behavioral health services. WellSpan patients can now schedule online appointments with a panel of virtual PCPs, psychiatrists, and therapists who share medical records with their WellSpan colleagues. The official service line add-on follows a successful pilot last year, which saw WellSpan and KeyCare deliver virtual care to over 11,000 patients.

• State of Women’s Health Benefits: Maven’s latest State of Women’s and Family Health Benefits Report gave a stellar overview of the benefits landscape, based on two separate surveys of over 1,000 HR professionals and 3,000 employees. A majority of companies appear to be providing staple benefits like mental healthcare (62%), parental leave beyond statutory minimums (62%), and maternity support (50%), although far fewer assist in areas such as adoption/surrogacy (25%) and menopause (24%).

• Trilliant Launches Network Explorer: Trilliant Health announced the launch of its new Network Explorer, a network performance management solution built on top of Trilliant’s national provider directory and all-payor dataset. Network Explorer tracks: 1) referrals inside and outside a network to identify misalignment with in-network providers; 2) practice patterns of independent groups to identify physicians and practices for partnerships; 3) network differences across specialties and health plans to inform growth strategies; 4) volumes and referral patterns of competitive networks to help with competitive analysis.

• In-Network Utilization Spike: In-network care unsurprisingly saw a major spike following the No Surprises Act, which protects patients from unexpected charges from out-of-network providers. A FAIR Health report showed that the share of in-network care increased from 84% to 90% across all specialties and settings, with an obvious jump in January 2022 following the new legislation. The specialties that saw the most immediate impact were also the most common sources of surprises, including anesthesiology, emergency medicine, pathology, and radiology.

• Mistakes to Avoid When Pitching Angels: The digital health dynamic duo of Nikhil Krishnan and Halle Tecco partnered up on a list of avoidable mistakes they’ve seen when getting pitched by early stage startups. In typical Out-of-Pocket fashion, the write up is loaded with spicy memes and juicy banter, but it also includes real pitch decks and email examples that are great tools for anyone playing the fundraising game. The most common mistake? Picking a solution before figuring out the pain point and business model.

• Teladoc Q4 Miss: Teladoc stock plunged 20% after missing Q4 revenue estimates and offering a downbeat forecast for the rest of the year. Although 2023 revenue was up 8% to $2.6B, mainly on the back of a 7% increase for the integrated care segment and an 11% jump for BetterHelp, Teladoc pointed to its usual suspect for the slowdown: marketing competition. “We experienced returns on our social media advertising that were below target in the second half of the year,” and it looks like those channels are expected to remain tough going forward.

• Digital Hypertension Programs Advance Equity: A meta-analysis in JAMA Network Open suggests that novel hypertension programs probably deserve more attention for patients experiencing health disparities. After reviewing 28 studies involving digital interventions for people of color and low income patients (e.g. connected BP buffs, app-based medication reminders), researchers found that participants experienced a statistically significant and clinically meaningful reduction in average systolic blood pressure compared to control groups.

• Gradient Debuts Atlas Data Suite: AI data sharing company Gradient Health launched Atlas, a new suite of products giving AI developers easier access to clinical data for algorithm training. Available in three flavors, Atlas is a self-serve offering that allows instant previews and full data delivery in less than 72 hours, while Atlas+ is the company’s most powerful tool for technical users who need large or highly complex datasets. Atlas Concierge is a fully outsourced data delivery service. The suite leverages Gradient’s large library of anonymized medical images for AI training.

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