The outbreak of COVID-19 is changing the world, in both the present and in the future. In these uncertain times, hospitals and other healthcare facilities are looking to implement new technologies to continue to provide services, while limiting their face-to-face interaction. But implementing HIPAA-approved telehealth applications in a short amount of time can prove to be a challenge. Thankfully, the federal government is lifting rules and reevaluating their regulations to allow healthcare companies to use other tools to reach their patients in these difficult times. On this episode of Inside Reproductive Health, Griffin talks to Jill Gordon and Sarah Swank, lawyers in the healthcare division of Nixon Peabody. They navigate the changes to HIPAA regulations in the midst of the COVID-19 crisis and how clinics can appropriately implement telehealth to help their patients through their journeys without seeing them in office.
61 - Financing a New Business in the Fertility Field, An Interview with Jeff Issner and Taylor Stein
Entering the fertility space outside of owning a clinic is challenging. Entering the space as a tech company, well, that’s a whole other story. On this episode of Inside Reproductive Health, Griffin spoke with Jeff Issner and Taylor Stein, co-founders of EngagedMD. Together, they developed software that helps to educate patients and provide informed consent in clinics across the country. They share the story of how they got started in the fertility space, from idea to execution, without any commercial debt.
Jeff and Taylor also talk about how they got doctors and clinics on board before their software was even fully developed. Plus, they discuss the ever-challenging hiring process and what they do to make sure they are getting the best people on board.
55 - Easing the Strain of Embryo Disposition on Patients and Clinics, An Interview with Andy Gairani
Embryo disposition is a sensitive topic for patients even long after they’ve left a clinic. However, there can also be a burden placed on clinics when it comes to making space and cryopreserving embryo, eggs, or sperm for an extended period of time. On this episode of Inside Reproductive Health, we learn more about how one company is working to alleviate the burden for both the patient and the clinic. Listen to Griffin talk to Andrew Gairani of Embryo Options, a web-based application that provides patients with disposition education and resources, along with other features that make storage easier for everyone.
46 - Can Innovative Practice Culture Drive Patient Satisfaction? An Interview with Dr. Alan Copperman
Building and growing an IVF practice can have numerous benefits for both the owners and the patients they serve. But growth can sometimes lead to loss of patient-focused care. On this episode, Griffin Jones, CEO of Fertility Bridge and host of Inside Reproductive Health, talks to Dr. Alan Copperman, Co-Founder and Medical Director of RMA of New York, one of the nation’s largest IVF centers. Together, they discuss how RMA of New York was able to retain their patient-focused culture while exponentially growing the practice. Their approach to delegating important tasks, understanding the “new” patient, and finding the right, compassionate employees has greatly contributed to their success today.
To learn more about Dr. Copperman and Reproductive Medicine Associates of New York, visit their website at https://www.rmany.com/.
Visit fertilitybridge.com to learn more about what Griffin and his team can do for your fertility clinic and take the first step in building your marketing system with the Goal and Competitive Diagnostic.
41 - Are Young REIs Entrepreneurial? One REI Fellow’s Vision for the Field, Eduardo Hariton, MD, MBA
The business of medicine is complicated and more often than not, the concept is split and managed by two people with different backgrounds and education. But what if they merged? On this episode of Inside Reproductive Health, Griffin talks to Dr. Eduardo Hariton, a clinical fellow at the University of California in San Francisco. While attending Harvard Medical School, Dr. Hariton also attended Harvard Business School, simultaneously earning his MBA. Griffin and Dr. Hariton discuss the merging of business and medicine and how new REIs can gain business skills while still focusing on what is important: the patient.
35 - Gina Bartasi - Can a Direct Service Delivery Model Increase Access to Fertility Care?
Increasing access to care has always been a topic of discussion in the fertility field. On this episode of Inside Reproductive Health, CEO and Founder of Fertility Bridge, Griffin Jones, talks to Gina Bartasi, CEO of Kindbody, a women’s health company working to increase access by sending out mobile clinics to reach patients closer to home. They discuss ways that other clinics can meet their patients’ needs, as well as the importance of giving partners and team members positions that match their personality.
34 - How At Risk Are You as a Physician? Mitigating Liability In Your Practice: An Interview with Dr. Steven Katz
A malpractice case can be the end of an REI practice, and with IVF errors often making it into the news, the pressure to be perfect is high. Thankfully, technology aimed to reduce errors has grown. On this episode, Griffin talks to Dr. Stephen Katz, CEO and Founder of REI Protect, a company formed to provide risk management services and coverage for REI practices across the country. They discuss what can go wrong in an office or IVF lab, and, more importantly, how to protect your practice from errors.
32 - Marianne Kreiner - Remote Jobs Are on the Rise: Can REI Clinics Follow Suit Successfully
Working from home has become more and more prevalent across all industries and is starting to catch on in the field of fertility. But how can working from home be beneficial and successful for both employee and employer? On this episode, Griffin Jones talks to Marianne Kreiner, Chief Human Resources Office at Shady Grove Fertility. Together, they discuss how implementing telecommuting in your office can boost employee retention, the importance of building culture with those who work from home, and how to appropriately set up telecommuting employees while following labor regulations.
30 - Unpacking Diverse Family Building Paths: An Interview with Dr. Mark Leondires
The world of fertility has grown and changed as the needs of families has changed. And now more than ever before, there are different populations seeking fertility care. In this episode, Griffin talks to Dr. Mark Leondires, a board-certified REI and the founder of Gay Parents-to-Be, about the various paths of family-building and how fertility clinics can provide personalized care to those with differing goals and needs.
27 - Setting the Vision for Your Practice with Intentional Culture. An Interview with Angie Beltsos, MD
In this episode, Griffin Jones hosts Dr. Angeline Beltsos, CEO and Medical Director of Vios Fertility Institute as well as the founder of Midwest Reproductive Symposium International (MRSi). In the competitive climate of large fertility networks, Dr. Beltsos’ independent fertility center, Vios Fertility, has thrived, largely in part to implementing an intentional culture of transparency. Dr. Beltos discusses how Vios is built on three important pillars: an unparalleled patient experience, early scientific adaptation, and robust and dynamic culture that starts at the head of the team and trickles down.
25 - Buy-in: Necessary for Successful Implementation of an EMR System? An Interview with Nicole Koczanowicz
In this episode, Griffin Jones hosts Nicole Koczanowicz, the Vice President of Artisan Medical Solutions. Koczanowicz’s focus on adoption and adaptation of Artisan’s EMR program to every practice has set Artisan apart. Jones and Koczanowicz have an honest conversation about the delicate dance between a practice fully adopting a necessary change, to the EMR team adapting to the individual needs and workflow of each practice. After all, Wall Street and Silicon Valley both want your patients, but there is a plan, if you are willing to take action.
Fertility Company Profile: The New Marketplace for IVF Patient Acquisition
Consolidation.
If you had to reduce the water-cooler talk of our field to one topic, it would be exactly this: the consolidation of IVF centers, fertility pharmacies, brokers, genetics companies and others, purchased with private equity money.
I wrote about these players, and the collective unease about them, in 2018. I have talked about it on the IRH podcast with guests such as doctors John Storment and David Sable. I hear the apprehensions and I share some of them.
Are we capable of betraying our patients’ best interest because of obligations to financial stakeholders?
That’s a very sound concern for the delivery of fertility care. Furthermore, it’s very likely that there are examples wherein this concern is justified.
I own Fertility Bridge outright, 100%. I often make decisions based on what I want for the relationships of our clients and employees. If I had to answer to many different shareholders, we would likely do things very differently.
Conversely, I also see examples where this pressure disrupts the status quo and forces innovation and efficiency when we have to compete to earn patients’ selection. Sometimes, the independent centers with the least competition are the least likely to invest in patient experience and team culture.
Either way, I do not see the consolidation of REI practice groups as the single greatest disruption coming to the field. Not by a long shot. In 2018, I also wrote that technological revolution dwarfs any disruption caused by the sale of IVF practice ownership to private equity.
While others are looking to Wall Street, I have my eye on Silicon Valley.
Consider it this way:
The independent REI practice is the local, 100 room hotel.
They’re worried about the Marriott building a 1,200 room, mid-rise on the waterfront.
I’m worried about AirBnB.
One view looks at larger and more dominant competitors in the same marketplace. I’m looking at a whole new marketplace.
The model for the delivery of healthcare, including fertility care, has become too estranged from the conveniences that patients are used to when researching, considering, receiving, purchasing, and evaluating goods and services as consumers.
Our patients under age 30 have conceivably never called by phone to invite a friend over, break up with a significant other, or even order food. Yet, for virtually every fertility center, there is ultimately no other way to schedule a new patient visit.
Please take my next admonition as commentary on the mechanics of patient relations and not on providers’ devotion to service; I know the depth and sincerity of so many practitioners’ vocations.
We’ve been too slow to adapt and have grown out of touch with our patient demographic. For some, it’s already too late.
I don’t envision large fertility groups or boutique REI practices going away, but another class is emerging to capture the middle, the entry, and everything around.
There is a wide opening to provide the user experience of patient acquisition and patient retention that the current demographic demands. With the right application, and/or scaled acquisition strategy, one or two platforms can become the gateway through which patients enter. Many companies are jockeying for that position. Some of them may win, or the winner may not yet be in the marketplace. The extent to which they’re able to scale is the degree of leverage they have over providers.
Put frankly, someone is building a better mouse trap than you have so they can sell (who would have been) your own patients back to you.
Many have tried and not (yet) succeeded, but it would be hubris to think that others won’t.
Here are some of these players now, and what they’re up to.
Important disclaimer: Neither I, nor Fertility Bridge, have a direct commercial relationship with these companies at time of writing, though we certainly may in the future. No information in this article comes from conversations that I have had with the executives of these companies. This profile is not a revelation of insider knowledge. Rather, it is a curated synopsis of public information. My observations and opinions are exactly those, based on information that has been publicly released by these companies or covered in the press.
CONSUMER APPS:
GLOW
The tech-forward platform for serves fertility patients and connects them with clinics by providing:
Glow- Ovulation and fertility tracker
- Includes:
Fertility Calendar
Daily health log
Health insights
App syncs with partners app
Glow Nurture - Pregnancy app
Glow Baby - Baby Tracker
Eve by Glow- period tracker and sex tips
Glow Fertility is segmented into a direct-to-consumer programs and a separate employee benefits program.
Direct-to-consumer programs:
Glow predicts ovulation patterns and fertility probability based on user data inputs and supports women with services such as egg freezing and IVF. In addition to helping clients navigate the process of getting pregnant, Glow also facilitates access to healthcare providers (with whom the Glow team negotiates discounts to reduce the financial burden of historically expensive fertility treatments).Employee benefits program:
On the employer side, the Glow Fertility Program negotiates contracts between employers and fertility care providers.
Millions of women input data on menstrual periods, doctor visits, sleep habits, sexual activity, and birth control (in addition to over 35 additional basal health data points), and Glow has all of that data.
Although Glow does not publicly share the full details behind it’s business model, the firm charges businesses for the employee benefits program, and is also able to charge a fee for facilitating access to services from preferred healthcare providers. Glow also offers women personalized consultations through its direct-to-consumer channel, offering one free session before converting to a charge for service model.
History and Funding:
Launched in 2013 by Max Levchin (co-founder of Paypal)
Glow originally spun out of PayPal Co-Founder and CTO Max Levchin’s business incubator, HVF.
According to Crunchbase, Glow has raised over $23 million in venture capital, $17 million of which was raised in a 2014 Series B round that included Founders Fund and Andreessen Horowtiz, reports Vox.
EMPLOYEE BENEFITS:
CARROT
Carrot is a startup out of Y Combinator working with employers to offer fertility care like egg-freezing and in vitro fertilization (IVF) as a workplace benefit.
Provides affordable options for those struggling with infertility by partnering with employers to add coverage for fertility services. They offer customizable plans to employers to include varying levels of fertility coverage at a sliding, per-employee dollar amount.
Founded by:
Tammy Sun, CEO
Dr. Asima Ahmad, Medicine
Juli Insinger, Growth
Arun Venkatesan, Engineering
Funding:
Total funding: $15.2 million
According to CrunchBase, Carrot has raised $15.2 million over four rounds, one angel, two seeds, and a series A. Their lead investors have been UnCork Capital with 3.6 million and CRV with $11.5 million.
Their family planning concierge, which reports to provide members with caring, live guidance, and support at every stage of the journey.
Help for members maximize existing benefits.
Access to preferred pricing at top clinics and pharmacies.
Access to customized fertility payment options.
Nubundle offers its products as a voluntary employee benefit, limiting the costs to employers. Employers pay a flat annual admin fee.
Founders
Chris D'Cruz
John Ciasulli
Total funding: $1.5 million
In a seed round, NuBundle raised $1.5 million from three investors led by Lightbank.
STORK CLUB
Family/fertility benefit suites for companies.
In 2018, Stork Club expanded their core offering by introducing a comprehensive suite of Flexible Family Benefits that include both Fertility and Parental programs designed for large enterprises.
Stork Club advertises to be the only enterprise-ready family benefits provider designed for self-funded employers. They process claims and pay providers directly, letting your team focus on more important goals.
They have employee-facing web and mobile apps to help employers on-board, manage, and validate new programs with vetted provider partners.
Founder, CEO: Jeni Mayorskaya
Early Stork Club investors and advisers include key employees from LinkedIn, One Medical, and Facebook .
They appear to be funded by slow ventures, but it is unknown how much money they have raised.
PROGYNY
Right now, Progyny is the fertility benefits company.
They provide fertility solutions for self-insured employers.
Some may remember, Fertility Authority, the consumer facing company and fertility clinic review platform that negotiated reproductive health benefits. The company changed its name to Progyny in 2015 after acquiring, or being acquired by, Menlo Park-based Auxogyn, the inventor of Eeva. They quickly sprinted ahead to lead the race of fertility benefits broker.
In my opinion, this is a one-horse race at the moment, with their young, new competitors looking to be the person who can disrupt their early lead as Lyft did to Uber.
Founded in 2008 as Fertility Authority, became Progyny in 2015
CEO: David Schlanger
Headquarters are located in New York, New York
Funding:
Total funding: $99.5 million in ten rounds from six investors, as documented by CrunchBase,
Who led the rounds has not been released.
Though we do know they raised $15 million in a new round in 2016.
THE FINANCIERS
Now this group is different. They’re not a new wave of tech companies launched from or by Silicon Valley serial entrepreneurs. However, by default, they do serve as lead generation and another entry point for patient acquisition from which they can bring new patients to fertility centers.
Also, I speculate a potential scenario in which one or more of these companies are acquired for easier, quicker, and more expansive entry into the fertility field.
Think about it. Many of these companies have an outdated user experience and some of the founders may be ready to cash out of the game rather than reinvest and overhaul. Again, this is Griffin Jones putting his Jim Kramer hat on and being purely speculative.
WIN Fertility:
Maybe they belong in the employer benefit group, but a few things set them apart:
They have been in the field for two decades.
WIN offers benefits through employers and affordable options for treatment through practices for those without insurance or for those who have exhausted their insurance benefits.
WIN integrates with national and regional insurance carriers, as well as the nation’s largest pharmacy benefit managers to procure fertility services. WIN patients are qualified prior to fertility treatment.
Available 24 hours a day, 7 days a week, WIN’s Nurse Care Managers guide patients through every step of their fertility journey.
Originally founded as an independent women’s health management company
Founded in 2000
President and CEO: Roger Shedlin
Attain Fertility
ATTAIN FERTILITY:
Attain makes themselves known for being the original multi-cycle plan provider. They offer bundled IVF cycle plans, called Multi-Cycle Discount Programs, that include multiple IVF cycles for a one-time, discounted fixed fee.
Being owned by IntegraMed they are affiliated with 40 practices, 130 locations, and more than 180 Reproductive Endocrinologists in their US wide network.
Some patients qualify for their Multi-Cycle Discount Program + REFUND. This offers patients who meet certain criteria the potential of getting a refund if their IVF cycles are unsuccessful.
$15.4 million
Founded by Pam Schuman
ARC Fertility
ARC says they are the access point to the “nation’s largest network” of fertility professionals and offer innovative financing options.
More specifically, ARC offers fertility treatment packages, refund guarantees, and finance options to people living with infertility.
Value proposition to clinics and/or patients:
Largest network
Most trusted
Doesn’t own/operate clinics -> looking out of patients best interest
ARC’s fertility care packages can be bundled with medication and genetic testing services and bundle the cost of services into one monthly payment.
History:
ARC was founded by David Adamson, MD.
THE WILDCARD
Fertility IQ
The most comprehensive review platform for fertility specialists and fertility clinics.
With FertilityIQ, prospective patients search by location or by a specific doctor or clinic name. Doctor profiles are detailed with aggregated metrics including communication quality, degree of individual attention, responsiveness, and overall recommendation. Patients’ summarize their experiences with doctors and clinics -- from the doctor’s approach to diagnosis and treatment protocols, to the nursing staff’s level of organization, to the competence of the clinic billing department.
History and Funding:
The founders of Fertility IQ, Jake and Deborah Anderson-Bialis, say they will never take marketing dollars from clinics. Rather than seek capital from outside investors, the couple decided early on to self-fund FertilityIQ.
Founded in 2015, went live in 2016
One of my clients once told me that they were weary of Fertility IQ because they thought they were building a mousetrap and they didn’t know what it was. I’m not weary because I believe Jake and Deborah have built their platform from an authentic ethos and are serving the market in a genuine and desperately needed way. Where the mousetrap will lead, I have no idea but it’s already a darn good one. Fertility IQ offers the best user experience for fertility clinic selection and has some of the best consumer generated data in the field.
Conclusion:
Up to now, I have presented private equity backed consolidation and venture capital backed innovation as two separate phenomena, though they certainly don’t have to be. What will happen when the largest fertility networks, their parent companies, or private equity firms, acquire the largest scale platforms for patient acquisition, financing, distribution etc? Vise versa?
Resilient businesses survive revolution and later thrive because they adapt to capitalize from these disruptive forces rather than be replaced by them. There is more opportunity for the independent REI practice than there has ever been before, but it isn’t coming from doing business the same old way. It requires new strategy, paying close attention to the new players in the market, and using them for their benefit.
If you would like help in adapting to these forces and benefiting from the disruption rather than being pained by it, learn more about how to implement the Fertility Marketing System.
14 - Should Fertility Doctors Become Advocacy Leaders? An Interview Dr. Serena H. Chen, MD
In this episode, Griffin speaks to Dr. Serena Chen, director of the division of REI and OB/GYN at Saint Barnabas Medical Center and clinical associate professor at Rutgers and St. George’s University. Dr. Chen strongly advocates physicians embracing social media to maintain cultural competence; she and Griffin discussed how this commitment to connection helps doctors communicate with patients and how embracing advocacy can prevent physician burnout.
12 - Technology: Will It Eat IVF? An Interview with Bob Huff from Imagine Fertility
In this episode, Griffin talks with Bob Huff, the Chief Technical Officer of Imagine Fertility, a software that seamlessly blends documentation with EMRs and a variety of third-party software solutions. Griffin and Bob chat about the impact that software with walls has had on everything from practice management to patient care and what the future holds for tech in fertility practices.
2 - Who’s Responsible for Lowering the Cost of IVF? An Interview with Dr. Kiltz
In this episode, Griffin talks with Dr. Robert Kiltz, the founder and director of the first successful IVF center in Central New York, CNY Fertility Center. Griffin and Dr. Kiltz discuss the topic of who is really responsible for lowering the cost of fertility treatments. They discuss whether the responsibility falls on the insurance companies, pharmaceutical companies, medical device, hardware and software companies, or the providers themselves. They then discuss Dr. Kiltz’s methods of becoming a successful fertility specialist that offers a lower cost treatment plan, creating a new market with new levels of accessibility and affordability.
Four Reasons the Tech Revolution Has Disrupted Fertility, and Why Practice Owners are Frustrated
CHANGING TECHNOLOGY
For some IVF centers, the change has already done them in. For others, it is the level playing field needed to thrive against massively funded competitors. No phenomenon presents a greater threat, nor a greater opportunity to today’s fertility centers than the technological revolution through which our society is living.
So far, we've deeply explored the four major implications of the following axiom: today's fertility practice is no longer a small, independent healthcare clinic, but an entrepreneurial venture. We talked about business structure, strategy and vision, and accelerated competition. These three tenets pale in comparison to our society’s rapidly changing technological and social behavior.
3 Common Things Fertility Practices Do On the Internet that Make HIPAA Lawyers Cringe
"We must all obey the great law of change. It is the most powerful law of nature."--Edmund Burke
In the summer of 2015, I asked my e-mail list of fertility doctors if if they had any questions about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to internet marketing. Except I didn't write HIPAA. I wrote HIPPA. Thankfully, someone who read the e-mail, corrected me. I was a little embarrassed. I knew what the acronym stood for, but I still wrote it incorrectly. Why would I spell it that way?
10 Infertility Support Ideas from a Conversation That Never Would Have Happened 10 Years Ago
On one hand, I absolutely hate millennial business buzzwords, and on the other, I deliberately use them often. I choose to say "silo busting" because of how important it is for different "departments" to be familiar with each other's goals and challenges. "Silos" aren't just separate departments within companies, they can be any sub-category of any group. According to social scientist, Tom Wolff, PhD, of the University of Kansas, all community stakeholders have to be engaged in order to solve common problems facing the community. In the infertility community, our many roles account for many different stakeholders. We have embryologists (scientists), reproductive endocrinologists (doctors), nurses, business managers, patients, support groups, mental health professionals, and advocates (among others).