As this happens, the health care system’s fragmented and disorganized infrastructure will get its biggest test since the pandemic. Accommodating the country’s large population will require an entire overhaul of how the system works.Ìę

began thinking about how to create a health care system that works with the elderly population when she worked at the Center for Medicare and Medicaid Innovation. After stints at and senior care tech platform , she founded , a telehealth platform that helps patients navigate specialty care. The San Francisco-based company has raised $22.2 million in venture funding, per Crunchbase.

Telehealth access to specialty care is far more difficult than, say, finding a therapist or primary care physician. Part of the reason is because much of speciality care is, by nature, unique, and doesn’t always translate well to a virtual setting. But as the number of patients gets larger and the number of speciality care providers gets smaller, telehealth is going to be an increasingly important piece of the health care infrastructure as boomers age.

Could you paint me a picture of what reality we’re going to see soon with the boomer population getting older? What do they want? What do they expect out of their care? And what exactly is the thing we’re supposed to be preparing for?

Mellard: So there are assisted living, independent living, skilled nursing facilities. And that’s one aspect of how we think about the aging infrastructure. Historically, that group of people who housed many of our aging seniors hadn’t thought of themselves as health care providers until very recently.

I think there’s a type of convergence between how we think about housing needs and health care infrastructure, and navigational infrastructure as it relates to senior care today and moving forward. And we’re finally starting to see where those two things are recognizing one another and the value that each of these categories brings to the service.

The aging population — even if they’re aging relatively healthily — still start to utilize our system more and more as a direct correlation to age, which is going to continue to drive the need for more care models to be delivered at various sites of care. So we now see more home-based models, more models going into people’s assisted living, independent living facilities.

You touched on something I am very interested in, which is this very tangible need that we are going to see very soon. And then on the other side, this beautiful utopian concept of preventive care that does not really exist in our system as we know it. But there is going to be, I assume, a need for us to push more preventive health care systems forward just because that’s going to be important in caring for this population.

Mellard: Most people think you go into an assisted living facility to die, as opposed to, “I’m going to live, and I’m going to live well.” And there’s going to start to be more of that conversation driving some of the development in this space that we haven’t historically seen.

There’s also this strain on the health care system. I think it’s something that we found really interesting at Sitka. We practice medicine across state lines to bring different levels of efficiency into our system. And so while telehealth needed to spike as a result of the pandemic, that’s come back down.Ìę

But there is going to be this need for general digital health, maneuvering and navigating not only across state lines, but also across interested parties, like within the family member spectrum.Ìę

The rural nature of most of our country creates incredible challenges of accessing the right care knowledge at the right time. So we are going to continue to see more digital adoption occur, even into the aging population. Historically, there’s this big story that seniors don’t use tech. And I think the pandemic kind of largely proved that’s not accurate. Our aging population is actually very capable of using technology, which is great.

Illustration: Dom Guzman

Eight-year-old Maven follows women and families through fertility and pregnancy to birth, pediatrics and menopause. Through its app, patients are connected to specialists who can talk them through a variety of medical procedures and long-term care plans for nutrition and child care. The company operates in 175 countries and offers care for families with different backgrounds and needs.

“We have reimagined the care model to address the complex needs of women and families in a global system that was not designed for them,” said , Maven CEO and founder.

New York City-based Maven works with employers to provide supplemental benefits, but doesn’t accept insurance — although its website indicates per-appointment fees cost less than most copays.

Specialized care gains traction

Maven’s raise, so far, marks the largest raise in the femtech category this year. Funding has dropped 52% since last year, garnering only $683 million in 2022.Ìę

But that’s not bad. Before 2020 and 2021, when a flood of funding ensconced the private markets, femtech netted $569 million in 2019.Ìę

Maven is one of several virtual health startups operating in the niche care space, where companies are building care plans for people who have otherwise been shunned by the mainstream health care system: women, people of color, queer people and immigrants. In October we covered ’s $30 million raise to further its care offerings to LGBTQIA+ patients such as gender-affirming health care, access to PrEP (medication that stymies the spread of HIV and AIDS), and fertility services for same-sex couples. , which raised $10.5 million in January, offers health care services for college-aged women such as sexual health education.Ìę

But FOLX, Maven and Caraway, like many startups in this space, don’t take insurance. Rather, they either accept out-of-pocket payments or work with companies or schools to offer benefits to workers. Operating outside the insurance network might make it easier for patients to access specialists that are in demand and otherwise hard to schedule an appointment with. But the system also shuts out another group typically evaded by health care: the poor.Ìę

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But now, additional eyes are on these startups as federal protections for the right to an abortion were struck down this summer in a °ùłÜ±ôŸ±ČÔČ”.Ìę

The court’s decision in June reversed the 1973 Roe v. Wade ruling, which gave pregnant women the right to an abortion until fetal viability, or when the fetus could survive outside the womb. By overturning Roe v. Wade, the Supreme Court made it so that states could ban or restrict abortions.Ìę

How this will or won’t impact abortion pill providers continues to be muddy regulatory waters. In the meantime, existing digital health companies could expand their offerings to include abortion pills.

Medication-based abortion

Medication-based abortion provides an option for women early in their pregnancy. The combination of the pills mifepristone and misoprostol was approved by the in 2000 to terminate a pregnancy up to 11 weeks, , a research and policy organization focused on sexual and reproductive rights.Ìę

Because of the COVID-19 pandemic, the requirement that women needed to visit a provider at a hospital or clinic to be prescribed mifepristone and misoprostol .

The change in rules led to an uptick in medication-based abortions, which now account for half the abortions in the United States, per the Guttmacher Institute. That’s up from more than one-third in 2017.Ìę

Since the change in rules, at least two startups focused on providing medication abortions received funding, according to Crunchbase data. Those include New York-based and San Rafael, California-based .Ìę

Hey Jane serves patients in California, Colorado, Illinois, New Jersey, New Mexico, New York and Washington, while Choix serves women in California, Illinois, New Mexico and Colorado.

Choix has raised $1 million in funding from , while Hey Jane has raised $3.6 million from investors including and , per Crunchbase.

Both companies provide virtual or text-based consults with patients who are early in their pregnancy and located in eligible states before shipping abortion pills, all for a flat fee.Ìę

Choix saw a 600% increase in web traffic on the day the decision to overturn Roe v. Wade was announced, according to CEO Cindy Adam. The company also experienced a 50% increase in the number of patients seeking care since the ruling, and it anticipates that increase to continue as people turn to medication abortion.

“Telemedicine clinics like Choix can also alleviate capacity issues, helping local clinics to reserve in-person visits for patients who require or prefer in-person care or are traveling from out of state,” Adam wrote in an email.

The company’s goal is to expand to every state where it can legally provide abortion medication by the end of next year, given how in flux the current situation is.

Medication abortion is currently in a bit of a gray legal area. While states now can ban abortions, mifepristone is approved by the FDA. On June 24, Attorney General Merrick Garland said in a statement that, ​​”states may not ban Mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy.”

Will more startups offer abortion pills?

While there are only two venture-backed startups in the Crunchbase database focused on providing the abortion pill, that doesn’t mean other health care startups aren’t looking to expand their services in light of the Roe v. Wade ruling.

, a partner at venture capital firm , who invests in the future of health, noted that the number of companies focused solely on providing abortion pills doesn’t provide the full picture of how startups are responding.Ìę

Some existing digital health companies are working toward offering the abortion pill and expanding their women’s health services as well, said Shakir.

Lux portfolio company , for example, said in November that it would begin offering medical abortion in California, Shakir noted.

And Adam of Choix said she is aware of other online pharmacies working to become certified to dispense mifepristone.Ìę

Online pharmacies grew more popular during the pandemic, as more people looked to have their medications shipped directly to them. But currently, there are only two online pharmacies licensed to distribute the abortion pill, including venture-backed

Shakir noted that it’s important for existing health care companies to expand services, given how difficult it is to start and roll out a company in a field as highly regulated as health care.

“I do think that it’s critical, because, especially if you’re starting a new company, it’s not easy to start and scale across states,” Shakir said. “So is making sure existing companies and companies focusing on other aspects of health care are stepping up to the plate.”

Women’s health has historically been dismissed as niche—something that Shakir said doesn’t make sense, considering women consist of half the population and make up around 80% of the dollars and decisions in health care.

Digital health is a relatively nascent space, though it’s gaining interest from investors as it matures, Shakir said.

“Human health is ‘recession proof’ in that we will continue to get sick and give birth and die and have significant health care needs,” Shakir said. “And the major stakeholders in this industry, going beyond patients, the pharma companies, the providers, the payers 
 are under pressure to propel pandemic digital progress and make it permanent.”

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One Hoboken, New Jersey-based startup wants to step into that process and has just raised $10 million from an investor who believes the company’s product has merit.

The startup, , has developed software to help reduce readmissions via remote patient monitoring and video visits. The company has just raised that $10 million in a “growth round” from out of Princeton, N.J. The financing brings the company’s to $17.5 million, according to its Crunchbase profile.

CEO developed the idea for the company in 2011 as a 24-year-old graduate student at when his grandmother was readmitted to the hospital for heart failure.

“So I convinced two friends to start the company and write all the software,” Bauer said. Not only is the company’s goal to help improve patient outcomes, but also to help hospitals protect themselves from being penalized for having a patient readmitted.

Health Recovery Solutions claims its platform, which includes software, predictive analytics and hardware/bluetooth devices, is cutting down on 30-day readmissions to healthcare facilities, especially those related to chronic illness, by as much as 80 percent.

Today, 140 medical centers including Penn Medicine, John Hopkins Medicine, WellCare and Henry Ford Health System use Health Recovery Solutions, and the company has monitored about 100,000 patients to date, according to Bauer.

“We’re using this $10 million for further product growth and also to help us reach our 1 million patient goal,” he told Crunchbase News. “We’ll be investing heavily in product development and in account managers so we can meet demand.”

Bauer expects the company to nearly double its revenue this year to $11 million compared to $6.3 million at the end of last year. Health Recovery Solutions, which has landed on the Inc 5000 list multiple times, currently employs 85 people with plans to double that over the next two years.

I asked Bauer how his startup does remote patient monitoring better than the slew of other companies in the space. To him, it lies in the fact that it’s cloud-based.

“A lot of remote monitoring companies tend to be more hardware-centric and then move into telemonitoring,” he said. “We were software-focused in the beginning and I believe that makes us more nimble. We have software and tablets to engage patients, many of whom are elderly, and apps for family members.”

While Edison has invested in a number of healthtech companies, including , and , among others, its backing of Health Recovery Solutions marks its first telehealth investment.

, operating partner at Edison Partners, said his firm believes the company’s patient monitoring platform “solves a critical problem in healthcare.”

“Hospital readmission rates are significantly higher than they could be because many recently discharged patients are not provided with the proper education to improve their condition or tools for clinicians to keep track of their progress,” he wrote via email. “The company provides a clear ROI to its customers healthcare systems and home health agencies—as well as to patients.”

Health Recovery Solutions is one of many telemedicine companies ranging in category from urgent care to fertility to cannabis that have landed significant capital over the past few years, as Savannah Dowling reported in March.

Take a look at some notable companies that have raised since the beginning of 2017:

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launched Remedy in early 2016 with the goal of providing “convenient and affordable access” to medical care from a patient’s home, or serve as “an Uber for house calls.” The Austin-based company initially started out providing on-demand house calls before pivoting to a traditional telemedicine model that starts first with virtual visits and then can be escalated to an in-person home visit if needed. The company also operates a walk-in clinic in its home base of Austin to which it can also refer patients. Remedy’s platform also includes 24/7 access to nurse triage and lab test visits.

Remedy currently provides its telehealth services in Texas and California but has plans to expand into other markets, according to Gabrysch. The Series A takes its total raised to a , according to Crunchbase data.

Dr. Gabrysch had worked as an emergency room physician in Austin for several years before he and his wife,, moved to Ethiopia in 2011. There, he served as chief medical officer for a 150-bed teaching hospital and realized how wasteful Americans could be of the resources available to them.

“I had seen people coming to the ER with non-emergency issues because they couldn’t get into their primary-care doctor,” he told me in 2016 when I interviewed him for an . “I also would often help out friends or family that didn’t have insurance or had high deductibles by going over to treat them or their children. We thought, ‘Wouldn’t it be cool to offer this to everyone?’ ”

The company has served “tens of thousands” of patients since its inception, according to Gabrysch. Its focus is on working with self-funded employers (including a Fortune 500 company), which make up a large part of its business. Remedy plans to use the new capital to expand to other states as well as broaden its technology platform, do some hiring, and open additional walk-in clinics.

“We want to scale and to grow as much as possible going to be in as many states as we need to be,” Gabrysch told Crunchbase News.

I asked him how Remedy differentiates itself from the host of other telemedicine startups out there, and Gabrysch said he believes it “offers a broader suite of services.” It also does not outsource its care to third parties, and instead hires providers to work as Remedy employees.

SantĂ© Ventures Managing Directors Dr. Joe Cunningham and Doug French are joining Remedy’s board as part of the financing.

“After reviewing numerous telemedicine companies in recent years, we feel confident Remedy can scale beyond traditional primary care delivery and is well-positioned to dramatically lower costs and improve outcomes for high-cost procedures and chronic disease management,” said Cunningham, in a written statement. “The market potential for coordinated care delivery and chronic disease management from a telemedicine platform is the next evolution of this technology.”

Last month, we reported on how , an Austin-based healthcare and life science-focused venture firm, had raised $250 million in its third fund.

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