Telehealth in tech-enabled maternal care models

By Tracy Massel, Randi Seigel 

Since the pandemic many tech-enabled clinical models received attention and funding – with women’s health capturing $1.16B or ~13% of digital health funding in 2022. As all startups need to evolve based on market feedback – given the massive shifts in care modalities over the last few years, we wanted to provide an overview for how three startups focused on maternal care are incorporating telehealth into their models. It’s worth noting that before the pandemic a handful of medical centers had begun testing and incorporating telemedicine into their standard of care for maternal health. Despite those early adopters, ~99.9% of pregnancy-related care occurred in person before the pandemic. 

To learn more about the landscape of telehealth in maternal care today, we spoke with leaders from Zaya, Oula, and Millie to understand their care models and telehealth priorities. The thesis and business models across these three organizations vary from creating a network of wraparound maternal care services who accept insurance, such as lactation consultants, mental health, pelvic floor therapy, and nutrition services (Zaya), to prenatal clinical organizations built on OB / midwife collaborative care models that include wrap around services and patient education (Oula and Millie). 

When considering telehealth, maternity care is particularly interesting because there are services that must be in-person (e.g. pelvic exams, ultrasounds, delivery). At the same time, services that traditionally were considered only in-person, such as lactation consultation, have been shifting successfully (to the surprise of many) to a more virtual model. Across these organizations, the founders estimate that close to 100% of patients engage virtually in some capacity (e.g. at least one virtual visit, asynchronous communication, group education sessions, etc.) and that ~30-50% of interactions are taking place virtually depending on the model, the patient and the practitioner. 

For this set of patients virtual care has been a win in terms of convenience. It allows both partners to more easily join appointments and group education sessions, it allows the patients to reduce the amount of travel with their “bump or newborn” and can improve access by reducing friction where there are childcare or transportation issues. In addition, the increase in asynchronous communication and related tools has been a value add to both patients and providers – but has required additional operational support and response teams to ensure the main clinical provider is operating at the top of their license and isn’t overly burdened. 

Across the three organizations, the clinicians remain torn in terms of the value they place on virtual engagement. The thesis of many of these organizations – shaped in conjunction with their clinical leadership – is a higher touch model and being there for your patients when and where they need creates better maternal outcomes. Virtual care allows clinicians to do that and to be able to answer questions closer to real-time, but without a hybrid model there is still a concern about the lack of a relationship and the likelihood that patients won’t feel as comfortable asking questions. That said, the operational benefits are appreciated (not having to travel as much, maximizing time they can spend on care).  

The three areas this cohort expects to evolve over the next three years are (1) an increase in Remote Physiological Monitoring – particularly as they evolve to work with riskier patient populations and the technology continues to mature (2) more group care / education settings and (3) creating personalized care pathways that combine in-person and virtual services specific to the risk profile and needs of the patient.

While these organizations are largely focused on commercial patients today – with a small amount of Medicaid mixed in – maturing the effectiveness and capacity to leverage telehealth is only becoming more relevant and important. Against a national landscape of closing maternity wards and a dwindling pipeline of OBGYNs, additional access and ease of access to care are imperative – particularly for Medicaid beneficiaries and persons residing rural communities. To support this expansion of services, ensuring that revenue models support providers and patients appropriately and addressing the digital divide must remain a key focus. 

Learn more about Manatt’s work on across the Healthcare spectrum – with particular foci on  Reproductive Health and Digital Health on our site.