Find the Metric That Matters for Your Moat, and Other Healthcare Advice from Tia’s Carolyn Witte

Tia is a great case study in just how fast telehealth is moving. It started in 2017 as a texting service for women’s healthcare questions—and its users soon signaled they wanted more. “They'd ask us a question about birth control or UTI. Next thing you know, they're like, ’Can you prescribe me this? Can you diagnose me with that?’” Cofounder Carolyn Witte says. “The answer was, ‘No, we can't, not until we become the doctor.’"

Which they soon did. “We saw this enormous opportunity to deliver care differently and create a new model for women’s healthcare” Carolyn says. “The easier path, in many ways, would have been to become a telehealth provider, but in those days (i.e. pre-COVID) insurance didn’t cover telehealth—and well, you can’t really do pap smears over the internet. 

So they launched the Tia clinic in New York City in 2019. “We still had chat and clinical triage, we were definitely a tech company. But in terms of revenue and services, a hundred percent of our services were delivered in person.”

Now that COVID has opened up telehealth as a much more billable norm, 60% of Tia’s services are delivered virtually. “We have the leading virtually-integrated women's health care platform in the space,” Carolyn says, “and that's really what I believe is the future of virtual care telehealth: right place, right care, right time, right provider, right cost in platforms that can connect all those moments in between.”

The Tia team’s success comes from connecting all the available dots in any given iteration of the healthcare landscape. “Every problem in healthcare, the root of it is misaligned incentives. If you can build a product and a business that aligns incentives, like Tia does, between consumers, payers, providers, and employers, everybody wins. And so we just decided to tackle that from the get-go. We are decidedly anti-fragmentation, and I think with the rise of so many new companies and products and services, in certain regards they're increasing access, but in other ways they're exacerbating fragmentation. It can, at times, make it harder for patients to get really good care when you're trying to piece together a bunch of disconnected point solutions. We need platforms like Tia that connect the dots to really address that."

All along the way, through fast-changing norms and opportunities in healthcare, the Tia team has kept a close eye on the metrics that demonstrate they can take on primary care—and win. 

“Deciding what metrics matter most for your business is one of the hardest things,” Carolyn says. “For us, highest-level, it was: Prove that women want this experience. Could we acquire members faster and cheaper than everybody else? Then, prove that we could deliver an experience that would just stand out. And that was an NPS. And then third was proving that we could completely overhaul the economics of a primary care practice.” 

“It was really demand, NPS, and economics, and then we could make primary care, which is traditionally a loss-seeing business, profitable. Being close to that and having a clear line of sight was really important to prove that a business not traditionally thought of as venture scale could be venture scale.”

But those guidelines won’t be the same for every business in this space. “At the end of the day, Tia is a relationship company, not a healthcare company, in the business of acquiring, engaging, retaining, and routing women across the entire healthcare ecosystem. So for us, building a direct-to-consumer brand is an important thing. But for another healthcare services company that maybe sells into a payer, that doesn't matter at all. It's irrelevant.” 

“The biggest thing is figuring out the metric that actually matters for the moat that you're selling. Why is this going to be more differentiated than anything else? And then what's the comp in the market for that? There are so many metrics that you could track, but what are the metrics that matter most for your business? And then how do you give an investor a mental model to compare that?”

See a deeper dive on our new digital publication, First Edition.