Better care for women 65+

Kristen Helton, CEO of Herself Health—a network of clinics designed for women 65 and older—is addressing the often-overlooked health care needs of an underserved population. With a value-based care model that prioritizes patient outcomes and focuses on the community, Her Health aims to address the unique challenges faced by older women, who are statistically more likely to be misdiagnosed or excluded from traditional health care systems. It has raised $70 million in venture capital.

Overlooked and Underserved: Women 65+ A Health Care Opportunity

Herself Health is a network of clinics offering health care services designed for women age 65+ and has a goal of serving the 32.5 million women 65 and older in the U.S. Juxtapose, an entrepreneurial studio, which developed the concept, conducted user research, recruited Kristen Helton as founding CEO in 2022, and invested in the company.

The company is based in the Twin Cities, Minnesota, and has since expanded to four locations, and in November it will be five. Health itself has over 100 employees serving over 6,000 patients. Helton, who also founded Profusa, a biosensor company, after developing product for Amazon Care, a digital health company, believes the traditional health care model is failing women, especially as they age.

“When you talk to women 65 and older, they say things like, ‘I don’t feel heard, I don’t feel heard, I’m invisible, my doctor doesn’t believe me,'” sighs Helton. I’ve heard that I have to live alone with this.”

Instead, “I loved the time and attention I got,” said Kimberly Lieb, a HerHealth patient. Nothing was rushed, and I felt heard and understood.”

Indeed, statistics support this claim. According to Deloitte, women’s health represents just 2% of the $41.2 billion in venture funding for health care companies in 2023. The Health Growth Network and Blue Cross and Blue Shield of Minnesota contract in Supporting stronger health for older women The report says women are four times more likely than men to be diagnosed with osteoporosis, three times more likely than men to have autoimmune disease, twice as likely to be diagnosed with Alzheimer’s and 33% more likely to was misdiagnosed as men.

Most people in the United States pay a fee for a health care service. Health itself uses a value-based business model. Value-based healthcare is a delivery model that prioritizes patient outcomes and overall value as central metrics of success. Unlike the traditional fee-for-service model, where providers are paid for each individual service, value-based care rewards providers for achieving positive patient outcomes and improving the quality of care.

This shift in focus fosters a more holistic, patient-centered approach, promoting preventive care, care coordination, and patient engagement in treatment decisions. Emphasizing value over volume, value-based healthcare aims to deliver the best possible outcomes for patients at the lowest possible cost, leading to a more efficient and effective healthcare system.

Self Health and Blue Cross and Blue Shield of Minnesota recently revised their contract to improve health care outcomes for older women in the Twin Cities by moving to a value-based care model. This means prioritizing preventive care and effective management of conditions to improve health and reduce costs for patients.

Herself Health’s value-based care system allows for more time with patients, allowing providers to focus on prevention. In addition, the company has community rooms at all four of its locations where they hold events such as book clubs and speaker series to help combat social isolation and loneliness.

In addition to its health, other companies are focused on the elderly. Devoted health and the modern age provide health services for all the elderly and the Pope provides companionship for all the elderly.

Health itself has raised $70 million in venture capital, including a recently closed $37 million Series B round. “Despite all the recent innovations in women’s health, there is still a huge unmet need for older women,” Andy Stein, Partner, Juxtapose. “They’re not getting the care or the experience they deserve, and they know it. Kristen and her team are building something truly unique for these women, and it’s been incredible to see the response.”

Navigating Regulatory Uncertainty: The Medicare Advantage

Self Health relies on Medicare Advantage programs to link incentives and support the additional work they do outside of traditional fee-for-service visits. Medicare Advantage plans allow Herself Health to pay for additional services that focus on prevention and keeping patients out of high-cost care settings. By partnering with Medicare Advantage plans, Herself Health can offer services like same-day appointments, longer visits and preventive care that aren’t typically covered by traditional fee-for-service models. This focus on prevention and value-based care aligns with Herself Health’s mission to provide personalized, preventative health care for women 65 and older.

However, relying on Medicare Advantage also presents challenges. Self Health must scale quickly to attract payers and acquire enough patients to make the value-based care model financially viable. This growth requires significant upfront investment, and the company must balance its growth goals with the need to secure contracts and generate revenue.

In addition, the Medicare Advantage landscape is subject to regulatory change and political uncertainty, particularly during presidential elections. Health itself must overcome these uncertainties by staying true to its mission and avoiding any questionable practices that could jeopardize its reputation or long-term success.

Fight stress with community

Personal challenges have recently taken a toll on Helton. Whether it’s suicide or substance abuse, when people have behavioral health challenges, it affects the people around them. It’s a challenge not just for Helton, but for many women. “It’s an incredible amount of stress and responsibility,” she explained. It can affect your health. “Seeing people in need is taxing; it is also motivating. What I have in my life and what I see in our patients is to surround yourself with people who lift you up.” Counteracts stress.

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