Healthcare startup Equip has tapped former Get Well executive Nikia Bergan as its first-ever president to shepherd the company through its next growth phase.
Equip, a provider of virtual, evidence-based eating disorder treatment, expanded to all 50 states in 2022 to keep pace with the rising demand for services.
An estimated 5 million Americans develop eating disorders each year, and that number has risen since the start of the pandemic. But only about 20% of those people receive treatment, with even fewer gaining access to evidence-based therapies.
Eating disorders, impacting nearly one in 10 Americans, are mental health illnesses with serious physical health implications and have the second highest mortality rate of all mental health disorders, following opioid addiction.
"What I love about Equip is that it's using tech and services to provide actual clinical care to patients. That was really meaningful to me. We have some lived experience in our family with individuals who struggled to find access to high-quality, affordable care for eating disorders. So it touched my heart in a way that some other opportunities didn't," Bergan said in an exclusive interview.
She added, "Having seen firsthand how under-diagnosed and misdiagnosed eating disorders are, and, when they are correctly diagnosed, how hard it is for people and families to find care that works. You're often trying to coordinate between multiple specialists, some are covered by your plan, some aren't. I think because eating disorders present somewhat uniquely as both medical and psychological conditions, the care navigation for the families is even more complex."
Virtual care technology can solve for many of the access and logistical challenges of getting care, she noted. "We can craft care teams because they can all be virtual and we can have parents and kids on the same call with dietitians, therapists and psychiatrists because we're all virtual. We can do this on a schedule that works for everybody."
Bergan will report to co-founder and CEO Kristina Saffran and will also serve as an observer on the company’s board of directors.
While at the Advisory Board, Bergan says she took a deep dive into business operations while working at Get Well brought her closer to the patient navigation space.
"When I was contemplating what my next step was going to be, I really wanted to move even a step closer to the frontlines of care," she said.
Bergan plans to use her business operations acumen to help Equip scale up its treatment model boosted by its rapid growth in the past two years.
"The company has experienced amazing growth, and through that, they have been able to serve more kids and families. I think the biggest opportunity for Equip is how do we think now about sustainable growth. They've developed a treatment model that delivers consistent results that can be applied to people with different types of conditions at different stages of their disease. And so now the question becomes, 'How do you continue to double in size, but do that in a way that is more efficient, more sustainable and ensures that you're always protecting the patient experience and patient outcomes?'" Bergan said.
In 2019, Saffran teamed up with clinical psychologist and researcher Erin Parks, Ph.D., to launch Equip as an all-virtual center for family-based treatment. Parks and Saffran both have backgrounds in research and academia but Saffran also brought lived experience. She recovered from anorexia as a teenager and founded nonprofit Project Heal at the age of 15 to help open up access to eating disorder treatments.
Parks and Saffran developed Equip with a focus on family-based treatment, a leading outpatient therapy for adolescents with eating disorders that’s been shown to reduce the chance of relapse by including parents in their child’s road to recovery.
The company provides families with a five-person dedicated care team, including a peer and family mentor, a medical physician (psychiatrist, primary care physician or pediatrician), a therapist and a dietician. Equip’s fully virtual platform allows families to arrange treatment to fit their schedules and needs.
Saffran says Equip is now the largest eating disorder treatment provider in the country and has doubled down on working with health insurers. The company now works with more than 15 major health insurance plans.
"Right now, 115 million Americans have full access to coverage to Equip through their network benefits, which is a little over a third of the country," she said. "We've scaled from tens to thousands of families across the country."
The company's headcount has grown 10x in the past two years.
The San Diego-based company has raised $75 million to date, most recently banking a $58 million series B round last year, backed by the Chernin Group, Tiger Global, General Catalyst, F-Prime Capital, Optum Ventures and .406 Ventures.
The startup's strong momentum is driven by 300% growth in both patient admissions and inquiries in 2022 compared to 2021 and a 250% year-over-year run rate, according to the company.
"There is this tension between the need to scale as rapidly as possible as somebody is literally dying every 52 minutes of an eating disorder. We need to move quickly. But we cannot sacrifice clinical quality at all or patient experience," Saffran said in an interview. "That's a fine tightrope to walk. I think we've been so successful because we've had such strong continued clinical quality and patient experience."
Bergan has the right business experience to help shepherd Equip through its next chapter with an eye toward sustainable growth and a path to profitability, Saffran noted.
"She has scaled a healthcare services company, as a president, working with a founder CEO; she's seen the growth that we are experiencing today. She's also seen two, three, four chapters ahead. To find somebody who has all that plus lived experience, who really cares about this issue, just is almost too good to be true," she said.
Saffran added, "I want to be spending the majority of my time externally continuing to sell payers, work with health systems and change the cultural conversation. We wanted a thought partner who has really 'been there, done that' from an operational perspective to help guide the team and our growth."
With a focus on making evidence-based approaches more accessible, Equip was built to be an all-virtual provider, even before the COVID-19 pandemic hit. Equip's data indicates that its virtual-based care model with a family-based treatment approach is an effective way to help patients recover from eating disorders.
The company reports that 92% of its patients are getting better. After eight weeks of treatment, 8 in 10 patients report a reduction in eating disorder behaviors and 73% of patients report improvements in depression or anxiety. Three out of four parents feel more confident caring for their child and 85% of families are highly satisfied with Equip.
What's more, 83% of patients needing weight restoration are gaining weight and 88% of families are still in treatment by week 8, and over half stay for a full year, according to Equip's data.
Equip's virtual services are filling a huge gap in the market as 25% of Equip patients live more than 20 miles from an eating disorder treatment facility.
"People struggle to find a good treatment team in New York City or San Francisco, let alone anywhere else. Three years of seeing families and we think [virtual] is the right approach for eating disorders. For one reason, eating disorder symptoms don't occur just at 2 pm on a Tuesday when you have an appointment with your doctor, these symptoms occur all the time. Our whole treatment philosophy is about delivering the right amount of care in the moment when folks need it," Saffran said.
In a separate interview, Bergan added, "Equip sits in this unique space because of the medical and psychological components of this. In some cases, we'll actually be able to provide better care in a more sustainable way virtually. I think those are the companies that are going to be the winners in this space, where you actually solve a treatment challenge uniquely using virtual care."
As 30 million Americans struggle with eating disorders every day, according to the National Eating Disorders Association, there is increased awareness among payers and health systems to step up efforts to address the condition.
"There's definitely growing awareness of the need for evidence-based approaches, and I think particularly what's been exciting for me is there also has been growing awareness in the Medicaid space," she said. "When I had these conversations two years ago, the general response was, "Not our problem, not our population.' Now, it's a very different tune. They say, 'There is a huge need in this space. These kids are cycling in and out of the emergency room.' I think some of the stigma reduction efforts that the field has been doing are really starting to pay off."
Looking ahead, the next big step for Equip will be expanding its services to adults along with adolescents and families.