Primary care and women's health company Tia has big plans for 2025 as it aims to open more locations and partner with new health systems.
"We're excited about moving into a growth phase," Felicity Yost, Tia co-founder and CEO, said during an interview on the sidelines of the J.P. Morgan Healthcare Conference in San Francisco last week.
"The last couple of years, we've been focused on building up the model, getting the operational design in place and figuring out, how do we enable this care team-based system to work, how do we have the technology that supports that and what are the operational structures. Working with our health system partners, on that relationship dynamic, and seeing the fruits of all the labor come to fruition has been a huge focus for us," Yost said.
Tia, which integrates primary care with gynecology, mental health and wellness services, has inked a number of health system partnerships since launching in 2017. The company's first partnership was with CommonSpirit Health, which operates 137 hospitals and more than 1,000 clinics, to launch Tia-branded women's health clinics. The first brick-and-mortar clinic opened in October 2021 in Phoenix with planned expansions in Arizona and other CommonSpirit markets.
In 2022, it landed its second major health system collaboration with UCSF Health in San Francisco. UCSF Health is collaborating with Tia to develop a new network of clinically integrated clinics for women in the Bay Area.
A year later, Tia signed its largest health system partnership to date teaming up with Cedars-Sinai to open up clinics in the Los Angeles area. It now has seven clinics open in that market.
It also operates two clinics in New York City.
Tia now has the "blueprint" for working with health systems to expand access to primary care and women's health services, Yost noted.
"Now we're focused on, 'How do we start bringing this to more women?' Ultimately, our mission is to serve and help women become healthier, and by serving more women, we believe that we can do that. We're setting our sights on additional markets and doing additional JVs (joint ventures) with new health system partners is a big goal," she said.
Tia, which now serves 40,000 members, is looking to expand its footprint to Chicago, Boston and Atlanta. "We're excited about finding markets where health systems are looking to expand their primary care presence and there's a critical focus on women's care," Yost said.
As Tia eyes expansion, the company will look to fundraise in the near future, Yost noted.
Comprehensive primary care model drives better health outcomes
Tia's model, what it calls a "modern medical home for women," includes virtual and in-person services, fusing primary care, mental health and gynecological care with wellness services like acupuncture and skin care in one integrated experience.
And Tia's model helps to fill critical preventive care gaps with higher rates for cancer and mental health screenings among its patient populations and better chronic disease management, according to the company's latest outcomes report.
About 70% of Tia's members did not have a preventative exam in the 12 months prior to joining Tia, data shows. Once patients join Tia, they engage in preventative care at rates 2-3x the national average, according to the outcomes report, based on data from its 40,000 members.
"As we have grown and scaled to new markets and new clinics, we continue to really care for a group of patients that did not have access to healthcare before," Jessica Horwitz, a board-certified family nurse practitioner and Tia's chief clinical officer, told Fierce Healthcare during JPM.
A significant percentage of Tia's new patients are "medical orphans" and disconnected from the traditional healthcare system, she noted. More than 90% of Tia's patients were not engaged with a dominant health system in their geographic market before joining Tia.
"We have this really distinct, unique privilege to be able to care for these patients. We are outperforming the national average across preventative care and disease management," Horwitz said.
Among Tia patients, 83% are up-to-date on cervical cancer screenings, nearly 2.5x the national average of 36.4%, and 61% of Tia patients have been screened for chlamydia, nearly double the national average of 36%. For HIV screenings, 46% of Tia patients have undergone screening, compared to the 17.7% national average.
And many of these outcomes are building on efforts outlined in Tia's inaugural outcomes report released in October 2023.
The latest data shows that 62.3% of Tia patients with diabetes have their condition under control, achieving A1c levels under 8%, exceeding the national average of 53.8%.
Tia also prioritizes addressing mental health issues. Among Tia's patients, 88% were screened for depression, nearly double the national benchmark of 49%, and 73.5% of patients reported significant improvements in their quality of life, using the World Health Organization's Quality of Life scale.
These health outcomes are critical as women continue to be underserved in healthcare, Yost and Horwitz said.
In a 2022 KFF report, 29% of women reported feeling dismissed by their doctor during their most recent healthcare experience—among women ages 18-35, 46% said they experienced a negative interaction with a healthcare provider.
About 20% of U.S. women do not routinely see a primary care physician and 50% do not have regular visits with an OB/GYN, according to a 2022 survey.
Tia's first outcomes report proved its thesis that engaging women in preventative-focused primary care works to improve outcomes, executives said. The second report builds on those efforts.
Tia's model and approach to care is designed to build trust and engagement with women, Horwitz noted.
"One of Tia's cornerstones is, how do we bring people in who have largely not found their medical home prior to Tia, and engage them in care. That's everything from the physical spaces they get to be in, the relationship they build with our healthcare team and the multidisciplinary team that cares for them. That's not the norm in traditional settings," she said.
Tia also built a differentiated clinical model for clinicians, Horwitz contends. The company developed a culture of learning, growth, support and collaboration for its physicians, nurse practitioners, nurses and physician assistants, according to executives. Tia boasts a 97% retention rate of its clinicians year over year.
Data also shows ongoing healthcare disparities for women of color and LGBTQIA+ individuals with limited access to preventative services. The 2023 National Healthcare Quality and Disparities Report found that, on average, women of color were 55% less likely than white women to have equitable access to primary care services.
Tia has invested in collecting, tracking and reporting health quality data by race and ethnicity to ensure quality outcomes are equitable, executives said. According to its latest outcomes report, Tia achieved balanced performance outcomes across diverse race and ethnicity groups, surpassing industry benchmarks.
"A lot of big health systems and big health tech organizations will say, 'It's complicated to report on health equity because we don't actually know the demographics from the beginning.' So, we really wanted to push against that to be able to prove and hold ourselves accountable that we were not only delivering exceptional clinical quality outcomes, but we were doing it equitably across race and ethnicity," Horwitz said. "This is the first time we're publishing that data to be able to say that across the spectrum, we have very little difference in terms of performance across race and ethnicity. That's something that we are committed to from the stage we are today as we continue to grow next year and beyond."
Building strategic partnerships in key markets
As Tia looks to expand its footprint and services to more markets to serve more women, health system partnerships will play a key role. Health systems like Cedars-Sinai, UCSF Health and CommonSpirit provide specialty care services to Tia patients outside of primary care.
"What Tia does excellently is engage people in preventative care, engage people in really comprehensive primary care, inclusive of chronic disease management, diabetes, hypertension and mental health. But we're not building out specialty care. We're not building out cardiology," Horwitz said. "We have strategic partners in all of our markets that are that trusted referral source that we can send people to, and then, frankly, they can come back to us for ongoing management for diabetes."
A patient living with diabetes, for instance, is "co-managed" by an endocrinologist at a health system partner and a primary care provider at Tia.
Health systems are increasingly partnering with primary care organizations to extend their reach in the ambulatory space and fill gaps in care.
"They want us to be the front door of healthcare for them. They want us to do primary care really excellently, and then engage them when patients need an elevated level of care," Horwitz noted.
For health systems, partnering with Tia offers an opportunity to engage with younger women who have "fallen out" of the traditional healthcare system.
"They are coming to us for the demographic that we can engage," Yost said. "About 65% of our population is between 25 and 45 [years old], but this is a population that isn't actually getting healthcare from the healthcare system. They're using point solutions, or they're showing up in the urgent cares and those places aren't giving them this comprehensive preventive care. We're tapping into this medical orphan population."
Tia's clinical pathways can refer patients to specialists at health system partners and "pull them back" into the primary care setting. "That's great from a cost standpoint. We're not relying on specialists to do ongoing management for these chronic conditions. We've been able to really perfect and train our providers to be comprehensive in that way. No one's ever been as focused on quality in primary care as we have," Yost said.
Tia offers a hybrid model with both brick-and-mortar clinics and virtual care services. Its clinics are designed to be more modern and comfortable than a typical doctor's office. The waiting areas look more like a lounge-ready living room and the locations offer yoga classes and speaker events in communal spaces.
Many big healthcare players made strategic moves in the past four years to move more deeply into primary care and those companies, like Walgreens, Walmart and CVS, have faced major challenges.
To scale primary care, it's critical to engage patients and understand the demographics you're serving, Horwitz said.
"It's really challenging to have an ongoing relationship with a provider out of a drugstore. I think those models are incredible for convenience. But, if you have people that are under your umbrella and you're caring for them, but they're not engaging in care, it's a really challenging model to scale," she said.
Yost added, "Tia's model is about engagement, and in order to drive really good engagement, you need to know your demographic. The successful primary care models out there have been able to say, 'I'm going to hone this demographic, and I'm going to figure out what exactly it is that they need and what they want in their care journeys'."
Tia has built a "sticky model" that connects with women and the company has built out services to meet their needs, such as weight management and skin care, along with primary care, gynecology and mental health, she noted.
Last spring, Tia unveiled key leadership changes as it ramped up its focus on operations and expanding its clinics.
Co-founder Carolyn Witte, who served as CEO since the company's founding eight years ago, stepped down and Yost stepped into the CEO role.