Healthcare costs don't seem to have anywhere to go but up — unless employers are prepared to invest in plans and programs designed to
For Ellen Rudolph, co-founder and CEO of virtual care platform
"Autoimmune patients are a top cost driver for every employer we work with," says Rudolph. "They drive about 30% of total pharmacy spend and 50% of specialty spend for a typical employer. We wanted to create a solution that would really be a win-win for the patient and the employer."
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WellTheory just launched their Hormonal Health Program, which is a benefit designed to support women navigating hormonal imbalances or conditions like polycystic ovary syndrome (PCOS), endometriosis, hypothyroidism and menopause. While these conditions aren't autoimmune in nature, Rudolph couldn't ignore the connection between immune system dysregulation and hormone imbalances, two conditions that disproportionately affect women. In fact, four in five autoimmune patients are women, according to Stanford Medicine, while studies estimate that up to 80% of women experience hormonal imbalances in their lifetimes.
"Before I was diagnosed with an autoimmune disease, I was actually first diagnosed with PCOS," says Rudolph. "No one ever explained to me that my hormonal imbalance could actually influence my immune system or increase my risk for autoimmune conditions. So I spent many years navigating unexplained symptoms like chronic fatigue, brain fog and digestive issues without any answers."
WellTheory's program includes a root cause assessment paired with advanced hormonal testing to identify what the patient is struggling with. Then members are matched with a care team, including a registered dietician, board-certified health coach and care coordinator, who creates a personalized plan designed to reduce symptoms and lower healthcare spend.
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"The plan includes evidence-based nutritional guidance, practitioner grade supplements that are tailored to them and targeted lifestyle interventions," says Rudolph. "For example, for a PCOS patient, we might recommend that they go through our blood sugar balance course because we know there's a strong correlation between PCOS and insulin resistance, or the inability to manage blood sugar levels effectively."
From there, members track their symptoms so their care team can see if there's any progress or if the care plan needs to be revised. Members can also message or video call their team with any concerns.
"There are millions of women in the U.S. who are affected by hormonal conditions like PCOS or endometriosis, which are unfortunately often misunderstood, dismissed or treated in isolation," says Rudolph. "You don't need to look sick to be sick — and when employees are suffering in silence, dealing with debilitating symptoms, they can't show up as their best selves to work."
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Rudolph challenges employers to investigate what conditions among their employees drive their healthcare costs, and consider whether their current benefits help employees seek and afford care to manage said conditions. She stresses that prevention and management save employers and employees money in the long run. And in a healthcare system where there are no guard rails on costs, it's more crucial than ever for employers to have a healthy workforce.
"[Autoimmune patients] are an expensive patient population," says Rudolph. "We have flare-ups that lead to the ER, we're accessing specialty care and medical procedures more often. Get a holistic view of your data and understand which conditions might be disproportionately impacting your population and bottom line."
