In the US today, a silent epidemic rages beneath the surface, hidden in the struggle of more than 50 million Americans who navigate autoimmune disease. 80% of them are women, with certain conditions 16 times more common in women. For people of color, the picture is even graver with increased mortality rates. It’s compounded by the fact that the journey to diagnosis and healing is unjustifiably long, physically and emotionally painful, and downright expensive. 

‍Five different doctors and more than four and a half years. That’s what it typically takes to reach an autoimmune diagnosis in America. Once diagnosed, patients often grapple with both their debilitating symptoms and the new unwelcome side effects of medications that are often ineffective. Unfortunately, these stats are intensifying at an unprecedented rate. In the last 30 years, the prevalence of autoimmune diseases has more than doubled, making autoimmune conditions the third most common category of diseases in the nation, surpassing even Type 2 diabetes.

The Hidden (and Massive) Enterprise Cost

It's not just those with autoimmune diseases who bear the burden; self-funded employers and payers also shoulder enormous costs. Autoimmune conditions drive 50% of total specialty pharma spend—that’s $100+ billion, and it’s up 459% in just the past decade. In aggregate, these 80-100 conditions make up a top area of spend for employers and health plans. However, invisible illnesses often fly under the radar not only in the workplace but also in claims data. Productivity is taking a hit as well, with 78% of full-time workers reporting that their job performance has suffered as a result of their autoimmune disease. 

As autoimmune prevalence soars, unfortunately so will the financial toll of higher premiums and a growing number of expensive interventions.

It's time for a profound shift—one that goes beyond surface symptoms to address the root causes of autoimmune diseases. It's a transformation that WellTheory not only envisions but delivers on.

Our Direct-to-Consumer Beginnings

WellTheory has been deeply inspired by our personal journeys and the gaps in care that we’ve each experienced trying to navigate the medical system. When we started the company, our north star was to create the experience we wish we had earlier on in our own health journeys as autoimmune patients and caregivers. We wanted to build the ideal experience for consumers first without the perverse incentives that can oftentimes exist in healthcare, ultimately leaving consumers with clunky experiences that belong in past generations.

From day one, making this care more affordable and accessible has been central to our mission. To achieve that, we needed to prove that WellTheory works—and works at scale.

Since publicly launching WellTheory to consumers last year, our core focus has been two-fold:

1. Build an engaging experience that consumers love
2. Prove that our intervention works

In that time, we’ve achieved transformative results across our members, including:

• 84% experience a decrease in fatigue and 53% report a decrease in pain within 16 weeks
• 74% report an increase in overall life satisfaction within 20 weeks
• 24% reduction in high-cost specialty medication, with annual gross Rx savings of $11,000 per patient
• 85% decrease in ER and urgent care visits within 16 weeks
• 43% reduction in unnecessary specialty visits and outpatient care within 16 weeks
• 80% reduction in 2+ missed workdays per month

With decades of clinical research and peer-reviewed published papers backing our approach, we’ve been able to demonstrate that our evidence-based approach tackles the root causes of autoimmune disease and treats the whole person: reducing symptoms, improving quality of life, and lowering costs.

Our outcomes were proof: this model is the key to expanding access and fundamentally driving a paradigm shift in autoimmune care.

Now, we've thoughtfully packaged our evidence-based care model into a first-of-its-kind, single-point enterprise solution for addressing the 100+ autoimmune conditions. Today, employees, providers, payers, employers, and more, have access to a new and proven standard of autoimmune care they so desperately need.

Our Enterprise Solution

Our all-in-one enterprise offering features products and services tailored to the unique needs of health plans, employers, and ultimately employees to drive outcomes and reduce costs at scale. 

We deliver cost-effective, evidence-based interventions that manage, prevent, and reverse the symptoms that keep employees sick and costs skyrocketing. 

Our goal is to seamlessly integrate into an enterprise’s existing ecosystem and embed within their network of providers, carriers, and other benefits to support a streamlined member experience.

Here’s an at-a-glance look at our solution:

• A Root Cause Care Approach: Our proprietary care model focuses on identifying and addressing underlying root causes that may contribute to a member’s most severe autoimmune symptoms. We dive deep to discover the origins of illness through qualitative assessments and advanced testing with an emphasis on fixing issues at their core rather than simply masking symptoms.
• A Collaborative Care Team: Members partner with a dedicated care team of autoimmune experts, including licensed registered dietitians, board-certified health coaches, and care coordinators who specialize in autoimmune disease. This approach aims to complement the member's existing care team, bridging gaps between doctor visits to improve long-term health outcomes.
• Tailored 360-degree Care: Our whole-person approach addresses the key factors that determine 80% of an employee’s health—personalized nutrition, sleep hygiene, stress management, movement, and daily habits—to improve quality of life long-term and reduce reliance on costly medical interventions. 
• High-Touch Ongoing Guidance: Members receive access to live 1:1 video sessions and unlimited messaging with our expert Care Team for longitudinal care. We empower members in between their live calls with asynchronous educational content and masterclasses.‍
• Community Connection and Support: Within a year of their autoimmune diagnosis, 52% of patients also receive a mental health diagnosis. Recognizing the connection between physical and mental well-being, we provide members with a range of tools and resources, including events, "office hours," and digital forums, to ensure they feel supported and stay connected within WellTheory's extensive network of like-minded members.

Collectively Reversing the Autoimmune Epidemic

To truly redefine the standard for autoimmune care, we must extend access throughout the entire healthcare landscape. It not only involves partnering with payers and employers but also expanding our team with stakeholders who share our eagerness to challenge the status quo.

As we kick off these partnerships to provide WellTheory as a covered benefit, it was critical to assemble an exceptional team of commercial advisors to support us on this journey. We're thrilled to introduce six esteemed advisors to our commercial board, all of whom possess a profound personal connection to the space WellTheory is addressing. Meet the team helping us expedite and expand enterprise access to our solution:

• Randy Forman: Chief Commercial Officer at Oshi Health, formerly the Chief Commercial Officer at Path Mental Health and Vida Health. He played a pivotal role in the launch of Livongo as their first commercial hire.
• Adina Safer: Former Vice President at CVS Health, who spent more than a decade in specialty pharmacy, working closely with payers and providers to implement products and programming to address autoimmune conditions.
• Greg Armer: 40-year healthcare veteran who co-created the first U.S. behavioral health insurance company. He also previously led sales and marketing at Anthem, PacifiCare, and Cigna.
• Ellen Meza: HR leader with over 20 years of experience in employee benefits, well-being, and operations at DocuSign, Stripe, Twitter, and more.
• Hassan Azar: Employer Health Innovation Roundtable (EHIR) advisor and former HR executive at US Foods, Kraft, Mondelez, and Ford Motor Company. ‍
• Brynn Bannach: Sales executive at Hinge Health and formerly at StayWell (now WebMD Health Services), where she spearheaded modern and cost-effective employer and payer solutions for care delivery.

What’s Next

The economic and social impact of the current approach to autoimmune care is staggering. We've seen it. We've felt it. We've been fervently advocating for change. And now, that call for transformation is resonating louder than ever with forward-thinking employers and visionary payers. We’re underway working with leading companies across industries to implement WellTheory as a covered benefit (we’ll have more to share soon!), and look forward to partnering with many more. 

Thank you for your continued support on this journey, and if you’re new here and want to learn more about our enterprise solution, please visit www.welltheory.com/for-businesses.

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Ellen, Claire, and Wallace 

WellTheory’s Founders