(01:26) Insights into the growth of FemTech and the focus on women in healthcare organizations

(07:08) Healthcare technology investments and the plethora of opportunities in the FemTech space

(09:34) Funding challenges in the FemTech space highlighting the need for more female investors

(19:21) AI in FemTech and how different sized companies are using it

(25:16) Marketing strategies for FemTech companies, emphasizing the need for a solid brand identity and messaging

(26:12) How much should be budgeted to marketing and PR

(36:33) How having outcome and ROI can reduce the need for significant marketing dollars

(37:28) How the current market focuses on access and anticipates a shift toward comparing outcomes and costs

(38:54) The societal implications of FemTech, particularly in understanding conditions that impact men and women differently

(44:29) Insights into successfully selling FemTech companies

(46:52) Leigh Ann, Shelly, and Margaret share what their favorite form of media is along with what they are currently reading

[00:00:04.410] – Kriste Goad

Hello, curious marketers! I’m stoked about today’s podcast because we’re doing something a little different. We have an entire panel of guests. Three powerful and kick-ass women are joining me, and we’re going to be talking about FemTech and its recent surge. I cannot wait to dive into this trending topic. We’re also going to talk about the impact of AI and FemTech as part of our wider AI series, as well as how this sector is being disrupted, the power of branding, marketing and pr, for new entrants as well as established players. A lot to cover today. Joining me are Leigh Ann Ruggles, an executive healthcare leader with expertise in building commercial organizations to drive business growth and market share. Leigh Ann has a strong background across the entire client life cycle, from revenue acquisition to retaining and growing market share with deep expertise in all facets of go to market functions. Leigh Ann most recently served as chief commercial officer at Guidewell Venture Group, which is the diversified business arm of Florida Blue.

[00:01:26.330] – Kriste Goad

She has also led sales at companies such as Onlife Health, MD Live and Verizon Mobile Health. Also with us today is Shelley Lanning. Shelley is currently the co-founder and president of Visana Health, a virtual women’s medical clinic available in all 50 states, treating dozens of women’s health conditions from menstruation to menopause. Shelley has spent more than two decades working in healthcare as both an investor and an operator, with a focus on companies that combine an innovative care model, a digital tech enabled platform, and a topic of significant passion. Our third guest is Margaret Malone. Margaret is a principal at Flare Capital Partners, one of the largest investors dedicated to healthcare technology. Partnering with entrepreneurs to improve outcomes and reduce costs, Margaret led the firm’s investments in Visana Health, Darby, docent, frame and Vivacare, and supported investments in Rightmove, inbound health, author Health, Eden Health, and Oshi Health. Before joining Flare Capital, Margaret partnered with entrepreneurs and investors to build executive teams at Oxion Partners. Margaret began her career as a clinical operations consultant with Huron Consulting Group. Welcome to the show ladies.

[00:02:44.730] – Leigh Ann Ruggles

Thanks for having us.

[00:02:45.800] – Kriste Goad

That was a lot because you guys have very impressive resumes. Let’s kick things off with Leigh Ann. Can you tell us a little bit about yourself and a little bit about how this topic of FemTech and FemHealth is impacting the healthcare industry.

[00:03:02.810] – Leigh Ann Ruggles

Yeah. So I think myself, you covered it in your beautiful introduction, really sort of owning the go to market function and digital health companies. And I really enjoy helping companies grow. And because of that, I’ve paid a lot of attention to FemTech just because there’s so much of it these days. You know, one of the things that I think is really cool about FemTech is that the really smart healthcare organizations are aiming their focus at these FemTech companies because they want to make sure that they are being responsive to the people that decide where the healthcare dollars go. And that’s really women. Right. So I think that people are starting to realize that there’s really kind of a renaissance going on in that. I actually, as I was preparing for this podcast, I just saw that just a couple of weeks ago, Blue Cross Massachusetts announced a whole new reproductive healthcare team, focused very much on supporting women across their entire life journey. And I thought that was great and a great sign of sort of where FemTech has really made a place for it. And I have to say, you notice that came just a year after Blue Cross of Massachusetts appointed their very first female CEO.

[00:04:10.550] – Leigh Ann Ruggles

So I think she really understands where the healthcare dollars go. So that’s one of the reasons I’m excited to watch it. Thanks for having me.

[00:04:16.100] – Kriste Goad

Thanks. Probably not a coincidence there. Shelly, let me ask you, tell us a little bit about yourself and what makes Visansa different from other women’s health companies.

[00:04:26.020] – Shelly Lanning

Well, I’ve spent my entire career working in healthcare as both an operator and as an investor. I have a real passion for early stage, where people can take ideas, germinate, find white spaces in the market, and be able to create something that has real value. And by spending time with, then building, growing, nurturing the company, and getting them to a point of commercialization to where now you’re showing, is there a there there… can you then grow it in a way that you can then make money? So I started investing in women’s health in 2018. I first made an investment in a spin out from the Mayo Clinic in fetal and maternal medicine. And then in 2020, I made an investment that spun out of Weill Cornell and All Medical and obesity management. And then I made another one in 2021, in fertility. And then I saw Visana in 2021. I liked that they were looking to be a real clinical model that could address women’s health conditions that fell outside of family building. So the complex common conditions, endometriosis, uterine fibroids, chronic pelvic pain, heavy menstrual bleeding. And we ran a pilot with a national health plan and enrolled women from all sorts of different conditions.

[00:05:43.270] – Shelly Lanning

And it was really clear that having a medical model based on evidence-based medicine, whole-person care that’s heavily coordinated with in-person brick-and-mortar care, can produce superior outcomes and provide a new and innovative model that women haven’t had available to them to date.

[00:06:02.290] – Kriste Goad

That is so exciting. I love the evolution of the story you just told, and it’s always so interesting how these different service models evolve out of existing. You mentioned obesity and evolution so often.

[00:06:17.950] – Shelly Lanning

It matches what we’re doing with our lives.

[00:06:20.220] – Leigh Ann Ruggles

Right?

[00:06:20.490] – Shelly Lanning

You get pregnant, or you try to get pregnant and you start focusing on areas that otherwise you just never paid attention to. And where Visana was really interesting is you get past that baby building stage of your life and you realize that there’s nobody focusing on anything in women’s health. Until just recently, we just never even talked about it. So it’s been really interesting to see the whole environment of women’s health just blossom with lots of new opportunities.

[00:06:50.750] – Kriste Goad

Here here. Margaret, I would love for you to jump in and introduce yourself and either comment on what has been stated already by Leigh Ann and Shelly as part of their introductions, but also just talk about what you’re seeing in the overall FemTech space and what trends you’re seeing.

[00:07:08.730] – Margaret Malone

Yeah, well, it’s great to be here. Thanks for having all of us very much excited to be part of this conversation, especially, I think since March is Women’s Health month, so timely conversation on that front, too.

[00:07:19.660] – Kriste Goad

Nice call out Margaret.

[00:07:24.750] – Margaret Malone

Totally. So I have the great privilege, as you alluded to in your introduction, of working with the Visana team and a handful of other companies as part of my role at Flare. And I’d say why I’m excited about this space, there’s just enormous opportunity. White space that still exists in women’s health. Just about 10% of our portfolio is dedicated to women’s health companies. Some of them, I’d say, that market themselves as women health companies, and others that are addressing needs or solutions around diseases that disproportionately impact women, which I think continues to be significant opportunity as we think about the funding landscape, agree with many of the comments that Leigh Ann and Shelly already kind of discussed, but maybe a couple of thoughts just on the funding landscape. So I think we’ll get into this in the conversation, but there’s certainly some headwinds and tailwinds that I think that impact this space. There’s a myriad of obstacles that I’d say FemTech startups are navigating. There is the quote unuote “crowded market” that exists. I think that is also largely driven because of the kind of misunderstanding or still kind of early in our understanding around disease progression as well, and access.

[00:08:40.660] – Margaret Malone

But there’s certainly skepticism that still exists around kind of the long-term opportunity. Here are these point solutions, solving niche pain points, small population size, that I cringe with all of that, but I think it’s influenced by it being an emerging market in terms of funding. And we’ve certainly seen funding increase, and I think it slowed down at times. But I continue to be bullish, and I’m hopeful that part of the challenge with increasing funding in this space is getting more women into GP seats. And I think the more gps we can have that are women, and being able to write large checks into these companies will just give rise to increased funding in this space. So those are just some additional thoughts, and happy to double click on any part of that.

[00:09:34.040] – Kriste Goad

I think that’s all fascinating. And your cringe moment of saying that women and women’s health is a small or a niche population, it is cringeworthy. Shelly, I’m curious, in the new, FemTech women’s health movement, is this a moment in time, or do you think this is here to stay?

[00:09:54.060] – Shelly Lanning

I don’t think the emphasis or the focus on women’s health is the moment in time in that, we just have such a lack of information and data. For years, forever, people thought that men equal humanity, that people thought of women as an offshoot of a man. Even our ovaries were thought of as testicles that were located on the inside, and our uterus was a scrotum that was on the inside. And for many, many years, we were not included in clinical trials. And maybe for good reason. Some of the work that drugs that were used on women in the 60s resulted in deformed babies. And the FDA took a really strong stance to say, let’s not have women of child possibility, childbearing possibility, produce or participate. And as a result, there’s this whole multi, multi decades where women were not included. So how do drugs impact us? How do disease progression, diagnostic treatment outcomes were never measured for women. So now people are paying attention, and I don’t believe it will go away because there’s a lot of research, there’s a lot of energy. But as it relates to an investment category, I think the jury is still out.

[00:11:08.950] – Shelly Lanning

People need to show that these are successful businesses that can attract and retain customers have real outcomes, show that there’s a business model around them in order to continue to attract and retain investment dollars.

[00:11:25.870] – Kriste Goad

Well, Shelley, I mean, the whole clinical trial thing that you brought up is just kind of mind blowing. Yeah, definitely. You know, hope we continue to educate, get more data, turn that corner. But in terms of your other points about early on in investments and where those are going to go, and the ability of companies to show there’s a there and to show the business model, Margaret or Leigh Ann, could you speak to that?

[00:11:53.430] – Leigh Ann Ruggles

Yeah, I’ll take it. And then. Certainly would love Margaret’s opinions as well. Some people would say that there’s a taboo, and actually, I think Margaret would agree with that. I would disagree with it. But maybe I’m just so hyped on this space that I think that everybody should be interested in it now. But I think part of the challenge is the disconnect between the founders and the investors. Right. So, to Shelley’s point, women weren’t included in clinical trials until really more recently. And I would say the same thing of investors. Right. So maybe twelve to 15% of investors are, in fact, female. Clearly, Margaret and Shelley are two of them, which is one of the reasons I love talking to them. But.

[00:12:30.350] – Kriste Goad

Go, ladies.

[00:12:31.350] – Leigh Ann Ruggles

Yeah, but if you think about it, right, when you’re pitching a company, part of what makes a successful pitch is that you have to have a personal understanding of the product. Right. So if I’m pitching a FemTech company, but I’m pitching to a male, there’s no way he could possibly understand what’s actually doing. And so, given that most investors are male, I think that that is part of the reason that there’s a lack of funding. I personally think there’s a second dynamic at play, and I think that women tend to be more transparent and maybe a little bit more honest. Not that I’m calling men dishonest, but I think that women’s style is to be very transparent about what they think and conservative. Right. And so, in my view, there probably are women who are founders who are going to get funding, and they’re probably being very humble about what they think they can do. That being said, I think that investors are frequently used to people who tend to maybe overstate what they think they can do or be very ambitious about that, and that, unfortunately, is not necessarily a female trait. So I would say both of those probably play into the lack of funding for it, just in my opinion.

[00:13:35.240] – Leigh Ann Ruggles

But, Margaret, would you add anything?

[00:13:36.790] – Margaret Malone

Yeah, maybe a couple of thoughts. So I think Shelley raises a good point around the business model, and I think what we’ve seen in women’s health is that the ROI to date has largely been kind of soft. ROI has been more qualitative rather than quantitative, specifically as health plans. And I’d say employers look to understand what a one year ROI is for their vendors. It’s just increasingly difficult when there’s just not a lot of data that exists in this market today. So as we think about kind of where the traction has been to date, I think maternity has kind of led the path in women’s health. And I think it’s because there’s been more clarity around that hard ROI. There’s a pregnancy, there are outcomes associated with that pregnancy, there are costs associated with that pregnancy, and that’s very, not easy, but it is easier to quantify than perhaps conditions that may be more longitudinal in nature and just require more time. But I do think startups, and I’ll pick on Visana, I think they’ve done a really excellent job of crafting that hard ROI story at such an early stage. But I think there’s kind of a phase approach.

[00:14:57.570] – Margaret Malone

Companies and buyers will focus on access to start, and then once they have access solved, it’ll shift towards outcomes and cost. And ultimately, I think the companies that can show signals of movement around cost, outcomes, quality and access and experience, too, I think, are going to be the ones that win. And I do tend to agree with, or disagree, I should say, with Leigh Ann and the taboo and stigma in this market. I do think that there are still communities, populations, pockets of people that we’re still trying to kind of remove the taboo and speak louder about women’s health conditions that affect women. It’s interesting. I think Viagra was something that everyone knew about at the age of. I don’t even know, but a very young age. But the concept of menopause, I don’t think I first learned about it until the actual term and what it meant until much later in life. And so I think that we’re still battling that. And especially as you think about kind of the diversity of the US, there are certainly geographies that are still light years behind where maybe more progressive communities are.

[00:16:14.020] – Kriste Goad

Well, as someone who is familiar with the menopause stage, I’m going to just comment that that is a huge market because it’s word of mouth mostly at this point, woman to woman, experiencing all that comes with that and the challenges on getting relief. What doctor do you go to? How do you address it? Oh, you go to this clinic. Oh, you get this, oh, you get this supplement. I just think there’s so much opportunity in that space and people don’t talk about it. That’s just my two cents. But can I ask you to dive in on something a little deeper? You said, Margaret, about access. Do you mean when you talk about access in the context that you talked about it in terms, you know, funding and business model, are you talking about access to specific services?

[00:17:05.990] – Margaret Malone

For the most part, yes, we can, you can look at, like, behavioral health, for example, there’s such a lack of behavioral health providers that exist today. For so much time, the market was focused on just increasing access to evidence based. Better, not even evidence based, but truly just like services to solve and help kind of be a band-aid for the needs of their employees, for their members. And I think what you’re seeing now is, and we’ve heard this, even I say, particularly on the health plan side, they’re now looking to quantify the outcomes of those treatments. And what is an evidence-based care provider versus one that isn’t? And how are the outcomes tracking between those two groups? And are their patients happy? Are their members happy? Are they seeing results? And so I apply that to the women’s health space. I think in this, it really has been increasing access to OBGYN. There are OBGYN deserts all across the country, and just increasing access to that service is critical for so many communities. But once we’ve kind of solved the access gap, it’s going to then be, how do we make sure that the access that we’re providing is high quality and showing noticeable clinical outcomes and saving costs for the healthcare system?

[00:18:40.700] – Kriste Goad

Thank you. That was really helpful to understand what you meant specifically by that. Okay, I’m going to shift gears just a little bit, ladies. We said at the top of the podcast we were going to get into artificial intelligence. AI is such a hot topic. Everybody’s talking about it. It’s almost like ad nauseam at this point. But I’m curious. I’d love to get your take on this. How is AI being used specifically in FemTech, if at all? Where do you see it evolving? And how important is it to the FemTech space, whether it’s how services are getting delivered or how you’re approaching marketing? I’m just super curious about this. I’m AI curious.

[00:19:21.900] – Leigh Ann Ruggles

So because I am not a FemTech expert, I’ll sort of give my two cents on using it from a sales and marketing perspective. And I would say that having led sales teams and high growth companies, salespeople love to talk buzzwords. And they love to use sort of the next big thing. So I guarantee you everybody is talking about it, whether they have it or not. And now the irony in that, I would say, is that the healthcare system, specifically payers and health systems, I would say, are very conservative in how they buy. Right. So they really prefer to buy vetted products. So I think that what you’re going to see is a little bit of a backlash of people talking about AI. I think already there’s some disbelief in how relevant that is to any given product. And I would also say that there is AI out there already. Right. Natural language processing has been around for some time, so it’s just AI by a different word. And I think people have to use it very carefully and very intentionally in order to get into the healthcare system. I mean, in the healthcare system, that’s a little scary, right.

[00:20:20.890] – Leigh Ann Ruggles

I don’t want Alexa piping up and asking how my breast cancer is or whatever. Right. So people are going to be very cautious about it, I think, as much as it sounds fun and exciting, but that’s just from a sales perspective. So, Shelly or Margaret, I don’t know if you guys would want to comment on its relevance to the FemTech world.

[00:20:37.290] – Shelly Lanning

I definitely feel like the use of AI has changed dramatically in the last year. One year ago almost to this month, I went to an LP meeting for a health fund, and the expert there was from Microsoft, and he was talking about AI and how it wasn’t perfectly accessible by young firms, and no one would expect it to be. And he is without a doubt, a leader in the entire industry world on the topic. And yet, every conference you go to now, even the early stage companies that don’t even have a customer, will say that they’re using AI. The important part that I would take away is to make sure that whatever stage you are in your business model, you’re thinking through the critical drivers of outcome to demonstrate what you have in your business model, whether it be engagement, enrollment, patient satisfaction, outcomes, clinical improvement, the ability to capture, report, and synthesize that data to show real savings, real outcomes. That’s what ultimately really matters when you’re selling. So how you get there is debatable. Maybe you can use AI to help improve automated outreach for your members or your patients. That might be a really good example, but the ability to capture and have the data and have the forethought to think through what’s going to be needed down the road.

[00:22:07.430] – Shelly Lanning

So you’re thinking 18 months ahead of where you are today in order to prepare for that ability. That’s what I think is ultimately the most important aspect and use of data in any healthcare company.

[00:22:18.990] – Margaret Malone

Yeah, and I can chime in, too. I think what excites me about AI and women’s health is because we’re still so far behind in terms of data and research, just how AI can be used as a tool to accelerate that. And I think of AI, really an analog for me, is like electricity. Electricity changed the way in which society functioned, and I think of AI similarly. So I really do think it’s going to change the way that how tasks are performed, how operations are completed, and it’ll kind of permeate all aspects of what we do, including building companies, including delivering care, particularly virtually, and the opportunity to help automate some of kind of the mundane tasks that need to occur to deliver that care appropriately. That’s where I think AI use case can be quite impactful. And it’s cool to see as a consumer using apps like Flow and seeing kind of where that data is, one, being used, and then the insights that are surfaced because of that. It’s interesting, and especially for a market where there is taboo and there are unknowns. And to the earlier point around menopause, it’s largely you learn through what you hear from women that have gone through it or friends that have gone through it, versus what if you had kind of a guide, kind of like what you have today.

[00:23:52.780] – Margaret Malone

There are a handful of apps on the market today, Ovia, What to Expect, Flo that help guide you through pregnancy. We’re still early in some of those consumer-driven solutions to help women kind of navigate other parts of the healthcare journey.

 [00:24:11.000] – Kriste Goad

That’s awesome. I know our podcast is a podcast for curious marketers, so I would love to really dive in a little more deeply. And my agency, we’re playing around with how to use AI, ChatGPT, those kinds of things in our work. I think a year into sort of like the big awareness around ChatGPT and AI and all that is like there was like, initially there was fear and it was just going to change everything immediately. But I think we’re all experimenting and learning ways to use it, how to use it, the ethics of using it. But from a marketing perspective, I’m super curious about marketing dollars, and maybe we’ll start with you, Leigh Ann. Do companies have to spend a lot of money on marketing? What if you’re a small company and you don’t have a huge budget? What if you’re a startup in the FemTech space, for example, how do you think about that? How do decisions get made about when and where to spend marketing dollars?

[00:25:16.500] – Leigh Ann Ruggles

Yeah, I think you have to be very pragmatic. And the short answer is no, you don’t have to spend a lot of marketing dollars. And I think the conversation we just had on AI is incredibly relevant. Right. There are programs that I can put in a description of what I want and it will create a video for me or a picture or a slide deck. So I know that marketers are sort of getting very excited to see what can come out of this at the same time as they are a little bit cautious about the sort of the IP impact there. But I would say, as a general rule, AI is going to be a boon for people who do not have a large marketing budget. I would say for small companies, it’s important that you get your brand right and that you get your messaging right. And so again, having led sales teams, and sometimes we as salespeople have a tendency to go say that we can do everything and be everything that the client or the prospect wants, but I think you have to nail here’s who we are, here’s the value, and really start with that.

[00:26:12.470] – Leigh Ann Ruggles

And then you can easily, you need a sales deck, you need a sell sheet, and then you need your salespeople to have good relationships. But I would say you don’t need, like you see some of these companies who go out there and they spend all this money on a sponsorship, $75,000 just to speak at an event. And I don’t think you need to do that. I think you can be very thoughtful about where you go. You can attend events, and if you have the right relationships, you can get those meetings without spending the 50 or 75K to sponsor. And then you can be very intentional about what you do, sponsor and just cherry pick a few shows that you know exactly the right audience is going to be there. And I think it’s also important that a marketer have the ability to create a crawl, walk, run plan. So when we have this much budget, then here’s the things that are really important. I have to get these things done. Oh, but if, Mr. CFO, you could give me this much more, here are the things I would do and why, and that’s really important.

[00:27:08.780] – Leigh Ann Ruggles

I had one marketing leader once who, for crawl walk run, he said, oh, we’ll do four shows and 20 emails, and then we’ll do eight shows and 40 emails, and then we’ll do 12 shows. And it didn’t make sense. That doesn’t make sense. You have to be very intentional about where you put those initial dollars and then every additional dollar. What’s the value you’re going to achieve from that and why? And then my other advice to marketers would be, stay very close to your CFO. I know sometimes it can be intimidating as a marketer, but I’ve always had great relationships with my CFOs, and as a result, they have had trust in me that I’m not going to spend those dollars, unwisely. Right. And so that’s really big because you can have that conversation, he can ask the questions, you can have the dialog around what you’re doing and what you would do if you had more money and why. Versus, I think, sort of marketing. My last head of marketing always used to hate getting called by the CFO. She’s like, oh no, he’s going to cut my budget. Right. There was sort of an element of fear, and so it’s important to be able to have that two way conversation.

[00:28:11.210] – Leigh Ann Ruggles

But no, short answer is, you definitely do not need a lot of money. And if you have good and happy clients, you need even less money because they’re very referenceable and you can use them for free. So just my two cents.

[00:28:21.110] – Kriste Goad

Good advice. I don’t hear that advice about the relationship with the CFO very often, but that’s very insightful. Shelly, what are your thoughts around this? You probably struggle as a founder and CEO and an investor, you understand all sides of it, and I think I’d love to hear how you think about it. How can marketers better understand the position that you’re in and the roles that you play and then how you’re making those decisions and what you need to know from your marketing team or your agency partners to be able to buy in or to understand why you should spend money in certain areas.

[00:29:08.770] – Shelly Lanning

Well, first, I’ll start by saying I’m actually a co-founder and president. I’m not title shifting

[00:29:16.100] – Kriste Goad

My apologies.

[00:29:17.220] – Margaret Malone

That’s okay.

[00:29:19.170] – Shelly Lanning

Totally okay. I think as an early stage company, I have envy over all that Leigh Ann just said. So we don’t have a real strong team budget that’s already been built out. When you’re launching, you sometimes need to have time on task before you can ask for references from customers, et cetera. So my real belief is to get out and talk to as many people as you can. Be a social butterfly at every single conference. And frankly, it’s really hard to know sometimes. Was that conference valuable? I don’t know. I was never there before, and it’s too early to say what type of return I’m going to get. So I try to be really busy in just coming up to the selling season, the start of the selling season, travel a lot, go to as many conferences, get as many speaking positions as you can that I don’t pay for, and make sure that you have relevant content and information that the conference cares about. And it’s the old-fashioned, feet-on-the-street method for an early stage company. I aspire to have what Leigh Ann was saying.

[00:30:38.700] – Kriste Goad

What about from like you mentioned earlier? Well, we all talked about sort of the lack of data in this space, but like, really needing that data to be able to make the case. And good marketing is always very data driven. Do you see opportunities kind of from the big m marketing perspective in terms of how you go about how important is that data? Are you able to gather some of that information in any of the work that you’re doing that can maybe in the future help power marketing?

[00:31:14.470] – Shelly Lanning

I stand behind the necessity to have data, and even if it’s Shelley Lanning putting it together in excel and it looks very jv or c squad, and then you try to put a little bit of color around it on a PowerPoint, the data is what drives the interest. The data is what shows the potential health plan partner or self-funded employer why they should care. I do really want to repeat that I aspire to what Leigh Ann has, because it surely does make for more efficiencies in your team when you have someone who’s thinking every minute of their day how to market it, how to make that brand, how to make that message, how to make it look good so that you feel like you know what you’re doing and that the data tells a story that feels really enjoyable to read and to hear about. And so as an early stage company, we’re still trying to sow our oats there.

[00:32:15.130] – Kriste Goad

Right. But you’re obviously gathering very valuable data about the members, the patients, the consumers, if you will, and their behaviors, which is extremely valuable, but a lot of times really hard to tap and especially hard to tap into and leverage for marketing and sales has been my experience.

[00:32:35.200] – Shelly Lanning

Sorry, one point of clarification. We’re early from a rounds of a financing perspective. I do not feel like we’re early from a work with health plans, lives under our care, our ability to have real customers that span a scope of small, medium, large and jumbo. So our care model has resonated very, very well with payers, and we’ve leaned very heavily into the data and the outcomes. But we consider ourselves early stage in that we don’t have a fully baked marketing infrastructure established just yet.

[00:33:14.900] – Kriste Goad

Right. So Margaret, I would love for you to chime in. That’s a great segue. How do companies know, how do investors know when is the right time to invest in marketing, to bring internal marketing talent to the table? And then I find it’s interesting… A lot of times you might be able to hire an internal person, but that person still needs support, whether it’s additional team members internally or outside agencies that they can leverage to actually get things done. That’s where I see a lot of the friction and the challenges come in in terms of these things take time and they take money and they take expertise as an investor. How do you guys think about that and how do you advise your portfolio companies?

[00:33:58.270] – Margaret Malone

It’s a great question. I think there’s probably a couple of different ways of thinking about it. I’d say at the earliest stages of a company, most of the marketing is kind of founder-led to what Shelley just described. Because you’re trying to have the signals of product market fit. You may have one customer that you know if it’s a tech enabled service enrollment for, but if you were to hire a head of marketing or build out that department, there just may not be enough work yet for them to really run and execute on. Because you’re building the car as you’re driving it in a lot of ways. But there’s an inflection point where you start to see and recognize that you need to invest in marketing, you need to invest in growth, and that may require a dedicated team member to really take it off. And I think that typically comes once you have a couple of customers. But it looks very different for every single company. So I’d say we don’t have kind of like a framework set in place, but certainly kind of think about all the different inputs and signals that we’re learning.

[00:35:20.860] – Margaret Malone

But I think there are breakout companies and I think that’s partly why we invest in like there were some really interesting signals around just kind of the interest in experience and delighting the people that were coming to Visana and replicating that is ultimately what the team is so focused on today. But it’s hugely important and I’ll put a line out there. I’m in the process of working with an expert in this space right now to really unpack this question. Kriste, so more to come on that hopefully we’ll.

[00:35:52.940] – Kriste Goad

I need to know more.

[00:35:54.200] – Margaret Malone

I’m excited for it you know essentially the topic, know what is growth and how does it look and differ between stages of companies? How do you interview for growth leadership? How do you think about the different marketing tools to really accelerate and in the environment that we’re in right now, where there’s a heightened awareness around profitability, especially at the earliest stages, how do you balance kind of growth at all costs with the pressure of demonstrating profitability and sound business fundamentals? So much more to come, but I’m excited to dive in here and we’ll certainly share it as follow up.

[00:36:33.050] – Leigh Ann Ruggles

Kriste, one thing I would sort of add on to, to loop back to what Shelley and Margaret have both mentioned is if you have ROI and if you have the data and if you have the clinical outcomes, you don’t need as much marketing dollars, right. There’s so much marketing, companies shall remain unnamed. But there was one company where they spent $700,000 on one event, at one conference, right? They brought in a band and all that, and they needed that because the product didn’t have outcomes yet. Right. It was brand new. But I think if you have outcomes, people listen, and specifically in this environment, I think buyers are listening to outcomes, right? So if you don’t have a strong ROI right now, you’re not going to get the attention of a buyer at a health plan, in my opinion. But if you do have an ROI, then that opens the door. So conversely, if you don’t have an ROI, you need to do a lot more to get their attention. There’s maybe more dinners, more press, more whatever, versus maybe have an ROI. I think you can save on those dollars, right? And it sounds like Visana has that, and they’re continuing to track that data, which is important.

[00:37:38.790] – Margaret Malone

I think women’s health is unique in a lot of ways because people are so desperate for solutions that if you have a great brand experience, some companies have been able to get in the door and sell because they’ve activated certain leadership team members and they’re so passionate about particular solutions. So in a lot of ways, I think, while I totally agree, Leigh Ann, with that comment, like clinical outcomes, and we’re firm believers, and if you have the clinical outcomes and the care model, ultimately you’ll drive differentiated and long term durable success there. But it is interesting because I think this market is so hot and people are making decisions left and right, that companies that are more well known sometimes are the ones that are winning bids because of just brand awareness and TBD. How long that lasts. Back to my earlier questions around access outcomes costs, initially, we’re still in this access phase. But I’m an investor in the outcomes and costs, so I think the market will eventually get to. Now let’s start to compare outcomes and costs with these different vendors and ultimately pick on outcomes.

[00:38:54.430] – Kriste Goad

Yeah. Well, as someone who lives in the marketing, branding, PR space, I’m obviously a big believer in it and a big believer in the power of your brand and your brand story and an amazing brand experience. Afford it at the level, which you can afford it, but ultimately you have to be able to deliver on that, right? You can spend whatever amount of dollars and come out and make a splash and have a beautiful brand. But if you can’t actually then deliver on that, that’s going to pretty quickly crash and burn. There’s got to be a there there over the long term, and I’ve run into that more times than I care to admit that there’s a big push and pressure on marketing to do the impossible. It’s like, okay, we have to have something to be able to talk about, and if not, we have to then create that story through some thought leadership, some research. Let’s just shine a big light on the problem and become an expert voice in that space if nothing else, especially in the health tech space, you see so much, or at least we have up until now, with kind of the current slowdown in funding and whatnot, we’ve seen so much of that just dollars just flowing into marketing and brand, and then in a few short years, that brand isn’t even there anymore.

[00:40:31.930] – Kriste Goad

Okay, so speaking of larger, I want to be sure that we cover. There’s a really important question I want to pose to you ladies, and that is, what are some of the larger societal implications of FemTech destigmatizing conversations around promoting inclusivity in healthcare? You mentioned earlier, Shelly, the just awareness data clinical trials. I would love it if you each would share your thoughts on that. In terms of the FemTech space.

[00:41:03.930] – Shelly Lanning

What I would say is some of the largest conditions are the largest cost drivers in American healthcare. Conditions that impact men and women at fairly the same rate, but have completely different everythings. And there’s so many of them that we just don’t know that much about. So the biggest impact that FemTech or companies can have would be figuring out more around all the aspects that drive these large concepts. So cardiovascular, stroke, Alzheimer’s, being able to take diabetes, very different between men and women. So taking really large segments of the population that have these conditions and being able to continue to study, and that can be a benefit by pharmaceutical companies, but digital health companies, health systems payers, we can all acknowledge that we need more. We need more information, more clinical trials working together. So I feel like there’s a whole positive momentum being generated by just learning more about what we don’t know.

[00:42:13.900] – Leigh Ann Ruggles

I think there are other implications as well. Right. There’s a whole body of conversation around keeping women in the workforce longer. And I’ll just use a personal example. There was a point where I was going through breast cancer, and I was in chemo, so I didn’t have much hair, so I was wearing a wig. And chemotherapy also throws you into menopause. Right? So not only am I wearing a wig, but I’m having hot flashes. And we’re in the lobby of a very large five state plan getting ready to call on this client. And I can tell you, if we weren’t meeting with women and I was walking up there sweating, and it doesn’t make you comfortable, it doesn’t make you feel like you can be successful. And so the ability to have the support that you need to not feel that way, like, again, the CEO of Blue Cross Massachusetts plan, I mean, if you know her, she’s awesome and she’s out there. And one of her big quotes was,” Hey, as a 52-year-old woman, I am drowning in perimenopausal symptoms.” You never hear other CEOs come out with that, but Sarah can do that because she’s Sarah.

[00:43:12.930] – Leigh Ann Ruggles

So I think that there are a lot of societal implications for women in sort of giving them more opportunities, which, as we’ve talked about, then gets more opportunities, to Margaret’s point, getting more GPs and that type of thing. So I think that there are many more societal implications beyond just the clinical implications. Just my two cents.

[00:43:34.800] – Kriste Goad

Margaret, do you have any thoughts on larger societal implications?

[00:43:40.550] – Margaret Malone

I won’t repeat.

[00:43:42.060] – Kriste Goad

It’s okay if you don’t.

[00:43:43.030] – Margaret Malone

Yeah, I won’t repeat what Shelley and Leigh Ann have shared. You know, I think that the more investment, the more awareness there will be profound impacts across every element of society. Research. I think Biden’s big push on maternal health now, some of the research initiatives in place today have had impacts already, and I’m hopeful that will continue and we’ll see progress there. But it’s really kind of a call to action, and I think we’re still kind of early in that phase in that journey.

[00:44:21.020] – Kriste Goad

Okay, awesome. Hey, Leigh Ann, you’ve successfully sold two companies. What is that like? And how can one do it successfully?

[00:44:29.730] – Leigh Ann Ruggles

Yeah, actually, it’s interesting how well this lines up with our topic. So earlier we talked about how investors, women, tend to be more humble, right? They tend to be more honest. They tend to say, here’s what I think my product can do, versus overstating it. So I think that hurts them sometimes from getting investment. But I would say, conversely, in selling companies, I’d had the opportunity in my roles both to be on the side that is pitching and defending my pipeline to those that were looking at acquiring my firm, as well as the one interviewing the heads of sales who were presenting their pipeline to me. And I actually think that one of the things that helped me, and I think that one of the things that helps women is the ability to really know their stuff and really be honest. Like, women, in my opinion, are less likely to put something in their pipeline that they can’t really defend because they like to know everything and have all bases covered. Versus I think sometimes people who have done a lot of deals and men who have done this a few times, they like just throwing numbers out there, and I think that’s expected.

[00:45:33.380] – Leigh Ann Ruggles

So I actually think that knowing your data really well, knowing your pipeline really well and being very honest about it really helps get you the valuation that you’re expecting versus throwing out a number there that’s 20% higher than anything that could be backed up. And then you’re not getting the valuation you want because they see through it. So those are my thoughts. Margaret, you probably have stuff to add because you’re on the other end of the conversation.

[00:45:58.190] – Margaret Malone

Yeah, maybe I’ll just add. I think your point around data is super important. I think, you know, for early stage founders, entrepreneurs, the more you can incorporate data, quantitative metrics, outcomes, referencing TAM (Total Addressable Market), referencing hard revenue numbers, and leading with the business case. I think you’ll be successful in those conversations with investors. But certainly I think storytelling is a critical part of building a company and refining that. So working with somebody you know, a great marketer can help you on that front, too.

[00:46:33.790] – Kriste Goad

I’m a big fan of storytelling. Shelly, anything to add there?

[00:46:39.680] – Shelly Lanning

Use examples from the kitchen and the garage that are super easy for anybody to be able to follow along and track. I tend to use sports, but find something in your storytelling and it goes a long way.

[00:46:52.370] – Kriste Goad

That’s great advice. What do you mean? Your kitchen or your garage? Can you give me an example there?

[00:46:58.310] – Shelly Lanning

Well, you can explain the concept of NMR nuclear magnetic resonance. And you can take a really complicated topic and be able to say it’s like having an oyster fork, a salad fork, a meat fork, a dessert fork. And they all have different characterizations. They’re very similar, but they’re different sizes.

[00:47:16.870] – Leigh Ann Ruggles

Right.

[00:47:17.070] – Shelly Lanning

And so all of a sudden, the person who maybe is a history major or a non scientist by training will say, I kind of get it. That’s really crazy.

[00:47:26.400] – Shelly Lanning

So find examples that are from everyday life that then people can feel like they understand what the most complicated thing you’re trying to explain and why that’s really important.

[00:47:37.730] – Kriste Goad

Simplify and less jargon. Awesome.

[00:47:41.620] – Leigh Ann Ruggles

I love that. I’m going to use that later today.

[00:47:44.230] – Kriste Goad

That’s all very good advice. Okay. Well, sadly, our time together is coming to an end, so I want to thank you ladies. But before we close, I love to ask a burning question, and I’ve got a couple you guys will do a round robin, take your pick. But I’m really curious what you’re reading right now and or what’s your favorite form of media? Where do you get your news?

[00:48:08.000] – Leigh Ann Ruggles

So I’ll go first. So what I’m reading right now is a book called Never Split the Difference. It’s a negotiation book, but it’s written by a guy who was a hostage negotiator. So it’s got some good lessons and then as well as some good anecdotes there to keep you interested. And then I would say that’s my favorite form of media, is books, until you invited me to be on this podcast. So I started listening to them more often now. And it’s perfect because you can do stuff while you’re listening to stuff. So I would say podcast is my new second favorite.

[00:48:42.350] – Kriste Goad

I love that.

[00:48:43.480] – Shelly Lanning

I would say that one of my New Year’s resolutions was to read more books. I love to read. And I find myself reading everything, journal articles, scientific papers. So I’m constantly reading. But they’re not books, they’re not stories. And I decided I would do a minimum of one a month. But what I’m doing a little different is, I’m rereading books that I know I loved back then, and it started by me wanting to read what my children were reading for their classes. And so I’m currently reading To Kill a Mockingbird. And it’s pretty wonderful to read it as an adult when you have children in middle school. And it’s really wonderful to see Ludo’s point of view. And I would agree then on the second point, I’m a big fan right now of the audiobook. I walk the dogs in the morning and I do a podcast. Go Spotify, or I do a book on tape. And it’s pretty wonderful. You can accomplish a lot at the same time.

[00:49:47.480] – Kriste Goad

Awesome, Margaret. Sure.

[00:49:50.510] – Margaret Malone

So I’m currently reading or kind of rereading, but I highly recommend it’s called Talent: The Market Cap Multiplier. And it’s all about talent and actually from the perspective of one of the partners at General Atlantic. And just really interesting to hear kind of their investment thesis around people. And highly recommend. That’s my workbook. I’m also reading, How to Survive Toddlerhood because that is a very real challenge right now in my life. And then in terms of favorite form of media, I’m pretty old school. I love a good newspaper. I try my best to read The Economist every week. And we have a paper format, but you’ll typically see me getting kind of daily news through the digital means, podcasts and various sources online, Axios, LinkedIn, all the above.

[00:50:47.720] – Kriste Goad

That’s awesome. So I can put you in the category, Margaret, of maybe one of only a handful of people I know in my life that still gets a physical paper copy of a newspaper.

[00:50:57.670] – Margaret Malone

Yeah, it’s probably wasting trees and paper, but.

[00:51:02.530] – Kriste Goad

There’s something about it, though, right?

[00:51:04.280] – Margaret Malone

Yeah, a cup of coffee and a paper. It’s pretty nice.

[00:51:07.450] – Kriste Goad

Yeah. Well, thank you, ladies. This has been so amazing. I’m sad that our time together is coming to a close. As always, though, for our listeners, we will include links, background, and we’ll go ahead and throw in links to all of the books and podcasts and news sources that have been mentioned on today’s podcast. So be sure to check those out on our website, growwithfuoco.com/howit’sdonepodcast or wherever you get your podcast. And don’t forget to hit the subscribe button so you never miss an episode. You can also find shelly at visanahealth.com and margaret at flarecapital.com again, my guests today have been Leigh Ann Ruggles, Shelly Lanning and Margaret Malone. I have loved this panel and this first ever panel podcast on how it’s done. Thank you so much, ladies.

[00:52:05.450] – Leigh Ann Ruggles

Thank you.

[00:52:06.310] – Margaret Malone

Thank you.

[00:52:07.130] – Kriste Goad

That’s it for now. Thanks so much for listening. We’re looking forward to keeping great conversations coming your way as we grow this podcast. There’s even more great content from our conversations on our blog. Be sure to check it out at growwithfuoco.com. That’s growwithfuoco.com. Stay tuned and till next time and no matter what, stay curious.

• Recommended reading:
  
  • Ovia Health
  • Flo
  • What to Expect
  • Female Founders Are Energizing Investment in Women’s Healthcare
  • Talent: The Market Cap Multiplier
  • Storytelling that Sells – Part 3: Good Marketing Spoils the Plot

• What are we reading right now:
  • To Kill A Mockingbird
  • The Economist
  • Axios
  • Never Split the Difference

• Find Leigh Ann Ruggles on:
  • LinkedIn

• Find Shelly Lanning on:
  • Linkedin
  • Visana Health

• Find Margaret Malone on:
  • LinkedIn
  • Flare Capital

• Find Kriste on:
  • LinkedIn
  • Twitter