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Making evidence-based pregnancy and newborn care universal

Written by
Marta Bralic Kerns
Pomelo Care
November 20, 2023
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I started my career in a basement room at a state Medicaid agency designing an alternative payment model for maternity care. As I dug through claims and set quality measure benchmarks, I didn’t realize the evidence of a national maternal health crisis was buried in those countless lines of data. Today, pregnancy complications remain on the rise, with one in ten newborns starting their life in the NICU and cesarean births increasing 41% over the last two decades. Even more stunning, the maternal mortality rate in the U.S. is more than three times the rate in most other high-income countries, with BIPOC women 2-3x more likely than white women to die from such complications.

Years later, when I had my daughter, Mia, and son, Luka, I experienced a preeclampsia scare, emergency room visits, and a large for gestational age baby. With only a few minutes a month with my OB/GYN, I faced these challenges with many more questions than answers. Millions of other women face similar and more daunting issues — patients like Shelly, one of Pomelo's patients who was gracious enough to share her story with me.

Shelly was overjoyed to become a first time mom at 43 after trying to conceive for many years, but she faced some unexpected complications. Gallstones sent her to the emergency room, where doctors advised her to cut all fat from her diet to prevent them from coming back. She left feeling confused and limited as to what she could eat. Shelly also risked developing gestational diabetes, which increases the risk of preeclampsia and preterm birth. Overwhelmed, she hit dead ends looking for answers on Google despite wanting to make changes to keep herself and her baby healthy.

I started Pomelo Care to help people like Shelly – and families all across the country — have healthy pregnancies and healthy babies.

We designed our approach around three core tenets:

  1. We need to increase access to care, close care gaps, and reduce the friction of getting care for families – we’re available 24/7 with expert maternal and pediatric care teams.
  2. Many pregnancy risk factors are known and addressable – we created data infrastructure to identify these risks earlier by analyzing claims, lab, pharmacy, and electronic health record data, and we surface patient needs to clinicians in real-time via our software platform so a holistic care team can address these risks by treating medical, behavioral, and social needs in concert.
  3. We need a value-based care model that improves outcomes for both mother and baby – we are laser focused on delivering evidence-based care that improves outcomes and reduces costs from avoidable complications.

From my early work in Medicaid to my own pregnancies, to conversations I’ve had with clinical leaders in our field, I’ve long been frustrated by poor access to care, late or no identification and management of risk factors, and the lack of a value-based payment model to change the status quo. So that’s what we’ve built.

Pomelo Care is a virtual, multi-speciality medical practice that uses a value-based care model to address underlying risk factors to improve maternal and newborn health. We provide 24/7 virtual care for patients from preconception until their baby turns one. Our team of OB/GYN, primary care, and pediatric clinicians, mental health therapists, social workers, dietitians, lactation consultants, and other experts care for the whole person. By proactively identifying and treating individual risk factors wherever a patient is – in their life and in the country – we aim to give everyone the personalized, holistic care previously only available to a select few. And we partner with health plans to deliver this care at no cost to patients.

When we met Shelly, we worked with her to create a personalized care plan that met her unique needs and goals. After learning of her gestational diabetes risk, she met with a Pomelo dietitian several times for nutrition counseling and meal planning. She saw a therapist to navigate the ups and downs of pregnancy. Before giving birth, she consulted a lactation specialist to help prepare for breastfeeding. Our team supported Shelly every step of the way and answered all her questions big and small. Shelly never developed gestational diabetes, and she gave birth to a healthy baby boy. Her Pomelo care team continues to help Shelly navigate new milestones like introducing solids to her son, now seven months old. Supporting patients like Shelly is what drives us to reach more patients faster.

Since 2021, we’ve been working with leading health plans, managed care organizations including the two largest Medicaid payers, employers including Mount Sinai Health System and Koch Industries, and academic medical centers to improve maternal and newborn health.

Today, I’m excited to announce that we’ve raised $33 million in venture capital funding, led by Andreessen Horowitz and First Round Capital to expand access to evidence-based care to 2 million covered lives this year.

They’re joined by SV Angel, Operator Partners, Allen & Company LLC, and BoxGroup, as well as incredible angel investors and healthcare industry leaders, including Adam Boehler (Managing Partner of Rubicon Founders, Former Director of the Center for Medicare and Medicaid Innovation, and Founder of Landmark Health), Nat Turner (Co-founder of Flatiron Health), and Puneet Singh (Former Chief Growth Officer, Diversified Business Group at Elevance). This funding will allow us to scale our technology, clinical, and operating teams to meet the needs of a growing patient population.

I don’t underestimate the challenge ahead. The maternal health crisis is only getting worse, and care access is increasingly under threat. But we know which interventions can turn the tide in this crisis, thanks to the dedicated efforts of maternal health clinicians and researchers. The challenge is to make these interventions accessible to everyone who needs them. Our team of passionate, smart, humble, and caring people is committed to fighting like hell to break down barriers to accessibility and finally improve outcomes for millions of patients across the country.

If you’re a payer or employer and want to join us in this fight, or you’re interested in becoming a part of our team, check out our website to learn more about Pomelo.
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All clinical services are provided by licensed physicians and clinicians practicing within an independently owned and operated medical practice, Pomelo, P.C. or affiliated professional corporations. Pomelo Care, Inc. does not provide any medical, nursing, or other healthcare provider services.