As Chief Business Officer — and as a woman who is incredibly passionate about transforming the way we provide healthcare today — I have the privilege of working closely on our delivery model designed for specialty care and partnering with an incredible team to build a seamless patient experience. 

We all know how challenging it can be to fit taking care of our health into our day to day life. As a woman, a parent, and a working professional, I know firsthand how this burden often becomes heavier overtime and understand how difficult it is to find and schedule doctor's appointments between time at work and time with my kids. It shouldn't be that way, and it doesn't have to be.

Our specialized approach to treating chronic conditions is designed to support the unique needs of the patients we serve, when they need us. Whether patients come to us to treat chronic migraine or rosacea, or come to us for a better understanding of their reproductive care options, each offering provides specialist-level telemedicine, personalized treatment, and ongoing condition management for exceptional care. Delivering this level of high-quality care requires an understanding of the overlap of the conditions we treat — and this is exactly where we see the importance and impact of mental health. We now have mental health services available today, and we are actively treating thousands of patients. Here’s how we got there, starting with pilot programs on Cove and Nurx, focused on helping more women meet their health needs more holistically, conveniently, and with high-quality care.

Cove has helped tens of thousands of patients see improvements in healthcare utilization and quality of life after only three months of patients using the service. With Cove, we reduce the amount of time to deliver care to patients by 28 days, reduce emergency department and urgent care utilization by 55% and 46%, respectively, and improve the healthcare experience with an NPS score of 73. Cove also provides more equitable access to care for BIPOC patients looking to treat their migraine. While we deliver on our commitment to democratizing access to migraine care, we always knew a strong link existed between migraine and mental health. Research from the American Migraine Foundation shows people with migraine are five times more likely to develop depression than those without. 

Similarly with Nurx, we knew women needed access to more holistic care offerings, especially in the midst of a complicated reproductive care landscape. We saw proof of this complexity when we saw a 300% increase in requests for emergency contraception last year amidst bans on abortion in over 10 states across the country. On top of that, more than 1 in 5 women in the United States experienced a mental health condition in the past year. Mental health care was the third most common reason women cited for accessing telehealth/telemedicine services, with 17% saying it was the primary purpose of their most recent telemedicine visit. It was clear women needed more options.

‍In the midst of these challenges, we brought ourselves back to our mission: How can we expand access to mental health for migraine patients that results in better outcomes? How can we expand access to mental health for women that is better than what’s being delivered today? Working alongside our Chief Medical Officer, Neil Parikh, and our medical experts across migraine, women’s health, and mental health, we developed Thirty Madison’s first mental health program to support patients with the level of specialty care they deserved. In 2022, we piloted programs across Cove and Nurx to deliver care specific to each patient base.

For Cove, our migraine specialists believed patients would benefit most from two different options: Cognitive Behavioral Therapy (CBT) and Coaching. With CBT, patients access a self-guided program uniquely tailored to migraine patients. At the completion of the pilot phase, patients had a 1.3 day reduction in monthly headache frequency, a 1.1 point reduction on the pain scale, and a 13% reduction in Migraine Disability Assessment (MIDAS) score. For the coaching program, patients were matched with a certified National Board for Health and Wellness Coach (NBHWC-certified) who provides asynchronous health services. Patients participated for 8 weeks at a time and shared their feedback: fewer headaches and a higher quality of life. 

On Nurx, the mental health offering for women addressed moderate anxiety, depression, Seasonal Affective Disorder (SAD), as well as Premenstrual Dysphoric Disorder (PMDD), Postpartum and Menopause Depression. Patients received ongoing follow-ups from their provider to make sure their treatment was working for them. 

As we do with every Thirty Madison brand, we placed patients and their safety at the center to ensure care is being delivered at the highest clinical quality. Medical experts worked closely with the product team to build a check-in experience in line with the best-in-class clinical practices. Frequent check-ins are held at a cadence determined by the provider and tailored to the patient based on their unique clinical needs for regular provider communication with patients. 

‍Positive feedback from patients and early proof of improved outcomes, all led by a thoughtful, empathetic approach from our medical team, helped us feel confident in moving forward the full implementation of our mental health service offerings for Cove and Nurx. We meet patients where they are on their mental health care journey, offering a variety of appropriate clinically-backed treatment options and educating them along the way. We bring clinical excellence to everything we do, accounting for their current condition to develop a cohesive treatment plan needed to improve their overall health. Consider this scenario: a patient who initially came to us for birth control mentions that they have some symptoms of depression. Their provider can now direct them to our mental health offering to fill out the comprehensive intake and learn if mental health treatment is right for them. The result: a better patient experience where they can manage all of their care in one place by communicating with an integrated care team. This quote from a patient demonstrates the kind of feedback we’ve received since offering mental health: "I am very happy with my health plan as it has dramatically improved my depression and anxiety.”

We always knew access to mental health would be pivotal to providing the best-in-class ongoing condition management across our therapeutic areas, and would drive our mission to improving outcomes for patients, especially for the women who need it most. Now, we deliver that care for patients every day. Our integrated care model continues to provide a seamless experience that nearly 1 million patients have grown to love — and we know it’s because every single step is developed just for their unique healthcare journey.

‍Caroline Hofmann serves as Chief Business Officer at Thirty Madison. Thirty Madison exists to deliver on healthcare's biggest opportunities: access and affordability; patient outcomes; and patient experience. Each of its specialized brands is focused on specific chronic condition areas, and thoughtfully designed to support the unique needs of its community with personalized treatments and care. With empathy at the heart of its innovation, its proprietary care model empowers hundreds of thousands of people with ongoing conditions with the accessible, effective treatments across a lifetime of care. Learn more at ThirtyMadison.com, and find out more about our mental health offerings here with Cove and here with Nurx.