Latest / CareTalk: Healthcare. Unfiltered. / Making Fertility Benefits An Employer Priority w/ David Stern, CEO, Kindbody

Transcript

Making Fertility Benefits An Employer Priority w/ David Stern, CEO, Kindbody · CareTalk: Healthcare. Unfiltered.

• 0:00
  SPEAKER_01: Fertility benefits have gone from a luxury perk to a boardroom priority in under a decade.
• 0:05
  SPEAKER_01: What started as a competitive talent play at a handful of tech companies has become standard expectation across industries.
• 0:12
  SPEAKER_01: Employers now demand something they haven't always received: real outcomes, transparent costs, and a clinical partner that operates like a business.
• 0:21
  SPEAKER_01: That shift is reshaping who builds fertility companies, how they grow, and what it means to scale access.
• 0:44
  SPEAKER_01: My guest today is David Stern, CEO of Kindbody, a fast-growing fertility, family building, and women's health company offering clinical care and benefit solutions for employers, health plans, and individuals.
• 0:57
  SPEAKER_01: David's career spans more than three decades and nearly every corner of the fertility ecosystem.
• 1:02
  SPEAKER_01: He started as an EMT, moved into Pharma, where he helped launch products including Nuvering, led Global Fertility at Merck EMD Serono, and scaled Boston IVF as CEO before joining Kindbody.
• 1:14
  SPEAKER_01: He's seen this field from the lab, the pharmacy, the clinic, and the C-suite.
• 1:18
  SPEAKER_01: David, welcome to the Health Biz Podcast.
• 1:20
  SPEAKER_01: Thank you, David.
• 1:21
  SPEAKER_01: It's great to join you today.
• 1:23
  SPEAKER_01: Yeah, I gave you such an extensive introduction.
• 1:25
  SPEAKER_01: I feel maybe we could just wrap it up right here, but we won't do that.
• 1:28
  SPEAKER_01: Let's actually rewind the clock a little bit.
• 1:30
  SPEAKER_01: You know, you've been in an in and out of this space for 30 plus years, and I'm wondering, you know, what drew you in in the first place and why is it still interesting after all that time?
• 1:39
  SPEAKER_00: It's well, what's interesting to me, uh David, is I actually, as you said, I was an EMT in college and I was a biology major and thinking I was going to go into medicine, and um I almost delivered a baby in my ambulance.
• 1:52
  SPEAKER_00: And for uh I worked in the summers uh on an ambulance, and I was like, oh, this is so cool.
• 1:57
  SPEAKER_00: I want to be an OBGYN.
• 1:59
  SPEAKER_00: And then over the course of um working two or three summers on an ambulance, I realized healthcare was changing, and so I decided not to go in to become a doctor.
• 2:08
  SPEAKER_00: Um, but I always had this uh women's health kind of bug and uh started out my career as a drug rep for a company that made birth control and was launching a new birth control product into the United States.
• 2:22
  SPEAKER_00: It was a European company called Oregon, and they were bringing products over.
• 2:25
  SPEAKER_00: And um so I started out because of my science background, I was always a very clinical salesperson.
• 2:31
  SPEAKER_00: I would use studies to talk with physicians and understood the mechanism of action, understood the different drugs and how they were working on the body.
• 2:41
  SPEAKER_00: And so it was kind of serendipity that the company I started out in women's health care selling contraception, and then they brought a fertility product to the space.
• 2:50
  SPEAKER_00: And it was a very small field, it's still small relatively, but this was in the early 90s.
• 2:56
  SPEAKER_00: And it's amazing how much has evolved in the time that I've been in the market, where today we can look at the genetics of embryos, we can identify good quality versus poor quality embryos, the implantation rate.
• 3:11
  SPEAKER_00: In the old days, the goal the goal was to put as many embryos in and see what can stick, almost like throwing spaghetti on a wall.
• 3:18
  SPEAKER_00: And today we can do single embryo transfers to reduce the risk of multiple births, and we can have typically between a 60 and 70% implantation rate and live birth rate, whereas in the old days it was maybe 20%.
• 3:33
  SPEAKER_01: That's a big change.
• 3:34
  SPEAKER_01: I remember working in the field some uh years ago, and you had those, you know, all the multiple births, which sounds like fun, you know, instant family twins, or but especially as you get to triplets and beyond that, the the health of the child, uh, never mind the family is usually uh not so great.
• 3:49
  SPEAKER_01: And that wasn't talked about too much, except people realized it once it happened.
• 3:54
  SPEAKER_00: A lot of patients actually feel like, oh, this is really cool.
• 3:56
  SPEAKER_00: I'll have twins and I'll be able to have my instant family, but they don't realize that it's not easy to take care of twins or triplets or more.
• 4:05
  SPEAKER_00: And as you said, the outcomes, uh the cost of multiple births has a significant impact on the overall healthcare environment and both on insurance companies or on employers when you're designing a health benefit, which is something that's very important and something that over the course of my career, I I've uh learned to look at as a way to differentiate uh either IVF practices or in the case of Kind Body, what we can offer an employer.
• 4:32
  SPEAKER_01: That makes good sense.
• 4:33
  SPEAKER_01: I mean, I think it was one of the first things looking at kind of the total cost for an insurer and seeing if you've got quadruplets, then uh whatever you might have saved uh you know upfront, you're gonna lose very quickly uh in the neonatal intensive care unit in terms of uh spend.
• 4:48
  SPEAKER_01: Okay, so let's fast forward a little bit because you uh have built the company or the company's been built around employer benefits channel.
• 4:54
  SPEAKER_01: And there are other models that are out there.
• 4:57
  SPEAKER_01: So direct to consumer.
• 4:58
  SPEAKER_01: Certainly, this is something where the consumer has a real interest.
• 5:01
  SPEAKER_01: There's hospital-affiliated clinics, or sometimes clinics that are just built around, you know, given REs that have that have put them together themselves.
• 5:08
  SPEAKER_01: Why this model uh that you have?
• 5:11
  SPEAKER_00: It's a great, um, it's a great question.
• 5:13
  SPEAKER_00: And and the founder of Kindbody had this idea.
• 5:18
  SPEAKER_00: She was also the founder of Progeny.
• 5:20
  SPEAKER_00: Progeny is the leading fertility benefit manager company.
• 5:23
  SPEAKER_00: And when it was founded, it was very much focused on the tech industry in California, the Google, the Facebook, the Apple, because California didn't have an infertility insurance mandate.
• 5:32
  SPEAKER_00: And so patients had to pay out of pocket.
• 5:34
  SPEAKER_00: So these companies initially started to say, hey, if we can cover this in a way that doesn't break the bank but offers our uh employees a benefit, we can attract and retain employees.
• 5:45
  SPEAKER_00: The challenge with Progeny, it was a third party that was essentially providing a benefit to the employer, but then also contracting with an IVF group.
• 5:53
  SPEAKER_00: And Progeny was in the middle.
• 5:55
  SPEAKER_00: When she started Kindbody, the idea was to have vertical integration.
• 5:59
  SPEAKER_00: So to have both clinics as well as a fertility benefit manager.
• 6:03
  SPEAKER_00: Now, KindBody doesn't limit the employers to only come to Kind Body Clinics, but because we have our own clinics, we can pass those savings along to employers.
• 6:12
  SPEAKER_00: And in today, uh in 2025, about 58% of the employees that have the Kind Body Fertility Benefit have come to a Kind Body Signature Clinic.
• 6:21
  SPEAKER_00: We have 26 clinics across the United States.
• 6:23
  SPEAKER_00: So we're in a lot of large cities, and we offer the choice for the employee to come to one of our clinics, or we contract with some of the top-performing IVF groups in the United States.
• 6:34
  SPEAKER_01: So when the employers started in with this, I understand what they were trying to do.
• 6:38
  SPEAKER_01: As they've gotten some experience and as they have evolved, uh, how has the discussion shifted when you speak with an employer, let's say, that actually has some experience with this benefit and not trying to get into it for the first time?
• 6:51
  SPEAKER_00: The employer is really looking at um having a seamless offering.
• 6:58
  SPEAKER_00: Uh, you know, you it's it's there's many, many benefits that they offer.
• 7:01
  SPEAKER_00: And traditional medical, you know, major medical is not fertility coverage in a lot of ways.
• 7:07
  SPEAKER_00: And as a self-insured employer, you don't have to follow the state mandates.
• 7:11
  SPEAKER_00: So, first and foremost, they want a solution that's easy.
• 7:15
  SPEAKER_00: They want a solution that provides choice and multiple options for their employees, but also they don't want to have headaches.
• 7:23
  SPEAKER_00: And so one of the things that we hear a lot from our benefit managers at the employers is when I don't hear about the benefit that there's a complaint, then I know that's a good thing.
• 7:33
  SPEAKER_00: Um, at the end of the day, though, the it's a terrific uh option for these employees to help build a family.
• 7:40
  SPEAKER_00: And there's a lot of stickiness to that employer.
• 7:42
  SPEAKER_00: There's loyalty because that employer is helping somebody who's having challenges to build a family on their own to be able to do it in a much more cost-effective way.
• 7:52
  SPEAKER_00: One of the things that we also provide employers is we don't have a per member per month model.
• 7:56
  SPEAKER_00: So we're not looking for every single one of their employees.
• 8:00
  SPEAKER_00: Our model is based on utilization, and we guarantee a certain discount rate off of the self-pay price.
• 8:06
  SPEAKER_00: So, what is good for an employer is they're not signing up for this huge cost to them.
• 8:10
  SPEAKER_00: It's only based on utilization, and they're guaranteed uh a discount uh when they do sign up.
• 8:17
  SPEAKER_01: So I know that employers are interested in outcomes and cost transparency, and those are general sort of terms, but what does it mean in your space?
• 8:27
  SPEAKER_01: You started off, I think, with some talking about like implementation rate, and there, I'm sure there's a number of other key uh metrics, but how how are you being held accountable these days?
• 8:37
  SPEAKER_00: We have service level agreements and we put into our contracts a certain amount of, for example, you use the example of multiple births.
• 8:45
  SPEAKER_00: Just to give you a couple of figures, a triplet in the United States is about$577,000.
• 8:50
  SPEAKER_00: A twin is$155,000.
• 8:53
  SPEAKER_00: That actually data is probably 10 years old, so it's probably grown even more.
• 8:57
  SPEAKER_00: If you're a self-insured employer, that cost is hitting your bottom line.
• 9:02
  SPEAKER_00: And so we have in our contracts a multiple birth rate that says we will guarantee below a certain percentage, usually 5% or below.
• 9:11
  SPEAKER_00: We have miscarriage uh rates where we have lower miscarriages because we're putting back tested embryos, so there's a lower risk of miscarriage.
• 9:20
  SPEAKER_00: We look at uh how long does it take for a patient or an employee to get in to see a provider.
• 9:27
  SPEAKER_00: So these are ways that we offer um essentially, you know, skin in the game for us, because if we don't hit these agreed upon parameters, then we give discounts back to the employers.
• 9:37
  SPEAKER_00: But what they're really concerned about is the risk of the multiple birth, because that can really be devastating to them as a self-insured company.
• 9:46
  SPEAKER_00: Uh, and they want to make sure that they're having good outcomes.
• 9:49
  SPEAKER_00: And so success rates in terms of what is a live birth rate is also important to them because they don't want someone infertility is a hamster wheel.
• 9:56
  SPEAKER_00: You're going around in circles, it can be very frustrating, it's very emotional.
• 10:00
  SPEAKER_00: Um, you know, there's time off of work and those type of things.
• 10:03
  SPEAKER_00: So the burden, there's an emotional burden.
• 10:05
  SPEAKER_00: So to make it easier for the patient, we have care coordinators.
• 10:09
  SPEAKER_00: We're actually working with artificial intelligence now to streamline the triage and to make it quicker and easier for patients to get in to see a provider and to make sure that we collect information so that they know the provider knows why this patient is coming in.
• 10:25
  SPEAKER_00: And you don't have to waste a lot of time when you do that first initial visit.
• 10:30
  SPEAKER_01: You mentioned before that uh there was a founder of this company who had a different uh approach.
• 10:36
  SPEAKER_01: And also your background, you've been around a lot of places, a lot of them you know, quite well established or larger organizations.
• 10:43
  SPEAKER_01: What was it like to take over from a you know founder-led uh company?
• 10:47
  SPEAKER_01: What's that been like?
• 10:49
  SPEAKER_00: Um, it's been a great challenge.
• 10:51
  SPEAKER_00: The founder had amazing ideas.
• 10:53
  SPEAKER_00: And when you look at what Kindbody was built upon, you know, I talked about this vertical integration, but also our clinics are beautifully designed.
• 11:03
  SPEAKER_00: Uh they the idea is that people should not be hiding the fact that they can't have a baby, that they're infertile.
• 11:11
  SPEAKER_00: Uh, they should really, one, reduce the um uh emotion.
• 11:16
  SPEAKER_00: So all of our clinics are very warm and welcoming.
• 11:19
  SPEAKER_00: Our physicians don't wear white lab coats because that's intimidating.
• 11:23
  SPEAKER_00: We don't have offices for physicians with diplomas behind them.
• 11:27
  SPEAKER_00: Again, it can be intimidating.
• 11:28
  SPEAKER_00: And our exam rooms are very large and have a table in the exam room so the physician or the provider can sit down with the patient and discuss with them what the treatment options are instead of it being done either behind a big desk with diplomas, which can be intimidating, or even sometimes in a stir-up, which is also a very uncomfortable type of position.
• 11:47
  SPEAKER_00: So the aesthetic, the design, there was a lot that went into designing the clinics.
• 11:53
  SPEAKER_00: Um, but fertility is uh a service where you're providing things.
• 11:58
  SPEAKER_00: Um, it's very important to have uh a reach.
• 12:02
  SPEAKER_00: And a lot of kind body clinics have one location without having uh satellite clinics.
• 12:08
  SPEAKER_00: Some of the larger IVF networks will have a centralized lab and then almost a hub and spoke model.
• 12:14
  SPEAKER_00: The lab is the hub, and then there are spokes around the lab so that patients can go and be seen and be treated.
• 12:22
  SPEAKER_00: Uh, during infertility for IVF, you're usually going into a clinic over a two-week period for blood work and ultrasounds many times.
• 12:30
  SPEAKER_00: And to have to drive into one location can be challenging, painful.
• 12:34
  SPEAKER_00: And so having a satellite office out in suburbs or downtown versus a lab in a suburb makes it easier for patients.
• 12:43
  SPEAKER_00: And that's one thing that um Kind Body doesn't have in many locations.
• 12:47
  SPEAKER_00: It's just one clinic.
• 12:49
  SPEAKER_00: So there are there are a number of things.
• 12:51
  SPEAKER_00: Uh I think a founder-led organization culturally is also very different.
• 12:55
  SPEAKER_00: Um I like to bring in a lot of people and have discussions.
• 13:00
  SPEAKER_00: But what's also important is we have to come to a resolution and make ideas and all go forward together.
• 13:05
  SPEAKER_00: And um, so I think my management style is a lot more um, I would say, inclusive.
• 13:10
  SPEAKER_00: Um, you know, sometimes the founder has a vision and it's like, okay, everybody's on that vision and going forward.
• 13:16
  SPEAKER_00: And uh it's important to have a mission and a vision, and that hasn't changed at Kindbody.
• 13:21
  SPEAKER_00: But I think some of the way that we maybe um uh manage the efficiencies of the clinics, I've brought in people who have been in the fertility space, who have managed other clinics in the past, and we didn't have that um at Kind Body before I came in.
• 13:38
  SPEAKER_01: Let's talk about drugs.
• 13:40
  SPEAKER_01: So, you know, a lot of the business actually was kind of specialty drug related back when I was uh looking at it.
• 13:46
  SPEAKER_01: And my understanding that's evolved, so there's more of commodity, so more of a commodity and not driving the whole business.
• 13:52
  SPEAKER_01: Now you've got a background on the pharma side, and I'm wondering how that has informed uh your approach to that part of the business.
• 14:01
  SPEAKER_00: The drugs are still, it's very interesting because um so I launched the Gananotropins, they're recombinant products in the late 90s, and they're they're two recombinant products in the United States.
• 14:12
  SPEAKER_00: And they, as you say, they're virtual commodities at this point.
• 14:15
  SPEAKER_00: One is called Fallist and one is called Gonalf.
• 14:18
  SPEAKER_00: The the products are still the same from launching them in 1997.
• 14:23
  SPEAKER_00: The difference is now they're in a pen, so similar to GLP1s, they're in a very easy pen that can be dialed and dosed.
• 14:29
  SPEAKER_00: Uh, and the pricing has become commoditized as well.
• 14:32
  SPEAKER_00: And so in today's world, um, there's a lot less uh, it is more commoditized, there's less differentiation between the products and with RX.
• 14:44
  SPEAKER_00: So this was a big, um, amazing announcement in October of last year, where at the White House, President Trump brought in EMD Serono and announced a reduction in the drugs for fertility by up to 80% by doing a contract with RX and offering those savings to patients.
• 15:04
  SPEAKER_00: Not every patient will qualify.
• 15:06
  SPEAKER_00: You know, there are income, but it did drop just the typical patient that is going into treatment.
• 15:12
  SPEAKER_00: It dropped the price of that by about 30 to 40 percent.
• 15:16
  SPEAKER_00: Um, and then the other company, Oregon, uh, followed suit very quickly thereafter.
• 15:20
  SPEAKER_00: So the overall drug pricing has come down significantly since this announcement, which is great for patients and you know, hopefully will allow access to care more so.
• 15:31
  SPEAKER_01: So we talked about drugs.
• 15:32
  SPEAKER_01: That's kind of the classic topic.
• 15:33
  SPEAKER_01: And I want to talk about a newer one, which is AI.
• 15:36
  SPEAKER_01: You know, we're not at the point where AI is completely replacing families yet.
• 15:40
  SPEAKER_01: Uh, so there's still an interest in having babies, at least as I understand it.
• 15:43
  SPEAKER_01: But AI is showing up everywhere, no, everywhere, but in in clinic workflows uh in particular.
• 15:49
  SPEAKER_01: And I'm wondering uh what's being done today with AI in your space and then where it may be uh heading.
• 15:57
  SPEAKER_00: AI is amazing.
• 15:59
  SPEAKER_00: And there are so many uh there are so many things that AI can do.
• 16:04
  SPEAKER_00: And what we're looking at and exploring right now is how do we take manual, busy work off of people's hands and make them more efficient?
• 16:12
  SPEAKER_00: So I'll give you a couple examples in how we're using AI and we're doing pilots right now because we think that this will save time.
• 16:20
  SPEAKER_00: We're not looking at it as a way to replace people, but we're looking at it as a way to reduce busy work.
• 16:25
  SPEAKER_00: And one example that comes to mind is when someone comes into a fertility clinic, they have a stack of medical charts because they've been pursuing a family, they've gone to an OBGY and a primary care doctor, they may have had some surgeries.
• 16:41
  SPEAKER_00: It's very typical a patient comes in with two to 300 pages of medical history.
• 16:47
  SPEAKER_00: And our nurse practitioners or physicians' assistants have to review that stack of papers, and it can take them anywhere from 45 minutes to an hour and a half.
• 16:57
  SPEAKER_00: Now we're working with an AI company that can scan all those pages in less than five minutes, pull out all the keywords, and have a one or two-page fact sheet of all the basic information that's needed that we've asked it to look for.
• 17:10
  SPEAKER_00: And now a nurse practitioner or PA can go through the highlights.
• 17:15
  SPEAKER_00: They have to go back and check to make sure it's accurate, but it can take them something that might be 10 minutes to review instead of 45 minutes to an hour and a half.
• 17:23
  SPEAKER_00: And we can then use them to do other things because they don't want to be sitting there reviewing charts for an afternoon.
• 17:30
  SPEAKER_00: So it makes the process so much more efficient.
• 17:33
  SPEAKER_00: Another way that we're utilizing it is on the uh treatment side.
• 17:38
  SPEAKER_00: Uh, when we have a treatment plan, we have a financial navigator that sits down with the patient and says, okay, let me show you what the plan is.
• 17:46
  SPEAKER_00: Here are the costs involved.
• 17:47
  SPEAKER_00: And you have coverage, maybe you have employer coverage, maybe you have traditional insurance coverage, maybe there's not coverage.
• 17:53
  SPEAKER_00: But that treatment plan, there's a lot of manual work that has to be done to ping insurance companies to see what is covered and what is not covered, if there's a deductible, if there's a copay.
• 18:04
  SPEAKER_00: We're now using AI bots to be able to get that information, populate that forum, and something that used to take five to six days to get back to the patient, we can now turn around in less than a day.
• 18:16
  SPEAKER_00: So it makes it much quicker for the patient to be able to understand what their responsibility is.
• 18:21
  SPEAKER_00: And then if there is a cost involved to them, we also are working with third-party financing companies that can offer them a way to pay for it over a period of time, one, two, three, four years, whatever's comfortable for them.
• 18:34
  SPEAKER_00: Um, one other example I want to give, because this is something that I actually was at a startup company with uh several years ago before AI that was using data analytics to give predictive modeling to patients.
• 18:46
  SPEAKER_00: In fertility uh IVF, specifically in the United States, there's actually a law that was put into place to have IVF centers report what their success rates are.
• 18:56
  SPEAKER_00: And this is something that the CDC collects every year.
• 19:00
  SPEAKER_00: But because you're waiting for a baby to be born and it goes by a calendar year, it's often delayed by 18 to 24 months.
• 19:07
  SPEAKER_00: But all that information is available online at the CDC or something called SART, the Society for Assisted Reproductive Technologies.
• 19:14
  SPEAKER_00: The way that they structure it is based on the age of the patient.
• 19:17
  SPEAKER_00: And so we'll say if you're under 35 at this particular clinic, here's the chance of having a baby.
• 19:23
  SPEAKER_00: If you're 40 to 42, here's the chance.
• 19:25
  SPEAKER_00: Age is only one factor.
• 19:27
  SPEAKER_00: There are so many others that have an impact on the success.
• 19:30
  SPEAKER_00: And so we're now using AI to be able to look through our own data and to understand someone with a hormone level of X, with a semen analysis of Y, with a history of endometriosis, a history of PCOS, we can see other patients that have very similar parameters and give a real-world predictive model to say, expectation setting, it may take you two egg retrievals to have a baby.
• 19:55
  SPEAKER_00: But if you do that, you're gonna have a 75% chance of having a baby.
• 19:59
  SPEAKER_00: And what that does is it sets the expectation for the patient that it's not a one-and-done type of treatment.
• 20:05
  SPEAKER_00: Maybe one time you'll be lucky and 40% of people will have a baby.
• 20:09
  SPEAKER_00: But if you stay with the treatment over time, we can get you up to that 70, 80% range of having a baby.
• 20:16
  SPEAKER_00: And so a lot of patients walk into a clinic and think, I'm lucky, I'm gonna have the baby on the first shot.
• 20:21
  SPEAKER_00: And if they don't, either they may stop treatment altogether or they might go to another clinic because they say, Oh, I didn't get pregnant at this clinic, let me go to another one down the street.
• 20:30
  SPEAKER_00: So by offering them this expectation and showing them their own data and how it compares to the data of that practice, you're able to set the expectation for them.
• 20:43
  SPEAKER_01: So Kindbody's actually expanded, I've seen, into some adjacent services like gynecology, mental health, hormone health.
• 20:49
  SPEAKER_01: What's the logic for that expansion and does it end where you have gotten this far?
• 20:55
  SPEAKER_00: So Kindbody, we have an expansion.
• 20:58
  SPEAKER_00: I wouldn't see gynecology.
• 20:59
  SPEAKER_00: We're not in general gynecology.
• 21:01
  SPEAKER_00: Um, and maybe when the company started, it was, which actually created some confusion.
• 21:06
  SPEAKER_00: A lot of patients coming into fertility treatment is coming from an OBGYN, and we don't want to compete with OBGYNs.
• 21:12
  SPEAKER_00: But we do have added benefits.
• 21:13
  SPEAKER_00: So one great example is dual care.
• 21:16
  SPEAKER_00: Uh, when an employer contracts with us as a fertility benefit manager, we have ancillary services like dual care.
• 21:22
  SPEAKER_00: We have a male, what we call kind mail, to be able to offer male male treatment because a lot of fertility, 50% is a female, 50% is a male, and a lot of times males never get tested, they never look into it.
• 21:36
  SPEAKER_00: So uh dual care is another great offering that we provide where we use 1099 employees, we have a network of dualist around the country, and it's a way for a patient or an employee to get that added support once they've been successful in fertility treatment.
• 21:51
  SPEAKER_00: It's actually something that's really interesting because when you go through infertility treatment, you're going through a process, and every day your nurse is calling you.
• 22:00
  SPEAKER_00: You're looking at your hormone levels.
• 22:02
  SPEAKER_00: It's a very high-touch type of treatment over the course of a month or two.
• 22:06
  SPEAKER_00: You do an embryo transfer, you get pregnant, you graduate from an ITF center, and you go to a general OBGYN and they say, We'll call you in two months.
• 22:14
  SPEAKER_00: Or, you know, you come in every six weeks for an appointment, and those patients are like, oh my God, what do I do?
• 22:19
  SPEAKER_00: You know, I'm feeling this, I'm feeling that.
• 22:22
  SPEAKER_00: And so a dual is a great way to have that additional support for that pregnant patient.
• 22:28
  SPEAKER_00: And so that's one of the ancillary services we offer.
• 22:31
  SPEAKER_00: We also offer mental health counseling, um, what we call kind 360.
• 22:36
  SPEAKER_00: And so this is a way for patients who are going through the the roller coaster of infertility to be able to speak to a provider and um and to talk to them about the emotions they're going through.
• 22:48
  SPEAKER_00: A lot of times people think they're alone and they're not at all.
• 22:51
  SPEAKER_00: A lot of people go through this.
• 22:53
  SPEAKER_00: It's not as easy as everybody thinks it is to have a baby.
• 22:55
  SPEAKER_00: Uh so that's one of the ancillary services that we provide as well.
• 22:59
  SPEAKER_01: Great.
• 23:00
  SPEAKER_01: A word that people use in healthcare a lot is access, and that has different uh meaning.
• 23:05
  SPEAKER_01: Sometimes it means just having an insurance card.
• 23:08
  SPEAKER_01: Sometimes it goes beyond that.
• 23:10
  SPEAKER_01: What does it what does access mean in fertility care?
• 23:13
  SPEAKER_01: And what does it mean to expand access?
• 23:17
  SPEAKER_00: Well, access from, I think to use your example of an insurance card is a great example of access to care.
• 23:23
  SPEAKER_00: Um, my former employer, Boston IVF, has a fellowship program, and one of the fellows wrote and published a paper about access to treatment in Massachusetts, which is a mandated state.
• 23:35
  SPEAKER_00: And people think automatically, oh, I live in a mandated state, so everybody gets treatment.
• 23:41
  SPEAKER_00: Everybody gets access to fertility.
• 23:43
  SPEAKER_00: And when you start looking at people that are excluded, Medicaid is excluded, federal employees are excluded, military is excluded, and self-insured companies are excluded.
• 23:52
  SPEAKER_00: So a woman in Massachusetts between the ages of 25 and 40, only 38% of those people actually have insurance coverage for infertility treatment.
• 24:03
  SPEAKER_00: And that's in a mandated state.
• 24:05
  SPEAKER_00: So first and foremost, access to care is being able to afford care.
• 24:10
  SPEAKER_00: And what Kindbody is doing with employers and being able to provide employer-based fertility care in a cost-effective manner helps to increase access.
• 24:21
  SPEAKER_00: One of our customers on the employer side is Walmart.
• 24:25
  SPEAKER_00: Walmart is the biggest employer in the United States, and we've worked with them for three years as their fertility benefit manager.
• 24:32
  SPEAKER_00: And what's amazing, and the this is just such a great story because in that course of the three years, 600 of Walmart's employees have had a baby through for through Kindbody, through access to that treatment.
• 24:47
  SPEAKER_00: And these are people that are shelf stackers and truck drivers and live in remote areas of the country where there isn't a fertility practice next to them.
• 24:55
  SPEAKER_00: And Walmart actually flies them in for treatment.
• 24:58
  SPEAKER_00: We do remote monitoring.
• 25:00
  SPEAKER_00: And so to be able to think about on scale how you can help 600 people build their family is just really amazing and something that we're very, very proud of.
• 25:11
  SPEAKER_00: And we value that relationship that we have with Walmart.
• 25:15
  SPEAKER_00: And we have many, many other employers that do that as well.
• 25:19
  SPEAKER_00: So that's that's access.
• 25:21
  SPEAKER_00: I think part of that as well is in the United States, large cities have IVF centers, but smaller areas don't.
• 25:29
  SPEAKER_00: So if you're in in, as an example in Arkansas, where Walmart is based, there are only two IVF centers in Arkansas, one in Little Rock and what in Bettonsville.
• 25:38
  SPEAKER_00: And we built, Kind body built the IVF Center in Bettonsville.
• 25:41
  SPEAKER_00: There is no fertility IVF center for hours from Bettonsville.
• 25:46
  SPEAKER_00: So we have people driving from Tulsa, Oklahoma, and Northeast Texas who are not Walmart employees, but just to be able to seek care.
• 25:54
  SPEAKER_00: And there's a lot of parts, when you think about the United States, the flyover states does not have good access to fertility care.
• 26:02
  SPEAKER_00: So there's a lot of opportunities there to improve the access to care.
• 26:08
  SPEAKER_00: And I think there's a company that I work with as an advisor, which is a Massachusetts-based company that's looking at ways to automate the egg retrieval process so that it doesn't have to be done in this big IVF clinic or lab, and that you could actually do it in smaller locations, collect eggs, have it be automated, freeze them, and then ship them the same way that a lab core or quest does with blood, ship them to larger IVF labs because it's very hard to attract and retain reproductive endocrinologists and embryologists in some parts of the country where there isn't a lot of support.
• 26:46
  SPEAKER_00: And you could be doing that in a way where it could be managed through telemedicine, could have an OBGYN locally extract the eggs and then send them to a centralized uh fertility lab.
• 26:57
  SPEAKER_00: So I think that's really exciting.
• 26:58
  SPEAKER_00: That's not around the corner, but maybe five years, 10 years from now, and that will help us access increase the access to care as well.
• 27:06
  SPEAKER_01: I want to ask you one more question about the model of having your own clinics.
• 27:11
  SPEAKER_01: There's been a fair amount of discussion recently.
• 27:14
  SPEAKER_01: I think even Mark Cuban has brought this up about having more direct contracting between provider organizations and employers with that the idea that the insurers don't add that much value and that there's people that are just, you know, creating these networks that don't actually uh do that much.
• 27:31
  SPEAKER_01: Now, I understand you've got your own, at least a lot of your own clinics.
• 27:35
  SPEAKER_01: What is it like when you're dealing with the employer?
• 27:38
  SPEAKER_01: Do they obviously your customers buy into this model, but what is the thinking now about say, I like working with you because you actually are the provider versus actually, no, I want someone to just, you know, manage providers uh for me?
• 27:50
  SPEAKER_00: There are a couple of ways to think about it.
• 27:53
  SPEAKER_00: Uh, I think from an employer standpoint, what we offer is really a white glove service, a concierge type of service, where we're providing overall not just the treatment in the clinic, but we're also providing a resource for the patient.
• 28:07
  SPEAKER_00: Because uh having worked in a managed care state, um, when you have commercial insurance, it's fantastic.
• 28:15
  SPEAKER_00: But you're really thrown in the deep end of a pool.
• 28:18
  SPEAKER_00: And you're basically, okay, I have Blue Cross Blue Shield, or I have United, or I have Aetna, and I'm covered.
• 28:24
  SPEAKER_00: But there is very little support there.
• 28:27
  SPEAKER_00: And those patients have to go through testing, they have to go through authorizations, um, they have to figure that out all for themselves.
• 28:34
  SPEAKER_00: And so the patient has to become an advocate for themselves to understand what do I need to do to get treatment.
• 28:40
  SPEAKER_00: When they show up to an IVF center, that IVF center will help them.
• 28:44
  SPEAKER_00: But there's still a lot that the patient has to do on their own.
• 28:47
  SPEAKER_00: When you go to a kind body as a fertility benefit manager, that is all provided for you.
• 28:52
  SPEAKER_00: So that employee who is experiencing a challenge in building their family will call our call center.
• 28:59
  SPEAKER_00: They can contact us.
• 29:00
  SPEAKER_00: We have these, as I mentioned before, AI agents that collect information from them.
• 29:04
  SPEAKER_00: Also, they educate patients on what the treatment process is, their different options, their different choices, what the different tests are.
• 29:11
  SPEAKER_00: And all that up front is being education and done.
• 29:14
  SPEAKER_00: And then on the back end, as I mentioned, the risk of multiple births is very high.
• 29:19
  SPEAKER_00: So we curate a network.
• 29:21
  SPEAKER_00: And so when we're contracting either with our ourselves as our clinic provider in our signature clinics or with a third party, we're contracting with them, and we have that expectation as well that they're not putting two or three embryos back, they're putting a single embryo back.
• 29:35
  SPEAKER_00: We look at their outcomes and we make sure that they're above average compared to the national US average.
• 29:41
  SPEAKER_00: So that the curated center of excellence model is something that employers get.
• 29:47
  SPEAKER_00: Whereas, again, in a typical insurance state, they contract with every single provider, and the patient has to be the one to understand, you know, they look through a Zoc Doc or some kind of review of what type of provider they're going to.
• 30:02
  SPEAKER_01: Give me one or two predictions about what's coming over the next number of years for the industry and maybe for Kind Body itself.
• 30:10
  SPEAKER_00: When we look at access to care in the United States, based on our population size, if we had the same type of model that Europe has, or you know, even now countries like Japan and South Korea, um, we would be doing a lot more fertility treatments based on the per capita population.
• 30:30
  SPEAKER_00: Um, in the United States, the access, whether it's a financial access or a geographic access, is substantially lower than other parts of the world.
• 30:39
  SPEAKER_00: So I think what we can do better is improve the access, improve the treatment.
• 30:44
  SPEAKER_00: We have a replacement rate problem.
• 30:46
  SPEAKER_00: If you look at data that's been shown, the number of people having babies in the US continues to drop.
• 30:52
  SPEAKER_00: Um, the sperm counts of people continue to drop.
• 30:56
  SPEAKER_00: And so it becomes an economic problem that we don't have enough people, enough children to replace ourselves.
• 31:02
  SPEAKER_00: And so that's why I think when you look at it over the next longer term, five to ten years, we have to do a better job of getting more access to treatment.
• 31:12
  SPEAKER_00: Um, I think some of the burden that people have with um monitoring, I mentioned before that you have to come in and you have to do blood work and ultrasound.
• 31:21
  SPEAKER_00: There's a lot of great opportunities to do that remotely and to do at-home ultrasound testing.
• 31:27
  SPEAKER_00: Um, use it.
• 31:28
  SPEAKER_00: There's actually now ultrasound machines that you can scan yourself.
• 31:31
  SPEAKER_00: It goes up to a cloud, the cloud measures the follicles and does everything that a human would do in one of the fertility clinics.
• 31:38
  SPEAKER_00: Um, same thing with blood monitoring.
• 31:39
  SPEAKER_00: Could it be done using a small blood, like a glucose monitor type of device?
• 31:46
  SPEAKER_00: Um, and so I think the burden that patients go through today, uh, in the next five to 10 years, we'll be doing things via telemedicine, having at-home monitoring, you know, maybe collecting eggs uh in a remote area and sending it to uh a larger kind of centralized fertility laboratory.
• 32:04
  SPEAKER_00: Um there's that's one of the things that's kept me in the field because every couple of years you have these improvements.
• 32:12
  SPEAKER_00: When I started, there's something called IXE, intercytoplasmic sperm injection.
• 32:17
  SPEAKER_00: And before Ixy, we take a single sperm and inject it into an egg and we get fertilization 90% of the time.
• 32:24
  SPEAKER_00: Before that, men who had poor sperm quality couldn't have their own child.
• 32:28
  SPEAKER_00: They had to use donor sperm.
• 32:30
  SPEAKER_00: So in the 90s, with IXE, we were able to increase the number of men with fertility problems that could father their own children.
• 32:38
  SPEAKER_00: Um, then we had changes in the growing of embryos.
• 32:42
  SPEAKER_00: And we used to throw them back in, use the example throwing them back after three days.
• 32:46
  SPEAKER_00: We now they'll grow them out to a blastocyst stage, six days, and we've developed ways to grow those embryos longer in vitro, and so we can select better quality embryos and put one back at a time.
• 32:57
  SPEAKER_00: We can use genetic testing.
• 32:59
  SPEAKER_00: There's interesting um technology to also look at disease.
• 33:05
  SPEAKER_00: And so while we can do what's called PGTM today, which is monogenic testing of cells of diseases like sickle cell anemia, um, uh inherited disease, spinal muscular atrophy, muscular dystrophy, we can eradicate those diseases by taking healthy embryos and transferring them as opposed to essentially rolling the genetic dice and having babies the old-fashioned way.
• 33:30
  SPEAKER_00: So there's a lot of great opportunities to increase access and to overall improve the health of our population.
• 33:39
  SPEAKER_01: Great.
• 33:40
  SPEAKER_01: Well, that's it for another episode of the Health Business Podcast.
• 33:42
  SPEAKER_01: I'm David Williams, president of Health Business Group.
• 33:45
  SPEAKER_01: My guest today has been David Stern, CEO of Kind Body.
• 33:48
  SPEAKER_01: If you like what you heard, please subscribe on your favorite podcast platform.
• 33:53
  SPEAKER_01: And thank you, David.
• 33:54
  SPEAKER_00: Thanks very much.
• 33:55
  SPEAKER_00: I appreciate it, David.