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[Colin Miller]

Hello, I'm Colin Miller, CEO at the Bracken Group and this is Fractals: Life Science Conversations. Bracken is the professional services firm for life sciences and digital health organizations. Our intelligence ecosystem fulfils consulting, regulatory, marketing and analytics needs with an integrated and strategic approach.

Today's episode explores how one company is transforming maternal health care, starting before birth and extending far beyond baby's first milestones. From breastfeeding support to high-risk pregnancy monitoring and mental health care, SimpliFed is redefining what it means to care for the whole family. I'm joined today and delighted to introduce Mary Hardy, their Chief Commercial Officer. So welcome to Fractals.

 

[Mary Hardy]

Excited to be here. We love working with your team. Happy to be here.

 

[Colin Miller]

So Mary, what drew you to this space, SimpliFed, the business, and how did your professional journey lead you to SimpliFed and its mission?

 

[Mary Hardy]

Yeah, great question, Colin. Been in health care for a long time. I don't like to add up all the years, makes me feel old.

We'll skip that part. But I was introduced to Andrea about close to three years ago and have been in health care, been in companies that are focused on pop health management, quality metrics, reducing cost of care, and always like to be someplace that was making a difference. And I'll be honest, when I first heard of SimpliFed and virtual lactation piqued my interest.

But where I really got involved and excited is when I started to learn more about what we're doing from a platform and a maternal health in general perspective. So incorporating mom and family, looking at things like maternal mental health, and really this inclusive, all-encompassing care support platform that they've developed, we've developed, just really drew me to the space, learning more about some of the needs in this area, some of the problems with maternal care deserts, and some of the poor quality metrics that we're seeing, unfortunately, in the US.

Proud to be part of an organization that's trying to make a difference in this space.

 

[Colin Miller]

Fantastic. Wow. In fact, I think our pathways must have crossed at some point, because I noticed you were at GE many years ago as well.

 

[Mary Hardy]

Yes, I was for a long time, for about 20 years. Yeah.

 

[Colin Miller]

So, I was an acquisition for a number of years back in the day.

 

[Mary Hardy]

Back in the day. Yes.

 

[Colin Miller]

Based on everything you've just said is just making major inroads, obviously, in maternal care. For the listeners who have not interfaced with SimpliFed before, can you just describe a little bit more about what the platform is and the concept behind the virtual maternal care and how you're really helping change the dynamics there?

 

[Mary Hardy]

So, we're a virtual maternal care platform, and our mainstay, kind of our flagship offering, is virtual lactation and baby feeding. So, when Andrea Ippolito, our founder and CEO, launched the company in 2019, that was an offering. She had her first child, started to see some of the gaps in care and support with lactation, realized that lactation is actually an ACA mandate, so health insurers are required to cover this care for their members, said, I really want to make an impact and a difference here.

So, we have a national curated network of what we call IBCLC, so International Board Certified Lactation Consultants, that support our patients across all 50 states. Now, what we've done with a product in the past year is really elevated our care models. Again, virtual lactation and baby feeding is our core offering, but we're starting to look at really solving this problem in what I'll call the postpartum time period.

So we start our care prenatally. We typically work with families around the 28-week time visit, starting to set expectations about baby feeding, breastfeeding, really we're very inclusive, meeting families where they're at and their needs, leveraging technology where it makes sense, but also they are really to support in that postpartum time period. We're adding things like remote blood pressure monitoring.

In early 2026, we're going to be adding continuous glucose monitoring, and we do a really good job, we can talk a little bit more about this, in screening for maternal mental health, which is a big area of focus for the company.

 

[Colin Miller]

Wow, that's a pretty comprehensive set of opportunities there. And now bringing in the mental health, which of course, postpartum depression is very well known and at least documented, I think people are aware of it, but of course, absolutely key. Where do you see that going in particular?

 

[Mary Hardy]

So about six months ago, we started adding in an additional focus for our providers. If you start to think about some of the perinatal mood and anxiety and depression screening, how do we help our providers with this process? So, all of our IBCLCs either have or are in the process of attaining something called a PMHC, a Perinatal Mental Health Coaching Certification.

So, we're not the behavioral health provider, that's not the goal, but in each of our appointments, we're doing something called a PHQ-4, where we're screening, we've got four screening questions, two for anxiety, two for depression, that is part of the conversation during an appointment. And what we're seeing is this is really driving up screening completion rates. More importantly, instead of just saying, hey, we met this HEDIS measure is saying we're leveraging this very strong, positive patient provider relationship, which can often be over a 15-month time period.

And then getting to some of these honest answers. It's very common to see paper screeners score a zero, but when you're sitting and looking at each other in the eyes, you're having this conversation, you get to the root of the problem, you get to the answer. And then we're also investing in behavioral health partners that we can refer our patients to.

So really saying where we want to be part of this transformation in maternal mental health and making sure we're helping to identify and connect to care, which is a big part of the problem that we're seeing in the market right now.

 

[Colin Miller]

Wow. Okay. That is something I've not picked up on as, as how that feeds in, if you, if you pardon the pun, but builds into the whole challenge.

So, wow. Very impressive. So absolutely fascinating the way the platform's being built here, Mary, really, as you think about it, I wonder if you could share a little bit more about what makes a simplified story and approach resonate so powerfully with families.

 

[Mary Hardy]

I think great question, Colin. And I think if, if I even go back to my era, many moons ago, having my kids and home two o'clock in the morning, breastfeeding, not working, who do you call? How do you get there?

It's a lonely experience. It's really why Andrea started this company with it, with the experience from her first daughter. And I think what we're seeing from a family perspective is just knowing you've got the support 24 seven.

And the beauty is really when we do this, right. We're starting this prenatal relationship. Like we said, about 28 weeks, that's a three month journey prenatally.

And there's, we typically have a one or two appointments on the prenatal side, but you have established this relationship with someone that was there to support you. Mom goes into the hospital, has baby. We're never competing with the inpatient team or lactation consultants that are there doing the great work that they do.

But we're there once they go back home again to pick them up. And we help with, obviously the foundational is virtual lactation and baby feeding, but we help with things like locally, where can you find a car seat? If you're going to be going back to work, how do you get an in-network breast pump?

How do you support families on some of these nutrition questions and sleep questions? So really there is a trusted advisor for this can often be upwards of 15 months of baby support in a time, particularly with your first one, that can be quite trying and quite nerve wracking. So I think just having that trusted partner is such a big piece of what we do in our care delivery model.

 

[Colin Miller]

That makes a lot of sense. And I think it also speaks to the fact that our society these days has become much more fractured. We no longer have the nucleus.

And I think as we work more and more remotely and not all with close family, et cetera, I'm sure that plays into it, doesn't it?

 

[Mary Hardy]

Absolutely. And you hit a nail on the head, Colin, but literally my own, I have identical twin girls have said we've lost the sense of community at least in the U.S. today. And what used to be this family nucleus isn't there any longer.

And when you start to see just when we start to look at some of the maternal care deserts in the areas that we don't have that in-person support, and now imagine military families who are picking up and moving every two years. Those of I didn't have family around when I had my kids. So just having that support and then leaning into technology.

ACOG just came out with their first upgrade to their guidelines since 1930. So 100 years later, yup, jaw dropping. 1930 was the last time they updated.

And really what they're leaning into is saying what we have to change is meeting in the maternal health space, particularly meeting social determinants, some of these social unmet needs, starting and measuring prenatal care. We in Healthcare USA wait until it's a crisis and then we try to solve it. So let's try to do these things sooner.

And then leveraging technology and virtual care where it makes sense. We're pretty excited about these new guidelines. We didn't help write them.

We'd love to say we did, but we sit right in the wheelhouse of what some of the national evidence-based standards are pointing at.

 

[Colin Miller]

I am absolutely amazed that it's taken 100 years for us to update guidelines like that.

 

[Mary Hardy]

Yes, crazy, but it's true.

 

[Colin Miller]

Any really major items that you see in those guidelines that specifically jump out at you?

 

[Mary Hardy]

I think it tracks to some of the trends, right? So we're now approaching close to, if not over 50% of all net new child births in the US are Medicaid. So when you compound our Medicaid population, some of these unmet social determinant needs that are in health plans or doing the analysis here are the very high cost drivers of some of the problematic areas.

And so when you see and having recommendations start to point the arrow to leveraging telehealth, I think COVID made a big change, right? And all of virtual technology for all of us and all of the platforms that we work on, not just healthcare, but as we start to look at leaning into these new times and having these accredited organizations point the arrow to be able to leverage technology when there's an OB shortage, there's a PCP shortage, when there's just not enough doctors, even in the non-desert areas, we have to start to do things differently to be able to meet patients where they're at.

 

[Colin Miller]

How really does this work? You've mentioned several times about you don't compete with the in-care specialty lactation teams, the OBGYNs, et cetera, and you provide the gap. How does that realistically interface?

How do people find out about SimpliFed first of all, and how do they get involved?

 

[Mary Hardy]

We partner with health plans. So we are a provider practice. So SimpliFed is paid by our health insurer partners, but the way we activate patients is through partnerships with either large health systems or large OB groups, OBGYN groups.

So in either case, the ideal scenario that's really driving the best outcomes is setting up a referral to SimpliFed within their EHR. So we like to say we punch above our weight class for a virtual lactation company. We've got a very strong technology stack.

Our CTO, very well-versed, he actually worked for the interoperability standards. So we know in healthcare, the two big speed bumps that we can face when trying to turn us on is cost and IT resources. And we really have addressed both of these.

I'll handle the cost side first, and I'll come back to how we work. Because we are a provider practice and we're not a big tech implementation, we offer our services at no charge to our health system and to our OB partners. We're a provider to provider referral.

And then on the IT side, we like to make this very easy for them. So we work with all the major EHRs. We have an address, so we're searchable within a provider's electronic health record.

So in an ideal world, we're working with a partner that sets us up in an order set. So what that means is that instead of a provider having to think to hit send to SimpliFed, every single pregnant woman that comes through that office at that 28-week visit, which is when they're in the office for a while, they do their glucose tests. There's other things they're talking about.

The provider shares that they're going to send a referral to SimpliFed for virtual lactation baby feeding support. And then they're often on that journey with us. And beauty of what we do is we are 100% virtual, but we're not a 1-800 number you call and get who's on staff that day.

We match a provider and a patient at that very first appointment. And those two are together through their entire 15-month journey. And we believe that's really the secret sauce of driving some of the downstream outcomes.

You've got a partner there that's with you before childbirth. They go inpatient to the hospital, have baby, come back home, and they're with us. And for our health system partners, we like to just say, we're just a virtual extension of your current team.

We're there to support where virtual makes sense. Your inpatient team and in-person team does a great work that they do. And then as you need us, once the mom and baby and family go home, we're there to support them.

 

[Colin Miller]

Wow. Okay. That is quite the comprehensive setup.

Let me ask you, if you're in a, I'll just say an OBGYN desert, for want of a better term, and my wife wants health and support if she's pregnant, how can they call you? Can they contact you through the website? Absolutely.

 

[Mary Hardy]

Yes, absolutely. There's a patient form right on our website that a patient can come to us directly. And you know what's interesting, Kyle, that you would think there would be more, we call that coming in our front door.

Lactation is one of those things that very often health systems are just busy and that may not be their top priority. And families don't to go looking for it. So if you sprained your leg to go to an orthopedic doc to get it looked at, you know that you need physical therapy, but lactation isn't one of those that is as common to go for a patient to go search for on their own.

And this is why we're trying to set up these partnerships with health systems, with large OB practices to get the word out. But yes, if someone that wanted to come in through the front door, we have a website searchable and there's a great link for patients to follow their way and they can find us there.

 

[Colin Miller]

Part of the thinking behind my question there was, I think a lot of people think lactation, just a natural thing that you do and you don't think, hang on, no, there's some complexity behind all of this.

 

[Mary Hardy]

And we also find sometimes we'll do a virtual appointment with families. They get going and say, I'm good. I don't need this any longer.

But at that three or four month mark, they're getting ready to go back to work and they've got questions. Or at that six month mark, they're transitioning to solids. They have questions.

We had our CEO, Andrea had an issue with her third daughter where at the 10 month mark, she just stopped sleeping. They had been sleeping and our providers can help with some sleep advice. So really there is that trusted partner through all the baby questions as you start to move through your journey for that, really for that kind of first year postpartum.

 

[Colin Miller]

So it's a much more rounded support system from the sounds of things right the way through. Wow. What a fascinating approach.

As you see all of this, you must be, you get a lot of rich data from your the patients, the mothers working with you, the families working with you. What has surprised or challenged your assumptions about maternal care?

 

[Mary Hardy]

I'll say the biggest surprise to me. So I worked in telebehavioral health before joining SimpliFed. So a passion there for many reasons, just realizing what an underlying driver it is of some of the downstream issues.

I was surprised as what a large driver it is in cost of care in maternal health specifically. And we did, we, SimpliFed actually did an actuarial analysis. We worked with a company, did an actuarial analysis about a year ago this time, as we were starting to think about other products that we particularly wanted, particularly wanted to layer in like remote blood pressure monitoring and gestational diabetes.

And we weren't surprised to see them on the list, but we were surprised. What I was surprised to see is maternal health is the number one driver of cost of care in the maternal space postpartum. So we're measuring day one from discharge for one year postpartum.

And I was surprised at its prevalence above hypertension and gestational diabetes. And what that really did was pushed us as a company to invest in what I was talking about earlier of training of our team, investing in our technology stack and screening differently, more intelligently. We improved our PMED screening rates from in the low thirties to we're up in over 85% completion rate now, and very proud of that.

And really believe that this ability to help families connect to care is a big differentiator. That was one of the biggest eye-opening factors in this space that I've seen. And I'm starting to see others in this space that are focused on this and investing in this area also, which is needed.

 

[Colin Miller]

That's why you have to use the data to find out where the market's going, but also what the needs are. And the key piece there is really what are the needs? And just wonder if you've very nicely peppered some of the answers with stories from your CEO.

I wonder if you have any other case examples that just show team win, if you will, and how you've supported a mother and baby.

 

[Mary Hardy]

There's a, we have someone on our team who supports our military families. She was in the military herself. And just, I think as we start exactly what you were saying.

So imagine a mom and family that doesn't have their own family there as support, and actually has a story of a mom that has worked with her over three children. All three children were born in different states. Her husband was typically not there.

And just starting with that first child there for, and they've stayed together through all three children. And just think of having that. Now you've become almost part of the family, right?

And that ability to doesn't matter where you go in the country. You don't have to worry about being tethered to brick and mortar and that care team. And she was, has gone through different providers in all of these spaces, some positive, some less.

And, but having that kind of trusted resource. And to me, that's where you have that aha of the power of virtual, the power of the relationship, and then the power of having that support network there when it isn't there for you, it boots on the ground.

 

[Colin Miller]

Yeah. Yeah. I assume from that, then your team that are providing the support have to be very flexible in their working hours as well.

 

[Mary Hardy]

Yes, absolutely. And I, that's another kind of power of our platform is everything is digitized so that when that referral comes in, it's the tech stack in the background, for that patient I just explained, knows who her provider is. And that's a priority and the matching, but we've got the ability to kind of look at a schedule, look at our kind of provider matrix, make sure that we've got the patient and provider together.

And then what does that availability look like? But it's, our volumes have over quadrupled in the past year. So it's, we've, and another thing that's very interesting, you didn't ask this question, but I want to share this because I was, something I was fascinated with when I first joined, we hear about the nursing shortages, right?

It's in the paper and the press and burnout and all the things. And we have over 300 providers that are on our roster and waiting list and have been vetted to be deployed. So we're hiring, you know, we're on a hiring ramp, but we're not facing the shortages.

We give our providers that ability to have a flexible schedule and that they themselves can be, what's very positive for their work-life balance. So we've really, I think, tried to make the best of all worlds. And even, it even affects kind of our recruit, on the recruitment side also.

 

[Colin Miller]

Wow. It certainly makes sense. Just, it actually reflects a little bit Rackham's consulting team as well.

It's exactly the same process.

 

[Mary Hardy]

Exactly.

 

[Colin Miller]

And I think it's the same model there, but it just speaks, I think, highly of the burnout that's occurring because the nursing and professional healthcare teams, those folks still want to work. They still want to be part. They don't want to just give it up, but they can't necessarily stay within the bricks and mortar and the rigid systems.

 

[Mary Hardy]

Absolutely. And when you have that flexibility and you've got that kind of positive work-life balance, it's a win-win for everybody.

 

[Colin Miller]

Yeah. Yeah. No, I can see it on the other side of the equation because you have to have enough really high professional staff to be able to manage the sort of questions and patient requests that are coming.

 

[Mary Hardy]

Right. Absolutely.

 

[Colin Miller]

So it's, no, I thank you for bringing that up because it's an important facet of being able to offer a service. It's, technology supports it, but it's still effectively what you've provided, I think, is the human touch in a technology enhanced system.

 

[Mary Hardy]

Yes, definitely. Where you don't want to forget that piece of it because it's very important.

 

[Colin Miller]

Yeah. Listening to you, I'm going, yeah, that's a very clever model that you've built out there. And so as you scale deep in your market presence, how do you position Simplified as not just a service, but really almost a new standard of care and new standard of approach?

 

[Mary Hardy]

Thank you for asking that because it is perfectly timed. And as we look at where we've been and growing and happy with our pace so far, we're actually starting to partner with two health systems where we're really becoming embedded in their postpartum care model. So today in maternal health, their health plans and health systems contract, there's something called a maternal episode of care.

So within that, there's an episodic payment from a health plan to a hospital for that inpatient stay. So you can read about trying to reduce C-sections and concerns over NICU babies and all very important things. That isn't where Simplified sits.

We do start prenatally with expectations before mom comes into the hospital. But because of that, we believe that what we're addressing is a cost driver in the postpartum time period. So we're really looking at this thing, we're trying to develop a new care model that we're calling a postpartum episode of care, where we will be partnering with our health system with building out a model with these health systems, where instead of just a referral, we are pre-scheduling, we're going to be doing first something called a smart on fire implementation, where we're right in the electronic health record. And then secondly, scheduling, pre-scheduling every patient for two prenatal and two postpartum checks that we're doing all of the clinical quality metrics, updating the system, we'll be leveraging additional types of care delivery. So think of registered dieticians helping with nutrition, family planning.

So things that are very tangential that our NPs can pick this up, we're just facilitating a role that the health system is looking for, doing the parental mood anxiety disorder screening and directly referring to their network of behavioral health providers. So really embedding ourselves into their care delivery model, really being a trusted partner in kind of all of these pieces and components and elevating kind of the return on investment and partnership and care delivery down the road. So really starting to turn a corner to changing the game and how we're looking at owning that, what we're calling that postpartum maternal care delivery model.

 

[Colin Miller]

Yeah, that's huge. And do you differentiate at all in the types of, and I'll put the background to this in a moment, the types of babies and the types of issues. And I say that because my wife is an ex NICU nurse.

And so you mentioned the NICU issues. So I've got some familiarity just because of my wife being involved in. So do you have, do you see special needs say for NICU kids or kids with other needs and you have to bring another specialist?

 

[Mary Hardy]

If you think of us as a hundred percent virtual platform, there's areas that we will address and areas that are best suited for someone in person to care for. As a true extension of a health systems team, leveraging virtual where it makes sense, but also saying if we're going to invest in and be part of this postpartum care delivery model, this is, we're still in the build phase, but I'll say we're going to be doing some things that are an extension of how we're doing things today. And thinking about how do you care for even a C-section mom versus a normal delivery mom coming home.

There's going to be NICU families that live very remotely, that this is where virtual is a great way to do that, that follow-up once they are able to go home.

 

[Colin Miller]

I want to just follow up if I may, Mary, as we think about some of the pieces that we've talked about today, you mentioned it's taken a hundred years for the update to the guidelines for maternal care. And I think we're seeing Simplified helping to accelerate how we think about this. If you had to write the guidelines in say 10 years time, where are you hoping, what are you thinking we should be putting into that would be different and where we should be?

 

[Mary Hardy]

Particularly with the acceleration of Medicaid childbirth, looking at how that is picking up in pace and the need to really look at some of the social determinants needs. So some of the basics of food, housing, shelter, like all of that is going to be, is something that is important for health systems to make sure we're working with families on. And even we, Simplified, do social determinant screening and our technology stack has the ability to connect families to care.

So I just see that on a trend that continues to need to be focused on. And I think we need to have creativity in how we support these families. I think the leveraging of technology is there and I'll continue to lean into the importance of maternal mental health and say that I honestly believe that one of the biggest areas, they don't call that out specifically in the telehealth, you can say it sits under that bundle.

I think there needs to be a much better process to be able to identify and connect families to that behavioral health care that they need. There's such an access gap today that it's not just maternal health, that's across the board. But my hope is that becomes an area of focus that not only we, Simplified, are working on, but that all companies in the space and providers in the space are doing a better job of.

 

[Colin Miller]

So Mary, if you had $100 million to spend, not immediately on everything that you see around you, but either in society or in general care, what would you do with it?

 

[Mary Hardy]

I love this question. I'm going to take it to, it's not necessarily the Simplified thing, but really what are we seeing in healthcare? And I'm going to come back to something you said at very beginning of the podcast that had to do with community.

And I do believe that we have, and it does affect maternal health and moms and families, but I think if you start to look at loneliness is an issue with the aging that is identified by health plans as actually one of the number one cost drivers now. I would invest in something I'm starting to term as a blended community. So how do we interject community back into the world in places that it's needed?

So what if we were to say there's a community that's built and set up to support, there's a military family who is new to the area. There's 3 elderly people who lost their spouses. I have an autistic child that could live there and would love help with gardening and knitting. And what if there was a Down syndrome child that could be supported by technology that is there to monitor those that need monitored, and that multi-age, multi-dimensional relationships, we put them back in society because we've taken them away.

I think it's something that if we look at some of the behavioral health issues as a major concern across all ages and all sectors of society, not just healthcare, that in investment of some of the root cause of the problem, my old GE days and Six Sigma, what's the root cause of the problem, I believe, as we've taken away some of this community piece. And if I had all the money in the world to go set up some of these and try it, that's what I would do.

 

[Colin Miller]

So yes, I don't know if you've seen the docuseries on called The Blue Zone.

 

[Mary Hardy]

Yes, exactly.

 

[Colin Miller]

Part of it, I think, is multifactorial, but I agree with you totally. It's that community, the village community, if you will.

 

[Mary Hardy]

Exactly. Put the village back and see how much changes.

 

[Colin Miller]

So with one final, I'll ask you one other final question, if I may. And if you could go back and talk to your younger self in your early 20s, what would you say to yourself? What advice would you give?

 

[Mary Hardy]

Oh, that's a fabulous question. I think it would be to stay grounded in what you believe in. And I'll tell you why I say that is that, and I know I keep coming back up to this kind of behavioral health thing, but it's an area that has affected my extended family over time, people that I've known.

And even back in my early GE days, this is back when behavioral health was a stigma, like you didn't talk about these things, is I wish I could have been a bigger voice in some of the areas when it was a stigma and pushing probably less GE, but more some of the startup companies I was with to put a focus in this area. and to know that it was all going to be okay to talk about someday. Does that make sense? Like it wasn't okay to talk about it back in the 90s, but it is okay now. And I wish I knew that back then because there's some companies I was working with, I would have, I think we could have done more and made a bigger difference in that area.

 

[Colin Miller]

Yeah, brilliant, brilliant. With that, thank you so much. It has been a real pleasure to have this conversation, this chat, to really understand a sector of the community, a community that for many of us is just a short chapter in our lives. And yet SimpliFed's supporting that and growing it out and for all the work that you do there. So thank you.

 

[Mary Hardy]

Thank you, Colin. I want to thank you and your team because the team at Bracken has helped us get this message out there and they've been fabulous to work with. So I really want to thank you for having us today and to your team for all the support they've given our company.

 

[Colin Miller]

Fractals is brought to you by Bracken, the professional services firm for life science and digital health organizations. Subscribe to Fractals via your preferred podcast platform, visit us at thebrackengroup.com, or reach out directly on LinkedIn. We'll be delighted to speak with you.

I'm Colin Miller, wishing you sound business and good health. Thanks for listening.