Here’s the 15-slide presentation Twentyeight Health used to raise $8.3 million to give Medicaid patients better reproductive healthcare

Bruno Van Tuykom, left, a cofounder and the CEO of Twentyeight Health, and Amy Fan, a cofounder and the president of Twentyeight Health.
  • Twentyeight Health provides underserved groups with reproductive and sexual healthcare online.
  • The startup works with health plans, nonprofits, and colleges to reach these low-income patients.
  • See the pitch deck Twentyeight Health used to bank $8.3 million in pre-Series A funding.

There are plenty of startups offering birth-control delivery and other reproductive-healthcare services online, from Hims and Hers and The Pill Club to Nurx.

The market began picking up steam during the COVID-19 pandemic and surged again last year when the Supreme Court’s decision to overturn Roe v. Wade sparked a nationwide debate on reproductive rights.

But digital-health startups don’t always build those services around the people who need them the most, Amy Fan, a cofounder and the president of Twentyeight Health, said. 

Twentyeight Health provides reproductive and sexual healthcare primarily for underserved communities, like low-income patients and patients of color. About 55% of Twentyeight Health’s patients are on Medicaid, which provides healthcare coverage to low-income individuals and families, and more than 60% of the startup’s customers said they didn’t have access to birth control before using Twentyeight Health, the company said.

“This is all tailored toward underserved communities, and that’s just not something any other company does,” Fan said.

Fan launched Twentyeight Health alongside Bruno Van Tuykom, a cofounder and the CEO of the startup, in December 2018. The New York-based startup just landed a $8.3 million round of pre-Series A funding from a host of venture-capital funds, including the new investors RH Capital, Seae Ventures, and Impact Engine, and the existing investors SteelSky Ventures, Third Prime, and Town Hall Ventures.

Labeling the raise a pre-Series A round allowed Twentyeight Health to get more financing from seed investors at a time when the market downturn is causing later-stage investors to pull back, Fan said.

Twentyeight Health, named to reference the 28-day average length of the menstrual cycle, also provides morning-after pills, prenatal vitamins, herpes treatments, and COVID-19 tests, in 34 states, as well as Washington, DC.

Twentyeight Health added abortion pills to its list of offerings in February. Medication abortions through Twentyeight Health are currently available only to patients in New York and California, where state regulations clearly support abortion-pill access by mail, Fan said. She said the startup plans to expand access to the service to more states over time.

Twentyeight Health provided Insider with the pitch deck it used to raise $8.3 million in pre-Series A funding. The startup removed information about its contracts with health plans that aren’t yet public before sharing the presentation with Insider.

Here’s the 15-slide pitch deck Twentyeight Health used to bank $8.3 million.

Twentyeight Health has raised about $15 million to date to tailor telehealth for people with diminished access to reproductive and sexual healthcare.

Twentyeight Health

Twentyeight Health provides care to patients from age 13 to age 49. While those patients primarily identify as female, the company lists its services as being available to people of all gender identities.

Twentyeight Health

Access to birth control and sexual-health education can help decrease the prevalence of unintended pregnancies, which is higher in low-income women and Black women than in white and higher-income women.

Twentyeight Health

Unintended pregnancies, which occur at higher rates in low-income and Black women, are associated with delayed pregnancy care and poorer health outcomes for newborns, according to a 2016 JAMA article.

Twentyeight Health’s website also includes articles to educate its users on topics like STIs and birth-control options.

Most adults on Medicaid plans are women, and about two-thirds of those women are of reproductive age — ages 19 to 49.

Twentyeight Health

Twentyeight Health has drawn these figures from a Kaiser Family Foundation analysis of Medicaid coverage for women.

Birth control is free through Twentyeight Health with insurance, and starting at $16 per month without it. Patients also pay $20 out of pocket annually for each medication to cover the cost of the doctor’s time to review the prescriptions.

Twentyeight Health

The Affordable Care Act requires that all US health insurers make birth control free to patients.

Fan said she uses this slide to explain to investors how Twentyeight Health sets itself apart in an increasingly crowded reproductive-health market. The startup says it’s uniqely focused on low-income communities and communities of color, and that’s reflected in parts of the business like Twentyeight Health’s partnerships with nonprofits and community colleges.

Twentyeight Health

Twentyeight Health makes most of its money from multiyear contracts with health plans, which provide the startup’s platform to the health plan’s members. The plan typically pays Twentyeight Health a flat fee every month for each member that engages with the platform.

Twentyeight Health

Twentyeight Health’s contracts with health plans sometimes include bonuses when the startup hits or maintains certain metrics, like a high net-promoter score, which is a measure of how likely customers say they are to recommend the startup’s services to others.

Twentyeight Health

In June, Twentyeight Health had notched $1.6 million in annual recurring revenue, or an estimation of the money coming into the business yearly based on subscriptions and contracts from that month.

Twentyeight Health

Fan and Van Tuykom said Twentyeighth Health plans to grow its business this year primarily through partnerships with more health plans.

Twentyeight Health

This year, the startup plans to expand to offer more products and services like STI treatments, breast pumps, and medication abortions, which the startup began offering to New York and California patients in February.

Twentyeight Health

Twentyeight Health said it saves health plans an average of $2,700 each year per member that uses its platform.

Twentyeight Health

Van Tuykom said the highest costs to payers are associated with a lack of sufficient pregnancy care, including care for unplanned pregnancies and complications during pregnancy.

Twentyeight Health has signed or plans to sign deals for 75 enterprise partnerships with health plans and other companies. The names of those companies and health plans are redacted because many of the deals are not yet public.

Twentyeight Health

The startup had planned to raise $6 million in pre-Series A funding, but ended up raising $8.3 million. Around 35% of that new funding will be used to lock down partnerships with health plans and other companies.

Twentyeight Health

Fan said much of the funding will also go toward hiring. The startup plans to grow its core team by about 50% over the next year.

Twentyeight Health’s long-term plan includes expanding into menopause care for patients over age 49 in 2024. “We want to have as many healthcare offerings on Twentyeight as we can,” Van Tuykom said.

Twentyeight Health
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