Marina Tarasova, Paloma Health, on modernizing thyroid care
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In this episode, I sat down with Marina Tarasova, co-founder & COO of Paloma Health, the first and leading virtual clinic, modernizing thyroid care. Marina started Paloma Health with her co-founder and Paloma’s CEO, Guillaume (“G”) Cohen-Skalli in 2018. Paloma’s model offers holistic care for hypothyroidism & Hashimoto’s disease, reducing the cost to treat these patients by over 60%. With their full stack approach, Paloma is drastically cutting the time patients have to wait to start treatment, and they are seeing better outcomes and patient satisfaction than traditional brick and mortar clinics.
Last year, Paloma raised a series A round of funding led by Springtide Ventures. With the investment, they’re continuing to build towards their goal of becoming the leading thyroid care experts and highlighting the importance of personalized thyroid care.
Marina and I discuss:
- Her path to starting Paloma Health and how her experience at large healthcare organizations led her to build in the digital health space
- How virtual specialty clinics can prioritize growth through the physician shortage
- How Paloma’s specialization in hypothyroidism allows the virtual clinic to make strides in patient experience, symptom improvement, and cost of care
Beginning to 7:57 — Marina’s Early Career
- Sparking her interest in healthcare: Marina started our conversation by sharing how her experience struggling with a kidney disorder as a child shaped her interest in healthcare. Marina grew up in Moscow where it was common for doctors to make home visits. As her physician guided her family through her illness, she was inspired by the compassion and comfort that her doctor provided.
- Paving her path into digital health: Marina attended college during the dot com bubble. She recalled the excitement of the emerging technology and the opportunity for financial and career success drew her away from the pre-med path and closer to Information Systems and Computer Science. After growing her career at larger biopharma organizations, including Johnson & Johnson and Celgene, Marina found herself drawn back to the technology and the opportunity to modernize an antiquated part of healthcare, the pharmacy, at Capsule Pharmacy.
- Launching into Entrepreneurship: While Marina was at BCG advising large healthcare clients as a Knowledge Expert, Guillaume “G” Cohen-Skalli contacted her on LinkedIn after researching her experience in the thyroid space. As a VC and experienced entrepreneur, he had the idea for an home care model for thyroid disorders after seeing his friend’s life upended by years of misdiagnoses and doctor visits, searching for proper thyroid treatment. Marina shared that, throughout her career, she had been thinking about what more could be built to significantly move the needle on improving patient experience. The stars had aligned for Marina to pursue that dream with Guillaume at what would be Paloma Health.
“As a daughter of immigrants, I prioritized being able to make money and pay back my college loans right out of college so medicine went away. Through my work history and now Paloma, I’ve been able to come full circle — not as a doctor but working closely with physicians to help deliver care…in the home.”
- Thyroid Care Left in the Middle: I asked Marina what about the current state of thyroid care made her want to build Paloma with her co-founder. She recalled how her time as a drug representative for a thyroid medicine called Synthroid taught her how nuanced thyroid care has to be but how it is often delivered in a one size fits all manner, leaving many people, mainly women, struggling through unaddressed, daunting symptoms. Marina described how primary care physicians and endocrinologists are often focused on diabetes and other serious conditions, leaving thyroid care as a large, neglected market.
“There are 25M people on thyroid hormone. It is a $35 billion market. It was perfectly amenable to virtual care, and no one was really attacking it in this way. It is not often that you get to build and be a first mover in a market. We’re really excited to be capitalizing on that”
7:58 to 16:14 — Paloma Health’s Services & Strategy Today
- Overview of Services: Paloma allows patients to handle everything related to their thyroid care from home. Paloma providers deliver patient care in synchronous and asynchronous modalities — from at-home lab testing kits to virtual provider visits and appropriate prescriptions. Once patients start treatment, Paloma monitors patient symptom progress through their mobile application which sends updates directly to their physicians and health coaches for action.
- Specializing in Hypothyroidism: Marina highlighted how hypothyroidism, which represents the majority of thyroid cases, is perfectly suited for virtual, at-home care as it is often treated by monitoring patient labs and prescribing supplemental hormone medication. With at home testing and telemedicine, patients can be closely monitored without losing treatment quality. Additionally, the largest cause of hypothyroidism is an autoimmune condition called Hashimoto’s disease. While there is no cure, lifestyle modifications can alleviate symptoms for many patients. By specializing in hypothyroidism, Paloma can provide personalized, holistic care plans, including high-quality hormone replacement care along with a robust lifestyle modifications program.
- Differentiation Through Nutrition Support: Marina shared how their lifestyle care component allows Paloma to add value above and beyond the traditional thyroid care model. Traditional appointment time constraints do not allow providers to determine if patients are getting enough nutrients for proper thyroid hormone conversion. Paloma leads patients through a full suite of nutritional and lifestyle changes to optimize their thyroid hormone health.
- Real Results from Holistic Care: As Paloma helps improve patients’ BMI, cardiometabolic health, and cholesterol, many patients are reporting a reduction in fatigue, brain fog, weight issues, and other common hypothyroidism symptoms severely impacting their quality of life. Some patients are also seeing a reduced need for thyroid hormone medication as they reduce their BMI.
16:15 to 18:40 — Expanding in Spite of the Physician Shortage
- Finding Endocrinologists: I asked Marina how the physician shortage, which is significant and growing for endocrinologists, has impacted Paloma’s model of care and patient engagement. Marina explained that they are receiving many inbound position inquiries from endocrinologists who are looking for virtual or even part-time commitments as a result of wide-spread burnout in the specialty. The outreach has been a key way for them to capture the specialists.
“It [Endocrinology] is one of the specialties that has the greatest need, especially with the obesity and diabetes epidemic. We get a lot of inbound from endocrinologists who are frankly burned out. They’ve been working hard on these very complex diseases. Honestly, they’re the lowest paid specialties. Things are breaking in that specialty and really should be addressed… We wouldn’t be able to do it with endocrinologists alone because they’re in great need.”
- Augmenting with Other Specialties: Paloma’s recent strategy has been to leverage other specialties, typically Family Health and Integrative Health Board certified providers, in an effort to ensure that patients can access care timely. Paloma’s physician treatment plans are evidence-based and go farther than the American Thyroid Association guidelines for holistic hormone management require. Paloma also ensure that their providers are up to date on the medications, comorbidities, and complications common with hypothyroidism to provide patients exceptional thyroid care.
- Functional Medicine Support: Many of their physicians have also completed functional medicine training to align with Paloma’s holistic approach to care and what their patients are requesting as a part of their thyroid care journey. The multidisciplinary Paloma care team also works closely with their physicians to provide lifestyle coaching and nutrition counseling for wrap-around patient care.
18:41 to 23:55 — Driving Down Out of Pocket Payments
- Path to Insurance Coverage: Limiting out of pocket payments has always been a priority for the Paloma team. They started the in-network contracting process shortly after founding the company, and they now have 60 insurance contracts across the country. At the time of recording, 36% of patients that have seen a Paloma provider have been able to successfully use their insurance to cover the visit. They’re working to increase that to 80% by the end of the year.
- Breaking Down the Benefits for Payers: When I asked about the ROI for payers, Marina described Paloma’s impact on both member experience and cost of care. Patients suffering from thyroid disorders often report high dissatisfaction with their care and poor quality of life. Paloma is offering a more convenient, enjoyable, and effective alternative to the traditional experience of patients being passed between specialists as they search for answers. This improved patient journey is a key benefit for payers’ overall member experience. Additionally, Paloma’s hyper focus on hypothyroidism has allowed them to lower the cost of managing these patients to $800–900 annually, compared to the average $2,500 that commercial plans spend.
23:56 to End — What’s Next for Paloma
- Previous Focus on Direct-to-Customer Growth: Paloma spent the last 3 years refining their care delivery model and launching it in the DTC market. Marina shared that patients are finding their clinic through web searches, Paloma’s wellness partners, and partner dieticians. Paloma has also gained traction through their patient ambassador program. They are now shifting their focus to include payer-driven customer growth.
- Transitioning to a Payer Expansion Focus: As Paloma continues to grow, Marina described their priority to expand their partnerships with payers and select self-insured employers to ensure that patients do not have to pay out of pocket for excellent thyroid care. While they will continue the direct to consumer model that has led to their success to date, payer coverage will only strengthen their customer conversion rate.
- Current Job Opportunities: Paloma is looking to hire an MBA Summer Intern, Health Coaches, a Chief Operating Officer, and many other roles in the near future. They will be posting updates on their LinkedIn.
We are so appreciative to Marina for joining us on this episode of The Pulse Podcast! Subscribe to our new releases on Twitter, Spotify or Apple podcasts.
