Many of us would feel better if we ate better. But for patients with chronic diseases, the issue is more pressing: Fixing their diet is often key to keeping their condition under control.
According to the CDC, six in 10 adults in the U.S. have a chronic disease such as diabetes or heart conditions. Millions of these could benefit from professional nutrition guidance but don't always have the time or means to seek care.
Enter Nourish, a U.S. startup that connects users with a registered dietitian (RD) via telehealth and helps them get their consultations covered by health insurance.
Telehealth is part of the appeal, both for patients and nutritionists, but the RD qualification is an important point too.
"All registered dietitians are nutritionists — but not all nutritionists are registered dietitians," the Academy of Nutrition and Dietetics warns. Unless you seek an RD or RDN (registered dietitian nutritionist), you won't be sure that your nutritionist is properly qualified for the job — and your insurance will not cover it.
Insurance coverage is a big part of Nourish's value add. The startup's CEO, Aidan Dewar, told TechCrunch that "94% of our patients are fully covered by insurance and pay nothing out of pocket. Most of the rest just have a small co-pay."
That's because since 2002, medical nutrition therapy has fallen under the scope of Medicare under certain criteria, a move that led major private insurers to follow suit.
On paper, qualified patients who are aware of this could get reimbursed after seeing an outpatient RD, whether online or off. But as often with healthcare in the U.S., the process is cumbersome for practitioners, and many end up not accepting insurance.
In contrast, Nourish's RDs are employed by the company, which took care of closing partnerships with Medicare and major U.S. healthcare companies Aetna, BCBS, Cigna, Humana and United Healthcare in exchange for a fee.
Nourish currently employs 50 RDs, but has a waitlist of more than 400 RDs interested in joining its team, Dewar said. Having launched in November 2021, the startup is pacing itself but already reports "millions in revenue" from "thousands of patients seeing dietitians each month." And by the end of the year, it plans to employ 200 RDs and grow its non-RD team from 18 to around 30.
Nourish's growth plans will be funded by a recent $8 million seed round that brought its total funding to $9.3 million. Led by Thrive Capital, it had participation from Susa Ventures, Operator Partners, Box Group and Y Combinator, whose accelerator the startup graduated from in 2021.
Dewar also highlighted that several of Nourish's angel investors built exciting healthcare companies, such as Alto Pharmacy (Jamie Karraker), Headway (Andrew Adams), Rightway Healthcare (Jordan Feldman) and Spring Health (April Koh).
"Nutrition has largely been excluded from the healthcare system, despite its importance and connection to people's health. We love that Nourish is changing that by bringing consumers, registered dietitians, and insurance companies together to build a more affordable and complete nutrition program," Thrive Capital general partner Kareem Zaki said.
Expanding nutrition therapy
Nourish has big goals: By helping people to eat well, the startup is hoping to contribute to solving the American healthcare crisis. "More than half of Americans have a chronic condition related to what they eat, which has contributed to healthcare costs going up and quality-adjusted life expectancy going down," its founders said.
Dewar and Nourish COO Sam Perkins are childhood friends and landed on Nourish's mission after struggling with chronic conditions themselves (migraines and irritable bowel syndrome, respectively). After experiencing the positive impact of nutritional care, they co-founded their startup together with CTO Stephanie Liu, who had become close friends with Perkins at Princeton.
The founders knew firsthand that working with a dietitian was a long-term process, but this vision is also reinforced by the startup's chief clinical officer, Adrien Paczosa. "We focus on a long-term, sustainable approach — truly a lifestyle change," she said. "We will never put you on a fad diet that is impossible to maintain, tell you to only eat salad for every meal, make you track everything you eat, or give you some generic, one-size-fits-all meal plan."
Because of this approach, the startup doesn't see itself as directly competing with weight loss apps. However, it plans to use its seed round to launch an app of its own by the end of the quarter, but with different goals in mind.
"The mobile app will augment the core experience of seeing your dietitian, with features including high-quality nutrition content and resources, clinical outcome tracking, and features that help you acquire the food such as integrated grocery delivery (so your RD can prescribe you food in the same way an MD can prescribe medicine)," Nourish explained.
The app's goal is to make sure that patients are achieving the desired outcomes. Indeed, Nourish has two priorities in 2023: growth and outcomes. This road map has to do with how Dewar and his team define success. "It's [both] about how many people we help and how much we help them."
There's still plenty of room for Nourish to grow on both fronts: The vast majority of chronic illness patients who could benefit from seeing an RD currently don't, and even when they do, eating well remains a struggle. Will an app help make their journey easier? Only time will tell.