Our May 2024 Newsletter
Why We Invested in NephroPlus
By Sophia Friedman and Anna Reilly
There has been a significant increase in both the number and severity of end stage renal disease (ESRD) and chronic kidney disease (CKD) cases in India over the past several decades. Of the estimated 1.3M individuals requiring access to dialysis services in India, only ~20% are receiving those services at the recommended frequency. This gap is primarily due to: 1) affordability as the average cost per session is price prohibitive to most; and, 2) supply side constraints given there is a significant gap in supply of dialysis machines, clinicians, and centers. Additionally, geographic location continues to serve as a barrier to access for individuals living in tier II or III cities versus tier I cities. While a number of private dialysis companies have been founded in India, few have been able to scale high-quality, affordable services across high-need areas. Similar challenges exist more broadly outside of India. In The Philippines and Uzbekistan, the number of individuals with kidney diseases continues to grow and the demand for services in these countries has far outpaced supply.
Solution
NephroPlus enables individuals suffering from kidney diseases to resume normal functioning of life through high-quality, cost effective dialysis treatments and services. NephroPlus is Asia’s largest chain of dialysis clinics with ~450 centers across 250+ towns in India, Uzbekistan, and The Philippines. The company offers services through both standalone centers and outsourced dialysis centers located in hospitals within tier I, II, and III cities, and through public-private partnerships. NephroPlus has an in-house dialysis staff training program, which both addresses supply side challenges and ensures high-quality delivery of services. During the last 10 years, more than 1,000 students have been trained and placed successfully at NephroPlus clinics. NephroPlus is well-positioned to serve the large and growing number of individuals with a need for high-quality, affordable dialysis services in India, The Philippines, Uzbekistan, and additional countries in Asia.
Why We Invested
The prevalence and severity of kidney disease cases continues to increase around the world, particularly across Southeast Asia. In India, The Philippines, and Uzbekistan, where NephroPlus operates, there is a significant supply-demand gap in terms of dialysis machines, centers, and clinicians required to care for individuals suffering from renal disease. To combat this discrepancy, the Indian government launched the Pradhan Mantri National Dialysis Programme, which partners with private providers to increase the number of centers, machines, and clinicians offering dialysis services in the country. The governments within The Philippines and Uzbekistan are also offering universal health coverage for these services through government partnerships. However, public programs alone will not be enough to overcome the gap in the number of needed machines. Further, these countries also struggle to properly recruit and train the number of nurses and technicians needed to provide care.
Given the need for machines, centers, and clinicians, NephroPlus is well-positioned to become a market leading provider of dialysis services across Asia. As a single specialty, multi-site provider of high-quality, cost effective dialysis services, NephroPlus will be capable of partnering with governments and outsourcing dialysis services for hospital and center partners. The NephroPlus founding team has extensive experience in the dialysis industry, including effectively scaling the company to ~450 centers since its foundation in 2010. Founder and CEO Vikram Vuppala founded NephroPlus with a clear objective to redefine and transform healthcare in India. Further, NephroPlus’s most significant investor, Quadria Capital, is committed to working together with the company to professionalize and optimize the business as NephroPlus continues to scale throughout Asia. The NephroPlus and Quadria Capital teams share a similar mission to build Asia’s largest network of dialysis centers offering high-quality, cost-effective services in countries with a significant need.
Impact
NephroPlus addresses all three barriers to services: accessibility, quality, and affordability. The company plans to add hundreds of additional centers across tier I, II, and III cities with the majority of centers added in tier III cities, where there is currently limited access to dialysis services. NephroPlus maintains a highly-qualified clinical board and ensures cohesive standard operating procedures lowering infection rates across centers and markets. Additionally, NephroPlus recently announced the publication of a research study in The Lancet Regional Health - Southeast Asia establishing the first national benchmark for survival amongst dialysis patients in India. The company has partnered with the governments in both The Philippines and Uzbekistan to ensure public coverage for services. Within India, while the company provides the majority of services through government models, either through PPP or offering services under government healthcare schemes, while the rest of services are either private insurance or self pay. NephroPlus intends to continue to partner with the Indian government to provide services through public-private partnership models.
Private Equity: Healthcare Heroes or Hucksters?
We absolutely must solve this crisis
Why We Invested in Mae Health
The United States is facing a maternal mortality crisis. Maternal mortality rates in the US exceed rates in other high income countries (by more than ten times in some cases, such as compared to Australia, Japan and Spain). Specifically, Black women are most negatively impacted and are 3-4x more likely to die from pregnancy-related complications. Further, 15% of Black births are premature, 35% of Black births are via c-section, and Black women are twice as likely to experience pregnancy-related complications. Various factors drive this inequity in care including access to care, social determinants of health (SDoH), and structural racism. Notably, structural issues such as implicit biases of caregivers and a lack of cultural competency materially contribute to these outcomes.
Solution
Mae Health is a culturally competent digital health platform connecting Black expectant mothers with critical resources to elevate the standard of care for Black women, with a focus on improving maternal health outcomes. Mae works in concert with healthcare payers and states to address the significant disparities in maternal health outcomes for Black mothers across the country by pairing a community-based model of doula support with best-in-class digital interventions.
Mae’s core offerings include continuous digital engagement and culturally aligned support. The continuous digital engagement provides multi-modal touchpoints such as culturally aligned content, virtual, small group ‘Mae Momma classes’ that offer programming on specific topics, SDoH monitoring, care flags to identify risks early and track data, and analytics to share with healthcare providers and payors. Mae’s culturally-aligned support offers virtual or in-person perinatal support from credentialed doulas. Mae connects expectant mothers with doula networks for the provision of care and also provides various levels of support to doulas including a client management interface, workflow tools, and billings and claims submission support.
Why We Invested
We believe that Mae’s approach is unique as it is entirely focused on reaching Black expectant mothers, and their sales traction to date has been 100% with Medicaid payors (though the company does have D2C users who can access free content). Some competitors have avoided contracting with Medicaid payors because of the complex reimbursement dynamics that vary by state, and inherent challenges to engaging these patient populations, but Mae has tackled this head-on and is a first mover in this space. Mae has proven a strong value proposition to payors by clearly mapping the cost savings of providing doula support and has seen great success with signing and launching new Medicaid payor contracts in recent months.
Further, the doula-centric approach is also unique, and Mae has made progress ahead of other players in building out a bench of doula talent. While there are several players in the maternal health market broadly, Mae’s approach is unique in its focus on optimizing doula benefits for Medicaid populations. Doula support has been directly linked to improved health outcomes as women who give birth with a doula present have a 22% lower risk of undergoing a c-section. By employing this model, there is significant impact potential in a market that not many companies have been willing to focus on. Lastly, the team is extremely impact motivated and brings relevant lived experience to the platform. Founder and CEO Maya Hardigan has prior experience on the innovation team at Pfizer and as the mother of three young girls, she has personally experienced the inequities that she is trying to address.
Impact
Mae aims to elevate the standard of maternal health care for Black women, with a focus on improving maternal health outcomes. Believing that many of the disparities Black women face are driven by biases in care, its model prioritizes on-the-ground support from community-based doulas who are known to improve pregnancy experiences and outcomes. Mae has already begun to demonstrate improvements, and its solution is linked to reduction in maternity cost of care, improvements in health performance metrics (HEDIS metrics), and enhanced member literacy, satisfaction and engagement. From an access perspective, at the time of investment, Mae’s enterprise users were 100% Medicaid patients, and several quantitative measures suggest that the approach is driving positive health outcomes amongst this population. Specifically, Mae has shown a 31% reduction in c-section rates and a 58% reduction in preterm birth rates amongst its users.
While not specific to Mae, many of the tactics Mae is employing have demonstrated a direct link to an improvement in clinical outcomes. For instance: women who attend a childbirth education classes are 26% more likely to have a vaginal delivery than those who do not; women who have a birth plan are 98% more likely to have a vaginal delivery than those who do not; and, mothers who use a lactation consultant are almost 71% more likely to exclusively breastfeed within the first month of the baby’s life. Thus, with time, Mae expects to collect additional data to prove its positive impact on health outcomes.
Our investment in Mae Health was part of a fundraising round led by Jumpstart Nova.
Big news - We closed our second private equity fund
We're starting 2024 with a bang!
Impact Engine Honored as #1 Impact Investing Firm on Top Impact List
REAL LEADERS®️ UNVEILS ITS TOP IMPACT COMPANIES LIST OF 2024
Chicago, IL — January 17, 2024 — Real Leaders® is thrilled to announce its 2024 rankings of Top Impact Companies from around the world, recognizing Impact Engine, an independent, women-led and employee-owned institutional investor managing venture capital and private equity strategies, as a 2024 Top Impact Company in the global impact economy.
With over 500 applications from over 15 countries, this year’s awards mark an outstanding achievement for Impact Engine, securing the No. 1 spot in the Impact Investing category. Additionally, among the hundreds of companies considered, the firm is listed as one of the Top 25 Impact Companies for 2024, coming in at No. 21 overall.
For over a decade, Impact Engine has worked to bring more capital into a market where financial returns are linked to positive social and environmental impacts. The firm specializes in private equity and venture capital funds and companies in the environmental sustainability, health equity, and economic opportunity sectors and is well-known for its specific sector expertise and its longstanding track record of generating measurable impact.
“Impact Engine is honored to be among the remarkable group of impactful organizations recognized by Real Leaders,” said Jessica Droste Yagan, CEO, Impact Engine. “From the beginning, our team has committed to investing in business models that align financial and impact returns such that there is minimal or no trade-off between the two. We’re honored that Real Leaders has recognized our firm as the number one impact investing company. It’s truly a testament to the hard work and collaboration of our team, investors, and community of leading-edge thinkers in the impact space.”
Now in its sixth year, the Real Leaders Awards rank privately-owned companies by asking 30 questions within six categories of I.M.P.A.C.T (Intention, Model, People, Accountability, Collaboration and Transformation) to vet and rank companies based on those parameters.
“After five successful years of producing the go-to list of the ‘Top Impact Companies,’ it was time for Real Leaders to expand its mission by growing an impact awards community that preserves its integrity while scaling its impact,” said Kevin Edwards, Real Leaders’ General Manager.
Click here to view the full list of Impact Awards rankings.
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About Impact Engine
Impact Engine is a women-owned and led Chicago-based venture capital and private equity firm investing exclusively in funds and companies driving positive impact in economic opportunity, environmental sustainability, and health equity. Impact Engine’s multi-faceted investment approach ensures that it operates at the center of the impact innovation ecosystem, giving the firm unique access to differentiated, high-quality deal flow and comprehensive knowledge of the market. Additional information about Impact Engine may be found at www.theimpactengine.com.
Media Contact:
Katy Wilner
Confluence Partners
424-207-7332
kwilner@confluencepartners.com
About Real Leaders
Real Leaders is the fastest-growing community for impact leaders backed by a global media platform dedicated to driving positive change. Founded in 2010, Real Leaders recognized and advocated that businesses take more responsibility to be as cognizant of their impact on employees, society, and the planet as they are on their bottom line. Real Leaders is an independently owned certified B Corporation and member of the UN Global Compact. Our mission is to unite farsighted leaders to transform our shortsighted world.
Media Contact:
Madelyn Dwyer
Real Leaders
All content contained herein is intended for informational purposes only and should not be construed as a solicitation or offer of securities. Compensation was provided in exchange for consideration for inclusion in the third-party rating. Impact Engine is not otherwise aware of any material conflicts of interest arising from any rating.