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Tammy Sun, the Founder and CEO of Carrot Fertility, is a pioneering leader driving transformative change in global fertility care. With a profound commitment to comprehensive and inclusive services, Carrot Fertility addresses the diverse needs of individuals navigating their family-building journeys and beyond.

Navigating the complex landscape of women’s health and fertility care demands an inclusive and personalized approach—a principle that aligns closely with Carrot’s mission. Tammy highlights the diverse needs of those facing fertility challenges, emphasizing the critical role of tailored support amidst a sea of information, costs, and legal considerations. Carrot’s innovative model encompasses the full spectrum of fertility and hormonal healthcare, pioneering a lifecycle approach that transcends traditional boundaries.

As Carrot continues to expand its offerings and educate members, Tammy remains steadfast in her pursuit of transforming reproductive health and family-building care on a global scale.

What motivated you to start Carrot Fertility?

In my 30s, I decided to freeze my eggs. I was surprised to learn that despite having a great job and health insurance, my three rounds of egg freezing wouldn’t be covered. I spent more than $35,000 out-of-pocket.

While the overall experience was emotionally challenging, I also felt grateful that I had enough money in savings to pay for my care. That’s not true for most people who undergo fertility treatments. Cost is one of the biggest barriers to accessing care, and I was set on changing that. Carrot’s mission was born from this vision of fertility care for all, inclusive of age, sex, sexual orientation, gender identity, race, income, marital status, and geography. Today, we are the leading global platform for comprehensive support and access to care for maternity through menopause — and pre-pregnancy through parenting.

Can you tell us a bit about the women’s health landscape overall? What makes fertility care so complex? Why is an inclusive, personalized, and comprehensive approach necessary for those experiencing infertility?

While fertility and family-building care is a fundamental part of healthcare, there’s no one-size-fits-all approach. Some people know they want to grow their family but aren’t sure where to start. Others have begun the process but have encountered challenges and need guidance on what step to take next. The experience is unique for everyone, but with so much information out there – and other added complexities, including navigating costs and local laws and regulations – it can be challenging for an individual to understand what’s best for them and their personal needs. That’s why we work directly with our members to create personalized Carrot Plans that guide members every step of the way.

How does Carrot stand out from other women’s health players? What current gaps is the company fulfilling?

What sets Carrot apart is our global and inclusive approach. We are the first organization to demonstrate an international presence since day one. We have reached into more than 130 countries and offer end-to-end translation of the Carrot app (web, iOS, Android) in ten languages, allowing employers to offer unilateral benefits.

Carrot is also the only fertility benefits platform that focuses on the full lifecycle of fertility and hormonal healthcare – from fertility preservation, treatments, and pregnancy to menopause and low testosterone for healthy aging. We have the largest provider network to support members globally, no matter their age or journey.

How has F-Prime supported Carrot in getting to where it is today?

Carl and the F-Prime team have been instrumental in Carrot’s journey by deeply understanding the significance of enhancing health outcomes through improving access to high-quality, lifelong fertility care. Since joining Carrot’s board in August 2020, Carl has been a key strategic partner when navigating challenges and seizing opportunities in the ever-evolving healthcare landscape. Carl’s strategic approach, coupled with his profound expertise, has guided us toward success for our customers, partners, and most importantly our members.

How did you come up with the company name?

First-generation fertility products were largely cycle tracking-related and feminized in their naming and branding. We knew early on that fertility was a human healthcare issue — not only a women’s health issue. Carrot is easy to say, easy to recognize, and we’re continuing to build a brand around the name that invites all people to engage in lifelong fertility and hormonal healthcare.

What’s been the most rewarding part of your tenure with Carrot to date?

Hearing directly from our Carrot members. We support people throughout some of the most meaningful times in their lives, and we don’t take that for granted. Whether it’s hearing from members who adopted their son, a member who was able to work with a postpartum doula, or a member who could now afford to freeze her eggs, each and every one of these personal stories means so much to me, and our team. It’s the most rewarding part of our work.

What’s the best piece of professional advice you’ve ever received?

One of the best pieces of advice I ever received was from a friend, who sadly passed away a few years ago. She was a daring, brilliant, and successful entrepreneur. She was also an author who published a best-selling book not long before she passed away. I once asked her why she decided to write a book and she replied, “because I could no longer not write one.” She had something she thought she could give the world. Similarly, there was a point when I could no longer not start a company whose mission is to bring fertility care to all people. This is the advice I’d pass on to anyone thinking about embarking on a journey to build an enduring company. Do it, but only if you think there’s no other pursuit you can, or should, be doing instead.

What are your near-term and future goals for Carrot? How do you see Carrot supporting expanded access to fertility and family building care?

We continue to focus on expanding access and improving outcomes for our members through personalized care. That includes educating our members about their options and guiding them to the right level of intervention based on their needs.

With preventive options like fertility testing, ovulation tracking, and nutrition support, we encourage members to approach their fertility health proactively. Two-thirds of Carrot members choose less invasive options over IVF when appropriate, eliminating costly and medically unnecessary procedures.

For cases where IVF is the best option, Carrot members are educated on the benefits of single embryo transfer (SET), which is the single most predictive indicator of a singleton IVF pregnancy and subsequent successful live birth. It is an important clinical protocol used to avoid multiple gestation pregnancies, which are associated with higher medical costs and poorer health outcomes for mothers and infants.

Last year, we published an internal study, also validated by independent actuarial service Milliman, demonstrating the highest reported SET rate of any fertility benefits vendor and an IVF pregnancy rate greatly exceeding national averages. The study found that Carrot’s SET rate of 93% was 27% higher than the national average and that our IVF pregnancy rate of 60% is 11% percent higher than the national average. Our industry-leading SET rate leads to a reduced risk of low-birth-weight deliveries and costly NICU admissions, ultimately reducing overall healthcare costs.

What makes you most hopeful about the impact that Carrot could have for women when it comes to family building and beyond?

Over the last few years at Carrot, we’ve launched new products and expanded our offerings to ensure our members have access to care, no matter what fertility, pregnancy, hormonal health, or family-building journeys they’re on. One product I’m particularly passionate about is our menopause support.

By 2025, 1.1 billion women worldwide will have experienced menopause. Symptoms can last for years and disrupt daily life, yet menopause is rarely discussed at work despite it impacting women at the height of their careers. In fact, 80% of women cite menopause as a workplace challenge and more than half have considered making an employment change due to menopause.

We were the first fertility benefits platform to introduce menopause support, and now, nearly all of our 1,000+ customers have started offering the benefit to their employees, showing promise that the tides are turning towards more menopause support in the workplace. I’m hopeful that a year from now, we’ll see even more leading employers recognize the need for menopause support and that it becomes a standard part of healthcare benefits.

Raised in families immersed in the healthcare field, Anand Nathan and Meena Mallipeddi, husband and wife Co-founders of AmplifyMD, are no strangers to the limitations faced by many doctors today. “Coming from families of doctors, we’ve watched frustrations grow when physicians are not able to practice medicine and deliver patient care in the way they had hoped,” said Mallipeddi. She noted one key shortcoming is a lack of timely access to specialist expertise, which prevents patients from obtaining the care they need when they need it.

Access to specialist physicians in the U.S. now largely depends upon a person’s zip code, Mallipeddi pointed out, and this access disparity impacts hospitals, patients, and their communities.  As a result, most hospitals in the US experience unnecessary transfers, prolonged hospital stays, excessive utilization of tests and diagnostics, and increased healthcare costs. Outpatient services also struggle with issues like patient leakage, avoidable readmissions, and delays in care, which all exacerbate the clinical and financial burdens on the healthcare system.

Determined to solve the glaring supply and demand gaps they consistently observed, Mallipeddi and Nathan set out to redefine how hospitals, clinics, and patients access specialty care. Mallipeddi explained, “Hospitals and health systems have been trying to solve the specialty shortage issue with telemedicine for years, but they haven’t been successful in their current piecemeal approach. Until recently, virtual care has been a glorified video call. But it must be so much more if we want a seamless experience with broad adoption and impact. The technology must integrate bi-directionally with the EMR (electronic medical record) and the health system’s existing clinical workflows. Just as important, it’s got to be incredibly functional and efficient for a remote provider to see patients across multiple systems without a million different logins and applications for them to wade through. Anand and I knew we had to offer something smoother, better, and faster so medical facilities and providers could use the technology to its full potential.”

And so Mallipeddi and Nathan created AmplifyMD, a next-level virtual care platform that took into account the pain points above and gave hospitals a built-in multi-specialty physician group to simplify access to specialist services. “By developing a network of providers alongside our fully integrated virtual care platform, we can support hospitals, health systems, and clients of all sizes in a way that hasn’t been done before.”

What motivated you to start AmplifyMD?

My husband, Anand, and I have backgrounds in healthcare and technology, and were constantly exposed to the firsthand frustrations of our family members who are medical professionals.

The recurring narrative we encountered was the limitations caused by their lack of access to specialists. This often led to unnecessary patient transfers, excessive testing, and, at times, suboptimal care, all because a clinician lacked a piece of critical information or a consultation from a specialist. Recognizing that knowledge in medicine is highly shareable with the right technological infrastructure led us to the founding of AmplifyMD.

What have you learned along the way from “peers” in the field, and how is AmplifyMD different?

Most of our learnings were around the need to develop a comprehensive solution versus a narrow focus on only the clinical or technological aspects of virtual care. Hospitals are seeking a holistic solution, and the fact that we offer 15 different specialties through one platform, across any device, use case, or clinical care setting is so key to them. Our approach also minimizes their need for the myriad point solutions they struggle to manage today, helping our clients achieve operational efficiencies they otherwise would never have managed. It’s one training, one integration, and you’re done. That has been huge for us.

What makes you most hopeful about AmplifyMD’s future?

It’s hearing the impact we are making on patients, providers, and hospitals each day. I was just visiting one of our clients the other week, and the CEO was raving about our doctors and how much she loves having them on staff. And it wasn’t only because of the impact they were making directly on patients by seeing, treating, and discharging them efficiently. It was also because they’d simultaneously lowered the burden on her in-house hospitalist team. Her staff is keeping and treating more complex patients on-site with more confidence, and we’re helping the hospital as a whole run at a higher level of performance.

That’s just one story, and it might seem minor compared to the more dramatic tales of life-saving consults we do every day, but it’s precisely these everyday successes that illustrate the profound effect we’re having on healthcare in America. Our ability to efficiently address common health issues, which traditionally might have led to prolonged hospital stays and escalating costs, showcases the potential of AmplifyMD and “virtual care done right” to streamline and improve patient care and healthcare outcomes.

F-Prime has played a pivotal role in our journey, particularly through the support of Carl, who has been instrumental in expanding our network and enhancing our credibility. Carl’s willingness to share his extensive contacts has opened doors for us, connecting us with key figures in the healthcare industry, fellow founders, and potential investors. These introductions have been invaluable in fostering relationships and building a solid foundation for future collaborations.

What’s been the most rewarding part of your tenure with AmplifyMD to date?

Witnessing our remarkable growth and the impactful milestones we’ve achieved. Our team has more than tripled in size over the past year, which just blows my mind.

Equally exciting is our leap in patient care, from serving 10,000 to over 50,000 patients annually. Currently, we collaborate with over 150 clinical sites and offer services in more than 15 specialties, supported by a robust medical group nearing 300 doctors. And we recently launched tele-stroke in our suite of specialties, with 100 activations in a mere two weeks, which marks another significant achievement. This exponential increase underscores our expanding capacity to make a real difference in patients’ lives daily.

From the foundational days of brainstorming ideas to reaching these milestones, the journey has been a testament to our collective effort and dedication. Witnessing these achievements unfold has been profoundly rewarding, and our team’s ongoing shared commitment to our mission continues to make AmplifyMD incredibly fulfilling.

How would you describe your leadership style?

Fundamentally, I am driven by results, and hold a firm belief in setting ambitious targets. The essence of my leadership involves not just setting ambitious goals, however, but also ensuring that the team believes in their ability to meet them. I see a crucial part of my role as inspiring and instilling confidence in my team, convincing them of what we can achieve together. Otherwise, I’d never have gone into the start-up world!

I’m also always very direct and transparent, a firm believer in giving credit where credit is due, but also in calling out areas for improvement as soon as they become apparent. Celebrating a job well done is just as critical to our team’s continued success and morale as making sure everyone knows we are all being held to the same high standards. We’re all in this together, everyone is giving it their all, and I think the more our employees see this in action, the tighter it makes us as a team.

Who is the one person who’s had the most professional impact on your career, and why?

That one’s easy: my co-founder and husband, Anand. As a husband-and-wife team, our dynamic is unique. Anand not only conceived the initial idea and vision for our company, but he also brings a level of empathy to our partnership that complements my more results-driven approach.

His extensive experience as a people leader has been instrumental in shaping our company’s internal culture. Anand excels in managing our team, effectively communicating our vision, and fostering a collaborative environment. His ability to provide unwavering direction and product guidance for the company and our platform has kept us at the forefront of the industry and helped us build a clear defensive moat around our offering. The balance between our skill sets allows him to focus on the internal operations of our company while I take on the external challenges.

Anand’s impact extends beyond professional guidance. He provides unwavering support during challenging times, and we rely on each other for strength. This mutual support system has been a cornerstone of not just our personal relationship but our professional success as well. Moreover, his ability to offer candid feedback whenever necessary has been invaluable in maintaining our focus and integrity throughout our journey.

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‘By developing a network of providers alongside our fully integrated virtual care platform, we can support hospitals, health systems, and clients of all sizes in a way that hasn’t been done before.”

— Meena Mallipeddi, Co-founder & CEO of AmplifyMD

In the dynamic landscape of healthcare’s digital transformation, where data access, timeliness, and quality are paramount, a fresh framework emerges: the Four Ds of Digital Health

Unlike conventional stakeholder-centric models, the Four Ds zero in on the essential functions individuals seek from healthcare: accessing the right mix of professionals, medications, and tests. However, a glaring obstacle obstructs progress: the sorry state of healthcare data

A student of mine in my side hustle as an adjunct lecturer once created “Four Gs” related to her academic project; humorously, she called it “a business school approach to remembering things.” In that spirit, I’ve been thinking about how best to encapsulate and frame the role of data access, timeliness, and quality as we collectively reshape healthcare as a digital-first industry.

Hence, I’d like to propose the Four Ds of Digital Health.

Before diving in, it is worth reflecting on the services we all enjoy daily that are only possible with accurate, up-to-date data. Like many frequent travelers, I often use the Uber, Starbucks, Orbitz, and HotelTonight apps. None of these services could function without accurate information about the “state” of location (Uber), inventory (Starbucks*), pricing (Orbitz) or quality (Hotel Tonight). Most of these apps and many others we use in our daily lives need real-time, accurate data about all of those elements. Some, such as Starbucks, are closed systems that will not let you know that another coffee shop is closer to you, while others are more like the more open marketplaces (e.g. Amazon) we have come to love: but at least they all are predicted on accurate, realtime data.

In healthcare by contrast, there is not reliable, up-to-date information about basic things like the address of a medical group, the status of a hospital or its on-staff doctors with respect to a provider network, the medical history of a patient, or the status of a health plan deductible. This is even true in closed systems like Epic where some health systems can’t seem to get out of their own way. Simply put, we cannot build services that improve the quality and cost of healthcare — thereby expanding access — without solving the sorry state of healthcare data.

Getting to the 4 Ds, I was tempted by other alliterative quartets. Often used is the four Ps of healthcare: patient, provider, plan, and pharma. That works, but it speaks more to the stakeholders than to the “jobs to be done”. I flirted with four As: access, automation, artificial intelligence, and accountability, but it felt too abstract.

Hence, I offer 4 Ds that are mutually exclusive and collectively exhaustive, while also upgrading DATA to the central role it deserves:

– Doctors (by which I include all care providers overseen by doctors, with everyone “at the top of their license” or the hospitals in which doctors do procedures)

– Drugs (including both the benefit from PBMs and the delivery from pharmacies)

– Diagnostics (labs, imaging, etc.)

– Data (which you could argue is orthogonal to the others, but as mentioned above needs to be treated as a key pillar, so I’m bending the framework accordingly)

By the way, you may say these also are not “jobs to be done”. That is true, but they are closer to that framing because what people really want to “get done” in healthcare is to stay well and address problems; this means they need the right mix of doctors, drugs, and diagnostics. What stands in their way are the myriad process breakdowns we all have come to accept driven by health plan bureaucracy, provider ineptitude, and related technology breakdowns; as well as the (criminal) conspiracy that is our incumbent PBM model. If you are sick, if you are managing a chronic condition, or if you merely seek to access preventative care, you are in the market for a doctor, a drug, or a diagnostic.

What makes all of this so frustrating is that our data model (our 4th D) is broken. Our data is siloed and often inaccurate; and few of the participants in the industry are interested in changing that. Remember when the Cures act opened up health data access and Epic took out a full page ad to explain to Congress why this would undermine quality? Ever notice how payers and providers treat “price” like a national security secret? Some have openly speculated that payers want provider data to be opaque, so that they can field “ghost networks” that meet network adequacy requirements in a phony fashion (I don’t share this view, but I empathize with those who wonder how we can easily access the hours of the deli down the street on our phones and yet major payers seem unable to provide accurate street addresses of the providers in their networks).

Innovation comes from clinicians, technologists, and business people working together to improve the processes by which people access the 4 Ds. With the advent of AI, it is now every more clear that the promise of value based care models, patient-centric care management platforms, and improvements to administrative cost all hinge on data quality improving dramatically. And, fittingly, the data we need improved relates directly to the other three Ds and deserves a full seat at the table.

– Doctors: We have “hacks” to access doctor’s (or some of doctor’s) schedules from early innovators like ZocDoc, but few solutions actually expose the inventory of provider time to the world for use and scrutiny, and the availability of “cash pricing” is scarce. New companies offering provider data APIs hold promise, but solutions also need to be adopted within the enterprise to ensure that provider data is accessible, actionable, and accurate. We need more than just online booking; we also need to know details about provider services and quality. Even more importantly, we need to know the PRICE of services, so patients (or doctors who navigate their care) can see what things actually cost. In short, we need a HotelTonight for medical care. We need doctors to simply explain what they need to be paid per hour (or, if you want to be fancy, per RVU). We should just cut to the chase: 15 minutes with an internist should cost about $100; a specialist should cost about twice that; NPs should be at least 25% less. If we just cut through the morass of “visit leveling” and modifiers, we can acknowledge that what we have is a broken marketplace for provider time. We should be able to expose the schedules and the prices, a la HotelTonight. Providers take home about half of the top-line today due to administrative bloat; with innovation those costs can come down, potentially reduction actual costs.

– Drugs: Anyone who has stood in front of the CVS counter with a doctor on one phone line and the PBM on the other knows how maddening it is to sync up the various parties who control the distribution of drugs. Again, there are “hacks” such as drug discount cards and related services like GoodRx, but what we need is a fundamental redesign. PBMs who talk about “average wholesale price” are disingenuous at best. Platforms like CapitalRx represent infrastructure to change the game and link prices to proper reference data. Some disrupters also are promoting the potential of biosimilars, which also would reduce cost if they didn’t eat into the profits of the PBM rebate game. PBMs also make a killing on generics where market forces should permit patients to pay the real costs of those medications. In short, by exposing data about what these medications really cost, we can begin to present tradeoffs to providers and patients who increasingly need to focus on budgets for care.

– Diagnostics: In some areas, we have achieved scaled low-cost tests, as with bloodwork at the national chains. In other ways, the data monopolies of health systems inhibit a real market from developing for services like imaging. Most people know of times when the big health system implies or states outright that they can’t look at images created outside their four walls. Similarly, patients often need to resort to “sneaker net” to carry images on CDs or as films. This is nuts and it’s wrong that health systems we are supposed to trust will not enable use of imaging that would cost dramatically less if done in a place that doesn’t have primates in the basement. What is missing here is a data network that can disentangle the imaging from the radiology reads. It is illegal to require patients to use only your own services and with data liberation we should be able to put an end to such misuses of market power. With a surge in new diagnostic possibilities, from genetic tests to cancer biomarkers, diagnostics also will need to yield to the power of platforms and markets to reveal price and other tradeoffs so the health fiduciaries out there can make better decisions in the interest of patients.

Which brings us back to data. If our health data was plentiful and portable, we could simplify the way we pay providers, rationalize the drug payment model, and open-up a marketplace of diagnostic solutions that would cost much less than what we pay to oligopoly health systems. Yes, data runs orthogonally to the other three Ds, but by giving it its own space as another “D” we can begin to rationalize and push the other three Ds to move forward. Providers, payers, pharma and diagnosticians would love to sit on the data and mete it out if and when it suits their interests; but we all would benefit dramatically more if data were open so the innovators can do their thing.

So, how will we get there? A hopeful data roadmap would include regulation to require data sharing with patients and providers (and crack down on market power abuses), development of data utilities and related APIs, and enterprise solutions to bring payers, providers, and pharmacies kicking and screaming into a modern data model. We also need marketplaces that make the cost and quality of doctors, drugs, and diagnostics crystal clear to those who control health budgets and to patients who increasingly have their own funds to allocate. As with the innovation we have seen in other areas of our lives, if we can focus on and fix the last D, data, we can unlock a new era of enhanced services at lower costs across the other three Ds.

And what does this have to do with digital health? Everything. We already have the ability to care for people across state lines via telemedicine, route patients to lower cost care settings, and leverage AI to find insights and solutions at a dramatically lower cost, IF the regulators permit it and the data is at hand. Innovators and their investors are ready to go and already are making a dent in these problems. And/but, if those sources of creative destruction had better data that was more fluid, more accurate, and more actionable, the innovation and improvement in our health system would be dramatic and profound.

So, let’s embrace technology and clean-up our data act.

Our health depends on it.