Kim
Kim, hello everyone. I’m Kim Thiboldeaux, and it is my pleasure to welcome you to NEBGH voices. Our guest today is Elizabeth Bailey, co-founder and managing partner at Foreground Capital. Elizabeth, welcome to the podcast.
Elizabeth Bailey
Thank you so much Kim for having me, and also, thank you so much for shining a really bright light on women’s health. As you know, one, one major barrier to innovation in the space has been the lack of public discourse, and so that we know, at a minimum, any progress has to start with changing the conversation. So I really appreciate you highlighting women’s health here today.
Kim
Well, at NEBGH, we are very happy to be highlighting this conversation, and it’s certainly a area of top interest for our members. Elizabeth, please tell us a little bit about you and your background and what drew you to co-founder and engage in the work taking place at Foreground Capital.
Elizabeth Bailey
Yeah, of course. So, you know, I’ve spent the the better part of the last two decades as a venture capitalist investing in early stage health innovations, and my interest in women’s health really started at the beginning of my venture career, when I started asking what I thought was a very simple question, namely, why isn’t there more investment going into women’s health? And I learned that there are many systemic reasons why, which we probably don’t have time to go into today, but I became really passionate about using this amazing engine of innovation that we have in venture capital and how we could apply it to women’s health. So after many years of investing and learning both about how venture capital works and ultimately the you know, the importance of how early stage companies work in terms of spurring innovation, I reached the conclusion that the only way I was going to move the needle on women’s health was actually to start a women’s health venture capital fund. So about six or seven years ago now, I went on a learning journey, really, to better understand both the needs of women’s health but also the investment opportunities. And so during during that exploration, I met my now business partner, and we answered a lot of fund sort of foundational questions, and then decided to jump in, raise a fund and start investing in the space.
Kim
Wow, terrific, really exciting. So you guys have really built one of the largest dedicated venture capital portfolios in women’s health, um, tell me, Elizabeth, what have been sort of some of the most exciting shifts in the sector that you’ve seen over the past decade, and what are the sort of big challenges or barriers that still remain?
Elizabeth Bailey
Yeah, I mean, what I what I will say is that I don’t think that a venture capital fund would have been possible when I started in venture 20 years ago. But if I contrast that with the environment that we find ourselves in today, I can unequivocally say that it is the best time there has ever been to be investing in women’s health. So when I think about what’s changed even over the last, you know, five to seven years since we started investing in the space, Silicon Valley has done a great job of tracking the progress of the sector, and we’ve seen this huge increase both both in terms of the pipeline of opportunities, but also in the amount of investment going to women’s health. So I saw an early release of that the newest SVB report, and 2024 saw health investment exceed $2 billion for women’s health. For the first time ever. There are also, you know, now, many dedicated funds in women’s health. And we have finally seen the generalist term, the generalist funds really step up and start investing in the space. So there is this unbelievable momentum in women’s health that really did not exist before, you know, five or six years ago, and it kind of started with this term femtech. Yeah, I have a bit of a love hate relationship with okay, I love it because it helped to create this whole category of investing that didn’t exist before. But at the same time, I struggle with it because it sometimes feels really limited in scope. And some people hear it and think, oh, it’s, you know, period tracking apps or other consumer apps, but not serious healthcare. So the other big shift, I think, is that we’ve seen the overall field evolve from this term FEM tech in this this more limited understanding, or. Concept of women’s health to really thinking about the overall health of women, which is much more expansive. And so obviously, you know, at foreground, we’re super bullish about women’s health. We’re out raising our third fund and seeing amazing opportunities to invest. But it’s also important to ground ourselves in the fact that we still have a lot more work to do, overall venture capital investment. While it surpassed the 2 billion mark, which is amazing, it’s still only about 4% of overall healthcare venture investing. And so you can see it as a major gap, or you can see it as we do, as a major opportunity.
Kim
all right, so we’ll, we’ll leave the term femtech in the love hate category. We’ll talk about overall, broader investment in women’s health. But we’re seeing numbers. I mean, you talk about 2 billion, we’re seeing numbers in the next 1010, plus years, and potentially up to up to 50 billion, even north of that. So what are the areas within women’s health that you see as the biggest investment opportunities over the next five to 10 years?
Elizabeth Bailey
Yeah, so I would say the good news and the bad news is that everywhere you look in women’s health, there is white space that’s, you know, really ripe for innovation and investment given just the the huge unmet needs in the space. So we have spent at foreground. We’ve spent the last five years or so investing in reproductive and maternal health, and I think there’s still a lot of need and opportunity there. But one trend that I’m particularly excited about is addressing things that both disproportionately and differentially impact women, so things like bone health and Alzheimer’s and autoimmune where we’re really just starting to understand why women suffer from these things more than Men. There must be some kind of biological underpinning, and once we figure that out, then we can hopefully come up with the right solutions. And we’re seeing really exciting innovations in those areas. And those areas, I think another space that we’re looking closely at is in cardiovascular so we know that women present with heart attack symptoms very differently than their male counterparts, but we’ve, as a healthcare system, we’ve really created a kind of one size fits all in in cardiovascular care. So we need much more personalized approaches and medicine, which, you know, is evolving, and I think we’ll be here soon. But we need those things to really ensure that women’s, women’s needs in particular, can be addressed.
Kim
So let’s, let’s stay on that, that precision medicine, personalized medicine. Let’s stay on that topic for a minute. Elizabeth, we know, you know, obviously, we’re looking at digital health. We’re looking at AI, you know, driven, you know, diagnostics. We’re looking at, you know, multi cancer, early detection, we’re looking at so many, you know, areas in this space. How do you see technology specifically shaping the future of women’s health?
Elizabeth Bailey
Yeah, I mean, one of the things I am most excited about is that, with all of the interest in momentum in women’s health that’s syncing up perfectly with these incredible advancements in technology. So from where I sit, technology is, is going to be the enabler to help close some of the gaps that, you know, have existed forever. You know, again, with personalized medicine, we’re moving away from this one size fits all model. We can now tailor care based on women’s unique biology or hormones or life stages, all of the digital health tools that are being developed, or, you know, they’re making care more accessible. So when we think about things like doula care, or, you know, virtual doula care for maternal health, or at home hormone testing. You know, we’re we’re, all of a sudden, making care much more accessible to to women, whether that’s in the home, in the community, and the big elephant in the room these days is, of course, AI which has huge potential in both the diagnostics and therapeutic space. So you know, think about earlier detection of conditions like endometriosis or heart disease, which have been historically under diagnosed in women. I mean, I could go on and on, but technology is the clear unlock in women’s health, for sure.
Kim
And I feel like in the technology space that we really are going to be seeing rapid and exponential growth through the use of technology. Absolutely agree. Yeah. Yeah. Elizabeth. Know that women do drive a significant number of the decisions in healthcare in our society and their families, potentially up to 80% of healthcare decisions, but yet do remain underserved by the industry. Why is investing in women’s health not just an equity issue but also just a smart business decision?
Elizabeth Bailey
Yeah, Kim, I mean, I think this is the absolute right question to be asking. So we have been making the moral imperative case for a really long time, but we see that things don’t always move just because it’s the right thing to do. Sometimes we need economic drivers to shift to market so women make up half of the workforce, right? Yeah, we have all of these needs that lead to things like absenteeism and reduce productivity, or in many cases, you know, massive attrition from the workforce. So if you want to support your workforce, you need to address the needs of women’s health period, and if we look at overall health costs, we know that many conditions in women’s health, in particular things like endometriosis and PCOS and maternal health, you know, you name it, there are many, if they’re left unaddressed, will have huge downstream health costs. So I worry a little bit about looking looking at women as P and L inputs, but we do know that addressing their health needs will unequivocally reduce overall health costs for companies. And so if that is a driver to move the needle here, then let’s, you know, let’s shine a light on that as well.
Kim
Now I think that, look, our employers are, you know, trying to do good and do well at the same time, right? And those things are not mutually exclusive. And so, you know, many of our employer members are really expanding benefits for women’s health or fertility to menopause and other other forms of support, but really, they often are pressed to make the business case for those investments. So, so why should companies invest in these programs? Elizabeth, what ROI can they expect in terms of employee well being and productivity? Let’s just continue that part of the conversation.
Elizabeth Bailey
Yeah, again, businesses are businesses, and they need, they absolutely need to understand the ROI for, you know, for where they’re investing their dollars and their resources. I am certainly biased in this, but from where I sit, investing in women’s health is one of the highest leverage investments an employer can make and if, if these employers can be proactive, they can actually turn health care from a cost center into a strategic advantage. And I think the biggest ROI really comes in the form of recruitment and retention and employee satisfaction. But there’s also a very real financial ROI related to health costs themselves. And so I do feel like it’s an investment in the workforce, just like other investments that companies make in the workforce, but I think the the payoff and the return on investment for addressing the needs of women, which have been so historically underserved and ignored. I think will, will, you know, generate huge, you know, huge dividends for companies.
Kim
And if an employer is feeling sort of overwhelmed, or an HRM benefits leader feeling sort of overwhelmed, and they don’t really know where to start. You know, any advice for that? I know we’re talking a lot about about fertility, about family planning at this sort of earlier end of the employees the spectrum, and then, of course, talking about perimenopause, menopause at the you know, and sort of lots of topics that that are happening in between in the life cycle of a woman. So if a company is looking to potentially prioritize top 123, things that maybe they should be thinking about or investing in for their employees.
Elizabeth Bailey
Yeah, I mean, I would say just to take a step back. I would say that the best place to start, and you know, I can keep this really simple, is to listen to the women in your company, listen to your employees, listen to their voices. What they need that really has to be the starting point. You need to understand their pain points. You need to offer them real solutions that can make them healthy and keep them healthy. You know, something that certainly has been in a lot in the news and you know sort of public discourse these days is certainly menopause. You know, you have menopause hitting women often at the. Peak of their career, and there are very few solutions. So I do think that, I do think that companies that are leaning in and supporting women on their menopause journey, and there are wonderful companies that have popped up in the last, really just three to four years to help address symptoms, underlying causes, and also just the realities of menopause for women in the workplace, I think could make a huge difference. I also, you know, just to go back to maternal health, women are just not supported on their maternal health journey and their pregnancy journey and things as easy, as easy as providing doula care. You know, doula support for women making sure that they have what they need for healthier pregnancies and that they also feel supported when they return to work. I think that’s a piece that is often missed. So we’ve seen more advances in supporting women during their pregnancy journey, but obviously having a baby for the first, second, third time can create huge life challenges and stresses and making sure that we support women to come back in a way that still allows them to, you know, just fulfill their their duties and needs at home as well as work. And I think that really, you know, I think comes in the form of flexibility and additional supports that companies can make.
Kim
Yeah, we’ve even seen a couple companies recently who are supporting women who are back to work, but also breastfeeding, in terms of places to breastfeed, places to store the milk safely, things like that. So I think those are probably the kinds of things that you’re referring to. Yes, absolutely. Terrific. Terrific. I’m just curious, Elizabeth, how does investment in women’s health in the US compare to other countries? Are there countries or global models that the US could learn from when it comes to funding and innovation? And look, many of our companies are global companies, so there may be dealing with different policies in different regions and countries around the world.
Elizabeth Bailey
Yeah. So this is, this is a big one, because I think the question is really bigger than comparing women’s health across countries. I think it’s, you know, looking at privatized health system versus socialized medicine. And so it’s, it’s, it’s big. I think a couple of interesting examples to point to for how other companies are really doing things differently. One is actually, if you just look at fertility coverage in Europe, for example, it looks really different than it does in the US. It is so much more affordable, which therefore makes it more accessible. I am hoping that that things are changing in our system related to a woman’s fertility journey, but and things like IVF, but we are so far from I mean, I remember seeing a company that actually would would their package was sending women over to Europe to get IVF, because it was a fraction of the cost here. I mean, we we have to fix that. We have to make, you know, basic fertility, reproductive care, accessible to women. And I think, you know, just to state the obvious, it’s related to health but not directly in health care is just our family leave policies, and you know, not not giving women or men, for that matter, enough time when they do have a baby to actually be home and and care for their family and not feel like their jobs are at stake. So I think you know, parental leave again, those are, those are much bigger issues, I think, than any one company, but can can fix. But I do think that regardless of what the laws are, the regulations are, I think companies can make the choice to offer better parental leave benefits. And I think again, the ROI is there because they will have much better recruitment and retention of their employees.
Kim
Great,great advice. Elizabeth, you’ve worked with a lot of early stage companies. What trends are you seeing in startup growth? And how do you invest in and ensure that these companies succeed at scale?
Elizabeth Bailey
So it’s funny, I actually just wrote an op ed that came out last week, that was published in stat news, addressing this very issue. So I just talked about some statistics, right? Venture investment has topped. 2 billion, super exciting. But when we look at where those dollars are going and where investment has been in women’s health, it’s actually been at the early stage. So companies that are getting from proof of concept, maybe, you know, early commercial pilots. But when we look at what’s needed to scale these innovations, we need later stage investment, and that can come from later stage or growth stage venture capitalists, but it also can come from strategic investment from large corporates. And so one of the things that is missing in the women’s health space right now is this, you know, kind of beautiful, seamless funding continuum that we see in things like oncology or neuroscience, where you have, you know, the early stage innovation happening, whether that’s government funded, you know, happening in academia, to early stage startups, you know, growth investors, and then a clear place for them to go, to go and scale with strategics. We don’t have that in women’s health yet. And I think part of that is we need to show clear demand from the the marketplace and investment, again, from strategic investors. That I think can, you know, really help create that that pull in the market and making sure that companies are financed so that they can actually get to scale. There are, you know, a few examples of companies that we feel like have reached scale. In the women’s health space. Maven is obviously a big one, but I think we are not where we need to be to really ensure that the companies succeed at scale.
Kim
Great, great. And we’ll, we’ll check out your your op ed in stat news. Elizabeth, I’m sure there’s a lot of insight there as we close the conversation. Elizabeth, I know you’ve said that Maya Angelou words resonate with you. The quote, I’d be a darn fool not to be on my own side. And so you know, as a woman leading sort of venture capital investment in women’s health, what keeps you passionate about this work, and what legacy do you hope to leave in women’s health investing?
Elizabeth Bailey
Yeah, so one of the reasons I love my Angela’s quote is it, to me, it really emphasizes the importance of women advocating for themselves. I think in many cases, we have suffered silently for a long time, and thankfully that that’s changing this. This podcast is a great example of how changing the public discourse, and, you know, finding comfort in talking about women’s health has changed in really, really positive ways. You know, I think what keeps me passionate is the belief that we really can do better for women, much, much better than we’ve done, and in terms of the legacy, that’s a big, lofty question, but I am really grounded in the fact that I have two amazing young daughters, and I am really determined to create a better future for them.
Kim
Wow. Fantastic, and a great inspiration, I think, for all of us. Elizabeth, I want to thank you for joining us today and sharing your expertise. I have no doubt that this conversation will spark inspiration and curiosity for many. This is NEBGH voices. I’m Kim Thiboldeaux. Thank you for tuning in today as always. I wish you wellness.
Closing Voices
And I am one of the voices, and I am one of the Voices, am one of the voices… of NEBGH.
