Good morning, Broadsheet readers! House Democrats choose Nancy Pelosi’s successor, Apollo cofounder Leon Black faces rape allegations, and a female-founded health tech startup is transforming physician referrals.
– 26 days. That’s how long it takes patients in major U.S. cities to get an appointment with a specialist physician. In some rural states, that delay is even longer. In Vermont, the wait for a specialist can take up to 61 days.
Kelsey Mellard, founder and CEO of the telehealth startup Sitka, thinks she has a solution. The platform connects primary care physicians (PCPs) with specialists. A patient experiencing an issue their PCP isn’t equipped to address can receive treatment from a specialist in a matter of hours instead of waiting weeks to see the same provider.
Mellard, the child of a pediatric occupational therapist in rural Kansas, built an extensive track record in health care before founding Sitka in 2018. She worked on the founding team of the U.S. Department of Health and Human Services Center for Medicare and Medicaid Innovation before joining UnitedHealth Group as vice president of health services policy. She eventually moved to the startup space, working on the executive teams of post-acute care management services company naviHealth and homecare tech company Honor.
While advising a company at one point, Mellard was met with a peculiar request: “Kelsey, come fix our clinic.” Specialty physicians were getting unnecessary patient referrals from PCPs, leading to poor survey results and low Yelp reviews.
“The expectation from the patient is so high, and rightfully so,” Mellard says. Nearly 20 million “clinically inappropriate” physician referrals occur each year, wasting the time of the patient and specialist and potentially leading to worse patient health outcomes.
Thus, Sitka was born. The startup has raised over $22 million from investors like Venrock, First Round Capital, and Optum Ventures.
Sitka’s services are especially crucial in rural areas, where access to specialists is limited, or mobility issues prevent patients from seeking care. While telehealth is rising—more than 76% of hospitals have implemented such services—patients in rural areas and tribal lands have limited access to broadband internet. Plus, rural communities represent the vast majority of primary care shortages in the U.S., despite accounting for less than 20% of the U.S. population.
Eighty-five percent of consultations on Sitka’s platform help PCPs avoid having to make a referral altogether, Mellard says, which is a cost-save for low-income patients. “These providers are desperate for a way to access specialty knowledge without exposing the patient to a copay, a gas tank, and the duration of getting that insight.”
Sitka has built a physician network that covers 20 specialties, including cardiology, gynecology, and rheumatology. It’s also partnered with several nationwide at-risk provider groups across the care delivery system, including Medicare Advantage plans, Institutional Special Needs plans, seniors-focused primary care provider ChenMed, and UnitedHealth-owned primary care provider Optum. Today, Sitka announced a new partnership with Elation Health, an electronic medical records system used by over 24,000 clinicians. The partnership will allow practitioners on Elation’s system to access Sitka.
As Mellard looks to the next five years, she says she’s excited to see the market grow to understand the value of specialty insights at the primary care level. Three years ago, the brand was struggling to gain market traction, “but a shift has occurred,” Mellard says. “When you’re early stage, you don’t have data to support, and now we have incredible amounts of data to prove the value we’re producing every day on the front lines for primary care providers.”
Paige McGlauflin
paige.mcglauflin@fortune.com
@paidion
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- Passing the baton. House Democrats chose New York representative Hakeem Jeffries to replace Nancy Pelosi as the party’s House leader next year. He will be the first Black person to lead a major party in either chamber of Congress. CNN
- Early signs. Several early staffers at Alameda Research, FTX founder Sam Bankman-Fried's trading firm, quit in 2018 over risk and compliance concerns. “We ended up not really knowing how much money we even had,” said Naia Bouscal, who left Alameda along with cofounder Tara Mac Aulay. Wall Street Journal
- Unroyal treatment. A Buckingham Palace staff member resigned after Ngozi Fulani, a Black British woman and founder of an antiviolence support group, said the staffer repeatedly questioned where she was from during a Tuesday reception hosted by the queen consort Camilla. New York Times
- Bombshell lawsuit. A woman is suing Apollo Global Management cofounder Leon Black and Jeffrey Epstein’s estate, alleging the investment firm’s former executive raped her at Epstein’s New York home. Lawyers for Black deny the allegations, calling them “categorically false” and “baseless.” Daily Beast
MOVERS AND SHAKERS: Audible promoted Susan Jurevics as the first global brand chief. Corvus Insurance hired Angela Whiteford as chief marketing officer.
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- 51 cents. Wednesday was Native American Women’s Equal Pay Day, the last day of Native American Heritage Month. Native American women earned 51 cents for every dollar a non-Latino white man earned in 2021. 19th*
- Earnings record. The U.S. Women’s National Team earned more from the male U.S. soccer team’s World Cup participation than it did from winning its own World Cup in 2015 and 2019, thanks to an equal pay agreement reached this year. CNN
- First court date. An arraignment date has been scheduled for Jackie Johnson, the former Brunswick Judicial Circuit District Attorney accused of hindering the police investigation into the murder of Ahmaud Arbery. Johnson will appear in court on Dec. 29, 14 months after her indictment. Atlanta Journal-Constitution
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