Marama Health, a doula-led, Medicaid-focused maternal and child care provider, has closed a $9.2 million seed round.
The oversubscribed round was led by Acumen America, a VC firm focused on health and economic justice, with participation from Wisdom Ventures, Capital F, Coyote Ventures, and angel investors. This includes a $2.3 million National Institutes of Health (NIH) grant and more than $1 million in California funding.
Marama will use the funding to expand into more Medicaid markets, expand its doula workforce, and deepen its partnerships with community health centers. The NIH grant will be used to study how women with high-risk clinical conditions can actively manage gestational diabetes and type 2 diabetes.
Malama, which means “nurture” in Hawaiian, was founded to address inequities and high-risk pregnancies by moving from episodic to continuous care. Leverage remote patient monitoring, chronic disease management, and care navigation to support women from pregnancy to postpartum and address their clinical and social needs.
“Health equity in maternal care requires trust,” Acumen America Executive Director Veenu Aulakh said in the announcement. “Marama Health has earned its trust in communities that have been failed by the health care system for generations. Our outcomes data shows what is possible when we build care around women, not appointments.”
Malama participates in Medicaid plans in California, Texas, and Colorado, which reimburse her for quality incentives related to closing care gaps, such as depression screening and outcomes, through monthly per-member payments. Although Malama is not yet at full downside risk, it plans to move toward deeper value-based care while collecting more outcome data. According to KFF, Medicaid is the largest single payer for pregnancy-related services, covering 4 out of 10 births.
“Malama was founded on personal, real-world experience. We exist to help mothers and babies thrive,” Micah Eddy, co-founder and CEO of Marama, told Fierce Healthcare in a preliminary interview. “The way we do that is really by building community.”
For eligible plans, marama doulas are embedded in the community and can attend births, conduct home or virtual visits, and connect mothers with social services such as medically tailored meals, doctor visits, and transportation to child care. Eddy said many mothers don’t realize these options may be covered by their plan.
“They know that pregnancy can be full of fear and anxiety,” Eddy said, adding, “To truly change clinical outcomes, we also need to address social determinants.”
Doulas undergo Marama’s in-house training program focused on quality and are supervised by a multidisciplinary clinical leadership team that includes obstetricians, certified clinical social workers, and other clinical consultants. Malama’s Medical Director is dual board certified in Obesity and Maternal Medicine.
Additionally, Malama has a free app available to users in every U.S. state and over 20 countries. Educational content written at a 5th grade reading level in multiple languages. The app allows mothers to track and share health data from wearables, nutrition logs, symptoms, social determinants, and more with their care team. Users can also access culturally appropriate nutrition guidance within the app and participate in Marama’s Postpartum Wellness Program, which is tailored for postpartum based on the Centers for Disease Control and Prevention’s National Diabetes Prevention Program.
Partnerships are a core part of Marama’s model. The company primarily works with community health centers and Federally Qualified Health Centers (FQHCs). These clinics can refer eligible patients to Marama’s services. (The app is free regardless of coverage.) FQHCs can also leverage Malama’s remote monitoring and care coordination platform for free to help patients track their biometrics and connect them to social services and other resources.
Malama syncs with a number of approved monitors and consumer wearables, so the platform tracks patient biometrics in real-time. It integrates with several EHRs, including Epic, and has also built a web-based version of the portal. Importantly, the platform shuts down information about the social services women received.
“This is the core piece that is missing in today’s infrastructure,” Eddy pointed out.
Patient-reported outcomes data from more than 2,300 Marama patients showed a 19% reduction in NICU admissions, a 13% reduction in cesarean section rates, and a 45% reduction in preterm birth rates. The data also show a 40% difference in outcomes for postpartum diabetes compared to standard care. A randomized controlled trial conducted at Tufts Medical Center found that women who used marama during pregnancy were significantly less likely to develop diabetes at birth compared to standard care.
The company is leaning toward an artificial intelligence co-pilot within the company, checking in on topics and suggesting prompts for doulas. Malama also provides ambient listening and documentation support to generate written notes from your visit. Malama also uses AI for internal resource matching and helps connect members to relevant services.
Malama’s app is used by more than 45,000 women in all 50 states. The company has reached out to more than 600 clinics and hospitals, primarily through app users sharing data with providers, but occasionally through inbound patient referrals.
“We were very careful about actually raising money from impact investors,” Eddy said. “Our impact investors are most excited about our postpartum wellness program, and are very happy with the continued support between appointments and the fact that we are local.”
