MIDI Health is Valued at $1 Billion
MIDI Health announced it is valued at $1 billion. That doesnât mean MIDI will be sold for that amount, but it does mean venture capitalists (VC) have it valued at that and believe they will eventually sell it for more (and that doesnât always happen). For now, itâs just a number, but it is also an indication that VCs believe they can scale the MIDI business model, and quickly. Isnât this amazing for womenâs health? Doesnât this mean people are finally taking womenâs health seriously? First, we need to discuss what VC money means to the nature of a business. It means MIDI took money from people who are expecting at least a 5-7 fold return on their investment, a much higher level of growth and profitability than has typically been associated with health care as it has been provided in the past. This return on their investment is coming from the money they receive from treating and selling services and products to women. The problem is not the concept of telemedicine, because reaching more women using modern technology can be a good thing, Itâs just that it isnât possible for someone providing quality telemedicine to be valued at $1B by simply being marginally more efficient than all the other Telehealth companies simply based on appointments and what most people would consider regular telemedicine care. The math just doesnât work. MIDI Health is charging $250 cash for a 30 minute new patient appointment for those without insurance, and itâs likely they are getting less than $200 (maybe $150-170) from insurance. There is overhead, like salaries, computers, medical records, malpractice insurance, developing AI models, and advertising. VCs are going to want a plan that demonstrates there is a lot more revenue. If doctors could make millions and millions of dollars easily from offering quality menopause care at a reasonable price or from insurance, there would be a lot of doctors doing menopause care. But they arenât, and every doctor and nurse practitioner who follows me on social media knows that it is hard to pay the bills by accepting insurance for menopause care (this is also the same in Canada, given the dismal reimbursement from the provincial health plans). So what are the ways a telemedicine company might create a business plan that would interest venture capitalists? Charge a lot for a visit and not take insurance. Order unnecessary lab tests that generate repeat visits for which people need to pay. Charge for a subscription membership for ancillary services that gives some kind of non-office benefits, such as access to a private Facebook group or the ability to email four questions a month. Degrade the quality of medical care through shorter visits, less qualified staff etc. This allows a provider to see more people per hour, so instead of billing $500 an hour, it might be $750 or $1000 (still not enough for the VCs). Less overhead could come via tactics like: Underpaying staff. Relying on AI, so there are fewer doctors or nurse practitioners to speak with. For example, follow ups could require a chat bot first, like at FedEx, before actually speaking with a medical professional. Or the AI model may take a questionnaire, formulate your plan, and you get 10 minutes to review it with a professional who is just checking major safety boxes. Force customers to get their prescriptions through their contracted pharmacy instead of the lowest cost provider, as there is profit in mark ups. One telemedicine company (not MIDI) which does this charges $119 dollars for three months of oral estradiol (but hey, free shipping), and the same three months of oral estradiol is $10.30 at CostPlus Drugs, although you do have to pay for shipping. Thatâs a $100 of pure profit every three months from just one prescription. Sell compounded medications, like estrogen face creams and GLP-1s, as deals with compounding pharmacies generally allows for a cut of the profits and these products have a good profit margin and limited oversight. Sell special menopause supplements, which are either more expensive than what is available at the drug store or âspecialâ in-house products. This also helps when people want to show their allegiance to the brand on social media (so itâs good for the packaging to be cute). These products have a massive profit margin and zero oversight. Push a subscription model with compounded estrogen face creams, GLP1-s, and other wellness add-ons, so instead of servicing patients, the goal is to generate repeat customers. Charging a lot for a visit, assuming evidence-based care with no sketchy add-ons (like compounded drugs or peptides), is the only honest option on the list because it says, âThis is what I am worth, I am telling you upfront, and you are paying for my time and expertise.â This allows people to decide if the money is worth it to them. Of course, there are limits, and the hypercapitalism exemplified by Dr. Peter Attia, charging $100,000 a year, is a different discussion altogether. I canât find evidence of unnecessary hormone testing, and MIDI doesnât have a membership tier that I can find. For regular prescriptions (non-compounded), people can use the pharmacy of their choice. So where is the âunicorn valuationâ money coming from? Iâve heard the pay is poor, and seen posts about it on social media. Low pay can affect the quality of staff you can hire and can also lead to high turnover, ultimately resulting in inconsistent care. Here is a comment I found on Instagram from a nurse practitioner posting publicly about her experience with MIDI: Cutting corners with billing is also a way to increase profits. There are a lot of complaints about MIDI at the Better Business Bureau, mostly about billing, and MIDI Health has a 4.1 star rating on Trustpilot. While MIDI has a lot of happy customers, 15% of reviews for MIDI on Trustpilot are 1-star, again with a lot of concerns about billing issues. Their reviews seem to be trending in the wrong direction as the 100 most recent reviews on Trustpilot (Feb 26, 2026 at 10am Pacific) have 31% with one and two stars. Maybe MIDI should be spending a bit more of the $252 million they raised on a better billing system? Just a thought. There are also complaints about short appointments, scheduling issues, and some dissatisfaction with care. The billing concerns are worth noting and tracking as they scale up, although I also know that Trustpilot can be gamed by flooding the site with positive reviews. I recently heard that some people are being required to pay for a visit every few months at MIDI, or even every month, to get their medications. This kind of practice might ensure a steady stream of revenue while other areas are scaling up, but who knows. This negative review posted on the Better Business Bureau (screenshot 02/25/2026) notes this concern: I obviously donât know the medication (it was blurred out), or the context, but this is something for consumers to flag if it happens. A doctor or nurse practitioner should be able to provide a solid medical reason for a monthly visit, for example, a situation that requires close monitoring, such as prescribing a weight loss medication for someone with insulin dependent diabetes. This would be the exception, not the rule. There is no menopause medicine that requires a monthly telephone call to prescribe. I almost always start with a three month prescription for menopause hormone therapy and set up a check-in for 10 weeks or so, and then at that point provide a year of medication. Obviously, when there are side effects or other issues, we set up appointments, virtual or in person, as needed. Most insurances give people a little discount for a three month supply of medication, so not giving someone three months at a time, regardless if they need to be seen more often, feels to me like you are holding them hostage for medication. MIDI actively advertises that they sell compounded GLP1-s, which are not recommended given all the issues with compounding. They also stateâŠ
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