Issue 145 · May 18, 2026 · The Business of Women's Health
Your coverage pathway starts before
your product does
The coverage pathway is a product decision — and most founders make it too late.
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Business of Women's Health
The Coverage Pathway Isn't a Reimbursement Decision. It's a Product Decision.
Most founders think about coverage after they've built the product. The ones who figured it out — the ones still standing — thought about it before they wrote a single line of code.
What I Didn't Understand Until Recently
I used to think coverage pathways were a reimbursement problem. Something you handed off to a market access team or a health economist once the product was built and the clinical data was in.
Then I spent time looking closely at how some of the companies that actually cracked coverage in women's health built their pathways — and the thing that surprised me wasn't the complexity of the process. It was when it started.
The companies that got covered didn't start thinking about coverage after their product worked. They designed the product around the evidence the payer would eventually need to say yes. The coverage pathway wasn't downstream of the product. It was upstream of it.
That's a fundamentally different way of building. And most founders don't know it until it's too late.
"The companies that got covered didn't start thinking about coverage after their product worked. They designed the product around the evidence the payer would eventually need to say yes."
Why "We'll Figure Out Reimbursement Later" Is a Company-Ending Strategy
Here's the problem with waiting: the data a payer needs to say yes takes years to generate.
Not months. Years. Clinical outcomes, real-world evidence, cost-effectiveness modeling — these aren't documents you produce. They're datasets you build, longitudinally, from the moment your first patient receives care.
If you start building that infrastructure at Series B, after two years of unstructured data collection, you are already behind.
The companies that fail at coverage don't usually fail because their product doesn't work. They fail because they can't prove it works in the language the system requires. Payers don't want to know your product helps people. They want to know it reduces NICU admissions, shortens time to pregnancy, lowers total claims spend.
They want a cost-effectiveness model built on real data from your actual patient population. They want to know who you've already convinced and what evidence package convinced them.
The data gap in women's health isn't just a research problem — it's a company survival problem. If you're building a women's health product and you're not designing your data infrastructure to answer payer questions, you're not building toward coverage. You're building toward a consumer play with a coverage aspiration.
What a Coverage Pathway Actually Looks Like: The Progyny Case
In 2016, Progyny pivoted from a consumer fertility company to a fertility benefits business. The bet they were making was that large, self-insured employers — not traditional insurers — were the right first payer to convince.
That choice was strategic, not accidental. Employers are more flexible than commercial payers. They make coverage decisions based on ROI, retention, and outcomes data rather than CMS coverage determinations and actuarial tables. And critically, they were already paying downstream costs — NICU stays, high-risk pregnancy complications, multiple birth interventions — that better fertility coverage could reduce. Progyny's job was to make that connection visible.
So they built the evidence package around the questions employers actually ask. Not "does IVF work" — employers knew it worked. The questions were: does it cost more? Does it generate high-risk multiple pregnancies that drive up our claims? Will it help us retain the employees we've already invested in?
Progyny's answer to every one of those questions was data. They contractually required every provider in their network to submit outcomes for every treatment cycle, for every patient — not a sample, not a subset, all of it.
They published annual outcomes reports and became the first fertility benefits company to have their methodology independently validated by Milliman. When an employer asked "how do I know this is real?" — Progyny had a methodology with a third-party signature on it.
The coverage pathway they built wasn't a one-time submission. It was a compounding body of evidence, designed from the start to speak the language of the decision-maker they were targeting. That data infrastructure was baked into the product design from day one — not retrofitted after the fact.
By the time Progyny went public in 2019, they had built a client base of hundreds of large self-insured employers. Not by lobbying CMS, not by waiting for state mandates, but by building a data machine that made "no" harder and harder to justify.
What This Means for You
If you are a founder, the coverage pathway is a product decision. Before you finalize your data model, ask: what does a payer need to see to say yes — and am I collecting it in a way that will let me prove it? That question should shape how you structure your outcomes tracking, how you credential your providers, and what you agree to report. Not at Series B. Now.
If you are an operator, pay attention to the roles being built around health economics, market access, and evidence generation. These aren't regulatory jobs or IT jobs. They're the strategic infrastructure behind whether a company can scale from consumer to covered. The people who can translate clinical outcomes into payer language are among the most durable hires in women's health right now.
If you are an investor, the diligence question isn't "does this product work." It's "what does this company's data let them prove — and to whom?" A company with a coverage pathway thesis is building toward a healthcare business. A company without one is building toward an acquisition, if they're lucky.
So what does this mean for you? The coverage pathway conversation in women's health is happening — but mostly behind closed doors, in rooms most operators have never been invited into. The IWH Reimbursement Summit in June is built around exactly this: not just understanding the payment system, but building a coverage strategy that works inside it. Session 3 includes a hands-on coverage pathway mapping exercise. This essay is the setup. The Summit is where you build yours.
See you in the work,
| Sessions Start June 1 — Register Now → | Explore the Full Summit Agenda → |
This essay was the case. The Summit is where you build yours.
Three sessions. The complete framework for building a coverage strategy that actually works inside the system.
This week's essay made the case that coverage pathways have to be designed before the product is built — not after. The Summit is where you learn what that actually requires. Three 90-minute sessions — June 1, 3, and 5 — covering who controls the money, where the system fails women, and how to build a coverage strategy that works inside it. Session 3 includes a hands-on coverage pathway mapping exercise.
📅 3 sessions · 90 min each · June 1, 3 & 5
🕐 12:30–2:00pm EST · Virtual · Recordings provided
$399 · All three sessions included · Recordings provided · Payment plans available · Secure checkout
Featured Roles
Roles worth your time this week
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Hologic Global Product Manager, Women's Health📍 San Diego, CA (Hybrid) · 💰 $106,500–$166,600 |
Hologic is a medical technology company focused on women's health diagnostics, working across breast health, GYN surgical solutions, and diagnostic assays. Their Women's Health diagnostics team brings innovative assays to market that help labs and clinicians detect disease earlier.
This is a product and lifecycle strategy role sitting at the exact intersection this week's essay is about — translating customer and market insights into products that get adopted and covered. If you want to build things that move through the system, not around it, Hologic is worth a close look.
Apply Now →|
Orderly Wellness Product Manager, New Products📍 Remote · 💰 $105,000–$135,000 |
Orderly Wellness is a consumer wellness company building innovative products with a test-and-learn approach. They're focused on meeting consumers where they are and scaling what actually works.
A solid entry point for someone who wants to own a product from research to launch in a lean, fast-moving environment. Consumer wellness with real PM scope — if you want reps building from concept to shelf, this is it.
Apply Now →📩 Once you've applied, email Meryl Macune to let her know.
|
Orderly Wellness Senior Product Manager, New Products📍 Remote · 💰 $150,000–$185,000 |
Orderly Wellness is a consumer wellness company with a bias toward bold ideas and fast iteration. Their Strategy & Innovation team owns the full arc from whitespace identification to commercial launch.
End-to-end ownership, real strategic scope, and a team that explicitly values "high capability, low drama." If you're a senior PM who wants to build in wellness without the enterprise overhead, this role is worth your time.
Apply Now →📩 Once you've applied, email Meryl Macune to let her know.
⚖️ Quick Take — This vs. That
Coverage pathway vs. coverage aspiration
Know which one you have.
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Coverage Pathway A deliberate evidence-building strategy designed before your product launches. You know what the payer needs and you're collecting it from day one. |
Coverage Aspiration Hoping reimbursement follows adoption — it usually doesn't. |
In the Community
Organization You Should Know: Tribunus Health
Tribunus Health helps medical practices and health systems negotiate better payer contracts using real market reimbursement data. They've negotiated over 10,000 insurance contracts and were named one of Modern Healthcare's Best Places to Work in 2025. If you're working in revenue cycle, market access, or practice operations — this is a firm worth knowing.
Learn more →Beyond the Community
A note on Cofertility's egg freezing program
We've been sharing about Cofertility's open roles here, and we wanted to take a moment to share more about their egg freezing program in case you're interested in learning more.
We know how many of you are laser-focused on building your careers right now. Cofertility is building a future where women don't have to choose between their career-building and family-building goals. With their unique egg sharing model, those who qualify can freeze their eggs entirely for free when they donate half of the eggs retrieved. By making egg freezing more accessible, Cofertility can give you more agency over if, when, and how you build your family, while also supporting someone else's path to parenthood today. Through their Split program, they're helping thousands of women across the country invest in their futures and alleviate the feeling of time pressure, while removing the cost barrier.
You can learn more about their program and see if you qualify at cofertility.com/freeze. Feel free to reach out to [email protected] with questions.
Learn more at cofertility.com/freeze →Upcoming Events
Where to find your people
| ⭐ IWH Members Only |
IWH June Office Hours
📅 June 12, 2026 · 2:00pm ET · Virtual
Members-only office hours with Jodi — bring your resume, interview questions, or anything on your mind in a confidential space with your IWH community.
RSVP (Members Only) →IWH May Monthly Women's Health Career Networking
📅 May 22, 2026 · 2:00pm ET · Virtual
Meet and connect with others building careers in women's health — bring your asks, share your intros, and walk away with new connections and actionable advice.
RSVP Free →Inside Lucina: The Roles Defining the Future of Maternal Value-Based Care
📅 May 26, 2026 · 3:00pm ET · Virtual
Lucina SVP Stephanie Winans shares the open roles shaping their next chapter and what it takes to succeed on her team — bring your questions.
RSVP Free →Using LinkedIn To Get Your Next Job in Women's Health
📅 June 16, 2026 · 3:30pm ET · Virtual
A live work session with IWH Founder Jodi Neuhauser — how the LinkedIn algorithm has changed, what you need to do to use it to advance your career in women's health, and when to do it.
RSVP Free →📋 Open Roles This Week
100+ jobs across women's health — updated every week.
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30 Clinical & In-Clinic |
28 Business, Strategy & Ops |
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15 International |
13 Product, Eng & Data |
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2 Freelance / Contract |
12 Senior, Marketing & Other |
Companies Hiring This Week
Hims & Hers · Natera · Babylist · Sword Health · Spring Fertility · Flo Health · Pomelo Care · Origin · Tia · Equip · Pinnacle Fertility · Midi · Ro · Thirty Madison · Maven Clinic · Bobbie · Progyny · Hertility · Sunfish · Herself Health · Orderly Wellness · Hologic · Babyscripts · Everly Health · Kindbody
| one more thing |
P.S. The coverage pathway starts before the product does. Sessions begin June 1 — come build yours.
