Health optimization is moving into the mainstream.

At the same time, do-it-yourself diagnostics, pay-as-you-go primary care, and concierge medical services are replacing trips to the doctor’s office.

As these paths converge, high-performance health promises to redefine the future of well-being.

How We Got Here

Not long ago, the idea of regular exercise or routine self-care was foreign.

As recently as the 1970s, running was considered a weird hobby. Along those lines, a 1978 edition of New York Magazine dubbed people who exercised as “The Physical Elite,” writing:

“Now it is clear—guilt-inducing to the rest of us, exhilarating to those who are In—that a new class has come among us that defines elitism in an entirely different manner.”  

Later, in the 2010s, fresh-pressed green juice and $30-dollars-a-pop fitness classes epitomized the rise of wellness culture. Pointing to Goop’s popularity, The Cut described a “wellness epidemic,” where obsessing over self-care was a “new dimension for luxury.”

More recently, as we detailed in Issue No. 78, The High-Performance Lifestyle, the focus has shifted from woo-woo wellness to personal well-being. A step further, sparing no expense, this new era of health optimization borders on opulence.

Mail-Order Diagnostics

From food sensitivity and fertility to hormone levels and the microbiome, diagnostic test kits are in high demand.

• The point-of-care diagnostic test market is expected to top $81B by 2028.
• Last year, venture funding for health diagnostics startups reached a record $4.8B.

In particular, the direct-to-consumer segment is booming. Explaining this trend, famed investor Fred Wilson recently wrote:

“Driven by advances in technology, a computer in everyone’s pocket, ongoing changes in the healthcare system accelerated by the pandemic, among other forcing functions, we are seeing more and more healthcare being accessed in our homes vs in the doctor’s office.”

On the popularity of at-home test kits, Everly Health (formerly Everlywell) CEO Julia Cheek said, COVID-19 tests aside, “Now, more than ever, there is a strong case for self-collection at home for critical, preventative screening, and testing across all lab markers.”

And Cheek should know — her at-home lab testing company saw sales jump 300% last year.

In early 2021, Everlywell raised $250M in capital over two funding rounds. Then, in March, the company acquired PWNHealth and Home Access Health, rebranding to Everly Health and earning a $2.9B valuation in the process.

Experiencing similar growth, and echoing Cheek’s sentiment, LetsGetChecked CEO Peter Foley said: “Everybody in the world knows what home diagnostics and telehealth is now.”

Last year, his at-home testing company’s revenue was up 15x as 1.7M customers used the platform. Leveraging this growth, in June, LetsGetChecked added $150M in funding at a $1.5B valuation.

Elsewhere, since early ‘20, at-home blood testing startups Base ($3.5M), Thriva ($5.5M), and Getlabs ($3M) added new funding. And last month, at-home lab upstart Kit was acquired by healthcare technology company Ro.

But experts are wary of the at-home testing craze. Everly Health, for one, has been subject to scrutiny, with some of its tests labeled a “wellness gimmick” and “pseudoscience 101.”

Hoping to shake that perception, Silicon Valley startup COR is pioneering a new approach.

Founded by former Apple platform director Bob Messerschmidt, who played a prominent role in developing Apple Watch, COR is an at-home device for analyzing blood samples.

Combining a weekly fingerprick with real-time results and in-app guidance, COR tracks changes in blood chemistry caused by fitness and nutrition interventions.

Beyond wearables or mail-in diagnostics, Messerschmidt said COR’s integrated testing protocol is the future for individual-centered health.

Premium Primary Care

Upgrading in-person visits to the doctor’s office, premium primary care is catching on.

In March, Forward Health raised $225M for its network of membership-based preventive primary care clinics. Billed as the “Apple Store of doctor’s offices,” Forward is valued at more than $1B.

An expense not covered by insurance, Forward members pay $150/month for a high-touch, tech-enabled experience that includes biometric body scans, genetic testing, and on-site blood testing.

From the intake exam alone, it’s clear: Forward is different. A battery of tests capture some 500 unique biomarkers that are used to create a proactive, personalized health program. And, compared with the typical 15-minute doctor’s visit, Forward members spend an average of 60 minutes with their physician.

A similar model, Parsley Health offers virtual and in-person care with a focus on holistic health and wellness.

According to Parsley founder Dr. Robin Berzin, the company prioritizes lifestyle behaviors and preventable conditions, “looking at a patient’s sleep, fitness, nutrition, and mental health to determine health optimization.”

Reimagining the drab, sterile medical office, Parsley clinics feature hardwood floors, natural light, and greenery. From the individualized treatment to the aesthetic, it’s all part of the elevated experience that runs members $175/month.

Making premium clinics look affordable, and their services seem underwhelming, concierge medical services were a pandemic luxury for the wealthy.

Sollis Health, a private medical practice, charges $3–5K/year for unlimited telehealth consults, house calls, and visits to emergency room-equipped health centers.

As lockdowns went into effect, membership doubled to 4,500 patients. To meet demand, Sollis opened a new facility in Los Angeles and teamed with upscale apartment complexes in New York City to offer in-home care.

Providing hormone replacement therapy, immune-boosting IV drips, and lab tests, Evolved Science also expanded its concierge services last year. Separate from the cost of treatment, members pay a $12K annual fee.

At Private Medical, founder Dr. Jordan Shlain described keeping pace during the pandemic as a “full-on war-room situation.” The elite of the elite, this practice keeps a low profile, spends nothing on advertising, and new patients come strictly by word of mouth. Here, members pay $40K to $80K per family to have Private Medical manage every aspect of their well-being.

Looking Ahead

Beyond blood tests and primary care, preventative MRIs, smart toilets, breath- and saliva-based diagnostics, and ambient sensors are transforming health optimization.

The hope? Innovation will increase access to care, improve its effectiveness, and also reduce the cost. For now, it’s a work in progress — and the gap between the haves and have nots is widening.

A sign of what’s to come, the pursuit of optimal health will intersect with longevity science in an effort to redefine aging.