2025 Health Outcome Report

Women’s health is at the center of a cultural reset.

More people are seeking health information before ever walking into a clinic, with over half of adults now using online sources to learn about symptoms or self-diagnose — and then confirming what they find with a clinician afterward. ChatGPT’s recent launch of its Health product corroborates these trends. This shift reflects a broader change: patients are acting more like health consumers who expect access, transparency, and prevention-oriented support. Amid the context of “Dr. AI”, supplying high-quality, relationship-oriented care becomes even more important and unique.

Across life stages — trying to conceive, postpartum, managing autoimmune symptoms, or entering perimenopause — many women report limited clinical guidance and end up searching for answers on their own. Research shows that women often look to friends or the internet first when navigating fertility questions, postpartum concern, or early autoimmune symptoms, largely because these experiences can feel dismissed or fragmented in traditional care. Perimenopause follows the same pattern: it can begin four to eight years before menopause, bringing real symptoms, and yet remains poorly understood in routine primary care. Together, these gaps point to a broader need for care that is proactive, validating, and designed for the full arc of women’s lived experience.

Many women enter perimenopause without formal education or clinical guidance, yet they experience real symptoms — fatigue, mood changes, night sweats, and more — that affect daily life. Large surveys show that women often seek information from friends or the internet rather than providers, pointing to unmet clinical education and care.

In 2025, more than 100k women who were not already Tia members, came to Tia and viewed Tia as a trusted partner to oversee their comprehensive care - which Tia is uniquely positioned across the women’s health market to deliver. Tia’s mission is to transform women’s health outcomes by building a care model that women actually want to use.

Across 2025 our clinical outcomes and engagement scores far exceeded national averages and other care delivery benchmarks, proving Tia’s care model is transformational for women’s health. Preventive screening rates continued to hit exceptional levels in particular across cervical cancer, depression, HIV, and STIs — a reflection of how engaged patients are when care feels personal and accessible. Tia maintains a ~90% satisfaction rate, with members consistently rating their care experience a 9+ out of 10 and new patients returned to Tia on average 10x per year for consultation and follow-up (count excludes Rx refills), showing that women stay connected to care teams they trust.

This year, across the healthcare ecosystem, longevity became a true buzz word; and patients increasingly shopped for care that would offer more in-depth analysis of critical biomarkers that would help them defer disease. Tia responded to this by launching comprehensive metabolic and heart health programs, as well as deepening our commitment to comprehensive mental health care. These are areas which disproportionately affect women and where integrated, relationship-centered is essential. In this report we share early results from new diabetes programs, including signs of A1c improvement across our population and how GLP-1s fit into long-term chronic disease management. We also track meaningful progress among women with high PHQ-9 scores, showing how consistent, relationship-based care can support sustained improvement over time.

We introduced Quality of Life (QoL) as a measure of whole-life health. Traditional and “new age” healthcare focuses on isolated biomarkers, but that view is too narrow for the complexity of women’s lives. QoL captures how women feel, function, and participate day to day, giving us a fuller picture of health across transitions. Research also links higher QoL with better physical outcomes and lower long-term risk, making it a meaningful signal for guiding care strategies and shaping Tia’s next phase of longitudinal, vitality-focused care.

As Tia scales its longevity and cardiometabolic work, QoL anchors how we design and evaluate care. It highlights what matters most to women: sustained energy, mood stability, strong relationships, and a sense of agency over health decisions.

In 2025, the data shows a clear pattern:

• When women have a care home that listens and responds, engagement rises.
• Preventive gaps narrow.
• Chronic conditions stabilize.
• Women feel more in control of their bodies, health and lives (women view these as inextricably linked!)

These results reflect a moment where women expect more from their healthcare. Tia is built for that shift, offering longitudinal, relationship-based care that follows women through every transition and addresses their needs as a whole person.

Preventive Care Excellence: High-Engagement Primary Care at Scale

Preventive care is the bedrock of primary care and a key differentiator for Tia. By delivering GYN, primary care, and mental health within the same integrated care home—and by designing clinical experiences that feel human, validating, and trauma-informed—Tia dramatically reduces the psychological and logistical barriers that typically limit screening adherence.

2025 Primary Care Health Outcomes

Cervical Cancer Screening

Tia sustained its exceptionally high cervical cancer screening rate again this year (81%, comparable to last year's 85%), nearly 2.5x the national average, while substanticlaly growing our population of members. Our ability to perform Pap smears in the context of primary care visits—versus requiring a separate GYN appointment—continues to be a unique operational advantage that keeps women up-to-date on life-saving screening.

Depression Screening

Tia maintained one of the highest depression screening rates in the country, consistently averaging 88%. Near-universal PHQ-9 administration ensures early detection, risk stratification, and timely care escalation.

Chlamydia, HIV & STI Screening

Sexual health screening remained robust and well above national benchmarks, bolstered by hybrid care pathways that include both in-clinic and home testing options. By normalizing sexual health as part of routine primary care, we continue to close gaps that traditional models rarely address.

Longitudinal & Comprehensive Health: Toward a Model of Whole-Life Vitality

How Quality of Life (QoL) Anchors Tia’s Longevity Strategy

Traditional longevity care has been built backward. It starts with biomarkers, interventions, and protocols—then works downstream toward how patients feel. Tia’s approach reverses this logic. We start with the lived experience of health: how a woman sleeps, moves, thinks, connects, and navigates her day. We treat QoL not as a soft metric, but as a central clinical indicator of system-wide health, a measurable expression of metabolic, hormonal, emotional, and behavioral stability.

QoL as a Clinical Integrator

Quality of Life is one of the only metrics in healthcare that integrates across biological domains rather than dividing them. It is simultaneously influenced by—and predictive of—cardiometabolic function, hormonal balance, mental health stability, inflammation, sleep, nutritional status, and stress physiology. Tia uses the WHO QoL-5, and 60% of Tia’s population has engaged in these surveys.

Unlike traditional quality measures that evaluate isolated organs (e.g., cervix, pancreas, vasculature), QoL reflects the interconnectedness of these systems. Modern longevity research increasingly recognizes this interconnectedness:

• Declines in metabolic flexibility diminish energy, mood, and cognitive resilience
• Dysregulated cortisol alters blood sugar, sleep, appetite, and emotional bandwidth
• Fluctuating estrogen impacts vasomotor symptoms, lipid metabolism, sleep, and affect
• Chronic low-grade inflammation (now considered a hallmark of aging) manifests as fatigue, pain, depression, and “brain fog”

QoL as an Indicator of Agency, Not Just Health

One of Tia’s core beliefs is that feeling in control is itself a health outcome. Women with higher perceived agency:

• Adhere more consistently to lifestyle, medication, and preventive recommendations
• Demonstrate better glycemic and blood pressure control
• Exhibit lower allostatic load
• Report fewer functional limitations over time

In women’s health—where symptoms are often subjective, cyclic, hormonal, and historically dismissed—QoL is also a measure of whether a woman feels heard, believed, validated, and supported in her care. That psychological safety translates directly into healthier physiological patterns via the stress axis (HPA), inflammatory pathways, and sleep regulation.

A longevity program that ignores this dimension is incomplete. By contrast, Tia’s model operationalizes agency as a measurable part of health.

QoL as a Predictor of Long-Term Longevity Outcomes

A robust evidence base shows that QoL correlates with—and in some longitudinal studies outperforms—traditional clinical predictors of mortality and morbidity. Research links higher QoL to:

• Reduced cardiovascular mortality
• Lower incidence of metabolic syndrome
• Decreased inflammatory markers
• Improved autonomic balance (HRV)
• Better cognitive aging trajectories

In this sense, QoL is not merely downstream of biomarkers; it’s a leading indicator of long-term healthspan.

Integrating QoL Into Tia’s Preventive Longevity Engine

As Tia launches its longevity and cardiometabolic programs, QoL becomes the “north star” for determining whether our interventions succeed holistically—not just biochemically. Our longevity strategy integrates QoL at four levels:

1) QoL reveals the domains of life where dysregulation is felt most acutely—fatigue, mood, cognition, sleep, pain—and helps personalize intervention plans.
2) Changes in QoL often appear before clinical markers such as ApoB or fasting glucose shift, allowing early course correction and behavioral reinforcement.
3) When QoL improves, adherence improves. Patients who feel better come back, stay engaged, and maintain lifestyle changes long enough for biomarkers to catch up.
4) While it is premature to show longevity outcomes today, by EOY 2026 we expect to correlate QoL improvement with measurable gains in:

• Cardiometabolic risk scores
• Blood pressure control
• Lipid panels (ApoB, LDL-C, HDL ratios)
• Metabolic flexibility (postprandial response patterns, glucose variability)
• Hormonal balance markers (estradiol fluctuations, cortisol patterning, thyroid balance)

This creates a dual-outcomes framework: QoL reflects the lived experience of vitality; biomarkers quantify the underlying physiology that sustains it.

Why Tia Is Uniquely Positioned to Use QoL As a Longevity Metric

No other women’s health organization combines:

• Integrated primary care, gynecology, mental health, and wellness
• Trauma-informed, relational care
• Longitudinal follow-up
• Psychometric and metabolic data collection
• A women-centered lens on physiology

These elements make QoL not merely a survey outcome, but a core operating metric that captures the full expression of Tia’s clinical model.

2025 QoL Outcomes

Meaningful Daily Impact:

Patients achieved an average +8.8 point improvement in QoL from their lowest recorded baseline - nearly doubling the industry standard for a "Minimal Clinically Important Difference" (MCID) of +3.0 to +5.0 points. In a clinical context, this shift represents a measurable reduction in the "friction" of daily symptoms and demonstrates that Tia’s integrated, longitudinal care model moves beyond simple stabilization to actively drive gains in daily functional capacity.
Sources: Journal of Patient-Reported Outcomes; WHOQOL & SF-36 MCID Validation Standards

• As of late 2025, 21% of Tia patients are considered to be in a “thriving” state (QoL score >=72). This exceeds the 15–18% national norm for high-tier well-being, serving as a clinical proof point of our longevity engine. Sources: Topp et al., Psychother Psychosom (2015); Front. Psychol. (2025) WHO-5 Community Norms

Engagement as a Catalyst for Improvement:

We see a direct “dose-response” relationship between how often a patient interacts with their care team and their subjective well-being:

• 43% of patients who scored a QoL below 72 saw at least a 4-point improvement based on their latest 2025 response. These patients engaged with Tia twice as often as those with no improvement (5.1 vs 2.0 annual visits) suggesting that consistent clinical touchpoints are one primary driver of stabilization.
• Patients experiencing the most profound impact (40+ point QoL gains) were also our most deeply engaged, averaging 6.2 visits per year.

Engagement & Experience: Trust as a Clinical Outcome

Women who trust their care providers engage more consistently, share more openly, and adhere more reliably to preventive and chronic care recommendations. Tia’s relationship-centered care model drives exceptional patient loyalty and satisfaction that directly translate into better health outcomes.

Net Promoter Score

Our sustained NPS reflects both deep trust and the consistently human-centered experiences Tia provides. Maintaining this score at scale underscores the durability of our model. It’s also worth nothing that t

Retention—an often overlooked but profound indicator of clinical continuity—rose to >80%. Members who engaged with Tia across 2 or more visits in the prior year saw significantly stronger retention, at nearly a +15pp improvement to members who engaged at a lower frequency. This stability supports longitudinal care, particularly in chronic disease management and mental health, where continuity predicts better outcomes.ypical healthcare services providers see a negative score for NPS.

Spotlight on Diabetes Management: Improving Metabolic Health Across the Population

Diabetes and metabolic disease are among the fastest-rising burdens in women’s health, with disproportionate impact across midlife and perimenopause. In 2024–2025, Tia expanded its chronic care infrastructure to drive deeper, more measurable improvements in A1c and metabolic risk across our population.

Why Diabetes Management Matters in Women’s Health

Women with diabetes experience higher rates of cardiovascular disease, infertility, pregnancy complications, and mental health comorbidities—and frequently receive delayed or insufficient diagnoses. Furthermore, there is new research that indicates women with diabetes could experience worse peri/menopase symptoms. Integrated primary care is essential to managing these risks holistically.

Tia’s Diabetes Population

2025 Screening Stats: 11.9% of Tia patients are dealing with diabetes – right in line with national levels – and 90%+ of this population lives with at least one comorbidity (i.e., hypertension, PCOS, depression) that impacts their day-to-day living– which is substantially higher than national benchmarks, but on par with a women’s experience.

New Care Pathways & Pilots

Over the past year, Tia deployed several pilots designed to improve glycemic control, including:

• Structured A1c follow-up programs
• Established partnership with nutrition partner Nourish to support in management
• Created ‘support group’ infrastructure for diabetes patients
• Medication optimization workflows
• GLP-1 clinical pathways for diabetes management

These initiatives aim not only to treat diabetes, but to address the psycho-somatic challenges of managing diabetes that women uniquely face.

Safety & Integrative Management

• While GLP-1s represent a uniquely effective tool in the clinical tool kit to support patients, it is not “free”. We are deeply cognizant of the risks GLP-1s can bring to women, in particular when considering muscular structure maintenance, osteopenia and osteoporosis and ongoing bone density monitoring and management. Tia’s approach to managing patients on GLP-1s include integration of nutrition coaching, bone density / DEXA scanes and body composition monitoring.
• Furthermore, often times we see the best results when medication is paired with deep behavior change that is driven through mental health and cognitive behavioral therapy results. Tia’s model is uniquely poised to support patients in such journeys given our integrated care model.

By contextualizing GLP-1s within an ecosystem of comprehensive care, Tia emphasizes therapeutic stewardship and long-term chronic disease management—not quick fixes.

2025 Diabetes Health Outcomes, A1c & GLP-1s

A1c: Bridging the Gap

While majority of Tia’s population maintains healthy glycemic levels (averaging an A1c of 5.2) we focus our most intensive efforts on patients facing “uncontrollable” A1c levels (>=8) - for these patients, the journey is more than just advice, it requires high-impact, evidence-based intervention

Dramatic Reductions

On average, these patients saw a 3.3-point drop in their A1c, moving from a high-risk average of 9.8 to a much safer 6.5 risk cohort have successfully brought their A1c below the 8.0 threshold.

GLP-1s

Given their strong evidence base, GLP-1 therapies are now an important part of diabetes management for appropriate patients. Currently, across diabetic Tia patients 6% are on a GLP-1 and have seen significant health improvements.

Secondary Benefits & Lifestyle Transformation:

By stabilizing metabolic function, we see a ripple effect across other key health markers:

• Weight & Metabolic Health: of patients in this cohort who presented with a BMI of 25+: 70% saw a weight reduction, averaging a loss of 15 pounds.
• Cardiovascular Health: the benefits reach the heart, too. The percentage of this population with high blood pressure readings (>= 130/80 mmHg) halved, dropping from 16% to 8% between tests.

Managing High PHQ-9 Patients to Improvement

Women face disproportionate mental health burdens, and depression often coexists with metabolic, hormonal, and reproductive conditions. Tia’s integrated approach aims not just to identify depression—but to help patients improve meaningfully over time.

The High PHQ-9 Cohort – what is its shape?

• 2025 Screening Stats: 22% of all Tia patients screened for depression presented with a PHQ-9 score of 10 or higher, warranting intervention.
• The Comorbidity Reality: 65% of patients with high PHQ-9 scores presented with at least one additional clinical risk factor or comorbidity - these included:
  • Cardiometabolic: 43.2%
  • Gynecologic: 14.5%
  • Heme-related: 12.3%
  • Neurological: 11.6%
  • Endocrine: 8.9%
• Closing the Loop - from Screening to Support: Tia ensures that a high PHQ-9 score is immediately met with a clinical roadmap for the patient. In 2025, 79.5% of patients with high scores were successfully bridged to specialized care - either through Tia’s internal psychiatric program or our integrated talk therapy partnerships (e.g., Talkspace)

2025 Mental Health Outcomes

Improvements we’ve effected in our population:

Meaningful Recovery:

• Nearly 1 in 3 patients who started with a high PHQ-9 score (>= 10) achieved response and saw a 50% reduction in their PHQ-9 score based on 2025 data.
• Additionally, 1 in 5 patients achieved remission, achieving a PHQ-9 score below 5. These outcomes are inline with collaborative care models.

Rapid Impact:

For patients experiencing improvement, the majority saw life-changing results in under six months:

• 70% of those achieving clinical response did so within 180 days
• 55% of those reaching full remission did so within 180 days

These outcomes indicate that our patients were able to achieve benchmark collaborative care model outcomes 6 months sooner than patients at other sites of care.

The Tia Difference:

By connecting patients to our specialized therapy and psychiatry programs, we saw even higher rates of recovery (+47pp improvement in achieving response and +11pp improvement in achieving remission across patients enrolled in Tia’s program compared to those who were not) proving that integrated care is the fastest route to healing.

Conclusion: Redefining What “Quality Care” Means for Women

These outcomes prove Tia has the highest quality care model for women on the market. By going deeper, by integrating more specialties, by ensuring we are seeing our patients in person and building uniquely deep relationships with our patients we are changing how women feel in their care journey – and ultimately, as a result – changing women’s health for the better. In 2026 we look forward to deepening the precision of our model by leveraging our unique longitudinal model to better understand and treat women. In particular, we will:

• Identify phenotypes of women who age differently.
• Predict which metabolic interventions yield the greatest QoL gain.
• Tailor preventive programs based on symptom clusters rather than single biomarkers.
• Develop evidence-based “care signatures” for reproductive transitions (menarche → fertility → pregnancy → postpartum → perimenopause → menopause → postmenopause).

Ultimately, QoL becomes the language through which Tia redefines longevity for women—not as a quest for optimization for its own sake, but as the pursuit of function, vitality, and a feeling of grounded, embodied agency over one’s health across the lifespan.