The governance layer for women's health has never been built.

The market funded apps. Crescent built the operating layer.

"She sees five specialists. Nobody sees her."

$8.4M

Annual Savings

84%

Of Maternal Deaths Preventable (CDC MMRC)

4.6 yrs

Avg Diagnostic Delay

For a 100,000-member book of business: $8.4M in annual savings. Fee: $1.50–$3.00 PMPM. ROI: 2.3x to 4.7x.

What Nobody Governs

The U.S. maternal mortality rate stands at 17.9 per 100,000 live births (CDC NCHS, 2024). Black women face 3.2 times the rate of white women (CDC MMWR, 2024). The C-section rate has reached 32.5% (NCHS, 2025). None of these numbers are improving at scale.

Women's health conditions span fertility, maternity, autoimmune, gastrointestinal, pelvic, and behavioral health. Each is managed by a different vendor, a different formulary, a different utilization protocol. Nobody governs the continuum.

The average woman with endometriosis waits 4.6 years for a correct diagnosis (AARDA). She sees multiple specialists. She accumulates imaging, labs, pharmacy spend, ER visits. The payer sees line items. Nobody sees the arc.

Point solutions address the symptoms of this fragmentation. Crescent addresses the architecture.

Structural Equity

How Governance Reduces Disparities

The 3.2x mortality gap is not a knowledge problem. It is a systems problem. Crescent's model addresses it structurally:

Protocol-driven coordination ensures equitable access regardless of health literacy. Every member gets the same protocol-driven outreach, the same follow-up cadence, the same escalation triggers.

Standardized clinical protocols prevent variation in care delivery based on demographics. The governance layer enforces the same pathway for every patient who meets criteria.

Outcome measurement stratified by race and ethnicity identifies gaps in real time. When a disparity emerges in the data, the protocol adjusts — not after a quarterly report, but within the care episode.

Postpartum monitoring is protocol-driven, not patient-initiated. The follow-up gap — where Black women are 2x less likely to attend a postpartum visit (ACOG, 2023) — closes when outreach is standardized and protocol-driven.

What Crescent Does

Crescent sits between the payer and the women's health delivery system. We review utilization, flag coordination failures, enforce clinical protocols, and manage transitions across every sex-linked condition — fertility through menopause. The same model that built the specialty management category in MSK, oncology, and cardiac care, applied to the one domain nobody has governed.

One layer. Seven modules. No member app required.

The Model

Seven modules. One continuum.

Module 01

Intake + Stratification

Claims-based risk identification. Flags rising-risk women before they become high-cost. No referral required.

Module 02

Fertility Governance

Protocol oversight for IVF, IUI, egg freezing. Site-of-care optimization. Lab stewardship on hormone panels.

From fertility to conception to delivery—

Module 03

Maternity Episode Management

Full-episode ownership from first OB visit through 12-month postpartum. C-section variance review. NICU prevention protocols.

Module 04

Postpartum + Behavioral Health

Mood disorder screening at 2, 6, and 12 weeks. Lactation coordination. Pelvic floor pathway activation.

From acute episodes to chronic conditions—

Module 05

Autoimmune + GI Continuum

Endometriosis, PCOS, IBD, IBS—managed as a condition class, not isolated diagnoses. Shared labs. Shared formulary logic.

Module 06

Pharmacy + Lab Stewardship

Cross-module formulary governance. Biologics management. Redundant lab elimination. Single review layer for all women's health Rx.

From clinical governance to member experience—

Module 07

Navigation + Advocacy

Assigned coordinator per care arc. Single point of contact across all modules. Transition management between specialists. Benefits literacy.

The market funded point solutions. Nobody funded the operating layer.

Coverage comparison — point solutions vs. governance
Company	Fertility	Maternity	Autoimmune	GI	Rx	Labs	Navigation
Maven
Progyny
Pomelo
Visana
Crescent

Point solutions address symptoms. Crescent governs the architecture.

Quality Measures

HEDIS Alignment

Seven HEDIS measures directly impacted by Crescent's governance protocols. This is what gets past a medical director's desk.

Measure ID	Measure Name	Crescent Module
PPC	Prenatal and Postpartum Care	Maternity Episode Mgmt + Postpartum/BH
PRS-E	Timeliness of Prenatal Care	Intake + Stratification
CBP	Controlling High Blood Pressure (pregnancy-related)	Maternity Episode Mgmt
CIS	Childhood Immunization Status	Maternity (maternal vaccination protocols)
FVA	Flu Vaccinations for Adults	Navigation + Advocacy (pregnant population)
BCS-E	Breast Cancer Screening	GYN / Navigation + Advocacy
CCS	Cervical Cancer Screening	GYN / Navigation + Advocacy

Crescent's governance protocols create the documentation, outreach cadence, and provider accountability that move these measures. The navigator layer closes the gap between eligibility and completion.

The Economics

$7.00 PMPM

PMPM Savings Generated (per covered member)

NICU avoidance $2,520,000 30%

Autoimmune flare prevention (modeled) $3,200,000 38%

C-section reduction $176,000 2%

Biosimilar conversion $1,400,000 17%

GI site-of-care steering $680,000 8%

Lab optimization $424,000 5%

Total $8,400,000

Pre-revenue model. Derivation and assumptions below.

Year 1

$1.1M

Year 2

$8.2M

Year 3

$37.8M

Year 4

$78.5M

Year 5

$125.4M

Cash-flow positive by Q3 of Year 2.

How it gets to $125.4M — the assumptions behind the trajectory.

	Year 1	Year 2	Year 3	Year 4	Year 5
Clients	3	12	30	50	70
Avg lives per client	13K	25K	47K	58K	66K
Total lives under mgmt	40K	303K	1.4M	2.9M	4.6M
Female members (~50%)	20K	152K	700K	1.45M	2.3M
Blended PMPM	$2.25	$2.25	$2.25	$2.25	$2.27
Avg modules per client	2–3	3–4	4–5	5–6	5–7
Annual Revenue	$1.1M	$8.2M	$37.8M	$78.5M	$125.4M

PMPM charged on total covered lives. Female members represent the governed population. Module attach rate drives upsell within existing accounts. Year 1 assumes three anchor clients: one mid-size employer, one TPA, one regional plan pilot.

The research behind the model — 31 sources, intervention-level savings, the governance-to-hybrid trajectory.

Read the full argument → Executive briefing · Request the actuarial business case

Savings Model

Build Your Case

Adjust covered lives, female mix, and modules to see projected savings for your book.

▸ How to use this tool

Build a savings case for women's health specialty management. Adjust covered lives and female percentage, then select which clinical modules to include (Maternity, Fertility, Postpartum/BH, Autoimmune/GI, Pharmacy/Lab Stewardship). The calculator shows estimated savings, program cost with tiered PEPM pricing, net savings, and ROI. The per-module breakdown shows where the value concentrates. Download your savings report for your benefits committee.

Covered Lives

25,000

Female Percentage

52%

Modules

Maternity 30% Fertility 15% Postpartum / BH 20% Autoimmune / GI 25% Pharmacy / Lab Stewardship 10%

Estimated Annual Savings $1,092,000

Crescent PEPM Fee $3.00

Annual Program Cost $900,000

Net Savings $192,000

ROI Multiplier 1.2x

Per-Module Savings

Go-to-Market

Phase 1 — Months 1–6

Employer Direct

Self-insured employers, 10K–100K lives. Maternity + fertility modules first. Prove savings on a single book.

Phase 2 — Months 6–18

TPA + Broker Channel

Expand through benefits consultants and third-party administrators. Add autoimmune and GI modules. Multi-module pricing.

Phase 3 — Months 18–36

Health Plan Integration

Full-continuum delegation from regional and national plans. All seven modules. At-risk arrangements on maternity episodes.

We did not build Crescent because the market lacked another app. We built it because the architecture was missing. Seven conditions managed as one class. One coordinator who sees the full arc. One governance layer that holds it together.

The women's health market does not need more point solutions. It needs the operating layer that connects them.

Your Book

In 10,000 Covered Lives

~650 women will use at least one Crescent module this year.
~340 are managing conditions across multiple specialties — that's where fragmentation costs compound.

Total modeled savings: $840,000/year (scaled from $8.4M per 100K lives)
Crescent fee: $180,000–$360,000/year ($1.50–$3.00 PMPM on total lives)
Net ROI: 2.3x–4.7x

For payers: Crescent reduces total cost of care through single-point navigation across 7 specialties. Fewer redundant consults, fewer ER diversions, fewer NICU days. It touches 7 HEDIS measures, 3 Star Rating categories, and the highest-cost DRG in your book.

45 days to implement. No integration required.

Includes employees, spouses, and adult dependents. Prevalence estimates: ~5% pregnancy (maternity), ~4% autoimmune, ~3% GI, ~2% pelvic floor, ~2% fertility, ~15% symptomatic menopause (age 45-55). Applied to ~4,500 adult women per 10,000 covered lives. Deduplication for overlapping conditions yields ~650 unique module users, of which ~340 (52%) are managing conditions across multiple specialties. Sources: CDC NCHS, AARDA, SAMHSA, ACOG.

Built by Joe Nalley, a specialty risk executive who has managed six condition-specific books — including maternity and musculoskeletal — across millions of lives at a top-three national health plan. His prior governance methodology, applied across 65,234 specialty pharmacy patients, established the approach Crescent extends to women's health.

If this is your problem, we should talk. We're looking for founding partners.

joe.nalley@showyourwork.health

Expect a response within one business day. We'll start with a 30-minute walkthrough of the model.