Case Study: Fella Health

Fella Health, a virtual clinic helping men manage weight and metabolic health, had a proven care model. But when they set out to scale, they faced an obstacle familiar to many digital health companies: navigating the regulatory maze of physician collaboration requirements across states.

In the highly competitive weight loss space, Fella Health’s core competence and differentiator is their clinical excellence. Maintaining quality care and clinical outcomes without overspending is highly important. So, Fella Health had to manage the quality of an advanced practice provider workforce as they attempted to scale their practice, while simultaneously avoiding the existential risks to the business of a compliance breach.

To expand quickly without compromising on clinical quality or compliance, Fella turned to Zivian Health.

The Problem: Compliance at Scale

Fella built its clinical model around a distributed workforce of nurse practitioners (NPs). But in many states, NPs can’t practice independently without a collaborating physician. Each state has different rules, and noncompliance carries real business risk.

Fella evaluated three paths forward:

Solution 1: Hiring Individual Collaborators

Building their own physician network would require extensive legal, recruiting, and administrative lift. Each new hire brought licensing logistics, legal contracts, ongoing chart review obligations, and state-by-state compliance tracking.

The projected cost for internal collaboration infrastructure, including potential 50-state licensure for physicians, was estimated at over $125,000 annually.

Solution 2: Hiring a Fractional Medical Director

While centralizing oversight might streamline quality assurance, this route was expensive, slow to implement, and posed its own risks.

A single director couldn’t support a national network and would still require backup infrastructure for compliance and board filings.

Solution 3: Partnering with Zivian Health

Fella chose Zivian. The Zivian platform provided immediate access to a network of credentialed physicians across all 50 states, automated compliance workflows, and integrated tools for chart reviews, board submissions, and secure messaging. Implementation took days, rather than months.

Zivian’s solutions enabled Fella Health to avoid building an in-house team and cut projected annual costs from $35,000–$150,000 to approximately $6,000 per NP.

Real Results: Efficiency, Safety, and Scale

By partnering with Zivian Health, Fella Health achieved measurable operational and financial gains:

• Reduced collaboration-related expenses by up to 80% compared to hiring their own physicians

• Saved approximately 65% compared to using a fractional medical director model

• Activated new markets in days, significantly accelerating time-to-launch across new states

• Eliminated internal compliance bottlenecks, streamlining operations and reducing legal exposure

• Gained full visibility into compliance performance, with centralized oversight and audit-ready documentation

• Reinvested operational savings into clinical quality and patient growth, fueling their continued expansion

Why Zivian Health Worked for Fella Health

Zivian didn’t just help Fella meet state-by-state requirements. We delivered a purpose-built platform that simplified collaboration, reduced risk, and accelerated growth. The solution included:

• A nationwide physician marketplace for instant NP coverage in every state

• End-to-end compliance automation for agreements, chart reviews, and board filings

• Integration-ready workflows that fit into Fella’s clinical operations

• Transparent, auditable records that prepared the organization for scale and scrutiny

With Zivian, Fella grew smart—with a system that protected their clinical integrity and positioned them for long-term success.

Build Smarter. Scale Faster.

If your organization is expanding across states and needs a trusted compliance and collaboration partner, Zivian Health is ready.

We help healthcare organizations grow their advanced practice provider workforce safely, efficiently, and without regulatory compromise.

Get in touch with our team today to see how Zivian can support your growth.

Get started with Zivian Health today.

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