Ellen Rudolph was climbing the corporate tech ladder until she found herself battling a chronic health mystery that left her almost completely bedridden seven years ago. Instead of enjoying the prime of her health and career, she experienced a host of debilitating symptoms that doctor after doctor couldn’t give her any straight answers about. 

“After a long, winding journey, I eventually learned I had an autoimmune disease,” Rudolph, now the co-founder and CEO of WellTheory, said. “For me, it wasn’t until I really got to the root cause of my symptoms and embraced an anti-inflammatory diet and lifestyle that I was able to reclaim my health.”

Rudolph went viral after sharing her story on social media, reaching over 25 million views. She cultivated a community of over 85,000 followers who were navigating similar journeys, which made it clear she wasn’t alone in her struggles with autoimmune disease. The Autoimmune Association states that approximately 50 million people in the U.S. have an autoimmune disease, a number that is quickly rising. People with autoimmune disorders represent roughly 15% of the workforce.

During a thought leadership spotlight at From Day One’s NYC half-day benefits event, Rudolph made her case for why employers must pay attention to this costly and underserved patient population during, sharing insights from her personal struggles with an autoimmune disorder. 

The Autoimmune Disease Blind Spot

An autoimmune disease is a condition that leads to the body mistakenly attacking healthy cells, organs, and tissues, causing damage and chronic inflammation. There are more than 100 autoimmune conditions, including rheumatoid arthritis, psoriasis, lupus, and Hashimoto’s thyroiditis. Thyroiditis alone is estimated to cost U.S. employers over $70 billion annually. 

Autoimmune disease is the third most common cause of chronic illness in the U.S., even more common than type 2 diabetes today. Research suggests environmental factors play a significant role in the dramatic rise in cases. 

“The research points to the role that environmental factors, such as the Western diet, environmental toxins, stress, and viruses, play in triggering autoimmune disease,” Rudolph said. 

The prevalence of autoimmune conditions has seen “steady increases with no signs of abating.” To make things worse, 76% of people who have been diagnosed with an autoimmune disorder were misdiagnosed at least once, as was the case with Rudolph. 

“The reality of these conditions is that they are invisible. You don’t need to look sick to be sick, and so often, they can fly under the radar, both in terms of the claims data, but also in terms of just your workforce more broadly,” Rudolph said.

One of the biggest challenges regarding diagnosing autoimmune disease is that, unlike other chronic conditions like cardiovascular disease or type 2 diabetes, which fall under well-defined ICD-10 codes, autoimmune diseases are fragmented across different buckets based on the organ affected. This fragmentation creates what Rudolph calls “the autoimmune horizontal,” which increases the risk of misdiagnosis. 

The High Cost of Specialty Drugs Driving Autoimmune Spend

Autoimmune disease is one of the fastest-growing areas of drug spend. Costs have increased 459% over the last decade, with specialty drugs for these diseases driving 50% of high-cost specialty drug spend.

“The reality is that these are drugs costing about $45,000 per patient annually,” Rudolph said. “If you recognize a lot of these drugs, then autoimmune disease is already a top cost driver for your organization.”

The autoimmune epidemic is also a women’s health crisis, with approximately 80% of patients diagnosed being women. Some conditions are as much as 16 times more common in women. Autoimmune diseases like lupus disproportionately impact minority populations, with Black and Hispanic women diagnosed at three times the rate of non-Hispanic White women.

The current standard of care is failing these patients. They typically undergo lengthy diagnostic journeys that take five doctors over four and a half years on average just for an accurate diagnosis. The process includes batteries of tests, ping-ponging from specialist to specialist, and trips to the ER, creating tremendous waste in the system.

Once diagnosed, the standard of care relies heavily on biologics, but about 40% of patients end up switching prescriptions due to side effects or lack of efficacy, leading to a trial-and-error process, which leads to more medication, more doctor visits, and more lost time at work.

“One of the fundamental challenges with the standard of care today is that it’s focused on masking symptoms rather than treating the underlying root causes of these conditions,” Rudolph said. “So, to treat autoimmune disease requires this fundamental paradigm shift in how we think about these conditions and really looking at the underlying issues, rather than just trying to fix what's above the surface.”

A Root Cause Assessment Approach to Autoimmune Care

Rudolph’s battle with autoimmune disease inspired the creation of WellTheory, a virtual care platform that's purpose-built for patients with autoimmune disorders. The platform provides evidence-based dietary and lifestyle interventions that address root causes. These offerings are packaged into specialized care management programs delivered in a digital, scalable format.

The WellTheory experience starts with a root cause assessment that includes a deep dive into a member's health history, nutritional, and behavioral patterns to uncover underlying triggers. Each member is matched with a dedicated care team of autoimmune experts, including a licensed registered dietician, board-certified health coach, and care coordinator.

Members receive continuous one-on-one care through video calls, unlimited messages, access to customized nutritional resources, whole-body care plans, interactive educational content, and curated community support. The program has been featured in four peer-reviewed, third-party published papers that demonstrate its effectiveness.

“Our intent is not to disrupt or duplicate the care that they’re already receiving away from their providers, but really fill the gap of care that’s missing outside of the four walls of the doctor’s office,” Rudolph said.

The results are compelling: 91% of members report meaningful symptom relief within 12 weeks, and 61% report a noticeable shift in symptoms of depression and anxiety. Members stay engaged for an average of 270 days, engaging with the platform 13 times per month on average.

Employer Benefits: The ROI of a Root-Cause Approach

Beyond health outcomes, WellTheory delivers significant cost reduction. An independent third-party actuarial analysis found the program delivers $5,200 in savings per engaged autoimmune patient annually and $9,400 in savings per patient on biologics.

“We offer a less expensive, lower risk, and more effective way to manage autoimmune disorders than the status quo,” Rudolph added. 

The analysis also showed a 71% reduction in imaging services, a 64% reduction in ER visits, and a 38% reduction in hospital stays. A case study with a Fortune 100 tech company revealed that autoimmune disease was driving 25% of their total medical and pharmacy spend. After implementing WellTheory, an independent actuary found a 2.2x net ROI in year one due to reductions in ER visits and hospital stays. Another partnership with a large school system delivered a 5-to-1 ROI.

“So we know that employers are under mounting pressure to see that cost reduction in year one, and we really stand behind our outcomes by putting our fees at risk in that first year,” Rudolph said.

Behind the data are members like Joanne, a retired school counselor diagnosed with Hashimoto's and Crohn's disease over 10 years ago. Joanne was hospitalized for over 100 days after a routine procedure went awry. She was still struggling with severe fatigue and muscle wasting that left her essentially bedridden when she came to WellTheory. Her goal was to reclaim her energy so she could chase after her grandchildren.

Joanne went from barely being able to walk around the block to being able to stay on her feet for two to three hours straight in four months, allowing her to walk her daughter down the aisle.

Joanne expressed her gratitude in a video shared during Rudolph's presentation. “Working with WellTheory has definitely impacted my quality of life for the better,” she said. “I definitely now have more energy. I feel like I’m able to do more things. It’s given me the confidence to get back my life.”

Editor’s note: From Day One thanks our partner, WellTheory, for sponsoring this thought leadership spotlight. 

Ade Akin covers artificial intelligence, workplace wellness, HR trends, and digital health solutions.

(Photo by Josh Larson for From Day One)