Issue 028
Welcome back to E&O Wednesdays, the enrollment-focused digital health newsletter from Exits & Outcomes — for paying subscribers only. This every-other-Wednesday issue digs into digital health companies that sell to self-insured employers as well as others that rely on enrollment-based distribution for their digital health programs.
E&O Wednesdays
Two quick news notes before some longer items below…
- This long-read on Noom is a thorough and up-to-date retelling of the company’s official narrative, which makes sense because it is largely based on interviews with the current exec team. The only new bit of information in here for E&O subscribers is a ballpark revenue figure for 2021: Noom “says it has continued its fast growth in 2021; at presstime, the company was expecting more than $600 million in revenue for the year.” As I mentioned in The Noom Report, the company typically says it pulled in around $400 million in revenue for 2020, but it was probably more like $378 million.
- More Omada Health news below, but I noticed an interesting growth metric reveal in this Health Affairs article the other day: Omada Health delivered its diabetes prevention program to more than 100,000 individuals in 2021. What’s notable here is that E&O’s Omada Health Report back in January 2020 calculated Omada’s net new users (almost entirely DPP) at about 110,000 for 2019. Of course, Omada has moved aggressively into other medical conditions in the meantime, but I’m still surprised to see an indication that the company’s DPP growth might have remained relatively flat these last two years. Another growth metric reveal: Omada just announced that it has more than 1,600 customers, which is up from the 1,000 it announced at the start of 2020. So, that’s 600 net new customers in the past two years.
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Omada unseats Livongo as “preferred” in Evernorth Digital Formulary
Omada Health announced today that it “has earned preferred status on the Evernorth Digital Health Formulary for its cardiometabolic digital chronic care programs: Diabetes, Hypertension and Prevention.”
Currently, Livongo’s diabetes, hypertension and pre-diabetes programs carry the “preferred” status in the formulary, but there can be only one. Livongo will lose that status in 2022. Evernorth evaluates the vendors in its Digital Health Formulary on an annual basis. The “preferred” status is based solely on best overall value (outcomes relative to price) to Evernorth’s clients.
On Linkedin, Omada Health CEO and co-founder Sean Duffy explained that the “preferred” status makes it easier for Evernorth’s and Express Scripts’ employer clients to add Omada’s cardiometabolic programs to their pharmacy benefits stack:
“So, what does this mean? Securing a preferred solution standing means that participating employers and health plans that work with Evernorth and Express Scripts can now simply integrate Omada Health into their pharmacy benefit.”
Cigna, which merged with Express Scripts at the end of 2018, has long been a proponent of Omada Health. Express Scripts, meanwhile, has a history with Livongo. Read my breakdown of Cigna’s pricing for Omada from Issue 016. This isn’t the first time Livongo has weathered a blow from a PBM’s digital health formulary. The company was the first one to be removed from CVS’ Point Solutions Management, as I reported in Issue 002.
Back to Evernorth. The only other “preferred” program in the formulary is Hinge Health’s for MSK. MSK programs from Omada and RecoveryOne are available too. When Hinge announced its “preferred” status, the company explained that it meant that:
“Evernorth client implementation is even easier with no required contracting, pre-assessed IT security standards, and integration of data sharing and billing.”
Walmart adds Vivante Health pilot and Omada’s MSK to employee benefits stack
Speaking of Omada’s MSK program, Walmart added it as a benefit to employees for 2022. The giant employer actually teased this in a corporate blog back in October but didn’t name the company behind the virtual physical therapy program it had chosen to add to its benefits stack. Here’s the pitch:
“Virtual physical therapy with Omada Health can help you:
- Prevent and heal muscle and joint pain
- Tune up your body to help you move better
- Manage chronic conditions with personalized techniques and treatment plans
- Prevent injuries with a self-directed program tailored to your needs
- Improve your emotional health by addressing physical pain”
The other addition to Walmart’s digital health benefit stack for 2022 is a trial run of Vivante Health’s GIThrive program. Industry watchers may have seen this one coming back in 2019 when Walmart’s former SVP of benefits joined Vivante as a consultant. Walmart offers up quite a bit of information on Vivante’s GIThrive program, but here’s the section that lists out what’s included:
- “An expert care team including a registered dietitian and dedicated health coach
- A personalized action plan that spells out the actions you can take to feel your best
- The GutCheck microbiome test kit to see how your gut bacteria compares to others
- Personal nutrition advice and special diets that can relieve digestive symptoms and reduce inflammation
- Your Smart Food & Symptom Diary, to help you track progress, detect possible trigger foods, and stay on course
- 24/7 Gut-Side Assistance for on-demand help from a gut health expert—anytime, anywhere
- Personalized education including self-paced courses, articles, and clever tips for better health
- The GIThrive app that ties the whole program together in one convenient place”
The digestive health pilot and Omada’s MSK program are only available to Walmart employees in these states: AK, AL, AZ, CO, IA, IL, IN, KY, MN, MO, NC, SC, TN, VA, WI, WV. Of course, if you want to read through the rest of Walmart’s digital health benefits, re-read Issue 001 of E&O Wednesdays. Walmart’s was the very first employer benefit stack this newsletter analyzed way back in November 2020.
Big employer digital health stack: Sony Pictures
Digital health companies love to boast how many Fortune 500 customers they have. This recurring feature of E&O Wednesdays digs into a different Fortune 500’s (or similarly-sized employer’s) digital health stack. So far, in past Wednesdays issues, I’ve written about the digital health benefits stacks of 27 big companies — click any of their names below to read that previously published Wednesdays newsletter over at the E&O site:
- Walmart,
- Activision Blizzard,
- JP Morgan Chase,
- The Home Depot,
- Boeing,
- 3M,
- Chevron,
- BorgWarner,
- Bank of America,
- UnitedHealth Group,
- Costco,
- eBay,
- McKesson,
- Ford,
- Dell,
- AT&T,
- Disney,
- Novartis,
- Red Bull,
- VMware,
- T-Mobile/Sprint,
- Adobe,
- Phillips 66,
- Cox Enterprises,
- Wells Fargo,
- PayPal,
- and Facebook.
This week, I dug into the digital health benefits that Sony Pictures is offering its employees for 2022. (Sony Pictures itself is not a Fortune 500, but its parent company Sony certainly is. Given how Hollywood-themed the enrollment materials are for Sony Pictures, I believe the benefits are likely not the same across the parent company’s various holdings. So, this is just the stack for Sony Pictures.)
Here’s what I found:
Sony Pictures employees seem to be on Aetna’s health plans mostly and the insurance company’s tools and services take up the bulk of the company’s enrollment marketing materials.
Spring Health replaces ComPsych as EAP in 2022
The biggest change for Sony Pictures employees going into 2022 is a new EAP: Spring Health will replace the company’s former EAP ComPsych.
“Spring Health provides mental wellness services that are confidential, convenient and available anytime, anywhere. Spring Health replaces our former EAP program (through ComPsych) and expands the services available to you and your family.”
“With Spring Health, you can book therapy sessions that fit your schedule, access work-life resources for help navigating life’s challenges and more. They also provide a library of on-demand self-help exercises and pair each employee or covered family member with a dedicated Care Navigator.”
“Sony Pictures employees and their covered dependents each receive up to eight free therapy sessions every year with a Spring Health provider. Those enrolled in an Aetna medical plan through Sony Pictures can continue seeing their Spring Health provider as an in-network provider following the first eight sessions.”
Virtual counseling: Teladoc
For 2022, Teladoc is positioned first and foremost as another option for seeking behavioral health counseling under the heading: Teladoc Counseling.
“If you’re enrolled in the Consumer Choice, PPO or EPO medical plan, you can connect 24/7 with a Teladoc virtual doctor. In addition to diagnosis and treatment of minor medical conditions, Teladoc offers behavioral health counseling seven days a week for you and your covered dependents. Therapists provide help with anxiety/ stress management, relationships, depression, PTSD and many other issues. It’s confidential and convenient.”
“The cost for the Sony Consumer Choice Plan Teladoc behavioral health service is $190 for the first consultation with a psychiatrist and $95 for all subsequent consultations with a psychiatrist. Consultations with a master’s level therapist are $85 each. Dermatology consultations are $75 each. Once you meet the deductible, Teladoc services are free.”
Aetna positions Teladoc as a big selling point when courting Sony Pictures’ employees:
“With Sony Pictures’ telemedicine program, you can call a doctor 24/7 for diagnosis and treatment of minor conditions. And it’ll probably cost you less than the price of an office visit copay, depending on your plan…. With Teladoc, you can get:
- Short-term prescriptions.
- Skin conditions diagnosed by sending a photo.
- Care for a loved one, even if they’re not on your plan. Register them on your Teladoc account, then initiate a consultation via three-way call.
And, Teladoc offers behavioral health counseling seven days a week for you and your covered dependents. Therapists provide help with anxiety/stress management, relationships, depression, PTSD and many other issues. It’s confidential and convenient.”
Another change for 2022: Despite all of the Teladoc promotion, Sony Pictures made the decision to discontinue offering Teladoc’s Medical Experts, a second opinions service formerly known as Best Doctors.
Aetna members have access to Hinge Health for MSK
“As an Aetna member, you’ll have access to Hinge Health, which offers innovative digital programs for back, knee, hip, neck and shoulder pain in easy-to-do 15-minute exercise therapy sessions.”
Aetna’s virtual benefits navigator tool Emma (from bswift)
Aetna acquired a benefits navigation company named bswift back in 2014. It still uses bswift’s online chat tool as its benefits navigator offering, which is named Emma.
“EMMA is Sony Pictures’ online virtual assistant. She can help you get the most from your benefits. EMMA asks you questions to make sure you get — and understand — the benefits information you need. Her plan recommendations are based on your answers. The information you share with EMMA is confidential; it’s used only to help you find the health plan that best fits your needs.”
Well, that’s a wrap on Sony Pictures’ stack. Some of these stacks are easier to figure out than others (so no promises), but let me know which company’s digital health benefits you’d like to learn more about by hitting reply to this email. If you happen to work at a Fortune 500 company (and I know that’s a lot of you), then please send me your benefits information.
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