Issue 007
Digital health research from Brian Dolan
E&O: National Virtual Clinics
Welcome back to E&O: National Virtual Clinics, a digital health newsletter from Exits & Outcomes — for paying subscribers only. This issue digs into digital health companies that operate virtual-first medical practices with direct patient acquisition and in-network provider agreements with payers. Most haven’t scaled nationwide yet. I usually track state-by-state rollouts in each issue (but I don’t believe there were any in recent weeks? Let me know if I missed one.) As always: Hit reply if you know of a virtual clinic that should have gotten a mention below but didn’t. There are many — please help: I want to track them all.
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Following Salvo Health’s pivot away from a DTC virtual clinic, here’s a look at Oshi Health’s self-pay pricing.
Last September I noticed that Salvo Health, a high-profile virtual clinic led by the former CEO of social media company Foursquare quietly pivoted away from its DTC virtual clinic go-to-market to begin selling its digestive care and remote monitoring software to other providers:
“Salvo Health announces the first-to-market RPM offering for GI chronic conditions, including IBS, GERD/reflux, dyspepsia, Celiac, SIBO, and more to optimize clinical outcomes and boost practices for participating partners.”
(It announced the RPM launch but not the DTC clinic wind-down.) When I first learned about Salvo Health’s pivot, I was under the impression that Oshi Health had shied away from DTC as a patient acquisition channel. Clearly, that didn’t work out well for Salvo. At the time I believe Oshi’s focus was strictly B2B2C and didn’t have a self-pay option. But it does now. While Oshi’s pricing for self-pay is almost certainly different from the rates it offers employers and health plans, it’s worth digging into to get a better sense of what Oshi may charge its B2B partners. Oshi’s pitch is that self-pay patients will have 12 months of unlimited visits and chat messaging with their care team for $3,000 or less — and they can cancel anytime.
Here’s how that breaks down: Oshi divides its self-pay care options into two phases.
Assess ($200-$300): The first is called “Assess” and it includes a $200 first GI provider visit along with a $100 second visit if needed. Oshi promises that these initial visits will be between 45 and 60 minutes, which is much longer than the typical 15-minute specialist visit the patient would get elsewhere. Oshi promises to review the self-pay patient’s records in advance of the visit. The provider will develop a personalized care plan that includes dietary and behavioral health suggestions. Finally, the provider will prescribe diagnostic tests or prescriptions if warranted — and these may carry additional co-pays.
Take Control and Maintain ($2700): The second phase Oshi offers self-pay patients is called “Take Control and Maintain”. This billing phase lasts between four and five months, but patients have access to their care team for long than that. Oshi bills the self-pay patient $900 for their first visit in this phase, followed by another $900 bill two months later, followed by a final $900 bill two months after that. During those months the patient has access to GI providers, registered dietitians, behavioral health providers and more. They have unlimited virtual visits and chat messaging with their care team for 12 months after their initial GI provider visit.
Oshi’s self-pay pricing is higher than what Salvo offered. If you recall, Salvo pitched the cost of its former offering like so:
“For $99/visit, members are matched with a board-certified doctor to identify and treat the root cause for your gut symptoms and provide a comprehensive treatment plan to get you relief that lasts. As a Salvo Health member, our $39/mo membership cost gets you access to continuous care, including unlimited messaging with your care team via chat, in-app content, and daily symptom tracking customized to help manage your condition.”
As I noted above, Oshi is mostly focused on B2B channels and has not historically invested in a DTC patient acquisition funnel. It doesn’t follow the recently popular GTM of state-by-state rollouts and in-network contracting with payers, however. It’s made employers its focus — similar to Maven Clinic. Last October, I asked Oshi’s CEO Sam Holliday for some help understanding how Oshi contracts with its employer clients. He wrote:
“We work directly with employers today as a virtual-first clinic that they promote as a covered benefit. An employer can contract directly with us and ask the carrier/TPA to set up a custom network to pay our claims (or pay us via invoice). A [UnitedHealthcare] employer’s people may have access to us today via the UHC Virtual Center of Excellence in their myUHC app (the network coverage), so all the employer needs to do is send benefit communications so their people are aware of how to access this care that they already have (no formal contract required, we’re already built into the network). This avoids the need to pay a ‘buy up’ fee to the plan while allowing the employer to gain the same value from our care.”
After a little sleuthing, I can report that Oshi has inked deals with several big employers (either directly or through channel partners), including:
- Restaurant Growth Services (owners of O’Charley’s and Ninety Nine restaurant chains),
- massive food wholesaler Sysco (which started offering Oshi this year via Aetna)
- financial services firm Jack Henry (via Oshi’s partner benefits navigator Quantum Health)
- employees and dependents at Cincinnati Children’s Hospital
- automotive safety tech co Autoliv
- US employees of the Japanese conglomerate Fujifilm
More on Oshi: The AMA tapped Manatt to write a great case study on Oshi Health. Lots of good details in it (but no specific pricing details or customer names like I dug up above). I especially liked the care model breakdown. Read it here.
Deals and other news: Cerebral growth. Calibrate growth. Secret and not-so-secret funding rounds.
Here’s a quick round-up of other deals, announcements, and news from national virtual clinic companies:
Blackbird Health quietly raised $22.8M: Blackbird Health, a virtual and in-person mental health provider for kids and young adults (2- to 26-year-olds) struggling with social, developmental, and school-related challenges quietly raised about $22.8 million in a mix of debt and equity. (The filing notes that the amount includes conversion of debt into equity.) The company counts Define Ventures partner Chirag Shah as a director — so I’m guessing Define was a part of this round of funding. Blackbird Health’s website.
Cerebral has doubled patients treated since the end of 2021: Just noticed in a recent job posting that Cerebral now claims to have treated 700,000 people since its founding. In E&O’s deep dive into Cerebral at the beginning of 2022, I noted that the company claimed to have treated 350,000 people by the end of 2021. That means it has doubled its cumulative patients treated in the (turbulent) two-plus years since.
New CEO at Calibrate and progress update: Weight loss clinic Calibrate named Rob Macnaughton as its new CEO after CEO and founder Isabelle Kenyon stepped down in October. Calibrate also published a results report that’s worth a read. The report mentioned that 40,000 people have enrolled in Calibrate’s program since its founding and the study that the report focuses on revealed that 26,891 members enrolled in Calibrate as of October 2022. That suggests about 10,000 new members joined the program in 2023. The company also wrote in its CEO announcement that it is now entering its “enterprise-era” and is focused on growing and expanding its partnerships with employers.
Equip Health now recruiting for its 75-person clinical trial: Equip first posted details about its interventional trial back in November, but it is now recruiting participants for it. Here’s the brief:
“This present study will examine the effectiveness of a single session, virtually delivered body empowerment program for decreasing participants thin ideal internalization. The intervention asks participants to identify cultural norms surrounding appearance and attractiveness, then challenge these ideals. Participants will answer questions about thin ideal internalization before and after the program.”
Async dermatology virtual clinic Piction Health goes in-network in NH with Anthem: Piction’s CEO and co-founder Susan Conover wrote on Linkedin:
“I’m excited to share we are now in-network with the biggest health plan in New Hampshire – Anthem! This is a great step in expanding to full insurance coverage in New Hampshire and Massachusetts. Now we’re in-network for 3.5M people in New England 🙂 Honored to work with a great team at Assured and Florman Tannen to make this happen, and keep expanding our practice to serve more patients at Piction Health.”
Piction’s services are available in Florida, Massachusetts, New Hampshire, and Connecticut. It served its 1,000th patient at the end of 2023.
News you probably know: Isaac Health raised a $5.7 million seed. Meridian Street Capital and B Capital led the round with contributions from Primetime Partners, Co-Found Partners, VU Venture Partners, and AirAngels.
“Isaac Health offers a virtual brain health and memory clinic platform with the goal of dramatically improving access to constrained brain health services. Isaac Health partners with health systems and payers to screen, diagnose, treat, and manage populations with brain health conditions such as dementia. Isaac Health is also available to patients or their caregivers directly as a memory clinic service.”
Weirdly — I didn’t spot any new state launches for this issue. (The in-network deal for Piction above was the closest thing I found to a new market expansion.) What national virtual clinic news did I miss? Hit reply and let me know.
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