Issue 033

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: Employers

A few quick notes…

• What do you think: Is it easier to build a health tech company that starts out DTC before adding B2B or is it easier to add a DTC revenue stream once you have built out your B2B business? This could take a few forms, but I’m mostly thinking along the lines of DTC virtual care provider that begins selling to employers later vs. an employer-focused digital health company that decides to go DTC later. (Yes, I know none of this is easy — I wrote “easier”.) Hit reply if you have a take.
• Last year Lyra Health made clear that it had big international ambitions, but a recent job post suggests Lyra will initially focus on France, Spain, Germany and Latin American countries. Then it would move into countries in the MENA and APAC regions.
• Stress and resilience-focused digital health company meQuilibrium has steadily built up a stable of big-name employer clients. Its investor Safeguard Scientifics, which owns nearly a third of the company, has disclosed in government filings that meQ brought in between $1 million and $5 million in revenue for 2018, $5 to $10 million in 2019, $5 to $10 million in 2020, and between $10 million and $20 million in 2021.
• The news you know… Since Quantum Health, which is a health navigator company, announced this at the beginning of the month you likely already read about it, but it’s fascinating how many digital health benefits aggregators there are now. Quantum’s Preferred Network includes Hinge Health, Oshi Health, Teladoc Health, Rx Savings, and Kidneylink. It plans to announce two behavioral health partners soon too.

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Update: Hinge Health’s cumulative users. Stumped on its annual revs. Details on its ROI guarantee

It’s been nearly two years since E&O published a deep dive into Hinge Health. At the time the company stated that nearly 40,000 people had participated in its MSK programs over the life of the company. In the report, I used those public disclosures to build the annual number of net new users graphs and to estimate the company’s annual revenues (net new users x price per user).

Calculating net new Hinge Health users since April 2020

At the end of 2021, Hinge Health started sharing an updated cumulative user figure in its marketing materials: More than 180,000 people had participated in its MSK program. So, Hinge Health added about 140,000 net new users between April 2020 and December 2021.

Calculating annual revenue based on cumulative users and pricing

For the April 2020 Hinge Health Report, I estimated Hinge Health’s pricing per participant per year by reading through its published studies. The company didn’t explicitly state its pricing in them, but it was easy enough to work out: $900. Since then I’ve seen actual Hinge Health contracts that show the price is actually $995 per participant per year. (That’s the maximum price and assumes the participant sticks with the program.) So based on those numbers: Between April 2020 and December 2021, Hinge Health brought in about $139.3 million in revenue (140,000 net new participants x $995). That’s a puzzling figure considering the company said it had crossed $100 million in revenue during an interview in January 2021. At the time the company expected to double or triple its revenue in 2021, which would mean $200 million or $300 million.

One revenue stream my numbers do not account for: Hinge will continue to bill participants another $995 for a second year if they continue to stick with the program. I haven’t found any hints as to how many Hinge participants carry over for a second year. Still, even the best-case scenario wouldn’t make these numbers work. What am I missing?

Calculating Hinge Health’s 1.5:1 ROI guarantee

I’ve previously reported (Issue 018) that Hinge changed its ROI guarantee from 1:1 to 1.5:1 since E&O published the Hinge Health report. Recently, I read a Hinge contract that helped me better understand exactly how the company calculates its money-back guarantee:

So, the pro-rated payout would be calculated like so:

Big employer digital health stack: News Corp.

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 31 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,
• Facebook,
• Sony Pictures,
• General Mills,
• General Electric,
• and Comcast.

This week I dug into the benefits stack of News Corp, owner of Fox News, The Wall Street Journal, and dozens of other media brands around the world. Here’s a rundown of the digital health companies that power News Corp.’s employee benefits stack along with some of the language News Corp uses to pitch the benefits in its benefits portal.

One Medical: News Corp covers the membership fee of One Medical. “A membership-based primary-care practice with quality care, free 24/7 virtual access to a doctor, and same-day or next-day appointments that start on-time. Services include prevention and screening, on-site labs, and anxiety and stress management as well as care for acute or chronic conditions, digestive disorders, sports injuries, allergies, asthma, diabetes, women’s health and travel health.”

98point6: Text-based virtual care. “On-demand primary care built for the whole family We added 98point6 to your benefits package to extend your access to convenient, affordable and quality primary care from trusted, board-certified physicians. No matter when or where symptoms strike, 98point6 provides 24/7 on-demand diagnosis and treatment to you and your family members ages 1+.” “Visits with 98point6 physicians are available to eligible employees and dependents aged 1 and older enrolled in a News Corp medical plan at no cost to PPO or HMO plan participants, and for only $5 for those with a CDHP.”

UnitedHealth’s AbleTo: One of News Corp’s mental health benefits is AbleTo’s 8-week, CBT-powered Therapy360 coaching program. “Therapy360 offers virtual therapy for individuals with co-occurring mental and medical health needs, who receive support from a licensed therapist, behavioral coach and digital tools and activities. High risk members are proactively identified and contacted using a proprietary data-driven approach.”

Aetna’s Resources for Living EAP: The EAP offers a range of services, including “clinical services, including 10 free face-to-face counseling sessions; Assistance through unlimited telephonic assistance; Therapy via video chat [powered by Teladoc’s myStrength]; Text-based therapy through Talkspace; Legal and financial services; Child and elder care referrals; Daily living assistance, such as finding pet care, a housekeeper, a plumber, party planner and shopping services.”

Headspace: “Headspace is an app that helps you and your family members boost mindfulness. According to research, practicing mindfulness can help relieve stress, lower blood pressure, improve sleep, and strengthen mental health. More than just a meditation coach, Headspace offers thousands of hours of content on sleep habits, physical fitness, healthy eating and much more to help you live your whole day mindfully.”

Multiple navigators: News Corp sends employees to three or four different health navigators depending on the problem. Two of them are digital health companies, so I mentioned them below. News Corp, however, acknowledges that this is a confusing set-up: ”

Navigating your navigators: It could be considered a good problem to have. But at News Corp you have so many programs available to you, it could get confusing on who to go to and why, when things go imperfectly. So we thought it might help to pull together this handy (and brief!) cheat sheet.”

Grand Rounds: If you are worried or unclear about a recommended medical treatment or you are looking for a quality doctor for a service you will need. “Grand Rounds will review all of your clinical information with their panel of experts and render an opinion on whether or not your course of treatment is right, and whether or not you are seeing the best possible doctor for the recommended treatment plan provided to you… They will provide you with network-based providers based on relevance and quality to your specific need.”

Included Health: This is now a part of Grand Rounds. This is yet another health navigator specifically tailored for LGBTQ+: “Thanks to Newscorp, you’ve got a personal care team and LGBTQ+ Care Concierge on call to get you the care you need, when you need it. Best of all, these services won’t cost you a thing.”

Health Advocate: Another navigation company. News Corp points employees to HA is they are in search of a doctor but are not on one of the company’s plans. They also suggest HA for when an employee has a claim denied or if they want an independent assessment for how a medical claim was handled.

Hinge Health: This reads like Hinge ran a (successful) pilot for the company in 2021. “News Corp is excited to announce that we are continuing to partner with Hinge Health in 2022. Hinge Health offers programs to help you conquer back and joint pain, recover from injuries, prepare for surgery, or stay healthy and pain free. Best of all, Hinge Health’s programs are provided at no cost to you and your eligible dependents enrolled in an Aetna medical plan through News Corp.”

Ovia Health: “Helps women and families navigate their most important moments with personalized and data-driven solutions for fertility, pregnancy, and parenting.”

Wellthy: Caregiving services. “Pairs online and app-based tools with a care coordinator to help source care resources, coordinate schedules, and keep everyone involved in a person’s care up to speed.”

Big Health’s Sleepio: “If you find that your sleep gets disrupted during winter months, Sleepio may be able to help. Sleepio is an online sleep improvement program proven to help people overcome the obstacles that are keeping them from healthy sleep in just six weeks. The program uses cognitive behavioral techniques that are backed by decades of clinical research, and has been shown in studies to help people fall asleep 54% faster, spend 62% less time awake at night, and have 45% better functioning the next day. Sleepio is available to you as a News Corp employee for free, and you can get started today.”

Mend Together: A cancer patient community site. “Mend Together is her personal endeavor to take what she learned during 12 cancer-related events and help others benefit from desperately needed social support. Headquartered in New York City, the Mend Together team works with individuals, cancer organizations, hospitals, and Fortune 500 companies to take the mystery out of what to say, do, and give during a hardship. We hope you will join us in making cancer less lonely. It’s important work and we need your help.”

News Corp employees on a Kaiser Permanente plan have access to telemedicine via KP’s app or site as well as access to Calm and Teladoc’s myStrength.

OK — that’s a wrap on News Corp’s benefits stack. The company certainly offers more digital health benefits than most of the others I’ve reviewed in past issues of this newsletter. Which big employer should I dig into next?

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