Issue 018
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
A few not-so-quick notes on things going on in enrollment-based digital health:
- Technically, Transcarent’s first customer probably isn’t really its first since the company was formed via acquisition with Bridge Health. However, I’ve been waiting for the first instance of an employer encouraging its employees to download the Transcarent app (even incentivizing them to do so). As far as I can tell, Municipalities, Colleges, Schools Insurance Group (MCSIG) is Transcarent’s first customer. (MCSIG used to stand for Monterey County Schools Insurance Group, but the group has branched out beyond that one county in California so it reworked the acronym.) Here’s their pitch for Transcarent… “Transcarent is your one-stop to: Access all of your MCSIG benefits. Chat with a doctor in 60 seconds. Talk to a health guide 24/7. Find a high-quality doctor. Obtain expert medical opinions… Get high-quality care for surgeries and back, joint and muscle pain.”
- American Well snapped up Silvercloud Health and Conversa Health in a combined $320 million double acquisition. The deals were 50/50 stock and cash transactions and that $320 million figure does not include potential earnouts of $70 million. So the final acquisition price could be as high as $390 million. The Irish Times reports that Silvercloud fetched north of $250 million of that combined price tag, which means Conversa went for $70 million or less. Other interesting details: Conversa and Silvercloud are expected to hit combined annual revenues of just $15 million for 2021. (Amwell expects to double it to $30 million next year.) 92 percent of this revenue is recurring and the companies have 70 percent aggregate gross margins. Interestingly, 75 percent of Silvercloud’s revenue is in the EU with the remainder in the US. And the two companies have more than 200 customers combined. A majority of those are health systems (but Silvercloud does have an apparently lesser focus on employers too). Check out this just-published investor preso for more.
- One Drop announced today that it would bundle in connected BP and weight scales from Withings for its employer clients. (The DTC launch of this One Drop-Withings-powered offering is still a few months off.) One Drop also revealed that it now has 1.4 million users worldwide.
- The news you know: It’s been widely reported that UnitedHealth Group is covering a one-year membership to the Peloton app for 4 million people on fully insured UHG commercial plans. One thing that seems to be lost on some commentators is that Peloton offers an app with a huge library of live and on-demand workout videos — this app does not require the expensive Peloton bike. UHG makes clear this is just for the 12-month period and members will have to pay for it themselves after that.
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Big employer digital health stack: Novartis
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 digital health stack. So far, in past Wednesdays issues, I’ve written about the digital health benefits stacks of 17 big companies:
- 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,
- and Disney.
This week, I dug into the digital health benefits that Novartis offers its full-time employees in the USA.
Here’s what I found:
Horizon Blue: American Well-powered video visits
Most Novartis employees in the US appear to be on a plan offered via Horizon Blue Cross Blue Shield of NJ. The insurer offers a white-labeled version of American Well it calls CareOnline:
“When you need to see a doctor or nurse — anytime day or night — simply sign in to access Horizon CareOnline. Get 24/7 access to U.S. board-certified doctors and registered nurses via video, phone or chat from the comfort of your home.”
Healthcare Cost Transparency: Castlight Health
Novartis positions Castlight under a header that reads: “Healthcare Cost Transparency,” which is the company’s core and original offering. Castlight’s landing page for Novartis employees, however, is a generic one that admits the features and offerings available to them might differ from the ones they are willing to call out on the public landing page. (There’s a good chance that Novartis employees have access to some of Castlight’s partners’ programs, but I can’t confirm this.)
“With Castlight, you can easily see a breakdown of your coverage and costs, discover benefits that make life easier, and get rewarded for the healthy things you do.”
Expert Medical Opinion: Grand Rounds
Here’s how Horizon and Novartis pitch Grand Rounds:
“Grand Rounds provides expert medical guidance and support on a variety of medical conditions, including cancer. Grand Rounds physicians can help answer questions about a diagnosis or provide a remote second opinion on a new or long-term health issue or treatment plan.”
Fertility and Maternity Benefits: Ovia and Progyny
Novartis and Horizon describe Progyny’s fertility offering like so:
“The Fertility Program offers superior fertility treatment education and guidance through a patient advocate as well as access to qualified providers.”
Horizon focuses on Ovia as a maternity-focused program:
“Ovia’s Healthy Pregnancy Program provides support and resources for healthy babies and moms.”
But a flyer from Novartis takes a broader scope and encourages employees to download Ovia’s three apps, which are focused on fertility, parenting, and pregnancy.
Employee Assistance Program: Rethink and Guidance Resources
Rethink is one partner that comes up quite a bit in these employer stacks:
“Rethink is a benefit for Novartis employees that gives your family 24/7 access to tools and resources to help you and your care team in understanding, teaching, and better communicating with your child. We specialize in helping care for children with learning, social or behavioral challenges and developmental disabilities.”
Horizon also lists Guidance Resources as an EAP option. This one is more focused on health coaching:
“Make positive lifestyle changes with expert health coaching, nutritional education and other tools.”
Well, that’s a wrap on the Novartis stack — some big names but also surprisingly sparse on chronic condition management offerings, right?
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.
And 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.
Hinge Health pricing and guarantee revisited: $995 per participant per year and 1.5:1 ROI promise
Hinge Health has come a long way since E&O’s deep dive report into the company back in April 2020. In that report I was confident in the pricing information I uncovered because it was based on a simple calculation that used dollar amounts found in the company’s published studies. At the time I figured the company charged $900 per participant per year.
This week I got my hands on a recent sales deck from Hinge Health that shows the current figure is $995 per participant per year.
That figure includes three separate claims of $695, $150, and $150. Some of those dollar amounts are probably based on utilization milestones and patients generally pay $0 out-of-pocket.
Here’s what that price includes according to the company:
- free expert medical opinion
- exercise therapy
- education
- video visits with a physical therapist
- health coaching
- wearable sensors
- and a dedicated tablet
In the pitch, Hinge estimates about 5 percent of the employer’s covered population will sign up for Hinge’s program. Hinge also hits on the fact that this deal won’t require any new contracts because of Hinge’s pre-existing relationship with the employer’s health plan (a Blue):
“No contract needed, data exchange setup complete and billing through BCBS’s Integrated health & wellness benefits, and product pairing…”
Hinge also promises a 1.5:1 ROI guarantee on all of its fees, which is a bit of a surprise to me because that was a 1:1 ROI when I wrote about it in the Hinge Health Report last year.
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