PLUS: Omada’s new trademark

Issue 003

 E&O Wednesdays.

Welcome back to E&O Wednesdays, the enrollment-focused digital health newsletter from Exits & Outcomes — for paying subscribers only. This fortnightly 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.

This is Issue 003 and if you like what you see, help me out by forwarding this to your biggest competitor. The surprise email from you will definitely distract them in the middle of the week, throw them off their game, and give you time to get ahead. It’s a win-win for you and E&O.

Here’s what’s happening this week:

• Hinge Health hired Austin Weaver as their first VP of Medicare. Weaver previously served as VP, Network Innovation and Payer Strategy at OptumCare. Is this just for Medicare Advantage or might Hinge be ready to move into Medicare soon too? (The 2021 CMS Physician Fee Schedule does provide some new, limited reimbursement for virtual care delivered by PTs.)
• Welldoc added a behavioral health program to its growing suite of chronic condition management offerings, which also include programs for diabetes, (Type 1 and Type 2), hypertension, heart failure and diabetes prevention.
• I noticed both Pack Health and Vida Health have progressed along the CDC Recognition spectrum for diabetes prevention programs (DPP). Pack now has preliminary recognition, while Vida has achieved full recognition.
• Lark‘s “conversational AI” -powered (think texting with a chatbot coach) chronic condition management programs are available to Highmark’s employer group customers in Pennsylvania, Delaware, and West Virginia, as well as commercial National group customers. (Unclear what’s new here as this is year two of the contract, but I’m not sure they previously announced this partnership when it started?)
• One more thing… Calm raised a $75 million Series C this week, but more interestingly stressed an increased focus on selling to employers. Alex Tew, Calm co-founder and co-CEO: “We’ve only just begun supporting companies on their journey to increase employee resilience. This financing round will advance our efforts in building a strong global workforce, meeting overwhelming market demand. Our Calm for Business expansion is a priority as employer investment in mental health skyrockets.”

Was this forwarded to you? Why not become a paying subscriber to Exits & Outcomes today? Head to the pricing page of E&O right here and put what’s left of your 2020 budget to good use.

Noom may focus more on self-insured employers

A week and a half ago, the Wall Street Journal had a quick piece on Noom hiring its first chief financial officer, Michael Noonan. It’s not surprising the fast-growing company (it posted $237 million in revenues for 2019) is ready for a CFO. Some kind of exit seems likely soon enough.

(One note on that though: After years of doing so, weirdly, Noom is reportedly not planning to share its annual revenue figures for 2020. Red flag? Indication they want to IPO soon so have to be a bit quieter?)

What was more interesting about the article was that it indicated a little bit of a strategy shift at Noom.

So, first, how Noom got this far: The company makes the lion’s share of its revenue from direct-to-consumer app-based weight loss programs and virtual coaching for cardiometabolic-related medical issues. In the past year or two, Noom has made a push to partner with pharmaceutical companies to pair its app-based programs and remote coaches with pharmaceuticals.

But unlike most digital health companies focused on weight loss, diabetes management, diabetes prevention, and similar conditions, Noom, which employs 2,600 people itself, has not made selling into self-insured employers a big focus.

Until now?

Back to that WSJ article:

OK, yes, maybe a few have scaled faster and gotten bigger than Noom — but at $237 million in revenue last year — that’s not a very long list. Livongo? And?

(::crickets::)

Noom has always left the door open to selling into self-insured employers. (Its website has included a page dedicated to its b2b customers for years.) Still, it seems the new CFO’s advice may be to build out this revenue stream more before heading for the exit. Curious to see what they do here.

Meanwhile, one of Noom’s healthcare provider partners, NYU Langone Health, is working on how to best integrate Noom’s digital diabetes prevention program into its EHR. The health system has a more than $600,000 grant from the NIH to conduct an observational study that explores how that might work across five of its ambulatory practices.

Based on the grant, one of the end goals is also to see “if connecting patients and providers through our novel dDPP-EHR tool suite has a measurable impact on diabetes prevention-related outcomes.”

Noom appear to be going for a rare business model hattrick here:

1. They already sell direct-to-consumer.
2. Their CFO sees selling into self-insured employers as a big opportunity.
3. And their provider partners are clearly exploring what a prescribed version of Noom’s DPP might accomplish (maybe that’s where a pharma partner comes in too?)

Fortune 500 Digital Health Stack: JPMorgan Chase

Digital health companies love to boast how many Fortune 500 customers they have. This recurring feature of E&O Wednesdays will dig into a different Fortune 500’s digital health stack.

So far, I’ve written about Walmart and video game giant Activision Blizzard. This week’s will be a little different because I picked JPMorgan Chase. Why? Well, because they got mixed up in that high-profile Amazon-Berkshire Haven thing, and I wanted to see what I could learn about their 2021 plans since Haven seems to be on ice.

One notable change for JPMorgan Chase is that it switched its health plan partners from UnitedHealth and Cigna (its 2019 and prior partners) to Cigna and Aetna (its 2020 and 2021 partners).

If you recall, UnitedHealth went so far as to sue the companies behind Haven after it hired away one of its Optum employees. Things obviously got tense, UnitedHealth lost the suit in early 2019, and — in probably related news — JPMorgan Chase no longer worked with UnitedHealth as one of its health plan partners going into 2020.

CVS and Aetna also merged in 2019. JPM had a pre-existing relationship with CVS, so that probably had something to do with it too.

Digging through JPMorgan’s benefits offerings, I was surprised to see how thin its digital health offerings are compared to the past two stacks I’ve shared. However, two digital health offerings that JP Morgan employees have had access to for a few years at least are Grand Rounds and meQuilibrium.

Grand Rounds helps JPM employees decide between treatment options, better understand a diagnosis, obtain a second opinion after getting a diagnosis elsewhere, and find a doctor. JPM positions Grand Rounds as a key part of its benefits package and sometimes it is listed alongside the two health plan partners as a go-to resource for various health benefits navigation questions.

meQuilibrium is JPM’s other longtime partner. JPM pitches it to its employees as “the online program (and app) designed to help you manage stress, feel your best and become more resilient.” meQuilibrium awarded Comcast NBC/Universal, JP Morgan Chase, Roche Genentech, and Goldman Sachs for their leadership in employee resilience this past October. (Also, that’s a clever way to show off your biggest name clients publicly.)

Its other two digital health partners are nestled under a Haven-inspired program, so let’s review that first.

When the enrollment period began for 2020, JPM employees in Arizona and Ohio were given the option of enrolling in The Simplified Medical Plan, which Haven helped create. Here’s how JPM pitched it:

(The Simplified Medical Plan is much more than a few digital health offerings, but they are a key part of it. I’ll get to those below.)

Mostly because of the pandemic, it seems, JP Morgan is not planning on mixing up The Simplified Medical Plan, or much of its digital health stack for that matter, going into 2021. In its benefits marketing to employees, it even mentions how the pandemic was a bit of a setback for Haven.

What was true in 2020 and will remain in place for 2021 is that JP Morgan’s two key digital health partners for The Simplified Medical Plan are and remain Newtopia and Virgin Pulse. In 2020, JPM employees in Arizona and Ohio who opted into this program had to go through a biometric screening and health assessment. Based on their numbers they were put on either Path A (AKA Activity Tracking), which includes Virgin Pulse, or Path B (AKA Health Coaching), which includes Newtopia.

Those JPM employees put onto Path B are the ones with higher BMIs and other metrics that were heading in the wrong direction. (Typically, Newtopia sends out a welcome kit with a connected weight scale and an activity tracker, and I think it is safe to assume they do that for JPM employees too). If participating employees do at least two of the below activities each month, JPM pays them $45 per month plus another $22.50 if their spouse/partner does too:

• One-on-one coaching activities through Newtopia
• Nutrition tracking (12 times per month)
• Weight tracking (8 times per month)
• Utilization of Newtopia’s app (12 times per month)
• A Newtopia challenge (once per month)
• Activity tracking (7,000 steps per day for 10 days per month)

The Path A employees in The Simplified Medical Plan are already pretty healthy, at least so far as their HSA numbers can show. Similar to the Path B group, these employees have similar incentives to participate in the Virgin Pulse program to get a monthly reward. In the end, their goal is to “complete an activity goal at least 20 days each month to earn $45 per month in your 2020 MRA (plus $22.50 per month when your covered spouse/domestic partner does the same).”

Omada amps up “digital care, made human” motto

Omada Health kicked off a big Facebook ad campaign this week clearly inspired by its 2020 rallying cry of “Digital Care, Made Human”. In a sign this marketing framing is working, Omada moved to trademark that phrase earlier this summer. The USPTO just published it for opposition a few weeks back.

The new marketing push stresses that Omada offers “human-led coaching” and suggests that for diabetes care, remote monitoring alone is not enough. Leaning in even harder to the human-led strategy helps Omada stand out from competitors who tout their AI capabilities more than their human ones.

Let’s put Issue 003 of E&O Wednesdays out to pasture. Hit reply. All feedback is most welcome and appreciated.