Issue 038
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
Here’s what’s going on in employer-distributed digital health…
- In recent Wednesdays issues, E&O noted an uptick in clinical trials appearing from employer-focused digital health companies after a rather long dry spell. This week I rounded up results from a few other studies published this month in peer-reviewed medical journals.
- Hinge Health published results from a study in a Journal of Medical Internet Research outlet: “The analysis included data from 675 nonparticipants and 262 intervention group participants. Compared to baseline, the intervention group showed significantly more pain improvement at 3, 6, and 12 weeks versus nonparticipants after adjusting for baseline factors.”
- Spring Health published results from a study in a Journal of the American Medical Association publication: “A total of 1132 participants (520 of 724 who reported gender [71.8%] were female; mean [SD] age, 32.9 [8.8] years) were included. Participants reported improvements from pretreatment to posttreatment in depression (b = -6.34; 95% CI, -6.76 to -5.91; Cohen d = -1.11; 95% CI, -1.18 to -1.03) and anxiety (b = -6.28; 95% CI, -6.77 to -5.91; Cohen d = -1.21; 95% CI, -1.30 to -1.13). Symptom change per log-day of treatment was similar post-COVID-19 vs pre-COVID-19 for depression (b = 0.14; 95% CI, -0.10 to 0.38) and anxiety (b = 0.08; 95% CI, -0.22 to 0.38). Workplace salary savings at 6 months at the federal median wage was US $3440 (95% CI, $2730-$4151) with positive ROI across all wage groups.”
- One Drop published results from a study in the Journal of Occupational and Environmental Medicine: “Diabetes research on work productivity has been largely cross-sectional and retrospective with only one known randomized controlled trial (RCT) published to our knowledge. Secondary analysis of the Fit-One RCT tested the effect of One Drop’s digital health program on workplace productivity outcomes, absenteeism and presenteeism, for employees and specifically for older workers with type 2 diabetes… Treatment and control group comparisons showed workers (N = 125) using One Drop see direct benefits to workplace productivity, which leads to productivity savings for employers.”
- Omada Health published results from a study in Sage’s The Science of Diabetes Self-Management and Care journal: “[Virtual digitally enhanced diabetes self-management education and support program] participants with starting A1C >7% experienced average reductions of 0.9% A1C and 2.1 kg of body weight (-1.7% of BMI) within 6 months. If these improvements were maintained, simulated outcomes include reduced 5-year onset of ischemic heart disease by 9.2%, myocardial infarction by 10.6%, stroke by 12.1%, chronic kidney disease by 16.5%, and reduced onset of other sequelae. Simulated cumulative reduction in medical expenditures is $1160 after 1 year, $4150 after 3 years, $7790 after 5 years, and $18 020 after 10 years.”
- Virta Health published results from a study in the Journal of Behavioral Medicine: “In the current study we explored changes in depressive symptoms over 2 years among 262 primarily non-depressed [type 2 diabetes] patients participating in a continuous remote care intervention emphasizing carbohydrate restriction. Subclinical depressive symptoms decreased over the first 10 weeks and reductions were maintained out to 2 years. Increased frequency of blood ketone levels indicative of adherence to low carbohydrate eating predicted decreases in depressive symptoms.”
- One more thing… Everyday Health, a division of the big publishing company Ziff Davis, just acquired one of the original weight loss app companies — Lose it! (The “!” is in their name — I wasn’t exclaiming there!) During the height of the pandemic, Lose it! said its daily active users had hit more than 2 million. The company offers a free and premium version of its direct-to-consumer weight loss app as well as a B2B corporate wellness offering, called “Challenges”.
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Big employer digital benefits stacks: Dow and RRD
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 dozens of 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,
- Comcast
- News Corp
- Vanguard
- Nokia
- HII
- Fidelity
- and AbbVie.
This week I dug into two big companies’ digital health benefits: the big chemical company Dow Inc. and multichannel marketing biggie R.R. Donnelley & Sons (RRD). First up: Here’s a rundown of Dow’s digital health benefits:
No telemedicine?
Surprisingly, Dow does not promote any kind of virtual visits or general telemedicine benefits in its enrollment marketing materials. Dow works with big health insurance companies like Cigna and Aetna, so those kinds of services are likely available to Dow employees, I just couldn’t find any mention of them.
Omada Health for diabetes management and prevention: Dow’s one big digital health benefit comes from Omada. Dow has been a customer of Omada’s for years, but it still pitches the company as if its services were brand new:
“We’re pleased to announce that Dow is now offering Omada, a digital lifestyle change program designed to help you lose weight and build healthy habits that last. Join today and get:
- A professional health coach for tailored support and guidance
- A connected scale to monitor progress (and keep for good)
- An online community personalized to your interests
- Weekly online lessons to educate and empower you
If you are at risk of developing heart disease or type 2 diabetes, and are a U.S. employee, pre-Medicare eligible retiree, spouse or adult dependent, Dow will cover the entire cost of the program—a $650 value.”
Optum’s Quit for Life tobacco cessation program: The other digital-enabled health benefit that Dow offers employees is Optum’s tobacco cessation program. It includes both online tools and support from human coaches.
WW (formerly known as Weight Watchers) for weight loss:
Dow covers the full cost of the WW weight loss program for its low deductible plan employees as well as those on the high deductible plan. Everyone else gets a discounted rate on WW.
Aetna’s Resources for Living is Dow’s Employee Assistance Program (EAP):
“Professional, confidential counseling on emotional, social and mental health issues for all US employees and dependents experiencing personal difficulties. Services are available 24/7 and provided at no cost. Participation is voluntary.”
That’s it from Dow’s stack.
Here are the digital health benefits that integrated communications giant R.R. Donnelly and Sons offers its employees:
bswift is RRD’s benefits administrator and it offers an app and built a dedicated site to help RRD employees better understand their benefits. One of RRD’s insurance partners is Blue Cross and Blue Shield of Illinois (BCBSIL).
BCBSIL offers Health Advocacy to RRD empoyees to help them navigate their benefits and their care options
“Get the most from your benefits with Health Advocacy Solutions, a concierge service from BCBSIL included with your RRD medical coverage at NO ADDITIONAL COST. Teams of specialists, including registered nurses, social workers, and health and behavioral advocates, work together to coordinate your complex care needs, help schedule appointments, deal with claims issues and more. They can help you and your covered family members:
- Understand your health benefits,
- Find high-quality, lower-cost providers,
- Cut through red tape by offering personal assistance with your health care matters,
- Sort out a new diagnosis and what to do next, and
- Find answers to your health questions.”
That’s not the only benefits navigator, however, there’s also MyEvive
In case Health Advocate and bswift aren’t enough, BCBSIL also offers RRD employees another benefits navigator:
“Organize your health benefits with MyEvive, your personal online health hub. MyEvive makes it easy to find, organize and use your RRD health benefits, including pharmacy, dental and vision. You’ll get personal care reminders, custom health alerts and more sent to your email or mobile device.”
BCBSIL also offers RRD employees Hinge Health for MSK
“Hinge Health is an innovative digital program designed to help reduce your chronic back, hip or knee pain. With the program app installed on your provided tablet, you’ll use wearable sensors for personalized exercise therapy that is shown to reduce chronic pain. This FREE program also includes unlimited one-on-one coaching.”
BCBSIL also offers pregnancy programs from Ovia
“Take advantage of apps from Ovia Health to guide you through fertility, pregnancy and parenting. Download the Ovia Fertility, Ovia Pregnancy and Ovia Parenting apps in the App Store or Google Play.”
Surprisingly, low down in the marketing materials is a one-line pitch from BCBSIL for virtual visits via MDLIVE
“See a doctor from your mobile device or computer anytime and anywhere without an appointment via MDLIVE.”
BCBSIL also includes a few mentions of Well onTarget, a broad health coaching program
“Well onTarget is designed to help you make healthy choices and reach your wellness goals. Through Well onTarget, you can:
- Check your health status by taking a health assessment.
- Access videos, podcasts, self-directed courses and other tools to improve your health and well-being.
- Work with a coach to set and reach goals, like losing weight, improving your blood pressure and quitting tobacco.
- Track your progress with built-in tracking tools.
- Earn Blue Points when you take a health assessment, link a fitness device, complete a self-directed course or work with a health coach. You can redeem your points for books, music, sporting goods, etc.”
BCBSIL offers Livongo for diabetes and high blood pressure
“If you’ve been diagnosed with type 1 or type 2 diabetes, the Livongo for Diabetes program gives you:
- Unlimited strips and lancets,
- An advanced blood glucose meter that automatically uploads readings to your private account and gives instant insights, and
- Expert advice from certified diabetes instructors.
If you have high blood pressure, the Livongo for Hypertension program provides you with:
- A blood pressure cuff,
- An exclusive FDA-approved touchscreen meter,
- Personalized reports and health coaching, and
- Access to a mobile app to view and track your readings”
Kaiser offers RRD employees its own virtual visits offering, Calm, and myStrength
For those RRD employees who opted for a Kaiser Permanente plan, virtual visits are available through Kaiser’s own virtual providers. KP also pitches Calm and Teladoc-owned myStrength as “selfcare apps” that it makes available to plan members.
RRD also offers UBreathe for tobacco cessation and WW for weight loss
Phew — OK, that’s a wrap on Dow’s and RRD’s very different benefits stacks. Which big employers should I dig into next?
Links to E&O’s reports, databases, newsletters
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