Issue 005
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, and I’ll track state-by-state rollouts in each issue (see below). 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.
E&O: National Virtual Clinics
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Eli Lilly taps 9amHealth, Cove, and Form to power LillyDirect-branded virtual clinics
Eli Lilly has quietly set up a few virtual clinics using the brand LillyDirect. The company recently began promoting the site via Google ads over the past few weeks. At the end of November, the pharma company also added links to LillyDirect on the homepages the websites for Mounjaro, its popular GLP-1 medication for Type 2 diabetes, and Zepbound, its recently launched GLP-1 for obesity.
The three clinics focus on obesity, migraines, and diabetes and each has its own virtual clinic partner powering it: Form, Cove, and 9amHealth. Truepill is Lilly’s online pharmacy fulfillment service provider for the offering. Here’s how Lilly pitches Form:
“You already know taking care of your health is important, but accessing obesity care can be a challenge. Your connection to obesity telehealth care can start here at LillyDirect. Introducing: FORM, an independent, virtual medical weight-loss clinic. FORM launched in 2020 to provide greater access to medical care for patients living with excess weight.”
Here’s how Lilly pitches 9amHealth:
“Getting your lab tests, medications, and questions answered shouldn’t have to wait. Your connection to diabetes telehealth care can start here at LillyDirect. Introducing: 9amHealth, an independent, virtual diabetes clinic for people living with type 2 diabetes. Inspired and created by people in the medical profession who are also living with long-term conditions like diabetes, 9amHealth offers a different, centralized source for care.”
And here’s Lilly’s pitch for Cove:
“Get your life back by taking that next best step in your migraine care journey. Your connection to migraine telehealth care can start here at LillyDirect. Introducing: Cove, an independent, online medical clinic for migraine care. Because migraine specialists are few and far between, connecting with an online medical provider who knows migraine can help you get the relief you deserve.”
Clinics that launched in new states: Midi Health, HeyJane, UpLift, AsYouAre, WW and Swing Care
This is a recurring feature that tracks virtual clinics’ state-by-state launches as they build up to nationwide footprints.
Midi Health aims for 50 states by January 2024: Midi Health, a virtual care clinic for women 40+ that focuses on perimenopause and menopause, managed to add about six states to its footprint in 2023 — taking it to 16 states currently. It had hoped to add 23 states during the year at one point. Back in September, the company announced that it is aiming to be available in 50 states by January 2024.
HeyJane added eight states plus DC in recent months: Birth control-focused virtual clinic HeyJane was operating in CA, CO, CT, IL, MD, MA, NJ, NM, NY, VA, and WA as of September 2023. It has since added DE, DC, HI, ME, MN, NH, OR, RI, and VT. “Get your choice of the pill, the patch, the ring, or the shot. Looking for emergency contraception? Our team of trusted providers can help with that too.”
UpLift adds five states via Minded acquisition: Virtual therapy and psychiatry clinic UpLift, which currently serves patients in Florida, Maryland, New Jersey, Virginia, and Washington, D.C., acquired women’s health-focused behavioral health clinic Minded in November. The deal expands UpLift’s coverage to five more states: beginning with California, Illinois, New York, Pennsylvania, and Texas. UpLift was incubated at Redesign Health.
Swing Care went live in Ohio: Fibromyalgia-focused virtual clinic Swing Care is now live in four states: Ohio (new) as well as Illinois, Tennessee, and Texas. “Swing Care was started in 2022 to provide virtual care for fibromyalgia. Our goal is to deliver world-class treatment, when and where you need it. We democratize access to experienced clinicians and fibromyalgia experts, cutting-edge digital medicine, and proven pharmaceutical treatments.”
AsYouAre adds six states and is up to 49 now: AsYouAre is a team of physicians who specialize in guiding families along their autism journey with a focus on virtual autism diagnostic evaluations for kids. It recently added six more states to its coverage area and is now just missing Illinois before it can claim nationwide availability. It expects to add Illinois by year-end. “Do you ever notice things about your son or daughter while they play, interact or communicate? Maybe you are unsure if a diagnostic assessment is needed, but you wish you could chat with a doctor? Our virtual clinic is here to help!”
WeightWatchers Clinic goes live nationwide: Earlier this year, Weight Watchers acquired Sequence, which operated a nationwide virtual obesity clinic. WW just relaunched Sequence as “WeightWatchers Clinic” this past week along with a broader program that supports people on GLP-1s for obesity.
Deals and other news: Vori-Ophelia, Bicycle-Override, Charlie-Talkiatry and more
Here’s a quick run-down of recent virtual clinic partnerships, deals, and other miscellany:
RPM bill floating around Congress: Of the many digital health-related bills that have cropped up over the years, very few successfully end up tucked into some larger spending bill that goes to a vote. Still, they’re worth keeping an eye on. Like this one, which stirred up quite a bit of interest in digital health circles this week: “The RPM Cost Sharing Elimination Study Act of 2023 would eliminate the 20% copay for remote patient monitoring (RPM) for two years under Traditional Medicare and study the effects of the elimination on patient outcomes in home health, as well as potential cost savings to Medicare.”
NY AG eyes inaccurate mental health provider directories: New York’s Attorney General’s office has taken aim at payers’ mental health provider directories. The initial report includes a poke at virtual clinic Talkiatry. “Three New York City psychiatrists practiced under a fully virtual psychotherapy service called Talkiatry, which could not guarantee an appointment with the doctor listed in the directory.”
Folx Health goes in-network: Folx Health, a virtual clinic for the LGBTQ+ community, announced on October that it would no longer operate as a cash-only clinic. A handful of big-name payers have since added Folx as an in-network provider for some of its services. Those include Cigna, Blue Shield of California, Blue Cross Blue Shield of Texas, Evernorth’s Behavioral Health services in Florida, and Optum’s Behavioral Health service in Colorado and Florida.
BCBSMA adds Oshi to provider network: Blue Cross Blue Shield of Massachusetts announced in October that it was adding gastrointestinal-focused virtual clinic Oshi Health as well as cardiometabolic program provider Virta Health to its in-network providers. BCBSMA “announced that it is growing its network of virtual care providers to treat two chronic conditions: gastrointestinal (GI) conditions and diabetes. Oshi Health and Virta Health are now part of Blue Cross’ network and, as part of their agreements with Blue Cross, offer convenient access to virtual care for members.”
Choix shuts down: Here’s news you probably know but just in case… “Choix (pronounced ‘Choice’), the first telehealth clinic to offer asynchronous abortion care in California, will cease its virtual operations on October 31st, 2023, following three years of delivering safe, affordable, patient-centered sexual and reproductive healthcare to over 8,000 patients across six states.”
Vori and Ophelia partner to refer patients to each other: This one is pretty straightforward, but makes me wonder if these kinds of partnerships might be hints about the shape that future consolidation in virtual clinics might take. “If the Vori Health care team has a patient who reports opioid addiction, they can be referred to Ophelia. Ophelia provides the gold standard of treatment for OUD, known as Medications as Addiction Treatment (MAT), in combination with counseling and behavioral therapies. Conversely, if an Ophelia patient expresses concern about MSK pain and is looking for non-opioid treatment options, clinicians can refer them to Vori Health for care.”
Bicycle and Override partner to refer patients to each other: Basically, the same deal as above. “The collaboration will allow Bicycle Health patients to discuss chronic pain management and connect them to pain management specialists across pain medicine, physical therapy, psychology, and pain coaching from Override Health. By that same measure, Override Health specialists who suspect pain patients may be struggling with OUD will have the option to refer those patients to Bicycle Health for evaluation.”
Charlie Health and Talkiatry partner to refer patients to each other: Same, same. “The partners seek to provide an integrated care experience to young patients stepping up to virtual intensive outpatient care at Charlie Health and stepping down to ongoing psychiatric care at Talkiatry.”
PursueCare bought Pear Therapeutics’ key assets from former CEO: More news you probably know because I wrote about it last week… Addiction care-focused virtual clinic PursueCare bought the assets of a handful of prescription digital therapeutics from the former CEO and founder of bankrupt Pear Therapeutics.
Swing study: Swing Care published early results from its study on its virtual clinic for fibromyalgia.
Charlie study: Charlie Health published a study focused on its virtual intensive outpatient program’s (IOP) impact on emergency department (ED) utilization.
Calibrate study: Calibrate presented new outcomes data for the company’s real-world cohort of over 11,000 individuals who participated in the company’s weight loss program.
Maven study: Maven Clinic published a study based on 9,000 Maven members that examined the impact of virtual doula care on birth experiences and outcomes.
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