Issue 022
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
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Learn to Live pricing for online CBT programs via Blue plan: $0.99 PEPM
Learn to Live (L2L) sells its online cognitive behavioral therapy (CBT) programs to self-insured employers, colleges/universities, and health plans. The company often pops up in the benefits stacks of companies that work with Blue plans like BCBS of Massachusetts or Blue Cross of Minnesota.
Here’s how BC MN describes Learn to Live:
“Learn to Live is a confidential online Cognitive Behavioral Therapy program. This form of therapy focuses on problem solving and changing behaviors. You can take online programs for the following conditions: Depression, Social Anxiety, Stress, Substance Use, Anxiety, Worry and Insomnia. The programs help you identify the problem(s), understand how your mind works, then learn and practice ways to deal with the problem(s).”
A recent email exchange that E&O read between one of L2L’s health insurance company partners and an employer client revealed that Learn to Live’s pricing is $0.99 per employee per month (PEPM).
Have to say, it is striking that L2L manages to charge less than $12 a year (per potential user) while prescription digital therapeutics companies are looking to charge between 50x and 100x that amount per Rx. It’s especially striking considering the pushback from another Blue plan, Premera, that I wrote about on Friday. That insurance company poked holes in the evidence bases of various prescription digital therapeutics — some of which offer CBT-based programs for some of the same conditions that L2L targets.
There’s been quite a bit of theoretical discussion around this pricing situation, but insurance companies are making moves now. Health plans are actually paying attention to both lower-priced digital therapeutics like Learn to Live’s (and marketing them enthusiastically to their employer customers) as well as higher-priced prescription digital therapeutics (if only to make clear they are not medically necessary and still unproven).
Big employer digital health stack: Adobe
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 21 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,
- Disney,
- Novartis,
- Red Bull,
- VMware,
- and T-Mobile/Sprint.
This week, I dug into the digital health benefits that Adobe offers its full-time employees. Here’s what I found:
Jellyvision’s ALEX for benefits navigation
Like One Medical below, this one wasn’t particularly easy to find in Adobe’s benefits stack. If an employee needs help to understand their options, they can use Jellyvision’s automated concierge, ALEX, to navigate their Adobe benefits:
“Get help with your enrollment decisions, maximize your tax savings, and then bask in a sense of accomplishment.”
The other place Adobe employees may run into ALEX is when they are looking to take some time off. ALEX can help get that on the calendar too apparently.
One Medical for primary care
It was kind of buried in Adobe’s benefits stack, but it looks like the company has tapped One Medical to provide primary care services to its employee population:
“Activate your free membership from Adobe… You are just a few clicks from becoming a member and experiencing a new kind of primary care. Once you’ve registered, you’ll have access to everything One Medical has to offer, from convenient, calming offices to same-day appointments to 24/7 virtual access.”
EAP: Spring Health
Spring Health is Adobe’s EAP. The company offers a long list of services to Adobe’s covered lives including:
- 24/7 hotline for connecting to a licensed mental health professional,
- 10 covered sessions (in-person or video visits) with therapists,
- Coaching — tips for managing stress and increasing focus
- “In-app moments and wellness exercises. Support your mental fitness on the go, with on-demand exercises in meditation, better sleep and more via the Spring Health mobile app.”
- “Medication management. Get personalized treatment, and minimize the trial-and-error process of medication with Spring Health’s clinically validated algorithms.”
“After a brief assessment, you’ll be assigned a personal care navigator who will act as a single point of contact. Your care navigator will recommend EAP resources or guide you to the appropriate EAP benefits, including 1:1 counseling or other treatment options, as appropriate. If you’re enrolled in one of our Aetna medical plans, your care navigator can help you find an appropriate in-network provider to meet your needs.”
The main smoking cessation program that Adobe offers its employees is also nestled under Spring Health. Spring offers 20-minute coaching sessions and/or 10 free 50-minute sessions with a licensed mental health professional.
Headspace for resilience and stress reduction
Interesting that this benefit also includes access for a “plus one” while the second opinions service below includes access to a long list of relatives including far-flung branches of the family tree like your grandparents-in-law:
“Headspace is a personal trainer for your mind. The Headspace app gives you access to short, guided meditation sessions—delivered straight to your phone or browser—that help you manage your stress, sleep better, find your focus, boost your creativity and achieve more balance in your life. It’s meditation made easy—and it’s free to you and your +1.”
LifeDojo for healthier habits
Along with Headspace and Spring Health, Adobe also offers its employees a more general healthy habits-focused program called LifeDojo:
“We know small changes lead to big results, and that’s why Adobe employees love LifeDojo, a wellbeing app that allows you to design your own program based on your personal goals and interests. LifeDojo lets you pick from 30 habits to focus on, lets you choose your own life coach and helps you get smarter about how you approach wellbeing with interesting articles and videos.”
Second opinions and care navigation: Teladoc Medical Experts (formerly Best Doctors) and three others
“If you’re facing a serious condition, Teladoc Medical Experts (formerly Best Doctors) is your resource for expert help, including:
- Expert second opinions Answers to questions about your diagnosis
- Help deciding on a treatment option—even while you are admitted to the hospital
- Help finding a local expert who specializes in your condition
Teladoc Medical Experts is available to you, your spouse/domestic partner, children, siblings, parents, parents-in-law, grandparents, grandparents-in-law and grandchildren.”
Adobe offers three other care navigation and second opinions-like services to employees: AccessHope, CareCounsel, and Aetna nurse care manager.
AccessHope:
“If you’re facing a cancer diagnosis, you can contact AccessHope for expert advisory review of your case and treatment plan. They’ll collaborate with your physician to share insights and recommendations on advanced therapies to identify the best path for your treatment.”
CareCounsel:
“CareCounsel can help you select a medical plan, answer general questions on how health care works and help with claims and billing. They can also help you navigate your Medicare options.”
Nurse care manager (Aetna-only):
“Aetna’s nurse care managers provide one-on-one support if you’re facing a serious medical condition. Your dedicated nurse care manager can help you work better with your doctor, get needed follow-up care and much more.”
Aetna members at Adobe also have mental health services from Teladoc and AbleTo Teladoc for behavioral health:
“As an Aetna member, you can use Teladoc video behavioral health to get support for anxiety, eating disorders, depression, family issues and more. Teladoc sessions [PDF] are covered according to your Aetna medical plan—i.e., after you meet your deductible, the plan pays 90% or 80% of the cost:
- Psychiatrist (initial visit): $190/session
- Psychiatrist (ongoing visit): $95/session
- Psychologist, licensed clinical social worker, counselor or therapist: $85/session”
AbleTo support program:
“If you’re struggling with a health condition or a stressful life change or with emotions like worry, confusion or anger, you can get support from a therapist and a behavioral coach through AbleTo [PDF]. AbleTo, an eight-week program tailored to your schedule and specific needs, connects you to support via phone or video for maximum convenience. And, because it’s part of Aetna behavioral health, it’s covered under your Aetna health plan. After you meet your annual deductible, the plan pays 100% of the program cost.”
Kaiser members have access to myStrength and Calm
myStrength: “This app offers a personalized program with in-the-moment coping tools, guided self-care, inspirational resources and more.”
Calm: “This meditation and sleep app eases you into a healthy state of mind. With Calm, you can build resilience and mental fitness by trying guided meditations, self-care programs taught by world-renowned experts, bedtime stories narrated by celebrity guests, mindful movement videos and more.”
Wellness reimbursement: $600 in the US
From what I can tell, Adobe doesn’t run any kind of corporate wellness program, instead, the company encourages its employees to spend $600 on a wide range of things that might contribute to their well-being:
“We want to help you and your immediate family members maintain a well-rounded, healthy lifestyle. We will reimburse you up to $600 per year for gym memberships, bike share memberships, fitness classes, massages, nutritional counseling, activities for kids and much more. Don’t get stuck in the same-old routine—try a new program on us!”
Well, that’s a wrap on the Adobe stack.
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. 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.
Omada has “successfully served” more than 13,000 seniors since 2013
Omada Health continued its annual campaign to convince CMS to modernize its approach to the Medicare Diabetes Prevention Program. In its comments on the proposed 2022 Physician Fee Schedule, Omada called out how shockingly few Medicare beneficiaries have taken advantage of the (in-person only) MDPP in recent years:
“CMS acknowledges that it lacks adequate supply of MDPP. This especially negatively impacts medically underserved populations. While there are over 16.4 million Beneficiaries eligible for MDPP, only about 3,000 have received these services, for a total of .00018 percent. Moreover, from the Evaluation Report, CMS knows that there are entire states with high Beneficiary populations and high populations of historically medically underserved populations, but with no MDPP available. The Evaluation report cites as examples, Alabama; Nevada; New Mexico; the Dallas, Tx, metropolitan area; and the Atlanta, Georgia metropolitan area.”
Omada, of course, is available in those cities and has served people living there for years:
“Meanwhile, CDC Fully Recognized virtual and video-based DPPs (and not just Omada) operate in all of these communities, and are successfully changing the lives of thousands of individuals. For example, in the fifteen months from January 1, 2020 to March 31, 2021, Omada served over 3,700 people in the metropolitan Atlanta area and over 3,300 people in metropolitan Dallas.”
The most interesting paragraph in Omada’s comments on the fee schedule, however, is the one below where the company shared how many people over the age of 65 that it has served:
“Omada is the largest supplier of CDC Fully Recognized DPP services in the country. We have served over one-half million individuals since 2013. By our estimates, we’ve successfully served over 13,000 people over age 65, which is 4x the number of people served by MDPP, and with a more diverse member base than the 74 percent white women cited in CMS’ Evaluation.10 We passionately want MDPP to succeed, but we fear MDPP will not be successful if CMS limits its changes to those proposed in the NPRM because it will clearly be too little to ‘scale MDPP as intended.'”
So, even though CMS still hasn’t decided to add virtual DPP to its Medicare program, some 2.6 percent of Omada’s all-time users were older than 65. Omada has included the number of seniors it has historically served in past comments to CMS too. Up until this year, the company typically said they had served more than 10,000 aged 65+.
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