Issue 010
Digital health research from Brian Dolan
E&O: National Virtual Clinics
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. I track state-by-state rollouts in each issue (Let me know if I missed any?) As always: 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.
Whoa there… was this forwarded to you? Click this link to become a paying subscriber.
Virtual Clinics Round-up: New growth metrics, funding, price changes, and closures
Here’s this issue’s round-up:
R.I.P Caraway Health: Caraway, which launched as a virtual clinic for Gen Z aged women with an initial focus on mental health, before expanding to gender neutral care, quietly shut down in late 2024. While the departure of Caraway’s CEO and co-founder was announced in June 2024 via a LinkedIn post, the company’s website was taken offline by year-end. Its company page on LinkedIn was also deleted. As of June 2024, Caraway had served nearly 10,000 people and had spread to 38 states. Caraway was originally conceptualized and launched out of 7wireVentures.
Not accepting new patients: Miga Health. Miga is a heart health-focused virtual clinic that provides care for weight management, blood pressure, diabetes, and cholesterol. It’s site’s FAQ states it is not accepting new patients (“No, at this time, we are not accepting any new patients.”) and for those that were patients of Miga, the company has set up a mechanism to retrieve your medical records from them: “If you received care from Miga, we want to make sure you have access to your medical records. Your medical records have been securely saved in compliance with your state’s regulations and HIPAA privacy standards. To ensure continuity of care, we have chosen Clary Document Management, who will act as the custodian of your records.”
Oshi Health treated more than 8,800 patients between 2021 and mid-2024: Oshi Health, a gastrointestinal health-focus virtual clinic, published an impact report that was based on “all 8,836 adults who were patients of Oshi Health from its initial launch in March 2021 through June 2024.” Some speculative notes on Oshi’s total revenue to date: One of the numbers in the report is that Oshi saved employers $6,724 in per patient GI-related spend on average. That number reminded me of an earlier sell sheet focused on Oshi. It claimed the company saved about $6,900 per patient, which was a 3:1 ROI. I know Oshi has a more complicated value-based pricing arrangement with most of its payer clients, but those numbers suggest an average price per patient of about $2,300 for Oshi’s services. So, between March 2021 and mid-2024 Oshi may have clocked ($2,300 x 8,836) a little more than $20 million in revenue across its first three years of operation.
Calibrate’s results report for 2025 shows at least 21K completed the 12-month program: Calibrate’s new results report doesn’t give an overall number for patients treated over the life of the company, but it does disclose that the report is based on an initial cohort of “21,214 individuals who had received at least one month of a GLP-1 medication and completed at least 12 months of the Metabolic Reset” program that Calibrate offers. That program runs about $199 per month for self-pay.
Hone Health has treated 55,000 patients and tested 300,000 since founding in 2020: Hone Health, a virtual clinic focused on longevity care, raised a $33 million Series A and acquired a home health care company ivee. “ivee’s offerings include a range of services like IV therapy, phlebotomy, and more, with treatments focused on longevity, wellness, and recovery.”
Bicycle Health has seen 40,000 patients since its founding — about 10,000 net new each year: In its recent funding announcement, Bicycle Health, a virtual clinic focused on addiction treatments, said it had seen “over 40,000 patients across 49 states since its founding.” In early 2022, Bicycle had served more than 10,000 patients and was in 23 states. By the end of 2022, it had served more than 20,000 patients and was in 29 states. By early 2024, it was providing care in 32 states and has served more than 33,000 patients. So, it has added about 10,000 net new patients each year.
Bicycle Health’s 2025 price change: Bicycle Health raised its self-pay pricing from $199 per month to $249 per month in early 2025. That fee includes doctor’s visits, unlimited instant messaging, care navigation, and online therapy groups, according to the company.
Parsley Health raised its pricing too: Parsley used to charge $79/month or $869/year when a member used their insurance for medical visits, pricing went up for 2025: “When you use insurance for medical visits, membership is $99/month or $1,089 for the year (which means you get a month free when you pay for the year upfront). This includes the rest of the Parsley experience, like your personalized care plan, health coaching, unlimited messaging and support, the secure online member portal, and more.”
Since its founding, Charlie Health has seen 40,000 patients as of late 2024: Charlie Health, a mental health-focused virtual clinic, has seen 40,000 clients in 37 states as of the end of September 2024. Between October 2023 and September 2024, some 20,000 people received care from Charlie Health. More in its 2024 Outcomes Report here.
Boulder Care grew from 12,000 to nearly 20,000 all-time patients in second half of 2024: Boulder Care, a virtual clinic focused on addiction treatments, said back in May 2024 it had helped 12,000 patients through its program. In mid-November 2024 the company said it had served nearly 20,000 total patients in the company’s history.
Rheumission now in-network in PA: rheumission, a virtual clinic focused on autoimmune conditions, announced an in-network deal with Capital Blue Cross in Pennsylvania.
As You Are autism diagnosis-focused virtual clinic closed for about five months last year: Soon after announcing a partnership with Included Health (which seems canceled now?) autism diagnosis-focused virtual clinic stopped taking new patients from July 2024 until sometime in November or December. It reopened its “virtual doors” under new management and ownership, the company’s site states. As You Are’s parent company, Quadrant Biosciences, announced its plans to shed the assets last June. Here’s what As You Are wrote last summer about the shutdown:
“As You Are is facing severe challenges within the healthcare payer space, forcing us to temporarily pause virtual autism evaluations for new patients. However, we’re actively exploring options to reopen and continue our mission. Effective July 1, 2024, we are not accepting new patients – we hope on a temporary basis. This difficult decision allows us to focus on providing a seamless transition and continuity of care to our existing patients. For those who have already had an initial appointment, we will do our best to complete your evaluations and provide appropriate documentation and resource support. Over the past two years, we’ve helped nearly 18,000 children access timely care. While we’re heartbroken that current circumstances prevent us from serving new patients, we remain committed to supporting families and are cautiously optimistic about the future. During this (hopefully) temporary pause, please know the following: We’re prioritizing care for existing patients and those mid-evaluation. We’re in promising discussions with potential partners to create a sustainable future.”
As you Are is back but not for patients in Hawaii or Kansas yet.
Some virtual clinics are available in fewer states in 2025 for Amazon employees on Aetna plans
In October I wrote about the 49 virtual clinics that Amazon and Aetna promoted to Amazon employees as in-network providers available to them. At the time my focus was on the fact that Brightline had decided to move away from the employee benefit marketing channel since it was not seeing significant engagement while buried in a list of dozens of virtual clinics. Amazon and Aetna have made a lot of tweaks to their list of in-network virtual clinics since 2024 came to an end. Here’s a round-up of changes: New virtual clinics beyond mental health (now more than 55 in total): I know some of these aren’t new benefits for Amazon employees, but its the first time I’ve seen these companies listed alongside the list of in-network virtual providers that Aetna built for Amazon.
- Amazon is now promoting Hinge Health as a virtual provider for physical therapy to its employees
- Oshi Health as an in-network provider focused on “digestive health”
- Folx Health for gender affirming care
- Hey Jane for telehealth medication abortions
- SimpliFed for lactation consultant services
- Midi Health for women 40+
- and Gennev for menopause relief.
Lyra is taking over for Brightline: Even though there are dozens of mental health-focused virtual clinics available to Amazon employees on Aetna plans, the companies are now directing anyone who tries to sign up for Brightline’s services to check out Lyra instead: “Amazonians that do not have a current pediatric care plan in effect with Brightline – or current Brightline users wishing to switch over their pediatric care from Brightline to Amazon’s new provider, Lyra – can do so starting November 1, 2024.” Interestingly (because Brightline isn’t actually available to Amazonians at all) the company was listed as being available nationwide for Amazon employees last year but it now reads — only available in CT, MA, NJ, NY, WA. Curiously, some virtual clinics are available in more or different states than they were last year, but many are available in fewer states.
Just speculation: I spot-checked a few and it seems like the companies are available and operating in some of these states so it appears as if Aetna or Amazon or both decided to cut back on which employees have access to which clinics.
Bicycle Health is available in fewer states: Last year Amazon/Aetna cautioned employees that Bicycle was not available for those in Hawaii or Arkansas. Now, the listing includes additional states where Bicycle is not covered for Amazon employees: Not available AK, AR, HI, KY, LA, NH, NJ, RI, UT, DC.
Blue Sprig Pediatrics is available in fewer states: Just three months ago Blue Sprig was available nationwide for Amazonians on an Aetna plan. Now it’s only in 16 states: Available in AZ, AK, CO, FL, GA, IL, KY, MD, NC, OH, OK, OR, SC, TN, TX, WA.
Groups Recovery Together is available in fewer states: While it used to be, it is no longer on offer to Amazonians in AZ, CA, GA, IL, SC, or TX but it remains available in FL, IN, KY, ME, NV, NH, NC, RI, TN, VA, WV.
Hopscotch is available in fewer states: It is no longer available to Amazonians in California. It is still on offer in AL, DE, FL, GA, NJ, NC, OH, PA, TX, WV.
Foresight Mental Health is available in more states: AZ, CA, CO, FL, GA, IL, IN, IA, LA, MD, MA, MI, MO, NV, NJ, NC, OH, OR, PA, TN. (bolded ones are new). Foresight was available in Texas for Amazonians last year, but doesn’t appear to be anymore.
Kyo Autism Therapy lost one state but gained two more: It is no longer in Washington state but is available in New Jersey and Idaho now. It remains available in AZ, CA, CO, FL, GA, OR, TX, UT.
Rula is available in fewer states: It used to be unavailable in KS, NJ, NM but now it isn’t available in DE, KS, NH, SD, VT.
Sondermind is available in fewer states: Amazonians in these states no longer have access to Sondermind — KY, ME, MD, MA, NE, NH, VT, VA. But it is still available to those living in AZ, CO, GA, IN, MO, OH, OR, TX, DC.
Two Chairs is available in fewer states: Two Chairs used to be available in CA, FL, and WA but is no longer avalable in Florida for Amazonians.
Vita Health is available in more states: Amazon employees in Wyoming now have access to Vita. The service is still not available in AK, HI, MS, MT, OR, SD, VT.
Links to E&O’s reports, databases, newsletters
Click below for dedicated pages for each of those categories:
- Read through the long-form E&O research reports here.
- Search and sort the E&O databases here.
- Skim more than 300 past issues of E&O newsletters here.
