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.
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Virtual Clinics Round-up: Marley Medical merged into Starlight; Oshi goes nationwide; plus other state launches and in-network contracts
Here’s a round-up of news and that signals the growth of virtual clinics in recent months. It includes new state launches, new in-network contracts, and other growth metrics:
Marley Medical acquired by (or at least merged into) Starlight Health: The last time we checked in on Marley Medical over the summer, the virtual clinic focused on hypertension and multi-chronic Medicare patients was operating in five states: Wisconsin, Illinois, Ohio, Michigan, Minnesota and Missouri. It had about 1,500 patients enrolled and about 16 employees. In recent months, however, Marley appears to have suspended its services before announcing that it would resume providing care under new management — another virtual clinic, Starlight Health, based in Oregon. Starlight is the name of the virtual clinic spun up by digital health company Kannact in July. Marley’s site informs patients that they will continue their care under Starlight’s management and one of Marley’s care providers will continue on with Starlight (she joined them in September) as part of the arrangement. The new clinic seems to be more health coaching-focused, however, and it will not include prescribers, at least not initially. More:
“So, Marley Medical isn’t closing after all? Correct! We have partnered with Starlight to ensure you continue to receive the high-quality care you expect. It’s the same clinic, now managed under Starlight, with the same commitment to supporting your health every step of the way.”
Marley’s CEO and co-founder Chris Hogg has been a vocal evangelist of the virtual clinic model, which he has described as B2C2B. Marley, which launched in 2021, had big name investors, including Andreessen Horowitz as well as a number of angel investors who were early digital health founders. (It’s unclear if Marley Medical Inc. will continue on in some form after shedding its clinic, but I’ll update this post if I hear anything. Hogg did not respond to a request for comment prior to deadline.)
As promised: Oshi Health now nationwide: Oshi Health, the GI-focused virtual clinic pre-announced that it would be available in all 50 states and D.C. in September 2024. It made good on that promise and confirmed it was available nationwide in its October 2024 funding announcement.
Swing Care is now available in PA: Swing Care, the virtual clinic focused on fibromyalgia, that was set up by Swing Therapeutics, a prescription digital therapeutics company, is now available in Illinois, Michigan, Missouri, Nevada, Ohio, Pennsylvania, Tennessee and Texas. The clinic is operating in one new state since our last tracker update a few months ago: Pennsylvania. Perhaps not coincidentally, Highmark also announced a positive coverage decision for Swing Therapeutics’ digital therapeutic in recent months too.
Accomplish enters now in 22 states: Medical weight loss-focused virtual clinic Accomplish Health has entered a few new states in recent months and is now in 22 states: WA, AZ, CA, TX, IL, OK, NY, PA, CT, MI, MD, GA, VA, FL, WI, IN, WV, NJ, MA, MO, OH, and TN.
Midi Health now in-network with Cigna (PPO/OAP) nationwide: Midi Health, a virtual clinic focused on women at mid-life, announced that it is now in-network with Cigna (PPO/OAP) nationwide. (mt sinai and hinge)
Piction in-network with Aetna in Florida: Dermatology virtual clinic Piction is now in-network with Aetna in Florida. It operates in Massachusetts, Connecticut, New Hampshire, and Florida currently.
Folx Health rolled out therapy services in Georgia, New York, and Missouri: LGBTQ-focused virtual clinic Folx Health rolled out therapy services in Georgia, New York, and Missouri. It’s also available in California, Florida, Texas, Virginia, Colorado, and South Carolina. “Get the care you deserve from an expert, affirming, LGBTQIA+ therapist who will see you without judgment. Sessions are $129/visit (in-network insurance coverage coming soon.”
Curious. Workit Health has been “coming soon” to New Mexico and Oklahoma since 2021: Workit, a virtual clinic for substance use disorders, is currently operating in five states but its website has promised since 2021 that it would bring its services to both New Mexico and Oklahoma “soon”.
Boulder Care now covered by Trillium health plan in Oregon: Boulder Care, a virtual clinic focused on addiction treatments, is currently operating in three states — Oregon, Washington and Ohio. It just announced a new health plan in Oregon: Trillium Community Health Plan.
Elektra Health is in-network with MVP and Molina in NY: Elektra Health, a virtual clinic focused on menopause care, now covered by MVP and Molina in New York, in addition to Aetna, EmblemHealth, Anthem BlueCross BlueShield, Wellcare, and Medicaid and Medicare.
Ophelia secured Medicaid reimbursement in NJ: Ophelia Health, a virtual clinic focused on opioid use disorder treatment, announced that New Jersey Medicaid will now cover Ophelia’s online opioid addiction treatment with Suboxone. Most patients will pay less than $10 for care.
Brightline and the 48 other in-network mental health virtual clinics that Aetna promotes to Amazon employees (an example of the problem virtual clinics face marketing to employers)
If you are reading this newsletter then you probably read the blog post by Brightline CEO and co-founder Naomi Allen about her virtual clinic’s shift away from its current go-to-market to focus on deeper, hybrid care in a smaller geographic service area and with less emphasis on employers. This part of Allen’s post really summed up the problem virtual clinics typically have finding traction through employers:
“Families that find out about Brightline through their employer have great clinical outcomes… and very strong NPS. But simply put, they are having too hard of a time finding us. Because we don’t sell directly to employers in our model, but rather through their health plans and partners, we aren’t top of mind enough for benefits leaders and therefore we don’t see enough of the types of marketing campaigns that really drive awareness amongst members.”
So, what does that look like, really? I wanted to dig into that by giving you an example of how one of Brightline’s health plan partners pitched the behavioral health-focused virtual clinic’s services to employees at a big self-insured employer. Aetna previously promoted Brightline to Amazon employees by creating a very long list of behavioral health-focused virtual care providers that Amazonians have access to. If an Amazon employee clicks through on Brightline today, the landing page informs them that services are available until the end of the year whereupon Brightline is ending its virtual care services for the company.
As you skim the list of 49 in-network virtual clinics that Aetna created for Amazon employees, note that Aetna also provided co-pay info, which was pretty much the same for all of the below so I excluded it, and URLs for each, which I also excluded to save space. Puzzlingly, Aetna provided no descriptions beyond “mental health” and the state availability and age requirements. No wonder Brightline concluded that this type of marketing — lost amidst a sea of dozens of other indistinguishable mental health virtual clinics — wasn’t working.
Aetna: Virtual Care Providers: Mental Health
- AbleTo – Available nationwide – Ages 18 and above
- Affect Therapeutics – Available in AZ, CA, FL, IN, KY, NV, OH, TN, TX – Ages 18 and above
- Alma Health – Available nationwide – Ages 5 and above
- Array At Home – Available nationwide – Ages 5 and above
- Aware Recovery Care – Available in CT – Ages 18 and above
- Bicycle Health – Not available in AR, HI – Ages 18 and above
- Blue Sprig Pediatrics – Available nationwide – 18 months to 18 years of age
- Brave – Available in AZ, FL, GA, IL, KY, NY, NC, TX – Ages 13 and above
- Brightline – Available nationwide -18 months to 17 years of age
- Brightside – Available nationwide – Ages 18 and above
- Charlie Health – Available in AZ, CA, CO, DE, FL, GA, ID, IL, IN, IA, MD, MI, MT, NV, NH, NJ, NY, NC, OH, OR, PA, SC, TN, TX, UT, VA, WA, WI, WY – Ages 12 to 28
- CHE Behavioral – Available in CA, CT, FL, GA, KS, KY, NJ, NY, NC, PA, SC, TN, TX, WA – Ages 18 and above
- CVS MinuteClinic Virtual Care – Available in AZ, CA, CT, FL, GA, IL, MD, NV, NJ, NY, NC, OH, PA, SC, TX, VA, DC – Ages 18 and above
- Eleanor Health – Available in LA, MA, NJ, NC, OH, TX, WA – Ages 18 and above
- Equip – Available nationwide – Ages 4 to 26
- Forefront Telecare – Not available in NV, ND – Ages 18 and above
- Foresight – Available in AZ, CA, CO, FL, GA, IL, TX – Ages 18 and above
- Geode – Available in GA, IL, NC, TX – Ages 5 and above
- Groups Recover Together – Available in AZ, CA, FL, GA, IL, IN, KY, ME, NV, NH, SC, TN, TX, VA, WV – Ages 18 and above
- Grow Therapy – Available nationwide – Ages 6 and above
- Headlight Health – Available in AK, CA, CO, ID, OR, TX, WA – Ages 18 and above
- Headway – Available nationwide – Ages 2 and above
- Hopscotch – Available in AL, CA, DE, FL, GA, NJ, NC, OH, PA, TX, WV – Ages 3 to 26
- Kyo Autism Therapy – Available in AZ, CA, CO, FL, GA, OR, TX, UT, WA – 18 months to 18 years of age
- LifeStance Health – Available in AZ, CA, CO, DE, FL, GA, IN, KS, KY, ME, MD, MA, MI, MN, MO, MT, NV, NH, NJ, NY, NC, OK, OH, OR, PA, RI, SC, TN, TX, UT, VA, WA, WI – Ages 18 and above
- Luna Joy – Available in AK, FL, GA, IL, MD, NJ, NC, PA, TX – Ages 18 and above
- Lyra Health – Available nationwide – Ages 2 and above
- Marvin Behavioral Health – Available in CA, CT, DE, FL, GA, KY, MA, MI, MO, NJ, PA, WA, WI – Ages 18 and above
- Maxim Healthcare Services – Available in AZ, AR, CA, CO, DE, FL, GA, IL, IN, IA, KS, KY, ME, MD, MA, MI, MO, NE, NV, NH, NY, NC, OH, OR, PA, RI, SC, TN, TX, UT, VA, WA, DC, WV, WI – 18 months to 18 years of age
- MDLive – Available nationwide – Ages 10 and above
- Meru – Available in AZ, AR, CA, CO, DE, FL, GA, IL, IN, IA, KS, KY, ME, MD, MA, MI, MO, NE, NV, NH, NY, NC, OH, OR, PA, RI, SC, TN, TX, UT, VA, WA, DC, WV, WI – Ages 18 and above
- Mindpath – Available in AZ, CA, FL, MN, NC, SC, TX – All ages
- Monument Telehealth Group – Available in AZ, CA, CO, CT, FL, GA, IA, KY, MD, MS, NJ, NY, OR, PA, SC, TX, VA, WA, DC – Ages 18 and above
- NOCD – Available nationwide – All ages
- Octave – Available in CA, CT, FL, NJ, NY, TX, DC – Ages 18 and above
- Pelago– Available nationwide – Ages 15 and above
- Rula – Not available in KS, NJ, NM – Ages 5 and above
- Sondermind – Available in AZ, CO, GA, IN, KY, ME, MD, MA, MO, NE, NH, OH, OR, TX, VT, VA, DC – Ages 18 and above
- Talkiatry – Available nationwide – Ages 5 and above
- Talkspace – Available nationwide – Ages 13 and above
- Tava Health – Not available in AK, CT, DE, IA, KY, ME, MS, MO, NH, ND, OK, OR, DC, WV – Ages 18 and above
- Teladoc Health – Available nationwide – Ages 13 and above
- Telemynd – Available nationwide – Ages 5 and above
- Thriveworks – Not available in VT – Ages 18 and above
- Two Chairs – Available in CA, FL, WA – Ages 18 and above
- UpLift – Available in CA, FL, IL, MD, NJ, NY, PA, TX, VA, DC – Ages 13 and above
- Valera Health – Available in AZ, CT, FL, MA, NJ, NY, OR, TX, VT, WA – Ages 6 and above
- Vita Health – Not available in AK, HI, MS, MT, OR, SD, VT, WY – Ages 12 and above
- WorkIt Health – Available in FL, MI, NJ, OH, TX – Ages 18 and above
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