Issue 035
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
Quite a few quick notes this time…
- Came across a purchase order this week that showed the FBI tapped Vida Health for about $25,000 worth of health coaching starting in April 2022. That’s about half of what the Bureau paid Vida around this time last year when it filed a PO that showed it intended to pay Vida more than $50,000 for health coaching services in 2021. FBI HR described Vida as an “Interactive/Digital Wellness Solution” in the purchase order.
- While Vida is coaching the FBI, the DEA is taking a look at Cerebral’s online prescribing practices, according to a breaking news report from Insider. (sub. req.) The DEA has questioned a few former Cerebral employees so far.
- Lots of bad news in recent weeks as Teladoc finally announced its impairment charge on the Livongo acquisition, which turned out to be a few billion more than the top of the range it told Wall Street to expect a few weeks back (Issue 032). Instead of between $800 million and $4 billion, the impairment charge was $6.6 billion.
- Soon after, Accolade led off its latest earnings call by announcing that its very first (and perhaps best-known) customer, Comcast, was not renewing its contract with the health care navigator after 12 years. As I tweeted earlier this week, Comcast went from being 100 percent of Accolade’s revenue (in the very beginning) to 45 percent of its annual revenue in the year ending February 2018. By February 2019, it accounted for 35 percent. Last year Comcast accounted for less than 10 percent of the company’s annual revenue. Had it stuck around for a thirteenth year, Accolade said it would have accounted for even less than that.
- Curious if Included Health/Grand Rounds picks up the full Comcast navigator account now or if someone new like Transcarent swoops in. What’s your prediction?
- Remember way back in January 2021 (Issue 005) I wrote about Alivecor’s plans to develop a cardiac offering for self-insured employers that it would price on a PEPM basis? Well, this week, some 15 months later the company officially launched it. Release is here.
- In other launch news that you likely know already, Transcarent added a cancer care offering for its employer customers.
- Finally, Hinge Health added a women’s pelvic health program to its MSK digital clinic, which now counts 700 employers and health plans as customers.
- One more thing… This survey from VC firm Venrock is always worth a read even though its mix of respondents is a little bit all over the place. (For reference: The majority are investors or working at health tech companies.) According to the survey, VillageMD, Omada Health, and Hinge Health are the three most likely IPOs this year.
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Big employer digital health stack: Vanguard
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 32 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.
This week I dug into financial behemoth Vanguard’s digital health benefits. Vanguard is a private company so it’s not in the Fortune 500, but it’s certainly a big employer. Here’s a rundown of Vanguard’s digital health benefits:
Teladoc via Aetna for general medical, behavioral, dermatology video visits
“Teladoc gives crew and their family members who are enrolled in Vanguard’s medical coverage faster, easier, more convenient access to a doctor. With Teladoc, you can access a doctor, therapist, or medical expert wherever you are by video or phone.”
Up until December 2021 and dating back to the start of the pandemic, Vanguard covered the cost of Teladoc visits in full. Starting in January 2022, Vanguard employees need to pay some per visit.
Accolade-owned 2nd.MD for second opinions
Up until 2020 Vanguard offered Teladoc-owned Best Doctors as its second opinions service, but 2nd.MD won the account two years back.
- “Expert Video Consultations: 2nd.MD provides video consultations with leading medical experts for second opinions and treatment plan reviews. No travel. No hassle.
- Personalized Local Support: 2nd.MD can help members find a high-quality, local physician that is in-network and perfect for a member’s medical situation.
- Text-a-Clinician: 2nd.MD provides the ability to text with our team through the 2nd.MD app when having a question about a new diagnosis or an existing condition. This service is not available to treat acute illnesses or prescribe medication.”
Lyra Health is Vanguard’s EAP
- “Mental health coaching — Get to the root of your challenges with effective care from a mental health coach via video or live messaging.
- In-person & video therapy — Meet with a therapist for diagnosis and treatment of mental health conditions like depression, PTSD, and more.
- Guided self-care with a coach — Get a care plan crafted by your Lyra coach and learn new mental health strategies at your own pace.
- Mental wellness tools — Tap into self-led wellness tools anytime, anyplace.”
Vanguard also offers a few non-health benefits from Lyra’s partner network for legal services, identity theft protection services, and financial consultations.
Healthcare Bluebook for care ratings and pricing
Correction: In the newsletter version of this Issue, I wrote that HBB was owned by Sharecare. Sharecare acquired a similarly named company 10 years ago (Little Blue Book). I regret the error (and much else).
This may be a legacy service that Vanguard no longer offers. The links Vanguard provides employees for accessing HBB all appear broken:
- “To find the fair market price for a procedure in your area (e.g., MRI).
- To compare quality ratings for the same surgery at different hospitals or medical centers.
- To determine the most cost-effective facility for care (e.g., CrewCare vs. a walk-in clinic or urgent care facility).
- To ensure the provider you use is not just highly rated overall but highly rated for the specific medical procedure you need.”
Wellthy for caregiving services and care navigation
Wellthy, not to be confused with Wellthy Therapeutics, offers a range of services that include sourcing babysitting agencies and evaluating in-patient facilities for mental health conditions. Here’s the list that Wellthy set-up to explain what they do to Vanguard employees:
“Here are some examples of families we’re helping:
- Evaluating and recommending babysitting resources or nanny agencies
- Locating support groups for spouse with a cancer diagnosis
- Tracking down in-home or on-site childcare and learning solutions
- Vetting in-network specialists for a child with autism
- Evaluating in-patient facilities for a sibling with mental health concerns
- Identifying resources to keep kids engaged, challenged, social and physically active
- Navigating virtual learning options for children
- Hiring in-home care for in-laws with multiple conditions including MS, Alzheimer’s, heart disease Setting up specialist appointments after a new diagnosis”
OK — that’s a wrap on Vanguard’s benefits stack. Which big employer should I dig into next?
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