Issue 008
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 usually track state-by-state rollouts in each issue (but there have been very few so far in 2024. Let me know if I missed one.) 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.
E&O: National Virtual Clinics
Whoa there… was this forwarded to you? Click this link to become a paying subscriber.
Midi Health on its early days, payer contracts, and why health systems value Midi’s patient pop
This week I tuned into an interview with Joanna Strober, the founder and CEO of Midi Health, a virtual clinic for women that started with a focus on menopause, on the Passionate Pioneers podcast. Strober made a few comments that helped me better understand Midi and virtual clinics in general. Few highlights:
Midi’s founding: Midi’s founders identified 32 symptoms of perimenopause and built the company’s care protocols around those. The team spent the first 18 months honing those care protocols with clinicians and simultaneously working to secure their first in-network contract, because they wanted the care to be covered by insurance and not direct pay. The company launched in September 2022 with in-network coverage in California with most of the big insurers in that state: Aetna, Anthem Blue Cross, Blue Shield, Cigna, Health Net, and UnitedHealthcare. As of December 2023, the company was live with in-network coverage in 16 states: Alabama, Arizona, California, DC, Florida, Illinois, Maine, Maryland, Massachusetts, Michigan, New York, Ohio, Oregon, Texas, Utah, and Virginia. Curiously, Midi recently partnered with a big health system — Memorial Hermann in Houston.
Strober explained that a bit more: Health systems care deeply about Midi’s patient population:
“This audience of women is going to make all of their healthcare decisions for their family. So they want to have access and they want to have a relationship with these women. But, on the other hand, this type of care doesn’t make them very much money. … We can partner with them. We can do this midlife care for their population and then we have a partner for care because 50 percent of the women who are coming to use are unaffiliated with a healthcare system… We need in-person partners for our care. I think of us now as a true front door to healthcare.”
Midi’s biggest challenge is speeding up the insurance contracting process:
“The complaint we get most on Instagram is ‘Why are you not open in my state?’ We now have providers in all 50 states, because we work with employers. When we work with employers we can set up a private network… What is so frustrating is just the time that it takes to get some of these contracts done. If anyone has any suggestions about that, I know that everyone is working on that — but it’s just a silly process. Quite honestly, we are going to get the contract it just make take another year-and-a-half, which is not really benefitting anyone.”
Deals and other news: Bicycle provider union? Hey Jane growth. Equip urges Congressional action. Payers sound the alarm on parity law tweak and more…
Here’s a quick round-up of other deals, announcements, and news from national virtual clinic companies:
Payers argue a proposed change to the mental health parity law will limit patient access to virtual clinics: This is obviously a one-side argument but AHIP, BCBSA and a few other groups are sounding the alarm that a proposed change by The Departments of Labor, HHS, and the Treasury “will significantly impact patient access to virtual behavioral health providers, particularly through new start-up companies with providers trained to treat eating disorders, obsessive-compulsive disorder (OCD), and SUD.” The group says that the proposal would limit (or eliminate) payers’ ability to use prior auth and concurrent review “thus hindering a health plan’s ability to inform a provider or a consumer that alternative or virtual treatments are covered and available under their plan.” Thoughts on this?
Bicycle Health’s providers announce plans to unionize: This is probably the biggest news in virtual care this week. Is it the start of a trend? In a joint statement the providers at Bicycle wrote: “There has been a shift in company culture where we as providers feel increasingly overworked, undervalued, and our feedback is regularly ignored. In order to continue providing the best care for our patients struggling with opioid addiction, we knew we needed to come together.” The providers are planning to join The Union of American Physicians & Dentists (UAPD), which has been in operation since 1972. The company will hold a secret ballot vote to unionize next month.
Hey Jane has served 50,000 patients so far: “We’re proud to announce that, in the three years since Hey Jane launched, we’ve helped more than 50,000 people get care… including abortion care — that they need.”
Meanwhile, NOCD posted a lengthy rundown on its therapist training program: This looks to be an effort to bolster recruitment of new providers? It’s a somewhat detailed look at the company’s clinical training.
Nema Health, a virtual clinic for PTSD, is now in-network for all members of Horizon BCBS of New Jersey. Nema is currently available in New York, Connecticut and New Jersey. It is also in-network with Oscar, UnitedHealthcare, Optum, Oxford, and ConnectiCare.
Midi inks new employer deal: J.Crew. The retail company publicly announced the new benefit for its workers: “Midi is the premier virtual clinic for perimenopause and menopause care for women. This benefit will help address dozens of symptoms women experience during midlife from poor sleep, mood changes, weight gain, brain fog, and more.”
Vita Health joins One Mind Accelerator: Mental health-focused non-profit One Mind announced the second cohort for its accelerator, and it includes suicide prevention virtual clinic Vita Health. Here’s how the announcement pitched Vita: “Vita Health delivers virtual therapy proven to reduce the likelihood of death by suicide by 60-80%. Vita Health is the only clinically proven, evidence-based solution focused on suicide risk reduction and prevention.” More details on the program here.
Cerebral tapped actor Dennis Quaid to create a documentary/infomercial on access to mental health care. Cerebral filmed a segment with Dennis Quaid’s company Viewpoint at the end of last year focused on access problems to mental health care.
Equip Health asks Congress to make Medicare access to virtual care permanent: Equip Health’s VP of Research Dori Steinberg wrote a column in The Hill that asks “Congress to stop kicking the can down the road” and give Medicare patients access to virtual care beyond 2024. (An extension of pandemic-era rules is set to expire at the end of this year.) More from Steinberg here.
Equip also launched a free preview version of its program: “Explore: Freeform is a self-paced, virtual module designed to help people 18+ build awareness of harmful appearance ideals and practice new ways to push back against them. It’s also a preview of Equip’s full-length Freeform group which includes four weeks of live sessions.”
Validation Institute certifies Calibrate’s metabolic health program: “Validation Institute’s comprehensive review focused on 16,098 people who enrolled in Calibrate’s Metabolic Reset and completed at least 12 months of the program with at least one month of access to a GLP-1 medication.” More
9amHealth brings in $9.5 million Series A extension led by Cigna. The additional funding will help the company serve employers nationwide. More Weirdly — I didn’t spot any new state launches for this issue. (The in-network deal for Nema above was the closest thing I found to a new market expansion.) What national virtual clinic news did I miss? Hit reply and let me know.
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.
