Roundup: Digital health payer news from 2016's fourth quarter

By MHN Staff
02:20 pm

From groundbreaking legislation on chronic condition management and telemedicine to partnerships with innovative technology companies, payers made gains towards playing a larger role in digital health advancements in 2016. Previously, we rounded up all payer-related news for the first quarter, the second, and third, and here is our list of all coverage in the last quarter of 2016.  

Taking lessons from Omada Health, the first digital diabetes prevention program, wellness company Noom announced it would adopt outcomes-based pricing for its programs. Noom will be charging only for successful outcomes for diabetes, obesity, prediabetes, and hypertension. 

A new digital health fund was announced in December: Independence Health Group, the parent company of Independence Blue Cross, is one of three companies to pitch in $2 million toward a new funding initiative for early stage digital health companies in Philadelphia. Investor/accelerator groups Ben Franklin Technology Partners and Safeguard Scientifics will also pitch in $2 million each, making a total of $6 million available.

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CMS released an API to help providers understand and select Medicare Access and CHIP Reauthorization Act (MACRA) measures. Along with MACRA comes CMS’s Quality Payment Program, which requires providers who bill Medicare more than $30,000 a year to report certain performance measures in order to adjust their payments based on performance. For providers who don't have time to slog through the 2,400 page final rule, figuring out what those measures are and how to report them is a challenge. So CMS released an API aimed at addressing that uncertainty.Cigna added fingerprint access to both the iOS and Android versions of its MyCigna app for members, the company announced last week. The company also has plans for an application called Cigna One Guide that will provide some personalized guidance to users.

UnitedHealth Group subsidiary Optum partnered with Boston-based meQuilibrium to integrate the stress management company’s digital coaching platform into Optum’s new Enhanced Employee Assistance Program (EAP) service, and to offer it as a standalone service as well. Through the partnership, both companies seek to offer a cost-effective, scalable method for employers to address behavioral health issues in the workplace. Rather than waiting for an employee to access their EAP when they are in crisis, meQuilibrium works to identify employees who may need additional support before they turn to an EAP. Employees start with meQuilibrium’s proprietary, 10-minute assessment -- either on their smartphone or computer -- that aims to get at the root cause of stress.

San Francisco-based Castlight Health, which offers consumers a personalized health shopping platform, added 14 new large customers, saw increased revenue and cash, and intensified its focus on evolving the business to gain more traction among mainstream buyers in the third quarter of 2016. Castlight’s new customers include Kraft Heinz and Tractor Supply, and the company said it had increasingly seen customers that subscribe to the full platform subscription. More than 80 percent of the company’s new customers have subscribed to the full platform offering, which is a combination of their employer-facing offering Castlight Action, which was introduced in the second quarter along with another feature called Elevate, which identifies employees who are at-risk of behavioral health issues and gives them access to care.

After offering the service to a few Medicare Advantage members in Arizona last year, Humana expanded a collaboration with MDLive to make telemedicine services available to Medicare beneficiaries in select counties in Georgia and South Carolina. Telemedicine is available as a benefit to some Medicare Advantage plans as of 2017. The benefit includes mobile visits via the web or mobile devices or telephone visits for non-emergency conditions including cold and flu, headaches and skin infections. Members will only have to pay a co-pay, just as they would for an in-person visit. Assuming the member grants permission, the MDLive physician will have access to the patient's records and will be able to add notes from the virtual visit to the patient's record.

AARP Services, a subsidiary of AARP, launched a new, interactive website designed to address gaps in the caregiving market, from scheduling and telehealth to professional advice. The CareConnection site, currently in beta, aims to be a central hub for caregivers, and is piloting services from a number of companies that provide resources for caregivers. The idea for the site is based on findings from a report conducted by the AARP and the National Alliance for Caregiving, which found the adoption of digital tools and technologies that make caregiving easier, more efficient and higher quality is still low.Eleven private insurers, including Aetna, Humana, and Anthem, wrote a public letter to the Congressional Budget Office urging the CBO to consider data from private insurers in estimating the cost savings associated with telemedicine. In the letter, emailed to MobiHealthNews by pro-telemedicine lobby group the Alliance for Connected Care (which is not a signatory), the insurers ask CBO director Keith Hall to consider non-Medicare data sources and offer up their own data.

Taiwan-based Health2Sync, an online diabetes management company, announced a partnership with Taiwan’s Ministry of Health and Welfare in a move that brings the web and app-based offering nationwide. Health2Sync’s offering is a multi-part patient management platform that includes a patient-facing app, a cable that connects various types of glucometers to a smartphone, and a data analytics engine that creates automated, personalized recommendations from each patient’s data. Taiwan’s single-payer National Health Insurance system is fairly comprehensive, but diabetes and its complications have always been costly to the system. Additionally, diabetes education in the country has been lacking – Health2Sync’s CEO Ed Deng told MobiHealthNews earlier this year that the certified diabetes educator to patient ratio is about 1: 900. 

Zaffre Investments, the investment arm of Blue Cross Blue Shield of Massachusetts, led a $10 million round of investment in Ovuline, which makes a suite of women's and family health apps and has rebranded as "Ovia Health". Ovia was already the brand name attached to its suite of apps. The company has been expanding its enterprise operations, with payer customers including Blue Cross Blue Shield of Massachusetts, Optum, General Electric, and Activision. Ovia recently hired Greg Nash, former VP of sales at Castlight and Omada, as the head of benefits products. CEO Paris Wallace told MobiHealthNews that the funding will primarily go to building out Nash's team.

Toronto-based mobile health startup League Health introduced its suite of health insurance products to market by partnering with Royal Bank of Canada’s insurance arm. Since Canada has a single-payer system, League isn’t a health insurer, but it connects insurance pools, providers and employers through its consumer-facing app. Through the League partnership, RBC now offers a “peace of mind” plan that provides comprehensive coverage for unexpected emergencies, as well as a range of life and health insurance products, which are available through League Insurance Angency. It also lets employees find and pay for services not offered in their current plans, such as dental or mental health services.

Highmark, which is the fourth largest Blue Cross Blue Shield insurer in the US and covers patients in Pennsylvania, Delaware and West Virginia, tapped Denver-based Welltok to offer a rewards program to members in its Medicare Advantage Passport program. Up until now, the Passport program has provider Highmark Medicare Advantage members with benefit information, savings opportunities and a personal care plan. The partnership will add access to Welltok's CafeWell Rewards program, which uses gift card incentives to reward patients for things like getting an annual wellness visit, getting an HbA1C screening (for patients with diabetes), or other health goals.

App-enabled “full stack health plan” Zoom+, which offers telemedicine, walk-in clinics, and health insurance as an integrated, tech-enabled offering in the Portland, Oregon area, launched a new feature, Zoom+Care Chat. The new feature allows Zoom+ users to get medical advice and even prescriptions via secure messaging and, ideally, will increase convenience for patients while also reducing the number of patients Zoom+ clinics need to see. 


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