Digital health-focused news involving payers during the third quarter of 2018 comprised a number of different focus areas, ranging from chronic condition management strategies to member engagement to high-profile deals. Read below for MobiHealthNews’ coverage of this sector through July, August and September.
Diabetes management and prevention
A handful of payer news during this period specifically focused on coverage of diabetes management tools.
In September, Cigna and Omada Health announced an agreement expanding the digital diabetes prevention program to all of Cigna’s regional and national employer customers. Another deal, cut a few months earlier between Blue Cross Blue Shield of Michigan and digital insulin therapy company Hygieia made the latter’s d-Nav Insulin Guidance Service available to members.
The case for payer-backed diabetes management programs such as these gained some support in July, when UnitedHealthcare and Medtronic announced new data suggesting that members who took advantage of the companies’ arrangement experienced fewer preventable hospital admissions when compared to members relying on multiple daily injections of insulin.
“These results show that patients with diabetes can benefit from using insulin pumps and comprehensive support services, thereby increasing the quality of the care they receive and reducing hospital admissions as well as costs,” Dr. Peter Pronovost, chief medical officer at UnitedHealthcare, said in a statement at the time.
In terms of telehealth, this quarter saw American Well’s service expanded to Anthem plan members who own a Samsung Galaxy device. The LiveHealth Online service was enabled through the Samsung Health app, once members enroll in the feature through their Samsung account.
On the other hand, Teladoc found itself in a lawsuit with Key Benefit Administrators, an Illinois-based administrator of self-funded employee welfare benefit plans for enterprises, over a billing dispute. In a statement, Teladoc said that it was “optimistic” that the lawsuit — which alleges a breach in obligations, pecuniary loss, defamation, and tortious interference all stemming from $450,000 in overcharges — could potentially be settled out of court.
“KBA does not know whether Teladoc has made the same error with respect to others who became Teladoc customers as a result of Teladoc’s acquisition of [Healthiest You],” the benefit plan company wrote in the complaint.
A July survey from Manatt Health looked at Medicaid fee-for-service reimbursement policies as well as state laws to give an overview of telemedicine reimbursement across the nation. Evaluating a number of categories, Manatt rated 20 states as “progressive”, meaning laws and policies “enable and incentivize” broad telemedicine usage. Twelve states came out as “restrictive”, meaning laws and policies inhibit telemedicine. The other 18 were rated as mixed or moderate, meaning they either supported telemedicine in some ways and inhibited it in others or they gave qualified or limited support.
Some of the most restrictive states were in New England and the South, with Massachusetts as the only state to bomb in all six categories Manatt investigated. On the other hand, the Southwest and Northwest made up much of the progressive block, with Colorado standing out as the only state that reimburses for live video conference, phone and email, remote patient monitoring, and store and forward.
Employee member engagement and support
This quarter saw news of a deal between Neighborhood Health Plan and Welltok, the result of which gave Neighborhood members in Massachusetts access to the CafeWell platform. The member engagement and messaging platform allows Neighborhood to reach out to its members through texting, calls and emails.
During July’s Employee Health, Benefits & Wellbeing Congress Summit in Boston, some benefits managers shared their experiences deploying digital services to employee members. Lisa Cummings, director of total rewards at Chesapeake Energy, noted that the company was able to reduce costs and extend its benefits to those living in remote areas thanks to Teladoc’s telemedicine services, while Mike Ezzard, senior director of global benefits at Activision Blizzard, found the variety of healthcare apps offered by Jiff, now part of Castlight, were an easy-to-use answer for the unique demographics of the video game maker’s staff.
“[We’re thinking] about keeping people healthy so they aren’t a trainwreck down the road. A lot of people are fairly sedentary,” Ezzard said at the time. “We want to deliver something my leadership feels is smart and is money well spent and so I can continue to do cool thing and be customer centered.”
Speaking of Castlight, the personalized health shopping platform was sent reeling upon news that Walmart, one of its largest clients, had decided to part ways on relatively short notice. CEO John Doyle told investors that the company would be restructuring as a result, and laying off 50 to 75 of its employees.
Investments and expansions
In August, Oscar Health announced the receipt of a $375 million investment from Alphabet, the second large backing for the tech-driven insurer this year. Oscar Health said in a statement that the funds will help move the New York City-based insurer into its next phase of expansion, entering the Medicare Advantage market.
"Oscar will accelerate the pursuit of its mission: to make our healthcare system work for consumers,” CEO and cofounder Mario Schlosser said in a statement. “We will continue to build a member experience that lowers costs and improves care, and to bring Oscar to more people — deepening our expansion into the individual and small business markets while entering a new business segment, Medicare Advantage, in 2020.”
Meanwhile, Cigna announced the launch of a corporate venture fund, called Cigna Ventures, equipped with $250 million in capital to invest in early and growth stage startups. The investments will go to emerging companies that are driving innovation in healthcare through the strategic areas of insights and analytics, digital health and retail, and care delivery and management.
Humana launched a new center for digital health and analytics, which could eventually employ about 250 people to develop new data-driven technologies to advance its healthcare initiatives for plan members. Humana Studio H will be located in Boston's Seaport District. Heather Cox will lead the effort as Humana's newly minted chief digital health and analytics officer, reporting to CEO Bruce Broussard.
Over on the other side of the world, Shanghai-based digital health startup CareVoice announced in late September plans to expand into the Hong Kong market, as well as to team up with Inter Partner Assistance Hong Kong to deliver joint offerings in this new market.
“There are now a few synergies that can serve insurance members in mainland and in Hong Kong,” CareVoice CEO Sebastien Gaudin told MobiHealthNews. “But Hong Kong is a very interesting market because you are [entering] a mature health insurance market. In Hong Kong, over 60 percent of people have private insurance to cover their routine clinical needs.”
Other Q3 2018 payer news
Fitbit was at the heart of a few news stories this quarter, the first of which was an August announcement that some BCBS members would receive a special rate on Fitbit devices if purchased through the Blue365 portal. The deal also allows BCBS employers to purchase the devices at a bulk or subsidized rate for their employees.
Fitbit’s other announcement came a month later with the unveiling of Fitbit Care, a connected health platform for health plans, employers and health systems. Born directly from its axquisition of Twine health earlier this year, Fitbit Care uses the devices alongside health coaching and virtual care to help improve disease management and prevention.
“We’ve taken the elements of Twine Health and the ingredients we know and combined them,” Adam Pellegrini, Fitbit’s general manager and senior vice president, said in September. “We’re actively selling it to employers, health plans, and health systems today, and we’re extremely excited to announce the expansion of our relationship with Humana. It has selected us as a preferred coaching solution for the employer group segment.”
The quarter also saw virtual physical therapy platform Reflexion Health make its first move into the employer market. Specifically, the company partnered with BevCap Management, a program manager for captive insurance companies, to provide the latter’s clients with access to its Virtual Exercise Rehabilitation Assistant (Vera) platform and supporting cloud-based clinical services network.
It’s worth noting that this quarter also saw a handful of payment proposals and moves toward the reimbursement of remote patient monitoring from CMS. Many of these have already come to fruition with the announcements and final ruling released by the agency last week.