Value-based collaboration provides preferred access to integrated multidisciplinary care for digestive conditions
WOONSOCKET, R.I. and New York, NY, April 6, 2023 — Aetna®, a CVS Health® company (NYSE: CVS), and Oshi Health (Oshi) today announced a new value-based collaboration that provides Aetna commercial members with in-network access to Oshi’s integrated multidisciplinary care teams for high-touch care and specialized treatment to achieve lasting control over chronic digestive conditions. For the first phase of its collaboration, Aetna is offering access to Oshi to commercial members in six states, with more to be added in 2023.*
“Adding Oshi to our differentiated provider network will help us offer integrated, whole-person care for gastrointestinal (GI) conditions — all done virtually so that members have convenient access,” said Bill Lamoreaux, senior vice president, Aetna Network Strategy and Provider Experience. “Our collaboration with Oshi opens the door to coordinated virtual digestive care for our members.”
Digestive health issues include a wide-ranging set of symptoms and conditions that affect one in four working age adults in America and incur higher direct healthcare costs than heart disease, mental health, or trauma. These conditions are best treated with a coordinated and collaborative approach involving GI specialized experts, including physicians, nurse practitioners, dietitians and behavioral health specialists. The Aetna-Oshi relationship goes beyond treating symptoms and adopts this proactive, team-based approach to keeping people healthy. There is also a value-based payment arrangement that financially supports Oshi’s comprehensive care model to support better member outcomes and effective population health management.
“Especially for stigmatized chronic specialty care categories, virtual clinics unlock the potential of value-based care by improving outcomes and patient experiences with proactive, integrated care models,” said Sam Holliday, CEO, Oshi Health. “By working together, we can support and integrate virtual care providers and incorporate dietary and gut-brain interventions that aren’t typically available into Aetna’s provider networks.
The multidisciplinary GI care model helps provide effective relief through evidence-based, whole-person care — including often-neglected dietary and psychosocial interventions — and can quickly achieve a diagnosis and guide individualized treatment. Patients connect with specialized providers via telehealth visits, their care plan is continuously informed and refined by monitoring their symptoms, food intake and bowel movements, and a health coach provides ongoing messaging and support to make sustainable lifestyle changes. Oshi coordinates with high-quality local health care providers when procedures or in-person care is required.
Oshi has helped people significantly improve their conditions, from diagnosis to individualized treatment, with over 90% of members gaining control over their symptoms, often within the first 10 weeks of treatment. Recent clinical trial results also demonstrated 98% member satisfaction while achieving savings of $6,724 per patient in GI-related costs, and $10,292 per patient in all-cause healthcare costs after 6 months in the program.
Through this agreement, Aetna members have virtual visits with members of their GI care team from the convenience of their phones, and their care journey is supported by symptom tracking tools, instant messaging services and more. Members in select commercial plans can access care through Oshi as an in-network provider. Those members with specific diagnoses characteristic of chronic GI conditions will also have access to additional care and services needed to help improve their condition that are covered under the value-based payment model developed in collaboration with Oshi.
This collaboration with Aetna follows a strategic investment made by CVS Health Ventures in support of Oshi’s Series A funding round in 2021. Serving as the CVS Health dedicated venture fund, CVS Health Ventures’ investment strategy is focused on companies that have the potential to drive the technology-enabled innovation and disruption in digital health care that is anchored in the company’s core strategy.
“Oshi’s virtual-first, integrated approach to GI care aligns with our mission to invest in companies that are improving health for more people,” said Vijay Patel, Managing Partner, CVS Health Ventures. “Our collaboration with Oshi is a powerful example of how our investments in high-potential, early-stage companies are helping to make consumer health care more accessible, affordable and simpler.”
About CVS Health
CVS Health® is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues including more than 40,000 physicians, pharmacists, nurses, and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Learn more at www.cvshealth.com.
Aetna®, a CVS Health business, serves an estimated 34 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit www.aetna.com and explore how Aetna is helping to build a healthier world.
About Oshi HealthOshi Health is a completely redesigned digestive health care experience that transforms access to care, the patient experience, clinical outcomes and healthcare economics. In a high-touch virtual care delivery model, Oshi Health provides diagnosis and integrated care for digestive conditions and empowers people to achieve lasting control of their symptoms. Launched in 2020, Oshi Health works with innovative employers, health insurance partners, health systems and community GI practices to scale access to multidisciplinary care, reduce healthcare costs, and improve the lives of millions of Americans with chronic gastrointestinal diseases. For more information, visit www.oshihealth.com.