Aetna, Oshi collaborate to provide virtual care for digestive disorders

Aetna, a CVS Health company, and Oshi Health have formed a new value-based collaboration that provides Aetna commercial members with in-network access to Oshi’s integrated multidisciplinary care teams.

The collaboration is designed 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 conditions — all done virtually so that members have convenient access,” said Bill Lamoreaux, senior vice president of 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 range of symptoms and conditions that affect one in four working age adults in America and incur higher direct healthcare costs than others. 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 companies noted.

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The Aetna-Oshi relationship goes beyond treating symptoms. There also is 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 of 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 healthcare providers when procedures or in-person care is required.

Oshi shared that it has helped people significantly improve their conditions, from diagnosis to individualized treatment, with over 90% of members gaining control over their symptoms. 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.

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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 also will 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 of 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.”