Aetna Offers Virtual Care Tool for Gastrointestinal Chronic Diseases

Aetna launched a partnership with a virtual care company to provide chronic disease management for members with digestive issues.

Aetna’s partner offers a virtual care platform dedicated to digestive health called Oshi.

“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 at 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.”

Chronic disease management for digestive issues requires a team of healthcare professionals that spans multiple specialties. Members will be able to use the virtual care platform to access dietitians, behavioral healthcare specialists, and others to secure a path toward better health.

Users can message a health coach through the virtual care tool and receive support in tracking their symptoms. They can also transition to in-person care when necessary.

Aetna and its partner entered a value-based care contract to support a whole health approach. As part of the value-based care agreement, the partners will pursue population health management, comprehensive care, and improved patient outcomes.

Executives mentioned that the virtual care platform can be valuable for members who have stigmatized conditions, reducing the barriers to care.

“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 of Aetna Network Strategy and Provider Experience at Aetna. “Our collaboration with Oshi opens the door to coordinated virtual digestive care for our members.”

CVS Health invested in the partner’s Series A funding round two years before the current announcement. Over patients’ first six months, the platform has proven to reduce gastrointestinal care costs by over $6,700 per patient and overall costs by nearly $10,300 per patient.

The platform will be available to individuals as in-network in certain commercial plans. As of April 2023, members of those commercial plans in six states will be able to use the platform: Florida, Maine, Massachusetts, Ohio, Pennsylvania, and Texas. By the end of the same year, Aetna will extend coverage into more states but the payer did not specify which states or how many.

Less than a year before the current announcement, Aetna revealed that it would start offering a virtual primary care solution. Starting January 1, 2023, members of self-insured and fully-insured plans were able to access the virtual care solution and CVS Caremark members acquired access in the second quarter of 2023.

Other payers have developed or partnered with other companies to provide virtual care opportunities for members. For example, Blue Cross Blue Shield of Michigan and Blue Care Network partnered with a virtual care and care management vendor to bring members virtual maternal care and family care.

Virtual-first health plans were a product of the pandemic when telehealth and virtual care utilization exploded. But some payers are still releasing these types of plans in 2023.

For example, Anthem Blue Cross and Blue Shield in Missouri (Anthem) announced a new virtual-first health plan at the end of March 2023. The plan is interoperable, offers cost-sharing options and price transparency tools, and covers members’ access to symptom checkers, routine wellness care, chronic disease management, and more.