Wednesday, June 14, 2017

Brief Blog: Omada Health Raises $50M, Led by Cigna

Omada Health, a leading provider of virtually delivered disease prevention programs, announced a new funding round of $50M on June 14, 2017.  For details, here.   


DPP Programs Validated Internationally
Type 2 diabetes is becoming one of the largest drivers of healthcare costs.   International studies have shown that intensive behavioral modification programs addressed to persons who do not have T2D, but are at elevated risk, have a material impact on better health.   In addition, the CDC has developed a certification program for diabetes prevention program (DPP) providers (here).

Medicare Roles Out New Preventive Services Benefit: DPP
Medicare - the Center for Medicare and Medicaid Innovation - ran a large-scale pilot program and found that DPP's were cost saving in the Medicare population (peer reviewed publication here).  CMS will roll out DPPs as a new Medicare preventive benefit in 2018, and plans to include both "brick and mortar" and virtual providers, since both have been proven similarly effective, including in the Medicare population (report of publication, here).  For CMS updates and more CMS links, see the CMMI DPP website, here.

Omada Health
For its home page, here.   For current news articles on Omada, here.  For an undated, but detailed, interview with founder Sean Duffy, here.  See also an announcement of a three-way partnership between Omada, AMA, and Intermountain Health in 2016, here.

Through 9/2015, Omada had previously raised at least $77M (here).  Besides Cigna, investers include Norwest, Humana and Providence, Oak and Oxeon,

Reimbursement Processes
AMA has been in the process of creating Category III codes for both "brick and mortar" and virtually delivered DPP services.   For more details of the Medicare program being planned for CY2018, see Medicare's Part B annual public rulemaking, which will be published in the Federal Register circa July 1.  CMS plans to create a new provider category specific to DPP which will be cross-linked to CDC DPP provider certification.

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image from Omada's press release website.