Putting Our Money Where Our Medicine is—Reversing Diabetes with 100% of Fees at Risk

November 14, 2018
February 4, 2020

We founded Virta to not only reverse type 2 diabetes in millions of patients, but also to substantially lower the cost of chronic disease for payers and society as a whole. Now that we have both clinical trial and commercial results showing that we can reverse type 2 diabetes and reduce costs on a population level, we are ready to fully align our economic incentives with those of our patients and payer partners.

I am thrilled to announce that as of today, 100% of Virta’s fees are performance-based and tied to type 2 diabetes reversal outcomes for our employer and health plan partners. I am hopeful and optimistic that the rest of the healthcare industry will also transition away from fee-for-service based medicine which incentivizes procedures over outcomes.

Using transformational outcomes to go at-risk

Fully at-risk models are of course impossible to implement without the ability to save payers a lot of money by repeatedly delivering transformational health improvement. This is one of the reasons why at-risk payment models are still rare, especially in chronic disease treatment. Traditional disease management tools and services have not been able to reduce the cost of chronic disease care, and in many cases they have just added to the total economic burden. We have been able to break this trend by reversing type 2 diabetes and rapidly eliminating costly medications among our Virta patients.

In fact, we are excited to provide a first-look at the outcomes of our commercial patients who participate the in Virta Health Registry.* At one year, real-world results match or exceed what we see in our peer-reviewed clinical trial outcomes. Specifically:

  • 61%: patients achieving diabetes reversal
  • 77%: diabetes-specific medication prescriptions eliminated amongst patients
  • 90%: patient retention at one year

It is these results combined with our cost savings estimates—on average $9,600 per patient in pharma and medical costs in the first 24 months alone—that reflect the reversal advantage and allow us to go 100% at-risk with a simplified approach. In our model, payers pay an enrollment fee only after an engagement milestone is met, ensuring patients stay active during the critical early stages of treatment.

After that, every dollar, and the majority of overall payment, is tied to health improvement based on diabetes reversal metrics such as HbA1c reduction—without per-member per-month payment or implementation fees. This means that if our patients don’t substantially improve their health, then our employer and health plan partners don’t pay. This is how most, if not all, of health care should be.

Aligning our care model with our business model

Going at-risk is much more closely aligned with Virta’s model of continuous remote care that is used to deliver our interventions. Traditional fee-for-service structures built for infrequent provider visits every 3-6 months are simply not compatible with our care model of giving patients unlimited access to and support from our technology-enabled Virta medical providers. Continuous remote care allows us to reverse type 2 diabetes sustainably while safely removing medications as metabolic health is restored through Virta’s individualized therapies.

As of this moment, we are treating thousands of patients like Kim, Neha and Preston, from all walks of life in 49 of 50 U.S. states. We are working hard to scale access to Virta to millions of patients in the coming quarters, while saving payers a lot of money in the process.

This is just another step in a very long journey to make diabetes a thing of the past, but it is a significant milestone on our way to making diabetes reversal accessible to everyone in the U.S. and beyond.

Sami Inkinen
Co-founder and CEO

If you are a benefits buyer or other healthcare professional looking to learn more about our fees-at-risk model, please join us for a special webinar on December 12th, 2018.

Footnote

Virta Health Registry for Remote Care of Chronic Conditions. Health and economic outcomes among commercially-referred patients enrolled one year, September 2018. One year retention across Virta Health Book of Business. Diabetes-specific medication refers to all classes excluding metformin. Metformin is excluded from these reversal criteria because it is not diabetes-specific—many patients choose to stay on this medication for reasons other than blood sugar control.

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