How the payer space changed in 2021, from virtual-first plans to digital mental health

More payers launched virtual-first plans, insurtechs went public, and the digital mental health space brought in plenty of funding dollars this year.
By Emily Olsen
11:05 am
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Photo: Jose Luis Pelaez Inc/Blend Images

COVID-19 changed how healthcare was delivered by accelerating the use of virtual care and telehealth

But insurers, employers and other payers are jumping on the virtual bandwagon too, hoping to lower the cost of care by offering technology and digital solutions to their members. 

More players launched virtual-first health plans, some big insurtechs hit the public markets this year, and digital behavioral and mental healthcare became one of the most popular clinical areas for investors. 

Virtual-first plans

In 2021, several insurers and startups launched their own virtual-first health plans, insurance where the first point of contact to the medical system is telehealth.

In October, major insurer UnitedHealthcare launched a virtual-first plan called NavigateNOW, developed with its sister company Optum. Under the plan, patients would have their own care team based on their needs, led by a primary care provider who would meet with the patient virtually. That provider could connect the patient to in-person resources when necessary. 

Another big insurer, Cigna, also revealed its own virtual-first plan for select employers using its recently acquired telehealth platform, MDLive. Telehealth giant Teladoc Health partnered with Trustmark Health Benefits to offer its virtual plan, built around Teladoc’s new primary care service, Primary360. 

Startup Firefly Health also launched a virtual-first offering geared toward small and midsize employers.

“Everyone deserves access to affordable, quality care rooted in empathy. This is a tremendous opportunity to take back control over healthcare and address the financial strain it places on individuals and businesses,” Fay Rotenberg, Firefly Health CEO, said in a statement when the plan was announced.

Insurtechs go public

Just days into 2021, Medicare Advantage insurtech Clover Health wrapped up its merger with a special purpose acquisition company and began trading on Nasdaq. About a month later, Oscar Health announced its plans to kick off an IPO and began trading publicly in early March. Bright Health hit the New York Stock Exchange in June. 

Since then, results have been murky. A STAT analysis showed share prices for the three companies have plummeted since they went public. Though Clover beat expectations in the third quarter, it still posted a $34.5 million income loss.

Bright Health reported a GAAP net loss of $296.7 million, though its revenue did increase from the prior-year quarter. It also scored a $750 million investment earlier this month.

Oscar also reported an increase in revenue in Q3 compared to last year, but it reported a net loss too

Behavioral healthcare at home

Behavioral and mental healthcare were front of mind in 2021, as Americans reported increased symptoms of anxiety and depression during the pandemic

But providing therapy or other mental healthcare also translated well to delivery at home. In September, about 61% of telehealth claim lines were for diagnosing mental health conditions, according to FAIR Health’s Monthly Regional Telehealth Tracker

Investors took notice too, with Rock Health noting mental health startups raked in $3.1 billion in funding through the third quarter.

Many of these companies are focused on partnering with payers, and work with employers or insurers to offer their services as a benefit to workers and members. BetterUp, a behavioral coaching company, closed a $300 million Series E round in October.

Spring Health raised a $190 Series C in September. Lyra Health scooped up $200 million. Meditation app Headspace merged with digital mental health company Ginger to form Headspace Health, reportedly valued at $3 billion. 

“Employers are starting to recognize they’ve got a real role to play and responsibility in addressing these issues,” Solera Health CEO Mary Langowski told HIMSSTV in September. “Because if they don’t step up, no one else will.”

 

Looking ahead at 2022

What the uptick in interest and usage of digital health will mean for the future of healthcare and what to expect in 2022 for the industry.

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