Commitment Statement:

The Omada Program is a digital therapeutic based on the Center for Disease Control’s (CDC’s) National Diabetes Prevention Program (DPP), designed with the goal of the prevention of obesity-related chronic diseases. Through an engaging digital experience, participants focus on the goals of losing body weight and increasing physical activity.

Omada ties all reimbursement/payment to engagement and participant outcomes in the program. After one initial reimbursement when the patient initiates the program, Omada’s monthly revenue is solely based on the percent of weight loss achieved by that participant in that month. There are no other charges for any element of the program.

Omada provides a valuable tool to organizations engaged in APMs by allowing them to address a population most likely to drive healthcare spending in the very near future. These individuals, already at the tipping point of diabetes, will soon be among the highest utilizers of healthcare resources. DPP’s focus on behavior change – diet, exercise, sleep, and stress – to support weight loss is important given the proven, direct relationship between weight loss, biomarker improvement, and chronic disease risk reduction. Omada enables organizations to intervene with these individuals before they develop chronic conditions.

Actions:

  1. Drive value based reimbursement models for digital health.
  2. Apply and advocate for medical coding that supports alternative payment models.
  3. Support APM by enabling health systems and payers to reduce costs associated with the development of chronic disease.

 

Commitments:

  • Educate members/stakeholders/consumers on the importance of APM adoption
  • Provide written and technical resources and assistance in support of APM adoption
  • Spread best practices around APM adoption
  • Encourage business associates to operate under value-based payment arrangements/APMs
  • Influence policy makers regarding the merits of APM adoption
  • Invite LAN experts to speak at meetings/events
  • Share LAN materials and information
  • Encourage partners and stakeholders to provide input into LAN activities
  • Provide leadership on and participation in LAN committees and workgroups

Website:

Omada Health, Inc.

To achieve the goal of better care, smarter spending, and healthier people, the U.S. health care system must substantially reform its payment structure to incentivize quality, health outcomes, and value over volume. The Health Care Payment Learning and Action Network (LAN) was established as a collaborative network of public and private stakeholders, including health plans, providers, patients, employers, consumers, states, federal agencies, and other partners within the health care community.

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