WellTheory announced this week that, in its first deal with a payer, the company will provide Sentara Health Plans' nearly one million members in Virginia and Florida with access to a dedicated care team providing 12 months of autoimmune care.
WHY IT MATTERS
Once members join WellTheory's platform, they can start their virtual care journey with root cause assessments that can uncover what's driving their autoimmune symptoms. The platform can help patients "suffering in silence" address hard-to-pinpoint autoimmune reactions, reducing their reliance on medications that treat symptoms, missed work days and healthcare costs.
The platform could also lower overall medical costs for health plans and employers, says Ellen Rudolph, the company's CEO and cofounder.
"I cost my health plan over $20,000 in just one year of my diagnosis journey trying to get answers," she said in Tuesday's announcement.
The proprietary patient assessment is delivered by a dedicated care team, including a licensed registered dietitian, a board-certified health coach and a care coordinator, WellTheory said.
Once the team uncovers the drivers of each member’s symptoms, they create personalized care plans that include one-on-one video visits, unlimited messaging and access to digital tools.
Sentara's members will receive the insurance-covered, high-touch services for a six-month intensive phase followed by six months of maintenance support, WellTheory said. Through the collaboration, the not-for-profit health system plans to focus on improving outcomes for underserved communities.
"At Sentara Health Plans, we’ve always believed that healthcare should be as diverse and dynamic as the people we serve," said Dr. Kristyn Greifer, Sentara Health Plans' senior vice president and chief medical officer, in a statement.
THE LARGER TREND
WellTheory launched its consumer platform in 2023 to support the 50 million Americans suffering from autoimmune diseases with 12-week programs designed to improve symptoms of fatigue, pain and more.
"They’re frequenting ER/urgent care less," Rudolph told Healthcare IT News by email after an entrepreneurial pitch event last year. Data gleaned from the consumer platform found users were "relying less on expensive medications and missing fewer days of work," she noted at the time.
Since those reductions realize savings to health plans and self-funded employers, Rudolph explained that WellTheory was forging partnerships to expand access to the platform through self-funded employers and payers.
Through enterprise partnerships, the company could serve more autoimmune patients in need of care, "particularly those unable to afford our services out-of-pocket," she said then.
By 2024, the company launched its first employer partnership with virtual provider Maven Clinic, which offers two virtual visits and unlimited messaging with WellTheory's autoimmune disease coaches. Then, last month, WellTheory raised $5 million to further the platform's artificial intelligence capabilities.
AI is helping healthcare providers decipher and diagnose the inflammatory pathways that trigger various autoimmune diseases, according to the Global Autoimmune Institute.
"Our AI-powered platform allows us to scale care while deeply tailoring it to each member's needs," Rudolph told MobiHealthNews, a sister publication to Healthcare IT News. "This is more than just technology – it's the foundation for a smarter, more connected future of autoimmune care."
ON THE RECORD
"Autoimmune disease is one of the biggest cost drivers in healthcare today – and yet most people still go years without a diagnosis or effective treatment," Rudolph said in a statement.
"By partnering with WellTheory, we’re taking an important step in offering our members personalized solutions that meet them where they are – especially those navigating the complexities of autoimmune disease," Greifer added.
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.
