How Digital Therapeutics Can Help Payers Out of Regulatory Fix


Commercial health plans will soon face a new Federal rule that will require them to provide counseling to obese and some overweight beneficiaries-and most will need help complying. Omada Health co-founder and CEO Sean Duffy, writing this month in Evidence-Based Diabetes Management, tells how the CDC has opened the door for digital health programs to offer a scalable, effective solution.


PLAINSBORO, N.J.—Almost a year ago, the US Preventive Services Task Force called for commercial health plans to offer behavioral health counseling for persons who are obese and those who are overweight with at least one cardiovascular risk factor. Just how that would happen was less clear.

That mandate will affect any commercial health plan with a program year start after August 26, 2015. But a new branch of medicine, dubbed digital therapeutics, can be part of the solution, according to a commentary by Omada Health CEO Sean Duffy that appears online today in Evidence-Based Diabetes Management, a publication of The American Journal of Managed Care. The full commentary can be found here.

As Duffy explains, health plans can deploy digital programs that have received recognition for meeting the evidence-based standards of the Diabetes Prevention Recognition Program, run by the Centers for Disease Control and Prevention (CDC). Some digital programs have demonstrated similar or better results than the in-person Diabetes Prevention Program, which has been widely used since its landmark clinical trial almost two decades ago.

The challenge for this type of behavioral counseling has always been scalability—how can the CDC and health plans reach the estimated 87 million Americans who have prediabetes before they progress to type 2 diabetes?

”The scope of the prediabetes epidemic —along with other obesity-related chronic conditions in this country – is staggering,” said Sean Duffy. “The only way to effectively reach the population at the tipping point for these diseases and change individual behavior is to scale up the delivery of these interventions – and digital programs must be part of the solution.”

About the Journals

The American Journal of Managed Care celebrates its 20th year in 2015 as the leading peer-reviewed journal dedicated to issues in managed care. Other titles in the franchise include The American Journal of Pharmacy Benefits, which provides pharmacy and formulary decision-makers with information to improve the efficiency and health outcomes in managing pharmaceutical care, and The American Journal of Accountable Care, which publishes research and commentary on new healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s news publications, the Evidence-Based series, bring together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.

For information on AJMC Contact:

Nicole Beagin (609) 716-7777 x 131

About Omada Health

Omada Health is a digital health company that inspires people to change the habits that put them most at risk for serious but preventable chronic conditions, like diabetes or heart disease. The company brings world-class behavioral medicine to anyone with an Internet connection, using insights about social networking, gaming, and behavioral science to motivate changes in lifestyle. Backed by investors including Andreessen Horowitz, Omada was named one of FastCompany’s 50 Most Innovative Companies of 2015. Omada recently expanded Prevent curriculum to cover those at risk for diabetes, heart disease, and other obesity-related chronic conditions. Omada delivers Prevent through enterprise clients, including employers Costco, Lowe’s, and Iron Mountain, as well as health plans Kaiser Permanente, Humana, and BlueCross BlueShield of Louisiana. To learn more, visit or

For more information on Omada Health, contact:

Adam Brickman

(914) 548-3748

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