DiMe convenes payers and virtual-first care providers to close the operational gap that leaves contracted virtual care providers invisible to patients

Omada Health (NASDAQ: OMDA) joined the Digital Medicine Society (DiMe) as title sponsor of the Post-Contracting Operational Readiness for Virtual-First Care project.

Rhea-AI Summary

Omada Health (NASDAQ: OMDA) joined the Digital Medicine Society (DiMe) as title sponsor of the Post-Contracting Operational Readiness for Virtual-First Care project. The 3.5‑month initiative will build a toolkit that helps payers and virtual-first providers integrate, list, and reimburse contracted virtual care within 90 days.

Argus Jun 9 session

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Details

News Market Reaction – OMDA

On Jun 9, the day this news came out, OMDA closed 2.46% above the previous close.

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Key Figures

Post-contract window: first 90 days Contracting time cut: up to 18 months Provider directory deadline: 2026 +5 more

Post-contract window

first 90 days

Integration, discoverability, reimbursement target after contract signature

Contracting time cut

up to 18 months

Prior DiMe V1C toolkit impact on time to contract

Provider directory deadline

2026

Provider directory accuracy requirements under the No Surprises Act

MA directory data

2027

CMS Final Rule requiring Medicare Advantage directory data submission

Experience duration

more than ten years

Omada operating virtual cardiometabolic care at scale

Sprint duration

three-month sprint

Initial convening period to build operational readiness toolkit

Project length

3.5-month focused sprint

Overall project timeline before releasing resources

Scorecard horizon

90-day operational readiness scorecard

Timeline for validating directory accuracy, access, claims performance

Historical Context

5 past events · Latest: May 27

5 events

1. May 27

   Conference participation

   24h Move

   +2.2%

   Management appearance at major Goldman Sachs healthcare conference with webcast access.

2. May 07

   Access partnership

   24h Move

   -9.6%

   Joined Lilly Employer Connect to expand GLP‑1 Care Track access channels.

3. May 07

   Q1 2026 earnings

   24h Move

   -9.6%

   Reported strong revenue and member growth with improving profitability metrics.

4. Apr 17

   Clinical study data

   24h Move

   +5.8%

   GLP‑1 Care Track study showed superior weight and body composition outcomes.

5. Apr 16

   Earnings date set

   24h Move

   +1.9%

   Announced date and webcast details for upcoming Q1 2026 results call.

24h Move is the share-price change in the day after each event; other market factors may also have contributed.

Key Terms

virtual-first care, telehealth, cms final rule, medicare advantage, +4 more

8 terms

virtual-first care medical

"Post-Contracting Operational Readiness for Virtual-First Care project."

A care model where patients are directed to remote consultations (video, phone or chat) as the primary way to get medical help, with in-person visits arranged only when necessary. For investors, it signals potential shifts in how healthcare is delivered and paid for—like an online bank that keeps branches for complex tasks—affecting patient volumes, cost structure, recurring revenue models and partnerships across providers, insurers and tech vendors.

telehealth medical

"new telehealth status tracking expectations, and the CMS Final Rule"

Telehealth is the delivery of healthcare services and consultations remotely using video calls, phone, text messaging, or connected devices to monitor and transmit medical information. It matters to investors because it can reshape how patients access care, lower costs, and create new revenue streams or risks for healthcare providers, insurers and technology companies—similar to how online banking changed financial services—while also exposing businesses to reimbursement and regulatory shifts.

cms final rule regulatory

"and the CMS Final Rule requiring Medicare Advantage directory data submission"

A CMS final rule is an official regulation issued by the U.S. Centers for Medicare & Medicaid Services that sets how government health programs operate, including payment rates, coverage rules, and reporting requirements. For investors, it matters because these rules can change how much healthcare providers, insurers, and drug or device makers are paid or must spend to comply—similar to a new instruction manual that can raise or lower a business’s revenue and costs overnight.

medicare advantage regulatory

"CMS Final Rule requiring Medicare Advantage directory data submission by 2027."

Medicare Advantage is a type of health insurance plan offered by private companies that covers services traditionally provided by government-run Medicare. Think of it as a bundled package that combines hospital, doctor, and other medical care into one plan, often with added benefits. For investors, it matters because the popularity and profitability of these plans can influence healthcare companies and the broader health insurance industry.

no surprises act regulatory

"2026 provider directory accuracy requirements under the No Surprises Act,"

A federal law that protects patients from unexpected out-of-network medical bills by limiting what providers and insurers can charge when care is received without a clear cost agreement. For investors, it changes how hospitals, physician groups, insurers and medical billing firms set prices, collect revenue and resolve payment disputes—similar to changing the rules of a game, it can shift revenue streams, margins and legal risk across the healthcare sector.

provider directory regulatory

"compliance exposure under provider directory rules, and weaker returns"

A provider directory is a maintained list of medical professionals, clinics and hospitals that participate in an insurer’s or health plan’s network, including basic contact details, specialties and whether they are accepting patients. For investors, it matters because the size, accuracy and accessibility of the directory affect how easily customers can find care, plan enrollment and claims flow—similar to how a reliable map helps drivers reach destinations and keeps traffic moving.

cardiometabolic medical

"delivered virtual cardiometabolic care for more than ten years, serving"

Cardiometabolic describes health conditions that affect the heart and the body’s metabolism—most commonly heart disease, high blood pressure, type 2 diabetes and obesity—that often occur together and share common causes. Investors care because these linked conditions drive large, predictable demand for drugs, medical devices and long-term care, and changes in treatment options, guidelines or costs can materially affect healthcare company revenues and government spending much like a problem in an engine and its fuel system impacts the whole vehicle.

claims performance financial

"validation checkpoints for directory accuracy, member access, and claims performance."

Claims performance measures how well an insurer or health plan handles customer claims — including how quickly claims are paid, how accurately they are processed, and how much they cost — similar to grading a company on fulfilling customer orders correctly and on time. Investors watch claims performance because it directly affects profits, cash reserves and reputation: poor performance can mean higher payouts, surprise losses, regulatory scrutiny and slower growth.

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Omada Health joins as title sponsor, bringing more than a decade of experience operating virtual care at scale across millions of members

BOSTON, June 9, 2026 /PRNewswire/ -- The Digital Medicine Society (DiMe) welcomes Omada Health as title sponsor to its Post-Contracting Operational Readiness for Virtual-First Care project. The initiative will develop shared operational best practices to ensure that contracted virtual care providers are fully integrated, discoverable, and reimbursable within the first 90 days after contract signature. Building on DiMe's prior V1C work, focused on co-creating a payer-provider contracting toolkit that cut time to contract by up to 18 months, this project carries that progress past the signature into real-world care delivery.

Commercial payers have expanded contracting with virtual-first care providers across many specialties, and virtual care companies have built scaled clinical models and secured national and regional contracts. What has not kept pace is the operational work required to make those partnerships function in day-to-day care for patients.

The result is a gap between what exists on paper and what patients can actually access. Providers are legally in network but operationally out of reach. They burn through capital sorting out denials while patients face avoidable cost and delay. For payers, the same breakdown drives member frustration, compliance exposure under provider directory rules, and weaker returns on virtual care investments.

This work aligns directly with 2026 provider directory accuracy requirements under the No Surprises Act, new telehealth status tracking expectations, and the CMS Final Rule requiring Medicare Advantage directory data submission by 2027.

"For years, healthcare has treated contract execution as the finish line for virtual care. In reality, it's the starting line," said Jennifer Goldsack, CEO of the Digital Medicine Society (DiMe). "Patients cannot benefit from providers they can't find, appointments they can't access, or services that aren't reimbursed correctly. As CMS raises the bar for provider directory accuracy and transparency, healthcare needs a shared operational playbook that ensures contracted providers are integrated, discoverable, and reimbursable from day one. That should be the standard, every time. It's a solvable challenge, and we're delighted to partner with Omada and other leaders in the field to establish that standard across the field."

Omada Health joins as title sponsor at a moment when payers are looking for partners who can stand up quickly, plug into existing operations, and deliver durable outcomes across benefits design. As an accredited, clinically rigorous, in-between-visit care provider, Omada has delivered virtual cardiometabolic care for more than ten years, serving millions of members, and offering flexible price points and benefit configurations so plans can match programs to member needs.

"Virtual care can help bend the curve of chronic disease, but it only delivers at scale when the operations behind it are as strong as the clinical model," said Wei-Li Shao, President at Omada Health. "Payers need evidence, not hype, and Omada is partnering with DiMe to share insights from the playbook we have built over the last decade so virtual‑first care becomes a dependable, scalable part of how chronic care is delivered, not a side project."

The initiative is being shaped by leading national and regional health plans and payers who seek to support virtual care at scale. Blue Shield of California, a returning DiMe partner, is participating to help define what operational readiness should look like across the field.

"Virtual-first care is quickly becoming a foundational component of modern health plan design—driving improved access, better navigation, and more efficient utilization." said a leading payer project partner. "Through our participation in the DiMe V1C Contracting Project, we are helping to co-develop the tools, best practices, and standards that enable these models to scale responsibly, ensuring members receive high-quality, coordinated care across an increasingly digital ecosystem."

Over a focused three-month sprint, DiMe will convene a curated group of commercial payers, virtual-first care providers, and policy advisors to build the Post-Contracting Operational Readiness Toolkit for Virtual-First Care. The toolkit maps the full path from contract signature to first successful claim and will include:
 

• A defined operational pathway from contract execution to first claim, naming the systems, teams, and handoffs where breakdowns most often occur.
• A minimum viable data and integration standard, so a provider can submit one common data packet and every payer knows how to map it.
• A 90-day operational readiness scorecard that assigns ownership across functions and sets validation checkpoints for directory accuracy, member access, and claims performance.
• A practical set of common failure points and fixes, drawn from real payer and provider experience.

This initiative carries that progress past the signature and into real-world delivery. The project will be a 3.5-month focused sprint, kicking off this summer, with resources released in the Fall of 2026. DiMe is actively welcoming additional payers and virtual-first care providers to join the cohort before kickoff.

About the Digital Medicine Society (DiMe)
The Digital Medicine Society (DiMe) is a global nonprofit organization dedicated to advancing the safe, effective, equitable, and ethical use of digital technologies to redefine healthcare and improve lives. DiMe delivers open-access resources, multi-stakeholder collaborations, and evidence-based frameworks to accelerate the responsible digitization of healthcare. Learn more at www.dimesociety.org.

About Omada Health
Omada Health (Nasdaq: OMDA) is reverse-engineering the way healthcare is delivered in America, putting the space between doctor visits–where health is won or lost–at the center of care. Today's healthcare system poorly serves chronic conditions that require ongoing support outside of the exam room, like obesity, diabetes, hypertension, cholesterol, and musculoskeletal conditions. Omada's virtual-first model combines human-led care teams, connected devices, and AI-enabled technology to deliver personalized care at scale, including support for GLP-1 therapy. Omada has served more than two million members since launch across 2,000+ employers, health plans, pharmacy benefit managers, and health systems. Learn more at omadahealth.com.

Media contact:
DiMe: press@dimesociety.org
Omada: Rose Ramseth; Press@OmadaHealth.com

View original content to download multimedia:https://www.prnewswire.com/news-releases/dime-convenes-payers-and-virtual-first-care-providers-to-close-the-operational-gap-that-leaves-contracted-virtual-care-providers-invisible-to-patients-302794816.html

SOURCE Digital Medicine Society (DiMe)

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What did Omada Health (NASDAQ: OMDA) announce with the Digital Medicine Society in June 2026?

Omada Health announced it is title sponsor of DiMe’s Post-Contracting Operational Readiness for Virtual-First Care project. According to DiMe, the initiative will create shared operational best practices to integrate, list, and reimburse virtual-first providers more reliably after payer contracts are signed.

What is the goal of DiMe’s Post-Contracting Operational Readiness Toolkit for virtual-first care providers and OMDA?

The toolkit aims to map the path from contract signature to first successful claim for virtual-first care. According to DiMe, it will define workflows, data standards, scorecards, and common fixes so contracted virtual providers become discoverable and reimbursable in routine patient care.

How will the DiMe and Omada Health (OMDA) project address virtual care access for patients?

The project focuses on making contracted virtual-first care providers visible and accessible to members within 90 days. According to DiMe, it targets directory accuracy, member access, and claims performance, helping close the gap between on-paper network participation and real-world patient use.

What specific tools will the DiMe and Omada Health virtual-first care initiative create by Fall 2026?

The initiative will create an operational pathway, data standard, readiness scorecard, and failure-point playbook. According to DiMe, these resources will outline systems, handoffs, integration requirements, ownership roles, and practical fixes to support scalable, compliant virtual-first care operations across commercial payers.

How long will the DiMe and Omada Health (OMDA) virtual-first care project run and when are outputs expected?

The project is designed as a focused 3.5‑month sprint starting in summer 2026. According to DiMe, resulting resources, including the Post-Contracting Operational Readiness Toolkit, are expected to be released in Fall 2026 for broad use by payers and virtual providers.

Which stakeholders are involved in the DiMe and Omada Health virtual-first care operational readiness cohort?

The cohort includes commercial payers, virtual-first care providers, and policy advisors, with Blue Shield of California as a participant. According to DiMe, additional payers and virtual-first providers are being welcomed before kickoff to help shape field-wide operational standards.