Virtual opioid addiction service Bicycle Health joins Cigna's Evernorth

The company hopes to reach the 90% of people who need treatment but don't pursue it

The pandemic led to a rise in addiction and drug overdoses, with a 14% increase in opioid-related overdose deaths from 2020 to 2021. On top of that, there are millions of Americans struggling with addiction, but only 10% are diagnosed or in treatment. 

There are many reasons why Americans aren’t able to access the addiction treatment they need to manage their opioid use disorder, explained Ankit Gupta, CEO and founder of Bicycle Health, a virtual addiction medicine clinic that helps treat opioid dependence or use disorder, to VatorNews, including that 40% of rural Americans live in a county without a single provider that offers medications for addiction treatment.

'Traditional treatment options are prohibitively expensive and time consuming–with in-person rehabilitation stays costing upwards of $15,000 for a one-month stay and requiring long stints away from work and family. Not to mention, the societal stigma around addiction precludes many from seeking traditional treatment options out of fear of discrimination and isolation," he said.  

Since its founding in 2017, Bicycle Health has served over 17,000 patients across 24 states, and now it will be able to reach an even larger number people as the company announced on Thursday that it has joined Evernorth’s behavioral health network.

"There are two big issues needed to be solved. One, 90% of people who are in need of treatment do not pursue it. Two, among those patients who do, retention is significantly higher (double) if they can pay with their health insurance," said Gupta.

"Working with Cigna allows us to partner with them to reach more of those 90% who need help, but don’t get it, with a simple, proven, private treatment option that is covered by their insurance."

Through this partnership, Bicycle will be available to all Evernorth clients, as well as Cigna health plan customers who receive health coverage through their employer or marketplace exchange plans in 24 states. Evernorth is the health services business of Cigna Corporation.

This partnership "is a huge step for our company and will increase access to affordable treatment for millions of Americans," Gupta explained, as with each major payor partnership, the company hopes to illustrate the efficacy of MAT, as well as telehealth as a more successful tool for addiction treatment than traditional in-person treatment models.

"Health insurance and the cost of treatment are a common concern for those seeking addiction treatment, making recovery financially restrictive for many. We are currently covered by Blue Cross Blue Shield, Aetna, Anthem, many Medicaid managed care organizations, such as Molina Healthcare, McLaren Health, and UnitedHealthcare, and now Cigna Evernorth," he said.

The reason Cigna decided to partner with Bicycle Health, according to Gupta, is threefold: they believe in the dire need for access to treatment, that stigma is an issue that can only be addressed through virtual care, and that Bicycle's clinical model is a strong mechanism for addressing these issues. 

Despite it being early days in the partership, Bicycle is already enrolling over 95% of qualified, prospective patients who have Cigna as their insurance, including new patients and existing patients who were paying with cash. Going forward, the two entities will work together on outreach to that 90% who are not yet in treatment, and integrate them into their care management program. 

"Not only will this partnership with Cigna Evernorth make our services available to a larger coverage area, but we hope that it further addresses OUD stigma by opening the door for OUD treatment across employer health plans. Through this collaboration, we hope that more people feel empowered to take back their life from the grip of opioids now that they have access to our treatment that is safe, affordable, and effective," said Gupta. 

The Bicycle Health solution

Bicycle Health's solution involves prescribing FDA-approved medications, including Suboxone, as part of its treatment; it also provides Clinical Support Specialists, who work from 6am to 8pm PDT every week day and are available via text, chat, or phone through its app, as well as online chat and appointments, prescription refills that are are sent via email to a local pharmacy, and online support groups.

When a patient signs up for Bicycle Health, they will chat with the company about their situation, who determines if they are a fit for the program. If the patient is suited for Bicycle Health’s services, the company will schedule a meeting with a physician, usually within 3 hours and, from there, the patient will work with the provider to receive a treatment plan that’s convenient, trustworthy, and completely customized to the patient and their individual needs. If the medical provider decides that Suboxone is the appropriate treatment, they can pick up their prescription on the same day from a nearby pharmacy. 

Once the patient is onboarded, they have access to therapy, both individual and group, peer-support programs that run several times a day, seven days a week, and social support services from its licensed clinical social workers, who help with life goal setting, housing support, violence prevention, and employment and nutrition. 

The company accepts most major insurances, and it also offers a self-pay monthly program fee of $199 per month, which includes doctor’s visits, unlimited instant messaging, care navigation and online therapy groups. 

"Telehealth has been an extremely beneficial treatment option because it removes many of the barriers that otherwise prevent people from seeking treatment, such as the stigma associated with being seen at a clinic, lack of available clinics nearby, ability to take extensive time off work or from family responsibilities," explained Gupta, though he also noted there are still barriers to overcome in its mission to make OUD care more accessible.

For example, Alabama, which has the highest opioid dispensing rate at 80.4 per 100 people, announced in July that it was discontinuing waivers stemming from COVID-19 that allow for the virtual treatment of mental health. In response, the company created the Alabama Airdrop, in which it flew in a team of providers and clinical support to Alabama to conduct in-person exams that would allow for their patients to continue accessing their prescriptions via telehealth for another 12 months. 

"We’re dedicated to doing everything we can to help patients continue to access care, and ultimately work to make telehealth OUD care available to all patients who need it," said Gupta.

In terms of ROI, the most common metric for addiction treatment is retention at 90 days, and Bicycle's 90-day retention rate is 80% for patients who can pay with health insurance and 70% at one year for patients who get past the 90 day mark. No-show rates for doctor’s visits were 9.5% for Bicycle's patients, compared to the 23% average of in-person treatment.    

(Image source: bicyclehealth.com)