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

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

PR Newswire

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.

Delivering clinical quality resources on a tech timeline to advance the safe, effective, ethical, and equitable use of digital medicine to optimize human health.

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

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SOURCE Digital Medicine Society (DiMe)