🧵 1/ if you're watching digital health stocks like $hnge, $omda, and $drio, the latest CMS proposal for the 2026 Physician Fee Schedule is worth your attention. It could be a real tailwind for companies tackling chronic disease management through telehealth and virtual care.
In this thread, we break it down step by step - proposal details first, then a deep dive into why these names might benefit, with fresh fundamentals.
But remember: DYOR as always!
In this thread, we break it down step by step - proposal details first, then a deep dive into why these names might benefit, with fresh fundamentals.
But remember: DYOR as always!
2/ Quick recap: Last week, CMS dropped a proposed rule aimed at slashing wasteful spending in Medicare while boosting care quality and chronic disease management.
For 2026, they're pushing for new codes in Advanced Primary Care Management (APCM) to make primary care more effective and integrated.
For 2026, they're pushing for new codes in Advanced Primary Care Management (APCM) to make primary care more effective and integrated.
3/ Key focus on chronic conditions: CMS wants to lower barriers for weaving behavioral health into primary care.
Think optional add-on codes for things like Behavioral Health Integration (BHI) or the Psychiatric Collaborative Care Model (CoCM). This could make holistic care easier and more billable.
Think optional add-on codes for things like Behavioral Health Integration (BHI) or the Psychiatric Collaborative Care Model (CoCM). This could make holistic care easier and more billable.
4/ Diabetes gets a spotlight too - the Medicare Diabetes Prevention Program could expand access to coaching, peer support, diet tweaks, exercise plans, and behavior strategies.
Plus, they're eyeing broader payments for digital mental health tools, even soliciting input on stuff like ADHD treatments and other digital therapies.
Plus, they're eyeing broader payments for digital mental health tools, even soliciting input on stuff like ADHD treatments and other digital therapies.
5/ Telehealth fans, rejoice: CMS is proposing to lock in some COVID-era flexibilities permanently. No more frequency caps on follow-up inpatient/nursing facility visits or critical care consults.
They'd also allow permanent direct supervision via audio-video for select services and simplify adding new telehealth services to the list.
They'd also allow permanent direct supervision via audio-video for select services and simplify adding new telehealth services to the list.
6/ For rural clinics and FQHCs, telecom billing (including audio-only) gets extended through end of 2026. Overall, this streamlines digital mental health payments and encourages preventive care over just meds.
Comment period ends Sept 12, final rule likely Sept-Nov. If it sticks, expect easier reimbursement for virtual chronic care.
Comment period ends Sept 12, final rule likely Sept-Nov. If it sticks, expect easier reimbursement for virtual chronic care.
7/ Now, how does this tie into $HNGE, $OMDA, $DRIO?
These players are all about AI-driven, virtual platforms for chronic issues like diabetes, MSK pain, hypertension, and behavioral health.
CMS's push could open up Medicare revenue streams and boost adoption. Let's analyze each with real numbers - no fluff, just facts for investors.
These players are all about AI-driven, virtual platforms for chronic issues like diabetes, MSK pain, hypertension, and behavioral health.
CMS's push could open up Medicare revenue streams and boost adoption. Let's analyze each with real numbers - no fluff, just facts for investors.
8/ First up, $DRIO (DarioHealth): They deliver an AI platform with connected devices, apps, and coaching for diabetes, hypertension, weight, and MSK.
Seems like a perfect fit for CMS's diabetes prevention and chronic mgt
(image source: dario's jan 2025 corp presentation)
Seems like a perfect fit for CMS's diabetes prevention and chronic mgt
(image source: dario's jan 2025 corp presentation)
9/ Fundamentals check for $drio: FY2024 revenue hit $27.0M, up 33% YoY from $20.4M. Q1 2025: $6.75M (+17% YoY, though -11% sequential due to seasonal factors).
Analysts eye ~$32M for full 2025. Q1 EPS -0.12 (missed est -0.05), but B2B2C growth is strong - watch for GLP-1 integrations driving upside.
Market cap ~$30M, trading around $0.70. Risks: Losses ongoing, but telehealth permanency could accelerate
(image from tradingview)
Analysts eye ~$32M for full 2025. Q1 EPS -0.12 (missed est -0.05), but B2B2C growth is strong - watch for GLP-1 integrations driving upside.
Market cap ~$30M, trading around $0.70. Risks: Losses ongoing, but telehealth permanency could accelerate
(image from tradingview)
10/ Next, $OMDA (Omada Health): Virtual programs for diabetes prevention, hypertension, MSK, and weight mgt, heavy on coaching and behavior change - aligns spot-on with CMS's prevention and peer support vibes. Fresh off June IPO at $19/share, raised $150M.
11/ Numbers: 2024 revenue $169.8M (solid growth). Q1 2025: $55M, +57% YoY from $35.1M - impressive momentum.
Net losses are narrowing (2023 was -$67.5M; expect updates Aug 7).
Valuation post-IPO ~$1.1B.
Why watch? CMS changes could supercharge employer/health plan deals, especially with GLP-1 demand.
Downside potential: Competition in virtual care space.
Net losses are narrowing (2023 was -$67.5M; expect updates Aug 7).
Valuation post-IPO ~$1.1B.
Why watch? CMS changes could supercharge employer/health plan deals, especially with GLP-1 demand.
Downside potential: Competition in virtual care space.
12/ Last, $HNGE (Hinge Health): Digital MSK therapy with apps, sensors, PT coaching, and education.
-ties into behavioral health integration and telehealth rehab for chronic
(image source: hinge health corporate presentation)
-ties into behavioral health integration and telehealth rehab for chronic
(image source: hinge health corporate presentation)
13/ Stats: IPO in May at $32/share, raised $437M. FY2024 revenue $390.4M. Q1 2025: $123.8M (+50% YoY, +6% QoQ). TTM ~$432M.
Earnings turning corner: 2024 net loss -$32M vs -$140M in 2023. Strong retention, profitability in sight.
CMS behavioral/telehealth proposals could expand MSK coverage - big potential opportunity.
(image source: tradingview)
Earnings turning corner: 2024 net loss -$32M vs -$140M in 2023. Strong retention, profitability in sight.
CMS behavioral/telehealth proposals could expand MSK coverage - big potential opportunity.
(image source: tradingview)
14/ Side-by-side for clarity (All estimates analyst avg where avail. Numbers rounded for brevity.)
15/ Bottom line: This CMS shift toward efficient, digital chronic care could unlock growth for $HNGE $OMDA $DRIO in Medicare and beyond.
But markets are volatile - watch execution, comps, and final rule.
Read more about the CMS Proposal here: cms.gov/newsroom/fact-…
#DigitalHealth #HealthStocks #NASDAQ #NYSE #FinTwit #MultiBaggers #wallstwire
THIS IS NOT FINANCIAL OR INVESTMENT ADVICE. WE ARE NOT LICENSED TO PROVIDE SUCH. ALWAYS DO YOUR OWN RESEARCH. This account is part of the wall street wire network which publishes partner and sponsorship promotional content about subscribers. dario is a paying subscriber to the wall street wire network which constitutes a conflict of interest and this thread should not be seen as financial or investment advice of any kind. Please refer to our full compensation disclosures here: wallstwire.ai/disclosures
But markets are volatile - watch execution, comps, and final rule.
Read more about the CMS Proposal here: cms.gov/newsroom/fact-…
#DigitalHealth #HealthStocks #NASDAQ #NYSE #FinTwit #MultiBaggers #wallstwire
THIS IS NOT FINANCIAL OR INVESTMENT ADVICE. WE ARE NOT LICENSED TO PROVIDE SUCH. ALWAYS DO YOUR OWN RESEARCH. This account is part of the wall street wire network which publishes partner and sponsorship promotional content about subscribers. dario is a paying subscriber to the wall street wire network which constitutes a conflict of interest and this thread should not be seen as financial or investment advice of any kind. Please refer to our full compensation disclosures here: wallstwire.ai/disclosures
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