Bring your clients a GI strategy you can defend.
Few plans manage digestive conditions, one of employers' most costly condition groups. Nerva is digital care for persistent symptoms: two fees per enrolled employee, backed by a 2x savings guarantee, not PEPM.
- 300,000+ people supported
- 8,000 active US providers
- RCT published in the AJG1
- 2x savings guarantee on client claims
GI is a top employer cost. GLP-1s are adding to it.
Digestive costs are spread across conditions, care settings and lost work, so they rarely reach a renewal agenda.
- Conditions and symptoms
IBS, functional dyspepsia, abdominal pain, bloating, constipation, diarrhea and GLP-1 side effects
- Medical claims
Primary care, gastroenterology, tests, medications and emergency care
- Workforce impact
Absence, disability and reduced productivity
Employer condition costs
Top 3
GI diseases are among employers' most costly condition groups.15
- reason adults visit the ED: stomach and abdominal pain.11
- #1
- of employed people with IBS report impairment while working.3
- 87%
Nerva supports employees whose symptoms persist after a clear workup.
Existing providers keep diagnosing disease and managing complex cases. For persistent abdominal pain, bloating, constipation and diarrhea, Nerva comes first: it costs less than clinician-led care and doesn't depend on clinician capacity. Those who need more step up to clinician-led GI care.
Why claims repeat
- 1Persistent symptoms
- 2Repeat visits, tests and ED
- 3Clear structural work-up
Where Nerva intervenesTarget: lower claims and more productive time.
What employees get.
A six-week digital program with clinical screening, brain-gut behavioral care, dietary guidance and symptom tracking, followed by maintenance access.
- Multimodal gut-brain care
Care without an appointment
One 15-minute guided brain-gut session a day for six weeks: on their phone, wherever they are, with no appointment to book.
- AI-guided accountability
Daily support personalized by AI
AI adapts coaching, reminders, education and dietary guidance to each employee’s symptoms, preferences and goals.
- Outcomes and reporting
Validated symptom tracking
Employees see their progress through validated symptom check-ins. Employers receive aggregate outcome reporting.
- Clinical governance
Clinical support when needed
Our care team screens at intake, reaches out to members who go quiet, and escalates warning signs to a provider.
The only virtual GI solution in the US backed by a randomized controlled trial
Backed by 17 published studies, including a peer-reviewed randomized controlled trial.
Overall IBS symptom severity
IBS Symptom Severity Scale (IBS-SSS)
Median change from baseline · Lower is better
81%1of participants met the primary symptom endpoint, compared with 63% on active control.
Randomized controlled trial · N=244 · active control · AJG 2025 Read the research →
- clinically significant abdominal-pain reduction, compared with 35% on control
- 71%
- lower six-month IBS management costs among Nerva completers.5
- 60%
RCT: n=244 randomized; n=240 primary analysis. Company-funded. Results do not imply cure or remission.
“Within the evidence reviewed, Nerva presented the strongest overall evidence for improving IBS symptoms.”
Peterson Health Technology InstituteVirtual Gastrointestinal Care Solutions, March 20267
$1,889
Estimated annual net savings per commercial user7
PHTI category estimate, not Nerva-specific
Average annual net savings per user by category
- Functional GI$1,889
- MSK$886
- Depression and anxiety$629
- Opioid use disorder$372
The four answers an RFP asks for.
- Evidence
- A randomized, peer-reviewed trial: 81% met the primary symptom endpoint vs 63% on active control.1
- Independent review
- PHTI, March 2026: “the strongest overall evidence for improving IBS symptoms.”7 PHTI has not rated the current enterprise offer.
- Savings
- Modeled, not observed: an actuarial model built with Accorded, assumptions shown.8
- Pricing
- Not PEPM. Two fees per enrolled employee, at start and at validated symptom improvement. A 2x savings guarantee: if measured year-one GI claims savings are under twice the fees paid, we refund the shortfall, up to 100% of fees.
Size the opportunity for a client.
Our actuarial model, built with Accorded, estimates a client's cohort, enrollment, net savings and break-even.8
- expected gross ROI in Nerva's actuarial model, developed with Accorded.8
- 4.7x
10,000 covered employees
$360K–$540KExpected annual net savings8
1,400employees likely seeking care for gut-brain digestive symptoms
$1,276net savings per enrolled member
What we handle for you.
Size it
A modeled estimate from covered lives, then a claims analysis to set the baseline.
Evaluate it
RFP and questionnaire answers, with the evidence, model assumptions and SOC 2 and HIPAA documentation in our Trust Center.
Launch it
A company link or eligibility file, with communications templates.
Report it
Aggregate enrollment, engagement and outcomes reporting for client reviews.
Two fees, a 2x guarantee. Not PEPM.
Two fees per enrolled employee: one at start and one at validated symptom improvement. A 2x savings guarantee backs it: if measured year-one GI claims savings are under twice the fees paid, we refund the shortfall, up to 100% of fees.
Questions from brokers and consultants
Which clients are a fit?
Self-funded employers, who hold the claims risk. For a fully insured client, the health plan is the buyer.
Does Nerva replace the carrier, TPA or GI network?
No. Nerva is the first step for persistent digestive symptoms. Employees start on Nerva, and those who need more step up to clinician-led GI care. Existing providers keep managing diagnosis, structural disease and complex cases.
How do employees access Nerva?
Through a company link or eligibility file. They can start immediately, with no appointment.
How is impact measured?
A claims analysis identifies the cohort and sets the baseline. After launch, we track validated symptom outcomes and measure GI utilization and cost in the client's claims against a matched comparison, with a method agreed upfront. We can publish the results with the client as a claims study.
Take a GI strategy into your next client review.
A 20-minute call on which clients are a fit and what a claims analysis would show.
Sharing this with a client? Send them the employer page →
Advising a health plan? See Nerva for health plans →
References
- Anderson, Ellen J.; Peters, Simone L.; Gibson, Peter R.; Halmos, Emma P. Comparison of Digitally Delivered Gut-Directed Hypnotherapy Program With an Active Control for Irritable Bowel Syndrome. The American Journal of Gastroenterology 120(2):p 440-448, February 2025. DOI: 10.14309/ajg.0000000000002921
- Frändemark, Å. et al. Work Productivity and Activity Impairment in Irritable Bowel Syndrome (IBS): A Multifaceted Problem. The American Journal of Gastroenterology, 2018;113(10):1540–1549: 86.8% of employed IBS patients reported impairment while at work and 24.4% reported missed work due to IBS.
- Peters, S. L.; Gibson, P. R.; Halmos, E. P. App-delivered gut-directed hypnotherapy halves the long-term costs associated with managing Irritable Bowel Syndrome (IBS) symptoms and improves work productivity. Retrospective study of 17,000+ Nerva users, presented at Digestive Disease Week: IBS management costs fell from USD 1,259 to USD 502 over six months, with significant long-term improvements in work absenteeism, presenteeism and overall productivity. Retrospective completer analysis, not a controlled trial.
- Peterson Health Technology Institute. Virtual Gastrointestinal Care Solutions Assessment. March 2026. PHTI estimated $1,889 in average annual net savings per commercial user for wraparound functional GI care, using IBS as the representative condition. PHTI's base cases in its other assessments were $886 for MSK (physical therapist guided, at a $995 price), $629 for depression and anxiety (self-guided) and $372 for opioid use disorder (medication-focused).
- Nerva actuarial model developed with Accorded, August 2026: expected economics net of the model's expected per-enrollee fee (built on IBS). The calculator covers disorders of gut-brain interaction, including IBS, functional dyspepsia and other functional GI symptoms. About 4 in 10 US adults meet Rome IV criteria (36.0% and 39.9% in two US surveys); in the study's Swedish data, more than a third of people with one had visited a doctor for GI problems (Rome Foundation Global Epidemiology Study). It assumes 35% seek care and 20% to 30% of them enroll in a year, about 3% to 4% of employees. That is in line with established programs: Hinge Health's members equaled 3.4% of eligible lives in 2024 (IPO prospectus), and Livongo enrolled 34% of recruitable people with diabetes within 12 months (S-1, 2019). GLP-1 GI side effects overlap this group and are not added separately. A claims analysis replaces these planning assumptions with the client's own figures.
- Centers for Disease Control and Prevention, National Hospital Ambulatory Medical Care Survey: stomach and abdominal pain is the most common principal reason for adult emergency department visits. See also Wu et al., Academic Emergency Medicine, 2025, on ED abdominal-pain presentations 2007–2019.
- Springbuk. Employee Health Trends 2025: gastrointestinal diseases are among the three most costly condition groups for employers.
- Wilding, J. P. H. et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). The New England Journal of Medicine, 2021;384(11):989–1002: gastrointestinal disorders were reported by 74.2% of participants on semaglutide 2.4 mg and 47.9% on placebo.
- Cotter, L. et al. Perspectives from employers on the costs and issues associated with covering GLP-1 agonists for weight loss. Peterson-KFF Health System Tracker, October 2025. A human resources director reported that GLP-1s went from number 32 to number one in pharmacy spending in a year. One employer's account from KFF's interviews, not a survey estimate.