Lower GI costs without adding clinical capacity.
Nerva uses AI to deliver personalized digestive care for members with persistent symptoms at population scale. Members start on Nerva first, and those who need more step up to your network, without a clinician for every member.
- 300,000+ people supported
- 8,000 active US providers
- RCT published in the AJG1
Persistent digestive symptoms keep generating avoidable GI utilization.
After serious disease is ruled out, many members continue cycling through visits, tests and medications because the care their symptoms need remains difficult to access.
2021 US GI healthcare expenditure
$111.8B
annual GI healthcare spend.12
- cost driver for plan sponsors.18
- Top 3
- reason adults visit the ED: stomach and abdominal pain.15
- #1
Your network rules out disease. Nerva comes first for persistent symptoms.
Many members still experience abdominal pain, bloating, constipation or diarrhea after serious disease is ruled out. They return for visits, tests and medications because evidence-based brain-gut care is difficult to access. These conditions are known as functional GI.3,17 Nerva comes first for these members, at a lower cost than clinician-led care, and those who need more step up to it.
Why claims repeat
- 1Persistent symptoms
- 2Repeat visits, tests and ED
- 3Clear structural work-up
Where Nerva intervenesGut-brain behavioral care at population scale.
More digestive care without more appointments.
Nerva is a personalized digital digestive care program combining clinical screening, brain-gut behavioral care, dietary guidance, symptom tracking and escalation when needed. It includes a six-week core program and continued maintenance access.
- Multimodal gut-brain care
Expand access beyond specialist capacity
Daily guided sessions combine gut-brain care, diet and GI education, breathing and symptom tracking, without appointments or waitlists.
- AI-guided accountability
Keep more members engaged through completion
AI adapts coaching, reminders and education to each member’s symptoms, preferences and goals, helping them stay on track.
- Outcomes and reporting
Measure the outcomes behind your spend
Validated symptom measures give plans clear reporting on completion and clinical response.
- Clinical governance
Scale care safely across the population
Automated delivery scales access, with screening, warning signs and escalation governed by Nerva’s medical director.
A provider network that brings members into care and supports the cases that need more.
Referring providers bring members into Nerva. Our clinical team screens and escalates when medical follow-up is needed, while existing clinicians continue to manage diagnosis and complex care.
- 8K+
- active US providers
- 50
- states
- 300K+
- people supported
Nerva platform data, August 2026.
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%
- adults randomized against a matched psychoeducation control
- 244
RCT: n=244 randomized; n=240 primary analysis. Company-funded. Results do not imply cure or remission.
Research and clinical collaborations
“Within the evidence reviewed, Nerva presented the strongest overall evidence for improving IBS symptoms.”
Peterson Health Technology InstituteVirtual Gastrointestinal Care Solutions, March 20262
$1,889
Estimated annual net savings per commercial user2
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
“My gut and my brain were stuck in a panic loop. A few weeks into Nerva, that signal shifted. I’m eating normally again, cooking with my family, going out without the dread.”
Pay for outcomes. Measure the result in claims.
Two fees per enrolled member: one at start and one at validated symptom improvement, with no PMPM or implementation fee. Part of the payment depends on outcomes, the same principle as CMS's ACCESS Model, in which Mindset Health participates in the musculoskeletal and behavioral health tracks.21
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. We measure your launch in claims against a matched comparison and can publish the results with you as a claims study.
250,000 members
$1.1M–$2.2MExpected annual net savings8
$1,276net savings per enrolled member
One program across every line of business
The care stays the same. The economics follow who holds the risk.Questions from health plans
Where does Nerva fit in our GI pathway?
Nerva comes first. Members with persistent digestive symptoms start on Nerva, at a lower cost than clinician-led care and without depending on clinician capacity. Those who need more step up to your GI network or clinician-led GI care. Medical providers continue to diagnose disease and manage complex cases.
Which members are eligible?
Nerva is designed for members with persistent digestive symptoms, including common conditions such as IBS. Clinical screening checks suitability, and warning signs are escalated for medical review.
How are members brought into care?
Plans can use targeted outreach, eligibility files and provider referrals. Nerva also has an active nationwide provider network that already connects members to the program.
What does implementation require?
An eligibility file or member link, an agreed outreach plan and a reporting cadence. No EHR or clinical-system integration is required to launch.
How are outcomes and cost impact measured?
Nerva reports validated symptom outcomes and program engagement. GI utilization and cost are measured in your claims against a matched comparison, using a baseline and method agreed before launch. We can publish the results with you as a claims study.
How is Nerva priced?
Two fees per enrolled member: one when they start and one when they reach validated symptom improvement, with no PMPM or implementation fee. 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. Minimums and the measurement method are agreed before launch.
Find the GI savings opportunity in your population.
We'll size the cohort, current spend, expected enrollment and break-even case, then design the launch as a claims study.
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
- 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).
- Lacy, B. E. et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. The American Journal of Gastroenterology, 2021.
- Keefer, L.; Bedell, A.; Norton, C.; Hart, A. L. How Should Pain, Fatigue, and Emotional Wellness Be Incorporated Into Treatment Goals for Optimal Management of Inflammatory Bowel Disease? AGA Clinical Practice Update. Gastroenterology, 2022;162:1439–1451.
- British Society of Gastroenterology guidelines on the management of functional dyspepsia. Gut, 2022.
- AGA Clinical Practice Update on functional heartburn and reflux hypersensitivity. Clinical Gastroenterology and Hepatology.
- Combined membership of the health plans and employers Nerva holds contracts with, in the US and Australia. A measure of partner reach rather than the number of members enrolled in or covered for Nerva.
- Nerva actuarial model developed with Accorded, August 2026: expected economics net of the model's expected per-enrollee fee. The range uses 6.75% to 13.5% enrollment across a 10% addressable, 50% eligible and reachable population.
- Peters, S. L.; Yao, C. K.; Philpott, H.; Yelland, G. W.; Muir, J. G.; Gibson, P. R. Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 2016;44(5):447–459.
- Stanghellini, V. Functional Dyspepsia and Irritable Bowel Syndrome: Beyond Rome IV. Digestive Diseases, 2018;35(Suppl 1):14–17: functional GI disorders represent 40% of diagnoses in gastroenterological settings. The structural/complex split either side is illustrative.
- Peery, A. F. et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2024. Gastroenterology, 2025;168(5):1000–1024. The latest peer-reviewed national estimate found $111.8B in GI healthcare expenditures in 2021.
- Sperber, A. D. et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology, 2021;160(1):99–114: over 40% of adults worldwide meet criteria for a disorder of gut-brain interaction (functional gastrointestinal disorder).
- 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. Retrospective completer analysis, not a controlled trial.
- 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.
- HIF and Mindset Health member health program partnership, current as at August 2026. Program details and outcome figures are available to funds and plans under discussion.
- Keefer, L.; Palsson, O. S.; Pandolfino, J. E. Best Practice Update: Incorporating Psychogastroenterology Into Management of Digestive Disorders. Gastroenterology, 2018;154(5):1249–1257. DOI: 10.1053/j.gastro.2018.01.045.
- WTW. Digestive Health Benefits Consulting, 2026: digestive health is consistently a top-five and can be a top-three cost category 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.
- Mindset Health participation in the CMS ACCESS Model, 2026: outcomes-based payment in the musculoskeletal and behavioral health tracks, with part of the payment withheld until outcomes are known. ACCESS has no GI-specific track, and participation does not create Medicare Advantage or commercial coverage.