For Medicare Advantage plans
Outcome-aligned functional GI care, built for the Medicare population.
AI behavioral care for your 65+ members' functional GI, on terms tied to measured outcomes. Built for medical, care-management and medical-economics teams.
Stays with existing GI care
Diagnosis, medication and procedures. IBD flares, bleeds, cancers.
Nerva
AI behavioral care for the functional-GI population, delivered as software, at scale. Complements existing care.
- IBS
- Functional dyspepsia
- Reflux hypersensitivity
Escalates when needed
Clinician-led multidisciplinary teams. Refractory DGBI, complex comorbidity.
Clinician-staffed GI clinics do valuable work in the complex tier, and their reach scales with clinician supply. Software economics are what make the whole addressable cohort reachable.
“Within the evidence reviewed, Nerva presented the strongest overall evidence for improving IBS symptoms.”
Peterson Health Technology InstituteVirtual Gastrointestinal Care Solutions, March 202610
Evidence you can take to your medical committee.
Brain-gut behavioral therapy is guideline-supported care for IBS,5 and Nerva's delivery of it is validated in a published randomized controlled trial. A dedicated 65+ retrospective study is in preparation.7
81%1of participants met the primary symptom endpoint, vs 63% on active control, in 244 adults aged 20 to 65.
Randomized controlled trial · N=244 · active control · AJG 2025 Read the research →
- Clinically significant abdominal-pain reduction, vs 35% on control1
- 71%
- Clinical studies on Nerva, indexed on our Research page
- 15+
The functional GI care program
Nerva is AI behavioral care: a structured, clinician-designed gut-brain program, evaluated in a randomized controlled trial,1 delivered entirely by software. AI tailors pre-authored content and pacing to each member, at a pace built for older adults.
One 15-minute guided brain-gut session a day for six weeks, plus short CBT-based lessons.
General diet and lifestyle guidance, including support for reintroducing foods.
Members check in on validated measures: IBS-SSS, abdominal pain and PHQ-4. Reports reach your team through quarterly reporting.
Our care team screens at intake, reaches out to members who go quiet, and escalates warning signs to a provider.
The governed pathway.
- Identify
Clinician referral, an agreed claims finder file, or both.
- Screen
Eligibility, diagnosis, alarm features: bleeding, unexplained weight loss, anemia, a new or changing presentation. Red flags route to a provider, never into the program.
- Treat
One 15-minute session a day, six weeks.
- Maintain
Flare support and re-engagement across a 12-month episode.
- Measure
Validated outcomes. Escalations logged and reported.
- Throughout
Support stays human: the care team answers members directly, and escalations run under a protocol owned by our medical director.
Nerva platform data · last 12 months
The members everyone worries about are our best users.
Members 65 and over finish the program at over 1.5 times the rate of younger users, and improve at least as much.7
- Audio-first
- Large type
- One action per screen
- No wearables to pair
- week-one retention, 65+ vs under‑65
- 1.3x
- median session-days per enrolled member, 65+ vs under‑65
- 1.65x
- program completion, 65+ vs under‑65
- 1.5x+
Enrolled members are self-selected, exactly the group a plan enrolls; cohort counts come with the plan analysis.7 90% of US adults 50+ own a smartphone.14
Built to move the measures you answer for.
Nerva improves outcomes associated with Stars and HEDIS measures. DGBI burden shows up in how a member rates their own health, which is what HOS asks.15 A dedicated Stars and HEDIS evaluation is underway.
3x weighted · 2027
Physical Health · HOS15
Validated GI symptom severity and pain: the burden behind the measure.
Your data
Utilization & claims
GI emergency, specialist, diagnostic and total cost, tested in the plan-linked evaluation.
A retrospective study of Star-relevant outcomes in Medicare-aged Nerva users is completing now, publishing as a transparent working paper. Ask us for it.
The ACCESS pattern, measured on your claims.
ACCESS moved digital care contracting from engagement fees to measured outcomes, and payers covering 165 million lives have pledged outcome-based structures by 2028.6,8 We propose plans run the same pattern for functional GI.
The CMS ACCESS pattern
A Medicare Advantage GI application
- Defined care period
- 12-month episode
- Recurring outcome-aligned payment
- Per-enrolled payment
- Standardized measured outcomes
- Validated GI symptom severity and pain
- Provider accountability
- Engagement floor and outcomes holdback
- Coordinated care
- Screening, escalation, provider interface
- Aligned data infrastructure
- Eligibility, attribution, PROM and claims files
We operate under these rules ourselves: Mindset Health has an outcomes-based pricing contract with Medicare through the CMS ACCESS program.9 That does not extend ACCESS coverage to GI; it means your counterparty already runs this model. ACCESS is an Original Medicare model and GI is not a current track; CMS says MA plans may independently adopt similar outcome-aligned arrangements.6 And CMS's ACCESS technical guidance indicates payments under ACCESS-aligned arrangements can generally be treated as medical expenses when the applicable regulatory conditions are met.12
The full analysis, in one report.
From ACCESS to Advantage: the modeled MA economics, contract structure and measurement design this page summarises, with every assumption stated.
Fit and implementation.
What does implementation require?
An eligibility file or referral pathway, agreed attribution on a fixed cadence, and reporting in FHIR-based, ACCESS-pattern formats. No clinical-system integration is required to launch.
How is member data handled?
HIPAA-compliant reporting on agreed measures, with data handling managed under SOC 2 standards. Security and privacy documentation is available for procurement review.
Which plans are not a fit?
Plans that need a guaranteed Star Ratings impact, want a staffed GI clinic, have no clinical or population-health sponsor, or cannot share claims for a joint evaluation. The model depends on measuring against your data.
Where does the conversation start?
With the analysis: your signal population, its current utilization, the eligible cohort, and the break-even for a first contract.
Build the first plan-linked MA evidence cohort with Nerva.
- Jointly defined eligible cohort, by referral and/or claims
- Agreed clinical and economic measures, with an outcomes holdback
- Plan claims access and a shared evaluation design
- Expansion decision after the evidence period, on your data
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
- Sperber, A. D. et al. Rome IV multinational epidemiology analysis of disorders of gut-brain interaction in older adults. Alimentary Pharmacology & Therapeutics, 2024: 31.9% of adults 65+ met Rome IV criteria in a 54,127-person analysis. “Met criteria” spans mild functional constipation to severe IBS; prevalence does not establish the size, severity or cost of a plan's Nerva-eligible population.
- Busby-Whitehead, J. et al. Disorders of gut-brain interaction in older adults in the United States. Journal of the American Geriatrics Society, 2024: 34.1% of US respondents 65+ met criteria, associated with lower quality of life and more healthcare seeking.
- Peery, A. F. et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States. Gastroenterology, 2022. The $119.6B estimate is a national whole-GI figure from 2018.
- Lacy, B. E. et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. The American Journal of Gastroenterology, 2021: gut-directed psychotherapies, including gut-directed hypnotherapy, are recommended treatment options for IBS.
- CMS ACCESS Model, 2026: model overview, payment pattern, billing codes and FHIR reporting; CMS guidance that MA organizations may independently adopt similar outcome-aligned arrangements with contracted providers. Functional GI and IBS are not current ACCESS tracks. CMS did not commission, contribute to, or endorse this page.
- Nerva platform analytics, August 2026: engagement and recorded before-and-after outcomes among users with valid initial and final symptom scores, compared across age bands. Retention, session-days and improvement are trailing-12-month figures; program completion is all-time. Descriptive platform data from a self-selected enrolled population, not trial results and not outcomes claims. A retrospective study of US users 65+ is in preparation.
- CMS ACCESS Payer Pledge, 2026: payers covering 165 million lives pledged to adopt outcome-based payment structures aligned with ACCESS principles by 1 January 2028. The pledge spans Medicare Advantage, Medicaid and private insurance and is not GI-specific. The contracting-window inference is a Nerva planning position.
- Mindset Health participation in the CMS ACCESS Model, 2026: outcomes-based arrangements in the musculoskeletal and behavioral health tracks. ACCESS coverage does not extend to GI.
- Peterson Health Technology Institute. Virtual Gastrointestinal Care Solutions Assessment. March 2026. PHTI separately estimated $1,889 in net annual healthcare savings per IBS patient for virtual GI care, in a commercial population, not Medicare.
- Nerva Medicare Advantage expected ROI model, 2026: modeled expected case for a first MA cohort; full assumptions, funnel, payment terms and fee structure are published in From ACCESS to Advantage (August 2026). The payment structure is proposed by Nerva, anchored to published ACCESS allowed amounts, and is not an executed price, a CMS rate, or a claim that ACCESS covers GI. Modeled estimates, not observed Nerva claims results.
- CMS ACCESS Model technical frequently asked questions, cms.gov/priorities/innovation: CMS indicates that payments under ACCESS-aligned arrangements can generally be counted as medical expenses when the applicable regulatory conditions are met, and that no new MLR policy was created for the model. Whether a specific MA arrangement qualifies is determined by the plan and its counsel, not by Nerva.
- Internal Nerva platform figures, August 2026: cumulative people who have used the program and clinicians who have referred patients, worldwide.
- AARP Tech Trends, 2026: 90% of US adults 50 and over own a smartphone. Adults 50+, not a Medicare-only sample.
- CMS 2027 Star Ratings measures; CY2027 Medicare Advantage and Part D Final Rule; NCQA HEDIS measure specifications: Improving or Maintaining Physical Health and Improving or Maintaining Mental Health (both measured through HOS) carry weight 3 from the 2027 Star Ratings; the CAHPS plan-rating measures carry weight 2; HEDIS Depression Screening and Follow-Up (DSF-E) enters Star Ratings in 2029. Nerva's GI and PHQ instruments are not the official VR-12/HOS instruments and its experience measures are not CAHPS; the plan-linked evaluation tests how Nerva's measures relate to official measures in the plan's own data.
- 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 plans under discussion.
- 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; all ages, not a Medicare-only sample.
Photography: Centre for Ageing Better age-positive library and Benjamin Chambon via Unsplash. Images depict models, not Nerva members.