Key takeaways:
- 85% of 4,714 paired respondents reported at least a 30% improvement in one or more tracked GI symptom measures.
- 9,012 adults aged 65+ completed PHQ-2 depression screening, with 36.9% screening positive at baseline.
- The white paper maps observed Nerva outcomes to HOS, HEDIS DSF-E and member experience priorities, then outlines plan-level validation.
Nerva Health today published Improving GI Health in Medicare Advantage, a new white paper examining real-world GI and mental health outcomes among US Nerva users aged 65 and over.
The report connects observed symptom improvement, depression screening and engagement to the physical health, mental health and member experience priorities Medicare Advantage plans already manage. It also sets out how a plan could validate those outcomes prospectively using its own HOS, HEDIS, experience, utilization and claims data.
What the analysis found
Among 4,714 users with paired baseline and follow-up assessments and calculable change for at least one of six tracked GI symptom measures, 4,009, or 85%, reported at least a 30% improvement in one or more measures. Each respondent was counted once.
Among 4,947 users with paired assessments for overall GI symptoms, 60% reported at least a 30% improvement and mean symptom severity fell by 38.6%. Across the measure-specific paired cohorts, 59% reported at least a 30% improvement in abdominal pain.
Mental health symptoms moved alongside GI symptoms. Among 4,630 users with paired PHQ-4 assessments, 44% improved by at least three points. The mean score fell from 5.53 at baseline to 3.25 at program completion, a 41.2% reduction.
Depression screening reached a broader population. A total of 9,012 users completed a baseline PHQ-2 screen, and 36.9% screened positive. This shows how a member-selected digestive care program can create a practical setting for standardized screening and repeated measurement.
Older adults also engaged at meaningful scale. A total of 7,128 users established a repeated practice across at least seven separate days and 5,021 reached the program completion milestone.
Recommendation and satisfaction measures remained strong among respondents at later timepoints, with a Net Promoter Score of approximately 50 at program completion and six months and average satisfaction of 4.24 out of 5 at six months.
A quality opportunity for Medicare Advantage
“Persistent GI symptoms are often treated as a specialty problem, but for members they can affect how they feel, function and engage with care,” said Alex Naoumidis, Co-Founder and Co-CEO of Nerva Health.
“This report shows that older adults will engage with digital digestive care at meaningful scale, alongside measurable changes in GI and mental health symptoms. The next step is to validate what that could mean for Medicare Advantage plans using their own HOS, HEDIS, experience and claims data.”
Approximately one in three older adults meets criteria for a disorder of gut-brain interaction. These conditions are associated with lower quality of life and greater healthcare seeking, but functional GI conditions do not have a dedicated Medicare Advantage quality measure.
Their effects may instead surface across whole-person priorities, including:
• Improving or Maintaining Physical Health through the Medicare Health Outcomes Survey
• Improving or Maintaining Mental Health through the Medicare Health Outcomes Survey
• Depression Screening and Follow-Up under HEDIS DSF-E
• Member experience, access and care coordination
• Utilization, claims and total cost of care
The report maps Nerva’s observed outcomes to these priorities and identifies the additional plan-level data needed to evaluate them. Observed Nerva outcomes are program measures, not official HOS, HEDIS, CAHPS or Star Ratings results.
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.
Moving from real-world evidence to plan-level results
The white paper proposes a plan-specific implementation model connecting member identification, program delivery, standardized depression screening, plan-defined follow-up and escalation, repeated outcome measurement and plan-level data.
A Medicare Advantage implementation could evaluate HOS-aligned physical and mental health outcomes, DSF-E screening and follow-up, member experience, utilization and claims. It could also establish the attribution, comparison and reconciliation rules needed for an outcomes-based arrangement.
Request the white paper
Request Improving GI Health in Medicare Advantage to review the complete outcomes, quality measure map, methodology and plan-level validation roadmap.Request the white paper
Explore Nerva for Medicare Advantage
Browse the Nerva Health resource library for health plans
You can also view the full PDF, explore Nerva for Medicare Advantage, or browse the Nerva Health resource library for health plans.
About Nerva Health
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.
Nerva is designed to complement existing care. It does not replace medical diagnosis, medication management or clinical supervision.
Methodology and evidence boundaries
This was a retrospective, observational analysis of deidentified program data through July 31, 2026. Outcomes were self-reported, each metric used its own eligible denominator, and the cohort was defined by age rather than confirmed Medicare Advantage enrollment. The analysis did not include a control group and does not establish causality. Full methods and sources are provided in the white paper.
For health plan or media inquiries, contact sales@mindsethealth.com.
