For Medicare Advantage plans
Give 65+ members GI behavioral care without the wait.
Nerva is a GI behavioral care program for members 65+ with persistent symptoms and repeat GI visits. The six-week digital program is available on demand, with fees tied to outcomes.
The missing care layer
Stop paying for the same unresolved GI symptoms.
Plans pay to rule out structural disease and manage complex cases. Functional symptoms keep members returning to care.
Why claims repeat
- 1Persistent symptoms
- 2Repeat visits, tests and ED
- 3Clear structural work-up
Where Nerva intervenesTarget: lower utilization and better health and experience.
Independent evaluation by PHTI
“Within the evidence reviewed, Nerva presented the strongest overall evidence for improving IBS symptoms.”
Peterson Health Technology Institute (PHTI)Virtual Gastrointestinal Care Solutions, March 202610
$1,889
Estimated annual net savings per commercial user10
Average annual net savings per user by category
- Functional GI$1,889
- MSK$1,300
- Depression / Anxiety$600
- Opioid Use / SUD$400
81%1of participants met the primary symptom endpoint (≥50-point IBS-SSS improvement), vs 63% on active control.
RCT · 244 adults aged 20–65 · AJG 2025 Read the research →
- Clinically significant abdominal-pain reduction, vs 35% on control1
- 71%
- Clinical studies on Nerva, indexed on our Research page
- 17
The solution
Functional GI care without the appointment bottleneck.
Nerva gives members 65+ a six-week gut-brain behavioral care program with daily guided sessions, practical skills and progress tracking. Plans receive aggregate reporting on completion and outcomes.
- Multimodal functional GI 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 engagement
Keep more members engaged through completion
AI tailors pre-authored education to member preferences and selected focus areas; therapy, triage and the protocol remain clinician-governed.
- Outcomes and reporting
Measure the outcomes behind your spend
Validated symptom measures give plans clear reporting on completion and clinical response.
- Clinical governance
Scale safely without adding clinical headcount
Automated delivery scales access, with screening, warning signs and escalation governed by Nerva’s medical director.
Enrollment and engagement
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
- 8,000
- active US providers
- 300K+
- people supported
- 156M
- gut-brain care minutes
Nerva platform data, August 2026.
Latest MA whitepaper · August 2026
Improving GI health in Medicare Advantage
Real-world GI and mental health outcomes among adults 65 and over, mapped to HOS, HEDIS DSF-E and member-experience priorities.
What improves for an MA plan
Improve the health and experience measures plans answer for.
Nerva improves GI symptoms, pain and anxiety. We are testing how those outcomes translate into HOS, HEDIS and CAHPS performance.15
3x weighted · 2027
Physical Health · HOS15
GI symptom severity and abdominal pain shape how members rate their physical health.
Enters Stars 2029
DSF-E · HEDIS15
Depression screening and follow-up sit inside Nerva's governed care model.
2x weighted
CAHPS plan ratings15
Fast access to condition-specific care can improve how members experience their plan.
Your data
Utilization & claims
Track GI emergency, specialist, diagnostic and total cost on the plan's claims.
The first study uses Medicare-aged Nerva users, followed by plan-linked data.
How you buy and measure it
Pay for outcomes. Measure them on your claims.
ACCESS made measured outcomes the basis of digital-care payment, and payers covering 165 million lives have pledged to follow by 2028.6,8 We bring that structure to functional GI.
The CMS ACCESS pattern
A Medicare Advantage GI application
- Defined care period + recurring payment
- 12-month episode + per-enrolled payment
- Measured outcomes + accountability
- Validated GI symptoms + outcomes holdback
- Coordinated care
- Screening, escalation, provider interface
- Aligned data infrastructure
- Eligibility, attribution, PROM and claims files
Mindset Health already runs outcomes-based contracts through CMS ACCESS for MSK and behavioral health. ACCESS is Original Medicare and does not cover GI; MA plans contract directly with Nerva.6,9
Bring functional GI care to your 65+ members.
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 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 estimated $1,889 in average annual net savings per commercial user for wraparound functional GI care, using IBS as the representative condition. Cross-assessment estimates were $1,300 for MSK, $600 for depression and anxiety, $400 for opioid use and substance use disorder, with no savings identified for hypertension or diabetes.
- 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.