The Digital Medicine Society (DiMe) unveiled a new initiative on Tuesday during the AHIP 2026 Conference that aims to create best practices for contracting with virtual care providers.
DiMe is a nonprofit organization focused on advancing safe digital technologies in healthcare. The new initiative, called Post-Contracting Operational Readiness for Virtual-First Care, will convene a group of commercial payers, virtual care providers and policy advisors to build a toolkit on how to execute virtual care contracts.
The project comes as commercial payers have built numerous contracts with virtual-first providers. However, there are often many issues that arise between signing the contract and implementing the virtual solution, according to Dina Bam, partnerships lead of DiMe. For example, a contracted virtual provider may not appear in the health plan’s directory, or may be listed with incorrect information, making it difficult for members to access care. In addition, sometimes claims will get rejected because the National Provider Identifier (NPI) mapping is wrong or missing.
“The core problem is that signing a contract between a [virtual-first care] provider and a payer and actually delivering reimbursable virtual care to a patient are two very different finish lines,” Bam told MedCity News. “What we consistently hear from both payers and virtual-first care providers is that the breakdown happens in the implementation gap between those two moments.”
The initiative will begin this summer and the toolkit will be released in the fall. The toolkit will include:
- A step-by-step roadmap explaining who needs to do what and in what order, focusing on when issues most commonly arise
- A minimum viable data standard for onboarding virtual-first providers, which helps both payers and providers know what’s required
- A 90-day operational readiness scorecard that sets validation checkpoints for directory accuracy, member access and claims performance
- A set of common failure points and how to fix them, based on real payer and provider experiences
“We are also exploring adding a member-facing marketing resource to the toolkit, to foster discussion between [virtual-first care] project members and payers on this topic, and outline clear operational responsibilities and information-sharing best practices that ensure members are aware of the virtual care offerings now available in-network under their health plans,” Bam said.
Blue Shield of California is participating in the initiative. Omada Health, a virtual provider for chronic conditions, is also a title sponsor and will share firsthand experiences on how to deliver virtual care at scale.
“Virtual care can help bend the curve of chronic disease, but it only delivers at scale when the operations behind it are as strong as the clinical model,” said Wei-Li Shao, president at Omada Health, in a statement. “Payers need evidence, not hype, and Omada is partnering with DiMe to share insights from the playbook we have built over the last decade so virtual‑first care becomes a dependable, scalable part of how chronic care is delivered, not a side project.”
The initiative builds on DiMe’s previous virtual-first care work, which created a payer-provider contracting toolkit. It also supports the new 2026 provider directory accuracy requirements under the No Surprises Act and a CMS final rule that requires Medicare Advantage directory data submission by 2027.
Photo: Issarawat Tattong, Getty Images
