Sacra estimates Virta Health hit $175M in revenue in 2024, up 51% from $116M in 2023. The company has maintained strong growth over the past few years, with revenue increasing from $35M in 2021 to $70M in 2022, representing a compound annual growth rate (CAGR) of 71% from 2021-2024.

Revenue is primarily generated through B2B2C partnerships with self-insured employers, health plans, and government organizations. Virta's revenue mix has evolved significantly since 2021, with diabetes reversal revenue decreasing from 78% to 54% of total revenue in 2024, while obesity revenue has grown from 10% to 27%. The remaining revenue comes from diabetes management (14%) and platform fees (5%).

The company operates with approximately 550 B2B customers as of 2024, achieving an impressive average revenue per customer of $318K - double that of competitor Omada Health ($158K). This higher ARPC is driven by Virta's focus on higher-value diabetes reversal patients ($2.8K/year) versus traditional diabetes management ($1K/year).

Virta's pricing model is value-based, with 100% of fees at risk tied to patient outcomes. Their diabetes reversal program commands premium pricing ($2,808 per member year 1, $2,388 subsequent years) and maintains strong retention rates (90% year 1, 74% year 2). Their obesity program ($900/year) and diabetes management program ($950/year) serve as additional revenue streams with lower price points but larger addressable markets.

Virta Health was last valued at $2 billion following its Series E funding round in April 2021, led by Tiger Global. The company has raised a total of $376.5 million across 7 funding rounds since its founding in 2014.

Based on Virta's estimated 2021 revenue of $35M, this valued the company at approximately 57x LTM revenue. Key investors include Tiger Global, Sequoia Capital Global Equities, and Caffeinated Capital. The company's Series D round was led by Sequoia Capital Global Equities in December 2020.

Virta Health was founded in 2014 by Sami Inkinen, who previously co-founded Trulia, after he was diagnosed as pre-diabetic despite being a competitive athlete. Inkinen discovered decades-old research suggesting the ketogenic diet could reverse diabetes and founded Virta to productize this approach through technology-enabled care delivery.

The product combines connected devices, continuous remote monitoring, and personalized coaching to help patients implement and maintain a ketogenic diet. When a patient enrolls, they receive a starter kit containing a connected glucose meter, ketone meter, and scale.

Patients check in with their Virta health coach 2-4 times daily through the Virta app, tracking their food intake and symptoms while receiving guidance on their personalized meal plan. Behind the scenes, Virta physicians monitor the data from connected devices to make medication adjustments, particularly crucial in the first 10 weeks as blood sugar levels normalize and insulin doses often need reduction.

Virta's approach differs from traditional diabetes management apps by focusing on reversal rather than helping patients peacefully coexist with their condition. The program requires intensive monitoring due to the risks associated with suddenly reducing carbohydrate intake to less than 50 grams per day while on insulin, which can cause dangerous blood sugar fluctuations.

To maintain high success rates, Virta carefully screens potential patients, rejecting those with c-peptide levels below their cutoff or certain comorbidities.

The company has since expanded its offering to include obesity treatment and prediabetes reversal programs, leveraging the same infrastructure of continuous monitoring and coaching.

Virta Health operates a B2B2C virtual care platform focused on reversing type 2 diabetes and obesity through intensive nutritional therapy and continuous remote monitoring.

The company primarily generates revenue through contracts with self-insured employers, health plans, and government organizations, who offer Virta's program as a covered benefit to their members.

Virta's pricing model is built around outcomes-based contracts, with their diabetes reversal program priced at $2,808 per patient for year one and $2,388 for subsequent years.

Their obesity program is priced at $900 per year, while their diabetes management program costs $950 per year. Notably, Virta puts 100% of their fees at risk - customers receive full credits if patients don't achieve specific clinical outcomes like A1c reduction and medication elimination.

The company's growth strategy leverages both expansion within existing accounts and new customer acquisition. With an average of only 180 patients enrolled per customer (roughly 5-10% of eligible population), Virta has significant headroom to grow revenue by increasing penetration within their current customer base of 550+ organizations.

Their obesity program, launched in 2020, has become a major growth driver - obesity now accounts for 45% of new enrollments, up from 20% in 2021.

Virta Health operates in a market that includes virtual care providers focused on chronic metabolic conditions, particularly type 2 diabetes and obesity. The competitive landscape can be divided into three main categories: digital health platforms, traditional diabetes management providers, and emerging GLP-1 focused solutions.

The primary competitors in this space are Omada Health and Livongo (acquired by Teladoc for $18.5B in 2020). Omada Health generates approximately $300M in annual revenue serving 300,000 patients across 1,900 customers, with an average revenue per customer of $158K.

Their platform combines connected devices with health coaching, focusing on diabetes prevention and management rather than reversal. Livongo, through Teladoc's network of 3,000+ telehealth PCPs, leverages existing relationships with 600+ employers and health plans to distribute their diabetes management solution.

Both companies have expanded horizontally into mental health and musculoskeletal care through acquisitions, while maintaining lower-intensity protocols built around calorie counting and balanced diets.

This segment includes established players like DarioHealth, Glooko, Perry Health, and Verily (Onduo). These companies primarily focus on medication adherence and lifestyle modifications within existing treatment paradigms.

They typically generate revenue through traditional insurance reimbursement and often partner with pharmacy benefits managers (PBMs) for distribution. For example, Omada is the preferred partner for Evernorth, giving them access to 180 million customers through the PBM channel.

A new category of competitors is emerging around GLP-1 medications like Wegovy and Ozempic. Companies in this space are developing managed programs that combine GLP-1 prescriptions with lifestyle interventions.

Insurance companies like BCBS Michigan and North Carolina's State Health Plan now require GLP-1 patients to participate in these managed programs. This has created opportunities for both traditional players and new entrants to develop GLP-1-specific offerings, though the high cost of these medications ($3,000 annually versus $900 for traditional management programs) has led some payers to seek alternative solutions.

Virta Health has tailwinds from the rising costs of GLP-1 medications and growing employer concerns about healthcare spending, and has the opportunity to expand into adjacent metabolic conditions like cardiovascular disease and non-alcoholic fatty liver disease (NAFLD).

The surging popularity of GLP-1 drugs like Ozempic and Wegovy is driving up employer healthcare costs, with spending on these medications expected to reach $25-30B annually by 2025. This creates an urgent need for cost-effective alternatives. Virta's obesity program at $900/year offers significant savings compared to $3,000+ annually for GLP-1s.

More insurers are now requiring GLP-1 patients to enroll in managed programs like Virta's, positioning the company as both an alternative and an "off-ramp" focused on sustainable lifestyle changes. As GLP-1 costs continue straining healthcare budgets, Virta's value proposition becomes increasingly compelling to payers seeking to control spending while maintaining clinical outcomes.

Virta's ketogenic protocol has shown promise beyond diabetes reversal, creating opportunities to expand into other metabolic conditions that respond to carbohydrate restriction.

Cardiovascular disease and NAFLD represent natural expansion targets given their close relationship with insulin resistance and obesity. The global NAFLD treatment market alone is projected to reach $21B by 2025.

Virta's existing infrastructure for continuous remote monitoring and medication management could be adapted to serve these conditions, allowing efficient scaling to new patient populations while maintaining their outcomes-based pricing model.

With only 5-10% enrollment among eligible employees at current customers, Virta has significant headroom to grow within its existing base of 550+ enterprise clients.

The company's shift from primarily serving diabetes patients (78% of revenue in 2021) to a more balanced revenue mix including obesity (27% of revenue in 2024) demonstrates their ability to expand scope while maintaining strong clinical outcomes.

As Virta proves the effectiveness of their model across multiple conditions, they can leverage their B2B relationships and outcomes-based pricing to capture a larger share of employers' healthcare spending. This "land and expand" strategy, combined with their high retention rates (90% in year 1), provides a clear path to sustained growth without requiring aggressive customer acquisition.

Three critical risks facing Virta Health:

1. Narrow Patient Selection: Virta's strict enrollment criteria (rejecting patients with c-peptide levels below their cutoff) and intensive monitoring requirements (2-4 daily check-ins) significantly limit their total addressable market.

While this selective approach helps maintain high success rates, it could hamper growth as they pursue their goal of treating 100 million patients. The company may face pressure to relax these standards to achieve scale, potentially compromising their impressive clinical outcomes that differentiate them from competitors.

2. GLP-1 Market Dynamics: While Virta positions itself as both an alternative and complement to GLP-1s, the explosive growth of these medications could reshape patient expectations.

As more insurers require managed programs for GLP-1 prescriptions, Virta risks becoming primarily an "off-ramp" program rather than a first-line treatment. This shift could reduce their pricing power and force them to compete more directly with traditional diabetes management programs from Omada and Livongo.

3. Revenue Mix Deterioration: Virta's revenue mix is rapidly shifting from high-margin diabetes reversal (78% in 2021 to 54% in 2024) toward lower-margin obesity treatment (10% to 27%).

This trend threatens their unit economics, as obesity patients have lower retention rates (85% vs 90% year 1) and significantly lower pricing ($900/year vs $2,808). While obesity represents a larger market, it's also more competitive and could compress margins over time.