Virta is initially going for the employer paid plans. If employers can get their diabetic employees off expensive medications and avoid surgeries in the future, the cost savings would be huge. Many larger employers self-insure some part of their health care expenses. It appeared the individual market would be a "next step" in scaling up.

And Virta was able to work out having doctors who advise patients on-line and across state lines. The legal hurdles to do this is major.

From NYT: "On the program, patients video-chat with a remote Virta doctor, who consults with their primary care doctor, reviews their blood tests and medical history, and makes diet and drug recommendations. "

And then: "Every day, patients use an app to upload their blood sugar levels, blood pressure, body weight and other measurements. A health coach, usually a registered dietitian, monitors their data and checks in by phone, text or email to discuss any problems or just to provide daily encouragement."

Their staff are not your average WW "diet coach".