Recapping the news from behavioral health companies that are B2B (business-to-business).

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Nov 23, 2022
5 min. read

Behavioral Health Plan Breakfast Recap from #HLTH2022

Going Digital: Behavioral Health Tech joined a breakfast with executives from various health plans and behavioral health organizations hosted by NovaWell at HLTH2022 in Las Vegas. Read the summary from NovaWell's CEO Suzanne Kunis.
Suzanne Kunis

Behavioral health in America is in a state of crisis.  Individuals meeting the criteria for a mood disorder has never been higher at 40% of the US population.  This prevalence is met with a pervasive stigma that holds many people back from seeking treatment.  Those who do must overcome the challenge of access to quality care.  As America’s first integrated behavioral care organization, NovaWell was created to breakdown the systemic barriers that prevent people from getting the care they need.  Last week at HLTH, I had the opportunity to host 13 behavioral health leaders to discuss these challenges and potential solutions in greater detail.  Takeaways from the discussion included:

Close the say-do gap: A misalignment exists between behavioral health as a strategic priority and the reality of implementing behavioral health solutions.  Competing priorities, which demonstrate measurable short-term results, often gain favor and funding over holistic solutions where the value is recognized downstream via improved whole person outcomes and reduced total cost of care.

Breakdown siloes: Incorporating behavioral health into the fabric of an organization requires systemic change.  The technology, processes and measurement of physical and behavioral health remain siloed.  The first step to breaking down these barriers is internal.  Organizations must undergo a cultural shift that emphasizes the benefits of whole person health, in order to fully realize the benefits.

Move beyond the network:  Access remains a clear challenge for most organizations.  Access was previously defined by the size of an insurer’s network.  The larger the network the easier it was to access care.  Our behavioral health crisis, pressurized by the healthcare staffing shortage and a movement towards direct-pay providers, requires the definition to change.  Today, access is defined by how quickly a member can get the care they need. Solutions must be grounded in reaching people when they’re in the right headspace and quickly connecting them to care.

Redefine success: Behavioral health is currently measured against a framework that rewards the reduction of discrete behavioral health costs and perpetuates members cycling through the health system. Measurement should be framed around driving affordability long-term through upstream interventions – not short-term gains of reduced costs. If behavioral health is truly a strategic priority and improved outcomes is our North Star, it’s time we are measured against it.

Insist on sustainable financing: Currently there are too few billable codes attributed to those with behavioral health conditions.  Existing CPT codes don’t provide enough insight into a person’s condition at traditional points of care - oftentimes leaving ED claims as the only source of data.  Under this system, sustainable financing starts to unravel, resulting in limited career pathing for those in the field.

Advocate for policy changes: Regulation has the potential to make new inroads into the value of behavioral health.  For example, students are required to get vision screenings prior to school, why not mental health screenings? With this type of data, school-based solutions could be funded that reach young people and teach them how to find care.

While the obstacles are great, I am heartened by the passionate, innovative leaders working to improve the lives of those with a behavioral health condition.  The lively discussion demonstrated that behavioral health is a priority for many organizations, but delivering on that priority requires a shift in how we think and operate.

Nov 16, 2022
4 min. read

Going Digital: Behavioral Health Tech Opens Its Doors to Payers, Providers, and Digital Health Companies for Their First In-Person Conference

Announces a Partnership with PESI to Co-Market Content and Provide Continuing Education Credits to 600,000+ Mental Health Professionals
Solome Tibebu


Going Digital: Behavioral Health Tech (GDBHT) Opens Its Doors to Payers, Providers, and Digital Health Companies for Their First In-Person Conference

Announces a Partnership with PESI to Co-Market Content and Provide Continuing Education Credits to 600,000+ Mental Health Professionals

San Francisco, CA, November 16, 2022: Today, Going Digital: Behavioral Health Tech (GDBHT) – the largest virtual conference focused on expanding access to mental health and substance use services through technology and innovation – announces that it will now also be live and in-person. GDBHT is furthering its mission to connect and accelerate mental health and substance use access by bringing together stakeholders in-person in addition to online: health plan executives, employers, benefits consultants, behavioral health providers, mental health startups, VCs, policymakers. 

“Over the last three years, we have convened thousands of stakeholders passionate about behavioral health and health equity, and I am thrilled that we will now be able to connect in-person next year, in addition to our traditional online experience a few weeks after.” - Solome Tibebu, Founder & CEO, Going Digital: Behavioral Health Tech.

The conference will take place in-person on November 15-17, 2023 at the Waldorf Astoria Biltmore Hotel in Phoenix, Arizona. The traditional mass online GDBHT conference takes place virtually three weeks later.  All online attendee revenue will be donated to their 2023 non-profit partner, to be announced.

In partnership with PESI, a nonprofit organization dedicated to providing accredited continuing education for mental health and substance use professionals worldwide, GDBHT will offer CE credits for mental health professionals who attend either the in-person or virtual conferences. 

“We are excited to partner with GDBHT to provide continuing education credits for mental health professionals at this essential summit,” said Tiffany Richter, Vice President of Marketing. “Expanding access to mental health and substance use care and supporting clinicians who do this important work has never been more critical.”  

The conference will showcase the changing technological, reimbursement, and policy landscape for telehealth and other virtual behavioral health solutions. Join thousands of other healthcare professionals working to make mental health and substance use care more accessible for all. Visit the Going Digital: Behavioral Health Tech website to request an invitation and join the weekly newsletter, and follow along on Twitter and LinkedIn for updates. 

About Going Digital: Behavioral Health Tech

The Going Digital: Behavioral Health Tech conference is the largest conference focused on expanding access to mental health and substance use services through technology and innovation. The conference convenes health plans, employers and benefits professionals, health systems, behavioral health providers, investors, startups and policymakers to share best practices for deploying effective, scalable behavioral health solutions to all individuals.  

The conference will showcase the changing technological, reimbursement, and policy landscape for telehealth and other virtual behavioral health solutions. Join thousands of other healthcare professionals working to make mental health and substance use care more accessible for all.  Visit us on Twitter and LinkedIn.   

About PESI:

Founded in 1979, PESI is the world’s leading provider of continuing education for mental health, healthcare, and rehab professionals. Our nonprofit mission to connect knowledge with need guides us in creating powerful trainings that give clinicians techniques to help people on their healing journey. PESI proudly partners with experts in the field, conferences, publishers, associations and institutes to support the betterment of mental health and healthcare worldwide.

Nov 15, 2022
8 min. read

Closing the Gap in Mental Health Treatment with Peer Coaching Support

Recent movements like the Great Resignation forced employers to address stress management and burnout as employees rebelled against toxic workplace environments and Hustle Culture.
Richard Jones

When Heritage CARES (Comprehensive Addiction Recovery Education & Support) was founded in 2021, the company was primarily focused on supporting and educating people struggling with substance misuse and its underlying causes such as depression and trauma. By mid-2022, the company had expanded its  focus to include additional mental health concerns like grief, stress management, and anxiety, and as a result rebranded the company name to Youturn Health to reflect its commitment to providing more holistic mental health education and support. 

“We’ve seen a tremendous focus on overall mental health in recent years,” says Hamilton Baiden, CEO of Youturn Health. “The stress of the pandemic really forced Americans to confront the fact that mental health needs to be treated at every level in every home.” Youturn Health’s virtual program combines peer coaching support with online education and family support to help people understand the nature of their struggles and make meaningful steps toward recovery.

Mental health concerns like depression, substance misuse, and suicide were issues before the pandemic, but added stressors like isolation during lockdown, grief from suddenly losing a loved one, financial insecurity, and job instability pushed more Americans to their breaking point. Additionally, recent movements like the Great Resignation forced employers to address stress management and burnout as employees rebelled against toxic workplace environments and Hustle Culture.

According to the CDC, 50% of Americans will be diagnosed with a mental illness or disorder in their lifetime. Despite this, Mental Health America’s The State of Mental Health in America report states that half of adults with mental illness do not receive treatment, amounting to over 27 million Americans. There are myriad reasons people may not seek treatment for mental health such as stigma, fear of judgement, and the belief they can fix it themselves. The impact of untreated mental health issues include:

  • Personal: Developing serious health conditions like Post-Traumatic Stress Disorder (PTSD), chronic illness, substance abuse, and Serious Mental Illnesses. Mental health issues can impact personal relationships, job, and most aspects of everyday life.
  • Social: Increased rates of substance misuse, incarceration, homelessness, and suicide.
  • Economic: Decreased productivity, motivation, and workplace morale; increased healthcare costs, sick day usage, and turnover.

This gap in treatment inspired Youturn Health’s leadership to act. “Through some phenomenal partnerships, we’ve been able to expand our focus to add support for issues like grief, stress, and burnout,” says Baiden. “For example, we had experience supporting people through grief tied to substance misuse – losing a loved one to an overdose or using drugs or alcohol to numb the pain of grief – but in teaming up with Taylor’s Gift, we can now also offer emotional and grief support to families after the sudden loss of a loved one for reasons beyond substance misuse.”   

Taylor’s Gift is a nonprofit organization helping families of organ and tissue donors navigate the grief process and was founded by Tara and Todd Storch after the tragic loss of their 13-year-old daughter, Taylor, following a skiing accident. “Grief is different for everyone,” says co-founder Tara Storch, “there is no right way to grieve, but so often we find people don’t know what to do with their pain. No one should ever have to grieve alone.” 

Following Taylor’s accident, doctors approached the Storches about Taylor being a candidate for organ donation. Tara and Todd agreed, and Taylor’s generous donation saved and improved the lives of five people. This left the Storches in a complex emotional state. They felt grief over the sudden loss of their young daughter but also felt gratitude that her final act helped improve the lives of others. 

Knowing firsthand how complex the grieving process can be for organ donors, the Storches created the Kindred Hearts Program to offer free grief support to donor families. The program is the signature program of Taylor’s Gift Foundation and offers one-on-one and family support with Caring Guides (trained peer coaches from Youturn Health), and support groups to help navigate the grief process. 

Caring Guides all have lived experience with grief and loss; they combine that lived experience with education and evidence-backed techniques to help grieving individuals and families develop coping skills to better understand and manage the loss of their loved one. "None of us choose to go through deep periods of grief but I found when I did, I was encouraged when I talked with others who had also experienced deep grief,” said Annalyn, a Caring Guide for the Kindred Hearts program. “It gave me hope that although my life would never be the same, it would go on.  I hope to give others a glimmer of hope in their darkness as well."

“The experience of the sudden loss of a loved one combined with the sense of gratitude you feel when that loved one becomes an organ donor – being able to offer a second chance at life to someone else – it’s a complicated mix,” says Storch. “It can be paralyzing, cause depression, affect your relationships, and put a stop to everyday life. The Kindred Hearts program gives families a safe place to talk about what they’re feeling, and the Caring Guides help them learn to take care of themselves while grieving.” 

And the program has been a resounding success. Since launching in 2022, The Kindred Hearts Program has 11 Caring Guide peer professionals and has had over 120 people reach out for grief support.  Just over the past few months, the program has provided support to over 75 people. Perhaps most impactful is feedback from Kindred Hearts program participants:

“I was set up with [my Caring Guide] to help with the loss of our daughter,” wrote one anonymous participant. “I've done talk therapy off and on for many years and found it helpful to a point. But I have to tell you I am flabbergasted that she has helped my soul feel lighter and move through things in an unbelievable way. It has been so transformational for me. I would love for my son to be able to visit with her too. This thing you do to help people is the most beautiful thing I've ever been a part of. Thank you!”

“It’s time to destigmatize seeking help for mental health issues like grief and stress,” says Baiden. “People shouldn’t have to ‘tough it out’ at the cost of their health and happiness. Education and support are proven to help and thanks to forward-thinking companies like Taylor’s Gift, we’re able to reach more people and help.”

Article written by Richard Jones, Chief Clinical Officer, Youturn Health.

Nov 8, 2022
7 min. read

Honoring and Rewarding Therapists in Tech

In digital behavioral health companies, clinicians should be included in the early stages of startups in order to ensure clinical quality from the very beginning. However, clinicians transitioning from a clinical role to joining a digital behavioral health startup often find it challenging to navigate the new terminology, culture, and norms.
Charlotte Hawks

In digital behavioral health companies, clinicians should be included in the early stages of startups in order to ensure clinical quality from the very beginning. However, clinicians transitioning from a clinical role to joining a digital behavioral health startup often find it challenging to navigate the new terminology, culture, and norms. But clinicians have essential expertise and skills crucial to a behavioral health company’s success. 

When building a mental health startup, it’s important to utilize clinicians’ skills and expertise and to pay them appropriately. A survey by Therapists in Tech found that clinicians who did not use their clinical license in their current positions tended to earn more (about $20k) than respondents who did utilize their clinical license in their current role. Mental health is historically poorly reimbursed, but low pay in the corporate world can also hinder progress as a mental health company. In addition to paying clinicians appropriately, there are several ways to effectively utilize mental health clinicians in behavioral health startups. 

Listening to Clinicians

When asked about the differences these clinicians see between companies that have a strong clinical voice versus those that do not, licensed clinical social worker Jaclyn Satchel points out that not having a strong clinical foundation can lead to a lack of clinical quality standards. She continues, “I believe that the lack of clinical quality standards turns into ignoring patient safety.” Patient safety and care should be baked into each company from the very beginning, and this happens organically when clinical leaders are involved from day one.

In the same panel with Jaclyn, panelists also dove into the balance between tech and touch and what both patients and providers think is the right balance. Dr. Hannah Weisman mentions that the field is still trying to understand, “how do you get people to engage with kinds of technology solutions, because the thing I keep seeing is that consumers still want the high touch support, regardless of their level of acuity. So I think there’s this mismatch in a way between being more efficient, but that’s not necessarily what the consumers are demanding.” Dr. Jessica Jackson echoes, “my humble prediction is that we’re going to get to a point where we need to integrate touch with tech. The reality is that no matter how far we get with technology, humans still want connection. “Finding the right balance will lead to better patient retention.

Dr. Grin Lord explains, “there are business decisions that are being made to make care efficient and to increase reach, but they may not be the appropriate clinical decisions. Every step of the way, you need a clinician helping you to understand how to balance those business needs and scalability with the appropriate clinical care.” Having a clinician on your leadership team can help you navigate multifaceted decisions where your team has to consider both profit and appropriate clinical care. 

Clinicians Transitioning to Tech

One thing that stuck out during our conversation is that clinicians who are working at digital health startups are looking to use their clinician expertise, but they are interested in work beyond just the clinical scope. However, Dr. Lord mentions, “so unfortunately… there’s still stigma or perceptions that you can’t both be a caregiver and have business acumen.” In her experience, she has found many clinicians excited to be involved and trusted with business decisions, but they can sometimes be overlooked as true business partners. 

Advice for Startups and Employers

Dr. Lord mentions, “there seems to be a predominant business model that’s based on the commodification of therapists. And at the end of the day, the unit economics of basically doing cheaper sessions… It’s ultimately not going to work. So the business that figures that out… how to retain clinicians and make them happy, I think it’s going to be – long term – very successful.” Dr. Lord further explains that clinicians have active licenses and can individually contract with insurance companies, so in order for companies to retain their clinical talent and reduce churn, they have to keep their clinicians happy and well-paid. 

Additionally, panelists talked about the relationship between rapid growth and clinical quality. Dr. Lord mentions that many companies are relying on the “lifetime value of…both the provider and the patient. And right now, what we’re seeing is high churn in both areas, when this quality problem hasn’t been solved.” She continues that patients look for a therapist-like relationship that is continuous over time, and “if your company can’t retain your therapists, you will lose…the patients.” This patient-provider relationship has to be a core part of the business model, and “it has to be viewed as a continuous one and one worth investing in intentionally. And once you can figure that out… I think there’s going to be huge impact and successes from a business standpoint.” True leaders in this field will be able to recognize this from the beginning and not try to approach clinical quality as an afterthought that can be solved while expanding.

Top Tips for Startups

  1. Invest in Clinical Leadership Early. Building a clinically sound product requires being thoughtful from the start and integrating clinical knowledge from day one.
  2. Focus on Retaining Clinical Staff. Understand that clinical staff is a core part of your product, pay them accordingly, and understand their limitations to prevent burnout and churn.

There is so much valuable and actionable insight from our conversation with the Therapists in Tech team. To hear our full conversation, please visit our video library.

Oct 27, 2022
10 min. read

Body, Mind, & Spirit: Elevating and Personalizing Behavioral Healthcare

At Evernorth, elevating behavioral health means providing a set of services that help to stabilize and improve a person’s wellbeing (body, mind and spirit) along with creating awareness, positive coping skills and tools to build resiliency.
Melissa Reilly & Dr. Doug Nemecek

In a world where behavioral health has been siloed for so long, is it really possible to find behavioral healthcare outside of point solutions? Is coordinated pharmacy, medical and behavioral care feasible? We spoke with Chief Growth Officer, Melissa Reilly, and Chief Medical Officer, Dr. Doug Nemecek, about Evernorth’s goal to make this utopia a reality. 

By now, we all know that unaddressed behavioral health conditions can negatively impact co-occurring physical health conditions. But first, Melissa and Doug dive into the ramifications that affect payers. They will also touch on Evernorth’s approach and key considerations in behavioral healthcare.

How do unaddressed behavioral health conditions affect costs for payers?

Melissa: Over the last few years, there has been such an increased focus on mental health and behavioral health needs and payers that we work with have a unique spectrum of needs that is often based on their unique populations.  Across that spectrum, we have seen firsthand, when members do not get the behavioral care they need – it increases the total cost of care and their members' ability to live the lives they want.

With the average delay between symptoms onset and treatment being 11 years, time to quality care has a huge impact on a payer’s total outcomes measures and also an individual’s ability to be a productive member of their community.

The other thing we tackle every day is that data across the care ecosystem is fragmented. Access to care is limited. Health equity and cultural concerns are often overlooked. Navigating behavioral health care without the right partner can lead to overspending. Members may start and stop care and/or switch providers a number of times before they find the right provider or the type of care that meets their unique needs. A first-of-its-kind analysis completed by Evernorth found that people diagnosed with a behavioral health condition, such as anxiety, depression, or substance use disorder, who receive behavioral outpatient care had lower total health care costs by up to $1,377 per person in the first year compared to those who didn’t. Not only that, the savings impact was sustainable over time with a two-year cost reduction of up to $3,109 per person.

Our behavioral health solutions support the reduction of overspending by addressing behavioral and mental conditions before they further complicate health.  We also can help payers solve some of their biggest challenges by leveraging our suite of Evernorth assets.  Our data and collaboration with our partners allow us to proactively identify and engage with members early before it leads to a bigger issue. By matching members to the right level of resources more quickly, our next-generation experience delivers data-driven, personalized care on demand. We partner with our clients and those we help every step of the way to guarantee results.

Doug: Unaddressed behavioral health conditions also play a large role in a person’s other medical comorbidities. Someone who is struggling with diabetes, for example, is significantly more likely to be struggling with depression. 92% of adults living with behavioral health disorders also suffer from physical conditions and cost approximately 3-6x more.

Our approach is focused on whole-person health, and it’s imperative to pay attention to both mind and body – that is where we see the most success.

What is Evernorth’s approach to good behavioral health care?

Melissa: At Evernorth, elevating behavioral health means providing a set of services that help to stabilize and improve a person’s wellbeing (body, mind and spirit) along with creating awareness, positive coping skills and tools to build resiliency—reducing the burden of their issues, big or small. Enabling people to contribute productively and effectively to live their life with peace of mind.

We are always innovating and connecting cohesively across the ecosystem – we don’t wait for the call – we are proactive in identification, engagement, and network outreach tailored to a member’s needs- like providing quick access to care and looking at medication impacts, how and when our employees used it, with measurement to ensure your population is on the right pathway to optimal health. We elevate behavioral health through a data-driven approach that meets members where they are across the healthcare ecosystem, like when filling scripts or visiting PCPs. We leverage capabilities like accurate and early identification, in-the-moment engagement and quality of care on connected platforms to deliver personalized behavioral health with the right resources and level of care at the right time, reducing total cost of care - with an emphasis and focus on measurement throughout the member journey.

Our goal at Evernorth is to break down the silos to provide coordinated pharmacy, medical and behavioral care – we strive to provide the right care, at the right time, in the right place.

Doug: ​What you may not realize is that access is only a small piece of the problem - the member's individual needs are not the same for everyone - from the time to first appointment, matching to the right provider and delivering quality outcomes. Our provider matching is second to none, we have the ability to guide members to find the right level of care for them, the right provider that meets their needs and preferences, and makes them feel comfortable seeking and continuing with care. We also follow up to ensure members get the care they need and that no one falls through the cracks.

We’re also always looking for ways to improve and expand our network. We identify providers that will meet members’ diverse needs. For example, we are actively working on contracting virtual providers that focus on using evidence and cultural competency to improve access and efficacy for people in BIPOC (Black/Indigenous/People of Color) communities.

19.4% increase in the number of providers specializing in addressing cultural/ethnic issues

Our large network focuses on quality providers, with capabilities to deliver all modalities and acuity levels of care from text coaching to acute inpatient care, virtual and face-to-face appointments, across all specialties, with our provider match based on preferences, and need. Navigation support along with our data insights to proactively identify and engage members – access is not just quantity of providers but the right care at right time with the right provider throughout the journey. Clinical models are built to engage members early based on our data and ensure every individual is getting the immediate support they need.

96% of Evernorth customers would recommend their in-network provider

​It’s important to address lack of access and high total medical spend and to choose a BH partner that challenges the status quo, delivering innovative BH care holistically and comprehensively without the need of added point solutions. Evernorth is the partner to do that.

What is the most important takeaway for our readers?

Melissa: Engaging the member early and often is where we’ve seen the most success. We can understand where the member is on their behavioral health journey and identify issues and engage the member earlier on.

Holistic care and measurement throughout are also critical. We can see how a member’s overall behavioral health is improving and provide the right level of care when the member needs it.

Doug: Helping each member to find the right level of care is so important. Whether that is coaching or an in-person therapist – every member is unique and we need to personalize the care journey for them. This approach is more affordable and prevents behavioral health issues from developing into more severe and costly conditions.

To learn more about Evernorth’s suite of behavioral health solutions or its approach to behavioral healthcare, visit Evernorth Behavioral Health | Evernorth or contact winningbehavioral@evernorth.com.

Oct 20, 2022
4 min. read

Healing Lives Together: A conversation about human-centric care for people with multiple chronic conditions

Lyn Health's Chief Commercial Officer, Steve Andrzejewski shared the benefits of prioritizing behavioral health conditions, simplifying the healthcare experience, and offering polychronic care for employees.
Steve Andrzejewski

Our past article touched on the difference between the treatment of mental and physical health conditions. However, what we didn’t mention are the innovative companies that are addressing multiple chronic conditions, including behavioral health diagnoses. Integrating the care of mental and physical health leads to better outcomes. Lyn Health, a human-centric healthcare provider created for people with multiple chronic conditions, has seen improvement in patients first-hand. Chief Commercial Officer, Steve Andrzejewski shared more about the benefits of prioritizing behavioral health conditions, simplifying the healthcare experience, and offering polychronic care for employees.

How does addressing multiple chronic conditions benefit the care of behavioral health conditions?

Lyn Health believes all chronic conditions are of equal importance and often impact each other. Any attempt to address one, while not taking into account the others can put both the clinician's care plan(s) as well as the member's overall wellbeing at risk. Additionally, we must also account for the member's personal goals alongside their clinical needs as we develop a singular, holistic care plan for all the member's chronic conditions.  

Lastly, we continue to see the benefits of prioritizing BH conditions, early. This focus can both help build patient/clinician trust as well as prepare the patient mentally to tackle other chronic conditions they are burdened with, many of which have been for years.   

Tell us more about how Lyn Health is simplifying how patients access healthcare.

Lyn Health firmly believes that for the polychronic population, the current healthcare ecosystem is less than ideal.  After decades of 'status quo", we are seeing a rise in the loss of hope throughout this population. These polychronic patients are attempting to manage a PCP, 3-7 specialists, health plan, provider system, TPA and in many cases a host of single-point solution vendors. We have created a model that makes it nearly impossible for someone to manage both their clinical needs as well as their personal life 

Lyn Health innovates around love, empathy and compassion and ensures that the member is in the middle of our work. Wrapped around each member is Lyn's Care Circle, a team of clinicians that not only delivers virtual care, but also provides;  care navigation, care advocacy, care management, virtual PCP and urgent care, integrated behavioral health and community and social support resources, 24/7. If we are to address each patient's health in totality, providing a single point of contact for all clinical and administrative needs is crucial to success.

Specifically for employers, what are the benefits of offering polychronic care to employees? 

Employers today face many challenges as it relates to their benefits portfolio, including cost. As an industry, we know that roughly 40% of US adults are defined as being polychronic. Financially, this group drives 70% of our annual healthcare spend and is expected to grow to 84M people by the end of this decade.  If we continue to ignore the rise in prevalence rates, we are guaranteed to see a continued escalation in both condition severity and spend.

Oct 6, 2022
12 min. read

The Value of Investing in Population Specific Mental Well-Being Programs for Higher Ed

With college-age young adults facing a myriad of stressors, from student debt to social isolation, we’re seeing more severe mental health acuity and higher rates of help-seeking behaviors.
Andrew Hermalyn + Mantra Health

With college-age young adults facing a myriad of stressors, from student debt to social isolation, we’re seeing more severe mental health acuity and higher rates of help-seeking behaviors. As a result, higher education institutions are taking action by investing in more robust mental healthcare resources and searching for a new model of care for their students driven largely by the inability to recruit and retain on-campus mental health providers. 

“More severe mental illnesses start to present themselves during this age group and research has shown that identifying these disorders early and treating them effectively has a huge impact on outcomes,” says Nora Feldpausch, MD, Medical Director at Mantra Health, the preeminent digital mental health clinic for young adults. “College-age young adults are just starting to become independent and think for themselves for the first time, but many have no prior experience with the mental health system. They don’t know where to begin or how to navigate their mental health needs.” 

There’s a growing demand for more student mental health care, as more students face higher levels of stress, anxiety, and depression, and it's becoming increasingly clear that every campus has a different need. Massachusetts Institute of Technology, a private institution known for its prestigious academic programs, partnered with Mantra Health, in part, to secure more providers of diverse backgrounds, training, and specializations. Alfred State College, in contrast, wanted to widen access to psychiatric care, which was difficult to find in the remote New York town – and found that Mantra Health’s telepsychiatry program offered the most comprehensive clinical care.

Mantra Health knows the importance of campus-tailored care and has recently partnered with institutions including Juniata College, University of Tennessee at Martin, and Siena College, and recently signed a multi-year contract with one of the largest state systems in the country.  Since raising $22m in Series A funding in December 2021, Mantra Health has grown exponentially and now serves 105 campuses and approximately 800,000 students. Aiming to serve over 40 million young adults over the next decade, Mantra Health explores the reasons for investing in a company that specialize in young adult mental health care. 

Why do young adults require specialized mental health care?

Not only is suicide a leading cause of death among young adults, but 75% of all lifetime mental health disorders develop by the age of 24, which means there are thousands of college students seeking treatment for suiciditality and symptoms of anxiety, depression, borderline personality, mood, persistent attention deficit/hyperactivity, and other mental health disorders for the very first time. 

“To properly care for this generation, we must invest in mental health providers that understand the brain of young adults, the daily challenges they face, and the systems of care in which they live, work, and study,” says Andrew Hermalyn, an independent Board Member at Mantra Health, and the President of Partnerships at 2U, an online education company that partners with 230+ campuses to serve 45 million higher education learners globally.

Building a system of care within the college community that focuses on the specialization of young adult mental health care is vital. A recent study reveals the importance of this, as young adults experiencing serious mental health problems require a specific philosophy of care that supports them into the transition to adulthood in which independence is expected. This type of care may not always be provided by adult psychiatry, as young adults are dealing with emerging and pre-existing mental illness while at the same time undergoing significant life changes. 

In addition to being transitional age youth, students also identify as LGBTQ+, parents, part-time workers, international students, first-generation students, athletes, among other identities. These specialized populations require specialized care and Mantra Health understands this firsthand and is working with industry-leading partners to support these students. Recently, for instance, Mantra Health conducted a nationwide survey of athletic leaders with the NAIA, finding that 92% of respondents want to make psychiatry services available to student-athletes, and published a white paper on best practices for athletic departments

Why must student mental health be met with provider diversity?

“The mental healthcare system today isn’t designed for young adults. Many college students are still covered under their parents insurance, living on their own for the first time, and putting their trust into an institution that has promised to support them during this transitional period of their life,” says Ed Gaussen, Co-Founder and CEO of Mantra Health. 

Historically, many institutions turn to medical providers or community mental health providers to try to fill the gap. At a rapid pace, higher ed institutions are shifting their resources to digital mental health companies as a full campus well-being solution. One challenge is finding a diverse group of mental health professionals who have experience working with young adults within the college setting. The second is designing and building the workflow and data integrations to ensure the care team is knowledgeable about the campus environment where this patient lives, and can tailor care accordingly, and at scale.  

“Not all care is created equal,” says Dr. Feldpausch. “If you’re going to invest in additional mental health resources, make sure you’re getting access to a team of mental health providers who can provide equitable and culturally-informed evidence-based care to all of your students, no matter their background, race or ethnicity, gender identity, sexual orientation, ability, religious belief, socioeconomic status, mental health condition, or circumstance.”

“Beyond patient-specific care, Mantra emphasizes campus-tailored care, where we have custom tools and product features that empower providers with campus-specific knowledge and protocols that will be most impactful to a patient’s care. This is how we can keep expanding our diverse pool of providers while maintaining a personalized care model for each of our institutional partners,” says Gaussen.  

How do you track and measure the success of student outcomes differently?

Good assessment and progress monitoring is foundational to evidence-based care. Mantra Health starts with a holistic assessment of student symptoms, as well as their clinical history and social situation. Students who receive Mantra Health care are assessed regularly for common mental health symptoms with an additional focus on psychological well-being, flourishing, and factors that may hinder a student’s ability to stay in school.

“Mantra Health screens for a broad range of social determinants that can derail a student’s academic career. This model gives us a much fuller picture of how each student is doing so that we can support them in moving beyond just surviving toward thriving in college and in life,” says Carla Chugani, PhD, LPC, the VP of Clinical Content and Affairs at Mantra Health, who specializes in DBT and recently joined from the University of Pittsburgh. 

When it comes to the health and safety of students, clinical partners and student affairs leaders on campus need real-time communication and on-demand reporting to manage patient progress, and clear evidence of program ROI and population analytics to make the case for continued investment in campus mental health resources. At Mantra Health, we have a partner success, care navigation, and medical and therapy supervision team who use a variety of clinical measurements, screening tools, nationally standardized clinical protocols, and evidence-based practices to support counseling and psychiatric services, fill gaps in care, and meet the diverse needs of students. 

Why invest in a mental health provider that works exclusively in higher ed?

Far too many college students are battling undiagnosed and untreated conditions, avoiding help-seeking behaviors, or refusing care because it doesn’t fit into their schedule or match their preferences or needs. 

“There are only really a few specialized mental health companies that work exclusively with colleges and universities who genuinely understand the challenges faced by college students and know the value of embedding mental health services into the campus community that these students call ‘home,’” says Matt Kennedy, Co-Founder and COO of Mantra Health. “The average higher education buyer is much more discerning around population specialization and quality than when we entered the market in 2020.”  

Young adults aren’t just students. They are also part-time workers, parents, athletes, and individuals battling homelessness, financial insecurity, the justice system, and other hardships. If higher ed institutions want to encourage help-seeking behaviors, build resilience, and protect their mental health, they need to be willing to invest in their overall well-being and provide them with quality care that’s tailored to their specific needs.

Colleges and universities have a unique opportunity – and arguably, an obligation – to build more comprehensive mental health offerings that safeguard the health and well-being of their students, all of whom are on their way to becoming the next generation of leaders and stewards of our world.

Mantra Health is a digital mental health clinic improving access to evidence-based mental healthcare for young adults. Learn more about the company and how they work with higher ed institutions here

Thanks to our contributors Andrew Hermalyn, President of Partnerships at 2U and Mantra Health’s Co-Founder and CEO Ed Gaussen, Co-Founder and COO Matt Kennedy, Medical Director Nora Feldpausch, MD, and VP of Clinical Content and Affairs Carla Chugani, PhD, LPC.

Sep 27, 2022
5 min. read

Leveraging Artificial Intelligence to improve quality, reduce costs, and increase staff satisfaction and productivity

Lyssn.io offers a clinically-validated AI platform capable of accurately assessing the use of evidence-based practices such as Motivational Interviewing and Cognitive Behavioral Therapy.
Richard W Mockler, MPP

Lyssn.io offers a clinically-validated AI platform capable of accurately assessing the use of evidence-based practices such as Motivational Interviewing and Cognitive Behavioral Therapy. With more than 54 metrics on everything from expressed empathy to open questions, Lyssn’s AI can help practitioners of all kinds hone their skills. On the organization side, Lyssn empowers them to better support staff and improve patient/client engagement and outcomes. In addition, Lyssn’s platform delivers draft clinical notes after every session and includes additional functionality for use in the hiring and training process. Rooted in over a decade of scientific inquiry, Lyssn’s technology has been validated in over 50 peer-reviewed academic publications, and it is in use in clinical, social services, academic, and population health settings across the US and in the UK.

Tell us about the clinical and technical research that provides the foundation for Lyssn’s AI.

Lyssn’s founders created the field of AI-supported quality improvement for behavioral health, wellness, and other healthcare conversations during their academic careers. Lyssn’s AI is built on more than a decade of their research and over 20,000 human-rated psychotherapy conversations (millions of labeled utterances). It’s been published in more than 50 peer-reviewed publications and secured $15 million in NIH funding. The core: We use the same established, gold-standard measures of fidelity as human raters in academia, healthcare, social services, and clinical practice everywhere – and we have trained our platform to do it at least as accurately, way cheaper, and way faster than the humans do.

With so many behavioral health companies competing for talent and customers right now, how can Lyssn’s platform improve hiring, training, and quality assurance?

The Lyssn platform can help at every step. Our hiring tool quickly and immediately assesses a candidate’s skills on gold-standard metrics for MI and CBT, giving hiring managers immediate insight into a candidate’s actual skills, not just their credentials. 

Lyssn's easy-to-access training programs provide the most effective form of education: instruction, followed by practice, followed by direct feedback. While most programs offer only instruction, Lyssn's proprietary evidence-based artificial intelligence, Lyssn AI, gives clinicians and others the chance to practice their skills. In addition, the Lyssn AI platform allows comprehensive measurement and reporting not just of participation but of actual improvement in skills.

Our notes tool drafts clinical-quality notes from sessions, saving clinicians time on their most-hated task.

And our always-on quality assurance measures those same metrics during sessions – with the accuracy of a human rater but at a far lower cost. This way, supervisors and clinicians both have access to specific feedback on where they are and are not using evidence-based tools, which then can feed right back in to use of the training modules.

So, what’s the ROI and other benefits behavioral health employers can see from using these tools?

The first is savings from having the platform do the work that humans would do. Very few people have the staff to do mock sessions with new hires – but with our tools, you can quickly measure skills to avoid the costs of retraining or turnover. Our training tools are available any time and fully self-service, so there are no additional costs for workshop trainings, and new staff don’t have to wait. One customer says Lyssn Notes has increased efficiency in that area by 100%, with room for more improvement! And our quality assurance replaces expensive review/supervision by highly-trained staff (usually of a small portion of sessions) with continuous review and feedback at a fraction of the cost.

But the quality return is even more important, and why we started Lyssn. Evidence-based practices work when they are implemented with fidelity. This is very hard to monitor, and many payers, patients, and others often wonder how well quality is being managed in behavioral health. Our metrics strongly predict both engagement and outcomes and are continuously available to help document the use of EBPs and keep improving fidelity so that people get better more often. This can be a strong selling point and is also a requirement of certain contracts, for example, in the Family First Prevention Services Program.

Sep 22, 2022
4 min. read

Investment Trends in Mental Health & Digital Wellness

There is a $132B expected growth of the U.S. behavioral health market by 2027. Telosity released a comprehensive market guide that provides extensive industry research and actionable insights about the Wellness & Mental Health Opportunity.
Anish Srivastava & Faye Sahai

Digital wellness is a $4.5T market, and mental health has a $6T global economic impact, with 970m individuals suffering with mental illness. There is a $132B expected growth of the U.S. behavioral health market by 2027. For digital wellness, we see prevention, sleep, nutrition, and activity as key. Telosity, a venture capital firm that invests in pre-seed and seed stage startups focused on digital wellness and mental health, has several exciting opportunities for our community. Read on to learn more about their newly-release digital wellness and mental health trends report, along with upcoming events below:

Highlights of Key Digital Wellness and Mental Health Trends:  

Telosity released a comprehensive market guide in Q3 that provides extensive industry research and actionable insights about the Wellness & Mental Health Opportunity. It serves as a tool for founders and investors to categorize and assess opportunities in the mental health digital arena.

The full report is available here.

Below are key themes that the market guide addresses:

Increasing innovation and technology are moving beyond teletherapy, with tech-enabled solutions having an impact at scale. 

  • 96% of all products developed by digital health ventures focused on mental health are mobile applications. 
  • 80% of adults would incorporate technology into their mental health routine
  • We are seeing more artificial intelligence, virtual reality, augmented reality, internet of things sensors, wearables, personalization, and predictive solutions emerging.
  • Numerous studies have demonstrated that mobile apps are effective and potentially significant tools for the assessment, management, and treatment of youth mental health. 

Expanding needs are stimulating the rapid growth of mental health and digital wellness.

The needs and market are growing globally with estimates of:

  • $4.75 trillion global wellness market projected to grow to $7 trillion by 2025 
  • $1.2 trillion spent in the U.S. on wellness, by far the largest wellness market in the world 
  • $44 billion in losses in workplace productivity due to depression
  • $132B Expected growth of U.S. behavioral health market by 2027

Growing investments and venture capital in mental health and digital wellness since 2018 with record-breaking years:

  • Mental health investments overall have increased by 10x in 4 years since 2018.
  • Youth mental health and wellbeing investments have grown 15x since 2018.

There is an urgent demand for mental health solutions for young people. For investors and startups, there is an unprecedented opportunity to build significant and sustainable business models while doing good and making an impact.

Learn more in the complete market guide available now to download, including in-depth analysis, opportunity areas, startup guidance, and additional resources for you to explore.

Join us at Upcoming Programs 

Mental Health Forum: Join leaders in the mental health field to discuss both front-line experiences and investment opportunities. “Mental Health Front Lines and Investment” is brought to you by Sheri Mac Enterprises, Soul Centric Counseling, and Telosity Ventures. The hybrid event will feature keynotes and leaders in both the field of investment and mental health. At the in-person location, there will be networking as well as refreshments.

Telosity Happy Hour: This invite-only event is designed to foster new connections and meaningful discussions on the latest happenings in digital health and investments. In addition, this is a great opportunity to chat with the Telosity Ventures team about their recent market guide highlighting investment trends in companies targeting digital wellness and mental health.

Contact the Telosity Team to learn more: anish@telosity.co and faye@telosity.co

Sep 13, 2022
4 min. read

Part II: Off to College? Let Tech Help

Six tech companies that can help navigate the college experience – a follow-up to Part I.
China Campbell

Increasingly demanding, stressful, and overwhelming. These terms are usually used in conjunction with college students expressing their emotions and feeling associated with college life. In addition to Part I of student resources, here are six tech companies that can help navigate the college experience. 


BetterMynd is a social impact startup that provides access to mental health services for America’s 20 million college students. They serve over 50 college campuses nationwide to supplement mental health and well-being. Through a network of providers and the power of teletherapy, BetterMynd is empowering college students to get the mental health care they need. Students can sign up for an account through their college’s unique BetterMynd portal.

The Zone

The Zone provides a personalized wellness platform designed for athletes’ mental health. You can be proactive with a state-of-the-art mental wellness platform that integrates perfectly into your organization’s wellness program. Their access to support makes reaching out for help more accessible and streamlined than ever before. The Zone provides an accessible and scalable platform for anyone wishing to improve their well-being.


PursueCare welcomes those in need of support and will always meet them where they are in the process. They treat a broad population group ranging from people with opioid, alcohol, or other substance use disorders, pregnant women needing addiction treatment, and those who have relapsed. They also offer complete psychiatric treatment and counseling/therapy for people with mental health issues. PursueCare has partnered with ChristianaCare to provide virtual mental health solutions to participating college campuses. Participating students can access ChristianaCare’s internal and family medicine providers and PursueCare’s mental health, psychiatric, and medication-assisted treatment providers through a single digital portal.

Pen, paper, and a textbook.


META provides the mental health support students need when they need it to improve engagement and retention. Students can choose from a diverse provider network. Monthly reporting helps to predict student needs, track outcomes, and gauge impact. META is trusted at 170 college campuses.


MindSpark programs deliver extraordinary professional learning experiences for educators, the community, and industry partners who take their new skills back to the classroom and beyond. They cultivate whole-person growth and sustained organizational outcomes through the world’s most extensive, customized, and extraordinary professional learning experiences. MindSpark aims to help leaders confront fundamental challenges and foster transformational progress by embedding key practices and strategies within your school. They draw on the expertise of impassioned researchers and practitioners such as former educators and industry leaders to solve critical issues around educator retention, cultural evolution, and school re-design.


Using AI Communications, including two-way texting, AI chatbots, and live chat, every student gets the answers they need and deserve, so no student is left behind. Ocelot’s comprehensive, AI-powered SaaS platform enables colleges and universities to proactively and reactively reach students and guide them through all aspects of the student journey to increase access, enrollment, retention, and wellness.

Aug 25, 2022
13 min. read

Shifting from Structure to Process and Outcomes in Behavioral Health

The Donabedian model provides a helpful framework for understanding the components of delivering quality care.
Alon Joffe

There has been a great deal written over the last two years about the increase in demand for behavioral health services (sometimes referred to as “the silent pandemic”) and the rise of virtual care like tele-behavioral health services. As it gets easier than ever for consumers to reach out for help and seek care with less stigma and more social openness, we are simultaneously facing a paucity of professional behavioral healthcare providers. Several recent publications by SAMHSA indicate we need 4.5M more clinicians to keep up with demand. The proliferation of virtual solutions and increased demand have exacerbated the shortage of clinicians and caregivers. In addition, the behavioral health market is moving to a quality-oriented model characterized by measurement, outcomes, and value-based reimbursement. In this article, we will propose a framework behavioral health providers can use to reconceptualize their care delivery models to both respond to the increased service demands and the shift to measurable quality. 

What is this framework you mentioned that providers can use to respond to the increased service demands and the shift to measurable quality?

It is called the Donabedian model. The Donabedian model provides a helpful framework for understanding the components of delivering quality care. The model consists of three main components: Structure, Process, and Outcome. It has been widely applied in general healthcare since its inception in the 1960s, and efforts have been made to apply the model to behavioral health (e.g., NCQA, efforts with PCMH with distinction in behavioral health, HEDIS, etc.) but not very broadly or effectively. 

Let’s dive into those three components. Tell us more about the “Structure.”

Structure = The Infrastructure Layer 

Structure refers to the fundamental foundation for enabling the delivery of high-quality care, including facilities, equipment, and human resources, as well as policies for overseeing how care is administered and monitored. This layer is often described as the "availability of competent service providers and adequate facilities and equipment" (Donabedian 2005). It can be broken down into four main areas, or what we like to call "The Five C's":

1. Clinicians 

  • Years of experience 
  • Demographics 
  • Training received 

2. Compensation 

  • The ability to provide good care and the best results can only occur if what is produced is valued and paid for adequately 

3. Clinics/Community 

  • Care settings 
  • Organizational structure 
  • Facility size 
  • Staff and patient ratio 

4. Consumers 

  • Demographics 
  • Comorbidities 
  • Access to care 

5. Communication 

  • Electronic Health Record (EHR) 
  • Telehealth 
  • IT Stack, data protection, and privacy 

In most cases, the structure layer is easier to measure, as its characteristics are binary - you either have it or you don't. For instance, it is pretty straightforward to describe a typical community behavioral health organization that has 350 social workers and 10 MDs. The center has an EHR and delivers 60% of its services through telehealth. This center serves Medicare/Medicaid patients primarily, but they are also in-network with a few commercial plans. It has 10 locations, and 90% of its volume of services is through intensive outpatient programs (IOP). 

And what about the “Process” of putting this model into practice?

Process = The Treatment Layer

While the presence of key structural elements suggests the capability of providing evidence-based, high-quality care, process elements assess whether the care being provided adheres to evidence-based criteria. “Several studies have conceptualized Process as the actual treatment stage in mental health service” (Badu et al., 2019). The Process is the heart of treatment; it is where the consumers and the behavioral health providers engage in a therapeutic conversation as a means of therapy. A few key areas to highlight are: 

  1. Consumers’ participation in service delivery (engagement) 
  2. Clinicians' usage of evidence-based treatments (EBT) 
  3. The therapeutic alliance (interpersonal relationship) 
  4. Setting personal goals 
  5. Multidisciplinary teams (integrated care) 
  6. Training and supervision 
  7. Adherence to medications 

Consider the area of “Setting personal goals.” For most behavioral health providers, this involves identifying intra- or inter-personal conflicts and addressing them through various forms of psychotherapy. But recent research and our own experience have shown some interesting trends. For example, in our analysis of more than 20,000 real-world anonymized conversations, we found that 90% of behavioral health conversations cover at least one topic relevant to Social Determinants of Health (SDoH), and over 50% of those conversations cover more than four. These topics also take up a lot of time in therapy conversations. Based on our analysis of commercial populations, the clinician and member discussed SDoH topics 23% of their time together. Clearly, it's not just the traditional inter-and intra-personal problems that are important to consumers. They need - and deserve - a comprehensive approach to address many problems simultaneously. 

Additionally, the Process layer includes the operations associated with care. An example would be developing a treatment plan and accurate documentation of intakes, progress notes, and discharge plans that conform to evidence-based care.

The Process layer helps behavioral health providers to answer questions like: Are standard care guidelines being followed? Why is the member dropout rate so high? Which interventions are being used? How accurate is the documentation? 

In some ways, the Process allows us to codify the best practices and replicate them across the organization. It helps clinicians focus on what matters most (providing quality care) and ensures every conversation counts. 

As you previously mentioned, the behavioral health market is moving to a value-based model. What does the “Outcomes” layer look like?

Outcomes = The Improvement Layer 

Today, different organizations measure different outcomes. For example, some organizations measure patient-reported outcomes (such as the PHQ-9 and GAD-7), and some measure consumer goals, hospital readmissions, or medical loss ratios. The goals outlined in Crossing the Quality Chasm (Institute of Medicine, 2001) will not be possible without measurement. 

In the Outcomes layer, we ask ourselves: Do consumers get better? “The outcomes measure the effects of episodic mental health services on the well-being and health of individuals and populations” (Donabedian 2005). According to Dr. Harold Pincus, Vice-Chair of the Department of Psychiatry at Columbia University and a world-renowned expert in the field of quality improvement, behavioral health outcomes include: 

  • Patient-reported outcomes (symptoms) 
  • Quality of Life (highly connected to social determinants of health) 
  • Treatment satisfaction 
  • Improvement in overall health and functioning 
  • Lower overall cost of healthcare 
  • Enhanced coping skills 
  • Achieving personal goals 
  • 30-day rehospitalization

A recent survey found that only 16% of behavioral health providers use measurement-based care (“MBC”). The reasons for this are varied. For example, clinicians are not compensated for tracking these measures, consumers find them cumbersome, and clinicians question their value, especially when their time is already limited. This means that most of our outcomes data is partial at best and largely based on claims data, which is limited in only noting an event/encounter has occurred (does not provide information on the encounter's content, nor a clinical assessment of the patient). 

In behavioral health, a significant part of treatment is administrating evidence-based interventions in the form of a conversation. Compared to traditional medical care, which has a plethora of measurements and biomarkers, behavioral health care includes large amounts of unstructured data, much of which does not reside within the EHR. However, with advancements in Machine Learning (ML), encrypted and de-identified conversational data can be fully embedded into the clinical workflow providing a wealth of previously unavailable data and new insights to clinicians - without creating additional work for overburdened clinicians. 

We at Eleos are in the business of providing Augmented Intelligence tools through technologies like Natural Language Understanding (NLU). As such, we’re strong advocates of these technologies. Our experience has shown that we can use this untapped resource of unstructured data to provide clinicians with perspectives on their treatments that were heretofore unavailable – we do so with superior accuracy and privacy. 

What does this model look like specifically in the behavioral health industry?

From Structure to Process to Outcomes, where do we stand? It seems like much of the $5.1B of dollars spent on digital behavioral health in 2021 was focused on building a Structure - like developing networks and aggregating clinicians groups. But lately, we have seen a greater emphasis on Process and Outcomes. Marc D. Miller, President and CEO of Universal Health Services (one of the country's largest providers), mentioned in his 2022 outlook to Behavioral Health Business that “2022 will mark a new focus on quality and outcomes. Digital and virtual-only point solutions in mental health and addiction will be commoditized as more comprehensive, multi-modal solutions deliver the quality and outcomes that are becoming the standard. Value-based care will continue to increase as quality and outcomes can be measured and rewarded by payors and patients alike” This shift has been articulated by payers and investors as well. 

In the behavioral health space, the next big differentiation will be quality of care - a measurable Process that results in lasting Outcomes. While no one knows exactly how this will develop, the following framework might provide some direction:

1. Measure the Process 

  • Analyzing unstructured data sets is key to automating much of the operations around care and allowing clinicians to focus on clinical processes as much as possible. 
  • Focus on real-world data - data derived from several sources associated with outcomes in a heterogeneous patient population in real-world settings.

2. Measure the Outcomes (see above) 

3. Extract and identify the relevant Process measures and codify best practices

4. Incorporate Process measures into the Structure 

  • Training purposes (how are staff trained/onboarded?) 
  • Supervision purpose (how do staff grow professionally?)

5. Demonstrate measurable Processes and lasting Outcomes 

  • Unlocking alternative payment models (e.g., value-based care)

In summary, the pandemic's ripple effects will remain for some time - with more people needing health care services, but the supply will not increase anytime soon. Behavioral health providers are in short supply. To create a meaningful change, we must shift our focus from systems structures to measurable Processes that will provide real impact and real Outcomes. 

Thank you, Dr. David Shulkin, Dr. Harold Pincus, Eric Larsen, Dr. Dennis Morrison, Dr. Dale Klatzker, Douglas Kim, Roy Wiesner, Dr. Nadav Shimoni, Jennifer Gridley, and Dr. Shiri Sharvit, as well as everyone else who contributed to this article.

Aug 25, 2022
15 min. read

Voice AI for Mental Health Treatment

Many new inventions and uses for technology are shaping how we treat and adapt the treatment of patients. We questioned a few companies on how they are using technology and voice AI.
China Campbell

We are in a world of changing technologies. Many new inventions and uses for technology are shaping how we treat and adapt the treatment of patients. We questioned a few companies on how they are using technology and voice AI to address mental health concerns. We heard from Ellipsis Health, Lyssn, Kintsugi, and OPTT Health on their technology and how it has impacted their care. 

Ellipsis Health

Mainul Mondal, Founder and CEO of Ellipsis Health, gave the following responses. 

How is Ellipsis Health leveraging technology for early identification of depression and suicidal ideation? 

Today, we are leveraging our technology specifically for the early identification of the severity of anxiety and depression - either of these, left untreated, can lead to a deterioration in condition or crisis, including suicidal ideation. We do this by leveraging the unique power of the human voice and artificial intelligence to identify people in need and then connect them to integrated behavioral health services and personalized care pathways.  

Now, through our groundbreaking technology, we have pioneered the only clinically-validated vital sign for mental health. Our solution generates a clinical-grade assessment of the severity of anxiety and depression by analyzing a short voice sample  - creating the first objective, personalized, and scalable clinical decision support tool for mental health. With the use of our technology, we can help payers, providers, and digital care platforms shorten the time to diagnosis, increase efficiencies, reduce costs and improve patient outcomes. 

Triage/Risk Stratification: Our partners look to us to improve risk stratification as we are able to quickly triage people into appropriate care pathways, improving patient outcomes and efficiency and reducing costs. In the clinical setting, care teams lean on us for early identification of mental health conditions to ensure the patient is triaged for the right care at the right time. Also, through partnerships with digital health platforms that offer self-help tools like meditation and stress management apps, we can identify those in need of more clinical care and help introduce them to options like telehealth and/or teletherapy provided by these platforms. 

Longitudinal Measurement: Through our technology, care teams are able to remotely monitor treatment efficacy and be alerted when a person is experiencing a significant change in the severity of their anxiety or depression - eliminating gaps in care by providing ongoing/in-between visit monitoring. We are also seeing our technology being used by care teams to support those with comorbidities before and after a major medical event, such as surgery, so the individual can avoid costly readmission or ED visit.  

Increased Engagement: The current status quo for measuring the severity of anxiety or depression is self-reported paper surveys (PROs) which are impersonal and unengaging. Our technology creates higher engagement than the current paper assessment. For a large partner, 70% of users surveyed were satisfied with our technology compared with only 30% on a paper survey.  

Do you have any examples/stories/use cases you would like to share? 

We have partnered with a large behavioral health provider organization that has implemented our technology within their clinical treatment workflow to determine its effectiveness and ability to identify emerging crisis events. The study had 90  participants who had a Depressive Disorder diagnosis and were in treatment, and the treatment team and participants utilized our technology before and/or between sessions. The results were utilized to inform care providers of patient progress or lack thereof in treatment as well as to allow clinicians to prioritize patient safety during the study period.  

Additionally, in a recent pilot with a digital health provider, users give a short voice sample and, based on their scores, are provided with digital interventions like education and mindfulness activities. Users were highly satisfied with this experience. One found  that “answering the questions felt comfortable and inspiring,” while another reported that  they were almost amazed at how good it made [them] feel.” Another user found that “This is easier and more personal. I didn’t feel examined in a non-empathetic way.” Ellipsis Health aims to meet people where they are at, asking low-stigma questions geared towards making users feel like they are speaking to a friend. Whether we engage patients actively through an app or passively layer onto care calls, we are providing a simple, comfortable way to improve mental health outcomes through early detection, triage, and monitoring.  

What do you think needs to happen to make this technology more widespread? 

Once large healthcare companies, payers, and providers adopt innovative technologies,  like ours, the impact of the technology becomes greater - reinforcing the financial impact and improved patient outcomes. Armed with the power of data, physicians will be able to drive measurement-based care for mental health - shortening the time to diagnosis,  increasing efficiencies, reducing costs, improving patient outcomes, and saving lives. 

OPTT Health

Moshen Omrani, MD, PhD, CEO & President of OPTT Health, gave the following responses.

How is OPTT leveraging technology for early identification of depression and suicidal ideation?

To address this challenge, OPTT has developed a novel Natural Language Processing (NLP) algorithm by combining a custom classifier with a publicly available deep learning Transformer model. This innovative algorithm compiles clinically relevant Natural Language Comprehension; meaning it evaluates the relationship of a textual statement to a set of CBT-relevant concepts. These concepts include depression, anxiety, and the five-part elements of CBT: situation (positive or negative), thought (positive or negative), emotion (positive or negative), behaviour, and physical reaction. For instance, when the algorithm is given the statement: “I feel my life is challenging most days. I feel irritable and down,” the following output is provided: this statement is 73% related to depression, 68% to anxiety, and 59% to negative thoughts. The observed percentage in the output is referred to as the “Symptomatic Score” and indicates the probability that our algorithm considers the provided statement to belong/relate to the CBT-relevant concepts (i.e., depression, anxiety, and the five-part elements of CBT). This algorithm allows us to objectively evaluate clinically relevant variables reflecting a patient’s mental status, which is essential in developing algorithmic and evidenced-based decision-making processes.

Do you have any examples/stories/use cases you would like to share?

There is a huge mismatch between mental health demand and resources, and yet there is no reliable method of matching the scarce resources to those with the most needs. For instance, there are around 1,960 patients with mental health problems per 1 psychiatrist in the US, which is 4-5 times more than the number of patients they can handle per year. This means patients should endure long wait times for their initial evaluation, whether they have a mild problem that would have benefited from lower-level resources faster or those with severe problems which should wait a long time to receive appropriate care. We have designed a triage module that relies on patients’ personal narratives of their problems and challenges to provide clinicians with an accurate diagnosis, predict patient compliance, and suggest courses and levels of treatment.

For instance, an important challenge in mental healthcare is the low compliance of patients in completing their course of treatment. Using our proprietary NLP algorithms, we were able to predict patients’ dropout with 70% accuracy, 4 weeks in advance of them dropping out, in a group of +250 patients across 4 clinical trials. This information could help the clinicians increase the level of their engagement with the patients to encourage them to finish their therapy. In fact, in our latest clinical trial in which the level of patient engagement was adjusted through their treatment, the number of sessions completed by patients increased by 20%, and the number of patients completing the whole round of therapy increased by 35%.

What do you think needs to happen to make this technology more widespread?

Given the absence of robust and precise quantitative measures, evidence-based practices, which are the cornerstones of all progress in the rest of medicine, have been largely missing in mental health. It is essential for the field to focus its attention on developing and using data-driven practices, which makes way for innovative solutions like ours.


Prentice A. Tom, MD, Chief Medical Officer of Kintsugi, gave the following responses. 

How is Kintsugi leveraging technology for early identification of depression and suicidal ideation?

Kintsugi is the global leader in leveraging AI voice biomarker analytic technology to screen for depression and anxiety across populations. We have developed the technology to quantitatively assess any person’s mental health across these two common conditions and can provide a fully automated and unbiased* assessment of whether the user of our technology suffers from any degree of depression or anxiety. Because our technology is completely non-invasive and scalable, it can be used to truly move the needle in the early identification of these mental health conditions.  

*(with respect to gender, educational level, language spoken, ethnicity, or other patient demographics)

Do you have any examples/stories/use cases you would like to share?

Our Kintsugi Voice Analysis Technology is currently being used in the spectrum of clinical settings. We do not own the patient data, as that information belongs to clinical partners who are using the technology. Also, because the technology is not dependent on the content of the conversation but rather analyzes the impact of psychiatric conditions on human voice generation, IE: the production of the sounds that make up the components of speech, we do not require any patient-specific information. Thus, for the above reasons, we do not have access to nor archive any individual patient stories. We can say that we are currently working with some of the nation’s largest healthcare entities, and our customers have found their clinicians truly appreciate how our technology augments their ability to identify patients suffering from depression and anxiety disorders. In fact, we are currently ramping up to greatly expand the availability of our voice analytic tool to meet the growing demand of our healthcare industry customers.  

What do you think needs to happen to make this technology more widespread?

Depression in the elderly, anxiety disorder in our nation’s youth, and burnout in our working-age population are now recognized as serious and growing health concerns. The impact of mental health conditions as an independent risk factor for diseases such as heart disease is a primary factor contributing to the cost of care in the US (65% of all recurrent emergency department users have been shown to have some mental health condition), and as a comorbidity to other diseases, such as post-partum depression -- is garnering much greater national attention. To date, our inability to quantitatively screen for these conditions and our inability to easily identify those who may be suffering from these conditions has led to mental health conditions being one of the most frequently, if not the most frequently, underdiagnosed conditions in healthcare. We need to create policies requiring our primary care clinicians to screen for mental health just as they screen for high blood pressure and diabetes, and we need to reimburse clinicians for performing this screening.    

The fact that literally millions suffer needlessly or have worsening other medical problems because of their untreated mental health conditions is unacceptable. As patients, we need to demand that we be assessed and screened for our mental wellness, just as we are for many physical health conditions. As clinicians, we need to take the lead in making it the standard of practice that all patients receive appropriate mental health screening. On the government and commercial insurance side, we need to recognize how early identification of mental health conditions reduces the total cost of care and appropriately incentivizes mental wellness screening for everyone.

Looking to the Future

The future is bright for the use of voice AI in the behavioral health industry. We look forward to seeing the opportunity expand into other common areas of the health field. This advancement has a major opportunity to help in the evaluation of people in crisis, as well as different levels of care needed at different levels of intervention. Let’s hope this leading technology makes a change that can alter how we view and treat mental health. 

Aug 23, 2022
5 min. read

Initiatives and Outreach LinkedIn Uses to Care For Their Employees’ Mental Health

How LinkedIn has been caring for its employees by centering initiatives and outreach around the pillars of wellness: thought, breathing, hydration, nutrition, movement, and rest.
Chisom Ojukwu

Two months ago, we talked with Michael Susi, the Director of LinkedIn’s Global Wellness Program. We spoke about how LinkedIn has been caring for its employees by centering initiatives and outreach around the pillars of wellness: thought, breathing, hydration, nutrition, movement, and rest. 

What LinkedIn is Doing for Employees

Some of the wellness services LinkedIn provides to support employees include: 

  • Wellness workshops
  • Mindfulness sessions
  • No Meeting Fridays twice a month
  • Well-being days off

Michael explains how there is a big push to inform managers of ways that they can support the mental well-being of their employees. For example, LinkedIn equips managers with the tools to implement 2-minute breathing exercises at the beginning of work meetings. Michael recalls a time last year when all employees were given a week off from work to “catch their breath.” 

Michael decides what services are delivered to employees by making use of quarterly employee voice surveys (EVS).” He emphasizes the importance of “being present and being responsive about what people share with us while we are taking our time to listen.” Making employees aware that Linkedin is available to support them is integral and achievable through outreach and strategic marketing. 

After implementing these solutions, LinkedIn sees positive outcomes overall, especially on a micro-level. When asked about the strategies and efforts that have not worked in the LinkedIn Global Wellness program, Michael says, “the biggest thing is overstretching. Going too fast too soon.” It is essential to “really understand what outcome you are trying to achieve. With that, it allows you to be more methodical.”  

Gaps in Care 

Michael does not feel like much is missing in the market; however, many people are unaware of the mental wellness market opportunities when facing stressors on a micro- or macro-level. With many solutions available, it should be up to the individual to use the wellness tool of their choosing. “We have an app behind the scenes that people can sync their data to. We can reward these behaviors by doing this minimally amount of times a week.” Michael says, “Ultimately, it is a very personal decision on how we care for ourselves.” 

Advice for Non-Profits & Start-Ups 

Michael recognizes the challenge some non-profit organizations and early-stage startups encounter due to a lack of resources. He says, “ultimately, it is about bringing these folks together for shared learning. Sometimes just letting people know that they are not alone in whatever it is that they are going through.” It is important to plant seeds of wellness in the workplace and, more importantly, listen so we can hear a little bit more about their specific needs.

Michael explained that when he joined LinkedIn, he focused on promoting the wellness program and thinking like a business owner. He says, “having that strategy of what your approach is… helps you, not only to stay on track but make what you’re doing teachable.” This technique empowers employees to be a part of the solution design and allows programs to be widespread in different regions of the world. “With guidelines, you equip an army of wellness champions, mindfulness champions. You equip them with so much that they do a lot without [you getting too] involved.” 

The Biggest Change In Employee Benefits in the Future

According to Micheal, the most significant change needed regarding employee benefits is utilizing what is available. We would benefit more significantly if services were used more within companies. For employees to take advantage of these services, the offering, marketing, and promoting what is available must be increasingly personalized.

You can watch our entire conversation with Michael here.

Aug 11, 2022
5 min. read

Forming Strategic Partnerships Between Vendors and Employers

In light of COVID-19, employers are making changes to their existing benefits packages. Senior Behavioral Health Consultant at Mercer, Carrie Bergen provides tips for employers and vendors.
Chisom Ojukwu

In light of COVID-19, employers are making changes to their existing benefits packages. Employers are focusing on work flexibility in response to feelings of burnout that many employees have experienced. In an attempt to retain employees, 70% of employers have focused on expanding behavioral access in their strategic roadmaps for the near future, according to a Mercer national poll.

A 2021 survey from Indeed found that 67% of workers believed their burnout worsened during the pandemic. “Burnout is often confused with personal stress,” however, the International Classification of Disease classifies burnout as an occupational phenomenon. “It is not an individual issue. It is very much an organizational culture issue,” Carrie Bergen, Senior Behavioral Health Consultant at Mercer, says. Carrie named a lack of connections, unsustainable workloads, and a lack of rewards for work are some of the issues that define the burnout culture in different work environments. She emphasizes how burnout is not solely the responsibility of HR professionals. The company leaders should encourage time off, embrace work-life balance, and promote mental health benefits to reduce burnout in the workplace. 

Biggest Challenges for Vendors and Employers

There is a large ecosystem of vendors who pitch their solutions to employers. All of the pitches begin to blend together for employers, which presents issues for both the vendors and the employers. In a very simplified manner: 

  • Vendors want to stand out and build seamless member experiences. 
  • Employers want the best fit for their organization that can be easily integrated with their existing benefits ecosystem.

What is Mercer’s role in all of this?

Mercer delivers innovative solutions addressing their clients’ and employees’ health and wellness needs. “We work with small, multinational, and large businesses and focus on delivering an array of health benefit solutions. We have a really large team of different types of experts,” Carrie says, “Within total health management, I provide subject matter expertise around behavioral health… to help support our clients.” 

Carrie advises to “start with the basics” when implementing scalable mental health solutions quickly and effectively. Mercer does this through qualitative and quantitative research methods. They use data to help determine what problems their clients are attempting to solve. 

Evaluating vendor fit is another critical element in this process. “We look at vendor experience and fit. Do the vendors we are evaluating offer services that create the ideal emotional wellbeing culture for the organization and fit within the client’s priorities,” Carrie states. Accessibility and promotion of the services are other elements Mercer evaluates when developing solutions. 

Advice for employers 

For employers who have already implemented solutions for employee mental health, Carrie gives several suggestions on how they can ensure they receive a return on the investments made in the past few years: 

  1. Continue monitoring data and comparing it to your baseline. “[Try] something like a gap analysis, where you are looking at all of your data that is available from the different programs and understanding where key pieces might be missing, or if there is overlap of services,” Carrie says. 
  2. Consider cost-effectiveness. Ask yourself, “Are you seeing a return on investment that you expected to see where you have a program in place?” 
  3. Create a strategic partnership with your vendors. Strategic partnerships evaluate the usage and outcomes of the services. Ask, “Are [your vendors] able to pivot and be flexible to continue to meet your needs, and with that, have strong integrations amongst the benefits vendors in your ecosystems?”

Advice for Vendors

Carrie also advises how startups and established vendors can successfully partner with employers to offer behavioral health services:

  1. Highlight what sets the solution apart and makes it a better option for employers.
  2. Prioritize ease of access. Online scheduling is both new and exciting, “as we move into this digital world, it is something that is needed.” 
  3. Focus on building more diversified networks. “Not only race and ethnicity of providers, which is critical, but also specialization of treatment areas. So is there capability to focus on children and adolescents, or substance use disorders, racial trauma?” 

For more on this conversation about workplace mental health, check out the full interview with Carrie, found here.

Aug 4, 2022
11 min. read

Creating The Standard Of Digital Care: An Enterprise-Grade Approach To Population Behavioral Health

While there is massive potential, aligning diverse technology solutions to effectively serve the needs of a population is challenging.
Tom Zaubler, MD, MPH

The original article can be found on NeuroFlow's website here.

Many of us are now familiar with the “digital front door” concept which came out of a desire to increase access to traditional care through advancements in technology—making it easier to schedule appointments, find a doctor, or review personal medical records. The digital front door was an important first step in using technology to increase access; however, it’s just the beginning.

Today, technology can extend an organization’s ability to identify needs, triage, and even deliver care with efficacy and scale that increases access, improves outcomes, and reduces the burden on staff. Paired with the growing understanding of how closely mental and physical health are linked, technology is creating new opportunities for providers to deliver care differently to their community in ways that add more value and frequency to patient interactions.

While there is massive potential, aligning diverse technology solutions to effectively serve the needs of a population is challenging. That’s why NeuroFlow is setting a “new standard of digital care,” a high-tech, high-touch approach to behavioral health that we believe health systems should and can incorporate. This standard of digital care creates a behavioral health infrastructure across enterprise health systems, enabling care teams to serve populations with varying and evolving needs in a unified way.

The New Standard of Digital Care for behavioral health is simply this:

  1. Community-wide, remote, and unbiased screening and assessment of needs, including needs related to mental health and social determinants of health (SDOH)
  2. Population triage and personalized referrals powered by artificial intelligence and machine learning
  3. Digital self-care resources and plans to manage individual health and increase engagement
  4. Personal outreach in crisis situations and referral to behavioral health professionals as needed

In this blog, we’ll explore how each of these core functions enables comprehensive behavioral health at the population level, and support other critical population needs like identifying and addressing SDOH and managing comorbidities.

Why Build the Standard of Digital Care Around Behavioral Health?

Behavioral health is inextricably linked to population health, but most health systems struggle to identify and support the behavioral health needs of their populations. Behavioral health typically remains siloed in a department that is understaffed and overloaded with demand, while scores of patients remain on lengthy wait lists, don’t follow through on referrals, or are never properly identified as needing behavioral health support at all.

Standard of Digital Care Behavioral Health

Technology plays a pivotal role in scaling behavioral health measurement and support population-wide, but to date a lack of consistent, principled approach to digital care has made it difficult to know where to start. The standard of digital care aims to resolve these persistent issues that have prevented behavioral health technologies from making the greatest impact on population well-being.

Population-Wide Identification & Monitoring

Before health systems can provide behavioral health support, they need a way to identify unaddressed needs, risk stratify their population, and identify the appropriate level of care. NeuroFlow accomplishes this by delivering regular behavioral health assessments via app when an individual begins using NeuroFlow and throughout their journey. Assessments include clinically-validated questionnaires like the PHQ-9, GAD-7, and WHO-5. These initial assessments achieve a 65% completion rate on NeuroFlow, creating a much clearer picture of population health. Plus, patients’ ability to take assessments on their own time, in the comfort of their home, is believed to improve response candor.

NeuroFlow’s measurement-based care approach provides longitudinal data that alerts care teams when a patient’s wellness is trending downward and an intervention may be needed. NeuroFlow’s proprietary Severity Score takes into account assessment scores and other user-reported data to generate a unique risk baseline for each patient, which enables detection of worsening conditions and prompts action by care teams when necessary. Changes to Severity Score are monitored over time in NeuroFlow’s Manage platform, helping care teams identify and prioritize who may need support on an ongoing basis.

Evidence-Based & Self-Directed Digital Programs 

A critical way to meet the diverse needs of a population is to empower individuals with evidenced-based behavioral health resources that they can discover at their own pace. Built on the tenets of digital cognitive behavioral therapy (dCBT), NeuroFlow provides a wide range of dCBT curricula, known as journeys, on topics like worry and tension, substance use, healthy relationships, parenting wellness, and more. Individuals have 24/7 access to journeys, and can explore the topics that interest them most in our Journey Gallery.

The platform also assigns relevant content to individuals based on changes to Severity Score. A notable increase in severity levels would not only trigger an at-risk alert to care teams, but would also assign the patient a depression journey, for example, to receive self-guided support.

Engagement is a critical part of NeuroFlow’s standard of digital care. Using a mixture of gamification, reminders, and notifications, NeuroFlow has achieved industry-leading engagement rates. After one month, 57% of registered patients remain active on the platform, compared to the industry standard of 6%. At the six month mark, 33% of these patients are still completing at least one activity per day on average. 

Increase Behavioral Health Access Through the Referral Network

Access to behavioral health specialists remains a huge barrier to improved population health. 45% of the U.S. population lives in an area with a shortage of mental health professionals, and 70% of all psychiatrists are 50 and older which will result in an even greater shortage as they retire. Teletherapy and telepsychiatry can help alleviate this burden, which is why NeuroFlow is excited to partner with four of the leading behavioral health organizations in the country: Array, LifeStance Health, Marvin, and Brightside Health. With these partnerships, NeuroFlow can leverage its Severity Score-powered triage engine to guide the right individuals to the right higher level of care when appropriate, either directly through the app or through care coordination.

Referrals can also be customized by population. If post-traumatic stress, for example, is prevalent within a population, NeuroFlow can prioritize therapists who specialize in PTSD. Alternatively, the app can refer only to therapists that take an individual’s insurance. This level of versatility helps NeuroFlow adapt to the unique needs of a health system and its population.

Suicide Prevention Protocol

Suicide is a leading cause of death in U.S., claiming over 49,000 lives in 2020. Tragically, 45% of individuals who took their own life had contact with primary care providers within one month of suicide. That is why suicide prevention is an essential part of a comprehensive behavioral health solution for populations. NeuroFlow offers Response Services, a network of certified mental health professionals who proactively contact individuals when they trigger an at-risk or urgent alert. These alerts could be triggered by a recent assessment or through natural language processing technology which analyzes and flags free text shared in the NeuroFlow app that indicates self harm or suicidal ideation. The combination of identification through technology and high-touch, compassionate care provided by our response services coordinators makes a significant impact on suicide prevention. 

“We actually had a woman who had been treated by doctors for years for a chronic illness, but had never been able to disclose that she’d had suicidal thoughts for years,” says Faith Best, NeuroFlow’s Clinical Services Senior Manager, “So using the app gave her the opportunity to identify that, and then NeuroFlow was able to respond, and we got her connected to therapy, which was huge for her. She actually said, ‘This might be a small thing for you, but it’s a big thing for me.’”

Partnering with CAMS-Care, an organization that provides suicide prevention training and resources, NeuroFlow incorporates an industry-leading suicide prevention protocol into our platform. We provide valuable assessment tools to care teams along with population monitoring and proactive crisis outreach. In addition, NeuroFlow offers easily accessible crisis resources, including the new mental health and suicide prevention lifeline, 988, which patients can contact directly through the app. With Response Services, NeuroFlow is able to intervene before individuals reach crisis and refer them to the appropriate level of care. 

Establishing the New Standard of Digital Care

A unified, holistic approach to behavioral health will make the greatest impact on population well-being. We’ve seen this time and time again at NeuroFlow. The more that health systems can engage, monitor, and proactively respond to their populations’ needs, the better they will be able to elevate and standardize quality of care across the population. A high-touch, high-tech approach can eliminate inconsistent behavioral health approaches across different sites and ensure high-quality care. According to the American Medical Association, the benefits of high-touch and high-tech behavioral health care include improved outcomes, greater access to care, lower costs, and improved provider satisfaction. To learn more about NeuroFlow’s unique approach to population behavioral health, check out our resources hub.









Jul 28, 2022
7 min. read

How Health Systems and Digital Solutions Can Successfully Partner

Health systems can utilize digital behavioral health solutions to augment and extend traditional services such as prevention, detection, support and treatment, and management or recovery.
Charlotte Hawks

The Going Digital: Behavioral Health Tech team just released a white paper, "Creating the Ideal Digital Behavioral Health Vendor Portfolio: A 4-Step Blueprint." In parallel, we spoke with Trina Histon, PhD Senior Principal Consultant in Prevention, Wellness, and Digital Health at Kaiser Permanente's Care Management Institute, about how Kaiser Permanente has adopted digital behavioral health tools. A similar conversation came to mind from the 2020 Going Digital: Behavioral Health Tech Conference with Tom Nix, CEO of Ria Health, and Kristian Ranta, CEO and Founder of Meru Health, about successfully partnering with health plans and health systems. With all this in mind, let's dive into how health systems can successfully integrate behavioral health apps. 

How Can Digital Solutions Help?

Health systems can utilize digital behavioral health solutions to augment and extend traditional services such as prevention, detection, support and treatment, and management or recovery. These tools can help patients with skill-building and self-care techniques and even help with symptom relief and resilience. Giving patients on-demand psychoeducation and support benefits everyone, from stakeholders to the patients they serve.

Additionally, when these tools are used at scale, health systems and other stakeholders are able to identify areas of improvement, such as service gaps and utilization barriers. If the digital solution offers validated measures, health systems and providers can receive detailed standardized, longitudinal data about each patient. Digital tools can also empower patients as they become more aware of their specific symptoms and triggers. Integrating digital health solutions can also increase behavioral health diagnosis and treatment rates if incorporated into existing workflows.

Under Dr. Histon's leadership, Kaiser Permanente has successfully integrated a few digital behavioral health solutions over the past few years. Dr. Histon explains that Kaiser Permanente originally wanted to use behavioral health solutions to target patients that were considered subclinical. But they found that digital solutions are "good for everybody. So if somebody has moderate or even severe depression and is in a comprehensive kind of care that includes medication, psychiatry, and therapy, at least tools can be a way to complete homework between sessions." These tools can be a way to keep patients engaged with their treatment and a way to track progress in between in-person interactions.

How to Get Started

Startups need to integrate both clinical evidence and user experience. Health systems will always prioritize digital solutions that can show sound clinical data. Tom explains that it's helpful for startups to acquire the outcome data first to demonstrate their worth to health systems sufficiently. He continues that it's essential to be "able to show people really good, clinical data and how it impacts the lives of their members. [Then you have the] opportunity to kind of think through the solution that makes the most sense, not only for the health system but for the patients and for the providers." Remember that each health system has unique needs and requests to cater to its specific patient population.

Dr. Histon also emphasizes the importance of creating a user-friendly experience and explains, "we're providing health care, and that's a very vulnerable relationship for somebody, and it's not the same as other consumer experiences. At the same time, consumers are expecting a seamless [digital] experience, like going shopping or taking transportation, and they're expecting that of healthcare as well." Younger generations are accustomed to a digital experience, and healthcare leaders need to think about creating a product that is easy to use and navigate. Having a user-friendly experience also leads to increased user engagement. Dr. Histon explains, "I think engagement is just critical. Because if you just open the app and download and you never do anything else, that's not going to work for us in healthcare."

Dr. Histon adds that due to the diverse populations your health system serves, there "is no one app that rules them all." Health systems need to consider their diverse member base and recognize that multiple digital solutions may be utilized to meet everyone's needs. Additionally, it's crucial to consider how these apps can foster trust with the patients using them. Having the right balance of tech vs. touch can help patients feel more at ease. As Kristian explains, "we're seeing that [including clinicians in the app] makes a whole lot of difference when people know, and hey, that's a provider that's now reaching out to me. I'm…engaging with a provider versus a kind of technology." Health systems and startups can partner to find the appropriate balance of technology and clinician interaction.

Key Reminders For Startups and Health Systems

1. Focus on clinical data AND user experience

Both aspects are essential to creating an effective app that patients want to engage with.

2. Digital solutions can support patients across the care continuum

Consider ways to support the diverse populations you serve through various digital solutions.

3. Check in along the way and ensure the digital solutions you choose are working for your population

As a health system, you have a lot of information about the patients you serve. Proactively talk to digital health startups about your specific needs and how your patients will feel most supported.

To hear our entire conversation with Dr. Trina Histon, visit our video library.

Jul 20, 2022
7 min. read

A Health Equity Conversation with Google Health Executives

Google Health is “building products to empower people with the information they need to act on their health."
Charlotte Hawks

During Going Digital: Behavioral Health Tech 2022, we were fortunate to be joined by two Google Health executives, Megan Jones Bell, PsyD, and Ivor Horn, MD. Dr. Bell is the Clinical Director of Consumer and Mental Health, and Dr. Horn is the Director of Health Equity and Product Inclusion. We discussed Google Health’s strategy, how the digital health industry is changing, how to wire digital health products for inclusion, and their hope for the future of digital health.


Google Health explains that they are “building products to empower people with the information they need to act on their health. We’re developing technology solutions to enable care teams to deliver more connected care. And we’re exploring the use of artificial intelligence to assist in diagnosing cancer, preventing blindness, and much more.” Google houses multiple companies, including Google Search, Youtube, and Fitbit, and each of these tools offers many specific services for consumers, caregivers, communities, and researchers. One of the tools they provide for consumers is clinically validated self-assessments available through Google Search for conditions like depression, anxiety, PTSD, and postpartum depression. 

Source: Google

Dr. Jones Bell recently published a blog where she discussed Google Health’s resources and how they analyze Google Search terms to give them more information. Searches for “mental health therapist” and “mental health help” reached record highs in 2022. And searches for “local rehab centers near me” have also reached record highs in the past few months. Google has a Recover Together page where people can find information about rehab centers, fentanyl overdose, and the importance of naloxone. Some Fitbit devices also offer apps for breathing exercises. Additionally, The University of Oregon is partnering with Google Health Studies to study how smartphones impact wellbeing.

Digital Health Industry

Before Dr. Jones Bell was an executive at Google, she was one of the earliest leaders in digital health with roles at Lantern and Headspace. She has seen the industry grow and change. We wanted to hear her perspective on where the industry has been and where it’s going. She reflected that “investment has historically come from two ends of the spectrum first, with some investment in telehealth solutions and in self-help apps. So largely CBT or mindfulness, things that are evidence-based but appropriate to do yourself. And I think over the last three to five years, we’ve seen more filling in in the middle so more connected services that bridge different levels of care, that integrate across the spectrum.” As we see more innovation in this middle section of the spectrum, digital health can become more cohesive across all aspects of care.

She continues, “these moments of care transitions [are] really where we see people fall through the cracks. So seeing more investment across these levels of care…more of these integration investments, I think are really important for our industry to actually, sustainably make a health impact on users, not just meet them in this fragmented, ad hoc way, as individual point solutions, so there’s a key maturing point for the industry.”


As the Director of Health Equity and Product Inclusion, Dr. Horn thinks about integrating inclusivity into Google’s tools. Dr. Horn explains, “for example, when we think about Search and we think about food insecurity—because health is beyond specifically healthcare—we want to make sure that when someone searches for food, they are also finding food pantries or grocery stores near them that are affordable.” Google Search can be a really powerful tool when built for all users.

Dr. Jones Bell notes room for improvement where there are limitations of Google and the industry as a whole. She talks about the industry’s ability to provide information about conditions such as anxiety and depression and Search’s ability to populate relevant information. “When you start to get more specific [such as looking into schizophrenia warning signs], we realize that our ability to help people is fairly thin, as an industry overall.” There has been recent excitement about SMI funding, which shows promise, but as an industry, we still have a ways to go.

As we think about inclusion, we also discussed the interplay between tech vs. touch and how digital health can strike a balance between the two. Dr. Jones Bell expresses that they try to approach health in three ways: 

  • Through consumers: “Meeting people where they are in everyday moments.”
  • Through care teams: “Supporting community with data, resources, and tools.”
  • Through community health: “supporting communities with data, resources, and tools.”

Dr. Horn echoes that a focus of Google Health is “meeting people where they are with the resources we can provide.

Hope for the Future

The digital health field has taken many strides, but what do we want the future to look like? Dr. Horn says, “My hope for digital health in the future is that we just call it health, and it is a part of what we do. And that we are building for everyone, everywhere.” Digital health is steadily becoming ubiquitous, but we must ensure that we are creating inclusive products and platforms accessible to all. Dr. Jones Bell agrees and says, “My thesis for digital health has always been: improve access, affordability, and effectiveness for people.”  

As we look to the future of digital health, we’re glad leaders like Dr. Horn and Dr. Jones Bell are in charge.

You can watch Dr. Horn and Dr. Jones Bell’s session here.

Want a lot more digital mental health and substance use insights? Subscribe to our behavioral health tech newsletter here.

Jul 18, 2022
7 min. read

What Do Employers Look for in Mental Health Solutions?

Some employers may have contracted with several mental health solutions over the past two years, so now it’s essential to reflect on those solutions.
Charlotte Hawks

There are various mental health solutions available from which employers can choose. But what exactly are they looking for in these offerings? We spoke with Dylan Landers-Nelson from the Business Group on Health, a non-profit association for large self-insured employers, about employer-sponsored mental health benefits and the 13th Annual Employer-Sponsored Health and Well-being Survey. We also look back on a conversation from the 2021 Going Digital: Behavioral Health Tech Conference with Barbara E. Wachsman, MPH, who is a Senior Advisor at Frazier Healthcare Partners, and former VP, HR, and Benefits at the Walt Disney Corporation.  

Mental Health and the Workplace 

The COVID-19 pandemic has shifted numerous viewpoints regarding how we think about mental health in America, especially in the workplace. A November 2021 survey found that nearly one-third of companies with more than 50 employees increased the ways their employees can receive mental health services and 46% of companies with more than 5,000 employees saw an increase in employees utilizing mental health services. A survey conducted by Calm found that 76% of employees think mental health benefits are crucial when evaluating new jobs. A McKinsey survey found that 80% of employers reported concern about employee mental health.  

New Trends and Developments in Employer Mental Health Benefits

Barbara mentioned the positives and hurdles for startups working with large employer groups, saying the “good news about employers like Disney is that they are always looking for new, interesting, innovative ideas. They’re always looking for ways to have more healthy, productive employees. The bad news is you’re working with these big brands, who are very conservative, and kind of apply the same techniques that you would to purchasing other things.” Barbara continued that while employers are interested in adopting new solutions, they may be slow-moving.

In the Business Group on Health’s recent survey, 91% of employer members said mental health was their employees’ top priority. Additionally, 75% said that in 2022 they are moving to implement low or no-cost virtual counseling. Also, 42% said they are implementing or considering centers of excellence for mental health services, and 31% said they are implementing mental health navigators. 

Top Mental Health Benefit Strategies for Employers 

The Business Group on Health found that in their 2022 survey, access to care was the number one focus area for employers, with 76% of employers saying it was their top focus area. Barbara echoed this idea by saying employers “want access. They want to know that if someone needs care, that they can pick up the phone, they can log in, they can go through a portal, and they will find someone to talk to and someone who will either guide them or be able to provide care when they need it.” 

Some employers may have contracted with several mental health solutions over the past two years, so now it’s essential to reflect on those solutions. As Dylan Landers-Nelson mentions, it’s time for employers to “take stock of what they have in place and… focus on programs that are successful.” The past two years have provided data on solutions that may or may not be working, so employers can make informed decisions about what works best for their employees.  

Additionally, large employers are thinking about affordable solutions that appeal to a large population. As Barbara explains, “equity is extremely important. We’re offering the same benefits at the same price to everyone. So you want to ensure that what you’re offering will really appeal to that broad range of employee base.”

What Should Startups Keep in Mind?

In the United States, employers can considerably influence how their employees receive care. Barbara emphasizes, “the employer in this country is the one that determines the kind of care delivered, how it’s delivered, how much it costs, and they have such a huge role to play in helping customers deal with things like mental health.”

As Dylan mentions, one thing medium and large employers look for is the “ability to practice across state lines, certainly virtual services help with that, but there are a lot of specific state laws.” Multistate employers will likely look to launch services for all of their employees at the same time. 

Additionally, Barbara confirms that employers often think about “how can this be integrated into the overall ecosystem of healthcare?” There is a genuine concern about integration with other solutions and how all of them will fit together to create a cohesive healthcare experience for their employees. In fact, employers are starting to feel fatigued over multiple solutions that are administered in various ways. 

Main Takeaways for Startups

1. Mental Health is a Priority

The majority of employers are focused on bringing mental health solutions to their employees. 

2. Integration with Other Vendors

As employers feel fatigued from multiple health solutions, consider how your solution can integrate with other vendors. 

3. Access and Cost are Top Priorities for Employers

Employers want their employees to have low-cost solutions that give them more access to care.

Please sign up for our video library to hear our entire conversation with Dylan Landers-Nelson.

Want a lot more digital mental health and substance use insights? Subscribe to our behavioral health tech newsletter here.

Jul 16, 2022
7 min. read

Helping Families With Neurodiverse Children Get Access To The Right Care

Neurodiversity refers to the concept that brains have developmental differences that result in normal differentiation that lead to different strengths and differences. Companies are trying to create a supportive community for these families, but "access for access sake does more harm than good."
Charlotte Hawks

We hosted a panel discussion about neurodiversity moderated by Tom Cassels, the President and General Manager of Rock Health’s Advisory business. One of the incredible leaders Tom spoke with is Marissa Pittard, Co-Founder and CEO of Beaming Health, a company focused on helping autism families find resources, get advice from families and experts, and learn about their child’s diagnosis. The conversation also featured Rebecca Egger, Co-Founder and CEO of Little Otter, a company that provides virtual mental healthcare for children 0-14 and addresses concerns such as anxiety, aggression, tantrums, attention difficulties, sleep, sadness, and relationship conflicts.

What is Neurodiversity?

Neurodiversity refers to the concept that brains have developmental differences that result in normal differentiation that lead to different strengths and differences. In other words, there is no “right” way of thinking, learning, or behaving. The term came about in the 90s to promote acceptance for people with autism spectrum disorder. But, the term now refers to a range of conditions, including autism, ADHD, dyslexia, dyscalculia, Tourette’s, Down syndrome, epilepsy, bipolar disorder, obsessive-compulsive disorder, borderline personality disorder, anxiety, depression, and others. Some people may not have a formal diagnosis but self-identify as neurodiverse and may have difficulty navigating social relationships, group environments, or sensory processing. 

An essential part of working with neurodiverse children is helping them work toward their own goals, rather than having a standardized set of benchmarks. For digital health companies working with this population, it’s important to work toward long-term relationships with therapists to help keep kids engaged.

How are Companies Helping These Families?

Marissa mentioned, “a parent told us recently, getting a diagnosis right now it’s like being pushed off a cliff and told to find your own parachute.” These companies are trying to create a supportive community for these families to land. Rebecca explains that “the end game for us is let’s support people as early as possible. And so we can have the biggest impact on their lives.”

In supporting these families, Rebecca and Marissa have both built their companies to focus on helping families in unique ways. Marissa explains how Beaming Health is “really focused specifically on autism families at the earliest part of this journey…how can we stand up a care model where families get access to the right care and resources as soon as possible?” Beaming Health emphasizes early intervention for autism families.

Rebecca explains that Little Otter “released a mental health toolkit. [Which] are free resources that provide really personalized feedback for parents…[and] our mental checkup that gives an entire 360 view of the entire family.” Little Otter emphasizes engaging the entire family unit in care to better understand total family mental health.

Choice and Quality in Behavioral Health 

In our conversation, we discussed the importance of quality and choice in behavioral health care. Marissa remarks, “every parent or caregiver is the expert on their own family. Who are we to tell you what might be best for your family, because you as parents know it so much better than us. Our job really is empowering parents and families with the information and resources they need.” She says that the team at Beaming Health they have found that “families have different preferences and communication styles, [and] the relationship between the family and the therapist, may not be quite right.” They have found that giving their families a choice has empowered them to find the best fit for their family needs.

Rebecca agrees that families know their kids best, and they should be able to make decisions that are best for them, but she also emphasizes that quality has to go along with finding a match for each family. She says, “We’ve seen many families who’ve tried up to 10 interventions before coming to us. And so, even though that’s great that there’s access out there, something we talk about is we’re improving access to actual quality care. And we need to add that quality bit because access for access sake does more harm than good in young children.”

Tom echoes a common refrain among neurodivergent families: “If I can get an appointment, I don’t want it.”

Important Partners 

Of course, these companies do not work alone in trying to help these families. Tom asked each panelist who their most important partners are in this work. Rebecca mentioned that “70% of all the mental health meds for young children are prescribed by pediatricians,” so they can be a significant partner in first recognizing that help is needed.  

She also mentions that “teachers who are interacting with the children every single day, they have the most impact on the child’s life… They’re often the first to realize something’s going on.”

Marissa talks about the role that payers play, saying, “there’s just so much power in how the reimbursement flow impacts coverage, the appropriate amount of coverage and thinking about new types of resources and services that are covered, to me is one of the most powerful forces for solving a lot of the problems we’re seeing with our families.” Rebecca echoes the power that payers have and emphasizes, “the most impactful for us would be if insurance companies can really wrap their minds around this whole family care model.” These startups cannot do this work alone and rely on other stakeholders and partners to create a community of care for neurodivergent families. 

These are just a few insights from our conversation with Tom, Marissa, and Rebecca. To hear the entire conversation, check out our video library.

Jul 8, 2022
6 min. read

Changing Relationships With Alcohol Through An Individualized Approach

Ria Health is a tech-enabled telehealth clinic that treats alcohol use disorder (AUD). Their team is singularly focused on helping people change their relationship with alcohol. As mentioned at this GDBHT2022 session, their evidence-based program combines science-backed methods alongside technology to improve accessibility and affordability.
Tom Nix

Ria Health is a tech-enabled telehealth clinic that treats alcohol use disorder (AUD). Their team is singularly focused on helping people change their relationship with alcohol. As mentioned at this GDBHT2022 session, their evidence-based program combines science-backed methods alongside technology to improve accessibility and affordability. Ria Health has helped close to 5,000 people experience successful outcomes and is available in nearly all 50 states. We sat down with their team to get more specifics on their virtual alcohol use disorder solution.

How does alcohol affect a member's mental health?

About half of heavy drinkers concurrently suffer from anxiety and/or depression, a problem that alcohol makes worse. People often drink to self-medicate for these underlying anxiety or depression problems but are left with worse symptoms when they withdraw from alcohol. This pushes people to drink again, perhaps even more often or more per session, perpetuating the cycle.

Misusing alcohol can also result in real-life consequences that can negatively impact someone’s mental health. This includes relationships, work-life balance, and can even result in legal problems (such as DUIs). These stressors can impact social settings and experiences, driving people to isolation, worsening a person’s mental health, resulting in anxiety and depression.

Significantly reducing, or stopping, alcohol consumption leads to an overall better mood and an improvement in levels of anxiety. Some patients will also benefit from counseling and/or an evaluation for anti-anxiety or antidepressant medications.

What does your team do to individualize treatment for each member's goals?

Ria Health’s medical staff includes both physicians and nurse practitioners that conduct a thorough initial assessment to tailor an individualized program for each Ria Health member. Our program combines both counseling as well as medication-assisted treatment (MAT) which, evidence shows, results in the best outcomes for those struggling with AUD. 

Our initial medication assessment takes into account an individual’s unique medical and psychiatric history as well as a member’s own goals. We’re not an abstinence-only program and understand that members may only want to reduce their drinking and overall consumption. We help align on a goal that is likely to result in a member sticking with the program and achieving the goal they want.

Depending on the individual’s pattern of drinking, our team members will prescribe one of several medications available for those struggling with AUD. Different medication is best suited depending on whether a member wants to abstain from alcohol or is looking to reduce consumption.

This includes medicine that can reduce cravings (Naltrexone, Topiraamate, Baclofen), treat symptoms related to withdrawal symptoms, anxiety issues, and lack of sleep (Gabapentin), as well as assist in maintaining abstinence (Acamprosate).

 On the counseling side, patients are able to match with a coach of their choice who helps them develop goals as part of a collaborative approach to treatment. These coaches and counselors provide ongoing accessible care that’s tailored and suited for a patients’ schedule to maximize support and availability. Depending on the member, coaches will pull from a myriad of tools, techniques, and options such as 1-1 counseling, workbooks, and group therapy that is aligned with a member’s preferred treatment and learning style.

How does Ria Health help employers with long term savings?

AUD isn’t just a personal problem — it’s a problem that can affect a person’s employment and work environment as well. Employers also experience negative consequences as a result of an employee with AUD issues. Productivity, work satisfaction, presenteeism, and absenteeism are all issues that can worsen over time without AUD treatment.

By helping employees become aware of their relationship with alcohol, an employee can begin the work towards addressing AUD which starts with an understanding of how alcohol can affect them across interpersonal relationships, home, and work life. When AUD is properly managed in the workplace, employers can save an average of $8,500 per employee per year. 

Ria Health helps employers give a treatment program that empowers employees to manage their AUD, resulting in increased productivity and performance while decreasing healthcare costs, bringing savings to both the employer and employees. 

By offering a focused AUD program, as opposed to a one-size fits all approach, employers can expect better engagement, adoption, and overall program success. We know that employees are specifically looking for specialty providers that offer more accessible options. Ria Health’s telehealth-based program is much less disruptive to employees' lives and doesn’t require a major uproot compared to a residential treatment facility or an IOP/PHP.

In many cases, the employee doesn’t even need to take time off of work to obtain treatment. The lack of disruption makes program adoption much easier and reduces the burden on the employer of having to cover for an employee who may be taking an extended period of time away.

Lastly, Ria Health is vastly more affordable compared to traditional inpatient programs — costing just a quarter as much. These savings are passed on to both the employers and employees.

Jun 30, 2022
8 min. read

Nice Healthcare Presents: How an Integrated Approach Can Best Address Mental Health

Read about this mental health event with Nice Healthcare and the Minnesota Vikings titled, “How an Integrated Approach Can Best Address Mental Health.”
Solome Tibebu

We recently participated in Nice Healthcare's event with the Minnesota Vikings, “How an Integrated Approach Can Best Address Mental Health.” We talked with an incredible group of leaders, including Dena Bravata, MD, Co-Founder of Lyra Health and Advisor to many health tech startups, Kendra Ripp, DNP, VP of Clinical Services at Nice Healthcare, Lindsey Young, Staff Writer and Editor at the Minnesota Vikings, and Vikings linebacker Eric Kendricks. We discussed how to create a workplace that promotes and honors mental health, how benefit managers can foster a supportive work environment, and what employers need to know about employee mental health. 

Key takeaways

Think about barriers to care: Look at your employee population and discuss its unique barriers to mental health care. How can you help address those barriers?

Create awareness around your mental health services: Make sure employees know what services are available to them so they know where to turn before they are in a crisis.

Create an open and empathetic work environment: The most important thing you can do is create a work environment where employees feel supported and able to be open and vulnerable. Employees want to hear from peers, managers, and the C-Suite about mental health.


In the past two years, mental health has become a greater focus for all of us, especially in the workplace. The Mind Share Partners 2021 Healthy at Work Report found that 84% of respondents reported at least one workplace factor that negatively impacted their mental health. Additionally, they reported that the most desired “resource” for mental health was an open culture about mental health at work. Employers can help create a mentally healthy culture at work by providing flexibility, promoting autonomy, establishing boundaries, and emphasizing the importance of empathy and authenticity. Additionally, the biggest influence on a company’s mental health program is engagement from the CEO and other top executives.  

Why Don’t People Access Care?

Some benefit managers wanted to better understand why people may not access mental healthcare. The truth is, as Dr. Bravata deftly explained, “every population has a different barrier to accessing [care].” She explained that many individuals in the military fear that accessing mental health services would be visible on their military records. For others, the cost is a barrier, and some people live in mental health deserts or the 570 counties in the U.S. that do not have any psychologists, psychiatrists, or therapists. Additionally, Eric mentioned that many of his teammates feel that time is a barrier for accessing mental health care. 

"Dr. Bravata emphasized that each "employer needs to understand the biggest access barriers for their own population. Once employers understand what is keeping their employees from accessing care, they can build tailored solutions to address these barriers. For example, Dr. Ripp explained that at Nice Healthcare, they are “seeing people who are accessing mental health care for the first time because of cost.” Nice Healthcare is an employee benefit that gives people a variety of primary care services including mental health therapy, at no cost to the employee.

Role of Stigma

Another barrier to accessing mental health services is stigma, which can feel like an even bigger burden in the workplace. According to a recent McKinsey report, 75% of employees think mental health stigma exists in the workplace. Lindsey detailed a time she shared her mental health journey at a previous job, and her manager approached her afterward, saying, “I hope you don’t expect special treatment.” Flippant comments like this, especially from leadership, can discourage people from sharing their struggles and accessing mental health care.

Eric explained his perspective on a football team, and he’s found that “men in general bottle things up, [we’re told to] tough it out and handle your business.” He emphasized that luckily we’re starting to see other athletes around the world, such as Michael Phelps, Simone Biles, Naomi Osaka, Kevin Love, and many others, using their platform to talk about their mental health struggles. And talking about these issues can tremendously reduce the stigma associated with them. This is what helped spark the idea for Lindsey's Getting Open Series, which showcases members of the Vikings organization speaking openly about mental health.

Seeing others be vocal about their mental health struggles lessens the stigma associated with mental health. Eric explained, “We’re all going through these things. It’s important to not only acknowledge it but reach out to those around you.” 

How Can Employers Help?

If we can understand the barriers to accessing mental health resources and how stigma plays a role, we can consider how employers can be part of the solution. Dr. Ripp encouraged employers to incorporate and advertise “more preventative solutions so people can have treatment or coping skills before there’s a crisis.” Dr. Bravata explained that many people don’t know what mental health benefits they have until they experience a crisis, at which point it is incredibly difficult to navigate. In fact, Mental Health America found that only 47% of employees know about their mental health services, and only 38% would feel comfortable using them. Employers should invest in mental health solutions for the workplace. Furthermore, they should embrace and advertise available solutions to create a company-wide culture of mental health awareness and support.

The most important thing that employers can do, as Lindsey explained, is “[make] sure that the workplace feels safe.” Dr. Bravata emphasized the importance of “having vulnerable leadership…to normalize these feelings for the employees and [to] have an explicit policy around non-retaliation.” Leadership sets the tone for the rest of the company, and a recent Ginger report found that 90% of employees appreciate a CEO that discusses mental health. 

Panelists advised that a multi-pronged approach to discussing mental health in the workplace is most effective to help employees feel more comfortable with seeking out and using the mental health tools that employers invest in. The best way those conversations can take place is through open communication about mental health from all stakeholders who interact with employees: peers, direct managers, and leadership.  

To hear more conversations like this, you can access all of our 2022 virtual sessions with employers, benefits consultants, telehealth leaders, health plans, and more within the Going Digital: Behavioral Health Tech free video library here.

Jun 30, 2022
5 min. read

Revolutionizing Care for Serious Mental Illnesses

We wanted to dive deeper into Mindstrong’s process, including how they are revolutionizing serious mental illness care, measuring outcomes, and partnering with payers.
Michelle Wagner

Our last blog discussed insights from innovative serious mental illness startups. One of the featured companies was Mindstrong Health. Their CEO, Michelle Wagner, gave a hope-filled opening session at Going Digital: Behavioral Health Tech 2022 this year

We wanted to dive deeper into Mindstrong’s process, including how they are revolutionizing serious mental illness care, measuring outcomes, and partnering with payers. You can read our conversation below.

How is Mindstrong revolutionizing mental health care for serious mental illnesses (SMI)? 

SMI populations are hard to treat, hard to engage, and as a result, are populations that are overlooked and underserved.  Supporting this population requires not only outstanding clinical care, but also the creativity and nuance to meet members where they are on their mental health journey.  

Mindstrong's blend of proven science, state-of-the-art technology, and dedicated care teams are the secret sauce behind our ability to help members feel better, do better, and stay better.  We believe in mental health care for all and specialize in serious or complex challenges. It may take more work, and we’re committed to better outcomes for everyone. 

The Mindstrong App & Care Platform includes measurement-based clinical care, customized interventions, case management and resources for SDoH needs;  24/7 support for all acuity levels, with a specialization in SMI gives our members the safety net they need to build confidence in their care.  Our integrated care team includes Care Partners, Therapists, Psychiatric NPs, and MDs.  Each Care team is a tailored blend of provider(s) based on members’ specific needs and preferences. Mindstrong is mental health care with the strength to tackle anything. 

What measurements are taken to evaluate progress in members?

Care delivery at Mindstrong relies on data to inform our Measurement-Based Care (MBC) approach to enable progress tracking and aiding in clinical decision making.

Bringing together technology, data, and care, we measure member progress on an ongoing basis to ensure that member needs and changes are continually assessed and met.

Our proprietary platform sends intelligent, clinically-informed symptom surveys to members automatically, in between sessions.

We use clinically validated assessments including DSM-5 and Level 2 PROMIS.  Providers use the Level 2 PROMIS Assessment information to better define the qualitative nature of the problems, determining a more accurate diagnosis, and developing measurable treatment goals. 

We complement the clinical assessments with post-session assessments and ongoing Care Plan reviews, to ensure we’re constantly meeting the needs and evaluating progress of members in a truly personalized way.

In addition, we are constantly measuring through member surveys like mood surveys and therapeutic alliance.

All assessments are automated based on smart logic that is built into the backend. This reduces the burden for our providers to have to manually send or administer questionnaires to members.

MBC has been shown to outperform treatment as usual, where data is a powerful tool in amplifying care effectiveness.

MBC also empowers and engages the member in their care by giving them the ability to track their progress toward their health and wellness goals and openly discuss their progress with providers.

How do you partner with payers to support SMI members?

We partner with payers who are shaping and leading the way in value based care. Mindstrong specializes in payers’ high-cost and often overlooked members, including those with SMI conditions and older populations. 

In our partnerships, we reduce TCOC for payers and improve clinical outcomes for members. We do this by focusing on outstanding clinical care, high-touch acquisition, whole-person care including SDoH and care coordination, predictive analytics based on passive data from members, and care teams that partner with members to eliminate roadblocks members experience in achieving their mental health goals.

Our start-of-the-tech, proven science, and dedicated care teams enable high member  engagement, real-time crisis intervention, and ongoing monitoring.

The results are improved financial outcomes for partners and improved outcomes for members.

For those interested in learning more, please reach out to Ceili Cascarano at ceili.cascarano [ at ] mindstronghealth [dot] com.

Jun 24, 2022
14 min. read

Insights from Innovative Serious Mental Illness (SMI) Startups

As investors and innovators in the mental health space start focusing their attention on serious mental illness (SMI) focused startups, they need to keep some critical concepts in mind if they hope to successfully engage and serve patients managing severe mental illness. Hear from leading SMI startups on their unique approaches to engagement and partnership in this week’s blog.
Solome Tibebu

Insights from Innovative Serious Mental Illness (SMI) Startups

During the 2022 Going Digital: Behavioral Health Tech Conference, the venture capital panel featured healthcare investors such as Chrissy Farr, a Principal and Healthtech Lead at OMERS Ventures. Farr remarked that startups focusing on anxiety and depression “will continue to be a tricky funding environment in the next couple of years. But more investors I'm talking to are thinking about severe mental illness…I think those companies will do quite well in the coming years because it's a space that has not been invested in in the same way.” 

As investors and innovators in the mental health space start focusing their attention on serious mental illness (SMI) focused startups, they need to keep some critical concepts in mind if they hope to successfully engage and serve patients managing severe mental illness. Hear from leading SMI startups on their unique approaches to engagement and partnership in this week’s blog. 


The National Institute of Mental Health (NIMH) defines SMI as “a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.” SMI can include conditions such as major depressive disorder, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder. 

As of 2017, there were 11.2 million adults in the United States with an SMI. Because SMIs involve serious functional impairment, these impairments can lead to difficulty maintaining employment, poor social support, multiple psychiatric hospitalizations, homelessness, incarceration, and co-existing substance use disorders. In fact, about 1 in 4 adults with an SMI also have a substance use disorder. The SMI population also has a life expectancy that is 20-25 years lower than those without SMI. People with SMI also have worse medical outcomes, higher rates of suicide, and greater levels of stigma than those without SMI. Even further, there is a shortage of providers who treat SMI. 

We spoke with Dr. Holly DuBois, the Chief Clinical Officer at Mindstrong, during our Going Digital: Behavioral Health Tech Conference and she emphasized, “We know that those social determinants [of health], for folks, especially with a serious mental illness, they're profound, and they have a huge impact on their ability to engage and then sustain any outcomes.” Watch her session here

Treating SMIs

There are a growing number of startups focused on SMI care, such as Amae Health, aptihealth, firsthand, Mindstrong, and NOCD

Amae Health utilizes psychiatry-led, integrated care providers for outpatient physical and behavioral health services delivered within in-person clinics. Amae Health focuses on caring for the highest need individuals who are experiencing unmanaged acute episodes or chronically unstable severe mental illness. Often these individuals are seeking care through Inpatient Psychiatry and ERs and unfortunately are met with months long waitlists to get any kind of specialty-related SMI care. For this population, piecemeal solutions or relying on the existing fragmented network has proven to be insufficient.

Amae Health’s solution is designed based on real world evidence and research from their CMO’s integrated care model at the VA, which demonstrated industry leading clinical and financial outcomes. Their tech-enabled integrated outpatient psychiatry-led behavioral and primary care services are delivered via our in-person clinics and community centers. Each patient has a dedicated care team who in addition to providing clinical care, focuses on basic needs, healthy living, social, and community components impacting the patient, helping them stabilize their lives, have community support, and rebuild purpose. 

aptihealth matches members ages 12 and older with a collaborative care team including a licensed therapist and psychiatric prescriber, if needed, and focuses on those with mild symptoms to those with SMI. 

aptihealth’s mission is to improve behavioral healthcare for underserved populations—one member at a time.  To accomplish this, they operate fully within the healthcare system, partnering directly with health plans, health systems, physician practices and community-based organizations to intelligently integrate care. With domain expertise in patient engagement, behavioral and medical care, virtual-first care delivery and unprecedented data and insights; their care model reliably impacts the most important behavioral health drivers of outcomes and cost. Their technology guides care using workflow best practices and data insights to enable right care, right modality, right time. Their modern design creates an intuitive experience for members and robust capabilities for providers to optimize engagement.  Insights from their treatment data drives breakthroughs in mental health understanding, treatments, and outcomes.  All of this results in informed, organized, coordinated, collaborative and successful care, evidenced by unprecedented member experience, clinical outcomes and return on investment.

Mindstrong offers telehealth and virtual care using therapists and psychiatrists. Mindstrong also users AI-powered digital biomarkers, collected passively as members use the Mindstrong app, to monitor patients' mental health status. 

Mindstrong's blend of proven science, state-of-the-art technology, and dedicated care teams are the secret sauce behind our ability to help members feel better, do better, and stay better.  They believe in mental health care for all and specialize in serious or complex challenges. It may take more work, and they’re committed to better outcomes for everyone. The Mindstrong App & Care Platform includes measurement-based clinical care, customized interventions, case management and resources for SDoH needs;  24/7 support for all acuity levels, with a specialization in SMI gives our members the safety net they need to build confidence in their care.  Their integrated care team includes Care Partners, Therapists, Psychiatric NPs, and MDs.  Each Care team is a tailored blend of provider(s) based on members’ specific needs and preferences. Mindstrong is mental health care with the strength to tackle anything.

NOCD is a telehealth provider for the treatment of OCD, utilizing therapists who are trained in Exposure and Response Prevention (ERP) therapy, the gold standard for OCD treatment. 

There are 179 million* people with Obsessive compulsive disorder (OCD) around the world. Never before has there been a dedicated platform to identify people who are suffering from OCD, bringing them to care, helping them navigate the healthcare industry, and providing in-between care support in order to make sure they maintain their care journey. This member-focused approach that was built from the consumer backward is truly groundbreaking in the behavioral healthcare space, arguably in the healthcare industry in general. People suffering from OCD no longer have to feel alone as they continue to reduce the social stigma surrounding OCD. Reducing this stigma & identifying people in need allows us to enroll patients into the largest telehealth network of OCD-specialized therapists.

NOCD has reinvented the front door to healthcare and revolutionized OCD treatment & patient experience. They have developed a discreet way of identifying a serious mental illness community through innovations such as finding those suffering where they are in their journey by engaging with consumers and helping them navigate the healthcare system in order to receive the right care. 

As well as utilizing technology to create an experience from treatment seeking to receiving treatment through our telehealth platform and offering in-between session care & support through peer communities, direct access to experts and self-help tools. 

NOCD’s telehealth platform enables patients to schedule live face-to-face therapy sessions with licensed clinical therapists specializing in ERP therapy. In between visits NOCD’s member tools empower them to better manage their OCD and practice therapeutic techniques. The combination of therapy, and care management support between sessions is an innovation in the behavioral healthcare industry. They have created an integrated platform between consumer engagement, healthcare treatment, and in between care, an integration that is unique in the behavioral healthcare space.  NOCD has designed this entire experience from the consumer backward in order to meet a suffering and underserved demographic where they are in their care journey, bringing them to affordable, accessible and insurance-covered care, and working with them to maintain their journey in order to regain their lives.  

*Based on a global population of 7.8 billion people and a recognized OCD lifetime prevalence of 2.3%

A Message from SMI Startups to Payers and Providers

What do SMI startups steeped in care delivery want payers and providers to know? Here are some of their thoughts:

Amae Health: “[Payers and providers] know that consistent high quality SMI+SUD, medical, and social integrated care are deeply necessary to effectively help this population. However, being able to bring these pieces together in an equitable, measurement, evidence based and incentive-aligned manner has been the primary challenge. Amae Health seeks to do just that in order to provide integrated care.”

aptihealth: “When care is clinically integrated with health plans and systems across all points-of-care; patients can be engaged whenever and wherever they touch the system, with insights that create the opportunity to navigate the patient to the optimal course of care, reducing ED visits and admissions. That’s the challenge, and it’s our job to make sure payers and providers know that there’s a solution.” 

firsthand: “Real support can only be financed if we truly integrate the medical and behavioral risk dollar. Without that integration, there is not enough savings to substantiate investment in appropriate whole-person clinical models at scale.” 

Mindstrong: “These populations need more than an episodic fix; they need support that balances mental health care with whole person care, with a goal of building resilience and empowerment.  With the right blend of data, technology, and care, SMI members can experience sustained outcomes and Payers can reduce [total cost of care].” 

NOCD: Obsessive-compulsive disorder (OCD) is a severe psychiatric condition. It is imperative that those suffering from OCD require specialized treatment: Exposure & Response Prevention (ERP). Lifetime prevalence of OCD is approximately 2.3%, affecting nearly 1 in 40 people (~8M Americans). OCD is debilitating; those suffering are 10X more likely to commit suicide, it is ranked by the WHO as 10th leading casue of disablity, and approximatly 1 in 4 people with OCD develop substance abuse. Despite the prevalence, OCD is widely misunderstood & misdiagnosed. This, combined with a lack of mental health resources, causes a 14-17 year patient journey to find appropriate care. Limited access to proper care at the appropriate time creates a burden on the healthcare system. Per 1M commercially insured, OCD generates $104M+ annually in behavioral health costs; of which, 96% is associated with inappropriate care.

Where to learn more:

To read more articles like this, read more of our Insights here. 

Want a lot more digital mental health and substance use insights? Subscribe to our behavioral health tech newsletter here.

May 19, 2022
7 min. read

Advancing Mental Health through Asynchronous Therapy

We discuss the benefits of asynchronous text-based therapy and how CVS and Aetna have successfully been able to partner with Talkspace.
Solome Tibebu

We recently hosted a webinar with Talkspace and Aetna titled, “Advancing Mental Health through Asynchronous Therapy.” We were joined by Dr. Derrick Hull, Research Director at Talkspace, Dr. Varun Choudhary, Chief Medical Officer at Talkspace, Pablo McCabe, SVP of Healthcare and Account Strategy at Talkspace, and Brooke Wilson, the Head of Resources for Living, a division of CVS Health/Aetna. In the session, we discussed the newly-released, impressive research on asynchronous, text-based therapy and how Aetna and Talkspace successfully executed their partnership.

Background about text-based therapy

With a growing need for mental health support, it is important for people to think creatively about how mental health care should be delivered in the United States. There is a mental health provider shortage and 55% of US counties have no psychiatrist, psychologists, or social workers. As we consider new ways to offer mental health resources to those who aren’t able to easily access care, text based asynchronous therapy is one solution.

Text therapy can be convenient for those with busy schedules, it’s cost effective, accessible, and allows people to be in the privacy of their own home. As Dr. Hull explains, “even if you have the money to seek care, some people don't. Scheduling the sessions can be a challenge, the travel, the commute, all of that can be a challenge,” and text therapy can help with that. Additionally, it may be helpful for people to look back on the conversations with a therapist to reflect on helpful tips and talking points. Some people may even find that writing difficult things in text might be easier than saying them aloud. Text therapy has also been shown to be a great way for people to be introduced to therapy, and some studies show that people then decide to seek face-to-face therapy after a positive experience with asynchronous text therapy

How Talkspace Works

Talkspace is a HIPAA compliant app where members have access to therapists through texts, voice messages and/or video visits but most of the interaction with providers is done through asynchronous text messaging. As Dr. Hull explains that Talkspace makes sure to use “licensed professionals who can structure the treatment with the same kind of clinical frame that you would expect if you were going face to face.” In other words, their aim is to provide as similar a treatment as possible.

Additionally, some mental health providers have seen the benefits of using asynchronous text based therapy. As Dr. Hull explains, “because messaging is unfolding daily, you almost have more insight into what's going on with the client than you do [if you’re meeting] weekly.” In their early research studies, Talkspace has also seen “that people engage more frequently, and they also tend to stay longer [than traditional therapy], and our assumption here is due to convenience.” More of their studies have also seen that as patients' improvement slows down, therapists are reaching out more, to keep members engaged. 

In a Talkspace study, they found that over a 12 week period of treatment, patient GAD-7 scores, measuring anxiety, decreased 48% and patients PHQ-9 scores, measuring depression, decreased 53%. In studying their effect on workers, they found that Talkspace users missed 50% fewer hours over a 90 day period, compared to prior to treatment, 64.7% increase in employee activities outside of work, and 56% increased work productivity. 

How the CVS and Aetna Partnership Works

Brooke Wilson mentions that the Talkspace partnership started as a pilot in 2018 as a new way to engage members. As she explains “we thought it would allow people another choice and preference in how they might like to access care.” As the pandemic started, Brooke mentioned that they had an increase in demand for mental health support and that traditional providers didn’t have appointments. 

Brooke continues, “we also were able to offer these different modes of connection beyond async. So for our customers, we have that option of a telephonic session, a video session, a live chat session as well as that asynchronous.” She echoes that giving their members choice and lots of different watts to connect opened up options for care. She adds, “we did think that this could attract new members who maybe weren't engaged with traditional means because it reduced barriers and was less stigmatized.” Brooke concludes that after adding in Talkspace, some members have seen utilization of their EAP jump 20% in one month.

Things to Keep in Mind for Asynchronous Text Based Therapy

Asynchronous text based therapy is a wonderful option for many people, including those who cannot talk freely such as those experiencing domestic violence, those with complex schedules such as airline workers, healthcare workers, and young parents, and for those who are new to therapy because it offers a low barrier to entry. Typically, clients with more serious mental illness or more severe symptoms such as those dealing with psychosis or mania may need more treatment than text based therapy can provide. 

Pursuing text-based asynchronous therapy is an individual choice and can be an excellent way of accessing mental health care. 

You can watch the full webinar here and to hear more conversations about digital mental health, please join us for the Going Digital: Behavioral Health Tech conference on June 8-9, 2022. Registration for the conference is free, or consider making an optional donation to our 2022 non-profit partner, the American Foundation for Suicide Prevention

Want a lot more digital mental health and substance use insights? Subscribe to our behavioral health tech newsletter here.

May 12, 2022
6 min. read

How to Improve Mental Health Care Accessibility for College Students

To say there’s a growing mental health crisis among youth is an understatement. Campus counseling centers are adapting quickly to meet the growing need for quality mental health care, but are often constrained by their own limitations. This is why Mantra Health is working with leaders in higher education.
The Mantra Health Team

Students are dropping out of school at alarming rates. While the overall dropout rate is 40%, 30% leave before ever reaching their sophomore year – and as of 2021, 71% of student drop-outs cited “emotional distress” as the reason. To say there’s a growing mental health crisis among youth is an understatement, as more and more students face anxiety, depression, and severe mental health concerns. Campus counseling centers are adapting quickly to meet the growing need for quality mental health care, but are often constrained by their own limitations. This is why Mantra Health, a leading provider of young adult mental health care, is working with leaders in higher education to expand service offerings, remove care barriers, and close mental health equity gaps. 

How do university students access mental health care on campus? 

Most colleges and universities have a counseling center and this is often the go-to resource for students in need of on-campus care. Often they exist independently of a school’s health center and include licensed counselors or therapists who are responsible for outreach efforts, preventative care, and one-one-one counseling sessions with students. Counseling centers provide vital services, but are often unable to meet student demand because of administrative responsibilities, limited resources, staffing challenges, budgeting constraints, and other factors.

Counseling centers don’t usually have the bandwidth to provide care on weekends, breaks, or over the summer months, nor do they have expertise in specializations, such as psychiatry, making it difficult to treat different states of acuity. To address these concerns, colleges and universities need to expand their mental health offerings to include more diverse and comprehensive care, such as teletherapy, telepsychiatry, crisis care, or unique therapy specialties, which are accessible at any time throughout the year.  

How is Mantra Health increasing mental health care accessibility? And how are their services designed specifically for university students?

Mantra Health has a diverse provider team, 50% of which identify as people of color and majority of whom are trained in unique specialities. Mental health needs are personal – and can occur at any time and place – which is why virtual offerings, flexibility, and personalization are necessary for college mental health care. University students are battling numerous stressors, including work obligations, financial strains, academic pressures, and busy social lives. We can’t expect students to wait three weeks to be seen by an on-campus counselor. More comprehensive needs require more comprehensive care. 

Mantra Health, a clinically-informed digital mental health provider, offers colleges and universities a variety of telemental health services, along with an innovative, student-focused platform that supports flexibility, collaboration, and ease of care coordination. Mantra Health works with colleges and universities to provide teletherapy, telepsychiatry, and crisis care to students, but the major difference is Mantra Health’s willingness to work intimately with counseling centers to fill in gaps, provide additional services, continue care through breaks and summer months, and ensure students’ needs are met in whatever capacity they are needed. 

Why is collaborative care an integral part of Mantra Health’s offering?

On-campus counseling services are necessary to the overall health of a campus and Mantra Health has no intention of replacing them. Rather, the telemental health provider offers an extension of services, working closely with on-campus counseling centers to provide additional care to college students. If students don’t have a car or if they can’t visit the center due to work commitments, academic obligations, or other reasons, they can access teletherapy or telepsychiatry through Mantra Health’s interactive, easy-to-use platform. This is where counseling centers, care navigators, and providers can maintain regular means of communication, ensuring that a student’s care is managed most appropriately and effectively. Should a student need care beyond the academic school year, Mantra Health’s team of providers can work with the counseling center or student directly to extend the student’s offerings, preventing unnecessary disruptions.

How does Mantra Health, an off-campus provider, ensure quality of care?

Mantra Health takes an evidence-based approach to mental health care. All providers are held to the highest quality standard of care and must maintain clinical and cultural competence. They are highly trained experts who understand the unique needs of college students. Mantra Health’s providers have their own diverse backgrounds, specialities, and perspectives, making them well positioned to work with many different populations of students, many of whom are seeking providers who understand their personal experiences and mental health challenges. 

Mantra Health is also one of the leading providers of telepsychiatry for young adults, a specialty area that is hard to find on college campuses, but incredibly important for the well-being of high acute students who face severe mental health conditions. Trained psychiatrists can work with on-campus clinicians and medical providers to assess the physical, mental, and psychological needs of a patient. This is incredibly beneficial when prescribing or managing medication or preventing a crisis situation from developing. 

If you want to bring mental health services to your campus or learn more about Mantra Health, schedule a call with our partnership team today.

Apr 28, 2022
7 min. read

The Iron Triangle: How AbleTo Is Working On Access, Cost, and Quality

As stakeholders in behavioral health, we’re all familiar with the importance of access, cost, and quality of care. Access to care has been especially difficult in the field of behavioral health – from the fragmented healthcare system to a shortage in providers. But in recent years, companies have been utilizing technology to innovate how people access care.
The AbleTo Team

As stakeholders in behavioral health, we’re all familiar with the importance of access, cost, and quality of care. Access to care has been especially difficult in the field of behavioral health – from the fragmented healthcare system to a shortage in providers. But in recent years, companies have been utilizing technology to innovate how people access care. Although in some cases, this isn’t enough because the cost is too high. And if someone finally finds accessible care that is within their budget, is the quality of that care even worth it?

In an attempt to make the best of all three worlds,  AbleTo has various strategies in place to increase access and quality, while reducing costs. We spoke to the team from AbleTo about these strategies and how they are advancing and innovating behavioral healthcare. 

How is AbleTo ensuring access to care?

AbleTo is continuing to meet the increased need for behavioral healthcare across the nation by ensuring access in 3 ways:

  1. Partnering directly with insurers

AbleTo partners with insurers to offer our programs as an eligible benefit, allowing us to treat a broad range of members across the socioeconomic spectrum, serving those on commercial, Medicare and Medicaid health plans. Due to the strong health outcomes and medical cost savings, health plans know there is a high value in removing barriers to care to improve the total care of cost such that AbleTo is a fully covered benefit with $0 cost share for 95% of our participants. 

  1. Expanding our ability to treatment scope through technology enhancements  

We also understand the importance of treating across the mental health spectrum, expanding our platform to meet the recently increased demand amidst the pandemic to enable a population-based approach to deliver the highest quality mental health care to members. Our technology helps us identify those individuals for care, including those who are especially vulnerable to mental health issues due to social determinants of health and comorbid health issues that show up in claims data. Through technology, we’re able to provide high quality, evidence-based care to people when and where they need it most across all 50 states to an eligible population of over 50 million lives. In fact, in 2022 we hit a milestone of delivering over 2 million therapy sessions. 

  1. Delivering culturally competent care

AbleTo also ensures that care being accessed is high-quality and delivered in a culturally competent manner. AbleTo’s network of 2000+ providers includes therapists and coaches across all 50 states. The network is reflective of the culturally diverse landscape of our participant population and is trained to address factors stemming from race and race trauma, racial stress, and issues that may be specific to individuals that identify as LGBTQ+. Many providers in our network are bilingual so participants can converse in the language that is most comfortable for them. Delivering the right care means recognizing that no one patient is the same. Providing the highest possible quality care ensures every patient gets the care they need for lasting improvements in their mental and physical health.

How does AbleTo provide personalized care, improve outcomes and reduce cost?

We know mental health isn’t one-size-fits-all. That’s why AbleTo’s suite of solutions ensure individuals get support that is truly personalized to their needs, from program intensity to the mode of delivery. Our 8 week long, Cognitive Behavioral Therapy (CBT) programs are proven to reduce depression, stress and anxiety for those with mild to complex behavioral health needs. With weekly 1-on-1 support from a licensed therapist, behavioral coach, or both, combined with digital tools, we help put learned techniques into daily practice. 

AbleTo’s approach to care is simple yet effective. We pair the human connection of empathy, understanding and expertise with digital tools and program resources that advance real life application between sessions. Ultimately, solutions that address the individual complexity and nuances of mental health result in greater positive health outcomes and patient satisfaction, and that’s what we see in AbleTo’s data. We are creating and adhering to a quality standard of care using an evidence-based approach, navigating people to the right programs, and simplifying the member experience through our app. These elements are central to our mission to ensure better outcomes and move the needle for health care.

Our members experience our 8-week programs and return to their lives feeling like they can manage. And for many of our health plan partners, AbleTo is a covered benefit that is 100% free for most people. Our outcomes show decreases in depression and anxiety symptoms along with other health benefits like stress and loneliness score reduction, increased medication adherence, reduced pain severity, reduced in-patient hospitalizations and more. And with a 98% program satisfaction rate among graduates, we know members feel the program works for them. 

How does AbleTo maintain a quality provider network?

Demand for care continues to outweigh the availability of quality providers, leaving companies to compete to attract providers to their network. At AbleTo, we are setting ourselves apart on the basis of quality standards of care. As the first behavioral health solutions provider to receive URAC accreditation, we’re constantly adopting the latest tools and best practices to support our providers, allowing them to deliver the right interventions to the right participants, grounded in quality care.

We also value the ability for our providers to grow and develop both professionally and personally. AbleTo's clinical roles expand with opportunities to supervise providers, train and develop providers, oversee network quality, support risk/escalation, shape our therapy programs, and more. Providers are encouraged to seek out and take advantage of any opportunities that interest them such as volunteering, mentorship, training and development, educational resources, and more. Driven by our collaborative culture, providers are equipped with comprehensive training and tools, as well as ongoing support from our skilled clinical supervisor.

Apr 21, 2022
5 min. read

Engagement and Relationships Are the Keys to Activation and Behavior Change

‍Engagement and relationship. mPulse Mobile addresses these two key pieces by measuring and optimizing their Conversational AI platform. mPulse recently interviewed me(!!!) about promoting mental well-being and health literacy by leveraging technology. And now the roles are reversed in this blog!
mPulse Team

Member engagement is a crucial component to achieving positive outcomes for patients. There’s a reason why payers value this statistic so highly. Members must be engaged in the care they are receiving if they are going to change behaviors and reach positive outcomes. If they are not engaged, new solutions may remain unused or underutilized.

Another influential part of quality care is the relationship between the member and the provider (you know we talk quite a bit about therapeutic alliances around here!). A good relationship between the two may look different for each member, depending on what they value most. Some patients may value the use of plain, jargon-free language so they can better understand their provider. Others may seek validation.

mPulse Mobile addresses these two key pieces by measuring and optimizing their Conversational AI platform. mPulse recently interviewed me(!!!) about promoting mental well-being and health literacy by leveraging technology. And now the roles are reversed!!... I sat down with the mPulse team and asked a few questions about their recent collaboration, their member engagement, and actionable conversations. Join us in the blog for another exclusive interview with a key leader in member engagement:

You recently acquired HealthCrowd!  What has come out of this partnership in the early months, and what is to come? 

 Through our new collaboration, we have enriched our use of an omnichannel communication platform to connect payers, providers, and health systems to their members and patients. Through digital-first health engagement, we combine the power of our conversational AI platform, streaming health education and deep expertise, to deliver personalized health experiences and improve health outcomes. 

We have united to strengthen our shared mission of improving health outcomes through market leading health engagement solutions. Together we have unmatched health engagement capabilities that transform how healthcare organizations improve both outcomes and the consumer experience through digital touchpoints, at-scale. 

Our teams bring a combined passion and deep expertise in designing and delivering health engagement solutions that unlock enormous value for our healthcare customers. Through this union, we have more resources to deliver an even better service to our customers that retains our focus on innovation, agility and close collaboration.

Over the past few months, we have been focused on identifying the best practices and our most impactful capabilities. This discipline will allow us to optimize our offerings to bring the market even more impactful engagement solutions.

Why is it important to measure member engagement to optimize your platform? 

Every member engages differently, so it’s integral to understand which channels are effective with which members, and where you may need to optimize, adjust or give more nudges. Today’s health care consumers have more choices, greater accountability and a wealth of information at their fingertips. They want their health care experience to be simple, personalized and convenient — anytime, anywhere. 

Member engagement is the foundation of payer success. With so much at stake, how do we know that our engagement tactics are making the mark?

Innovative engagement technology, complete with accurate measurement, enables continued improvement of engagement. Payers should count on engagement technology that provides reporting which illustrates what is impactful for member programs to achieve best practice member retention and satisfaction, improved health outcomes and cost reduction. 

How does your Conversational AI platform initiate actionable conversation?

 mPulse’s Behavioral Data Science team and Conversational AI platform combine the acumen and automation to intelligently tailor conversations to build stronger, more impactful relationships with members and patients. Natural, plain-language conversations create understanding and trust. This trust makes people more likely to take key actions to improve their health and help payers reach their organizational goals.

Relationships are the key to activation and behavior change that ultimately drives positive outcomes. It's also about data and insights. That's how we get to know the consumer and honor their preference.

We have patented technology that facilitates this key differentiator. mPulse partners with more than 150 healthcare organizations including 9 out of 10 of the nation's largest payers and many local and regional plans. We have engaged more than 50 million consumers with 1 billion automated conservations each year.

Apr 21, 2022
10 min. read

What You Need to Know About Collaborative Care

Collaborative care uses a team-based model of treating behavioral health in the primary care setting bringing primary care and behavioral health clinicians together to provide treatment.
Solome Tibebu

The current mental health care system unfortunately is not adequately addressing the roughly 50 million Americans who experience a mental illness. In fact, it takes on average 11 years from onset of mental illness symptoms to treatment. Additionally, 55% of US counties do not have a single practicing Psychiatrist and 148 million people live in a designated Mental Health Professional Shortage Area. With these statistics, the current US model for mental health treatment needs to find new ways to address the disconnect between the need for mental health services and the lack of available providers. 

Is integrated care the answer?

Integrated care, which is the partial or full blending of behavioral health services with general medical care, is one solution for addressing this problem. We recently hosted a webinar on “How Technology can Support your Journey Towards Integrated Care” with panelists Dr. Frank Webster, the Behavioral Health Chief Medical Officer at Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas, Kacie Kelly, Senior Vice President for National Policy Implementation at the Meadows Mental Health Policy Institute, and Dr. Tom Zaubler, Chief Medical Officer at NeuroFlow. On the webinar, we discussed how integrated care overall could solve for several key challenges the behavioral health industry is facing. More specifically, we talked about the benefits of one model of integrated care called collaborative care. 

What is collaborative care?

Collaborative care is a specific type of integrated care using a team-based model of treating behavioral health in the primary care setting bringing primary care and behavioral health clinicians  together to provide treatment. All patients in a primary care clinic are universally screened for psychiatric illness as part of their visit. Collaborative care has been studied in more than 80 randomized control trials and has been shown to improve patient outcomes, patient and provider satisfaction, and reduce healthcare costs.   

Collaborative care in practice may have primary care physicians meeting with patients and prescribing medications, while Psychiatrists are often used as a caseload supervisors. Dr. Zaubler explains that “this allows Psychiatrists to manage a much larger caseload of patients than if they were seeing them individually.” 

Offering behavioral health interventions in primary care settings is convenient, can reduce stigma, can deepen the patient-provider relationship, and can improve care for those with co-occurring mental and medical conditions. In our webinar, Dr. Zaubler noted that “95% of all mental health providers are practicing in siloed settings. And yet, when patients present with their psychiatric problems, roughly 80% either present in medical settings for their psychiatric care. There's a huge disconnect here in terms of where people are seeking care and where the care gets delivered.” Collaborative care attempts to bring together where people are already  seeking care and the need for greater behavioral health care.

Challenges for implementing collaborative care

While the evidence supporting collaborative care continues to grow, uptick and adoption remains scant when it comes to implementing collaborative care across providers. 

We have evidence that collaborative care is beneficial, but what challenges do health systems and providers face when trying to implement collaborative care? To start, some primary care physicians may have anxiety about a new way of doing things and disrupting current workflows. There is particular concern around prescribing psychiatric medications, which is why it's important to create an environment where primary care physicians feel supported by their behavioral health team and clinical decision support tools.

Additionally, creating a sustainable model of collaborative care requires an upfront investment. Health systems may be hesitant to adopt a new way of working that includes upfront costs. That’s where partners such as the Meadows Mental Health Policy Institute can be beneficial and Kacie Kelly remarked that, “we come in and oftentimes leveraged philanthropy to offset transition costs or startup costs and then help the practice with the operational workflow changes that need to happen, help them understand the changes with billing and reimbursement, and overall practice changes.” In fact, Kacie remarks that collaborative care “can be cost neutral around 6-9 months of utilization, and cost savings at the 9 month mark.” Collaborative care ultimately leads to cost savings through decreased medical utilization, emergency department visits, and inpatient stays.  

An important component of collaborative care is measuring patient symptoms using validated measures such as the PHQ-9, a questionnaire screening for depression, and GAD-7, a questionnaire for anxiety. However, this can be time consuming and can create more paperwork for the front desk staff members.

Finally, there can be challenges for health plans reimbursing properly for behavioral health. Dr. Webster noted that “behavioral health typically makes up 3-5% of healthcare costs for commercial insurance. However, it's important for people to understand that 3-5% has a huge impact on medical costs.” Additionally, providers need to understand that they can bill and be reimbursed for these behavioral health assessments.

How can technology help?

We’ve seen the reasons why collaborative care is so important and obstacles to pursuing it, but how can technology help us implement this strategy? Digital solutions can plug into various parts of an integrated care model, as shown in this diagram from Raney et al.

One digital solution, NeuroFlow, is a two-sided behavioral health platform that leverages technology to both remotely assess and identify patients appropriate for collaborative care as well as increase the efficiency of the care teams managing the patient panel. NeuroFlow’s engagement platform allows patients to quickly and easily complete assessments such as the PHQ-9 and GAD-7 in the comfort of their home and immediately engage with relevant clinical content based on their scores. At the same time, their providers and supporting BH care team collaborate on their treatment through a tech-powered registry that populates information directly into electronic medical records, allowing providers to track patient progress over time and be alerted to patients who are at risk. Their combined offering of technology and clinical services showcases the exciting road ahead for empowering care teams with technology to help scale proven models of care.   

Another example is Valera Health, which acts as a practice extender and telepsychiatry option. Patients access Valera Health through a mobile app and are triaged by health connectors and then routed to therapists and/or psychiatrists as needed for telehealth visits. Patients then access appropriate self-guided programs and exercises to stay engaged.

 Finally BCBS utilizes the Learn to Live program. Health plans have unique challenges because they use claims as healthcare information, but they cannot tell what is happening today, or predict future care. Additionally, health plans have billions of clinical data points but as Dr. Webster mentioned, “getting claims organized and sorted is really difficult.” To address some of these issues, BCBS utilizes the Learn to Live program, which is an online platform where individuals can take assessments and then receive web-based CBT lessons and live clinician coaching. Patients receive treatment and health plans can capture their assessment information as clinical data to help them get targeted resources to the people that need them.

Tips for getting started with collaborative care:

1. Work with experts

Look for behavioral health providers who are well versed in collaborative care to help you with your founding team. Having technical expertise will make a huge difference in the success and longevity of your program.

2. Think creatively about startup costs

Ultimately, collaborative care leads to cost savings, but look into philanthropic options if you need help with startup costs.

3. Remember your CPT codes 

Have your staff start getting used to billing CPT codes for all behavioral health assessments to ensure proper reimbursement.

4. When integrating technology, focus on measurement

As Kacie Kelly noted in our webinar, “I would encourage you, as you’re trying to figure out how to extend your workforce and how to get people tools between sessions, to really prioritize those tools that are measuring the outcomes and the impact” of your intervention.

To dive deeper, check out the full webinar, review a helpful collaborative care Q&A from NeuroFlow, and please join us for the Going Digital: Behavioral Health Tech conference on June 8-9, 2022. Registration to the conference is free, or consider making an optional donation to our 2022 non-profit partner, the American Foundation for Suicide Prevention. 

Want a lot more digital mental health and substance use insights? Subscribe to our behavioral health tech newsletter here.

Mar 17, 2022
5 min. read

Is the answer to provider shortages humans or robots?​

Artificial Intelligence (AI) has been a hot buzz word for years now, but things have really been picking up when it comes to AI specifically in behavioral health. Some companies are leveraging AI to evaluate the emotional state of an individual user and then automatically triaging them into the appropriate level of care, whether that be a lightweight self-guided solution or hands-on intervention with a professional.
The Wysa Team

Is the answer to the mental health provider shortages more humans or robots?​ Perhaps a lil of both!

Artificial Intelligence (AI) has been a hot buzz word for years now, but things have really been picking up when it comes to AI specifically in behavioral health. Some companies are leveraging AI to evaluate the emotional state of an individual user and then automatically triaging them into the appropriate level of care, whether that be a lightweight self-guided solution or hands-on intervention with a professional. 

The team from Wysa, a popular app that uses AI to support mental health, shared insights on how they are helping users self-manage stressors by blending AI-guided listening with professional expert support. Read more about their approach and what’s on the horizon next at their startup: 

How can artificial intelligence aid the supply/demand issue in mental health?

Artificial intelligence provides a unique opportunity to provide support on an individual level by understanding the user and determining an appropriate intervention based on the user’s expressed needs. Wysa is the world’s leading AI-based digital companion for behavioral health. Wysa scales access to mental health support with 365/24/7, anonymous, quality care delivered via an easy-to-use app interface. Wysa supports the broad care spectrum; at a subclinical level Wysa bypasses the need for human intervention thereby reducing provider burden and ensuring immediate access to mental health support. For those at a clinical level, Wysa’s digital assessments and e-triaging ensure real-time escalation to the appropriate level of care, including access to Wysa licensed coaches and therapists, thereby improving provider productivity and reach.  

What would you share with someone who is unsure about the efficacy of AI/chatbots for mental health care? 

Wysa’s clinical efficacy has been measured in real-world studies, clinical trials and now, in RCTs. For the past three years, Wysa has consistently ranked as the highest-rated app on ORCHA (the digital health app rating agency in the UK), on the basis of an evaluation that examined - the evidence surrounding it, the quality of evidence-based content within the app, usability and accessibility scoring, and its capacity to protect the data of its users. In the review, Wysa’s compliance with ISO standards as well as DCB 0129 (NHS Clinical Risk Management Standards) were also noted. The techniques used within Wysa are based on proven evidence-based paradigms of psychology and mental health, such as cognitive-behavior therapy and mindfulness-based therapy. In an independent analysis, Dr. Wasil at Harvard University (2019) had examined all popular apps for anxiety and depression, and concluded that Wysa was the app with the highest number of evidence-based elements.  

In 2018, Inkster et al. (University of Cambridge) looked at the effect of Wysa on users with different degrees of engagement. They found that the high users of Wysa had significantly higher average improvement (mean 5.84 [SD 6.66]) compared with the low users group (mean 3.52 [SD 6.15]) on their depression and anxiety levels.

What's next for Wysa? Your website mentions solutions for healthcare and insurers. Can you tell us more?

This is a very exciting time for Wysa! In conjunction with psychologists around the world, we are creating dedicated new programs to serve individuals with specific concerns of worry, anxiety, depression, social phobia, substance use, and maternal health. We are also beginning to release a version of the app in Spanish. This year, Wysa is dedicated in its focus to curate specific and targeted interventions and increase access to mental health support globally. In an effort to make things easier, scalable, and more effective, we are also building out our new therapist companion which will greatly improve the in-person therapeutic experience based on insights gained from Wysa.

Wysa also currently has solutions for both health systems and insurers with a focus on both population and person-centered care. We've learned a lot in the past few years from our research about important use cases that could really move the needle in terms of things like chronic pain and adolescent care. We are excited to offer these solutions to our valued partners.

Mar 10, 2022
4 min read

Let’s Get Real: Real World Evidence in Mental Health

While many a mental health or chronic disease startup can generate conclusions about their solutions in a clinical trial, but evidence gained out in the harsh real world can provide a true picture of a clinical intervention’s impact on people’s lives day to day.
Scott Kollins, PhD

What exactly is real-world evidence and why is it important? 

The FDA explains real-world evidence as “the clinical evidence regarding the usage and potential benefits or risks of a medical product derived from analysis of RWD. RWE can be generated by different study designs or analyses, including but not limited to, randomized trials, including large simple trials, pragmatic trials, and observational studies (prospective and/or retrospective).”

While many a mental health or chronic disease startup can generate conclusions about their solutions in a clinical trial, but evidence gained out in the harsh real world can provide a true picture of a clinical intervention’s impact on people’s lives day to day.  

This week, Holmusk's Chief Medical Officer, Dr. Scott Kollins, shares more about Holmusk’s approach to leveraging data to transform mental health care measurement, delivery and quality: 

How do data and analytics from Holmusk's platform enhance research?
Holmusk is building the world's largest real-world evidence platform, starting with behavioral health. There is a critical need for better evidence in this space, where measurements and assessments are often subjective. Holmusk provides a range of digital solutions to help generate evidence in studies examining a range of behavioral health conditions, including major depressive disorder, opioid use disorder, schizophrenia, and ADHD. 

Our NeuroBlu Research platform enables pharmaceutical companies to build cohorts from a database that contains more than 20 years of data on over 1,000,000 patients, as well as perform advanced analytics to generate new insights about these patients. NeuroBlu Research has been used for applications ranging from developing new understanding about how to treat young children with ADHD to building a predictive model to ascertain which patients are most likely to stop treatment for opioid use disorder.

How does Holmusk's work improve clinical care?
One of the data sources that feeds our continuously growing behavioral health database is our MindLinc EHR. We have designed MindLinc specifically for behavioral health settings, aimed at providing real-time analytics to behavioral health providers and their clinics and creating stronger, clinically meaningful ways of increasing engagement between patients and their providers. MindLinc's unique emphasis on high-quality data capture not only fuels stronger research, but it also enables evidence-informed care that leads to improved outcomes across the behavioral health ecosystem.

MindLinc's unique emphasis on high-quality data capture not only fuels stronger research, but it also enables evidence-informed care that leads to improved outcomes across the behavioral health ecosystem.

You've recently closed a deal with US-based Metrocare Services. Tell us more!
We recently entered into a collaboration with Metrocare Services, the largest provider of mental health and developmental disability services in North Texas. The agreement will play an important role in advancing both behavioral health research and value-based care by enhancing Holmusk's RWE platform through secured, de-identified AI-powered analytic models that help drive improved clinical outcomes. In addition, Metrocare will have access to Holmusk's data analytics tools to provide insights that will improve delivery of care within its health system.

Mar 3, 2022
6 min. read

Is VoiceAI the solution we’ve been looking for?

Provider shortages have taken a toll on individuals searching for care. Behavioral health technology companies are innovating solutions left and right. One unique solution that has surfaced is VoiceAI.
Alon Joffe

Behavioral health technology companies are innovating solutions left and right to address the supply and demand issues prevalent in our industry. One unique solution that has surfaced is VoiceAI. VoiceAI saves time for clinicians by passively generating data and identifying best practices during sessions.

VoiceAI saves time for clinicians by passively generating data and identifying best practices during sessions.

By minimizing the administrative work that mental health clinicians have to do, VoiceAI is creating more availability dedicated to actually providing care. The reported data can be transformative to individuals, providers, and companies. 

Alon Joffe, CEO of Eleos Health, provided some further insights on VoiceAI capabilities and its impact below.

Eleos provides modern VoiceAI capabilities and helps clinicians and care teams provide access to more personalized care. Why is now the time for this sort of innovation?

The behavioral health field is struggling to keep up with the surge in demand for services. We need four times the number of clinicians that we have today just to keep up with individuals requesting care. The workforce shortage puts extreme pressure on clinicians creating large caseloads and a high administrative burden. Clinicians do not get into the field to do paperwork, they get into the field to help individuals. 

There has not been a solution until this point, mainly because no one has ever built modern tools dedicated to clinicians in behavioral health. In our space, a big part of the treatment is the conversation. With the advances in voice and natural language processing (NLP) in the last five years, these technologies are approaching human levels of accuracy of 95%. Coupled with our ability to identify the information to make sure it’s HIPAA compliant, safe, and secure — we believe it is time to leverage those conversations to make a difference.

Eleos believes the advances in these technologies will allow clinicians to focus more on care delivery and less on operations. This is why Eleos Health is about to introduce a new category to the market. 

This new category will empower clinicians to focus on what matters most while optimizing the workflow by offering insights into sessions while assisting with operations all the way from documentation to reimbursement. Stay tuned.

There has been a lot of talk about value-based care and demonstrating outcomes and performance in our space lately. That can be hard to execute manually, though. How does Eleos automate and enable value-based care in behavioral health?

The synchronization of medical, behavioral health, and social determinants of health (SDoH) data is considered the holy grail to drive outcomes for the whole person. Behavioral health comorbidities with physical health conditions are a key driver for the total rising costs of care (2-6x on a per member per month basis) and are often linked to other socio-economic and SDoH issues.

 By running in the background of calls/meetings/sessions, Eleos Health allows providers to generate performance data right from the conversation passively. The data is then used to provide insights on the use of evidence-based practices. At the same time, it automates the collection of consumer-reported outcomes providing the basis for measurement-based care. Together these give clinicians actionable insights to help individuals get better, faster.

To get at the heart of value-based care, Eleos Health’s use of unstructured data points provides a unique solution to integrate medical, behavioral health, and SDoH domains by closing gaps in care, identifying best practices and infusing them back into the clinical workflow, managing care longitudinally, increasing consumer satisfaction, and lowering medical loss ratio – all while improving outcomes.

Your technology analyzes hundreds of data parameters with each therapy session, what can clinicians and management teams do with that information?

For clients, we can improve treatment outcomes. When using the Eleos Health platform, depression symptoms, as measured by the PHQ-9, as well as other symptoms such as anxiety and more, have decreased faster compared to treatment as usual (48% throughout treatment compared to care as usual settings, where depression symptoms decrease 30-35% throughout treatment).

One of the main benefits for clinicians is a 35-40% reduction in documentation time. Eleos writes a base note for the clinician based on data collected in the session. Eleos Health can also automate manual EHR clicks and, for one clinic, reduce manual click time by 90% for group sessions.

For compliance staff, Eleos Health identifies compliance risks and helps avoid clawbacks.  Unlike a human, Eleos Health’s artificial intelligence reviews every note generated for billing for red flags such as mismatched CPT codes, generic or copied notes, and wrong session duration times. In an analysis of 5,000 notes at a large telehealth company, Eleos Health was able to identify 95% of improper documentation, identifying over $70,000 in potential clawbacks.

Feb 24, 2022
7 min. read

Digital Therapeutics Specifically Targeting Panic Attacks and PTSD

Digital therapeutic companies which pursue a narrowed focus conduct deep dives into research on clinical outcomes, cost savings, and overall impact for a specific condition.
Dr. Chris Wasden

As a teenager, I recall the dreaded experience of what felt like I was surely dying. Or so, I thought at the time. In fact, I later learned that it was my first panic attack. Panic disorder is a debilitating condition that stops individuals from work and life, and the NIMH says an estimated 4.7% of U.S. adults experience panic disorder at some time in their lives.  

My experience only made me more excited to learn about interventions supporting people struggling with panic attacks and PTSD. GDBHT partner Freespira is the first FDA-cleared digital therapeutic that significantly reduces or eliminates symptoms of panic attacks, panic disorder and post-traumatic stress disorder (PTSD) in only 28 days. 

As a refresher, digital therapeutics are a non-drug alternative to treat, manage, and prevent various disorders. Some digital therapeutic companies cover a broad spectrum of conditions. However, others choose to focus on specific conditions. Those digital therapeutic companies which pursue a narrowed focus conduct deep dives into research on clinical outcomes, cost savings, and overall impact for a specific condition.

Those digital therapeutic companies which pursue a narrowed focus conduct deep dives into research on clinical outcomes, cost savings, and overall impact for a specific condition.

This week, I’m joined by Freespira’s Chief Clinical Officer, Bob Cuyler, PhD, to discuss this new digital therapeutic treatment in the blog this week: 

Freespira has the first FDA-cleared digital therapeutic to significantly reduce or eliminate panic attacks, panic disorder, and post-traumatic stress disorder (PTSD) symptoms. You have some exciting study outcomes with partners like Highmark. Tell us about it.

Freespira collaborated with Highmark Health and Allegheny Health Network on a study of patients diagnosed with panic disorder (Kaplan et al., 2020). Researchers measured clinical outcomes and cost reductions over a full year following treatment with Freespira and the results were notable. 

In terms of outcomes, 91% of patients reported significantly fewer symptoms at the one-year mark, and 68% were in remission as measured by the Panic Disorder Severity Scale (PDSS). These long-lasting results also contributed to cost savings. Overall medical costs were down 35%, pharmacy costs dropped 68%, and emergency department costs were 65% lower. 

Another Freespira client is a managed Medicaid plan. In less than 12 months, the plan is seeing positive clinical and financial results. Of the patients treated with Freespira, 70% have achieved clinically significant reductions in their panic disorder and PTSD symptoms after the 28-day treatment – an outcome that compares favorably with traditional treatment via medication or psychotherapy. Early data point to a nearly 40% reduction in medical costs, which we expect will improve further when measured a full 12 months after treatment. Both clinical studies and real-world results are vitally important when health plans and providers evaluate digital therapeutic treatments as part of their behavioral health strategies. 

Both clinical studies and real-world results are vitally important when health plans and providers evaluate digital therapeutic treatments as part of their behavioral health strategies

It’s great when research demonstrates impact, but the treatment has to work in real life, too. Freespira has shown benefit in both in studies and everyday practice, which is contributing to our growing adoption. 

Freespira does a lot of work with the Veterans Administration. How are you supporting veterans to reduce or eliminate panic attacks and PTSD symptoms?

Yes, veterans are very important to us. Freespira is available through Veterans Healthcare Administration benefits and as you might expect, the need is high. An estimated 11-20% of veterans have been diagnosed with PTSD (U.S. Dept. of Veteran Affairs) while more than 8% meet the diagnostic criteria for panic disorder (Gros et al., 2011). 

In trying to treat these conditions, veterans face challenges ranging from transportation for  appointments to finding qualified providers nearby to feeling stigma around behavioral health issues. And psychotherapy and medication don’t work for everyone. Medication side effects and reluctance to take part in exposure-based therapies are significant hurdles. 

In a survey we conducted with veterans, we found that 77% expressed interest in trying a PTSD treatment that does not involve additional medications or long-term therapy. The Freespira alternative is a medication-free, at-home, adjunctive treatment. Our 28-day treatment is convenient. It’s supported by virtual coach visits and the equipment ships directly to patients. 

A study of PTSD patients at the Palo Alto Veterans Affairs Health Care System showed that 89% had a clinically significant reduction in PTSD symptoms after the 28-day Freespira treatment, with 50% of participants still in remission six months later (Ostacher et al., 2021). 

I am looking forward to the upcoming webinar with you. What can audience members expect to learn?

Yes, we're excited to have you moderating a panel discussion on Mar. 1, 2022: “An Rx for Behavioral Health Equity—Digital Therapeutics.” 

As most of us know, the pandemic has affected mental health and changed the ways patients receive care. The need for new, accessible behavioral health solutions has ramped up significantly, and digital therapeutic treatments help address critical gaps. 

We’ll discuss how to evaluate and deploy digital therapeutic treatment solutions, which transcend common treatment barriers while effectively addressing access, adherence and symptom management.

Attendees will learn about five key characteristics of digital therapeutic adoption: 

  1. Does the digital therapeutic treatment have regulatory approval?
  2. Are there peer-reviewed clinical studies on the solution?
  3. Do the studies and other data show improved health outcomes?
  4. Can the digital therapeutic help reduce total costs of care?
  5. Does the solution work in the real world?

AHIP, the national trade association representing the health insurance community, is co-sponsoring this timely and fascinating conversation. We invite your readers to register for the webinar on the AHIP site with this link

Feb 3, 2022
4 min. read

Utilizing Digital Therapeutics to Personalize Care & Sustain Engagement

In 2022, digital therapeutics continue to make headlines. As defined by the Digital Therapeutics Alliance, digital therapeutics (DTx) deliver medical interventions directly to patients using evidence-based, clinically evaluated software to treat, manage, and prevent a broad spectrum of diseases and disorders.
The DarioHealth Team

In 2022, digital therapeutics continue to make headlines. As defined by the Digital Therapeutics Alliance, digital therapeutics (DTx) deliver medical interventions directly to patients using evidence-based, clinically evaluated software to treat, manage, and prevent a broad spectrum of diseases and disorders.

While there are many digital therapeutics solutions on the market today that target a specific condition, few companies have developed a comprehensive suite of digital therapeutics to integrate a variety of physical and behavioral health issues. One such company is DarioHealth. They develop digital therapeutics to provide a holistic approach to care, and they have seen increased attention from employers in the past year. The DarioHealth team shared with us more about their digital therapeutics, why it’s advancing the way they provide care, and the outcomes they have seen thus far. 

It seems like employers are starting to gravitate toward solutions that can address multiple chronic conditions on a single platform. Tell us more about Dario's approach and what you are hearing from employers?

Dario was created for one purpose: to make it easy for people to manage chronic conditions. Our digital therapeutics platform was originally designed for diabetes but has since expanded to other commonly co-occurring conditions and those that are reactive to behavior, including diabetes, weight management, musculoskeletal and behavioral health. Today, our platform can monitor the patient’s entire journey and adjust the experience and support as necessary using real-time data from apps and our connected devices. 

Dario Digital Therapeutics are designed with a user-centric approach that provides an integrated experience for people with multiple chronic conditions, looking at their whole health for the best overall results. This is something that is attractive to employers as well. We are hearing from employers of all sizes interested in lessening the burden of managing chronic conditions for their populations and seeking solutions that can provide a better, more holistic experience that can deliver on the promise of lasting results.

What are some of the ways digital therapeutics are advancing the field of digital health? 

Digital therapeutics are accelerating progress in both digital and traditional health care by shifting the paradigm from provider-centric to consumer-centric. When Dario launched as a direct-to-consumer solution, we had to design an experience that would keep people engaged with our solution and ultimately, their health, by offering highly personalized support for everyday life. This fundamentally changed how people access and experience care by creating value for the users as well as our partners.

Dario’s digital therapeutics solutions combine real-time data, technologies, and human expertise in a single platform helps create a more effective way to improve whole health. By scaling our consumer-centric approach across multiple conditions, we can deliver a truly holistic approach that addresses the common underlying behaviors for more sustainable change and longer-lasting results. 

How does all of this lead to sustained member engagement and improved outcomes? 

Dario’s approach is anchored in billions of data insights from more than 10 years of engagement, enabling a hyper-personalized experience for each person on our platform that adapts to changing needs and preferences to keep people on track. This allows us to effectively attract and retain people in our solutions and on our platform year-over-year. In fact, 80% of our users stick with Dario after the first year. 

That ability to keep people engaged with healthier behaviors leads to outcomes that last, and our 28 clinical studies with plenty of evidence that demonstrates how we can help people sustain positive clinical outcomes for more than two years. 

Jan 20, 2022
5 min. read

Decreasing Wait Times And Increasing Access to Quality Care: New Directions Behavioral Health Acquires Tridiuum

GDBHT partner New Directions Behavioral Health has acquired Tridiuum, another GDBHT partner, creating a leading provider of technology-enabled behavioral health services.
Shana Hoffman

Seeking behavioral healthcare can sometimes be challenging due to long wait times to see a provider. However, one revolutionary partnership is changing that for over 15 million members. GDBHT partner New Directions Behavioral Health has acquired Tridiuum, another GDBHT partner, creating a leading provider of technology-enabled behavioral health services. This partnership will decrease wait time, increase access to care, and improve quality of care. Shana Hoffman, President & CEO of New Directions Behavioral Health, and Mark Redlus, CEO of Tridiuum, spoke with me about their partnership. Read our exclusive interview here:

Shana, in your press release, you talked about how in your partnership with Tridiuum to date, the average speed for a patient to book a first appointment from initial screening was approximately four days. Why is that significant?

Shana: By integrating Tridiuum’s leading technology platform with our best-in-class care management team, we are able to immediately schedule members with our comprehensive network of behavioral health providers. In the behavioral health ecosystem, current average time to care sits at around 25 days, with some patients waiting over 90 days for their first appointment. Achieving an average time to care of just four days is game-changing for our members. With increased speed and ease of access, we are able to eliminate many of the barriers faced by individuals nationally, while expanding the number of untreated and undertreated members in care. More than 100 providers groups have joined this program already in its first phase, and we look forward to expanding our reach even further.

Mark, Tridiuum's technology and measurement based-care analytics will further enhance the quality that New Directions can provide members. Can you tell us more about why that is important?

Mark: At a time when the need for behavioral health services is incredibly high, this combination allows us to set a new standard of care. Our technology utilizes population analytics to enable value-based contracting and maximize network quality. Jointly, we will be providing users with real time information to support improved clinical decision making while also measuring quality of care. The result is accelerated access to the most appropriate care for New Directions’ members. At Tridiuum we’ve reimagined how to deliver timely care in the past, so to be able to do that again – and to now do so with the support of and in partnership with New Directions – is special.

Shana, how can the health plans you work with reap benefits from this new partnership?

Shana: It’s important to remember that Tridiuum’s technology is already used by nationally recognized medical and behavioral health plans. Likewise, at New Directions, we support our over 15 million members in partnership with health plans, employers and higher education institutions. By now fully integrating Tridiuum’s suite of solutions with our existing care navigation and human services capabilities, we will be able to together deliver even smarter outcomes at scale to both new and existing members. Our health plan partners will now be able to have access to Tridiuum’s products and New Directions services to replicate the experience we’ve already demonstrated with our customer Florida Blue. 

What excites you the most about this partnership?

Shana: One of the reasons why this is so exciting is that our two companies share similar missions. This became clear as I got to know Mark in recent months as we launched our partnership and worked to close this transaction. His passion and vision to advance behavioral health aligns with that of mine and New Directions. I look forward to together building a new path in behavioral health that will revolutionize access to quality care for all. 

For those who are interested in more information about our combined offering, please contact communications@NDBH.com

Dec 9, 2021
8 min. read

Precision Treatment Models: Leveraging Data to Achieve Better Behavioral Health Outcomes

When it comes to conditions such as depression and anxiety, there is no one-size-fits-all treatment. Each treatment plan must be personalized and rely on data in order to achieve better outcomes.
Dr. Mimi Winsberg

When it comes to conditions such as depression and anxiety, there is no one-size-fits-all treatment. Each treatment plan must be personalized and data-driven in order to achieve better outcomes. 

Precision treatment models use data to personalize care to the individual and their symptoms. Dr. Mimi Winsberg, CMO of Brightside, shared with me how effective their precision care model is and why it's intriguing to payers. We discussed shifting trends in behavioral health and what payers are looking for in behavioral health solutions. You can read our conversation below.

What are some current limitations of telemental health care for anxiety & depression?

As the pandemic continues to drive unprecedented demand for depression and anxiety treatment, patients are finding that access to quality providers is severely limited. They may have to wait weeks or even months to find a specialist, and the treatment they do receive often comes from primary care providers who are not set up to deliver successful mental health care. In addition, very little measurement-based care is practiced, so efficacy is hard to demonstrate.  

The widespread adoption of telemedicine and reabsorption of behavioral health benefits by payers has certainly increased access, but access alone is not enough. Delivering the quality of care that payers, employers, providers, and patients demand requires a data-driven approach to diagnosis and a closed-loop treatment model—both of which are uncommon in the mental health space. Because “what gets measured gets managed”, it is only by quantifying outcomes that we can work to improve them.

Of course, it’s difficult to measure or assess a treatment protocol that hasn’t been standardized. Telepsychiatry and teletherapy have followed a somewhat haphazard approach—we really don’t know what’s happening in Zoom rooms. What are providers communicating? What are patients absorbing? How is the right medication selected? And what are their therapy sessions accomplishing? Effective and quality mental health treatment is evidence-adherent and follows standardized, measurable protocols. 

Also, most telehealth solutions are designed for people with mild to moderate anxiety and depression but don’t provide options for those higher on the severity and complexity continuum. Only a data-driven approach can significantly improve the quality of care, enabling treatment that’s both convenient and personalized—which today’s consumers demand of all service industries. Addressing these limitations in access and quality is what drives Brightside’s founding mission. By driving superior outcomes and addressing the segment of the market with more clinical burden, Brightside has all the rigor of a healthcare company in addition to all the innovation of a technology company. 

What is precision treatment, and how can it help resolve these limitations?

Mental health conditions like depression and anxiety are highly heterogeneous—they can present in hundreds of ways: for example, two patients can share just one symptom and get the same depression diagnosis. Selecting and delivering the right treatment for each individual is critical in order to achieve the best outcomes.

Brightside’s precision care model enables its psychiatrists and therapists to quickly match each patient with the appropriate treatment, resulting in better outcomes, faster. Rather than simply bucketing a patient into a general diagnostic category, and then spending precious time on trial and error treatment selection, Brightside providers leverage data-driven, evidence-adherent solutions for both assessing and treating each patient’s unique symptom clusters. Progress is tracked continuously, and follow-ups are proactively scheduled when a member may need support. This efficient approach allows providers to minimize administrative tasks and focus on delivering quality care to those who need it most.

Offering patients nationwide access to precision psychiatry and therapy within 48 hours dramatically streamlines the care journey. Brightside’s proprietary algorithm, PrecisionRx, optimizes initial treatment selection, and our smart platform allows patients and providers to track the progress of personalized protocols on a granular level to achieve outcomes far superior to traditional treatment.

By delivering access to high-quality personalized care at scale, Brightside’s world-class providers help patients across the severity and complexity spectrum feel better, faster, and stay that way. Our next-generation platform is delivering life-changing depression and anxiety treatment and establishing a new standard of care for the telemedicine age, while also leading the transition from fee-for-service to value-based care.

How are payer attitudes shifting when it comes to behavioral health?

For many years, a large portion of behavioral benefits were outsourced from payers to MBHOs (Managed Behavioral Health Organizations), similarly to how pharmacy is outsourced to PBMs (Pharmacy Benefit Managers). But this period included longstanding and pervasive problems with access, measurement, care integration, and quality. Vocal employers, members, and providers have long been demanding better solutions.

Payers are listening. Beacon, Magellan, and New Directions have now all been acquired by payers, as payers reinvest in behavioral health care and demonstrate commitment to better access, quality, and cost. Telemedicine has been both a catalyst, and an accelerant, offering new tools and approaches to help payers achieve these goals.

What are payers looking for from behavioral health solutions?

Payers are looking for a few key factors beyond access to behavioral health care providers. First, they want effective care with better clinical outcomes and lower cost.  Data is of course essential to driving better outcomes and reduced costs, including measurement-based care delivery, deeper insights into member needs, and cost impact analysis. 

Second, payers want to stand out based on their behavioral offerings. This means offering integrated solutions that meet the needs of their employer customers, ensuring that employers can get all of their solutions through the payer, obviating the need for ancillary siloed service providers.

Third, payers want to support their large provider networks, particularly those that are risk bearing, like ACOs (Accountable Care Organizations). These ACOs are taking on behavioral health risk without strong tools and skills to manage it. 

How is Brightside helping payers achieve and exceed their goals? 

Brightside was built to deliver measurably better care at scale, even among the hardest to treat member populations. We deliver industry leading outcomes - 50% better rates of treatment response and remission than a leading US health system, or our closest competitor, nationwide, with appointments available within 48 hours.

In doing so, Brightside is opening up the path to true value based care. Because we stand behind the quality of our care model, we’re happy to put our dollars behind delivering outcomes, not just care. We’re collaborating with our payer partners to finally open up value based care in mental health.

Dec 2, 2021
6 min. read

Data on Behavioral Health Providers Is Often Inaccurate. Here's What Ribbon Health Is Doing About It.

This week, we have an exciting interview with one company who is making leaps and bounds towards improving provider data accuracy to support patients in getting the exact right care they need.
Shelley Sasson

I’ve talked frequently about the need for more personalization and access to the right specialists in mental health and substance use care. Personally, I recall the struggles my family faced with finding an adolescent OCD and anxiety specialist. This week, we have an exciting interview with one company who is making leaps and bounds towards improving provider data accuracy to support patients in getting the exact right care they need. Ribbon Health just raised $43.5 million in series B financing from General Catalyst, Andreessen Horowitz (a16z), BoxGroup, Rock Health and an investment from Sachin Jain, president and CEO of SCAN Health Plan. Join me for an exclusive interview with Ribbon Health and some of their investors in the blog: 

What is Ribbon Health and what is some of the work you're doing in behavioral health?

Ribbon Health offers the most comprehensive, accurate API data platform that is the infrastructure for a future where every patient care decision is convenient, cost-effective, and high-quality. Built to integrate seamlessly into existing healthcare workflows, Ribbon offers a reliable and straightforward way for health plans, providers, and digital health solutions to develop and maintain accurate provider directories and competitive networks, simplify referral management, and ensure efficient care navigation — all in one platform.

At Ribbon we power more intuitive provider searches and better matches between patients and behavioral health specialists. As part of our Focus Areas data set, we provide information on almost 500,000 behavioral health specialists, including the type of specialists, conditions they treat, and treatments they offer. One example would be someone who treats sleep disorders and also conducts sleep studies - this is something very detailed that would be hard to find without Ribbon's data. In addition, data on behavioral health specialists is often inaccurate, and Ribbon seeks to get people to not only find the right care, but also show up at the right place.

You have some big news! Please tell us more! 

We are incredibly proud and excited to share our $43.5MM Series B funding round, led by General Catalyst and joined by previous and new investors that include a16z, BoxGroup, Rock Health, and Sachin Jain. 

This funding will enable us to accelerate and scale Ribbon Health, creating even more value for our partners with exceptional talent and technology. We will expand our reach across health plans, provider organizations, and digital health solutions. Ribbon will improve the health plan member experience with enhanced provider matching and data management and strengthen health plans’ competitive moat by delivering unique insights on network adequacy and design. Ribbon will continue to solve key navigation and referral challenges, improve care operations, and drive meaningful growth for our customers. Importantly, by investing in our platform’s distribution and ease of use, Ribbon will seek to eliminate the problem of data inaccuracy altogether and ultimately partner with all healthcare companies that seek to build solutions that drive positive patient experiences and better healthcare outcomes.Ultimately, Ribbon will become the connective tissue that allows patients to find the care they need across any touchpoint in the healthcare system.

Accurate provider data, delivered through our flexible and intuitive API data platform, is the infrastructure for a future where every care decision is convenient, cost-effective, and high-quality. Delivering on these goals will require an experienced, passionate team, and so today, we say – join us. We’re ready to simplify healthcare.

Interested in Ribbon’s data? Contact us to learn how we can help.

Tell us about why you partnered with these investors in particular and what you look forward to for the future?

We are excited to have Holly Maloney, Managing Director at General Catalyst, join the Ribbon board given her strong connection and dedication to our mission and vision. "Ribbon is on a path to power the next generation of care navigation for both patients and referring clinicians,” said Holly Maloney, managing director at General Catalyst. “What Ribbon Health has built is not only a leading healthcare data platform that solves the decades-old issue of not being able to easily find the highest quality and most affordable clinician but a mission-driven culture that has set them up to scale and succeed. General Catalyst is thrilled to be leading Ribbon’s Series B, as they share our vision of healthcare as a powerful, connected ecosystem.”

We are also thrilled to have continued investment from Julie Yoo, General Partner at a16z, who is equally as dedicated. "That's one of the attractive factors or dimensions of infrastructure bets is that you truly get an index on what’s happening across healthcare. One of the reasons that Ribbon stood out to us was its ability to create network effects. Every single day, every single minute that organizations use Ribbon, the data gets better and better. And, it almost becomes one of the only sources of truth, because there really is no source of truth for provider data at a national scale,” said Yoo.

We look forward to partnering with all of our investors to help grow and scale Ribbon into the future. 

Nov 11, 2021
7 min. read

How NeuroFlow and Magellan Health are Coming Together to Help with Suicide Prevention

How NeuroFlow and Magellan Health are working together on an initiative to support a health plan for suicide prevention efforts, using technology to proactively identify individuals needing support and getting them access to mental health support.
Dr. Caroline Carney

Last month at the HLTH conference in Boston, I got to meet with Dr. Caroline Carney, CMO of Magellan Health, and Chris Molaro, CEO of NeuroFlow. After so much time without in-person gatherings, it was refreshing to reconnect with members of our GDBHT community. We talked about how NeuroFlow and Magellan Health are working together on an initiative to support a health plan for suicide prevention efforts, using technology to proactively identify individuals needing support and getting them access to mental health support. Read more about their collaboration via the Q&A with Chris and Dr. Carney below.

It was great to connect with both of you at the HLTH conference last month! What caught your attention at the event?

Chris: It had been quite a while since our last in person event, so it was even more exciting to reconnect with partners, customers, and team members. The agenda called for two separate workstreams dedicated to mental and behavioral health which I think is a great indicator of not only the increased focus on the topic but all the exciting work being done to address the challenges of truly integrating behavioral health. 

Dr. Carney: The event really showcased how far we’ve come as a country and as innovators in reducing stigma against those with mental illness and in bringing forward innovative solutions to address the needs of persons with behavioral health needs, physical health support, and integration of these.

There has been a lot written about your two organizations coming together recently, but I’m not as familiar with the suicide prevention work you are doing together, can you share more?

Dr. Carney: Magellan rolled out our new model earlier this year, focusing on transition of care and care management needs. We know in real time when a person has entered a higher level of care because of suicidal ideation or an attempt. Our care managers identify those members and outreach to the member to be enrolled on the NeuroFlow platform. Through the platform we can push out evidence-informed content, send messages, and interact to better meet the member’s needs. The 30-90 days following a suicide attempt is when it is most critical to provide support and keep an individual linked to care. During the early months of the pilot, nearly a dozen individuals were provided resources and offered to connect with a care coordinator. Those are precious lives that could have fallen through the cracks and not gotten the level of direct support provided through this collaboration.

Chris: Put simply, we’re coming together to get the right people to the right level of care at the right time by building the first of its kind operating system centered around behavioral health.  And the engagement has been outstanding, 92% percent of registered users have completed at least one assessment in the last month, but as Dr. Carney mentioned, the real value add here is in the link between the engaging, personalized experience for the end user back to a clinical dashboard that helps to risk stratify individuals and flag those who were marked needing elevated levels of support.

What has some of the response been from end users? 

Chris: Just recently, a member triggered an at-risk alert and a team member responded by emailing her resources and an offer to provide more support. She then emailed NeuroFlow requesting support in connecting with mental health treatment that led to a phone call where we found a psychiatrist who she could see through telehealth who was also in-network for her. We scheduled an appointment for her that was just 8 days away, entered her insurance info on their website and she received a confirmation email right away. To me, that’s a great example of technology and human support coming together to help achieve our mission. That’s one person that may not have received the support they needed.

Dr. Carney:  The care manager feedback has also been very positive. Their role to this process is critical as they serve as a liaison between the member, the provider and the Magellan psychiatric consultant who recommends the best course of action. Here was a review we received from one of the care managers trained on NeuroFlow: 

“I offer [NeuroFlow] to every individual. I love that this is an option and all feedback has been positive. Members love mindfulness and the education available.”

What’s next for this project? 

Chris:  We initially rolled it out to a subset of Magellan’s population, specifically for people that have recently been discharged from an in-patient stay or emergency department visit but the impact and feedback has been so impressive that we’re planning to expand the project. There are also product enhancements we’re considering around the behavioral economics and gamification for the mobile app as well as customized reporting and dashboarding for the care team platform.

Dr. Carney: Our collaboration with NeuroFlow has shown how creative and collaborative organizations can be when focused on the right things. We value this relationship and are excited about new opportunities rolling out in the near future!

It has been wonderful to see these two GDBHT organizations work together towards integrated collaborative care, and we can’t wait to see how they continue to address accessibility to care in the future. Take time to watch the full Magellan Health and NeuroFlow sessions from Going Digital: Behavioral Health Tech 2021.

Oct 7, 2021
7 min. read

Mental Health 2.0 is Coming — What Does it Look Like?

This week, I got a chance to talk to Kristian Ranta, Founder and CEO of Meru Health, about how they are deploying their evidence-based approach to mental healthcare and their recent funding announcement.
Kristian Ranta

The mental health industry is overflowing with innovations. At the same time, the need for more scalable mental health interventions has also grown more than ever. Many companies are attempting to meet the high demand for mental health services with teletherapy and online education, but few have truly unique and high-quality models to address the growing need.

This week, I got a chance to talk to Kristian Ranta, Founder and CEO of Meru Health, about their evidence-based approach to mental healthcare and their recent funding announcement. You can read our conversation below.

The balance of tech vs. touch for virtual mental healthcare has been an ongoing debate. What is it about Meru's program that really perfects the balance?

At Meru Health, we’ve found that the human element is essential. Having a human connection drives significantly better engagement and clinical results when compared with technology alone. 

However, many of the teletherapy-based solutions we’re seeing in the market right now are basically just an online version of the traditional care, with a therapist talking with patients online either via video or chat. This leads to two main problems: 1. There aren't enough providers out there to help everyone in need. 2. The quality of care is not standardized. If you scientifically analyze the treatment outcomes, they’re actually quite poor. What mental healthcare needs is true innovation – not a new version of an outdated system. 

At Meru Health, we’re doing things differently. Each participant has a personal therapist, who serves as a guide throughout the program. But the program isn’t just delivered from the therapist to the participant — the participant takes an active role in their health. Participants are empowered to complete weekly/daily lessons independently and gain critical insight about their health and wellbeing through biofeedback tracking. While the program is self-guided, their therapist will regularly check in to discuss the practices, and participants can always reach out for support. One therapist is able to treat up to 8x more patients with this model compared to traditional therapy. 

With this model, we’ve seen engagement rates of 80% and remission rates of 60% (meaning participants have no symptoms at the end of treatment). Importantly, these rates are sustained 12 months after starting the program. The idea is to empower people with the skills they need to care for their mental health both during and after the program. Meru Health’s treatment isn’t a “quick fix” — it’s about building lifelong wellbeing.

An important factor I'd like to add here is that mental healthcare isn’t going to improve just by bringing therapists online — the care itself needs to improve. At Meru Health, we’ve created a comprehensive and holistic program that looks at a person’s whole experience: Are they eating nutritious food? Are they practicing sleep hygiene? Are they getting enough exercise? Is there inflammation behind their depression symptoms? Mental health is about someone’s entire experience, and their treatment should be, too.

Meru has always had an extra emphasis on research and outcomes. Can you tell us more about your recent study?

Gladly! We’ve published 8 peer-reviewed research papers to date. Our most recent paper, currently under peer-review, examined the effect of the Meru Health program on suicidality. As you might know, this topic is a personal one for me. I lost my brother Peter to suicide. He had been struggling with depression for a long time and eventually it led him to take his own life. 

In this study, we assessed participants’ reductions in suicidal ideation by tracking their PHQ-9 (Patient Health Questionnaire-9 item scale) scores. This data was combined with a published study that estimated the changes in suicide attempts and deaths from changes in PHQ-9 assessed suicidal ideation. 

We found that through using the Meru Health program, participants’ suicidal ideation fell from 22% at the start of treatment to 9% at its end, 8% at 3-month follow-up, and 7% at 6-month follow-up. Estimates showed that suicide attempts and deaths by suicide fell over 30% over the course of the program and continued to slightly reduce over the course of follow-up, indicating a sustained effect up to 6 months after treatment. From this data, the Meru Health program is estimated to prevent 1 suicide attempt for every 438 patients we enroll and 1 death by suicide for every 5841 patients. I could not be prouder to be part of the solution to help prevent suicide.

Congratulations on your new round of funding! How will it further your mission to change the future of mental healthcare?

Thank you! We’re thrilled to keep expanding nationwide access to our Meru Health Treatment solution as well as our new coaching solution. The new coach-led prevention solution is an important step towards preventive mental healthcare. We’re able to help people who are showing early signs of depression, burnout, anxiety, or stress and keep their symptoms from worsening. We can teach people the skills they need to care for their mental wellbeing, so they won't reach clinical levels of depression or anxiety. On top of this, we plan to continue building our in-house research team and partnering with top universities to continue developing the new standard of mental healthcare.

Sep 16, 2021
5 min. read

Employers and Suicide Prevention

World Suicide Prevention Day was on September 10. I want to highlight some of the great efforts taking place within our Going Digital: Behavioral Health Tech community to prevent suicide, starting with our friend, colleague and employee benefits guru, John Hansbrough.
John Hansbrough

World Suicide Prevention Day was on September 10. According to the World Health Organization, more than 700,000 people die due to suicide every year. I want to highlight some of the great efforts taking place within our Going Digital: Behavioral Health Tech community to prevent suicide, starting with our friend, colleague and employee benefits guru, John Hansbrough:

Solome: “John, addition to your work with employers and mental health and wellness benefits, you've also held leadership/governance roles at American Foundation for Suicide Prevention. What do you think is the most misunderstood aspect of suicide and what can or should employers do to play a role?”

John: “Leadership in the workplace are the single most important force multiplier when it comes to suicide awareness and prevention. 

Stigma and awareness continue to be misunderstood and undervalued aspects of suicide prevention. Given that 80% of those who die by suicide are in their working age years, employers have a particular opportunity to prevent, intervene, and respond to suicide and signs of distress.

The non-profit Workplace Suicide Prevention, a collaboration between AFSP, the American Association of Suicidology, and United Suicide Survivors International, provides employers a roadmap of 9 recommended practices, all of which require an awareness of the stigma associated with suicide and workplace mental health. Leadership plays a pivotal role in this process, and leaders must step forward when it comes to reducing job strain, communicating with employees and “going first” when it comes to authenticity and personal experience.

When leaders go first, express authenticity, and encourage and support others, they multiply their own efforts throughout their organization to prevent suicide and increase mental health awareness."

Go here to watch my entire session with John. 

We have some amazing individuals and organizations in the Going Digital: Behavioral Health Tech community who are driven to doing all they can to prevent suicide. Kristian Ranta, Founder and CEO of Meru Health, started the company after losing his brother to suicide. As Ranta described earlier this week, “For years, I wondered why he could not be treated effectively and how people like him could be helped in the future, before it’s too late.”  In a peer-reviewed study, researchers found that 48 percent of patients responded to the Meru Health anxiety, depression and burnout intervention, and 60 percent of participants did so at 12-month follow-up.

Other Going Digital: Behavioral Health Tech partners are doing important work towards suicide prevention, including

  • Jaspr Health is empowering evidence-based suicide care at scale in emergency departments.
  • Psych Hub has partnered with Aetna to empower providers with no-cost, evidence-based instruction, tools, and resources to identify and treat those at risk of suicide.
  • Magellan Healthcare announced high-touch and high-tech resources to advance suicide prevention and intervention.
  • New Directions Behavioral Health announced that it has launched its annual Suicide Prevention & Awareness toolkit.

The World Health Organization offers some steps for employers and managers to prevent suicide in their workplaces:

  • Provide information sessions for your staff on mental health and suicide prevention. Ensure all staff know what resources are available for support, both within the organization and in the local community. 
  • Foster a work environment in which colleagues feel comfortable talking about problems that have an impact on their ability to do their job effectively and supporting each other during difficult times. 
  • Become familiar with relevant legislation. 
  • Identify and reduce work-related stressors which can negatively impact mental health. 
  • Design and implement a plan for how to sensitively manage and communicate the suicide or suicide attempt of an employee in a way that minimizes further distress. Measures should include the availability of trained health workers and support services for staff.
Sep 9, 2021
7 min. read

Measurement-Based Care in Behavioral Health: What You Need to Know

Eric Meier, President and CEO of Owl, talks about what are some of the latest methods for measuring outcomes in our field, why it’s important, and how an organization implement measurement-based care in behavioral health successfully.
Eric Meier

"Measurement-based care" is a term that has grown in popularity in the past year, but in behavioral health, it has not been without its challenges. I spoke with Eric Meier, President and CEO of Owl, about the latest methods for measuring outcomes in our field, why it’s important, and how an organization can implement measurement-based care in behavioral health successfully.

1. Given the high spend and significant investments into behavioral health, how will we know if we’re making progress?  

We are at the point of undisputed realization that behavioral health issues are very real and at times, serious.  With $225 billion spent on behavioral  health treatment and services in 2019, according to OpenMinds, and $1.5B in VC funding towards behavioral health technology and services in 2020, we must ask ourselves, are we making progress?

It’s promising to see the increase in resources being deployed into the field, but I still believe there is a critical missing component to the conversation - how are we measuring quality and outcomes?

After all, how can one improve something that they cannot measure?

Though widely understood that measurement-based care, the systematic evaluation of patient symptoms before or during an encounter to inform behavioral health treatment, is clinically validated to increase treatment effectiveness and improve patient outcomes, only 18% of psychiatrists and 11% of psychologists use it in routine practice (Jensen-Doss et al., 2018).

One of the biggest reasons why the adoption rate of measurement-based care has been so slow is because until very recently, such tools and approaches have not been easy to use. They were complex and would not integrate easily with existing clinical workflows and health care IT infrastructure, giving clinicians great pause. The good news is that today we have some incredibly user-friendly measurement-based care solutions that seamlessly integrate with clinical workflows so that clinicians can easily incorporate measurement-based care into their care model without any wasted time or disruption of their regular routines. Furthermore, these solutions are very simple for patients to use, delivering highly engaging experiences. 

With measurement-based care, clinicians receive patient-reported information on their moods, behaviors and feelings prior to their appointment throughout the entire course of treatment. This gives clinicians powerful context to focus on with the patient during the encounter, leading to a more personalized, targeted and efficient session. By answering evidence-based, clinically validated questionnaires delivered automatically to their phone, patients provide valuable data that can be tracked longitudinally to monitor progress and measure outcomes. Measurement-based care is proven to improve clinical outcomes and efficiency,  and improve the therapeutic alliance between the clinician and patient. 

2. Why is measurement-based care in behavioral health so important?

The more we measure care, the more we can show improvement and ultimately accelerate patient recovery times and improve patient access. The more we speed up patient recovery times and open up access to care, the better off for everyone.

Another way to answer this question is to flip it around a bit:  Imagine if there was no widely adopted form of measuring treatment effectiveness for physical medical issues including hypertension, diabetes, and cancer. The concept of measuring patient progress is so tightly embedded within the practice that the term “measurement based care” barely exists. It’s just part of the everyday routine. After all, can you think of a situation where an oncologist or cardiologist would not rely on measurements to prove patient progress and guide care? Of course not, so why should it be any different with behavioral health?

And as we are seeing the move from fee for service towards value-based reimbursement contracts in many segments of behavioral health, measuring and proving outcomes will be a necessity.

3. How can an organization implement measurement-based care successfully?

Based on experience helping many organizations successfully implement measurement-based care, here are my four critical success factors:

High patient engagement: measurement-based care only works if patients are engaged, so you have to provide them with an easy approach to access and complete the clinical assessments with the user-friendly experience they have come to expect from every other online or app experience that they use daily. I’ve seen well over 80% patient engagement rates when this is done right.

Ability to track treatment throughout the course of care: measurement-based care isn’t a one or even two-time occurrence at the beginning and/or end of treatment. It is a continual, regular part of the ongoing treatment approach to track and monitor progress and achieve the desired treatment target.  If you need to adjust care, you can do so with confidence. With an automated solution, you can ‘set it and forget it,’ so that the right assessments are sent to the right patients at the right time based on the nature of the condition, symptom severity, and treatment approach.

Data that not only looks at the individual patient level, but the population in aggregate for the organization: Today’s behavioral health executives need analytical tools to understand their patient population and any trends and insights that can help them further improve clinical care and financial results. Understanding treatment and clinician effectiveness by individual and group empowers leaders to make decisions that improve clinical outcomes.

Data to communicate effectively with payers: As payment models move towards value-based care, behavioral health executives need critical data on patients, their conditions, and effectiveness of care to share with their payers to inform accurate reimbursement models based on a patient’s condition, treatment progress, and not simply based on time.

Aug 26, 2021
5 min. read

Treating The Whole Person, Not Just The Symptom

The integration of physical and behavioral health services is increasingly becoming a priority for health insurance companies, employers and providers. Stephanie Tilenius, Founder & CEO of Vida Health, shares her thoughts.
Stephanie Tilenius

The integration of physical and behavioral health services is increasingly becoming a priority for health insurance companies, employers and providers. And yet, behavioral health has been siloed from the rest of the healthcare world for so long. However, there are many revolutionary organizations changing that, and Vida Health is one of them. Vida Health addresses chronic and co-occurring physical and behavioral health conditions. They are integrating care by treating the whole person and have measurable results of its success.

This week, I talked to Stephanie Tilenius, Founder & CEO of Vida Health, about their polychronic design and strong outcomes. You can read our conversation below.

So, Vida is polychronic by design. What does that mean, and why is that important in this day and age?

Basically, we believe that point solutions miss the point. Nobody wants to switch between three different programs on three different apps to manage their obesity, depression, and diabetes. We built Vida from the ground up to manage multiple chronic conditions simultaneously. We do this with a balance of machine learning that personalizes each person’s treatment as well as the human connection of real life therapists, health coaches, and providers who bring the empathy and accountability people need to reach their goals. We think it’s always been important to treat the whole person, not just the symptom, but it’s especially important today because nearly half of Americans have more than one chronic health condition and in order to successfully treat them, you need to not only address the full range of conditions they have but also the behavioral conditions – the stress, the habits, and often the depression and anxiety – that accompany and fuel these health conditions.

You have some exciting new announcements, including one with Blue Cross Blue Shield of Illinois. Tell us more!

Yeah! We have so many exciting things happening right now. BCBSIL is certainly one of them — in July we announced that we joined Blue Cross and Blue Shield of Illinois’ network as their only on-demand 100% virtual mental health therapy and coaching practice. Going in-network is something we’ve thought about for a while and when the BCBSIL opportunity arose we knew it was a great fit both for us and for BCBSIL’s nearly 6 million covered lives. Some other exciting announcements for us are the Validation Institute reports that confirmed health improvement and cost savings for our diabetes and therapy programs, new partnerships with Humana, as well as a program that serves Kentucky’s Medicaid population. As with most virtual health companies these days there’s a lot going on so really no shortage of things that I’m excited about.

Health plans and employers are expecting strong outcomes of behavioral health vendors more than ever. What is Vida's approach to demonstrating outcomes?

Vida rigorously tracks our clinical outcomes and we stand by our claim that we have some of the best outcomes in the industry across mental and physical health. As for how we demonstrate outcomes to our clients — for both our health plan and employer clients we provide comprehensive reporting that spans enrollment, engagement and outcomes. Some clients also provide claims data, which allows us to do claim-based measures like medication adherence and total cost analysis. We also publish our outcomes in peer-reviewed journals, we have more than 15 publications and case studies that demonstrate our outcomes across our programs. Ultimately we’re so confident in our ability to get meaningful outcomes we put participation fees at risk if mental health outcomes aren’t achieved for the population.

You can check out our video library for more discussion on Vida’s virtual continuous care model and measurable results here

Jul 29, 2021
5 min. read

Digital Therapeutics Update: Why Should Payers and Employers Pay Attention to Digital Therapeutics for Mental Health?

There is a lot of activity happening in digital therapeutics right now. I caught up with Dr. Chris Wasden, Head of HappifyDTx, again to learn about their latest announcement.
Dr. Chris Wasden

There is a lot of activity happening in digital therapeutics right now. Happify recently announced Ensemble, the first and only transdiagnostic prescription digital therapeutic for the treatment of patients who have Major Depressive Disorder (MDD) or Generalized Anxiety Disorder (GAD). Pear Therapeutics went public through a $1.6B SPAC deal. Freespira's FDA cleared digital therapeutic is the first to significantly reduce or eliminate symptoms of panic attacks, panic disorder, and PTSD. Woebot announced a $90M series B funding round.

At the Going Digital: Behavioral Health Tech conference, I sat down with Dr. Chris Wasden, Head of HappifyDTx, to discuss the rise of the digital therapy platform for the mental health pandemic and how Happify is supporting health plans, pharma and employers with their suite of digital therapeutics. I caught up with him again to learn about their latest announcement, the launch of their Ensemble digital therapeutic:

If I'm a patient receiving an Ensemble prescription for the first time, what will my experience look like? 

Wasden: You will be guided through 112 therapeutic interventions over the course of 10 weeks, with 2 activities to complete each day which consist of CBT, mindfulness and positive psychology based interventions (aka activities). Every two weeks you will complete both the PHQ-9 and GAD-7. All your data is collected and shared with your clinician to support you in your treatment journey. We would expect you to spend 15-30 per day on these activities. 

Why should payers and employers pay attention to digital therapeutics for mental health? Why are they better than today's alternatives? 

Wasden: Payers, and providers, are aligned with the Triple Aim of healthcare: affordable care with greater access and high quality. DTx products like Ensemble improve a payer’s ability to deliver on the Triple Aim.  Most patients must wait weeks or months to get an appointment for mental health disorders, with Ensemble, the patient can start treatment immediately while they wait to see a physician or therapist. Clinical trials and studies have demonstrated that these products are safe and effective at treating these disorders. We estimate that using a DTx product like Ensemble improve the physician and therapists management of the patient, but having the patient spend 10 hours on therapy on their own time for every hour they spend with the healthcare professional, thus allowing the healthcare profession to spend more time with the patient on specific healthcare activities that are of high value and can only be done through face-to-face interaction. 

One concern some people have about digital therapeutics is that if individuals need a prescription to access them, will  that make mental health support less accessible than if they were like many of the other online CBT tools that are freely available online.

The reality is that there are thousands of online CBT apps and tools available online, and most are not efficacious. The majority of commercially available apps make claims related to mental health that they cannot back up with scientific evidence, per Dr. John Torous and his team at the Division of Digital Psychiatry at Beth Israel Deaconess Medical Center. Those apps must go through the very rigorous process of FDA approval if they want to claim to actually treat a patient with a specific diagnosed disease with a digital therapy. If those solutions aim to achieve the FDA approval, they must be a prescription therapy per FDA guidelines. 

Be sure to watch my robust #GDBHT2021 conversation with Dr. Wasden here, where we covered everything from creating “value beyond the pill” for Pharma companies, FDA changes, business models for digital therapeutics, point solutions vs platforms, and here the future of digital therapeutics is going. 

Jul 15, 2021
2 min. read

What is Happening in Collaborative Care?

Collaborative Care has been taking off lately in behavioral health. In fact, many speakers at our conference talked about how they are launching new Collaborative Care initiatives.
Chris Molaro

Collaborative care has been taking off lately in behavioral health. In fact, many speakers at our conference talked about how they are launching new Collaborative Care initiatives, including Dr. Udall from Ginger, Dr. Benders-Hadi from Doctor on Demand, Spencer Hutchins, CEO from Concert Health, Ken Fasola from Magellan Health, and finally, Chris Molaro, CEO from NeuroFlow.

What is collaborative care anyway?

Collaborative Care Management (CCoM) is an evidenced-based model proven to improve behavioral health conditions such as depression and anxiety within the primary care setting. Because there is significant drop-off between a PCP making a referral to a behavioral health specialist and the patient actually being able to see that behavioral health specialist, many virtual care providers are finding ways to implement some version of CCoM into their solutions to address that gap.

For example, one of our GDBHT partners, NeuroFlow, is a digital health company combining workflow automation, patient engagement solutions and services, and applied AI to promote behavioral health integration in all care settings. NeuroFlow’s suite of services and HIPAA-compliant, cloud-based tools simplify remote patient monitoring, improve risk stratification, and facilitate collaborative care.

Why is now the time for Collaborative Care Management (CoCM?)

"Healthcare is at last acknowledging that behavioral health is not in a silo- it not only impacts but is directly correlated to physical health.  The clinical and financial benefits of CoCM have been proven repeatedly in the past in addressing this integration. Now, an increased adoption of digital health tools to facilitate the model combined with skyrocketing demand for behavioral health create a unique - and timely - opportunity for mass adoption of the integrated model in our healthcare system.” - Chris Molaro, CEO, NeuroFlow.