I wrote yesterday about the digital mental health companies and factors that have led to their rapid growth in consumer base and revenue (see Why Are Digital First Mental Health Companies So Popular?). While these new entities have changed the market landscape by changing consumer and health plan expectations, their role in the service delivery system is not static. We heard about their future plans during our 2021 OPEN MINDS Strategy & Innovation Institute keynote panel, The Future Of Mental Health Service Delivery: Up Close & Personal With Ginger, Lyra, & Talkspace. Karan Singh, Co-founder and Chief Operating Officer at Ginger; Rachel O’Neill, Ph.D., Director of Clinical Effectiveness at Talkspace; and Sean McBride, Vice President of Partnerships at Lyra Health explained how their services continue to evolve in two ways—expanding into new markets with new services and developing a full care continuum through collaborations with face-to-face provider organizations. They also explained how they are increasing capacity through innovative approaches.
Growth with new customer groups and new services. These well-capitalized digital first mental health companies are planning to expand their consumer and health plan base. Lyra Health covers 2.2 million consumers in 180 countries through its 75+ employer partnerships. During the session, Mr. McBride shared Lyra’s plans for global expansion of its prevention and coaching services. Lyra also plans to introduce new clinical offerings with digital tools for consumers with more severe or complex needs, including alcohol abuse, suicidality, severe depression, depression, and anxiety.
Talkspace currently serves 2 million consumers and covers 55 million lives through direct-to-consumer offerings as well as employer and health plan partnerships. They plan to “grow its user base, add partnerships, and expand internationally” (see Talkspace, A Leading Virtual Behavioral Healthcare Company, Completes Merger With Hudson Executive Investment Corp. & Will Begin Trading On Nasdaq Under The Symbol “TALK”) according to Ms. O’Neill.
Ginger currently covers more than 25 million lives for over 500 employers in 50 countries and also partners with a number of health plans, including Cigna, Kaiser Permanente, and Oscar. Mr. Singh noted Ginger’s plans to work with government payers and to extend their services to the Medicaid population. He said, “We as an industry need to demonstrate value, we need to focus on supply side innovation, we need to upskill our workforce, we need to introduce new types of care and providers, and we need to pull costs out of the system to unlock access for more people. Value matters in making mental health care affordable for both buyers and members.”
Integrating into the service delivery system by building face-to-face capacity. The other interesting future strategy is the plan for these digital first companies to add to their capability to provide face-to-face services.
Pre-pandemic, Lyra found that 60% of consumers wanted to get care in person. So they built a network of provider organizations and clinical professionals who could provide care not just virtually but also in their offices. They “integrate deeply into their providers’ practices,” and monitor the capacity to accept new consumers and offer appointments in real time, so they can provide same-day appointments, Mr. McBride explained. Lyra is looking to grow its network of provider organizations and welcomes applications through its website (see Apply To Become A Lyra Provider) from group practices as well as individuals to be part of its network to get referrals. They get hundreds of applications every month and have a rigorous selection process. Mr. McBride said, “Our North Star is making sure that our selected providers are trained in and applying evidence based treatments, in a way that meets our clinical standards. We also ask that our providers are comfortable that we’re going to be using third party and validated clinical assessments throughout treatment to assess whether their patients are seeing symptom reduction.”
Lyra wants to provide a more seamless experience when consumers have a special need for higher levels of in-person care—intensive outpatient, hospitalization, or residential. Or if consumers need to see clinical professionals who specialize in treating substance abuse or suicidal ideation. Mr. McBride said, “Lyra is actively working on partnerships with provider groups around higher levels of care that we don’t provide today. We are exploring special partnerships with those who align with our approach to evidence-based treatment. Today, we have a dedicated team that assists patients in finding that higher level of care if they need it. But we would love for that to be something where you can book an appointment and do the intake online and get into an in-person facility in an even more seamless way.”
Ginger has been building their referral network to ensure that they are able to “refer upstream” when they cannot meet consumer’s needs through their platform. They have a care navigation group responsible for referrals that is building a database of pre-vetted provider organizations. When Ginger’s clinical professionals determine that a consumer’s condition is too acute and they need to be seen in person, the care navigation team provides digital referrals to provider organizations in their area. They monitor follow-through for referrals to ensure there are no gaps in care. Ginger is working on how to share data with provider organizations they refer consumers to or get referrals from to make care coordination and collaboration effective.
Mr. Singh explained, “We’ve been working with the folks at Kaiser (health plan and health system) for many years now, and have some really deep connections and partnerships there in a variety of regions where we’ll refer members who need in-person resources or they’ll send us members who need our support. We are very interested in being able to integrate and interface with a variety of different health systems that may not have the capacity to deliver care and send us members and who we can send members to if they should be too acute to be seen in a virtual setting. We’re interested in organizations with a larger regional or national footprint that we can know we can refer members to, especially if we can find best in class resources.” Ginger is pursuing additional provider organization referral relationships on a “case by case basis” in specific regions.
Dr. O’Neill said Talkspace also has the built-in ability to provide referrals to face-to-face services and higher levels of care—a growing need as consumers are presenting with more serious concerns and higher acuity conditions. They train clinical professionals to provide case management, care coordination, and referral services in the virtual environment.Increasing capacity through innovative approaches. Ginger offers “team-based care” where behavioral health coaches (typically masters level clinical professionals with a mental health background) serve as the “front door” to a full suite of services. The coaches are available 24/7 and greet consumers within two minutes of their signing up. Coaches get to know consumers through text-based conversations, use motivational interviewing to problem solve and develop treatment goals, and direct consumers to proprietary self-care exercises where appropriate. Mr. Singh said, “You don’t need a diagnosis to get access to great care. About 80% of members actually have their needs met within a subclinical setting, because we’re able to catch them early, reduce the friction, and get them through that front door.” The use of coaches also frees up clinical professionals to focus on those who have a higher level of need.
Lyra uses a “blended care model”—after each session, the clinical professional recommends appropriate digital exercises, from Lyra’s proprietary library, to help consumers learn to manage their own emotions and behaviors. This model has helped consumers get better with 50% fewer sessions with a clinical professional, Mr. McBride said. Ginger offers self-care content, which is used as a step-down level of care after therapy sessions are completed. Talkspace—in addition to text-based and live therapy—offers “secondary solutions” in the form of content and self-directed exercises on wellness and mindfulness.
There is no doubt that the digital-first behavioral health companies are a phenomenon that is here to stay. These companies are raising the bar on access and engagement, measurement-based care, and marketing. Traditional provider organizations—from the small private practices to national specialty provider organizations—are going to have to improve their performance in these areas in order to remain competitive and maintain marketshare. And, in this era of “frenemies,” traditional face-to-face provider organizations should consider the emerging partnership opportunities with the digital first companies as referral channels for their niche expertise.
In the meantime, for more on success factors for the digital-first era of health care, check out these resources in The OPEN MINDS Circle Library:
- How Virtual Behavioral Health Organizations “Fit” In the Health Care Ecosystem
- Digital Platforms Are Offering New Mental Health Options To Employers & Building Their Networks
- More Mental Health Advertising, Less Mental Health Stigma?
- Data Doesn’t Have To Be A Four-Letter Word For Clinical Professionals
- Post-Pandemic, Strategy Needs Technology
- To Succeed With Hybrid Services, Make Sure Your Digital Storefront Is Ready
- Want More Flexibility? Want Better Rates? Get The Performance Data
- Using Analytics to Personalize Consumer Service: Lessons From Netflix & Amazon
- Virtual Care Is So Much More Than Just Telehealth – Embracing All The Tools Of The Digital Care Environment
- Digital Transformation: Beyond Telehealth, Beyond The EHR
And for even more, mark your calendar for the 2021 OPEN MINDS Technology & Analytics Institute in Last Vegas, October 25 to 28. Our keynote speakers include Joseph Lee, M.D., President and CEO-Elect, Hazelden Betty Ford Foundation on Extending & Expanding The Specialty Treatment Care Continuum: The Future Of Family & Peer Supports & The Implications For Payers and Joseph Kvedar, M.D., Vice President Of Connected Health, Health Partners Massachusetts on Are Virtual Hospitals The Health Care Centers Of The Future?