Insurers seeking to scale their mental health services may face a paradox of choice.
The American Psychological Association estimates that there are about 20,000 mental health applications on the market today. Funding for these startups has reached record levels in 2020. And over the past year, consumer demand for mental health services has increased, with some companies looking to bolster benefits as a way to increase employee satisfaction and retention and also to reduce absenteeism.
Insurers are also under regulatory pressure to expand their mental health networks. In 2020, California, for example, ordered that plans organize coverage for out-of-network mental health services when in-network providers are no longer available. Some insurers partner with startups like Talkspace, Ginger or LifeStance Health to scale when demand exceeds supply.
But without independent studies comparing the effectiveness and prices of services, how can an insurer determine the right partner for them? Below are five things observers say payers should consider before entering into an agreement with a teletherapy provider.
The proof is in the independent data
Insurers have to ask themselves if there are independent data around the effectiveness of care promised by some of these startups, particularly those that offer care through a new delivery model, such as text. While many society-sponsored studies have been reviewed by third-party academics, these reports can suffer from bias, and can be difficult to assess without the eye of a statistician. If independent data do not yet exist, payers should ask themselves why neutral studies are not available, and when they can expect these reports to be published. They will also have to consider how the existing tools compare to what is already available in the market.
Remember about your patient population
Different startups offer different models of care aimed at different groups — Ginger, for example, offers a mix of behavioral health “coaches” and psychiatrists designed to treat early mental health problems; Authorized Talkspace providers can diagnose and treat clinical conditions through video and text; and LifeStance’s mix of in-person and virtual therapy services can help treat those with more acute conditions, such as schizophrenia. Employers, insurers, and government taxpayers should consider the needs of their patient populations, review data on patients ’economic and clinical outcomes, and also consider the length of time their members generally stay. with the plan.
Protect your brand
Payers will need to consider a startup’s net promoter point before adding a new online partner, as well as reviewing recent stories about startups in the media, analyst reports, and interactions in and social media. If there are reports of a company losing patient confidentiality data, or offering to pay legal fees for out-of-state therapists, consider how those stories will reflect on your product and influence engagement among members.
What is the cost of these extra benefits?
Payers will also have to consider the types of benefits that the partner company provides and the extra costs they bring. Some mental health startups offer integrated services with an in-person network of primary care clinics. Others offer only virtual tours, while others rely solely on AI or pre-programmed content to target certain conditions. Because many mental health problems come with comorbidities, it is important to talk with potential partners about how their services can reduce costs directly related to mental health diagnoses, and how their tools can decrease costs relative to other chronic conditions. .
Problems with billing?
If a provider’s employees don’t like working here, their prospect won’t remain a secret for patients for long. Payers should review supplier turnover in startup companies, request retention data and compare that with industry standards. In addition, insurers may want to consider the employee models employed by different startups, and how these models will influence their ability to serve their member population.