Insurers looking to scale up their mental health services can face a paradox of choice.
The American Psychological Association estimates there are about 20,000 mental health apps on the market today. Funding for these startups reached record levels in 2020. And over the past year, consumer demand for mental health services skyrocketed, with some companies looking to beef up benefits as a way to increase worker satisfaction and retention as well as reduce absenteeism.
Insurers also face regulatory pressure to expand their mental health networks. In 2020, California, for example, mandated that plans arrange coverage for out-of-network mental health services when in-network providers are not available. Some insurers are partnering with startups like Talkspace, Ginger or LifeStance Health to scale up as demand outpaces supply.
But with no independent studies comparing the services’ efficacy and prices, how can an insurer determine the right partner for them? Below are five things observers say payers should consider before inking a agreement with a teletherapy provider.
The proof is in the independent data
Insurers should be asking whether any independent data exists around the efficacy of care promised by some of these startups, particularly ones that offer care through a new delivery model, like texting. While many company-sponsored studies have been reviewed by academic third-parties, these reports still could suffer from bias, and can be hard to evaluate without a statistician’s eye. If no independent data exists yet, payers should be asking why neutral studies aren’t available, and when they can expect these reports to be published. They should also consider how existing tools compare to what’s already available in the market.
Remember your patient population
Different startups offer different care models targeted at different groups—Ginger, for example, offers a mix of behavioral health “coaches” and psychiatrists aimed at treating mental health problems early; Talkspace’s licensed 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 payers should think about the needs of their patient populations, review any patient economic and clinical outcomes data and also consider the length of time their members generally stay with the plan.
Protect your brand
Payers should consider a startup’s net promoter score before adding a new partner in-network, as well as review recent stories about the startup in the media, analyst reports and social media interactions. If reports exist of a company leaking patient privacy data, or offers to pay legal fees for therapists that practice out-of-state, consider how those stories will reflect on your product and affect engagement among members.
What’s the cost of those extra benefits?
Payers should also consider the types of benefits the partner company will provide and the extra costs they carry. Some mental health startups offer integrated services with an in-person network of primary-care clinicians. Others offer only virtual visits, while others rely solely on AI or pre-programmed content to target certain conditions. Because many mental health issues come with comorbidities, it’s important to talk to potential partners about how their services can reduce costs directly related to mental health diagnoses, as well as how their tools can decrease costs related to other chronic conditions.
Problems with turnover?
If a provider’s employees don’t like working there, their perspective will not remain a secret to patients for long. Payers should review provider turnover at startup companies, asking for retention data and comparing that with industry standards. Additionally, insurers may want to consider the staffing models employed by different startups, and how those models will impact their ability to serve their member population.