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It takes a pandemic: Mental Health parity may finally have its day!

By EMILY EVANS

Emily Evans is the health policy guru at equity research company HedgeEye. She sends out these reports in emails to her clients regularly but (since I asked nicely) she allowed me to publish this one from late last week on THCB. You can catch Emily in person on the “How Much Are These Companies Really Worth? The IPO & SPAC Panel” at Policies|Techies|VCs–What’s Next for Health Care, the conference Jess Damassa & I are chairing on September 7-8-9-10 — Matthew Holt

Politics. President Biden is going to have more important things to do this week than worry about the mask/vaccine wars. At some point though, probably soon, Biden will need a scapegoat at the CDC. Several reversals on guidance around masks for the vaccinated and the unvaccinated have left local governments confused and people, most notably, parents of school age children, angry. The spread of the Delta variant isn’t helping matters.

While there may be political motivations for some of CDC Director, Dr. Rochelle Walensky’s guidance. A better approach, this last week anyway, would be never assign to cunning that which can be explained by incompetence.

Bringing a large, sprawling bureaucracy into line after a decade or more of being considered irrelevant is not a simple matter. It is made particularly difficult by the agency’s remote location in Atlanta to which Dr. Walensky commutes. 

For the time being eclipsed by a messy exit in Afghanistan, the CDC’s failures are still being noted by longstanding supporters of the agency like former Food and Drug Commissioner, Scott Gottlieb. As the Delta variant follows the same summer path as Alpha from south to north and break-through infections become identified as more common than previously thought (though mild for the vaccinated), the pressure to get the CDC reorganized will grow.

The good news, notwithstanding the vitriol over mask wearing and vaccine mandates, is the assumption underlying the CDC’s guidance on masks/vaccines is that children will be going to school and college students to class. It is, we can all hope, the first step in recognizing that there is no Zero-COVID; no magic bullet; just adaptation and adjustment, something at which humans excel.

Policy. Last week, the Department of Labor simultaneously filed and settled a lawsuit against UNH for violations under the Mental Health Parity and Addiction Equity Act of 2008. The dollar value of the settlement was immaterial but United HealthGroup (UNH) agreed to take corrective action which will be substantive.

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#Healthin2Point00, Episode 225 | Amwell acquires SilverCloud & Conversa – plus more deals

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Today on Health in 2 Point 00, we have a deal so big it’s brought me out of vacation just for this episode! Amwell acquires not one, but TWO companies – DTx mental health company SilverCloud Health and chatbot company Conversa Health for a combined $320 million. In other news, mental health company Sondermind raises $150 million, bringing their total to $188 million, and femtech company Elvie raises $80 million, bringing their total to $133.9 million. —Matthew Holt

Ofer Leidner, Happify Health

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by MATTHEW HOLT

Happify Health is a online mental health company that is focused almost exclusively on scaling care by offering self-service tech solutions across the patient journey. After R&D starting in 2012, they’ve been scaling since 2017 and now are working with large employers and big health plans. What they don’t do is have their own therapists or psychiatrists. This is an interesting approach and probably much more scalable than many of their competitors. Today they raised $73m more to build out their solutions. I talked to Happify Health’s President, Ofer Leidner about how far they can go with automated self-service. He thinks it’s a long way.

Modern Health’s CEO on Becoming Digital Mental Health’s Latest Unicorn

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By JESSICA DaMASSA, WTF HEALTH

Digital mental health startup Modern Health just closed a $74M Series D, bringing their funding total to $170M, and earning the company a $1.17B valuation that makes it the FASTEST-EVER female-founded company to hit unicorn status. CEO Alyson Watson explains what sets Modern Health apart in the incredibly crowded, well-funded, and highly-competitive mental health tech space where the growing issue of skyrocketing demand for care is likely soon to become a shortage of care providers.

Modern Health is hoping to win here by becoming a one-stop-shop for a full-suite of mental health services. They’re bundling together all the different kinds of mental health point solutions currently out there – from tech-enabled self-service cognitive behavioral therapy programs and peer-to-peer group therapy all the way to one-on-one virtual visits with clinicians – and differentiating by designing a better way to intake patients, so care can be more accurately and cost-effectively matched to patient needs. Says Alyson, “If you’re just solving mental health through the old-school way of connecting someone to a therapist, and that’s your be-all-end-all and your only solution…well, eventually, that bubble will burst.”

Founded in 2017, the company has grown both its client-base (220 employers) and coffers quickly. They’ve already acquired Kip, another digital mental health biz, and are looking for more. Tune in to hear what Alyson’s got on deck for 2021 and what she expects to be driving further growth in the mental health virtual care market.

Minding the Competition: Ginger’s Karan Singh & Russell Glass on Digital Mental Health Investments

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By JESSICA DaMASSA, WTF HEALTH

Digital Mental Health startups continue to scale up — in customers, revenues, and investments — as the covid19 pandemic wears on. One of these companies, Ginger, has tripled its revenue this past year, expanded its client base to count more than 200 health plans and self-insured employers, and, for good measure, just added a fresh $50M Series D to their coffers. How much more money can investors put into digital mental health startups? Are things “frothy” in this space, or is investment just “catching up” to meet a latent demand that’s just really been brought to light? And, what is one of this category’s leaders planning to do now that they’re extra flush with cash? (Don’t forget, they’re sitting on a $35M round that closed late 2019…)

Ginger’s co-founder & COO Karan Singh and CEO Russell Glass join us to weigh in on the mental healthcare market’s state-of-play, including the buzz around their own business as both a potential acquisition target and a potential acquirer of additional behavioral health tech. We cover everything from investment to healthcare incumbent’s recent cries for more clinical validation, but my favorite part of this whole interview is when we start talking about the competition and tackle Lyra Health’s recent $100M raise and $1.1B valuation. Tune in around the 15:55-minute mark for some very DETAILED competitive analysis about Lyra-versus-Ginger from Ginger’s own CEO.

As this market gets more crowded, competition heats up, and healthcare consumers receive the benefit of more solutions to access at lower prices, Karan and Russ also help me speculate on what’s ahead, including whether or not they think we’ll see a “digital mental health equivalent” of a massive game-changing-market-moving deal like we saw when Teladoc merged with Livongo to shake up of both the virtual care and chronic condition management spaces.

Kids & Mental Health: Brightline Aims to “Grow Up” Pediatric Behavioral Health Care with Tech

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By JESSICA DAMASSA

Despite the fact that kids make up 20% of our national patient population and that their parents are likely just the tech-savvy market of health consumers that most digital health companies are targeting with their own virtual care solutions, very little has been done to use technology to ‘transform’ the way that they take care of their kids. One of the founders hoping to push this market into a growth spurt is Naomi Allen, co-founder & CEO of pediatric behavioral health company Brightline.

From seed to Series A in just 8 months ($25M total funding), Brightline is already looking to scale out its full-stack clinical model to help tackle the behavioral health issues that are often under-diagnosed and under-treated in kids. Naomi says that 75% of all severe mental illness manifests before age 14, but that only 1 in 5 kids will ever even get a behavioral health diagnosis. And more shocking? Of those that are diagnosed, only 1 in 5 of those kids will ever even receive any care.

The supply-and-demand equation is off — stymied not only by a clinician shortage, but by literally poor reimbursement from health plans concerned about the lack of quality metrics, measurements, and processes in pediatric behavioral health despite the prevalence of those kinds of quality guidelines around adult mental health care.

So, how is Brightline going to fix this? Technology, clinicians, coaches. A full-stack clinical model with a “scaffolding” of support for parents built around it using telehealth, digital tools, and, for those health plans, metrics. Tune in to find out more about their business model, what Brightline’s kids are saying, and how you can find their services yourself if you think your child might need help.

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“Going Digital: Behavioral Health Tech Conference” Matthew Holt & Jessica DaMassa’s Long, Exhaustive & Boring Overview

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Matthew Holt and Jessica DaMassa gave a talk at the “Going Digital: Behavioral Health Tech Conference” on June 17, 2020. They spoke about how technology is evolving the mental health space, along with their thoughts on where the future of the industry is headed.

Jess & Matthew first start off with their “Health in 2 Point 00” segment, discussing all of the funding deals in the mental health space, from Headspace to Mindstrong raising money in Q1, to Kaiser rolling out MyStrength to its members.

Then they jump into a deeper dive segment, where they discuss how the money is being distributed in the mental health space, and how startups are coming up with creative solutions to package their services. Some mental health companies are wrapping solutions into other digital health platforms that already manage chronic conditions, like Livongo & Omada, others are working to directly address and treat mental health issues, and some are developing digital therapeutic solutions to manage mental health problems. As this part of the industry grows, Matthew & Jess predict how the mental health tech space will change & develop with increasing demand, more investments, and a lot more innovative tools to serve the population’s needs.

Zoya Khan is the EIC of The Health Care Blog & a Strategy Manager at SMACK.health

Provide Emotional Personal Protective Equipment (PPE) for Physicians Facing Psychological Trauma From the COVID-19 Crisis

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By SUZAN SONG MD, MPH, PhD

The U.S. now has the highest number of COVID-related deaths in the world, with exhausted, frightened physicians managing the front lines. We need not only medical supplies but also emotional personal protective equipment (PPE) against the psychological burden of the pandemic.

As a psychiatrist, my role in COVID-19 has included that of a therapist for my colleagues. I helped start Physician Support Line, a peer-to-peer hotline for physicians staffed by more than 500 volunteer psychiatrists. Through the hotline and social media, physicians are revealing their emotional fatigue. One doctor shared her sense of powerlessness when she couldn’t provide comfort but instead had to watch her young patient with COVID-19 die alone from behind a glass window. Another shared his sorrow after his 72-year-old patient died by suicide. She was socially isolated and didn’t want to be a burden on anyone if she contracted COVID-19. An internist felt deep distress and alarm that her hospital was quickly running out of ventilators and had 12 codes in 24 hours. 

Through a brief survey I conducted across the U.S., 269 physicians reported moderate to severe symptoms of anxiety (53%), depression (43%), and insomnia (16%). About 46% wanted to see or would consider seeing a mental health clinician for severe anxiety (30%), not feeling like themselves (27%), or being unhappy (21%). These are all similar statistics to the front line health care workers in Wuhan. 

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Leading Mental Health Platform on DTx Reimbursement, Scaling | Ken Cahill, SilverCloud Health

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By JESSICA DaMASSA, WTF HEALTH

Digital mental health platform SilverCloud Health is the digital-therapeutic-of-choice for mental health services in the UK’s National Health Service (NHS) and serves nearly 250 healthcare organizations around the world, racking up 1.5 million therapy hours and 5 million clinical interactions. CEO Ken Cahill stops by to catch us up on SilverCloud Health’s impressive clinical outcomes and how he’s tackling challenges around reimbursement that are common for many digital therapeutics startups. His unique approach (spoiler alert: he partners with providers to approach payers for exception codes) may give some inspiration to those in a similar situation, but tune in for Ken’s full explanation and details on how the company plans to double over the next year.

Filmed at Frontiers Health in Berlin, Germany, November 2019.

Solving the ‘Supply Side’ of Scaling up Behavioral Health Care | Russell Glass, CEO, Ginger

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BY JESSICA DAMASSA, WTF HEALTH

The ‘virtual-care-for-behavioral-health’ space is getting a bit crowded these days, particularly as demand for such services reach new heights among patients. Russell Glass, CEO of health tech startup, Ginger (formerly known as Ginger.io) thinks his company has solved the supply-and-demand imbalance with their unique model that offers on-demand coaching, video therapy & psychiatry, and self-guided content by a range of different mental health care providers. Trained behavioral health coaches serve as the front-line of Ginger’s service, then act as care coordinators to bring in fully-licensed therapists and psychiatrists as needed. With 60 enterprise clients, double-digit patient engagement rates, and outcomes beating standard of care rates, Ginger’s got traction — and also cash. The company’s raised more than $70 million, having closed a Series C (with a follow on) in late 2019. Russ details scale up plans AND answers the question that all you health tech pundits are no doubt dying to ask: what happened to the ‘.io’?!

Filmed at HLTH 2019 in Las Vegas, October 2019.

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