Podcast: The consumerization of mental healthcare

Executives from BetterHelp, Bind Benefits, K Health and JustAnswer weigh in

The second breakout session of the Future of Mental and Behavioral event on July 14 focused on consumerization of mental healthcare.

In a patient-centric world, are consumers empowered to make the right decisions? Moderators: Dr. Archana Dubey (Global Medical Director, HP), Bambi Francisco Roizen (Founder and CEO, Vator) Speakers: Alon Matas (President, Teladoc’s BetterHelp), Andy Kurtzig (CEO, JustAnswer), Allon Bloch (CEO, K-Health), Shawn Wagoner (Chief Revenue Officer, Bind).

Takeaways:

-- Bind offers personalized health insurance that gives members more transparency around treatment options and their prices. 

-- BetterHelp is a provider of direct-to-consumer virtual therapy sessions with 30,000 therapists in the US.

-- JustAnswer connects consumers with experts across 700 verticals, including mental health therapists.

-- K Health is a data-driven primary care service that is a free symptom checker app with a medical layer of physicians to treat chronic, acute and mental health.

Q: Why direct-to-consumer? 

Allon Bloch - We do have enterprise partnerships but our psyche is to give consumers direct access to information, control and empowerment. We’ve also wanted to learn from the consumer. We started with acute-first-diagnostic visits and then expanded into chronic conditions and mental health. Also, a third of our users are uninsured; a third have high deductibles. We wanted to enable people to get this product who didn’t have other options. [While we are primarily primary care, mental health should be part of primary care.]

Andy Kurtzig: I started 18 years ago when enterprise wasn’t ready. Our mission was serving the consumer and getting them access to experts. Our first need was access to a doctor who could answer questions for my wife who was pregnant. When we nailed that down, then we thought we could do that across different channels. For our doctors, we aren’t trying to establish patient-client relationships. Doctors answer high-level questions and sometimes action-based advice but never prescriptions. 

Alon Matas: I’m a big consumer guy. This is my fourth startup. As a product person, I find the consumer segment far more fun. When you’re charging consumers $200-$300 a month you want to make sure you’re providing the best service. In enterprise, you’ve got so many elements to deal with that’s not consumer-related. The consumer side also has bigger potential. 

Shawn Wagoner [on how a focus on consumer makes building up Bind different than other insurers]: We started with a blank whiteboard. Our insurance solution isn’t just new technology, it’s a new financial product. We align our financial instruments to the needs of individuals. Most insurance companies are focused on the risk of a group. How do we design an insurance product that morphs and changes as a person goes through life? How do we allow insurance to flex with that? The uniqueness of our offering for consumers is that there’s no deductible. Also, we give people options around care decisions and importantly we are transparent about the price. For instance, if someone has anxiety, they can search and find options: 1) go to a therapist for $30 or go to ER for $300. 

Q: How has direct-to-consumer changed the way consumers behave or take care of their healthcare?

Andy: It feels like Blockbuster video with late fees and how Netflix revolutionized that by doing away with penalties and still allowing you to watch more videos. Today there’s no penalty if you have a pre-existing condition because companies like ours are giving people access to care. 

What’s your business model - episodic/subscriber base?

Alon: Members pay with their CC and a monthly fee (weekly live session and unlimited messaging between the sessions); Andy: We match with the customer need; sometimes it’s a membership and sometimes it’s a fee-for-question. Allon: Five million people use our product for free; a quarter of that number is a mix of subscription and episodic. We’re looking to build primary care and a relationship with our users

How are your services attracting providers?

Allon: K Health doctors are on salary. A big chunk of what doctors do today is not what people need. We do the admin so they can focus on care. 

Andy: Doctors get paid per answer and there’s a different amount based on the quality of score. They also get surge pricing. On averaging the response time for an answer is three minutes. And some doctors make upwards of $30k a month just answering questions. They like working on our platform because they do what they do best - help people.  

Alon: Firstly, therapists are different than PCPs because you need more therapists for a given population. With a PCP, if someone has a medical problem, most PCPs can treat it. For therapists, most people want differentiation. They may want a female, an older person or a therapist of color. Then there needs to be the right chemistry. Our therapists like the flexibility and they get paid based on hours worked (either through live sessions or messaging). 

Shawn: We have a network and we also partner with Unitedhealthcare’s network. The economics are the same. But what providers notice is that with Bind members, they tend to pull out their phones and do searches. For example, if they need a prescription filled, a member can search where they can get that prescription filled; Turn left and pay $5 at this location or turn right and pay $15. Or if it’s a procedure they have to decide on, they can, similar to Amazon, receive suggestions that are: People like you did this procedure or took this option. In essence, they get choice and for those choices, they see the price to pay.   

On Millennials and their behavior:

Alon: Millennials use less overall healthcare because they’re sick less; But millennials are more likely to use mental health services. They’re more open to using therapy vs older generations who feel these are personal matters they can handle alone. Also, because of COVID the technical gap has closed as millennials as well as older generations have no choice but to use virtual care and other technologies.   

What will we see in the next five years?

Allon Bloch: There will be a change in business models away from per, per month to true usage and true value. Alon: Just like Amazon, if they need healthcare and there’s no reason to see a doctor, the default will be online and virtual. Andy: Amazon made purchasing better, cheaper and more accessible. Healthcare will be the same: it will be better, cheaper, accessible and faster. Shawn: America is an individualistic society. That won’t change and it can’t be stopped. People will want things contextualized for themselves: contextualized answers and products. The medical industrial complex was also not built around a person; it was built to get paid. That will change.

Future of Mental and Behavioral Health is brought to you by Vator and UCSF Health Hub. Thanks to our sponsors: Advsr, Scrubbed, Stratpoint. As well as BetterHelp, go to  BetterHelp.com/Vator for 10% off BetterHelp. This podcast is also brought by Octave, your partner for mental health and emotional well-being. Learn more at FindOctave.com. Also thanks to NeuroFlow which is working with hundreds of healthcare organizations to provide best-in-class technology and services for the effective integration of behavioral health. Learn more at neuroflow.com).