Brightside Health partners with payors to provide care to Medicaid and Medicare members

Steven Loeb · October 5, 2023 · Short URL: https://vator.tv/n/5723

Insurance partners include Optum, Blue Cross and Blue Shield of Texas, Centene, and Lucet

Recent estimates indicate one in four Medicare beneficiaries are living with mental illness but only between 40 and 50% receive treatment, with Medicaid being the single largest payer for mental health services in the U.S. The ongoing mental health crisis places an increasing and disproportionate burden on Medicaid and Medicare recipients, making it extremely hard for participants in these programs to access care.

"These access issues in turn exacerbate severity and complexity, which can increase costly and ineffective utilization of emergency departments (ED) for mental health needs, said Brad Kittredge, CEO and co-founder of Brightside Health, a telemental health platform that delivers mental health care for mild-to-severe clinical depression, anxiety, and other mood disorders.

"This cycle will only repeat itself until these patients get not only timely care but the appropriate level of care that factors in their individual needs," he explained. 

That's why the company announced a series of partnerships with leading payors on Thursday,  including Centene, Optum, Lucet, and Blue Cross and Blue Shield of Texas, to offer mental healthcare to Medicaid and Medicare beneficiaries. With these additions, Brightside will be able to provide in-network mental health services to 50 million more people, bringing its total covered lives to well over 100 million.

Brightside is able to help solve for the primary barrier to care for this population, which is insufficient supply of providers, making it extremely difficult for them to get appointments, Kittredge explained.

"Delayed care can result in exacerbations, driving people to use the ED as their only way to get care. Other examples of barriers to care include unreliable transportation, lack of childcare, and the inability to miss work. High-quality virtual mental health care ensures that care can fit into real-life constraints that people have in seeking care," he said.

"Brightside Health’s expansion aims to do just that by breaking the cycle and offering high-quality care to millions of Medicaid and Medicare beneficiaries."

Going forward, members of these plans will be able to use their benefits with Brightside Health the same way they do with in-person care, whether they find Brightside through their plan, online, or through a provider referral.

When a member goes to Brightside, they start with a free assessment leading to a personalized treatment plan. From there, members can make an appointment to be seen within 48 hours and get started working with the same care team from start to finish. 

Brightside's platform includes personalized psychiatry with PrecisionRx, which provides AI-driven recommendations based on over 100 data points, as well as real-time care management, which can track progress and identify risk levels in near-real time, allowing for automated risk escalation to the provider. In addition, patients also get advanced quality management with ActiveSupervision, which scans charts to verify completeness and identify situations that a supervisor should review, and Crisis Care, a national telehealth program for treating individuals at elevated risk for suicide.

Within 12 weeks of using Brightside, 86% of patients experience clinically significant improvement, while that number is 88% for those reporting suicidal ideation at intake. The company also sees 71% achieving remission, compared to 69% for those reporting suicidal ideation at intake. Of the patients achieving remission within 12 weeks, 65% did so within 28 days, and 82% did so within 48 days. The mean time to remission was 31 days.

When it comes to the insurance companies, the ROI that they will want to see is that the company is providing timely access to care, producing great clinical outcomes, and managing costs, which is exactly what Kittredge says Brightside delivers: timely and easy access to mental health appointments, measurably better outcomes, and the ability to reduce the most costly of events, for example ED and in-patient psychiatry admissions and readmissions.

"In doing so, insurance providers are able to reduce costs while also improving performance against quality measures and improving patient satisfaction along the way. Because only a handful of telehealth platforms serve Medicaid or Medicare beneficiaries’ behavioral health needs – and even fewer support both – Brightside Health’s data-driven platform stands out even more," he said. 

This is only the beginning for Brightside and this expansion, and the company will continue with more new and expanded contracts to be announced in the coming months. 

"From the beginning, we have known that trust and credibility must be earned in healthcare. At every step, we’ve shown our work, publishing 10 peer-reviewed studies on our methods and outcomes and sharing granular data with our payer partners so they can see the impact we are making on their populations," said Kittredge.

"The opportunity to partner with these payers is not only validation of that approach but in our ability to help them achieve their clinical and financial goals."

(Image source: silvermaples.org)

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