Birches Health, a virtual provider for gambling and pornography addictions, has added a new clinician executive.
Cynthia Grant, Ph.D., is now vice president of clinical for Birches. She will oversee clinical strategy and execution, including scaling evidence-based care. Grant has more than 20 years of experience in behavioral health, with a career across clinical practice, health system leadership, academia and digital health. Previously, Grant was VP of clinical strategy at Grow Therapy and head of clinical care at Rula Health.
Throughout her time in the industry, “what I started to see and hear is the need for specialized care,” Grant told Fierce Healthcare. In her past roles, large national payers would approach with requests for gambling, sex and pornography addiction treatment.
“Payers know that when an individual has a specialty condition and they don’t get into care with a provider who knows how to treat that specialty condition, they don’t actually get better,” Grant said.
“Dr. Grant has dedicated her career to improving how behavioral health care is delivered, measured, and supported, emerging as one of the industry’s foremost clinical experts,” Elliott Rapaport, founder and CEO of Birches, said in a press release. “Her leadership raises the ceiling of what Birches Health can deliver for patients, partners, and the broader US healthcare system.”
Concerns about problem gambling have become more widespread as states move to legalize sports betting and online gambling. High-profile scandals in the press like the one surrounding the NBA last fall have also drawn attention. The National Council on Problem Gambling, a nonprofit focused on gambling-related harm that conducts regular surveys on the topic, estimates 2.5 million Americans meet the criteria for gambling disorder. Another 5 million to 8 million struggle with mild to moderate issues. And 20 million Americans report problematic gambling behavior.
There is some indication that more people are seeking help. Over the past eight years, internet searches for help with gambling addiction grew 23% nationally, per a recent study. This growth was associated with the legalization of sports betting, per the study. Still, estimates find that only 4 in 10 Americans see gambling addiction as “very serious.”
Grant believes the current estimates on gambling addiction prevalence are likely an undercount. “I don’t think clinicians even know to ask about it,” Grant noted.
At Birches, Grant is tasked with developing different care pathways, from individual to group to family therapy, as well as more peer support, which is crucial to addiction recovery, per Grant.
“This is a very unique platform in that all of those services are going to be part of what the clinical model looks like,” she said of Birches.
To that end, the company plans to track a variety of measures to help demonstrate outcomes. They include: anxiety and depression; gambling, sex and pornography addiction; and quality of life. In the future, Birches also plans to launch programs for gaming and social media addiction, including for teens.
Some of these conditions are not in the Diagnostic and Statistical Manual of Mental Disorders yet, Grant said. Even gambling disorder was not recognized as a non-substance behavioral addiction until 2013. The challenge is that without a diagnosis, there is no solid prevalence data in claims to indicate how big of a problem these conditions might be, per Grant.
Birches is also committed to training a gambling care workforce. While there is no national standard to be a certified gambling disorder provider, the International Problem Gambling & Gaming Certification Organization (IPGGC) offers a voluntary certification program. For any provider treating gambling disorders, Birches puts them through the program to get certified. A provider is brought on as a contractor while they go through the process, and, if they complete it successfully, they become employed with Birches. More than 300 Birches providers have signed up for the program, per Grant. (Editor's note: The president of IPGGC, Jody Bechtold, is an advisor to Birches.)
“The focus right now is really about expanding access to insurance-covered specialized care for gambling disorder treatment, and then we also have the sex addiction treatment,” Grant said.
Birches raised $20 million in a series A round last fall. Its clinical outcomes data show 85% of patients reported clinically significant improvement in gambling disorder symptoms and 68% experienced clinically meaningful reductions in anxiety after nine sessions. The company operates in all 50 states and works with major national payers, including United Healthcare, Cigna, Aetna, Tricare and Blue Cross Blue Shield.
“I do think that Birches is doing something very unique, and that we’re doing it the right way to be able to set up this national footprint of gambling disorder treatment,” Grant said. “Certain conditions need a specialized provider, and that is what we’re offering.”