Demand for behavioral health services continues to grow across the country, along with mental health providers reporting longer waitlists or no openings for new patients.
WellSpan, a health system serving south central Pennsylvania and northern Maryland, is teaming up with Concert Health to expand access to same-day behavioral health services alongside primary care. The service will be rolled out across all of WellSpan's primary care clinics.
Concert Health, founded seven years ago, uses a collaborative care model to help medical groups and health systems integrate behavioral health care into primary care settings.
Through this partnership, Concert Health will connect with referred WellSpan patients within 24 to 48 hours over the phone or by video to monitor symptoms and medications and provide evidence-based counseling interventions.
WellSpan’s collaboration with Concert Health will work in tandem with the health systems's existing suite of behavioral health services already offered through WellSpan Philhaven. This includes a wide range of treatment and support including inpatient services, intensive outpatient programs, partial hospitalization programs, telemedicine, behavioral health specialists embedded in emergency departments, and residential care.
Recent data released by the health system shows a 50% decrease in the number of patients in WellSpan emergency departments seeking behavioral healthcare.
"Physical health and mental health are inextricably connected This model of collaborative care that WellSpan and Concert Health are partnering on moves us more in that direction integrating physical and mental health by creating an extra layer of connection between the patient, the primary care team and the behavioral health team," said David Vega, M.D., senior vice president and chief medical officer at WellSpan Medical Group, WellSpan’s employed practice division, in an interview.
Despite WellSpan's strides in getting patients access to care, Vega, as an emergency physician, is all-too-familiar with the results of limited access to behavioral healthcare.
"Unfortunately, I've seen that many patients over the years have come to the emergency department as their kind of last resort for their behavioral health needs," he said. "WellSpan has been leader in helping patients avoid the ED and also in embedding additional behavioral resources within our emergency departments. However, the environment and nature of the ED is just not the best setting for these people. And, sometimes there are significant delays in being able to connect people with the longer-term resources that they need. Another great reason that this partnership with Concert Health is so great is that it helps to create easier connections to behavioral health resources when patients need them and help to prevent some of that escalation of their illness and possibly prevent some of the need for turning to the ED for help."
As part of the collaboration, Concert Health’s psychiatric providers will provide WellSpan primary care providers with a holistic view of their patients by reviewing patients' cases regularly, providing feedback and guidance both to the behavioral health team and making specific treatment recommendations back to the WellSpan primary care provider. The patient experience will also be embedded within the MyWellSpan patient portal.
Collaborative care is an evidence-based model developed by a group of University of Washington psychiatrists several decades ago, according to Spencer Hutchins, co-founder and CEO of Concert Health.
The model aims to help providers connect patients showing symptoms of depression or anxiety with behavioral care managers, who follow up with the patient regularly to provide counseling, manage medication or monitor symptoms, depending on the patient’s needs. And, the collaboration supports patients across insurance types, including Medicare, Medicaid and commercial insurance coverage, Hutchins noted.
"The founders of this model built it to recognize some fundamental truths. There aren't enough psychiatrists, many people don't want to go see them even if there are and the mind is connected to the body. If you have a combined care plan that recognizes someone's total disease burden and their situation of life, you are going to be more effective, both in engaging the patient and improving their life. And, they recognized that you needed a way to measure symptoms and change interventions," Hutchins said in an interview.
He added, "Collaborative care also is about recognizing that we need to embed in the primary care workflow and the primary care team. What Concert Health is does, we virtually embed two clinicians onto the primary care team, a master's level behavioral health clinician that's taking referrals the same day or the next day doing a spectrum of interventions, some they can act on like therapy, some that are symptom monitoring like med check and many in between techniques, like motivational interviewing or behavioral activation, that can often be done briefly, but can be very effective."
These clinicians also measure symptom severity over time, he noted.
"They do that very explicitly as part of the primary care team. They are not referrals, we call them warm handoffs between our two teams," Hutchins said.
As part of the collaborative care model, psychiatric consultants, board-certified psychiatrists and psychiatric nurse practitioners, meet weekly with collaborative care clinicians. Concert Health psychiatric consultants do not prescribe medication; rather, they make diagnoses and treatment recommendations in the provider's EMR.
"Having that kind of team-based approach with the psychiatrists as the 'player coach' is really critical," Hutchins noted. "With the access problems for behavioral health, this takes the psychiatric provider's expertise and ensures they can support many, many more patients through that indirect coaching mindset versus how many they could see in individual visits. This model allows you to bring everybody's expertise and everybody's skills to bear across the psychosocial, psychotherapy and medication domains."
Many health systems are now partnering with virtual behavioral health providers to complement their in-house services and meet growing demand for care. As one example, Houston-based Memorial Hermann Health System is partnering with Charlie Health to expand access to outpatient mental health treatment for teens and young adults.
"To fully meet the needs of our communities, I think we're going see continuing partnerships like this," Vega said. "In the first five days of this partnership, we already had 187 patients referred to the program. So, we're really getting some great results here at WellSpan."
Concert Health has treated nearly 100,000 patients within its collaborative care model. Half of these patients have seen at least a 50% decrease in anxiety or depression symptoms (PHQ9 or GAD7) in less than 90 days, according to the company. The medical group currently partners with 35 medical groups and health systems across 17 states, including Mass General Brigham, AdventHealth, CommonSpirit and Trinity Health.
Concert Health’s care team upholds a 72 net promoter score among patients.
The company also has spearheaded nine peer-reviewed studies that provide rigor around the measurement and reporting of collaborative care outcomes.
Concert Health’s collaborative care solution is one example of a proactive and scaled approaches to address the growing mental health crisis, according to the company. More than half of behavioral health clinicians say they don’t have openings to see new patients, and, at the same time, they’re also seeing patients with more acute symptoms that need longer treatment times, according to the American Psychological Association.
Concert Health raised $42 million in series B funding in April 2022, led by Define Ventures with participation from existing investors Healthy Ventures, Vertical Venture Partners and Townhall Ventures. The startup also received strategic investments from CommonSpirit Health and Advent Health.
The company has raised $56.5 million to date, including $14 million in a series A funding round in January 2021 led by Vertical Venture Partners with participation from Town Hall Ventures and Silicon Valley Bank.