Brave Health, whose telehealth platform delivers mental health services to patients in 18 states, is joining forces with MedArrive to collaborate on home-based services.
Virtual mental healthcare consists of many things, but no one wouldn't typically confuse it with "boots on the ground" care.
Brave Health aims to change that through a partnership with MedArrive, a provider network of skilled paramedics, EMTs, and other healthcare professionals delivering a mix of in-home healthcare services, diagnostics, health assessments, and other preventative health measures.
The collaboration combines Brave Health's telehealth platform with mobile integrated health services offered by MedArrive, giving both new opportunities to improve access to care.
Based in Miami, Brave Health now operates in 18 states. Through the new partnership, if a MedArrive care team identifies an eligible health plan or Medicaid member in need of mental health support, they can immediately refer that member to Brave Health's behavioral health providers and schedule care within a few days. Conversely, if Brave Health identifies an eligible health plan member that may benefit from MedArrive's home health services, it will then work with that health plan's case management team to coordinate support.
In this interview, Brave Health CEO and co-founder Anna Lindow talks about the challenges of serving a predominantly Medicaid-insured population receiving virtual mental healthcare services. This interview has been lighted edited for brevity and clarity.
HealthLeaders: Why would a health system partner with Brave Health, rather than with traditional mental health partners?
Anna Lindow: For some patients, having a virtual option is a better option for them. 20% of our patients live in towns of 2,500 people or fewer, so it's not uncommon that a patient is going to go back to a home that's far from any provider. We have lots of patients who, even if they don't live in a rural area that may have transportation barriers, behavioral health fits into their life better if they can do it virtually.
Anna Lindow, co-founder and CEO of Brave Health. Photo courtesy of Brave Health.
Our goal is to make a commitment to the discharge planner to make the process of making referrals seamless for them. They need to put a date and time appointment into that discharge plan. We get that to them quickly and seamlessly. Our focus on Medicaid is pretty uncommon, and something we've seen as a huge opportunity and need. It was always where we wanted to go.
HL: There's a shortage of therapists. You're out there competing with every other provider to recruit those therapists. How do you do it?
Lindow: These are people who've devoted their lives to being healthcare providers in a community. Logistically, though, you're right, there's no surplus of behavioral health providers. We can recruit providers to work for Brave who live all over the country.
HL: Is internet access an issue if they're rural?
Lindow: Even since I started working in this field five years ago, I've seen a lot of improvement. When we started Brave, smartphone adoption among Medicaid beneficiaries was lower than the American adult average. That has changed. The government programs that furnished cell phones have evolved. Second, I do think we've seen broadband access improve. There's certainly more work to be done, but it's improving. The pandemic has helped to demystify what being a care provider in a telehealth setting is like.
HL: MedArrive is a provider of EMS services. So this seems like another piece of the puzzle.
Lindow: There's so many things we can do with virtual care, but we cannot be in the home physically. Brave can't exist in a vacuum. We want to work with the organizations that are doing great work on the ground.
HL: Is the role of MedArrive not just to facilitate services and treatments, but also to evaluate a particular patient's social situation, their lives, their living arrangements? Are you counting on them to provide that input back to you as part of this?
Lindow: I don't want to speak for them in terms of exactly the scope of their services. But I think your point is well taken, that you get information when you go into someone's home. They are seeing an individual in a setting where they may get cues or information that tells them, hey, I think behavioral health services could help this person. They could say, I'm sitting right there with you. How would you feel about this? And if the member says yes, [MedArrive] can say, how can we get that started right now? Let me give Brave a call.
HL: You have to be striking a careful balance there between helping the patient and at the same time respecting their privacy.
Lindow: Absolutely. That patient has to say yes. Our job in the context of this partnership is to help people who are ready for services and want services to get them more seamlessly.
HL: Are the Brave Health encounters always with camera on?
Lindow: There have been some flexibilities around audio during the pandemic, but typically, it's an audio-visual set of services.
HL: Can you do group therapy with a virtual system?
Lindow: Yes, we can and we do. One of my favorite things about group therapy in a telehealth setting is group therapy is typically designed around some kind of shared characteristic or experience. If somebody lives in a relatively rural area, or even in a city, what are the chances you're going to find eight people who can commit to 7 p.m. on Thursday, who live within half an hour? Whereas we're able to bring together people from Tallahassee to Tampa to the Florida Keys.
HL: To what degree are you a prescriber of medications?
Lindow: We have psychiatric providers as well as therapists. The majority, not all, but the majority of patients do receive both services.
HL: There's been a pulling back from the willingness to open the pocketbooks of payers during the pandemic. Is that an issue for you?
Lindow: It's so specialty dependent. There are some specialties where what happens in the office can never be replicated virtually. But there are dynamics with behavioral health that uniquely position our field for long-term telehealth delivery.
HL: What's your growth trajectory?
Lindow: In the very beginning of 2020, our world changed. And the fact that we had this model suddenly went from being relevant and interesting to critical. We were really fortunate that we happened to be ready and in a position where we could help. That caused dramatic growth for us. We grew by 20x in 2020. By the beginning of this year, we started to diversify to become a national virtual community mental health center, and now our patients are across the country, but the majority are in Florida, New York, and Texas.
“Our focus on Medicaid is pretty uncommon, and something we've seen as a huge opportunity, and need. It was always where we wanted to go.”
— Anna Lindow, co-founder and CEO of Brave Health.
Scott Mace is a contributing writer for HealthLeaders.
Virtual care saw a surge during the pandemic, as both healthcare providers and consumers saw the value in accessing care at home.
Some services still have to be done in-person, so mobile integrated health, or community paramedicine, also saw new interest, as healthcare organizations developed teams of mobile care providers that could visit a patient at home.
The collaboration between Brave Health and MedArrive enables the latter's mobile care teams to connect with the former's virtual care platform when a patient at home is in need of and requests mental healthcare services. Conversely, Brave Health can organize a home visit by a MedArrive team if it sees a need.