Cambia Health Solutions is partnering with New York City startup Quartet to better integrate behavioral health care and primary care for regional health plan members.
The Portland, Oregon-based health plan will first launch Quartet's technology and services to regional health plan members in Washington state and later expand to Oregon, Idaho and Utah. More than 2.6 million people in the Pacific Northwest are enrolled in Cambia's regional health plans.
The payer also is investing in Quartet through Echo Health Ventures, Cambia's joint venture capital arm that combined with Blue Cross of North Carolina's Mosaic Health Solutions.
Echo Health Ventures and Deerfield Capital Management contributed $7.5 million in funding. That financing combines with a $60 million investment led by Centene Corporation earlier this year to close out Quartet's series D funding round.
The company, founded in 2014, has raised a total of $160.5 million to date from investors including Oak HC/FT, GV (formerly Google Ventures), F-Prime Capital Partners and Polaris Partners.
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The company has developed a central technology platform that enables physicians, mental health providers and payers to coordinate care and drive down health costs. The company currently operates in seven states—Pennsylvania, Washington, California, New Jersey, North Carolina, Louisiana and Illinois.
David Wennberg, M.D., CEO of Quartet, said the company will use the capital investment to build its team with a focus on continuing to innovate in the mental health space and scale the business. Quartet also will be looking at potential acquisitions to add capabilities to its platform, he said.
Addressing mental health care
Wennberg said Quartet's mission of improving the lives of patients with mental health conditions is deeply personal to him. His daughter had challenges with her treatment for mental health conditions, and, as a physician, he was able to intercede on her behalf.
"Most patients who are stuck don’t have access to a physician parent who can intercede on their behalf. I want something more equitable," he said.
Cambia Health Solutions shares Quartet's view that "mental health is health," Wennberg said, and the partnership will help expand Quartet's reach.
A recent report from consulting firm Milliman found growing disparities in provider payments and network adequacy between physical and mental health despite a federal law demanding parity. The out-of-network utilization rates of behavioral health providers were higher than medical and surgical providers from 2013 through 2017, according to that report.
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"There are certain health plans, and Cambia is among the elite, that recognize how the barriers to getting access to good care, including mental health care, is not only challenging for the members, it’s also not a long-term vision of what a health insurer can do to create value for their members and customers," Wennberg said.
He added, "Cambia recognizes that mental health care has been under-invested in and it is a critical aspect for whole-person healthcare. From that standpoint, this is a powerful partnership."
Cheryl Pegus, Cambia's chief medical officer and president of consumer health solutions, said Quartet's integrated approach to mental health care and primary care was an attractive feature of its platform. "We're going with a proven partner with demonstrated results and a company that recognizes the importance of that relationship between patients and their primary care physicians," she said.
The collaborative approach also helps break down the traditional silos between primary care and mental health care and decrease the stigma associated with behavioral health issues, Pegus said.
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Nearly 1 in 4 Americans experiences a mental health condition, yet more than half don’t get the treatment or support they need. Research (PDF) shows connecting primary and mental health care improves patients’ overall health and reduces the total cost of healthcare.
Quartet’s network of mental health providers offers in-person care as well as telehealth and online options. Patients are increasingly willing to try telepsychiatry, and there is a growing number of people interested in computer-based cognitive behavioral therapy, Wennberg said. "And there are a lot of people still interested in face-to-face care. It's about matching patients to their needs and preferences," he said.
To do this, Quartet uses artificial intelligence and machine learning algorithms to connect patients to the right mental health provider and channel of care based on the patients' needs, preferences and insurance coverage.
"We were looking for a partner who could meet the needs of our members in our communities, whether they live in rural areas or within cities, who have demanding work lives, and a telehealth solution is a key component for us for how we move forward," Pegus said. "We want healthcare wherever are members are and a solution that can do that is important to us."