Payers are Covering Digital Behavioral Health Solutions and Payer Venture Funds See the Value in this Approach
Payers have quickly learned that increasing coverage for digitalized solutions is vital to protecting patients struggling with moderate to severe – but arguably treatable – behavioral health conditions. Digitalized solutions provide patients with greater flexibility of care options, removing barriers to entry for patients and better aligning with the push for a value-based care system throughout the U.S. ²
Simultaneously, actively reimbursing for high-quality care insulates payers from the potential added costs that come with health deterioration when chronic disease management at actionable points is ignored. ³
Moreover, throughout the last two years, payer venture activity validates payers’ beliefs that digital solutions are key to addressing the needs of their most expensive patients. Although 50% of all U.S. healthcare spend comes from the sickest 5% of the population, at least 1/3 of those patients have conditions that can – with proper treatment – be improved or at least kept under control. ⁴
Solutions funded by payer venture funds are directly addressing these types of patients, actively providing modernized care options with high-patient level contribution margins to the patients from which payers can optimize their cost-savings potential.