During this year’s HLTH conference, Demi Radeva, one of Digital Health Today’s global ambassadors, had a one-on-one with Katie DiPerna Cook, Senior Vice President of Partnerships at Headspace Health.
Headspace is a technology-enabled behavioral health provider.
Katie shares her perspectives and experiences for securing reimbursement and investment in what are often labeled “squishy“ innovations. These include innovations in spaces such as behavioral, wellness, health equity, and social determinants of health.
Read on for practical workarounds, tips and tricks.
Q1: Discuss the power of digital health technology reimbursement. How has it helped or hindered your progress?
Katie: Reimbursement is a huge accelerator. It is a really significant way to give affordable access to care for millions of people. However, it is all based on providing measurable outcomes.
Payers want proof of patient satisfaction, clinical outcomes, and lower total cost of care. However, mental health isn’t like physical health, metrics fluctuate. The healing process isn’t a straight line. However, one
metric that we have started to track is % of members that feel like access to this type of care added value to their overall health plan experience and that has been extremely helpful in proving our value in conversations with payers.
Q2: What strategies, tools, and mental models have helped your company secure reimbursement?
Katie: We can’t sit outside the healthcare ecosystem, we need to sit inside it. One powerful example is our partnership with Cigna. They are reimbursing us via CPT code for coaching and therapy. There is real validation of the power of being an in-network covered member benefit.
The Power of Digital Health Technology Reimbursement Coaching, therapy, and Headspace aren’t just floating, point solutions, but are part of a reimbursable model and platform, which is much more powerful than just trying to get reimbursement for all these individual services.
We shouldn’t be creating more fragmentation in the health system by providing point solutions. Ultimately, this line of thinking led to the Ginger and Headspace merger. Now, we can offer the full spectrum of care. As a patient, whether you need self-directed resilience training, or coaching and clinical services, it doesn’t matter, we provide one destination. This makes it easier for the patient but it also makes it a lot easier for a health plan or employer to pay for the solution.
By integrating Headspace Health, members will get support no matter where they are in their journey and they will get support at the right level of need. Members don’t need to be in therapy forever. Going back to the earlier point of mental health not being linear, it is really powerful to have a platform that allows members to step up or step down their level of treatment.
Q3: What has hindered your ability to gain reimbursement?
Katie: A big lesson learned is the continued need to generate clinical validation of both self-directed content and coaching. We are going to have a lot more evidence-base studies and research published over the coming year helping us to showcase the impact we are having through our connected experience. This will help us further the ability to reimburse for these alternative modalities of therapy.
Q4: What can payers do differently?
Katie: Continuing to hold organizations accountable to measurement-based care. Also, providing whole person care solutions – including mental and physical health. And last, ensuring that point solutions aren’t
creating further fragmentation in the system, rather providing access to platform that can provide care throughout a member’s health journey. For example, in our partnership with Cigna, we are a part of their
ecosystem as a mental health partner. They are working on managing member’s chronic conditions better and know they can refer to us and we know we can refer back to them if a member needs something
The Power of Digital Health Technology Reimbursement different. What that means is that members get an integrated experience across their whole spectrum of needs including behavioral ones.
Lightning Round
- What is a saying, quote or phrase that motivates you?
Instead of saying, quote or phrase, it is a song – “I Hope You Dance” by Lee Ann Womack - What advice do you have for others working to innovate and healthcare?
Seek out advice and mentors. Listen to the people who have done this before. - What book do you recommend to our listeners?
Forever Ours: Real Stories of Immortality and Living from a Forensic
Pathologist by Janis Amatuzio, MD - What is a technology that makes your life better and easier and keeps you healthy?
Smartphone – it makes everything easier, especially for parents. - What is a space in healthcare that isn’t getting much attention, but should?
Multi-disciplinary modalities of care around coaching can create accessibility to behavioral health but also, at an affordable cost. There is huge supply and demand imbalance in behavioral health. A lot of people need someone to talk to, however, it’s not possible to have therapist available 24/7, however, a coach can help with those in the moment needs. And a lot of people get better at the coaching level and don’t ever need a therapist.
