How In-Network Behavioral Health Coaching Could Help Address the Industry-Wide Therapist Shortage

Arguably one of the biggest takeaways from the pandemic is the importance of maintaining behavioral health in the face of major life challenges. Even as the world slowly returns to normal, the need for more options to treat a variety of behavioral issues remains.

Despite efforts and legislation over the years to establish parity between physical and behavioral health services, the cost of behavioral health care can still run high for people with insufficient insurance coverage or none at all.

As such, Ginger CEO Russ Glass worries that people are delaying getting help due to cost and access issues, allowing behavioral health conditions to get worse. The issue, he said, is compounded by the industry-wide supply-demand mismatch.


“There are just not enough providers out there,” Glass said. “Reducing friction to access care is an incredibly important part of [fixing] the problem. [But] what you see is people don’t start in their mental health journey today until they’re pretty acute.”

Glass made those comments during a recent webinar hosted by the on-demand, virtual behavioral health care provider.

He said that as behavioral health issues become more acute, they also become harder to treat, as patients struggle to find in-network therapists and grapple with the high costs of care. Glass believes preventative behavioral health coaching is the answer, allowing patients to address lower-level emotional issues before they morph into bigger ones.


“It really gets to the value equation of … making sure employees and audiences are able to access the right level of care, but not in a way that’s super expensive,” Glass told webinar attendees.

Cigna bets on behavioral coaching

In April, Ginger reached an agreement with Cigna to provide coaching services to the insurer’s behavioral health customers. Users can access Ginger’s self-guided content and skill-building activities 24/7, with coaches on hand to help throughout the entire care experience.

Cigna is the first health plan manager to offer Ginger’s services as an in-network benefit.

“Navigating the mental health world … can be really challenging and scary for people,” Douglas Nemecek, Cigna’s chief medical officer of behavioral health, said during the discussion. “That’s why it’s been exciting … to partner with Ginger … and to … bring them into our network to give people access to a coach.”

Glass added that, from a business perspective, it makes sense for companies and insurers to invest in coaching services. His view is in line with a report released earlier this year by Ginger, which showed that more employees want mental health assistance and feel that their workplaces could do a better job in helping provide access.

The report surveyed 150 CEOs and over 1,200 full-time US workers, with 86% of CEOs saying that they believe poor mental health among their employees adversely impacts workplace productivity. While almost every CEO surveyed said that their company was meeting employees’ mental health needs, 69% of workers said that their employers were not doing enough.

“What that means is … companies … not only have to put these solutions in place, but then they have to take the next step and make sure they’re communicating [to their workers],” Glass said during the discussion. “[They need to] make sure that executive teams are talking about the importance of mental health and self care. [They need to] make sure that the company is talking about these resources and how they want employees to use … these resources that are available to them.”

Glass and Nemecek also talked about misconceptions of behavioral health coaching, with one example being the belief that the service is not delivered by certified professionals and that it can’t meet users’ emotional needs.

In reality, Ginger strongly encourages coaches to have certification, which is offered by organizations like the International Coaching Federation (ICF) and the Center for Credentialing & Education, in addition to a number of colleges and universities across the country.

The health care coaching market is also growing, with current estimates putting its worth at $7 billion with 128,000 workers, according to financial data site Research and Markets.

“The certified coaches really add a service,” Nemecek said. “They are high quality when they’re providing that coaching, and we’re really proud to … have expanded our network to allow these coaches, [who are] now available.”

Another commonly held misconception Nemecek and Glass discussed was the notion that insurers do not pay for coaching services.

Individuals might have to pay out-of-pocket in certain instances, as some insurance plans do not provide coaching as a covered benefit. However, with the Cigna arrangement, Ginger’s coaches are reimbursed for services in the same way as therapists and psychiatrists who are in-network.

“We’ve been able to debunk that myth and demonstrate that we … have the ability to … reimburse and pay for coaching in the same way we pay for other health services,” added Nemecek.

Glass feels that with more insurers covering coaching services, it not only benefits those with lower-level needs, but it also indirectly benefits others who are in real need of higher level services like therapy.

“[We] … would massively transform our ability to deliver care at the scale needed in this country and globally, if people realize that … therapy today not only is incredibly hard to find and access, but it’s most often not necessary,” Glass said during the discussion. “[R]eserving those resources for the people who actually need them [and] who need that next level of care is something that, … as a country, we need to do better.”

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