Phoenix-based Connections Health Solutions recently scored $30 million in its first-ever round of growth funding, which came from the private equity firm The Heritage Group. While the crisis stabilization company has been around for more than a decade, it’s growth story is just getting started, in large part thanks to that new funding.
Founded in 2009 by Chris Carson and Robert Williamson — who previously worked as psychiatrists in Texas — Connections provides crisis stabilization and outpatient behavioral health services to patients with mental health conditions and substance use disorders (SUDs). It has two Arizona locations — one in Phoenix and the other in Tucson — and it bills those behavioral health facilities among the largest in the nation.
Connections serves over 35,000 people per year, with 65% of patients safely returning to their homes after less than 24 hours of care with the help of its “Crisis Now” model. Meanwhile, people who need more intensive care are transferred to Connections’ subacute inpatient program for 3 to 4 days.
Connections also provides crisis consulting services to a number of counties, health departments and state Medicaid agencies nationwide. Additionally, the company partners with hospitals, health plans, law enforcement and housing agencies to provide holistic patient care.
With the new growth funding in tow, next up on Connections’ to-do list is expanding its model nationwide with the addition of new centers, according to Connections’ CEO Colin LeClair. LeClair recently shared those plans with Behavioral Health Business, along with his value-based care goals and the markets where Connections is looking to plant its flag next.
You can read the conversation below, which has been edited for length and clarity.
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BHB: Can you give some background on Connections’ origin story?
LeClair: Chris Carson and Robert Williamson invented the first version of [the Crisis Now model]. Back then they were both practicing psych ED doctors. Their hospital was asking them to find a better solution for patients that were flooding the EDs — because EDs are not that well designed for mental illnesses. They’re great if you are dehydrated, or you get a broken bone or a heart attack. But mental illness is not on the menu.
What the hospitals were doing — and what they continue to do across the country to this day — is they ward them. They have nowhere to put them, they can’t safely release them and have no real place to send them on an emergency basis. That is partly from a medical liability standpoint, but also because of a lack of a better alternative. So they’ll ward them in the hospital for days and weeks and months until an inpatient psych bed opens up.
And so [Carson and Williamson] said, “Look, why don’t we build a separate triage unit for patients who, when they come to the ED, you can direct them our way and we’ll treat them aggressively?” They believed — and this has been proven out over the years — that the vast majority of patients who are finding their way to a psych bed didn’t need to be there. It was just the only alternative.
Back then the hypothesis was that between 70% of the patients could actually have been managed in a short term … observation unit, and then released with good care coordination. So that’s what they built [at their hospital] … and it worked.
So they brought that model from Texas to Arizona?
Arizona is … version 2.0 [of the Texas model]. The difference in Arizona was … a funding mechanism.
It simplified the world [for us.] We can now say yes to every single patient that comes through the door. That allows you to build a business at scale, [and] it allows you to stand in front of a growing population. It [also] allows you to do other interesting things to keep patients out of that [ED] setting.
Connections recently received growth funding to help facilitate national expansion plans. Can you talk more about what those plans will look like?
It’s the first growth funding we’ve ever done. The company has been looking for ways to expand to new markets for a long time, but we lacked the capital. We built a consulting business years ago to help municipalities and states to design the architecture of their crisis systems, including [facilities] like ours, but we’ve never done it with the intent of becoming the operator. It was purely to help other markets develop a similar system like in Arizona.
What we learned over the course of that time was the demand for these services is growing rapidly. And so we switched gears about two years ago and said, “Look, we’ll continue to work on a pro bono basis as needed to help with design [and] the architecture [of their systems].
What we’re good at is operating. We have set the bandwidth for crisis facility operations for a decade. This is our strength … and what we committed to doing was attracting growth capital that would allow us to replicate our model in markets across the country. It’s going to create a seismic change for us for sure.
In the announcement of the growth funding, you talked about how Connections is looking to be a leader and innovator in value-based care, as opposed to the traditional fee-for-service payment model that has been more common in health care. Can you talk about that?
The value based model is much more intensive, much more enveloping [than the fee-for-service model]. You really are helping the patient, you’re following them in between visits. You’re coming out to see them in their home, you’re delivering meds [and] you’re doing whatever it takes to keep them out of ambulatory care and out of the hospital. The value based-movement has been a major catalyst for [us].
Does Connections have any short-term objectives with the growth funding?
We want to take the model outside of Arizona … [and] demonstrate value-based payment models in behavioral heal health. I would argue we’ve already made that point … in Arizona, which is very urban and very rural. But I want to see us do this in another state .. and demonstrate that this is applicable and transferable to other urban and rural settings.
Are there particular markets that Connections is looking to break into?
We’re planning expansion in Florida, California, Idaho, Utah, Ohio and Illinois. We expect to break ground in at least three of those [states soon]. We’re forging ahead trying to figure out the path of least resistance in all of these other markets and try to be in as many communities as possible, starting with major metropolitan areas, then to the more rural areas. We want to demonstrate this model can work in both a rural setting and a community hospital.
Any other long-term objectives the company has now that it has growth funding?
We’ll be able to move faster in offering patients an extended litany of services. I’d like to get in every major market. I think seeing is believing, and what we know in Arizona is when people come in and look at our model and the data, they go home believers.
I don’t think we’re going to enter every corner of the country until we’re demonstrating [that]: “Yes, it can work here, it can work in the Northeast, it can work in New York, which is dominated by hospitals, and it can work in extremely rural Montana, [which] is mostly tribal land.” I think we have to demonstrate that over the next few years to get true believers, and then we’ll have an influx of support resources, Medicare plans and commercial plans buy in.
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