Foresight Mental Health is on a mission to deliver value-based care nationwide, but to start on that path it was forced to pivot from being a technology solution to an actual behavioral health provider.
Founded in 2018, Berkeley, California-based Foresight provides both in-person services and telehealth to residents in 25 states, with 21 locations making up its physical footprint. Foresight’s team of clinical providers currently numbers in the high hundreds, which the company expects to reach 1,000 in the next few months.
Foresight’s offerings include psychiatry, therapy, neuropsychology and nutritional therapy, in-office services such as transcranial magnetic stimulation (TMS) and drug therapies like ketamine for treatment-resistant depression.
Foresight’s service model is especially tech-driven – from the genetic profiles it creates of patients prior to receiving services to the use of wearables to gather data and track patient health. The company’s data-intensive focus also reflects its goal of delivering value-based care to patients, which is the direction health care has been moving more towards.
“It’s certainly where the industry is going,” Foresight Co-Founder Matt Milford told Behavioral Health Business. “Having the technology and the providers in-house makes Foresight well positioned for that transition.”
Like a number of tech-driven behavioral health companies, Foresight has managed to attract the outside attention of investors who last year supplied the company with a reported $25 million in Series B funding. Most recently, the company purchased Psychiatric Addictive Curative Therapies (PACT) Atlanta LLC, a Decatur, Georgia-based multidisciplinary mental health practice that operates 14 clinics in the Atlanta area.
Both Milford and Foresight Co-Founder Doug Hapeman – who function as the company’s co-CEOs – have ambitious growth plans to build one of the industry’s first truly tech-enabled outpatient mental health providers.
The birth of Foresight
The roots of Foresight go back to personal experiences that Milford and Hapeman – both of whom met while studying engineering at the University of California-Berkeley – had with mental health challenges.
While Hapeman was dealing with prescription access issues, Milford was studying in Paris on November 13, 2015 when coordinated terrorist attacks in the city killed 130 people.
In the aftermath of the attacks, Milford said that he witnessed a number of his study-abroad friends dealing with conditions like stress, depression, anxiety and PTSD.
“It was seeing them trying to find a provider, being placed on a waitlist and paying hundreds of dollars out of pocket because no one wants to take any insurance,” he said.
Drawing upon his own tech studies, Milford felt that even when friends were able to overcome issues of stigma to see a provider, the care they were receiving was insufficient.
“Even if they were able to get in, [it was] a low-tech, outdated experience, and a lot of people weren’t even tracking outcomes,” he said. “Seeing those challenges in the existing system was what really motivated me personally, and made me quite interested in solving some of the challenges in mental health care.”
Back in Berkeley, both Milford and Hapeman started thinking of how they could draw on technology to make the mental health care experience more seamless.
“We really started discussing some of the challenges that we had seen in that industry, particularly around the prescribing decision making process,” Hapeman told BHB.
By their estimates, the two would consult with around 100 psychiatrists to learn more about mental health care practices and would also work on a software program to track patient outcomes, which was the genesis of Foresight.
“We originally started Foresight as a software company and tried to solve some of those problems as an engineer would with software, but found a lot of challenges with distributing software,” Milford said.
Although the software failed to get a sufficient number of providers on board, the idea of tech-driven health care still struck a chord with the two. From there, the groundwork was laid for Foresight’s new direction through the help of entrepreneurship programs and incubators in and around Berkeley.
Foresight pivots to become a provider
From its early days and challenges of distributing software, Foresight would pivot to its current incarnation in late 2018 as a full-service, tech-driven mental health provider, with local college students serving as its initial customer base.
“We ended up taking the technology we were working on, bringing it in house and hiring our own psychiatrists and therapists in the Berkeley area,” Hapeman said.
Individuals seeking assistance from Foresight begin through a process where they are steered to services either by their own selection or from that of the company. Would-be patients then are guided through an intake process to gather more information, after which they are directed to an appropriate care specialist with a tailored care plan.
“That care plan could range from various things like lifestyle changes, diet and exercise,” Hapeman said. “It’s really a wide spectrum of tools that our providers have in their toolbox.”
During the care journey, patients are given wearable technology to measure their sleep and exercise patterns, which subsequently generates data that is used to adjust care as needed.
“While our members – as they progress – may not directly receive services from Foresight from time to time, we certainly still do want them engaged in that journey of self improvement,” Hapeman said.
The company employs GAD-7 and PHQ-9 assessments for anxiety and depression, respectively, using technology to track progress and manage care. Through its work, Foresight claims that it has been able to reduce the severity scores of both behavioral conditions by almost half.
The company said that it would make more data publicly available later this year demonstrating outcomes.
“Outcomes are incredibly important in mental health, and the industry has long been starved for quantitative progress,” Hapeman said.
Foresight’s growth plans
Telehealth has also been a big part of Foresight’s services, with the company having switched over to it fully during the pandemic. Nonetheless, Foresight plans to have a sizable physical presence going forward as it expands into new markets, which Milford estimates to represent 25% of its growth strategy.
“We’re quite nimble,” Milford said about Foresight’s physical operations. “Now, it’s a question of when do we go back. The most recent [Covid] variant delayed our plans, but we’re certainly excited to get back into the office to open up certain services that are harder to provide or impossible to provide through telehealth.”
Foresight’s recent purchase of PACT Atlanta is a window into the company’s future growth prospects. Although acquisitions are part of that strategy similar to companies like Lifestance Health, Foresight is focusing more of its energies by expanding physically through de novos.
“I think it’s great for the industry, generally,” Milford said about Lifestance. “Their model is different from ours in a number of ways. They’ve focused primarily on inorganic growth, whereas we focus more so on organic growth.”
Foresight’s growth plans will be driven by a mix of earnings and funding from potential future rounds — the company declined to disclose its total funding amount raised to date. As Foresight looks to expand into new markets, it also has plans to accept government-sponsored insurance such as Medicaid and Medicare — the latter of which it will begin accepting in the second quarter of 2022.
And as Foresight expands, the company is betting big on delivering quality outcomes as a core part of its strategy.
“We anticipate the majority of our services will be under value-based arrangements in the next few years based on current payer partnerships,” said the company in an email to BHB.