Across the health care ecosystem, hybrid models are integrating behavioral health more as part of the full continuum of care offered to patients. For San Clemente, California-based Crossover Health, hybrid care is not just a buzzy term but a core part of their overall services.
Founded in 2010, Crossover provides a full continuum of care to patients by connecting them with interdisciplinary teams made up of such workers as therapists, psychologists and coaches – with services delivered both in-person and online. Since its inception, Crossover has raked in $281.5 million in funding.
Patients are largely connected to Crossover through employer plans, with the provider operating 34 employee campus clinics nationwide and eight shared locations across California, New York and Texas. Along with in-person care, Crossover offers telehealth services in all 50 states.
“What the virtual team and our physical centers allow for is people to choose how they want to access service,” Michael Boroff, the mental health program manager for Crossover Health, told Behavioral Health Business. “We think that’s what people want and will continue to want moving forward.”
Individual plans for Crossover’s services range from $200 for 30 days of services to $1,500 for a full-year membership. Among the companies Crossover has partnerships with are Apple, Amazon, Microsoft, Comcast and CVS Health.
Crossover currently has around 430,000 eligible members, with 14% of all health care visits in 2021 coming for mental health. According to the company, Crossover has achieved a steady growth rate of around 30% since 2017.
As hybrid care models have become increasingly utilized in a total health care approach, Boroff noted that Crossover’s own behavioral health services have continued to increase since the time of its founding.
“With mental health, there’s so many solutions popping up these days trying to address a major need and concern,” Boroff said. “But mental health doesn’t occur in a vacuum. What happens with our physical health impacts our mental health and vice versa.”
It has been estimated that 55% of individuals during the onset of the pandemic went untreated for mental health concerns. That figure has been attributed to primary care providers not having the proper resources and tools to address behavioral health concerns.
“When the different care team members aren’t able to actively collaborate around care, it’s not a great care experience for the patient, and outcomes suffer,” Boroff said.
Boroff stated that since the pandemic, between 80-85% of its mental health visits have come via telehealth, with the number figuring to grow even more.
“One of the nice things about mental health is it transitions pretty seamlessly to virtual,” Boroff said. “I do have folks [that] just really want to be back in the room with other human beings. But I do think that virtual is going to continue to play a big role for mental health in particular.”
Going forward in 2022, the company is looking to grow its employer partnerships and coaching services, along with expanding its virtual offerings even further – which Boroff believes will be just important to Crossover’s overall care delivery as in-person services.
“The virtual team and our physical centers allow for people to kind of pick and choose how they want to access service,” he said. “That’s what people want and will continue to want moving forward. That hybrid approach will continue to be a core part of what we do.”
How Crossover integrates mental health
Over 5,000 patients last year received behavioral health services from Crossover Health, and the company expects to see more this year. As part of its total care team, Crossover employs around 90 therapists and between 30-35 coaches.
Those who are interested in starting a care journey with Crossover do so first by booking an appointment online, where patients can either self-refer for specific services or be given warm handoffs to various programs that Crossover operates.
“Your primary care doctors can develop relationships with a therapist [and say], ‘Hey, this therapist would actually be a great fit for you, let’s get you set up with them,” Boroff said.
Such connections, according to Boroff, also help to address issues surrounding the stigma that some may still have when it comes to them directly reaching out for behavioral health assistance.
“One of the challenges with siloed mental health solutions is they can only treat the people who come to them,” he explained. “When you lose integration, you lose the ability to work with people who are maybe a little bit more ambivalent and have some hesitancy around mental health services. In our system, our primary care doctors know how to talk to folks about what mental health services are like.”
After screening for conditions such as anxiety and depression, patients are directed to various workers who will make up part of their care team as they progress to therapy.
Boroff stated that the data generated from the screening process is effective in identifying the appropriate care personnel for patients to be connected with.
“For some people, a health coach is an easier entry point,” Boroff said. “For [others], an acupuncturist is an easier access point. We can have conversations with them and build that relationship.”
Crossover asserts that its whole services reduce total health care costs by 15%, with over 90% of its members reporting that they “love” the provider’s services. As a way to deliver on value-based care, Crossover has teamed up with digital solutions company Tridiuum to track outcomes of services rendered to patients.
To assess some outcomes, Crossover uses the Behavioral Health Index (BHI), which is a six-question tool that tracks a patient’s mental health. Through the use of the BHI, Crossover has determined that its patients have seen three times greater mental health improvement than they otherwise would have received in other care settings.
“We really want to be able to show that the investments … in mental health services yield outcomes, that people are getting better, and that they’re getting better efficiently,” he said.
Companies featured in this article:
