Thriveworks CEO: Hybrid Care Model Key to Luring Clinical Talent, Boosting Patient Experience

Chatbots will have no place at Thriveworks, but digital tools will be a key part of the company’s future documentation and patient-reported outcomes tracking.

Thriveworks’s new CEO, Will Furness, has two goals for his tenure: to make Thriveworks the place a mental health clinician wants to spend their whole career and focus the company on patient-reported outcomes. To accomplish both these objectives and to overcome major industry challenges, the company is pouring money into its technology tools to create seamless experiences in both virtual and in-person care for clinicians and patients alike.

“We are building our own technology. Largely, it’s to make the therapist’s ‘everyday’ better and to make the client experience better,” Furness told Behavioral Health Business.

Furness became CEO in April, succeeding founder and CEO Anthony “A.J.” Centore, who started the company in 2008. Furness came to the role after spending the previous three months as company president and the six months before that as chief operating officer.

Thriveworks was founded by mental health clinicians. Now at the helm, Furness seeks to continue this provider-focused mission

This manifests in the technology investments through a focus on ease of use and convenience for clinicians and patients, Furness said.

Thriveworks is in the process of rolling out a digital booking and intake management platform, and other custom tools for therapists, including schedule management and tools for paperwork, Furness said.

“The actual care delivery, in my view, is the best when it’s human-to-human care; it’s not a bot or a chat,” Furness said.

The company’s internal investments and other operations are backed by $340.2 million in equity funding raised in 2021.

Thriveworks announced in July 2021 that Boston-based private equity firm Wellington Management Co. LLP led a funding round that included Fidelity Management & Research Company LLC, RA Capital Management, Redmile Group and Transformation Capital. New York City-based Regal Healthcare Capital Partners remains Thriveworks’ largest shareholder after the round.

Furness said the company raised additional capital in 2022 from existing investors but said the 2022 funding was “nothing we’re going to disclose.”

Experiences with the hybrid model

Making the Thriveworks experience as effortless and smooth as possible is winning in several challenging aspects of the behavioral health industry.

Furness said this is especially operating in a hybrid model — where care is provided in both telehealth and in-person settings.

Many behavioral health providers, Thriveworks included, made huge swings to telehealth following the onset of the pandemic and resultant mitigation efforts. At one point, 100% of Thriveworks appointments were completed via telehealth.

The industry and Thriveworks are recalibrating to support patient demand.

Before the pandemic, about 3% of Thriveworks’ sessions were conducted via telehealth. Today, that rate is 80%.

The rate of telehealth use shrinks by about 2 percentage points each month, Furness said. He expects the company eventually to get back to 60% to 70% in-person visits. It’s not clear when that will happen.

“Probably unusual compared to a lot of providers, particularly new entrants in behavioral health care, our clients tend to shift back and forth between in-person and telehealth,” Furness said. “So they might start off feeling telehealth, and then decide they have something very sensitive and they want to get out of the house and they’d rather be in person.”

This is also true with parents of young patients, ages 7 and under, Furness said. He said that it’s likely the company would see far fewer bookings if Thriveworks couldn’t accommodate in-patient sessions.

Even with the high rate of telehealth utilization, Thriveworks is growing its real estate footprint to accommodate new business to meet patient demand. Furness pointed to a Blue Cross Blue Shield of Massachusetts Foundation survey that finds most patients (78%) received behavioral health services in-person in the year before taking the survey.

The survey also found that 68% of respondents received care through an audio-only telehealth visit; 68% reported using an audio-video visit; 41% received care through email, text or chat functions.

Telehealth makes the company more efficient in terms of real estate needs. A local Thriveworks clinic that only conducted in-person visits would house between six and 10 providers. But with the present telehealth usage rate, Thriveworks is able to associate about 15 clinicians to an office.

The battle for talent

Making the lives of clinicians as easy as possible is also a retention and recruitment strategy, Furness said.

Presently, the company employs about 3,000 workers, with about 75% (about 2,250) being clinicians. And all clinicians on staff are W-2 employees, Furness said.

Furness doesn’t take a gloomy view of the behavioral health workforce market. Rather, he said he’s excited about the story that Thriveworks can tell to clinicians looking for another job.

On top of the for-clinicians, by-clinicians culture, the company can proudly point to where it’s making investments with confidence, Furness said.

“When we can get clinicians on the phone and tell them about who we are, why we started, how it’s run, what our ethics are, and say, ‘By the way, a big thing we’re investing in is not chats and bots. We’re investing in technology to make your everyday experience better so that all you’re worried about is practicing and helping your patients, we can have great conversations,’” Furness said.

A survey by the National Council on Mental Wellbeing found that clinicians frequently pointed to reducing paperwork requirements as a way to help meet the increased demand for behavioral health that came because of the pandemic. The same survey found that nearly all (98%) respondents found it difficult to hire staff.

In parallel to investing in in-house tech tools, Furness also said the company invests in additional clinician training.

An example specific to technology, Thriveworks offers clinicians a certification in telehealth that includes training on best practices such as how to see a client in a virtual setting, using digital tools, being HIPAA compliant and ensuring their home clinic is appropriately set up.

Other clinician supports include ongoing mentorship, professional development, benefits, continuing education, training on the latest practices

“What we’re really doubling down on is … building that set of tools for them that [makes] life just feel way easier to practice and help patients here because [they’re] not dealing with as much of the administrative burden,” Furness said. “The core of why we keep people is all of the wraparound coaching, training and education for therapists — they feel like they can grow here.”

On value-based care

The company is also investing in technology to help track patient-reported outcomes.

While this is key Thriveworks potentially entering more complicated value-based care reimbursement deals with payers, outcomes tracking is a vital extension of the clinician-minded ethos of the company.

“I want to have such a rigorous approach to collecting the client’s experience … that any new customer coming in knows upfront this is the best place to get care,” Furness said.

Last year, Thriveworks started tracking patient-reported outcome measures including the validated questionnaires GAD-7 and PHQ-9, measures of depression and anxiety, respectively. The company started doing so as part of its obligations to some of its payer partners, Furness said.

Thriveworks also measures customer satisfaction data.

“We are looking at several sorts of more complex value-based care agreements, including looking at the whole person’s cost of care,” Furness said. “It is still early for us but we’re moving quickly.”

Presently the company doesn’t have any value-based care arrangements of any sort but will have some in place by the end of the year, Furness said.

“I think [value-based care] is really is an important step in any area of health care in the U.S., to try to reorient how our dollars are getting spent and asking is it really helping patients,” Furness said.

Adding B2B to its D2C

Thriveworks has its eyes on developing a B2B business that seeks to serve self-insured employers and municipalities, to help expedite access to mental health services.

“Making sure that that employee has access to care and sooner — that sort of quick-access, white-glove experience — is good for that whole person, but it’s also good for the company’s future whether it’s work productivity, absenteeism, total cost of care,” Furness said.

The company has been partnering directly with employers for about a year. Thriveworks recently signed a contract with the City of Joliet, Illinois. The city, Thriveworks and the local Silver Cross Hospital announced a partnership to increase resident access to mental health services. Area publication Herald-News reported in May that Joliet officials are considering making $400,000 of city money available to make care available for uninsured and under-insured city residents.

“We’re such a large therapy company now that we noticed we were routinely helping large amounts of patients from one company,” Furness said. “We can have a more thoughtful partnership than just waiting for the patient to bounce around from a bunch of therapists [where] they don’t have access and then end up with us.”