Payer Partnerships, Provider Support Key to Bloom Health Expansion Strategy

It’s important to have the right tools in place before entering a merger in the outpatient mental health space. Bloom Health CEO Lorraine Riche said the process is akin to putting on an oxygen mask before helping someone else with theirs.

That partly illustrates the strategic thinking and years of preparation that Riche, the president of Towson, Maryland-based provider, said went into the creation of her company.

In March, Psych Associates of Maryland — where Riche was previously the president — acquired Arlington, Virginia-based Comprehensive Behavioral Health to create Bloom Health Centers. The company claims this merger created the largest in-network mental health provider in the Northern Virginia/Washington D.C. area. The terms of the deal were not disclosed.


Dr. Nithin Krishna began in 2018 building the foundation and tools that Psych Associates of Maryland needed for strong growth when he acquired the company. He oversaw the development of the company’s own proprietary software, led organic growth and brought on a major investor.

The Chicago-based private equity firm New Harbor Capital Management LLC made its investment in Psych Associates of Maryland in July 2021.

Driven by a mission to improve access to mental health services, Riche and her fellows at Psych Associates of Maryland realized that the company needed to do two important things to make care accessible — have the tools and savvy to operate in-network with payers and to make the clinician and patient experiences as painless as possible with technology.


“Health care is probably one of the most complicated businesses,” Riche said. “Creating access to care means navigating the complexity of working in a third-party payer system and creating an environment where you can take care of providers so they can take care of other people.”

Bloom Health Centers is constantly reiterating its proprietary system, Riche said. The company recently created a position of a user experience/user interface (UX/UI) position at the company. The system encapsulates Bloom’s electronic medical record, practice management and clinical systems.

Once the company was in a position to grow — with its internal systems in place and backing from an investor — the thinking switched to the best mode of growth, Riche said.

“You can either go faster alone … or you can go further together,” Riche said of the thinking around organic versus inorganic growth. “You either build more access or you have an opportunity to partner. That’s what happened here.”

In sum, Bloom Health Centers operates nine centers — four in Virginia and five in Maryland — and employs about 160 employees. That group includes about 80 clinicians.

Bloom Health Centers will remain focused on the Mid-Atlantic region to build on its “nucleus of resources and relationships.” De novo growth is definitely in the plan for Bloom while M&A activity is a lower priority, Riche said.

Even outside of de novos and M&A, Riche said Bloom Health Centers is moving its Annapolis, Gaithersburg and Baltimore clinics to larger locations to facilitate organic growth.

The company has facilitated a large share — about 90% — of its visits via telehealth. But that share of telehealth services is shifting. Riche said intake visits and early sessions are better facilitated in person.

“We’ll always be multimodal meaning telehealth and in person,” Riche said, adding that the company will likely get to between 60% and 70% of telehealth visits in the next two or three years.

Riche said the company’s telehealth strategy is focused on patients who want and are able to use telehealth. Bloom Health Center does not want telehealth to become a barrier to care for patients who have social determinants of health challenges. These include financial insecurity or geographic issues that may limit access to reliable devices or internet service.

Other growing outpatient mental health providers have also seen large shares of visits facilitated through telehealth.

Thriveworks, a 3,000-employee strong, outpatient mental health provider sees about 80% of its patient visits coming via telehealth. Lifestance Health Group Inc. (Nasdaq: LFST), the largest outpatient mental health provider in the U.S., conducts about 79% of its visit via telehealth. Telehealth makes up between 80% and 90% of Sacramento-based Mindpath Health’s visits.

With the heightened levels of telehealth and a focus on its internal technology, Bloom Health Centers is also in the early days of establishing value-based care practices such as collecting patient-reported from standardized assessments. These will also include patient satisfaction from Net Promoter scores and clinical assessments such as the GAD-7 or PHQ-9

“We’re building our tech now so that we can ask those questions in the future,” Riche said. “We’re a little way off, but we’re thinking about it and trying to get better.”