After a rocky 2023, mental health providers are considering new approaches to growth and sustainability.
In the wake of the bursting venture funding bubble and cooling M&A market, providers are taking stock of their assets and looking for new revenue generation.
Some providers have opted for new partnership opportunities with public entities, such as state governments, schools and city programs. These deals help public entities address the mental health crisis in their communities while allowing providers to reach new populations.
Other operators are looking to pull back from their previous rapid growth strategies and better integrate assets. This is especially true of providers that made acquisitions over the last few years.
While many providers are looking for their next step to mature, there is still room for newcomers to enter the market with fresh ideas and perspectives.
Read on for the five mental health companies Behavioral Health Business will be watching in 2024.
Partnerships a golden opportunity: Brightline
Virtual pediatric behavioral health provider Brightline has had quite the start to 2024. In January, it announced that it had inked a deal with the state of California to provide behavioral health services to all residents aged 12 and under, which includes roughly 6.3 million children.
The partnership was part of a larger deal worth $680 million split between Brightline and virtual behavioral health provider Kooth, which provided services for people aged 13 to 25.
While this deal was a massive boost to Brightline, the company had a rocky 2023. In May, it cut 20% of its workforce — its second round of layoffs since the start of 2022. At the time of the reductions, the company said the layoffs were targeted at corporate roles to accommodate more clinical and patient-facing positions.
Like many of its digital health peers, Brightline saw a funding boost during 2021 and 2022. The company has raised a total of about $212 million.
Despite the post-COVID-19 funding boost, many digital behavioral health companies have faced some struggles in the wake of an investment cool-down and the post-pandemic return to in-person services.
However, partnerships, especially large public-private partnerships like the one Brightline signed with the state of California, could be a path forward for digital providers to generate substantial revenue and tap into new populations.
Brightline isn’t the only company using this strategy; digital mental health provider Talkspace recently signed a deal with New York City, providing its services to every resident between the ages of 13 and 17.
“If you look at why [these deals] are important to the Talkspaces of the world, it is because they are walking into a turnkey immediate population of patients and customers,” Richard Lungen, a general partner at HC9, previously told BHB. “It’s a very creative way to leverage their assets and collaborate. But it’s still another form of revenue creation.”
Child and youth-focused providers, in particular, may be especially sought after by public entities struggling to keep up with the demands presented by the pediatric mental health crisis facing the nation.
It’s a very creative way to leverage their assets and collaborate. But it’s still another form of revenue creation.
– Richard Lungen, general partner, HC9
BHB will be watching Brightline to see if this partnership strategy helps set it apart from other digital providers that have had stumbles in the last few years. The company could demonstrate a way forward for digital providers to follow if successful.
Mindpath Health: The integration game
Private equity-backed mental health provider Mindpath Health underwent a significant leadership change in 2023.
In June, former CEO Chris Brengard announced that he would transition to board chairman after two years in the CEO role. The company tapped Stephen Farber to replace Brengard as CEO. Before joining Mindpath Health, Farber served as CFO of Kindred Health and Tenet Healthcare.
Mindpath Health was formed in 2021 with the merger of outpatient mental health providers Mindpath Care Centers and Community Psychiatry. The Leonard Green & Partners-backed provider operates in seven states and boasts over 100 locations. It offers therapy, medication management, family and marriage counseling, psychiatric evaluations and other outpatient behavioral health services.
The leadership change came after some turbulence for the company. In February of 2023, Mindpath announced that it would close its offices in Ohio and lay off an undisclosed number of employees. At the time of the announcement, a spokesperson cited “organizational restructuring” as the reason for the downsizing.
I really like for growth to be methodical, balanced and paced along with the evolution of the overall platform and the integration of all the different elements that we already have.
– Stephen Farber, CEO, Mindpath Health
The leadership shakeup also represents a transition in Mindpath Health’s strategy. In a previous interview with BHB, Farber stressed that the company’s new focus will be bringing various parts of the organization together to create a more coordinated company. This comes after Mindpath Health acquired several smaller providers over the last few years, including Vertava Health and Psychiatric Centers at San Diego.
Farber also noted that the company will be focusing on its current markets, especially Arizona, Florida and Texas, instead of continuing to rapidly expand. This is a departure from its previous acquisition strategy.
“I think we have a lot of opportunities where we currently are,” Farber previously said. “I really like for growth to be methodical, balanced and paced along with the evolution of the overall platform and the integration of all the different elements that we already have.”
Mindpath Health’s new strategy of operational efficiency and integration of its current systems, as opposed to rapid expansion, is a tactic other platform companies will likely leverage.
We are monitoring Mindpath Health closely to see if its strategic goal of operational efficiency across its acquired companies is successful. If Mindpath Health’s consolidation and integration efforts pay off, it may provide a model for other companies that have pursued rapid expansion through acquisitions and are now working to optimize their combined operations for the future.
Lightfully: Giving it the college try
In 2022, outpatient mental health provider Lightfully put forth an ambitious five-year growth strategy to open 30 outpatient mental health facilities in California, Colorado and Washington. At the time, the company’s CEO, Jennifer Steiner, told BHB, “We are seeking to basically be the DaVita of mental health.”
The New York-based provider got a $30 million investment boost from private equity firm Regal Healthcare Capital Partners in the summer of 2021.
Now, two years after Lightfully announced its expansion plans, it has 12 behavioral health facilities and an additional one listed as coming soon.
From the get-go, Lightfully prioritized in-person locations over digital — though it does have a digital option. This could be an advantage over other digital-first providers that launched around the same time as Lightfully and don’t have brick-and-mortar locations to send patients to.
Still, Lightfully has recently expanded its virtual reach through a new virtual intensive outpatient program (IOP) targeted at college students. This could be a savvy way to help struggling universities address the mass influx of students living with behavioral health conditions.
While most digital providers teaming up with colleges focus on the lower acuity side of behavioral health care, Lightfully’s offering is geared towards students with higher needs who can access care while staying in school.
BHB is watching Lightfully for two reasons. First, the company is nearly halfway to its expansion goals. BHB is interested in whether the company’s brick-and-mortar strategy will pay off and be an example to other newcomers in the space. Secondly, the company’s efforts in the university space could create a new avenue for college students to access higher acuity behavioral health services while still in school.
Changes for Refresh
Refresh Mental Health has been relatively quiet since it was acquired by UnitedHealth Group’s Optum in 2022 for nearly $1 billion.
Founded in 2017, the behavioral health provider has over 300 locations in 37 states. Its services include mental health and substance abuse treatment, residential, partial hospitalization, intensive outpatient and in-home care. It also offers psychiatry, medication management and medication-assisted treatment (MAT).
While the provider has flown under the radar over the past year, there are some changes.
At the beginning of 2024, the company confirmed that it was closing its four eating disorder service lines. This closure impacts at least 16 locations. A representative of Optum cited “local market conditions” for the shutdowns.
Refresh isn’t alone when it comes to closing eating disorder facilities. Large behavioral health providers Odyssey and Discovery Behavioral Health also recently scaled back their eating disorder locations.
But the scalebacks in eating disorder treatment aren’t the only changes for Refresh. It also appears Steven Gold, Refresh’s founder and former CEO, left the organization, according to his LinkedIn. Gold served as CEO of Refresh from 2017 until April of 2023. He then moved on to chief business development officer at Optum Behavioral Health Solutions until September of 2023.
Gold isn’t the only Optum executive departing its behavioral health division. Last year, former CEO of Optum Health’s Behavioral Health Solutions, Trip Hofer, announced his departure. Hofer left to serve as a partner at VC firm .406 Ventures and CEO of data integration platform Redox.
BHB is watching Refresh in 2024 to see how these leadership changes impact the industry. Additionally, BHB will be monitoring which parts of behavioral health the company plans to focus on and where it will move away from. Refresh is one of the largest operators in the space, and it could set the tone for the entire industry.
The organization’s close links to Optum and UnitedHealth could help it be a pioneer for value-based care and primary care integrations that require strong payer-provider partnerships.
New kid on the block
Guidelight, a newly launched mental health provider, offers intermediate levels of behavioral health care, including partial hospitalization programs (PHPs) and IOPs. These levels of support have garnered the attention of patients and payers. These types of programs can be used as a step up for outpatient services and a step down from inpatient care.
Patients in need of more acute care often opt for this level of care because it allows them to access services while working and living with their families. Payers are eyeing this type of care because it costs much less than inpatient care.
Guidelight offers hybrid care with an emphasis on in-person sessions. The program consists of individual and group therapy, as well as medication management. Patients are grouped with other participants based on experiences, age and other affinities.
Investor giants GV, formerly Google Ventures, and Triple Aim have bet on the company investing at least $16.35 million in the startup. It bodes well for the newcomer that these investment firms have a long history of behavioral health involvement. For example, GV has previously invested in Headway, Brightline and Quartet.
The leadership team at Guidelight is also made up of behavioral health veterans from Headway and Optum.
BHB is watching Guidelight because of its focus on the intermediate level of care. While many providers offer PHPs and IOPs, Guidelight is looking to entirely focus on this space.
Others to watch
While BHB will be closely watching those companies mentioned above to see what they do in 2024, plenty of others in the space are sure to make moves.
For example, outpatient behavioral health provider Nystrom & Associate had significant leadership changes last year. In January 2023, the company named Mark Peterson its new CEO. Then, in April, Brian Nystrom, former CEO and chief clinical officer, and Peter Nystrom, former chief commercial officer, announced their departure from the company. This could lead to a new direction for the company.
We’ll also be watching to see if outpatient mental health provider LifeStance’s (NASDAQ: LFST) bet to scale back on in-person locations pays off. Last year the company announced it would close 70 centers and revealed that it conducts roughly 73% of its visits virtually.
2023’s headwinds disrupted the mental health space overall, but this year will tell what these changes could mean for the industry.
Companies featured in this article:
Brightline, Guidelight Health, Lightfully Behavioral Health, Mindpath Health, Refresh Mental Health