Behavioral health provider Quartet has launched a new program in partnership with Medicare plan Clover Health (Nasdaq: CLOV) focused on serving patients with serious mental illness (SMI).
As part of the partnership, Quartet will work with Clover’s Home Care division to provide services to members in Clover’s high-need cohorts. Specifically, Quartet will roll out its Whole Health program, designed to address the behavioral, physical, and social determinants of health challenges for patients.
“Our view on this is that for far too long, behavioral health solutions have not focused enough on the SMI population,” Christina Mainelli, Quartet CEO, told Behavioral Health Business. “This program seeks to simplify the process for them to get care. We’re coordinating care across multiple providers and delivering treatment through a care team trained in physical and behavioral health with the ultimate goal of improving patient outcomes while lowering the cost of care.”
New York-based Quartet works with health plans and systems to connect users to virtual behavioral health services. It also has its own medical group with more than 250 clinicians and has raised at least $219.5 million in venture capital funding.
Care teams are led by physicians and nurse practitioners, and also include care coordinators, social workers, medical assistants, dedicated case managers and peers. If a patient needs more specialized services, they can be referred out to a preferred partner.
“We have duly trained care teams, and by that, I mean [trained in] physical health and behavioral health. We’re also addressing what we call SDOH or social care needs,” Mainelli said. “So that’s where we see this being a very holistic treatment for this population.”
The Whole Health program is a hybrid model, meaning patients can access care virtually or have a provider visit them at home, in a care facility, or in another location. Mainelli noted that making care more accessible and less fragmented is especially important when treating the SMI population.
“This population experiences very fragmented care today. [Patients] often have comorbid health conditions as well as behavioral health conditions,” Mainelli said. “The SMI population has as many as three comorbid conditions on average, three times a higher rate of emergency room visits, and often drives a medical loss ratio of over 120%. … So that’s why we think it’s so important to address physical health, behavioral health, and then take into account their social care needs, whether it’s food transportation.”
The program, which caters to adults on Medicare Advantage plans, uses a capitated value-based payment model, which means Quartet takes on total cost of care accountability. Quartet is looking at several metrics to help measure their quality of care.
“In the early phases of these programs, engagement is critical, especially when you have an attributed population, and we are currently exceeding our targets for engagement rates, and we’re also seeing patients coming through for second and third visits,” Mainelli said. “I think that’s a very good marker of success. Ultimately, what we are measuring is quality scores around HEDIS and total cost of care reduction. So we are accountable for reducing the total cost of care for this population.”
Founded in 2014, Quartet started as a behavioral health referral platform. It has since evolved and now offers behavioral health care delivery. In the future, Mainelli said we could see more of this direction from the company.
“We went from pure health tech to tech-enabled care delivery,” she said. “We acquired a company, InnovaTel Telepsychiatry, that was very deeply ingrained in the moderate to SMI population, so it felt like a natural fit to focus our treatment on the moderate to SMI population. We do deliver care to all acuities, but with this value-based care program, we focus on the moderate to SMI. We feel like there’s a real opportunity there. Our goal is to be the leading value-based behavioral health care enablement and delivery company.”
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