Virtual pediatric behavioral health care company Fort Health will soon integrate with more than 450 primary care providers in New Jersey and Pennsylvania.
Fort partnered with Advocare, a provider group practice with 750 providers based in New Jersey, to address difficulties associated with a severe shortage of practicing child and adolescent psychiatrists. The company developed a collaborative care model through which Fort clinicians work alongside the child’s pediatrician as part of a care team.
“[Collaborative care] is not only clinically more effective in terms of remission rates, especially for depression and anxiety but is also more cost-effective in terms of overall medical costs, which is why payers like it,” Natalie Schneider, CEO of Fort Health, told Behavioral Health Business. “Additionally, you can really increase your patient panel.”
New York City-based Fort Health offers short talk therapy interventions, psychiatric evaluations and parent coaching. Its services are tailored for people aged 4 to 24 with mild to moderate behavioral health conditions. For specialist behavioral health care, Fort refers to other behavioral health organizations including InStride, Equip and Cortica.
The company secured $9 million in funding in March 2023, of which Blue Venture Fund contributed approximately $4.5 million, bringing the company’s total raise to $10.5 million.
Fort will integrate into Advocare’s physicians’ electronic health records (EHRs), allowing pediatricians to electronically connect patients with a Fort care team consisting of a consulting clinician and behavioral health care manager.
Fort has a staff of 30 clinicians. It exclusively operated on a fee-for-service model in 2023 but added a collaborative care model as an additional revenue stream in 2024.
Fort’s collaborative care model involves shorter, more frequent interventions. Patients are billed once a month rather than per session.
“With collaborative care, it’s a separate set of [Current Procedural Terminology (CPT)] codes,” Schneider said. “It requires the integration, hand and glove, of our behavioral health care team with the pediatrician. We are co-managing that patient, and that is why it is such an effective model.”
Research demonstrates that collaborative care models can provide better health outcomes and be more cost-effective, including among patients from marginalized groups who experience a greater burden of mental health problems.
While almost every U.S. state is currently experiencing a severe shortage of practicing child and adolescent psychiatrists, nearly 90% of children receive a well-child checkup from a pediatrician.
“Pediatricians are this magical key to unlocking solutions,” Schneider said.
Collaborative care may also help alleviate burnout among primary care physicians, who may be forced to diagnose and medicate children with behavioral health issues within a 15-minute appointment without additional psychiatric training.
“It also helps to address the issue of over-prescribing,” Schneider said. “Kids treated under collaborative care are taught coping skills by behavioral health care managers, versus simply being prescribed medication.”
Most commercial payers cover collaborative care, Schneider said, and Medicaid covers collaborative care in 22 states. This alleviates a significant barrier to care for children, for whom a mental health appointment is 1,000% more likely to be out-of-network than a primary care appointment and twice as likely as an adult’s mental health appointment, according to the American Academy of Child and Adolescent Psychiatry.
Fort’s fee-for-service model primarily serves patients with commercial insurance. The company is “payer agnostic” for its collaborative care model and accepts both Medicaid and commercial insurance.
Pediatricians prescribe all of the patient’s medications under Fort’s collaborative care model, which is unusual for other care models. Under this model, the pediatrician may not know details about the patient’s treatment or medication until the child’s next well visit.
“We do the psychiatric evaluation and make a recommendation on medications, but it’s always left to the clinical judgment of their pediatrician,” Schneider said. “It keeps that important relationship intact.”
Fort will roll its collaborative care program into New Jersey and Pennsylvania primary care practices one clinic at a time. The company has already integrated the first of these clinics and identified the next four.
