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mental health care, including the high cost, the stigma around it, and the difficulty of access. He thinks it will be particularly helpful to those on Medicaid, who might face other hurdles to getting care, like a lack of childcare, time away from work, or transportation.
He also hopes it will cut down on the difficulties of finding a good therapist. Every provider on the site has a profile, and about a third have welcome videos that allow potential clients to evaluate them before they even talk online. [Updated 10/11/13; a previous version of this incorrectly stated that all Breakthrough providers have videos on their profiles.]
So far, the start-up has partnered with 100 licensed psychiatrists and psychologists in four different states: Texas, California, Virginia, and Maryland, as well as the District of Columbia. Because regulations are set both by individual states and the federal government, Breakthrough makes sure that patients only meet with health care professionals who are licensed in their states. All 50 states do allow telemedicine, however.
Redwood City, CA-based Breakthrough used to do its own background and licensing checks, but now that so many insurers have signed on, they can focus on providers who have already passed insurers’ checks.
The company doesn’t charge therapists anything to join their network, and works to get them rates that are the same, or at least close to the same, as an in-person visit. Insurers pay the company a per-session fee; it’s a better model than a subscription service, Goldenson says, because the insurers only pay when their members get care, which makes it easier for them to see the return on investment. And Breakthrough purposely makes it easy on the insurance companies. “We’re not saying, ‘Here’s this cool technology and you have to go implement it and recruit providers, and make it secure behind your firewall,’” he says. “We have the network. We’ve already trained them on the technology, you don’t have to put it behind your firewall, just sign us up like an in-person practice group.” He compares the service to Uber’s car-sharing service: instead of hiring therapists and starting a new practice, Breakthrough has leveraged technology to connect users to an already available service in a more efficient way.
So far, patients seem to be happy with it. The two-way sessions last up to 50 minutes, just like in-office therapy. Every few sessions, Breakthrough gives its patients a quick, four-question survey to see how it worked for them. So far, 64 percent of their patients have reported that they would not have been able to get care if it wasn’t available through Breakthrough, Goldenson says.
A lot of the company’s success so far, Goldenson says, has been about timing. Before he started the company, he talked to other founders who had tried to make similar models work. And he realized that two big pieces had finally fallen into place that could make teletherapy a reality: “Now we have greater research supporting telemedicine, and people are more comfortable digitally,” he says. “I think the market is ready for it.”
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