A startup is helping Froedtert Health remove barriers to behavioral health care. Here's how.

Since the behavioral medical startup Concert partnered with Mercy Health, one of the largest health care systems in the country, more than 13,000 patients have received behavioral health care that dramatically lessened their anxiety and depression levels.

Much of that was the result of nixing the nearly six-month-long wait times to see a counselor, having less expensive co-payments and tracking patients' moods on an ongoing basis, said Spencer Hutchins, CEO and co-founder of Concert Health.

Now, Froedtert Health in Wisconsin has put 30 of its providers in the ring.

In spring 2023, Wisconsin became the 17th state Concert Health operates in. Froedtert Health announced the partnership in an effort to quash the burgeoning mental health crisis in Wisconsin, one that especially plagues young people, pregnant and postpartum people, and rural residents. The partnership aims to increase access to behavioral health services for pediatric, women's health, and primary care patients of 30 providers associated with Froedtert Health in Manitowoc and Sheboygan counties.

"Froedtert Health is committed to delivering the highest quality care to our patients, and we recognize the critical importance of addressing both physical and mental health needs," said Mark Behl, executive vice president and chief operating officer at Froedtert Health. "We are excited to partner with Concert Health to deliver a collaborative care model that will improve patient outcomes and enhance the overall health care experience for our patients."

Here's how it works.

Concert Health uses a collaborative care model to address behavioral health services.

Somewhere along the way, the medical services road split into two separate routes, with physical health occupying the main artery and mental health traveling in a parallel, if less straightforward direction. The result had a siloing effect on the health care industry: Primary care providers weren't reasonably trained in how to treat patients' behavioral health conditions, health insurers didn't adequately cover treatment for mental health and few people got a proper education that helped them recognize their own mental health needs.

The Collaborative Care Model challenges that separation. Think of it as a superhighway that centers the patient's needs. Integrating behavioral health and general medical services, it turns out, is good for everyone: it improves patient outcomes, saves money and reduces mental health stigma.

Primary care providers lead the collaborative care team and, staying with the superhighway metaphor, make frequent stops to work with behavioral health care managers, psychiatrists and other mental health professionals.

Part of what makes comprehensive care models so effective, Hutchins said, is the registry, a caseload tracker that looks at how your symptoms are trending over time. The registry offers insights into the clinician's psychosocial or psychotherapy interventions, the patient's diagnosis, and if applicable, the medication dose the primary care provider is using to manage the patient's condition. It also helps ensure patients aren't falling through the cracks.

Together, the team works with patients and actively monitors who among a given patient population are or are not meeting their goals. If a patient isn't following their goals, modifications are made, be they medication changes, therapy interventions or something as simple as sleeping with your phone in a different room.

"An important difference between collaborative care and more traditional psychotherapy is that, by definition, we're sharing information with primary care. We're saying, 'No, we're not going to do care in silos, we're part of their team,'" Hutchins said.

How does Concert Health work with patients?

During a typical primary care visit, patients struggling with their mental health, sleep or concentration in general fill out a patient-health questionnaire, or PHQ-9, that quantifies a patient's depressive symptoms. That's normally the extent of the screening measurements.

But for primary care providers who use a comprehensive care model, the PHQ-9 is an ongoing measurement tool.

As Hutchins explained, for the Froedtert patients in Manitowoc and Sheboygan counties who screen positive for a mental health condition, there's a "warm handoff" from the primary care provider to one of Concert's licensed behavioral health providers.

"We work really hard to reach out to patients the same day or the day after they are referred from primary care so you really have momentum coming out of that special visit, that point of connectivity, the same that you would have with primary care," Hutchins said.

Behavioral health clinicians speak to patients between two and five times a month either over the phone or through Zoom. That removes the obligation of driving somewhere to see a therapist, which can free up time especially vital to working parents.

Recommendations for medications are made available in the patient's primary care charts, which the primary care physician can review and act on. The primary care physician routinely has patients update their PHQ-9s to better assess what treatments are working and, importantly, what isn't working.

Why Manitowoc and Sheboygan counties?

Some of Froedtert's larger hospitals have a psychiatry department, but it's much smaller in scope than the primary care footprint. Referrals for mental health services far outpaced what the hospital systems could provide.

Froedtert executives came to Concert after they heard about the impact Concert had at Mercy Health, where patients from Missouri, Arkansas and Oklahoma saw a major positive upshot in mental health care.

"Concert Health aims to be an easy button, a high-performing, high-quality medical group that can do more together than each health system trying to figure this all out on its own," Hutchins said.

Increasing numbers of clinicians at Concert means more patients in more states are treated.

Concert has 250 licensed behavioral health clinicians who work with about 4,500 primary care physicians from about 60 medical groups or health systems across the country.

Hutchins said Concert is actively hiring 20 to 30 new clinicians per month.

So far, Concert has worked with about 60,000 patients across the country, and it's seen a great deal of success.

When it initially launched in 2021, Concert's partnership with Mercy Health served as a pilot program for 47 providers across nine clinics in Missouri.

Then, Mercy Health and Concert Health expanded the program to include 150 clinics and 1,300 primary care providers that specialized in adult and family medicine, women's health, and pediatrics across Arkansas, Oklahoma and Missouri.

"Working with our partners at Mercy, we called everybody waiting six months to see a specialist, and said, 'It doesn't make any sense for you to be waiting with nothing. You should be getting support in your primary care office,'" Hutchins said. "In the time that they would wait to get their first psychiatry appointment, they got treated effectively."

A good number of those Mercy patients received immediate telehealth services that were covered through primary care benefits. Not only did they save time, money and a grueling wait time to access services, but 41% of patients with anxiety and nearly 40% of patients with depressive symptoms reached subclinical levels upon discharge, according to the results from Mercy Health's program.

How much does it cost?

One of the benefits of the collaborative care model is the spectrum of services available through the primary care provider, which are normally the least expensive co-pays available and the one most likely to be part of someone's insurance plan.

Hutchins said he's proud of how accessible these services are for people with lower socioeconomic status who typically fall through the cracks of mental health care.

More than half of the 60,000 patients who use Concert have a government-sponsored insurance plan like Medicaid or Medicare.

"Mental health is one of those cases where, even people with means have trouble finding access in the United States," Hutchins said. "But one thing I'm really proud about at Concert Health and this collaborative care model is that we can help primary care providers across that spectrum, including people with lower socioeconomic status or older adults."

Natalie Eilbert covers mental health issues for USA TODAY NETWORK-Wisconsin. She welcomes story tips and feedback. You can reach her at neilbert@gannett.com or view her Twitter profile at @natalie_eilbert. If you or someone you know is dealing with suicidal thoughts, call the National Suicide Prevention Lifeline at 988 or text "Hopeline" to the National Crisis Text Line at 741-741.

This article originally appeared on Manitowoc Herald Times Reporter: Froedtert Health partners with health startup Concert to improve mental health access