Nema Health, a virtual clinic focused on post-traumatic stress disorder (PTSD) treatment, has announced a partnership with a Blues plan in New Jersey.
Nema is now in-network for commercial members with Horizon Healthcare Services Inc., otherwise known as Horizon Blue Cross Blue Shield of New Jersey. Through this and another contract with a major national payer, which was not disclosed on the record, Nema will reach about 3.6 million lives in the state.
All Nema patients get clinical care from a trained therapist and psychiatrist as needed as well as emotional support from a peer mentor and daily support from a case manager. Patients are in intensive treatment five times a week for about two to four weeks, after which they enter a stabilization phase where they can still access their therapist as needed and continue with peer support.
More than three-quarters of Nema patients no longer meet the criteria for PTSD after four weeks of intensive treatment, the company claims.
About six of every 100 people will experience PTSD at some point in their lifetime. Traumatic events like war, a natural disaster, gun violence, childhood abuse or sexual assault can all cause PTSD. Nema co-founder and CEO Sofia Noori, M.D., had her own experiences with trauma.
“Trauma is a huge issue especially for civilians, and people don't have really good access to PTSD treatments that we know work,” Noori told Fierce Healthcare.
Many people who suffer from PTSD either don’t realize it, and therefore don’t seek treatment, or they go to weekly talk therapy—which is not the right treatment for PTSD, according to Noori. What’s more, the prevailing narrative around PTSD is that if you have it, you can’t recover and must live with it forever, she added.
But PTSD is a “recoverable illness,” per Noori. With the right therapies, patients can see permanent improvement. One approach is cognitive processing therapy, which generally takes about a dozen sessions to complete, she said.
During the start of the COVID-19 pandemic, Noori started Nema with the goal of expanding access to evidence-based treatment that goes beyond managing symptoms and helps patients actually recover.
“Our goal is to get people into recovery as quickly as possible so that they can rebuild their lives after PTSD,” Noori said.
Therapists can get trained in trauma therapy, but it can be time-intensive and take them away from their practice. Nema developed its own rapid training protocol for its staff that doesn’t take away from their ability to provide therapy in the meantime, Noori explained.
Horizon has long been an innovative payer when it comes to behavioral health solutions, Noori said. Since 2020, it has more than doubled the number of in-network behavioral health professionals available to its members.
Nema, which started seeing patients in 2021, is currently accepting new patients in New York, New Jersey and Connecticut with plans to expand. The startup has raised $4.1 million in seed funding to date. Noori hopes the company will be fully scaled across the U.S. within the next few years and accept most commercial plans.
Beyond commercial payers, however, government plans are also important to Noori. “I don't think we can say we are increasing access if we’re not also thinking about Medicaid and Medicare,” she said.
All of Nema’s contracts are value-based, and the company is taking on some downside risk. The company is currently in discussions with managed Medicaid organizations, Noori said. While Nema does not disclose its prices, it is designed to be cheaper than the total annual cost of care for the average patient seeking PTSD treatment.