Startup Brave Health, a virtual-first behavioral health provider, is teaming up with The Doula Network (TDN) to provide virtual mental health support to expectant mothers on Medicaid.
The collaboration seeks to address the maternal and mental health disparities that disproportionately affect women in underserved communities, executives said. Postpartum depression and anxiety are the leading complication of pregnancy and childbirth, impacting 1 in 5 mothers nationwide. Yet, only 50% receive treatment. Untreated maternal mental health conditions cost the U.S. over $14 billion annually and increase the risk of adverse outcomes—particularly for women in underserved areas where it can be more difficult to access care. Medicaid finances nearly 45% of all U.S. births and an estimated 50% to 60% of pregnancies in rural areas. The population of women covered by Medicaid face many socioeconomic challenges that inhibit their ability to access high-quality maternal care.
“Mental health conditions that go untreated or undiagnosed can have devastating consequences for individuals and their families. This is especially true during times of change, both physically and emotionally," said Anna Lindow, CEO and co-founder of Brave Health. “By expanding integrated access to both doulas and behavioral health services, we can provide the physical, mental and emotional support that everyone deserves.”
Founded in 2019, TDN has created care networks in Florida and New Jersey with 13 Medicaid health plans. The organization operates a foundational system of doula services that are integrated into maternal health care. The organization works with health systems and health plans to enmesh birth doulas into the Medicaid system. TDN's provider network of 100 credentialed and certified doulas serves nearly 1,000 Medicaid members annually with intentions to incorporate more payers and broaden into other states.
By aligning with doulas, clients, health plans, communities and technology, TDN improves the maternal health experience, maternal and infant outcomes and reduces healthcare costs, according to Elizabeth Simmons, founder and CEO of TDN.
Since launching with health plans in Florida in 2019, Brave Health now serves 65 million covered lives across 125 health plans and 11 states including Florida, New York and Texas. Brave Health offers a virtual alternative to traditional outpatient services such as therapy, psychiatry, case management and medication-assisted treatment for mental health and addiction that have traditionally been hard to access in local communities. The company offers same-day assessments, reduces wait times to less than a week and works closely with Medicaid case managers, providers and major Medicaid plans across the U.S. to increase patient engagement and lower overall costs of care, according to the company.
"We want to operate within the system and use the things that are available within the system to get the best overall care for that end user, the patient," Lindow told Fierce Healthcare.
To support Medicaid members during and after pregnancy, TDN’s partnership with Brave Health provides a full spectrum of behavioral health services including individual, group, family and couples therapy as well as psychiatry and medication management, which have been increasingly difficult to access locally as demand for mental health providers soars. By combining virtual behavioral health services with a trusted network of community-based doulas, TDN and Brave Health can meet members where they are, Lindow said.
“This partnership serves as a critical safety net for the vulnerable population of women who struggle obtaining the care they need and so desperately deserve,” said Simmons. “Mental health services can be a lifeline for many of our members who often have limited support from friends and family or may be in difficult relationships. Together, interventions from TDN’s doulas and Brave’s mental health team can significantly improve outcomes for mothers and their babies, and diminish unnecessary risks and medical costs.”
The partnership with TDN is one of several that Brave Health has initiated to bring high-quality behavioral healthcare to the nation's most vulnerable. Earlier this year, Brave Health engaged with Circulo Health to provide mental health services to Medicaid members in Columbus, Ohio.
"We believe in this concept of operating within healthcare rather than without it," Lindow said. "So we are working with the case managers at health plans, working with people's primary care physicians and working with the discharge planners at hospitals. And, with The Doula Network, it's the same model where we're saying, 'who's the person that this individual has built trust with?'"
Innovation in the Medicaid space is overdue, Lindow said, with almost 1 in 4 people in the U.S. a Medicaid beneficiary, or close to 90 million people.
Investment in innovations for Medicaid populations has been ramping up, she said.
"We're starting to see more capital come into the space and we will start to see businesses able to grow faster," she said. "One of the things that investment allows is more innovation at scale. With this partnership, the goal is to do things at scale. Today we've started to do something in Florida, and we'll continue to do it in other states and that will let us take this show on the road."