A conversation with Brianna Brennan, SVP Operations, Ontrak Health.
Behavioral healthcare is more important than ever. But members don’t always have the quality access they need. That’s why Ontrak Health continues to invest millions in expanding behavioral health networks for its clients.
To better understand Ontrak’s unique approach, the Editorial Team recently sat down with Brianna Brennan, SVP of Operations at Ontrak Health. Among other things, Brianna leads the network operations team—and brings nearly two decades of on-the-ground experience.
What follows is a lightly edited transcript of our conversation.
Editorial Staff, Ontrak Health
Thanks for sitting down with us today.
Ontrak Health talks a lot about access and availability when it comes to behavioral healthcare. What is the difference between those—and why do they matter?
Brianna Brennan, SVP, Operations, Ontrak Health
For us it’s important to distinguish between access and availability because it gets to the heart of why it’s so hard for members to get the quality behavioral healthcare they need. Our customers include health plans and value-based provider groups.
Access means that members have the ability to receive high quality, specialized, affordable care from in-network behavioral health providers in their area.
In the behavioral healthcare space, many members struggle to even find in-network behavioral health providers in the first place. This is often due to the member not understanding how to navigate health plan websites or provider availability not being properly updated.
But availability is something else altogether. Just because you can find an in-network or collaborating behavioral health provider doesn’t mean that they have appointments available when a member is seeking or in need of care. It also doesn’t mean that providers offer appointments tailored to a member preference such as virtual visits,
or face-to-face within a reasonable commute or extended hours.
So, this is where access doesn’t necessarily translate into availability.
Sometimes members have to wait 3+ months before they can be seen. Sometimes even longer than that. And that’s just not in line with our mission—or the mission of our clients.
Why is it so hard for health plans to build behavioral health networks that provide both access and availability?
There are a lot of factors. Some are things our customers and prospects control, other things that they can’t control, for example:
Some of our prospects still don’t consider behavioral health a medical service and haven’t made the investments necessary to integrate behavioral health into their broader systems.
We try to show potential clients with real data that unaddressed behavioral health needs actually cost health plans a lot more than they think. Because behavioral health needs are linked to chronic comorbid physical health conditions like hypertension and obesity.
Even if they’re not spending a lot on paper for behavioral health, they’re spending a lot in medical services because of the relationship between behavioral health and other high-cost comorbidities.
So, there’s definitely reason to invest.
You said there are a lot of factors. That’s one. What else?
Regardless of health plans dedicating more resources to invest in behavioral health integration, there are still serious challenges.
There are just fewer behavioral health providers who practice versus the overwhelming need. Part of the shortage is due to the increasing demand as a result of COVID, coupled with destigmatizing behavioral health care. Another part is that behavioral health services have traditionally had their own contracts and are licensed to deliver behavioral health services and haven’t needed to contract with health plans for business.
Many providers can maintain a private practice or operate autonomously from insurers. It’s simpler. They don’t have to work with health plans. And the demand keeps them busy.
So, how does Ontrak help with this? If there are comparatively fewer providers, many of whom won’t work with health plans or provider groups, what options are on the table?
We’ve been doing this a long time and we’ve built a reputation among the provider community of being a truly collaborative partner. We’ve found that network building in behavioral healthcare is all about trust and relationship building.
We have strong relationships with thousands of providers because we share their mission to truly change people’s lives. Ontrak providers know our team and have access to them via phone and direct email. Also, we touch base with our providers on a quarterly basis.
Providers trust us—and they value the coaching we bring to every one of their patients. By working with us, they can be confident that their patients will get the ongoing support they need to tackle their behavioral health conditions.
Collaboration allows providers to work at the top of their license and focus on treating the patient’s behavioral health condition knowing that coaches provide day-to-day support that includes coaching to the treatment plan, addressing social needs, and building healthy durable habits.
That trust and collaboration with care coaches is what makes many providers join us—and participate in our clients’ health plan networks.
So, our shared mission essentially converts providers into our client networks.
That’s powerful—and really compelling. The idea that providers want to work with someone who is as committed to member wellbeing as they are. It makes a lot of sense.
So, by bringing new providers into your client’s network, you instantly expand their network—and expand access for members.
Of course, as we said, access isn’t availability. So how do you ensure availability?
Here again it comes back to those provider relationships. We provide a steady flow of members ready for treatment, up to 18+ sessions while enrolled plus we provide credentialing services, enhanced rates, and timely reimbursement.
And then, in turn, they agree to volume and timeliness of appointments.
But they also like working with us—and want to work with us. For all the reasons I said before.
It’s not uncommon for our members to get priority. It makes sense, right? Providers want to work with members who have a strong support system. And we measure member progress and outcomes, something that is unique in behavioral health. Then providers can actually see how their efforts truly help people.
Which is what we’re all here to do.
For sure. So, expanding a client’s network is a big part of this. But Ontrak health plan clients also bring their own networks.
How do you work with those providers who are already part of a health plan’s network?
It is a lot of the same, but here we have to be far more careful. We obviously don’t want to disrupt availability for existing members who are regularly receiving in-network treatment.
That’s why we say our number one goal is to expand access and availability first. Then you have more cushion to go in and optimize relationships with existing in-network providers later.
So, let me say a little more first about how we further expand client networks. When we have a new client ready to join Ontrak Health, our team gets to work fast reaching out to private-practice and out-of-network providers in that area.
These are providers we don’t have a relationship with now but will work to build one to strengthen our client’s network. With new providers comes additional availability.
We pride ourselves in being able to match providers with our member treatment preferences beyond just specialty—such as cultural and diversity preferences, face-to-face visits close to their home, or appointments on Saturday mornings, among others.
For the same reasons we’ve built a large network over the years, many new providers are willing to work with us—and join our client’s network.
They like the mission. They like the support. They like the incentives. So, it’s usually a very easy sell. We regularly convert out-of-network and private-practice providers who feel compelled by our whole package.
In part we bring over existing relationships. And in part we immediately build new relationships to expand those client networks right out of the gates.
2023 brings in a new component for our providers as we build an Ontrak Health network of providers backed by our NCQA certification status. Providers across the country are excited to be affiliated with our network and many say they can’t wait to serve more of our members.
Glad you said that about not disrupting existing care for existing members. Because, yeah, you can totally see how that would be counterproductive. It would be like robbing Peter to pay Paul—to use an inelegant metaphor.
So, it sounds like, then, once you initially expand that network, you can work to build relationships with the in-network providers who come with your clients at the outset?
That’s right. First, we bring providers we are already working with. Then add providers from those newly formed relationships. And then, sort of step three, we start connecting with our clients’ existing in-network providers.
And it’s the same thing there.
We immediately elevate care for members because they’re assigned a Care Coach, which gives them all the amazing resources and support that Ontrak Health is known for.
And then over time, providers tend to love that model, and give priority to our members over other members if they work with several networks at once.
That’s where some real magic happens. In effect, our clients’ members get a priority lane over other health plan networks. I mean, the health care system at large is always striving to achieve availability.
So, when we talk about increasing availability for members, a lot of it comes down to that Ontrak fast lane.
We’re preferred by most providers. And that means better, faster care for our members.