Payers’ investment in virtual drug treatment increases

Highmark Health has entered into a new partnership with virtual alcohol use disorder provider Ria Health, following a growing number of insurers looking to expand telehealth benefits for addiction as demand increases.

The more than 6 million Pittsburgh-based payor members will now have access to virtual care for alcohol use disorders offered by Ria Health’s 45 San Francisco-based clinicians who can prescribe medication during visits telehealth. Highmark isn’t the first insurer to strike a deal with the four-year startup: Ria Health also has contracts with Anthem, UnitedHealth Group’s Optum, Beacon Magellan and more.

About 60% of the company’s users come from its paying relationships, which mainly offer the service to its employer clients in the form of social benefits; the rest comes from its direct-to-consumer branch. Ria Health charges approximately $ 4,200 for a 12-month subscription to its service.

“The pandemic and really the growing kind of imbalances in our country’s economy as well as politics are certainly leading to increased incidence rates,” said Tom Cassels, chairman of digital consulting firm Rock Health. “I think the positive outcome of growing these compositions is that there has been a greater reduction in stigma and a reduction in barriers to entry by having virtual and home clinical care levels compared to rehabilitation of hospitalized patients. “

The pandemic has accelerated payers’ interest in the startup, reducing the time it takes to sign a contract with insurers between 2020 and 2021 by around 40%, said Tom Nix, CEO of Ria Health. Nearly one in four adults, or 23%, said they drink more alcohol to cope with stress during the COVID-19 pandemic, a proportion that reaches more than half of all adults with children of age primary, or 52%, according to a February report from the American Psychological Association.

For Ria Health, that means 66% of its users are women, more than double the number enrolled in traditional rehabilitation programs, Nix said. user goals to drive growth. The on-demand nature of the service is also helpful.

“There is such an increase in demand from people seeking treatment that we have seen residential treatment programs either have no capacity or have a four week waiting list to place. people, ”Nix said.

And Ria Health isn’t the only one that addiction startup payers are investing in.

Anthem announced Tuesday that it has partnered with Portland-based Boulder Care to provide digital treatment for opioid addiction to members in Ohio. In June, Pear Therapeutics went public through a $ 1.6 billion special purpose acquisition merger, after the digital prescription therapy company received an investment from the venture capital arm of the provider Arboretum Ventures and has partnerships with local health plans in Ohio, Minnesota and Massachusetts. In May, Woburn, Massachusetts-based Groups Recover Together raised a $ 60 million Series C funding round for its hybrid approach to opioid addiction, with the participation of branches of the UnitedHealth Group business. and Kaiser Permanente as well as Oak HC / FT of Greenwich, Connecticut, a venture capital firm partnered with former White House adviser Dr. Ezekiel “Zeke” Emanuel.

Payers are adding substance abuse treatment benefits in a bid to retain employees, as well as interrupt costly member visits to emergency rooms, said Dr. Vikram Bakhru, medical practitioner at the University of California at the San Francisco Medical Center and Chief Medical Officer of managed care startup Medicaid Circulo. The relaxation of state laws regarding the types of drugs that can be prescribed through telehealth, as well as federal rules regarding pay parity for video tours have also spurred the growth of these startups, Bakhru said.

“The contracts from insurers are seven digits and these are leaps of faith,” he said. “Because if you can actually move the cost of a handful of emergency room visits in this particular population, you can more than justify paying for the substance use disorder program. “

Note: This article has been updated to clarify the subscription price charged by Ria Health.

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