As it plots its path forward, Forge Health has added key executives with deep payer experience to its board of directors and established a health advisory board, tapping a handful of former CEOs, CMOs and healthcare executives.
Forge Health, a provider of behavioral health and substance abuse care, has been on a strong growth trajectory in the past two years, expanding its clinics, adding thousands of new patients and doubling its revenue in 2023.
Focused on the Northeast region, the White Plains, New York-based company operates 19 clinics in Massachusetts, New Hampshire, New Jersey, New York and Pennsylvania and provides a hybrid of in-person and virtual care.
Founded in 2016, Forge Health aims to be a “one-stop-shop” for outpatient mental health and substance use treatment as well as co-occurring conditions, especially for individuals with moderate to severe conditions.
The company raised $21 million in venture capital funding in 2022 and is looking to double down on its success, CEO and co-founder Eric Frieman told Fierce Healthcare.
“We’ve really been able to refine our value proposition. We’ve continued to grow our clinical care capabilities and we’re serving more individuals and more markets. We’ve opened up an additional 10 locations over the past year. We’ve also had success in driving new partnerships as well as enhancing existing partnerships, where we are serving as the preferred behavioral healthcare provider for certain organizations in the healthcare ecosystem, whether it be an employer, health system, an accountable care organization or a payer,” Frieman said.
“In 2023, alone, every metric has grown by over 100%, whether it’s net revenue, new patient admissions, billable sessions, number of clinics and number of clinicians,” he said.
The company has highly profitable unit-level economics and Forge Health will hit profitability this year as new clinics continue to mature, Frieman said.
The behavioral health space has grown in the past eight years, particularly as demand for mental health services soared during the COVID-19 pandemic and the ongoing opioid crisis. But, many virtual care companies focus on individuals with mild conditions and target treatment for depression and anxiety.
Forge designed its clinical model to serve individuals with more severe conditions and offers a multidisciplinary care team to address social and co-morbid medical needs.
“The moderate to severe patient population is woefully underserved in behavioral health. And that’s a big value driver and a differentiator for us,” Frieman said.
Providers often approach mental and physical health separately and substance use disorders are often siloed out of both mental and physical medicine – and at times ignored altogether.
The company partners with primary care physicians, specialty medical groups and health systems to provide integrated mental health and substance use treatment building on streamlined referral management, information exchange and care coordination. In some cases, these partnerships also include physical co-location to improve diagnosis, collaborative treatment and timely access to care.
With a roadmap for future growth, Forge Health has ambitions to continue to scale rapidly and develop new products and partnerships to integrate mental health services more deeply into physical medicine.
The company aims to offer a new psycho-oncology offering and will work with payers, health systems and oncologists to offer integrated and coordinated mental health and substance use support to individuals battling cancer.
Forge also wants to work with payers and health systems to be the behavioral health partner for those discharged from a medical hospital who need outpatient behavioral healthcare. This initiative will entail developing assessments of clinical needs and referral workflows and determining data sharing needs with healthcare partners.
“We are building our regional density. That’s how we best serve our patients, that’s how payers best serve their members and health systems and physical health providers best serve their patients. We need to get more access and more comprehensive care in the markets that we already currently serve,” Frieman noted.
To help support and guide this strategy, Forge Health has added key executives with deep payer experience to its board of directors. Alisa Bahl, Ph.D., former chief of innovation and strategy at Magellan Healthcare and Alan Muney, M.D., former chief medical officer at Cigna have both joined the board, as well as Richard Synder, M.D., executive vice president, facilitated health networks at Independence Blue Cross, as an observer.
“We’ve only scratched the surface in terms of how innovative we can be alongside our partners to better serve individuals. Having someone like Alisa Bahl, who has been a payer executive for decades, and is a psychologist by training, and her ability to provide insight from the payer angle, from the psychology angle as well as from the business angle is absolutely paramount and incredibly valuable,” Frieman said.
Muney brings insights into how to “connect the dots” across different medical fields, he noted.
“This will help us create innovative partnerships or solutions or just streamlined information flow, which is something that’s absolutely critical. Because a lot of times with payers and the health systems, the left hand doesn’t talk to the right hand. The behavioral health side doesn’t integrate or talk well with medical oncology, diabetes, or even primary care. A leader like Alan Muney is fantastic to help us through on how best to achieve better solutions,” Frieman said.
The company also established a health advisory board and tapped a handful of former CEOs, CMOs and executives with operational experience from Aetna, Independence Blue Cross, Walmart Health and VillageMD. Members of that advisory board include Brent Asplin, M.D., former COO of VillageMD and co-founder and CEO of Gather Health, Marcus Osborne, former senior vice president at Walmart Health, Steve Hamman, who served as president at BCBS Illinois, Simeon Schindelman, former CEO of Brighton Health Plan Solutions and Bright HealthCare and Seth Feuerstein, M.D. executive director and founder of the Center for Digital Health and Innovation at Yale University School of Medicine.
“This is just an enhancement to what we’ve created on the board to help us solve different challenges as well as put all of our perspectives together so that we can continue to enhance what we’re doing and doing it at a bigger scale and in a better way,” Frieman said.
In 2022, the company released findings from a national payer-led clinical outcomes research study that demonstrated its patients maintain significant improvement in both medical utilization and overall health outcomes due to its intensive outpatient treatment.
Patients who participated in Forge Health treatment had significant overall health benefits even a full year later, including a 62% reduction in emergency room visits and 75% reduction in medical hospital admissions, the study found. The patients included in the study also had a 39% reduction in all-cause hospital admissions.
The study compared the health and behavior of 70 patients over the 12 months prior to engaging with Forge Health to their health and behavior in the year following treatment.
Forge patients see their primary care doctors more frequently, according to the study, with a 20% increase in primary care visits, which indicates patients are taking better care of themselves. The results indicate that addressing underlying mental health and substance use issues can move the needle to improve an individual’s overall health, Forge Health executives said.
“In my over 30 years of experience in the addiction and mental health field, I have never seen study results that demonstrate such a significant relationship between behavioral health and physical health, or that so clearly show the positive impact behavioral health treatment has on an individual’s physical health,” John Rodolico, Ph.D. Forge’s chief science officer, said in a statement about the study.
Frieman points to the company’s care model that combines multidisciplinary clinical teams, data analytics and streamlined care delivery that leads to effective treatment for patients, while also driving improved health outcomes.
“Our multidisciplinary care teams make us unique, with W2 employed clinicians, and that care team includes a licensed mental health therapist, a psychiatric provider as well as a care coordinator. Everything we do is integrated with someone’s overall health, whether that’s medical or social determinants of health. As part of our treatment plans, we ensure that our patients are living a healthy and self-directed life,” he said. ” If they have a medical chronic condition, a comorbidity, we make sure that they’re going to get their care with their endocrinologist. Our care coordinators keep the specialist physicians and primary care physicians in the loop on how patients are progressing through our care. That unified whole-person approach is unique.”
This approach ties into Forge Health’s strategy to scale up its partnership with payers and healthcare providers to tackle the massive demand for mental health and substance use disorder treatment in the U.S.
“We want to take that next step to go from an in-network provider to truly being a value-add partner to payers,” he said.
Frieman says he sees a growing openness to partnerships in the behavioral health space, a trend that is long overdue.
“There was not a lot of partnership among behavioral providers, as much as I would have liked to see. What we’re seeing now is that everyone does something really well and when you focus on what you are very good at, and you work alongside other partners who are very good at a complementary service, you create an ecosystem that is in the best interest of the patient,” he said, noting Lyra Health’s new complex care service that includes a specialized network of more than 250 facility partners to address more severe mental health needs.
It takes a village to innovate in behavioral health, Frieman noted, and providers and payers are showing more willingness to collaborate
“Health systems are willing to plug us or other providers in to fill gaps in their behavioral healthcare service offerings. We don’t want to take over what they do, and they don’t want to build out what we do. How do you do this economically efficiently? You work together and you fill those gaps. We’re seeing that a lot with health systems across the board, in all different states that we operate in,” he said.
