Featuring: Elliott Rapaport (Founder of Birches Health) and Dr. Doug Nemecek (Senior advisor with Birches Health and former Cigna/Evernorth CMO)
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This episode with two experts in the mental health space (Elliott Rapaport, Founder of Birches Health, and Dr. Doug Nemecek, a senior advisor with Birches Health and former Cigna/Evernorth CMO for behavioral health) was one of the more eye-opening conversations Hospitalogy’s Blake Madden has had on payor behavioral spend.
Think about this: 39 states + DC have legalized online gambling, FanDuel and DraftKings are sponsoring everything that moves, and yet payors will tell you they don’t “see” the gambling disorder volume in their claims data. That’s because it’s getting coded as depression or anxiety. F63.0 never makes it to the bill.
Blake, Doug, and Elliott get into the real prevalence numbers (a recent Pennsylvania study puts roughly a third of the state somewhere on the gambling-risk spectrum), why specialty networks for behavioral process addictions are about to follow the same pattern Equip ran in eating disorders, and what AI actually does in this model (spoiler: it’s not replacing the therapist).
Blake also pushed Elliott on the “anti-capitalism” of building a clinical model that explicitly wants patients to use you less over time. Elliott’s answer was sharp.
Follow Birches Health on LinkedIn: https://www.linkedin.com/company/bircheshealth/
Follow Doug on LinkedIn: https://www.linkedin.com/in/douglasnemecek/
Follow Elliott on LinkedIn: https://www.linkedin.com/in/er1/
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Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.
https://navvishealthcare.com/vbc
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Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/