Accessing behavioral health through primary care

Primary-care providers write most of the anti-depressant prescriptions in the U.S., where just under a fifth of all adults are taking some kind of psychotropic medication.

These providers may have “limited” training in mental health treatment, according to the American Psychological Association, but they remain the front door to psychiatric care for many.

Rather than ignoring that this is happening, Arun Gupta is working with it, giving primary-care providers and their patients access to mental health resources through the Quartet Health platform, which identifies patients who may have mental health conditions and pairs them with mental health providers.

It also gives primary-care physicians direct access to behavioral health providers for consultations about patients, creating a team-based care model. According to consulting firm Milliman, integrating behavioral and medical care could save the industry $26 billion to $48 billion annually.

Gupta founded Quartet in 2014 after work as a consultant and a stint as an adviser for software developer Palantir Technologies. “I didn't just want to built another startup,” he said. “I wanted to build a company that applies modern technology to healthcare in a way that could create order around this super-messy experience that all of us have in our lives in the healthcare system.”

Because Quartet has enterprise relationships with large payers and health systems—including Highmark, Humana, and Sutter Health—it can combine results from behavioral health screenings with their data to reveal which patients might benefit from behavioral healthcare. It also draws on big data techniques to match those patients with local behavioral health providers who accept the right insurance; telehealth behavioral health providers; and online resources, like cognitive behavioral therapy.

“Individual experiences make us think that people have the power of choice, that they can just will their way out of addiction and depression,” said Quartet board member Patrick Kennedy, a former U.S. representative who sponsored the Mental Health Parity Act of 2008. “Tech-enabled solutions like Quartet benefit not only patients but the entire healthcare system by lowering costs and improving productivity.”

By giving patients a more efficient way into the behavioral health system, Gupta hopes to destigmatize mental illness, he said. “I've heard from some of the providers that patients are relieved once they know someone is going to do the legwork of finding a provider and that the provider is linked to primary care and that the provider accepts their insurance,” said John Boyd, CEO for mental health services at Sacramento, Calif.-based Sutter Health, which began using the Quartet platform in September 2017. “Ultimately we want to provide more personalized healthcare to our patients using a variety of tools and delivering it in a setting they prefer.”

Quartet officials say using the company's system lowers costs. Because hospital systems and insurers pay for Quartet's platform, it's free to use for patients as well as primary-care doctors and behavioral health specialists. The platform is currently available in five metropolitan areas: Boston, New Orleans, Pittsburgh, Sacramento 
and Seattle.

Though the company is growing, the pace is tempered by the healthcare system itself. “Anything in healthcare takes time and is slow, and you have to be really methodical,” Gupta said