Naomi Allen knows firsthand how difficult it can be to get the right treatment for kids experiencing anxiety. “It was just a black box,” she says of getting help for her then five-year-old son, which required navigating waitlists, multiple clinicians and antiquated paper-based systems. That’s why Allen co-founded Palo Alto, California-based Brightline, which announced $20 million in Series A funding Wednesday, to provide other families with an easy-to-use virtual behavioral health solution.
“We are using technology to really lean in on a measurement-based approach,” says Allen, who cofounded Brightline with psychiatrist Dr. Giovanni Colella. It’s an approach that was extremely successful at Livongo, where Allen previously served as chief growth officer. That company, which was acquired by Teladoc in an $18.5 billion deal earlier this month, used a combination of data measurement, coaches and clinicians to help patients manage diabetes. Allen and Colella are applying a similar model to the untapped market of children’s mental health.
The funding round was led by Threshold Ventures and returning investor Oak HC/FT, along with SemperVirens VC and Rock Health. Blue Shield of California, Blue Cross Blue Shield of Massachusetts, and Boston Children’s Hospital also participated. The company has raised $25 million to date.
Emily Melton, a partner at Threshold who joined Brightline’s board of directors, had a similar experience to Allen seeking care for one of her daughters, leading her to realize “how huge the market is, but how underserved it is.”
The big telemedicine players, including Teladoc and AmWell, are all beefing up their behavioral health offerings for adults, but kids require an entirely different set of protocols and training. And the disruption to normal life caused by the coronavirus pandemic has only accelerated the need for these services, as families adjust to the new normal. “If you’re an employer or a payer, and you’re trying to give solutions to parents for their own mental health, and you’re not providing a solution for their kids, you’re not providing a solution,” says Melton. “If the kids aren’t alright, the parent isn’t going to be alright.”
The Brightline platform includes an app through which children virtually meet with their clinical team to work on issues, including ADHD, anxiety, depression, disruptive behavior and speech-language therapy. At each meeting, the provider inputs data measurements so there is long-term progress tracking. The company also involves parents in the treatment process with specialized classes and digital exercises to reinforce what the kids are learning in therapy. Care is coordinated and tracked by a coach, who also serves as a liaison with other programs, such as school-based interventions.
All of this data collection and adherence to evidence-based protocols can help overcome one of the main barriers that has long plagued behavioral health: reimbursement. A shortage of providers across the country, paired with historically low reimbursement rates for services, means many providers are out-of-network with insurance plans. But Brightline hires providers and pays them a salary to do proper documentation and care coordination, which can convince insurance companies to pay higher rates. “We’re able to go to health plans and enter into multi-year agreements that get more sophisticated over time, around value and proof of value,” says Allen.
Even though Brightline is a relatively young startup, its outcomes-based approach has enabled it to attract top-tier healthcare partners such as Blue Shield of California. That insurer was attracted to Brightline’s technology, says Jeff Semenchuk, senior vice president and chief innovation officer, because behavioral health is a particularly challenging and costly area. If issues like anxiety and depression are left unaddressed, they translate into much worse health conditions and outcomes further down the line. “It was really a wonderful thing to see this company, which we think is the first of its kind in this country that is focused solely on the moods of the youth and their behavioral, mental and emotional health,” says Semenchuk. Blue Shield of California is planning to offer Brightline to all of the customers in its self-insured market starting in 2021.
That year will also mark a quarter century since Allen has been working to solve healthcare problems using technology. She began her career in 1996, when Congress passed both the health care privacy regulation, known as HIPAA, and the Mental Health Parity Act, which was supposed to ensure that insurers paid for mental healthcare the same as other medical services (but it hasn’t always worked that way in practice).
After working as a consultant at Deloitte and McKinsey, she honed her healthcare technology skills in a series of executive roles at Castlight, alongside the company’s founder Colella, later landing at Livongo. Allen and Colella cofounded Brightline in 2019.
Brightine just started to offer services in northern California in June, moving up the launch date of its product to meet demand stemming from the coronavirus pandemic. The company eventually plans to introduce a monthly subscription-based model, but the subscription fee has been waived for the remainder of 2020, meaning users are only responsible for insurance co-pays.
The funding round will allow the company to expand its geographic reach, as well as its patient base. Right now the platform includes protocols for ages 3 to 12, with plans to expand to include teenagers. Allen says she is also in early discussions with colleges and universities to potentially offer solutions for their students.
The platform’s long-term goal is to have ongoing relationships with its patients, which because of its virtual relationship doesn’t require being tied to any one location. That said, the company also intends to build in-person clinics for specific services, but the digital aspect will remain the focus for the time being. “The magic of what we’re doing,” Allen says, “is we’re laying the scaffolding to deliver everything by telehealth if the world continues to be this way for a long time.”