Virtual pediatric behavioral healthcare company Fort Health will soon integrate with more than 450 primary care providers in New Jersey and Pennsylvania.
Fort partnered with Advocare, a 750-provider group practice based in New Jersey, to address the challenges of a severe shortage of practicing child and adolescent psychiatrists. The company has developed a collaborative care model whereby Fort clinicians work alongside the child’s pediatrician as part of a care team.
“[Collaborative care] is not only clinically more effective in terms of remission rates, particularly in depression and anxiety, but is also more cost-effective in terms of overall medical costs, which is why payers like it,” said Natalie Schneider, CEO of Fort Health , before Behavioral Health Business. “Also, you can really increase your patient panel.”
New York-based Fort Health offers brief therapeutic interventions, psychiatric evaluations and parent training. Its services are tailored for people ages 4 to 24 with mild to moderate behavioral health problems. For specialty behavioral health care, Fort refers to other behavioral health organizations, including InStride, Equip and Cortica.
The company secured $9 million in funding in March 2023, of which Blue Venture Fund contributed approximately $4.5 million, bringing the company’s total raised to $10.5 million.
Fort will integrate with Advocare physicians’ electronic health records (EHRs), allowing pediatricians to electronically connect patients with a Fort care team consisting of a consultant and a behavioral health care manager.
Fort has a staff of 30 clinicians. In 2023, it operated exclusively on a fee-for-service model, but in 2024 it added a collaborative care model as an additional revenue stream.
Fort’s model of collaborative care involves shorter, more frequent interventions. Patients are billed once a month, not per session.
“With collaborative care, it’s a separate set of [Current Procedural Terminology (CPT)] codes,” Schneider said. “It requires the integration, hand-and-glove, of our behavioral health care team with the pediatrician. We co-manage this patient and that’s why it’s such an effective model.”
Research shows that collaborative care models can deliver better health outcomes and be more cost-effective, including among patients from marginalized groups who experience a greater burden of mental health problems.
Although almost every state in the US currently has a severe shortage of practicing child and adolescent psychiatrists, almost 90% of children receive a well-child pediatrician review.
“Pediatricians are that magic key to unlocking solutions,” Schneider said.
Collaborative care can also help alleviate burnout among primary care physicians, who may be forced to diagnose and treat children with behavioral health problems within a 15-minute appointment without additional psychiatric training.
“It also helps address the problem of overprescribing,” Schneider said. “Children treated in collaborative care are taught coping skills by behavioral health care managers rather than simply being prescribed medication.”
Most commercial payers cover shared care, Schneider said, and Medicaid covers shared care in 22 states. This eases a significant barrier to care for children, who are 1,000 percent more likely to have an out-of-network mental health appointment than a primary care appointment and twice as likely to have an adult mental health appointment, according to the American Academy of Child and adolescent psychiatry.
Fort’s fee-for-service model primarily serves patients with commercial insurance. The company is “payer agnostic” for its collaborative care model and accepts both Medicaid and commercial insurance.
Pediatricians prescribe all of a patient’s medications according to Fort’s model of collaborative care, which is unusual for other models of care. In this model, the pediatrician may not know details of the patient’s treatment or medications until the child’s next visit.
“We do a psychiatric evaluation and make medication recommendations, but it’s always left to the clinical judgment of their pediatrician,” Schneider said. “It keeps that important relationship intact.”
Fort will roll out its collaborative care program to primary care practices in New Jersey and Pennsylvania one clinic at a time. The company has already integrated the first of these clinics and identified the next four.