The Future of Collaborative Mental Health with Spencer Hutchins of Concert Health

Startups get the party. Startups get the party started. Startups get the party. Startups get the party started. You want tech and tacos? Tacos and tech you know we got tacos and tech is on smash border green guacamole keep accountants counting beans Contador quentan frijoles found us trying to raise some queso la vida San Diego school of rappy rapping Fire tortillas round jalapenos in these modern times a crappy beer and coffee my coding yoga posse fold the body origami we be surfing coronado eating tacos El gordo, the taco stand in pesto lucha libre and sombrero got a shout out to cost angels by the ocean watch the sunset la Hoya shores Entrepreneurs trying to get funded When San Diego Startup Week is popping in the summer Oceanside, the Tijuana esti be full of hustlers from couch surfing to penthouses right on the beach Tech leaders who who believe stars are within reach we interview and founders who be shooting for the Moon SDTechOS with your host, Neil Bloom. Startups get the party. Startups get the.

Welcome to the Tacos and Tech podcast where we discover cutting edge San Diego technologies and the builders making it happen. I'm your host, Neil Blum, San Diego's tech ambassador, and together you're going to put a face to the name of today's tech leaders with our own blend of local lifestyle.

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All right, welcome back to the Tacos and Tech Podcast. I'm your host, Neil Bloom and I am lucky enough to be joined by one of our favorite co hosts, Amy Chang, entrepreneur and angel investor who's been on many pods. Amy, it's great to have you back.

Same here. Thanks for having me.

Throughout the entirety of you being a co host, we've talked a lot about our angel investments, including how many you have, which are a bit more than me, but one of them that shared together that we have is one of our favorite companies in town, Concert Health. Pretty excited to have Spencer Hutchins, co founder and CEO of Spencer on joining us.

Yeah. Great to see you, Amy and Neil.

I think collectively, I don't know who goes back the furthest. Amy, you Or I. But at least it's five years with Spencer, right? Is that true? How long possibly we've known each other? Amy, how long do you go back with Spencer?

Gosh, I'm trying to remember Spencer. I feel like maybe 2017 is when we first met perhaps.

Yeah, that does sound right. Which is amazingly a long time ago now.

Yeah, I think I tracked it in my spreadsheets. I actually tried to figure out how we met. Oh, I remember how we met. We were introduced by the founder of Lead Crunch, Olin Hyde. That's right. Olin introduced us.

Really cool. Spencer, do you want to give us a quick intro of what Concert Health is? And then we want to dive into your story and we'll get to know the whole company later in the episode too.

Yeah. So at Concert Health, we're trying to build America's largest and best behavioral health medical group. So really proud of the startup story, the technology we built. But fundamentally we're actually a care delivery organization. The vast majority of our 100 employees are licensed behavioral health providers like social workers, marriage and family therapists, as well as nearly 20 psychiatrists and psychiatric nurse practitioners spread all around the country. And we team up with primary care and women's health groups to help integrate behavioral health services right into the primary care setting and do a better job of sort of integrating people's behavioral health support, their depression, their anxiety, alongside of the rest of what's going on with their chronic conditions or other health settings. Really proud. Been at this about since Amy and I met. We might have been an idea back then in 2020, 17, I think we were a C corp and an idea and on our path to treating our first patient and just last month treated our 10,000th patient. So really excited to see the progress. That's awesome.

Congrats on that. You've had a long career in digital health or has your entire career been in digital health? Is that true?

Yeah, it depends on where you start it. I worked in political campaigns before business school, tried to get John Kerry elected president, but been mostly at the intersection of health and technology ever since. The other side of that, since about 2007.

Oh, wow, wait, we have to know about the political side. Give us a little download on that.

Yeah. So I graduated in 2003 and grew up in Massachusetts. My parents live in New Hampshire and so decided to go and first job. I think my first title was senior intern, which meant I was expected to work 80 hours a week. And I think I made $400 a month stipend or something. Like that I paid for gas. Fortunately I could live with my parents in New Hampshire and started Kerry campaign was about 60 employees. I remember vividly the first event I did with the senator was and this was about nine months before the New Hampshire primary. This is before Google Maps, so I got to Send his Driver MapQuest link. For those folks in the right generation, they'll remember that his driver trudged over to to his house in Boston, picked up their minivan and drove him up to see generously 45 people. And that included both my parents and like seven of their Republican friends who were just filling me out. So I didn't get embarrassed with how few people showed up and then worked on that from there all the way through the general election. Ended up down in Tampa, Florida for the general and last event I did with the senator was I think it was the Sunday before election day. Florida is obviously a big swing state and there was 24,000 people there. He had a 75 car motorcade from the office and we had snipers on the roof because at that point he might have been the president elect in a couple of days. And so he got near presidential level. So if anyone thinks they've had a tough job interview process, try running for president because that thing lasted a long time and he had to do a lot, a lot of work.

Wow, that's pretty cool experience, that's for sure.

Yeah, we didn't end up getting to work for the President, which was a shame. That would have been awesome. But I did meet my wife, she worked at a different office in the New Hampshire primary and started dating there as a campaign fling. That turned into a whole lot more and 17 years later are still loving life and now living in San Diego.

That's pretty cool to have had that story and to have met her. So why the change in the digital health after an mba?

Yeah, so I always wanted to have a public spirited career path, but didn't want to just work in politics and the public sectors or had a real belief in the power of and dynamicism of business and entrepreneurialism. And so I did what anybody after business school that has no idea what it is they want to do. I went into management consulting. It's the ultimate career punt and I could pretend as though I had a strategy around it, but really I ended up just getting staffed on a mix of healthcare cases and technology cases. So worked at a large health system, helping think about all sorts of strategy and budget issues and then worked on a bunch of tech companies, originally a bunch of random things but then increasingly was working on technology companies thinking about health as a vertical and then increasingly health systems and health providers thinking about digital strategies and heading there. Mostly it operated in kind of two parts of my brain. Had an opportunity to take a leave of absence and join the first term of the Obama administration administration and kind of put them together and help start a health care team at the Federal Communications Commission. So this is right before the Affordable Care act passed. And there was this view of, hey, there's this vision. It was the number one priority for President Obama, domestic priority. And there was a view at that point, the iPhone had just come out. We were thinking about mobile medical devices and whether or not the iPhone had become regulated by the fda. How you think about that? Kind of the intersection of what had been the FDA regulating drugs and devices and the FCC regulating communication devices. And those things weren't separate categories anymore. So I got a great opportunity to work with a small group to advise the chairman and think about how to align the FCC into part of that broader agenda, which was a blast and got to have not maybe a second row seat to the passing of the Affordable Care act, the major what now gets called Obamacare. And knew at that point I had learned a lot, loved this intersection, what we now call digital health. Knew that I didn't want to go and buy giant healthcare corporations or giant governments for the rest of my career and wanted to find a way to move more directly into an innovation role in young companies. So that I think stoked my passion and interest and had an opportunity to come to California and start working in the earlier stage businesses, which was a great opportunity that I jumped out once I could give Inslauri to decamp to the West Coast.

Hey, Spencer, I was curious, you know, because behavioral health is a relatively specific sector of healthcare and it's going to grow. I mean, it's, you know, the BLS is saying that in our country it's going to grow by healthcare employment and mental health and behavioral health is going to grow by 15%, you know, by 2029. And so I was just curious, you know, was that one of the drivers of why you chose to do that or is there an underlying passion around that for you?

Yeah, you know, behavioral health is a term now that medicine uses to mean sort of mental health and substance use disorders. Right. So for those of you that might not come from the industry, it wasn't a expertise of mine before concert for sure. I'd say professionally, I knew it as one of those places that everyone talks about as even More broken than normal, terrible supply constraints, payment problems, lack of credible access, sometimes in even outcome measures. It was just sort of. Everyone knew it was worse. That professionally fascinated me. It was sort of like, hey, this is a big problem. I like big problems. Personally, like everybody, though, I have close friends and family that have been touched by mental health disorders of substance use. And you've seen both how transformative great care can be and how easy it is not to get it in this country. Right. And so I think I took those two things and had a good fortune of sort of stumbling upon a model in behavioral health called collaborative Care Management. Got fascinated by it. One of those moments where you start learning about something, you say, I have to be part of bringing this to more people and really scaling this. And that genesis, that idea is what turned into Concert Health.

I remember when we first met and we were talking about Concert Health, and you mentioned to me, yeah, there's a billing code that supports this. Here's the unit economics around it. I already knew about the demand for behavioral health and the demand for care coordination. Right. And how that can really improve patient outcomes and the difficulty that physicians were having in finding a turnkey solution where a lot of them, they don't have the resources to hire two whole behavioral health specialists for their practice, but, boy, can they benefit from something like Concert Health. But I remember you had me at billing code in unit economics. With my background in healthcare staffing and as an angel investor, that's definitely why I wanted to. Wanted to support the company, because to me, it just made sense.

Yeah, it's a great point. One of the reasons I knew we wanted you as an investor after that first meeting was, I think, the recognition that to build big businesses in healthcare, so often you have to deliver an exceptional product. Right. Whether or not that's just software or in our case, clinician services enabled by smart technology. But it's always necessary, but not sufficient to just have that. You really have to sort of embrace the complexity that is the US Healthcare system and the revenue model attached to it. And when you get that right, exceptionally good service that really delivers value to people's lives and a clear path for how it is you fight through insurance coverage or other models is, I think it's those two things together are so critical.

Yeah, and I saw that. I mean, you've recently had some huge contract wins that are very exciting, which really goes to show that the acceptance in the healthcare community of what Concert Health can bring. So maybe touch on that a little bit. I think it's Very exciting.

Yeah. So we work with, I think it's now 46 medical groups and health systems. Most of our early partners were smaller independent primary care teams. Started in Phoenix in rural areas of California, Imperial County a couple hours east of San Diego, and a bit in the Hudson Valley in New York. We thought for a long time and basically what we do is we sign agreements with primary care teams, deliver exceptional care together. So we provide same day, next day access to our licensed clinicians. Beams are documented directly in the primary care physician's medical record. So you really have a truly joint plan, A joint care plan together. Then each week our behavioral care managers, our therapists or counselors meet with one of our psychiatrists to review those patients that aren't getting better and the psychiatrist isn't there to take over care, but they can provide written recommendations to the primary care provider. Still love working with smaller independent groups and will continue to. They do great medicine. They're never going to build this service internally. We can identify them, find them, they make decisions quickly, they move fast and we can do great care with them. But frankly, a lot earlier than we expected. Really large health systems said, hey, we've identified this as a problem. We have huge primary care footprints and a behavioral health team either doesn't exist or really wants to specialize in very high acuity care like inpatient psychiatric hospital or something like that, and found some momentum. So this fall announced a really exciting partnership with Common Spirit, which is one of the largest Catholic health systems in the country. 21 states, 125 hospitals. We're really proud to launch in Bakersfield area, Kern County, California with them as our first market. Look to be rolling out to more. Also working with some great partners like Saratoga Hospital, Sun River Health, Women's Health usa, which is a large ob GYN group in many states. We work with them in both Connecticut and Arizona. So really excited to sort of work with the breadth of organizations and be able to support patients no matter where they get their primary care.

That's huge. Congrats. Congrats on all that. I know remembering from the beginning as well, comparing to now, you know, the grind that it's been going out to Imperial County. I know for you often a lot now to be working with such big systems. Congrats.

Yeah, I remember I was telling a story earlier this week. I used to fib a little bit in Arizona and you know, you're trying to get meetings and you'd say, oh, I'm going to be in the area. Right. You know, and then you should get five minutes with the pcp and I got them on this practice I really wanted to work with. I got up at three in the morning and started to drive so I could be in the area in Scottsdale at, you know, in a mid morning meeting. And the practice manager called me at about 8 in the morning and I was like 45 minutes past Yuma, driving out to Phoenix and she said, oh, it turns out, you know, the provider's going to be in the hospital today, we'll have to reschedule it. And I had no right to be mad at her because I had lied to her and I said I was going to be in the area, not five and a half hours away. But then, you know, so politely tried to reschedule and then I had to drive 10 more miles before I got to the next exit on the eight so I could turn around and come back home.

That's the grind of an entrepreneur for sure.

So in the beginning, you know, I would got to imagine telehealth. What the sale then versus this post. Covid world is so different. Take us through what that's been like, seeing the new rapid adoption during COVID Did we just.

Were you.

What did you think the acceleration was going to be like without Covid and where did we actually get to now?

Yeah, I mean we were growing a lot and really hitting our stride pre Covid operationally fundraising wise it was a little scary because we were planning on raising NA over the summer and said, oh, what's this going to look like? But we really first and foremost experienced Covid in a very human and personal way, which is we work with a lot of practices in Brooklyn and Queens. Small groups in the area is one of our strongest markets. And we were seeing this start to happen on site where everybody got Covid, a couple of our team members, all the doctors, everyone there because people are starting to get sick. No one really knew what it was. And they were showing up at their offices, they didn't even know to wear masks, much less have them. And at the time it was really hard. Primary care, you know, had to learn how to do telehealth overnight. You know, many of them watched 90% of their revenue disappear because people stopped going to the primary care office. And most primary care physicians are still paid per visit. So you know, people stop showing up and the revenue stops coming and they have a whole team of medical assistants and nurses and rent and all these expenses to pay. So they were reckoning with one of the hardest things clinically to happen to them. A real shock to their business model. You know, fortunately we could be there. Our model already worked remote, we did some co location, but we already even pre Covid did most of our care via video visit or telephone call. So what that meant is that, you know, most importantly, we could continue to serve patients and help identify new ones that were experiencing depression and anxiety, other behavioral health conditions and get them care with our care team being safe, the patient being safe and everyone being able to do the work remotely. And also, frankly, we're probably one of the only revenue models that stayed up and running as these primary care offices were figuring out how to get themselves onto some telehealth platform and do video visits themselves. We could help them a little bit in that process and be there. And it was interesting. It was clarifying on the sales funnel for new deals. Some just shriveled, right? They said I can't think about any new relationship. I'm just, all I'm doing now is figuring out masks and gowns and ppe. And we totally got that. I think there's still places that I swore I was going to sell Q2 last year that we haven't even had another substantive conversation with them. It's just been a focus. But we've had others that really thought behavioral health is part of their Covid strategy. They knew anxiety and depression was skyrocketing. People that worried they had Covid or people that were diagnosed with COVID and had to understand how can we get them treatment that they need in a way that's safe. And so we also saw this real explosion, acceleration of certain partnerships that they were maybe going to happen over, over a nine month period because that's the pace that things happen. And they happened in a nine day period because it was like, listen, you're on the Covid team. Let's make this happen. We're moving heaven and earth. Let's get the contract signed, let's get you in our emr, like let's get the integration going and let's start patient care. And so, you know, we saw that on both and you know, three or four times the size we were in March of last year and really excited to be, to be there. I think most importantly, really being there as a true partner for those groups who are working for in a time that is the hardest professional life, professional year of many of their lives as clinicians, as business owners and the hardest year for many of their patients. And hopefully a lot of them are saying, listen, concert health was there for us. They figured this out. We did great care together and they helped me, you know, sort of make this transition and that's been an awesome part and hopefully a foundation that helps us build something really special with both our current and new partners in the next few years. Yeah.

You know, Spencer, one of the things I liked about concert health was that it was already forward thinking and knowing that you needed to be tech enabled and to be telehealth enabled. And so, you know, it's really great that you were already, you know, set up for that. Do you think that, you know, in your view and in healthcare that things will totally go back to in person visits or do you think that, you know, in primary care there's, we're going to see an acceleration of telehealth. Like it's just going to accelerate even more even as Covid quiets down.

Yeah. I think like most things in healthcare, the first answer is it's complicated. Right. It's going to be very dependent on conditions. Obviously there are certain things that physical proximity to your physician is necessary if they're going to do something to you. Right. If they're doing a procedure, if they need to evaluate, need to touch you, need to give you a shot, all those things. And so I think there will be always be space and the need to have a physical infrastructure for most things, behavioral health in particular, our space. I think a huge amount of it can be done remotely. It's already, that had already been demonstrated through a lot of high quality studies. It's more convenient for patients sometimes even frankly, the phone versus a video visit can be a more engaging way for a patient to start out. They can be resistant to the idea of going in person or even doing a video visit, turning the camera on. But it's a lot easier to take a phone call and it can be easier, smaller step for them. I think the winners will probably recognize that what's critical is doing amazing care, doing it cost effectively, demonstrating your value and being really focused on that consumer experience. And most of us are going to say, listen, sometimes I need to come into the doctor, I'm going to need a blood draw. Someone needs to be there to draw my blood. But hey, if I've got a question, I want to text you, I want to do a video, I want to fit it inside my life. No more of this context of you're only open Monday through Friday, 9 to 5. And so I've got to go take a few hours off work. Right. Or people that work hourly. I've got to lose $30 in income because I got to take two, three hours off to come see you. And I think those kind of those days are going to be gone. The winners are going to have these hybrid models which recognizing there's going to be brick and mortar but a huge amount of that can be virtual. I think also it's really going to be about those sustained arrangements. I think there's some explosion of these kind of one off telemedicine visits and sometimes telemedicine gets our telehealth gets talked about as if it's a one time video visit with a PCP and that can be effective. A couple of very specific use cases like hey I might have an infection, you got to figure out if it's, if it's viral or bacterial and give me an antibiotic. You know those sorts of things can be done in real time but those represents a really small percentage of it. And I think those companies that are just trying to do one off visits, there's going to be less the model and more about how do I have a longitudinal relationship with my patients, how do I keep them happy, healthy, out of the hospital? And to do that it's going to include all sorts of ways I'll communicate with the.

Yeah, the patient engagement is really huge. I'm aware that you had a big series A and just wondering if you wanted to talk a little bit about how is that going to support the company? Are you going to use it to support growth with clients, to implement them or is it to continue perfecting your technology? What are your thoughts around that?

Yeah, we were really excited. Both existing investors and some new ones came in. You know, I think absolutely always our top priority is clinical excellence. And so I think a lot of that is building on what was already on. Effective training, learning, development programs, supervision, really investing in recruiting, onboarding, training and infrastructure to create amazing experiences for phenomenal clinicians. Make sure we're the employer of choice for that market. Certainly a piece of it is we're moving into four new states and it's hiring the infrastructure that allow us to do that in 21 and beyond and continue to invest in the technology platform that sort of enables that. So all across the board growth. But most importantly also I've always thought about ourselves mostly funding the business with revenue and so we're happy to see sort of losses falling and really build up, build a relationship that's founded with our partners and yeah the unit economics working for everybody. Both our organization and the primary care practices we work with. That's awesome.

Congrats on that. Proud for Amy and I to participate in the beginning. Pretty fun for Amy to have bought out some of her shares to participate in this round as well too. So. Thanks, Amy.

Yeah, no, I didn't mind. As an angel investor, I think it's important for folks to know out there that there are shifts at all stages of a company's growth. In this case, I actually some of the shares that I purchased originally, I sold them to Neil and some other investors because it's funny, we're in the middle of a pandemic and I just as a human being thought maybe it wouldn't hurt to have some extra cash around. I took a little off the table just from a personal risk mitigation strategy. I know, Spencer, you want to prove me wrong by batting a thousand here. And. And you know what? If you do it, I will only be happy for both of you.

Yeah, I'm looking forward to. Well, all three of us will grab drinks sometime and very glad of the return we created for you. And I know Neil and others are glad that they could get themselves on and we'll celebrate the success and think about all the other great companies in San Diego and elsewhere that we can be a part of recirculating that capital back to.

Yeah, I think of it as passing the baton in some ways, but I will always be a super fan.

Yeah, I think it's really proud to show, you know, the local ecosystem, supporting local companies, entrepreneurs, funding entrepreneurs is pretty cool to be a part of that. So thanks, Spencer, for allowing us to join early on in the journey when it was an idea.

Yeah.

So some of the things also about being a San Diego company happen to be, you know, the living here as well too. You know, it's hard to have a digital taco even during COVID We gotta get our taco craze. Do you have a favorite taco spot?

I was trying to narrow it down and I couldn't get to one. I got to two. So one, which I've been really missing is south of the border in Tijuana. Taqueria Los Paisas went to twice. I hope they are still open. I have not been able to cross for a year, but used to love that. I felt like just loving the fact that in 15 minutes you could be down in a new country and go grab dinner and come back. And that place is a real hole in the wall. Had amazing al pastor here in San Diego. I think my favorite spot is La Fechata in Sherman Heights. Found that one day when I was trying to go to Las Cuatro Milpas, which is sort of an institution in Barrio Logan to get some tamales, but the line was too long and so Yelp helped me discover another one. They have amazing tacos and at night they have a big open grill grilling up beans and onions and everything like that. They're sort of sitting there grilling all night. You get your tacos and then toss them some hot onions on top with an amazing, amazing fresh salsa and love that place.

Ooh, good ones.

Sounds yummy.

Those have not been mentioned and we are excited to add them to the list. Find some hot spots. Amy, do you have a where's your go to taco?

Right now I probably go the most to Roberto's by the ocean. Love Roberto's but you know I really enjoy every other Friday I like to go to Lahaina's and hang out there by the ocean and Pacific beach as well.

Good ones for sure. Well Spencer, we appreciate you sharing so much of your story while doing so much good that you're doing with your company. You know, I think that's very San Diego thing that we build. Impact driven, mission driven companies that change lives. And we're really excited for what you have built and what the future holds now that so much more is based on telemedicine, especially the way that you guys are doing delivering care. So congrats on that and thanks for joining us.

Yeah, well, thank you both for getting it going and for helping me understand all that's happening in town by getting to listen to this podcast every week.

This was fun. Thank you.

Thanks for joining us on the Tacos and Tech podcast with Neil Blum. Thanks again to Cox Business for helping make this possible by expanding the reach of the San Diego tech ecosystem. Big shout out to School of Rap for our rad intro music and thanks for as well to Nest Podcast Network where we are recording live inside their studio at Nest Co Working in Bankers Hill. You can find Neil Bloom on Twitter eelbloom as well as fresh brewed tech and Tacos and Tech Pod on Twitter too.

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