Behavioral health point solutions—digital tools, apps, and niche services designed to address specific mental health and behavioral challenges—are increasingly looking to forge partnerships with payers. These partnerships offer an opportunity to expand access, improve outcomes, and generate revenue. At the same time, payers are eager to collaborate with digital health companies to deliver more comprehensive behavioral health support to their members. Yet, despite mutual interest, successful partnerships require careful alignment of goals, expectations, and long-term vision.
Payers See Behavioral Health as a Priority
Behavioral health point solutions have risen to the forefront as rates of depression, anxiety, and other mental health conditions continue to climb. Payers are recognizing that traditional models of care are often insufficient and that digital and point solutions can fill critical gaps. More than $5.5 billion in venture capital has flowed into behavioral health digital solutions, demonstrating the growing market potential and the demand for innovation.
“Many of us have more than 50% of the market share in the state we live in,” Suzanne Kunis, vice president of behavioral health at Horizon Blue Cross Blue Shield of New Jersey, said at HLTH. “We have the ability to change how things happen there.”
Horizon Blue Cross Blue Shield provides coverage to 3.8 million people, highlighting the scale at which payers can influence behavioral health services. Similarly, CVS Health, the parent company of Aetna, is exploring ways to bring innovation into behavioral health care.
“There is advanced conversation, new innovation, the largest investment from venture capital in behavioral health – ever,” Cara McNulty, president of behavioral health and mental well-being at CVS Health, said at HLTH. “So the art of possibility is here, but we all have to take it and put it into action so the people we serve really feel those results.”
High-Impact Areas Are the Focus
Payers are not just interested in any behavioral health solution—they prioritize interventions that address high-cost areas with high demand. Behavioral health point solutions that serve only a small population may struggle to capture payer interest, unless they clearly demonstrate measurable outcomes or integrate into broader care pathways.
“The way we look at it is, what are the problems we see as most important for our clients that we need to solve short, medium, and long term,” Eva Borden, president of behavioral health at Evernorth, said at HLTH. “It’s really being able to plot out startups and say who falls into which group, and who has a long-term trajectory. Not just to be the flash in the pan today, but you can see that they can build.”
Evernorth, the health services division of Cigna Corp., exemplifies how payers are strategically structuring behavioral health point solutions investments to maximize long-term impact. Understanding where a point solution fits in the care continuum is also critical—solutions that complement existing services and integrate seamlessly into care plans are more likely to succeed.
Red Flags and Pitfalls for Startups
With hundreds of behavioral health point solutions on the market, payers face the challenge of identifying which products are credible, stable, and likely to deliver results. This also creates pressure for startups to make a strong and honest first impression.
“It’s a huge amount of work to try to set up these kinds of relationships,” Kunis said. “Startups need to be prepared, but honesty is the best policy.”
“When you do get the opportunity to pitch a health plan, do yourselves a favor – be honest,” Kunis continued. “Tell the truth. Where are you? What’s reality? Don’t make up a story that’s not going to come through.”
Payers want to understand both the potential and limitations of behavioral health point solutions. Transparency helps them evaluate how a solution fits into the broader health ecosystem and sets realistic expectations for outcomes.
Stability is also a major factor. Solutions backed by venture capital may be flashy, but payers want to see a committed leadership team, operational reliability, and a proven product.
“When you come in and start telling me from Day 1 that you’re going to take a [risk-based approach] on my membership, that’s a major red flag for me,” Kunis explained. “All that means to me is you’re a startup, you got some VC behind you with a bucket of money that’s saying, ’Let’s go in there, make it easy for them.’”
It’s also encouraged for startups to ask questions. If a potential partner isn’t an expert in health plans or isn’t fully familiar with the health ecosystem, asking questions is far preferable to guessing and risking misalignment.
Creating a Pathway to Partnership
To make payer-point solution partnerships more accessible, many payers have developed formal processes for evaluating potential partners. CVS Health, for example, has a dedicated team that identifies gaps in behavioral health offerings and assesses over 500 potential partners annually. A quarterly “shark tank-like” process further evaluates and selects promising solutions.
“I want to know what you’re solving and why,” McNulty said. “It’s important for us to understand the purpose and value of the solution, not just its features.”
Alignment is key to creating a true partnership. Payers seek behavioral health point solutions that complement their existing strategies and can be integrated as collaborative partners, rather than simply vendors.
“We can have an honest dialog about what those aligned goals are,” Borden said. “That’s when I see partnerships going a long way because it’s really a virtuous way of helping each other.”
The Future of Payer-Point Solution Collaborations
As behavioral health continues to evolve, partnerships between payers and point solutions will play an increasingly critical role in shaping the landscape. Behavioral health point solutions have the potential to improve access, efficiency, and patient outcomes when implemented thoughtfully.
For startups, the message is clear: focus on honesty, stability, and value. Understand where your solution fits in the larger care ecosystem and be prepared to work collaboratively with payers to solve high-impact problems. For payers, identifying and nurturing the right behavioral health point solutions can expand access, improve member outcomes, and foster innovation in behavioral health care.
Ultimately, these partnerships have the potential to transform behavioral health services, making effective, accessible care a reality for millions of members.
