Brightline, a leading virtual pediatric behavioral health company, has recently announced a significant transformation of its business model, marking a pivotal moment in the company’s evolution. This strategic overhaul involves narrowing its operational footprint, shifting away from nationwide services, and embracing a hybrid care model in select states. Along with this shift, Brightline also made the difficult decision to lay off a substantial portion of its workforce, signaling a clear departure from its previous go-to-market strategy.
In this blog, we’ll take a deeper look at the reasoning behind this change, what it means for the future of Brightline, and the broader implications for the growing field of virtual pediatric behavioral health care.
The Vision for the Future: A Hybrid Care Model
Founded in 2019 as Emilio Health and later rebranded as Brightline, the company initially set out with an ambitious vision to provide virtual behavioral health services for children. Offering therapy, counseling, and psychiatry via telehealth, Brightline’s mission was clear: to make high-quality mental health care accessible to families across the United States.
At first, the company followed a hybrid model, blending both virtual care and physical clinic visits. However, when the COVID-19 pandemic began, Brightline, like many other companies in the telehealth space, quickly adapted and transitioned to a fully virtual care model. While this shift allowed Brightline to continue providing services amid the pandemic, the demand for virtual care remained steady, and as time went on, there was also an increasing need for in-person services.
To better address this demand, Brightline has decided to return to its hybrid roots, but with a more focused approach. The company will now provide both virtual and in-person care in five select states, allowing families to choose the most suitable option for their needs. This shift is designed to improve access to care and better address the needs of high-acuity patients who require more intensive treatment that virtual services alone may not be able to provide.
Scaling Back Nationwide Operations and Refocusing on Key Markets
As part of this transformation, Brightline has made the difficult decision to significantly scale back its operations in 45 states. This means the company will cease accepting new patients in November, and by the end of the year, it will stop treating patients outside of the five states where it plans to establish its new hybrid care model. This reduction in service areas is part of the company’s effort to focus more deeply on specific markets and provide higher-quality care in those regions.
CEO and co-founder Naomi Allen addressed the restructuring in a heartfelt blog post, acknowledging the tough reality the company faces. “It’s been a hard week for Brightline,” she wrote. “We made the decision over the last couple of weeks to restructure our national virtual-care employer-focused business to focus on a new go-to-market strategy that we believe will allow us to serve our mission in a more effective way.”
This decision to narrow the company’s geographic focus is not just about reducing costs but about building deeper, more meaningful relationships with local providers, schools, and health systems. Brightline believes that by focusing its efforts on these select states, it will be able to better serve the families in those regions, improving clinical outcomes and enhancing patient satisfaction.
Impact of the Restructuring: Employee Layoffs and Shifting Workforce
Unfortunately, this shift also came with significant workforce reductions. Brightline announced layoffs affecting a broad range of departments, particularly those in enterprise functions such as sales, marketing, and client success teams. Clinicians working in states outside of the five selected for the hybrid care model were also impacted.
While the company declined to provide specific figures, Brightline confirmed that this round of layoffs was substantial, though they emphasized that the restructuring was necessary to align with the company’s long-term vision. The company’s public sector business, which includes its work with the state of California under a $680 million contract, was unaffected by the layoffs. Brightline also assured its remaining employees that it does not anticipate further reductions in the workforce.
Laid-off clinicians will continue to receive compensation through the end of the year, allowing them to continue providing care to their current patients until the transition is complete. Brightline’s leadership expressed deep gratitude for their employees’ hard work and commitment to the company’s mission, acknowledging that these decisions were painful but necessary for the future of the business.
Brightline’s Hybrid Care Model: Meeting the Demand for Both Virtual and In-Person Care
One of the most compelling aspects of Brightline’s new strategy is the company’s adoption of a hybrid care model in its selected states. This shift will allow families to choose between virtual or in-person consultations, depending on their preferences and the level of care required. As Brightline’s executive team explained, offering both options will enable the company to provide more comprehensive care, including for high-acuity patients who may not thrive in a virtual-only environment.
The hybrid care model will also allow Brightline to offer medication-assisted ADHD treatment, a critical service for children whose needs cannot be fully met through virtual consultations alone. By providing a combination of virtual and in-person services, Brightline aims to improve the patient experience, making it easier for families to access the care they need in a way that works best for them.
Brightline’s hybrid care model will also provide an opportunity for growth in new areas. The company plans to open physical clinics in mid-2025, either through mergers and acquisitions (M&A) or new builds. These clinics will play a key role in expanding Brightline’s footprint and improving its care delivery in the five selected states.
A Shift in Business Model: Direct-to-Consumer Marketing and Focus on Public Sector
In addition to focusing on hybrid care, Brightline is pivoting its marketing strategy away from selling to employers. Previously, Brightline’s primary channel for customer acquisition was through employer health plans, but the company has acknowledged that this approach has proven to be challenging. In particular, Brightline found that families who learned about the company through their employer had great clinical outcomes, but they faced significant barriers in accessing care due to a lack of awareness and the complex process of navigating employer-sponsored health plans.
To address this, Brightline plans to shift its focus to direct-to-consumer marketing, making it easier for families to find and access services without relying on employers or health plans. The company is already in active conversations with large potential partners in the five selected states to build stronger relationships with local communities and raise awareness of its services. This new approach will help Brightline grow its membership base and improve patient acquisition, allowing it to scale more efficiently and profitably in the future.
Additionally, Brightline is committed to expanding its public sector business, including its lucrative contract with the state of California. The company sees the public sector as a key area for growth, and its focus on Medicaid contracts and partnerships with smaller, local health plans will ensure that its services remain accessible to underserved families.
A Path Toward Profitability and Long-Term Success
Despite the challenges presented by this major transformation, Brightline is optimistic about its future. The restructuring is designed to set the company on a path toward profitability by enhancing its unit economics at the individual clinic level. By narrowing its focus and improving its member acquisition strategies, Brightline is confident it can drive better financial performance and increase its long-term sustainability.
The company has raised a total of $212 million in funding from high-profile investors such as KKR, GV (formerly Google Ventures), Oak HC/FT, and Threshold. With this financial backing, Brightline is well-positioned to weather the current restructuring and emerge stronger than ever.
The Bottom Line: A New Era for Brightline and Pediatric Behavioral Health Care
Brightline’s shift to a hybrid care model and its decision to refocus on a smaller number of states represent a bold new direction for the company. By offering a combination of virtual and in-person services, the company aims to improve accessibility and provide more comprehensive care for children and families. While the restructuring has undoubtedly been difficult, Brightline’s leadership remains committed to the company’s mission of delivering affordable, high-quality pediatric behavioral health care.
In the coming years, as the company builds out its hybrid care model, opens new clinics, and refines its marketing strategy, Brightline has the potential to redefine the landscape of pediatric behavioral health care. With a renewed focus on regional markets and public sector partnerships, Brightline is poised for long-term success, delivering the care that families need while ensuring sustainable growth.
