Behavioral health provider Quartet has partnered with Medicare plan Clover Health (Nasdaq: CLOV) to launch a groundbreaking program aimed at improving serious mental illness care coordination for high-need patients. This collaboration focuses on better integrating behavioral, physical, and social care to serve Medicare Advantage members with serious mental illness (SMI) through Quartet’s Whole Health program.
Filling a Gap in Serious Mental Illness Care Coordination
For many years, individuals living with serious mental illness have struggled with fragmented healthcare systems that lack effective serious mental illness care. “Our view on this is that for far too long, behavioral health solutions have not focused enough on the SMI population,” said Christina Mainelli, CEO of Quartet. The Whole Health program seeks to streamline serious mental illness care coordination by connecting multiple providers and simplifying access to comprehensive care tailored to patients’ complex needs.
People with serious mental illness often experience multiple comorbid physical health conditions that require close coordination between behavioral health and primary care. The lack of effective serious mental illness care coordination contributes to high rates of emergency room visits and hospitalizations, with this population driving medical loss ratios over 120%. Addressing these challenges requires a holistic and coordinated approach, which the Whole Health program aims to deliver.
A Holistic and Hybrid Care Approach
Quartet’s Whole Health program delivers a hybrid model combining virtual visits with in-person care at home or care facilities. This flexibility supports more effective serious mental illness care, enabling patients to receive treatment in settings that work best for them and reducing barriers to continuous care.
Multidisciplinary care teams, led by physicians and nurse practitioners and including social workers, case managers, and peer support specialists, are trained in both physical and behavioral health. This cross-training is critical to the program’s success in providing truly integrated serious mental illness care coordination that addresses behavioral symptoms, physical health needs, and social determinants of health such as transportation and food security.
If patients require specialized services beyond the Whole Health program’s scope, the care team ensures timely referrals to preferred partners, maintaining seamless serious mental illness care across the care continuum.
Value-Based Care with Accountability
Targeting Medicare Advantage adults, Quartet’s program operates on a capitated, value-based payment model where the company assumes financial responsibility for the total cost of care. This approach aligns incentives around quality outcomes and effective serious mental illness care coordination.
Quartet measures success by tracking patient engagement, repeat visits, and quality scores such as HEDIS, all key indicators of strong serious mental illness care. Early results demonstrate high engagement rates, signaling that patients trust and benefit from the program’s coordinated approach.
Quartet’s Growth into Care Delivery Leadership
Since its founding in 2014 as a behavioral health referral platform, Quartet has expanded into tech-enabled care delivery with a focus on serious mental illness care coordination. The acquisition of InnovaTel Telepsychiatry, which specialized in moderate to severe mental illness, strengthened Quartet’s expertise and commitment to this population.
“We went from pure health tech to tech-enabled care delivery,” said Mainelli. “This value-based program allows us to focus on moderate to SMI patients where effective serious mental illness care can make a real difference. Our goal is to be the leading company in value-based behavioral health care enablement and delivery.”
Why Serious Mental Illness Care Coordination Matters
The partnership between Quartet and Clover Health represents a significant advance in healthcare’s understanding that behavioral and physical health must be integrated for vulnerable populations. Effective serious mental illness care improves patient outcomes, reduces costly emergency visits, and addresses social factors impacting health.
As Medicare Advantage programs grow, this model of coordinated care for SMI patients can serve as a blueprint for other plans and providers seeking to improve quality and control costs through holistic, patient-centered care.
Summary
- Quartet and Clover Health’s Whole Health program enhances serious mental illness care for Medicare Advantage members with SMI.
- The program combines virtual and in-person care delivered by multidisciplinary teams trained in behavioral, physical, and social health.
- Operating under a capitated value-based payment model, Quartet is accountable for improving outcomes and reducing costs through better serious mental illness care.
- Early results show high patient engagement and strong quality indicators.
- Quartet aims to lead the field in value-based care delivery focused on serious mental illness care for complex populations.
This innovative partnership sets a new standard for comprehensive, accessible, and integrated care tailored to one of behavioral health’s most underserved groups.
