By Liese Klein
When Ed Mercadante went to investors four years ago, they thought his idea for a new company was crazy. Providing mental health services via the internet? No thanks.
“People couldn’t spell telehealth four years ago,” Mercadante said.
All this growth reflects increasing demand for the company’s main service: virtual mental health care for patients in skilled nursing and assisted living centers. The COVID-19 crisis has both boosted demand for MediTelecare’s core services and validated its delivery system.
“The pandemic has fueled an expansion of the need and reinforced some of the issues that were there before and prevalent around access,” Mercadante said. “We were fortunate to be in the right place at the right time.”
Essex resident Mercadante founded and sold a series of companies before he launched MediTelecare, applying skills he developed both in business and health care to his new venture. A pharmacist by training, he developed an interest in mental health care while working at a company in Old Saybrook that served patients in skilled nursing and other facilities.
Upon leaving that firm, Mercadante tried to retire but found “I’m not a good golfer.”
Combining virtual care and mental health services at a new company made sense to him because of ongoing issues around stigma, access and delivery in many care facilities, he said.
“The laws were changing, the regulations were changing and I felt as though telehealth through tele-video linkage could break down all three of those barriers,” Mercadante said. “I said there’s got to be a better way to do this.”
MediTelecare debuted in 2018 with a suite of virtual tools that allowed psychology and psychiatry providers to interact via videoconferencing with patients and staff at skilled nursing and long-term care facilities. The software allows for clinical assessment, treatment and reporting and was soon adopted by hundreds of facilities, recording 250,000 patient encounters as of earlier this year.
By 2020 the firm had expanded into South Dakota, Colorado and Pennsylvania, and added Massachusetts, Connecticut and Florida in early 2021. (Due to a noncompete clause Mercadante had signed, the company was not allowed to provide services in Connecticut until this year.) Now the firm operates in 21 states, with a home base on the sixth floor of the Middlesex Corporate Center at 213 Court St. in Middletown. Providers are based across the country.
Virtual care allows for easier access, puts less stress on patients and staff at facilities and results in better outcomes, Mercadante said. His claims are backed up by research that shows MediTelecare patients showed 50% less use and overuse of antipsychotic medications than the national average, averaging 7% versus a national average in skilled nursing centers of approximately 14%.
“They have a better quality of care throughout the experience they have in a nursing facility,” Mercadante said.
Telehealth, increasingly known as “virtual care,” is growing as an option for mental health (aka behavioral health) treatment at providers including Trinity Health of New England, said Dr. Syed Hussain, senior vice president and chief clinical officer at the health system.
Since launching virtual care shortly after the pandemic began, Trinity has expanded and improved its platform and services and hired “virtualists,” physicians with training in providing care via videoconferencing tools. Some of those newly-hired virtualists specialize in behavioral health due to high demand from patients and provider shortages, Hussain said.
Behavioral health and primary care have been a linchpin of Trinity’s strategy to bolster virtual health services, Hussain said. The system is also trying to use the technology to take on a major issue that has arisen anew in relation to pandemic-era care: health disparities.
“Some challenges that we continue to work on are how do we improve access — leveraging telehealth — for vulnerable communities, for communities of color,” Hussain said. “It’s something that we are working on; it’s something that is important to address.”
Major payers are also taking note of the virtual care trend: Cigna’s Evernorth division announced on March 1 that it would buy MDLive, a Florida-based virtual care platform. The Bloomfield-based insurer sees great potential in virtual care, according to company executives.
“We see an immediate opportunity to build a new model of care delivery, one that delivers a connected experience with greater affordability, predictability and simplicity,” Evernorth CEO Tim Wentworth said.
“MDLive will be part of the new, differentiated and future-state care solutions that improve the patient experience, close the patient-provider accessibility gap, and bring providers opportunities to augment the services they currently offer,” added Evernorth President and COO Eric Palmer.
Another aspect of behavioral health, addiction services, has also benefited from the rise of virtual care.
Aware Recovery Care, a Wallingford-based provider of in-home addiction treatment, announced in February that a private equity firm had made a “significant growth investment” in the company. The $17.5 million cash infusion, according to a federal securities filing, from New York’s Health Enterprise Partners will allow Aware to expand its program beyond its current service areas in Connecticut, New Hampshire, Maine, Florida and Massachusetts.
“The pandemic actually increased interest and understanding for our model because people didn’t want to leave home,” Eacott said. “Our model was ideal for the many that still needed [treatment] due to the increase in mental health issues and substance abuse across the board.”
Aware Recovery Care was founded in 2011 to provide in-home addiction treatment, a model in which providers visit patients in person.
“There’s huge benefit in treating people in the communities where they live,” Eacott said, adding that he himself had failed at several attempts at recovery before finding success with Aware. With the company’s model, patients can keep working and remain with their families while they get support to recover from addiction.
The program gets results: Anthem Blue Cross Blue Shield of Connecticut found that 60% to 70% of its members who followed Aware’s program achieved yearlong abstinence from drugs and alcohol compared to less than 10% of those who attended residential treatment programs.
With the arrival of the pandemic, Aware quickly pivoted to offering more treatment via a virtual platform, with up to 20% of services offered online at certain points. But the nature of addiction treatment requires some in-person contact, Eacott said. Going forward, he expects the company to develop a hybrid model that combines both modalities of treatment.
“With substance abuse clients, there’s an absolute need to have that face-to-face connection,” Eacott said.