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Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

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21–30 of 38 posts

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#21
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Earlier quoted context omitted.

Do you have a triage system in place where you have a phd level provider that diagnoses and funnels to the appropriate level person to do ongoing treatment? Also why would Good provide join your team what are you offering that makes you competitive to a provider.

I actually really like that idea because it fits into one of our longer-term visions of providing an off-the-shelf turnkey "care team" solution, whereby a cadre of professionals work together to provide care for our customers' patients. Currently, we don't have such as system in place, but our customer might! In that case, a customer might use a PhD or mD from us to provider higher levels of care and then a social wo…

There are a couple issues I see with this model.

1) Credentialing is super slow in medicine and probably quite expensive. It will take your provider months to come online.

2) If you aren’t paying high at 65-70% of billable rates you will have trouble finding providers that want to go through all that hassle when they can just work more hours at their regular job.

3) It’s not clear to me that you are doing anything different than what a regular private practice would do. Everyone is full online now post pandemic so they are mostly limited by availability of clinicians. They could hire parts time folks and offer the same deal I think many just choose not to. You would get stuck with all the compliance costs and little actual revenue.

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#22

Disclosure: I'm an MD who specializes in psychiatry. The idea that Nurse Practitioners and Social Workers "do almost everything that psychiatrists do but (for historical reasons) charge lower rates" doesn't feel like a fair characterization. I have worked with many excellent NPs and Social Workers, and have a tremendous regard for their work, but the level of training is - objectively - much different. Here's an info…

This is a very good point, and thank you for sending this information. However, the infographic is quite misleading because it doesn't stack up nursing school vs. medical school (i.e. it doesn't show the type of courses and training taught in a 4-year nursing program at all). A undergraduate bachelor's degree even in biology is not comparable to the clinical training in nursing school.

That being said, I see your point. There some types of complex care that only MDs/PhDs should be providing, and we will have psychiatrists and doctorate-level psychologists for that care. However, many of the services that our customers provide can be done by other clinicians in our network under the supervision of an excellent MD or PhD.

Part of our goal is to really figure out the "matching" problem so that we can triage care to the clinician type with the right amount of training for the patient situation. By doing that, we feel like we can really increase access the way that we hope.

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#23
post #21
post #15

Earlier quoted context omitted.

I actually really like that idea because it fits into one of our longer-term visions of providing an off-the-shelf turnkey "care team" solution, whereby a cadre of professionals work together to provide care for our customers' patients. Currently, we don't have such as system in place, but our customer might! In that case, a customer might use a PhD or mD from us to provider higher levels of care and then a social wo…

There are a couple issues I see with this model. 1) Credentialing is super slow in medicine and probably quite expensive. It will take your provider months to come online. 2) If you aren’t paying high at 65-70% of billable rates you will have trouble finding providers that want to go through all that hassle when they can just work more hours at their regular job. 3) It’s not clear to me that you are doing anything di…

Thanks for highlighting these issues.

1. Credentialing is definitely super slow. We want to get to the point where we can handle billing for our customers as well, so we'll have to create relationships with payers to speed the process up. Right now, many of our customers and clinicians are already used to this long process, so nothing is really different here.

2+3. We are providing the patient volume at 0 cost to the clinician. This is all just extra income for the clinician at the cost of their time, regardless of whether the clinician is in private practice or working for a hospital with a fixed salary. Opportunity cost requires for the private practice to do marketing, etc to drive patient volume to them. Also, the private practice, again, has the same problems around recruiting and scheduling that a hospital would have.

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#24
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I don’t understand why anyone won’t want to get cut rate mental health treatment when they don’t pay for it. In the us folks are not price conscious for health care so why pick the minimum qualified person to provide care?

You're totally right - no one wants cut rate mental health treatment. If you see my response to Jonni, I explain what our quality process is. Hopefully that convinces you that these aren't cut rate folks and rather very high quality professionals. And you have good intuition about most of the US health care system, but mental health has some nuances that should be shared. First, many mental health practitioners do no…

You are going after the wrong market. The bottom of mental health is not a money maker. Even if your somehow get more efficiency your margins will suck. Instead go for the best and charge like the best.

Like you described above it’s a 6 month wait to get care from someone decent, so why not charge folks for the opportunity to get care now from the same qualified folks they would have waited months to see?

Your mom need psychiatry meds? Fine we will get someone today or tomorrow no wait but it’s 600$. I’d pay it if it was my mom.

Daughter suicidal and needs to start with someone now? We can do that but there is additional costs.

Want access to that doctor that never has an opening at the regular practice. Well for $300/ 15 min he can see you next week.

Better yet apply sliding airline style pricing and you got a recipe for serious returns

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#25
Well, I don't quite get it, but anything is welcome in this part of healthcare.

I'm looking for a psychiatrist and am being told they're not taking on new patients or that I need to wait 3 months for an appointment.

I just need a prescription for a medication that I had before. While being forced to pay for health insurance, being told that this country has great healthcare, losing my voice (literally), and trying hard to get myself to jump off a bridge, I can't help but find the whole thing a bit ridiculous.

Best of luck to you, and try looking into an European expansion. Things aren't as good as they might seem.

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#26
post #23
post #21

Earlier quoted context omitted.

There are a couple issues I see with this model. 1) Credentialing is super slow in medicine and probably quite expensive. It will take your provider months to come online. 2) If you aren’t paying high at 65-70% of billable rates you will have trouble finding providers that want to go through all that hassle when they can just work more hours at their regular job. 3) It’s not clear to me that you are doing anything di…

Thanks for highlighting these issues. 1. Credentialing is definitely super slow. We want to get to the point where we can handle billing for our customers as well, so we'll have to create relationships with payers to speed the process up. Right now, many of our customers and clinicians are already used to this long process, so nothing is really different here. 2+3. We are providing the patient volume at 0 cost to the…

What you describe is not 0 cost. You take some sort of cut for services provided, that’s what a private practice does. In exchange for patient flow computing scheduling compliance and billing they charge 30-40% of the patient bill. In a modern work from home environment a provider could contract with a local urban private practice and offer part the hours for the same arrangement. The only real difference is they would have to interview and provide stable ability, the work can be fully remote otherwise. Also typically the practice takes a higher cut if you work fewer hours.

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#27
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Earlier quoted context omitted.

Great question, and I really appreciate you bringing that up. This is one that we get from many of our customers. First, we have consulted with experts from across health care to implement the most rigorous quality standards for the professionals in our network. Not only do our clinicians have to pass tests of baseline quality (background check, licensure check, etc.), but they are also directly assessed based on the…

I don't know about this. Most psychiatrists I've known have always recommended to meet in person rather than holding something over call. Always set up extra appointments and made time for them at no expense. The ones who would do anything lower than that would come off to me as sub par (and I've had online psychiatrists too, and all of them were subpar).

Very true observation there is a lot of unpaid work that happens for patients in crisis

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#28
post #25

Well, I don't quite get it, but anything is welcome in this part of healthcare. I'm looking for a psychiatrist and am being told they're not taking on new patients or that I need to wait 3 months for an appointment. I just need a prescription for a medication that I had before. While being forced to pay for health insurance, being told that this country has great healthcare, losing my voice (literally), and trying ha…

Hang in there? Maybe you can find a primary care doc who can write you a prescription to hold you over for 3 months… Hopefully a psychiatrist will have a cancellation you could grab sooner.

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#29
post #25

Well, I don't quite get it, but anything is welcome in this part of healthcare. I'm looking for a psychiatrist and am being told they're not taking on new patients or that I need to wait 3 months for an appointment. I just need a prescription for a medication that I had before. While being forced to pay for health insurance, being told that this country has great healthcare, losing my voice (literally), and trying ha…

You need to go to your pcp and talk to them about suicidal tendencies. They can priority schedule you. PCP to provider schedules going will give higher priority to high risk patients

Re: Launch HN: Legion Health (YC S21) – Smarter Staffing for Mental Health

#30
post #25

Well, I don't quite get it, but anything is welcome in this part of healthcare. I'm looking for a psychiatrist and am being told they're not taking on new patients or that I need to wait 3 months for an appointment. I just need a prescription for a medication that I had before. While being forced to pay for health insurance, being told that this country has great healthcare, losing my voice (literally), and trying ha…

Hey, if you have suicidal ideation or self harm tendencies and can't find help, please go to the emergency room. They can help you there.

Also, here's the link for the Suicide Prevention Lifeline: https://suicidepreventionlifeline.org/

Please find help and take care of yourself.

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