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October 5, 2020

The Modern Health Approach to Research: A Look Back and Preview of What’s Ahead

All our work is rooted in an ample body of peer-reviewed research. 

Research has been central to Modern Health since our founding. As pioneers in the effort to make mental health care the fourth pillar of employee benefits, we were the first company to offer a truly comprehensive mental health solution—based on a stepped care model that decades of research has shown to improve mental health outcomes through the cost-effective provision of care. By matching people with the right level of care based on their need, our model addresses the enormous treatment gap in mental health care and provides a continuum of clinically effective services to more people at a lower cost.

Every part of the Modern Health care plan—from one-on-one therapy and coaching, to group support sessions, and digital resources like mindfulness meditations—is designed by our clinical care team of PhD and PsyD researchers, licensed therapists, and certified coaches. Each component is rooted in clinically effective treatments that are supported by an ample body of peer-reviewed research. We start with a triaging protocol that leverages the clinically validated WHO-5, PHQ-2, and GAD-2 assessments to screen individuals and recommend options for care. We are unrelenting in reviewing applicants to our global provider network, ensuring that we only engage therapists and coaches who rely on evidence-based treatments in their work. And we consistently infuse cutting-edge, research-backed behavioral science into our digital mental health programs. 

Now a few years into our mission to deliver better mental health care to employees everywhere, we’re delighted to share with you our vision for research at Modern Health—including a retrospective of existing research, a glimpse at findings coming later this year, and our exciting plans for research ahead.

Current research at Modern Health. 

In addition to leveraging reliable peer-reviewed research to design and improve our services, we are committed to measuring the impact of our product through several internal research initiatives. We conduct quarterly customer satisfaction surveys and our Care Operations team works tirelessly to maintain a 4.95 (out of 5) average coach session rating. We’re currently using customer feedback and internal provider research to influence tiered coaching designations that will make the member experience even better.

We also field quantitative surveys to examine current trends in the mental health landscape. In May 2020, we partnered with consumer insight firm Spectacle Strategy to survey more than 500 U.S. and 200 U.K. adults about the impact of COVID-19 on their mental health. Findings from our ensuing report—State of the Industry: Mental Health in the Coronavirus Era—have been used as supporting evidence in national and international media stories on mental health and help guide our own COVID-era care and support strategies for our customers.  

How we think about outcomes and effectiveness. 

We also invest in rigorous outcomes research to investigate the real-world effectiveness of our platform. As a research psychologist and the staff Behavioral Scientist on the Modern Health Clinical Care team, I direct our program of outcomes research and want to share how we go about measuring real-world effectiveness. 

At Modern Health, we take a comprehensive approach to understanding our impact. We assess outcomes across three key areas that cover the spectrum of health care delivery from micro to macro processes. The first area is clinical effectiveness, in which we measure individual improvements in mental health and well-being, including changes in emotional health constructs like anxiety, depression, and life satisfaction. The second is organizational effectiveness, wherein we gauge improvements in company culture and individual functioning as it pertains to the company as a whole; things like employee retention, productivity, and employees’ perception of leadership support for mental health. The third is cost-effectiveness, an important component of our stepped care model where we assess shifts in health care spend due to prevention and reduction in co-morbidities. We also examine potential savings from improved organizational effectiveness. 

We consider these areas of effectiveness to be inextricably linked: Clinical outcomes affect organizational well-being which modifies overall medical spend. These levels mutually influence each other and studying them in combination is crucial for demonstrating the impact of our innovative mental health care delivery model.

Our Behavioral Science team takes a multiform approach to conducting research across our three areas of effectiveness. At Modern Health, all our care options (therapy, coaching, and self-guided digital tools) are generally administered through a single point of service—the Modern Health app. We measure meaningful clinical outcomes within our app to track how the utilization of our services relates to longitudinal improvements across the spectrum of mental health. We also conduct custom-designed, company-specific surveys to measure the clinical and organizational outcomes most important to our clients. Engaging our clients in research collaborations is a cornerstone of our approach to demonstrating effectiveness. 

We also partner with academic researchers to design high-quality studies, strengthen our methodology, and enhance the rigor of our work. We intend to publish our research in peer-reviewed scientific journals because we deeply value the scrutiny of the scientific community and peer review process. 

At Modern Health, we value research integrity above all. As scientists, we take the research high road, even if that means our research takes longer to produce. For example, we believe in using our own real-world data to demonstrate effectiveness so that when we present findings about clinically validating our model, we are representing how our care supports our actual members’ lives. We take a similarly detailed approach when designing a study and analyzing data: We prioritize research that can establish causality, select validated measures to track outcomes, and are dedicated to conducting thorough analyses that follow best practices for handling outliers, missing data, and non-normal distributions. This level of investment in conducting academic quality effectiveness research with pragmatic real-world data takes longer to conduct and produces impactful results that are accurate. When we make claims about employee well-being improvements or our product’s ROI, we prioritize transparency about our process and are confident in our findings. We also care deeply about data privacy and security and are honest, accurate, and forthcoming about our methods and conclusions in all our work. 

New research coming soon. 

We are currently executing our outcomes research program and in the fourth quarter of 2020 we are releasing two studies on the clinical effectiveness of Modern Health—one on the effectiveness of our triaging system, which demonstrates how we assess individual employee well-being and match each employee to the right level of care at the right time, and another on the effectiveness of our coaching program showing improvements in well-being scores, burnout, and presenteeism. Both studies will emerge first as white papers to preview our results and then will undergo the rigorous peer review process for journal publication, hopefully to be released in 2021. 

What’s in store next year and beyond. 

We are excited to share a few upcoming initiatives that will continue to establish our position as a leader in mental health care delivery research. First, we have partnered with Cerebrae, an independent actuarial and analytics firm that uses deep subject matter and engineering expertise to solve financial and operational risk management problems within the health care industry. Tech-enabled and product driven, Cerebrae partners with health care payers and providers to create a next generation of more nimble actuarial and analytics infrastructure. To examine cost effectiveness, we will be working with Cerebrae to conduct analyses that demonstrate the financial value of Modern Health. 

Second, we are in discussions about a collaboration with researchers at the Stanford Clinical Excellence Research Center (CERC), where our own VP of Clinical Care, Dr. Myra Altman, completed a post-doctoral fellowship in value-based health care. With CERC, we are planning to investigate how our care model improves both clinical and cost outcomes. 

Finally, we are expanding our client research partnerships to track the organizational outcomes that matter most to our customers—including reducing the stigma surrounding mental health and increasing access to care for all employees. We look forward to sharing these and other outcomes and contributing further to the body of peer-reviewed research upon which our work relies. 

Sara Sagui-Henson, PhD

Dr. Sara Sagui-Henson is a behavioral scientist at Modern Health.

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