Scaling Disruption: The Road to Behavioral Health Reimagined

By Steve Biljan and Erik Osland, Co-CEOs

When we started evolvedMD seven years ago, we never imagined that it would become the market leader in behavioral health integration. But in just seven short years, we’ve done just that.

With a passionate and committed team, we have built a company that has already achieved so much since 2016, including:

1. Enhancing and commercializing the traditional Psychiatric Collaborative Care (CoCM) model
2. Increasing access to affordable behavioral health services,
3. Building a renowned culture of self-care and work-life balance, while
4. Proving that doing the right things can drive a successful business.

We’ve accomplished a lot in a relatively short period of time, and here’s the kicker: neither of us have formal backgrounds in behavioral health.

How did we get here? Personal and familial experience combined with a passion to disrupt a broken healthcare system. While running a successful healthcare startup is challenging, we’ve been able to transform evolvedMD into a vehicle for igniting meaningful change and are proud of the progress we’ve made. Today, we’d like to share our journey and what we’ve learned along the way in hopes of inspiring other healthcare leaders looking to create change.

Disrupting The Status Quo


Disruption and innovation are inherently intertwined and when both are leveraged appropriately, can lead to game-changing products and services. This is especially true in our legacy healthcare system with all of its embedded complexities around where services can be delivered, who can provide them, who pays for them - and that’s without mentioning parity, networks, prior authorizations, exchanging information, or tracking outcomes.

Both of us are naturally curious and to get to our level of success, you must be a bit rebellious too. For us, the need for disruption stemmed from deeply personal ties to health care and mental health that inspired us to launch a pilot at a primary care practice in Phoenix, Arizona. Bob Iger once said, “You can’t allow tradition to get in the way of innovation,” and this was our opportunity to disrupt tradition.

Passion is an extraordinary driver for disruption, but we had to define it for ourselves first with a strong and clearly stated purpose. Today, our purpose (read: our passion) is innovating and leading the integration of behavioral health services in modern primary care, because patients are best served when primary care and behavioral health work together.

Key Takeaway: Define your purpose—your passion—and let it fuel your desire to disrupt, no matter how difficult it may be.

Tackling the Right Problem with the Right Solution


Disruption is not just an action but a mindset that’s integral to success and we learned early on that we must be willing to disrupt ourselves, too.

In the initial stage of evolvedMD, we were laser-focused on testing integrated medication therapy management to treat complex chronically ill patients. We didn’t think to integrate behavioral health into the model until 80% of our patients screened positive for anxiety and depression, compelling us to pivot and shift our mindset to treating the whole patient knowing that physical and mental health are interconnected.

Tackling a growing problem with a clinically validated solution, we knew we were on the right path. With this change in focus, we were one of early companies working to bring integrated behavioral health services to primary care providers and their patients. We knew that the quantitative and qualitative evidence to do this was strong and growing, but also still fairly nascent. Shifting gears to adapt our model to reimagine the healthcare landscape allowed us to be well-prepared for when the impending movement behind integration took off.

This shift looks like placing master’s level mental health clinicians onsite and in person at each of the practices we serve. This empowers us to increase access by meeting patients where they are and where they prefer care, provide higher quality-services, and ensure consistent care with the whole patient in mind. Our radically different approach to behavioral health integration is actively disrupting healthcare and igniting meaningful change.

Key Takeaway: To solve big problems, you must build innovative solutions and test those solutions. However, you must be willing to zoom out and pivot your solutions along the way to proactively address even bigger problems.

Committing to Commercial Viability and Excellence

Oftentimes in healthcare, clinically forward solutions lack commercial viability to scale. With our backgrounds, we knew that to increase access and bring our model to the masses, we had to make it financially feasible for both practices and patients.

The biggest testament of our commitment to commercial excellence is our collaboration with HonorHealth, a leading Valley healthcare system serving 1.6 million people in the Phoenix area. Starting with four pilot sites in 2020, we’re rapidly scaling across HonorHealth’s other primary care locations which will provide Arizonans increased access to critical behavioral health services.

Our approach isn’t just recognized in the Southwest, Dr. Jennifer Thomas, Medical Director of Integrated Health at Morris Hospital in Illinois, said, “evolvedMD’s consultation was crucial in helping Morris Hospital operationalize and commercialize integration across our six sites. Bridging us from an academia-based pilot to a real-world comprehensive rollout was mission critical as we expanded services across Illinois and evolvedMD’s understanding of how to scale this model was invaluable.”

Key Takeaway: Anyone can have an idea, but you must thoughtfully cultivate and nurture the components that truly make you unique in the market to prove viability.


Finding the Right People


Delivering on an audacious ambition while making a population-level impact requires finding the right people. Deliberate and intentional in recruiting talent, evolvedMD attracts committed changemakers who are radically different from anyone else in the market.

With a company that’s now 170+ strong and growing, we have proven that we can effectively recruit and retain individuals passionate about the delivery of our unique approach to behavioral health integration, individuals driven by passion and integrity, individuals who understand the power of patients and providers working together to ultimately deliver great care.

Key Takeaway: There is plenty of great talent out there, but that doesn’t mean they’ll be a great fit. Take your time assessing who will thoughtfully and intentionally champion your product, culture, and team.

Spearheading a Cultural Transformation to Reimagine Behavioral Health


You can’t disrupt an industry without thoughtfully building your company culture. Think about it: if the people you depend on to deliver exceptional care to patients every day don’t feel supported and become burned out—an unfortunate reality in this industry—their ability to treat patients and collaborate with providers suffers. As an employer of choice recognized as a Best Place to Work by Phoenix Business Journal, we’ve led a workplace paradigm shift by building a people-centric culture that puts our employees first so they can deliver high-quality, whole-patient care. Disrupting workplace culture looks like:

• Linking individual bonuses to self-care

• Limiting clinician caseloads

• Promoting work-life balance

• Regularly supporting personal and professional development

• Offering free clinical supervision for licensure and continuing education

• And much more

Quite simply, we have proven that in the behavioral health industry, good culture drives good business.

Key Takeaway: Take care of your people, and they will take care of your patients, and therefore your business.

Building Resilience


Roadblocks and setbacks are inevitable when running a business. For us, the difference between success and failure is how we approach these obstacles: remembering and holding fast to our mission. Even in the face of failure, we still believe that our upfront, innovative, and ongoing approach is the better way to integrate behavioral health.

Sure, we’ve been turned down by primary care practices who didn’t share our vision, but that didn’t deter us from why we started evolvedMD in the first place: disrupting the status quo by reimagining behavioral health. We’ve proven our model works, scaled it dramatically across the Southwestern U.S., and continue to capitalize on boundless opportunity on the path to market leadership.

Key Takeaway: Face any obstacles and failures by remembering your mission, and let any opposition fuel your desire to innovate and disrupt even more.

Closing Thoughts
We’re driven by creativity, compassion, and change. Even though neither of us have backgrounds in behavioral health, we think having an outside
perspective and leading with passion and vision helped us to disrupt the current state of behavioral health and drive meaningful change. Proving commercial viability is always great but knowing we’re also rewriting the narrative of what it means to deliver improved patient outcomes, increase access to mental health services, and taking good care of our employees is even more rewarding.

Learn more about evolvedMD, our unique approach to behavioral health integration, partnership opportunities, and open job positions. We’d love to have you join us in our journey to reimagine behavioral health.