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How are advancements in digital healthcare changing the landscape of employee benefits? How can companies address the mental healthcare needs of their employees? Catherine Clifford, Senior Writer at Entrepreneur.com, leads a panel on the future of work benefits.

Catherine Clifford
Moderator

Senior Writer

Entrepreneur
@catclifford

Terrence Cummings

Director of Business Development

Stride Health
@tdoogles

Cheryl Swirnow

CEO

Sherpaa
@sherpaahealth

Dr. Andy Sekel

Advisor

Talkspace
@talkspace

Jordan Goldberg

CEO & Co-Founder

StickK
@stickk

Catherine Clifford:
Hi, guys. How is everybody? Okay, so this is the last panel before you get to go to your happy hour. We’re going to talk about workplace benefits, and it’s the last panel of the day. We have a challenge, and I think the first thing we should do is everyone needs to stand up, just … We got to get this excited. We’ve got to be interested. You’re going to get beer after this.

Terrence Cummings:
Stretch out.

Catherine Clifford:
Yay. Okay. Okay. Good. Good. I also want to get a sense of who’s in the audience. Who are you? Are you business owners? Are you therapists? Let’s start with therapists. Wow.

Cheryl Swirnow:
All right.

Catherine Clifford:
Okay. Okay. Good. That’s a lot of therapists. I was really nervous about anything that I’m going to say. What about business owners? Okay. Okay, a few. That’s good. You? Okay. It’s hard to see. Who else might we have? Therapists, business owners, who else are you? Anyone else who isn’t in one of those categories?

Andy Sekel:
Press?

Audience Member 1:
Press, yes.

Catherine Clifford:
Press? Okay, good. Thank you. All right. All right. Well, cool. That’s good. We’re going to have Q&A at the end, but I also … The idea is this should be engaging and think about your questions, and don’t just dream of your beer although that will come soon. Okay, good. We’re going to start to have everyone just briefly tell you their name and what they do or what company they run. Okay.

Andy Sekel:
Hi. My name is Andy Sekel, trained as a clinical psychologist, practiced for a long time and just finished ten years at OptumHealth and now I’m an adviser to Talkspace.

Catherine Clifford:
Yay, Andy. Okay.

Terrence Cummings:
My name is Terrence Cummings, and I run business development for Stride Health. We help individuals to navigate the world of health insurance. That’s finding, buying and managing their health plan throughout the year.

Catherine Clifford:
Yay, Terrence. Okay.

Cheryl Swirnow:
Hi. I’m Cheryl Swirnow. I’m the co-founder and CEO of Sherpaa and our job is to make health care accessible and affordable for businesses and their employees, and so we provide them with health care via the Internet.

Jordan Goldberg:
My name is Jordan Goldberg. I’m the co-founder and CEO of stickK. We help users set and achieve their own personal goals and then establish a great behavior change. In addition, we run corporate-based incentive wellness programs.

Catherine Clifford:
Okay. Good. Good. Everyone’s still there. Okay. First of all, I want to start with some broad questions. Everyone can participate, jump in. How are employers’ perspectives on mental health care changing in the last few years? Maybe we could do a little prediction of the future, too.

Andy Sekel:
I think they’re changing a lot. I think some of the changes happen because of ACA and because of the parity laws that-

Catherine Clifford:
ACA?

Andy Sekel:
Affordable Care Act, better known as ObamaCare, and because many of you know right before ACA passed, Patrick Kennedy sponsored a bill that provided parity for mental health, which meant you couldn’t restrict mental health benefits in any different way than the rest of health care. I think that changed employers’ view. It opened up mental health in a much bigger way, and I think many of them have recognized the contribution that mental issues have toward chronic illnesses and the overall wellness of their population. Most importantly, for a lot of employers, they’ve recognized that engagement is a really important part of the workforce and that mental health problems deteriorate engagement.

Catherine Clifford:
Okay. Anyone else want to participate in this, how employers’ perspectives about employee mental health?

Terrence Cummings:
I can hop in. We deal primarily, I’ll say, only with the individual coverage market, so just to put that as context, and one thing that’s really interesting, I think this is building off of what you just said is … I think there is a perspective now with who we work with where there might not have been before. A lot of that is because through our platform or we actually bring up for people that tell us that they actually have issues with depression, and these are issues that prior to that, it wasn’t even known. We can bring data that says X percent of your population actually says that they have issues with depression and that’s surprises a lot of people. For us, I’d say that there has been a more important emphasis, I think, placed upon it, just generally where they might not have been before because the problem wasn’t known. It just wasn’t surfaced.

Catherine Clifford:
So more of an understanding is meaning that employers are paying attention more.

Terrence Cummings:
Exactly.

Cheryl Swirnow:
Yeah. We’re seeing the exact same thing at Sherpaa. One of the buckets that we offer, so when an employee first logs into our site, they tell us they’re sick, they’re hurt, they needed a prescription refill, etc., and one of them is either mental health concern. That is our fastest-growing bucket right now and it’s everything from general workplace stress, up until the more chronic issues. We’re seeing employers getting that information, understanding that their population, while they might be young and healthy, mental health is a huge portion of what that is and they help to try to destigmatize that and provide access so that people can get the care that they need.

Jordan Goldberg:
Yeah. I think, what we’ve seen at stickK, from a corporate wellness perspective and from a benefits perspective, is employers used to come to us, say, three, four, five years ago and they would say, “You know what? We just want to get our employees to complete their health risk assessment and complete their biometric screening,” and that’s it. Maybe focus on some physical activity and some nutrition-based goals, and we would set the frameworks for that. What we’ve seen now is employers saying, “Well, we really care much more about total lifestyle behaviors.” Right? It’s not just physical activity and nutrition. It is mental well-being. It is different forms of stress management. Now we’re actually creating goals for the employees of our large clients around what we call financial wellness because obviously, that’s a big contributor to stress. We have goals around work-life balance and getting good sleep habits in place and making sure that people have digital detox times. I think it’s really important that employers have begun realized just how critical the role these little behaviors play in people’s mental well-being. I think that’s why you’re starting to see a shift in their perspective on the issue.

Catherine Clifford:
Do you think they’re caring more because it’s the right thing to do or because it’s making their employees more productive, if they’re taking more interest in this or it’s some of both?

Jordan Goldberg:
I think it’s some of both. I mean, I think there are a lot of employers who are in it because they want to have employers who are happier and more productive and that’s going to contribute to their bottom line. It’s also retention tool. At the end of the day, these benefits become important because they are offering them and competitors are. They might lose out on some key talent. Yes, I hope at the end of the day, there’s some interesting motivation about the fact that it’s the right thing to do. I think you probably see a mix of incentives when it comes to that.

Catherine Clifford:
Yeah. Okay, good. Touch me a little bit about the difference between millennials and how millennials and maybe how older generations are willing to engage in mental health care benefits offered by their employers.

Terrence Cummings:
You don’t want to talk about millennials. You mentioned-

Andy Sekel:
No. I actually don’t want to talk about millennials, but I would talk about boomers, which I belong to. I mean, we have this discussion earlier and I’m not sure there’s a huge difference. I think there’s been this notion that people of my generation don’t want to use technology and I think that’s wrong. I mean, I think we’re all very engaged in technology. When we look at some of the data, even a Talkspace or other sites, then you realize that people that are in Medicare now are using technology a lot. A lot of the large of the Medicare providers are promoting the use of technology. I think ten years ago, that might have been true that boomers were still getting used to technology. I’ve an 85-year-old grandmother and we saw her recently, and she said, “The best thing that ever happened to me was texting.”

Catherine Clifford:
Okay. Also, how about the, not just the technology but also the idea of engaging with mental health benefits. I mean, do you think that younger people are more willing to? Is there more of a stigma for maybe older people?

Terrence Cummings:
I don’t know if they’re more willing to because I … But I can say that they are very much so willing to.

Catherine Clifford:
Okay.

Terrence Cummings:
It deals with, part of it’s, I think, technology. The other part of it, I think, today is just the idea of privacy has changed, right, and kind of going away. The word stigma has come up a lot. I think the stigma and the cloud that lives around it has started to dissipate a little bit. People are more aware and they have more data that there are issues out there and so, therefore, you’re not alone. It’s not as big of a deal, I think, to seek these benefits. I will say that it is still incredibly difficult for both groups to be able to find the benefits they need, whether that’s in finding a therapist or the right therapist or a counselor. I think that’s still very difficult even though things like the Affordable Care Act have tried to make it simpler, right? They’ve mandated that plans that’s equal, right? There’s parity but I think when it really comes down to it, it’s still difficult for people to actually get the help they need but they’re very willing.

Andy Sekel:
Yeah, and I think that partly happens … We were talking earlier because access is defined as having someone within eight or ten miles of where you live and people that work on campuses and jobs on campuses or don’t feel like traveling eight, ten miles in Southern California. I think what ties the generations together is that we’re all interested in getting easier access.

Cheryl Swirnow:
Also the right access, too, which I think is a huge piece of what we do. For us, on the mental health side, it’s about finding the right professional. You might come to us with an eating disorder. You’re going to seek different treatment and needed different provider than somebody that’s coming to us with a relationship issue or a deep depression. I think it’s important not only that it’s somebody within eight or ten miles but it’s the right person within eight or ten miles. I agree it’s … People want that ability to be able to seek that help, I think, more than ever, but it’s finding the right help and knowing how to get that.

Jordan Goldberg:
Yeah. I would agree, I think, to both Cheryl and Terrence’s point. Yeah, access, it’s not that effective. The access isn’t there. It’s really … It’s about the communication that’s often the bottleneck. I find that … I often have conversations with folks. They ask me what stickK does and I explain it to them. They say, “Oh. I could really use something like that.” Then I go and do my homework. It turns out they are. The employee has no idea. It’s not because the vendor that they’re using is not a submission product and ours is so much better. It’s that the communication piece is often really lacking and people don’t even know what’s offered to them by their employer. I think it’s the communication is a big bottleneck.

I also want to go back to a point that Andy touched upon at the beginning of this question around engagement, especially when it comes to technology and so this stereotype that the older generation isn’t really as adept. We have found that we engage people over the age of 45 almost equally as the people under 45 for our corporate offering. There is a slight skew to the younger population but the average age of an employee who’s eligible to participate in our program is 44. The average age of an actual employee is 40. We do a pretty good job from that distribution and I should even say we do a good job of … It’s not that any brilliance on our part. I think it’s the fact that no, it’s great to see the fact that the older population and the younger population can both equally engage with technology. Five years ago, maybe that wasn’t the case but today, I think they’ve caught up.

Catherine Clifford:
Do you think that there’s … Is there any … Have you heard any hesitation from users on talking about … As you were saying, so you … One of the most popular questions people log in and they say, “I have mental health issue.” Is there any resistance or hesitation or inhibition towards saying that they … Putting into the interwebs, the computer, making … In the Internet that you have mental health issues?

Cheryl Swirnow:
We haven’t seen that, but I think it’s also about building a relationship and about the communication as you said. For us, it’s knowing that there’s somebody on the other end. It’s not just going out into the Internet that some of this is going to be able to help you but we really haven’t seen that. I forgot who brought … I think you brought that up as well. Other areas that we’re finding to kind of tie into mental health are finance questions. We have sex questions in our wellness site that are very often much more about mental health and they are about actual sexual health. I think, yes, I think that people aren’t really having those issues and again, where in stigmas come up a lot but I think people want to get the access they want to get help.

Andy Sekel:
Yeah, and I think it’s really upon us about the security of our systems because it shouldn’t go out into the Ethernet.

Catherine Clifford:
Of course, it shouldn’t but I think there’s the fear maybe. To put that …

Andy Sekel:
Yeah, I think there is that fear but part of developing that trust relationship is really reassuring people that you have a secure site and that you’ve done all the HIPAA requirements and all the things that make it secure. I think sometimes people don’t understand that but it’s a part of, I think, the education that you’re not buying something on eBay. You’re really on a different kind of site that has a certain level of security that makes it really hard to access your purse. That’s an issue for all of us. I mean, we’re all required by law to have secure information. We all have standards that we have to adhere to and we just have to keep educating people that those standards and those systems are in place.

Jordan Goldberg:
Yeah. I think that’s exactly right. I think the security is there but then it’s, to your point, it’s the trust that’s the … Again, going back to the communication piece of it, right, which is that we have employers … We have employees that will will write into our customer support. “Does my employer have access to this?” They don’t, but we have to … It’s not just about convincing of that fact. It’s about setting the entire stage, so we know we white label our products and they’re branded for our clients but we tell them, you know what? It’s not that we want to promote our own logo for stickK, but we want to make it clear that there is a third party that’s managing this and that as a result of having that third party who is responsible, it helps divorce a little bit the association between my personal health and my employer. We’re sort of that buffer and I think that’s an important piece that all of us have to play when we’re dealing as an intermediary between the employee and the employer.

Catherine Clifford:
Are you guys still with me? Yes? Okay, good. We’re going to go to questions. We have about eight, ten minutes, so if you have questions, start thinking, start thinking. Okay. How about the future trends of health benefits? Now that there is so much more data and there is so much more information, talk about personalization of benefits. How are benefits changing and how will they become more personalized?

Terrence Cummings:
For us, as I said, we’re focused on the individual market and personalization is incredibly important. It’s the core of our system, and so we … As someone comes through our system, they provide us with all the standard information like age, gender, etc. They also tell us what they’re current conditions are. They tell us what prescription drugs they’re on, and we use that to recommend the right health care plan, right, and additional benefits for them. I mean, for us, it’s incredibly central. It’s not an … I think the days of the aggregators, I think, are over where you can say, “Here’s the full menu and choose what you want.” It’s a time where people are more willing to provide data, and so if they are more willing to provide data, we can use that data for their benefit.

As a part of that, I’ll go back to last question too, I think it feeds into trust as well because as long as you show them value and particularly, it’s a real-time feedback and value all along the way. People aren’t willing to just provide a lot of data and then you say, “In three months, you’re going to see why you provided us that data.” Looking at our experience, each step, as you provide us with more data, we then provide you with … It might be as simple as here’s so many doctors in your area or here’s the average cost of a plan based on your ZIP code, that kind of thing. We just provide them with more and more information. I think that then feels trust. You say, “Okay. You ask me that because you’re going to give me something.” You also establish credibility. That’s incredibly important. That tying into the personalization, those two really go hand in hand.

Catherine Clifford:
It sounds like what you’re saying is baby steps. You give me this information. I’ll give you this. You give me this information.

Terrence Cummings:
That’s what we found works incredibly well with sensitive data. Otherwise, you’re asking for a lot of sensitive data and you’re not-

Cheryl Swirnow:
Upfront.

Terrence Cummings:
Yeah, upfront. You’re not-

Cheryl Swirnow:
Hi, the person I’ve never met. Like, here’s all of my information.

Terrence Cummings:
Exactly.

Andy Sekel:
Yeah. I think personalization, besides of how it impacts benefits, will also go deeper into as electronic medical records become more pervasive where I think we’ll have better recommendations for individuals about here are some things that you could do that would mitigate some of the potential problems that you’re having. A simple example is, if you have even a mild heart condition, you’re probably more prone to depression. Those kinds of pieces of information that can really help someone in some pretty significant ways, I think, will become more of the dialogue. We’re all making sure that people get the right kind of benefits but then the next step is making sure they get the right kind of care.

Cheryl Swirnow:
We’re actually doing that now.

Andy Sekel:
Right.

Cheryl Swirnow:
When an employee first logs in with Sherpaa, they do a risk assessment, an HRA, and when there are things like they are trialed for heart disease or anything, that will automatically create a case with our mental health professionals, with our doctors that will then say, “Okay. You have a risk. We’re flagging it and let’s start to work together on a plan.” I think that, that’s the real key here. From a health care perspective, people want to plan. They want to be engaged. They want to feel like they’re participant. They’re not just being told what to do, that there is some level of engagement. This is the plan. Do you agree to this plan? That’s how you really get people just stick to a plan, and that’s how a change actually happens. I think when you tell everybody, this month we’re losing weight as a corporate challenge, that’s ridiculous. Nobody’s going to do that. I think it’s, what are your challenges? What are you looking to do, and then let’s work together with a professional to come up with a plan that we can all adhere to.

Terrence Cummings:
I … Sorry, I think it’s huge what you both said. It’s incredibly important because we are at the stage where I think a lot of places, they’ll sell you benefits and then that’s kind of the end of their relationship. The benefit is only as good as how much you use it. You’re not going to value it if you don’t, and so getting the support of, as we talked about earlier, actually finding the right person to go talk to, that’s a huge component. Actually, personalization, I think, of benefits is it’s a first step and as you stated, personalization around care is actually the long-term play. Right? That’s all throughout your life and understanding in a year, you’re going to be a different person you are today, right? You’re a different person today than you were a year ago, and so how does that continually change as we go along? It’s pretty critical.

Jordan Goldberg:
Yeah. I think what we’re saying is, frankly, we don’t get highly personalized with our offering but what we do is we pair what we provide with some of those offerings and what you’re starting to see is a lot of these pieces start to be stitched together to one seamless experience. For us, what we have seen is, first, we have seen a widening of the different behaviors that people work on, so we talk a little bit about the fact that it’s not just about traditional wellness anymore. It’s about touching every line item on that balance sheet of your life around mental well-being, financial well-being, social well-being, all those other pillars that are critical to one’s overall sense of self-satisfaction. We’ve expanded that, but it is still largely a menu. Each client gets their own unique menu but the employees then sort of pick and choose their own path.

What we’ve seen an increasing usage of is what we call our referee framework where you can designate for your goals an individual to verify your achievements to close that verification loop. Often, that’s a close friend or a family member, significant other. Obviously, these are people who are privy to how well you’re doing in a lot of your personal goals. These are not professional goals. These are personal goals. Now what we’re seeing is a lot of clients will come to us and they already have telephonic health coaches in place. They have onsite care coordinators in place. We even have one client that has Weight Watchers that work onsite.

What we do is we integrate these existing professionals to serve as referees on our platform to give them that more personalized and curated experience, and they will put together these personalized plans for the employees and then say, “Go make commitments around all these different … These points that we want you to work on.” What we do is we now try to take these disparate assets than an employer is already paying for, bring under one umbrella, create one seamless experience so that it’s easier for the user but also it’s continuous. The engagement is not fragmented as a result and there’s not these different pockets and these islands. As a result, you get them more personalized experience but you also get better retention and a more engaged user as well.

Catherine Clifford:
How do you keep that employee engaged in their own care? Because that’s the other thing. You can make these programs as sophisticated as possible but if you aren’t getting employees committed to participating in their own care, then you’ve got this beautiful programs and employees that aren’t using them.

Terrence Cummings:
It’s not the job of the employee to be engaged. I think it’s a job of our platforms to engage them. That’s the critical element that I think has been missing for a very long time. You talked about the plan earlier, right? It’s our job to produce that plan and so we can sell you … We’ll sell you a health care plan that comes with 88 free preventive care services. Go. Right? That’s typically like what happens, but really, what we need to do is say, and this is what we do on our platform, is we say, “We’re going to sell you this health care plan. It comes with 88, but there are three that makes sense to you. Here’s a primary care physician that lives five miles away and you can book a doctor’s appointment next Thursday at 9 o’clock.” Right, like that’s something that … Now we’re engaging you and you have to click a link. Right? I think that’s what’s core instead of just providing them with, again, a menu.

Andy Sekel:
I think it’s the last big challenge because we know how to, at least, improve people’s health that have diabetes or stabilize people. We still struggle with how to engage them, right, and all these different variations that we’re talking about and people on Talkspace platform, I think, do a really great job of engaging people in therapy but the experimentation around engagement is going to make a huge difference about how the health care system moves and what we’ve discovered in that process and how it moves ahead because there are a lot of diseases we know how to treat. We just can’t get people to pay attention to doing what they’re supposed to be doing. That engagement is going to become more and more critical. I think we’ll start seeing … My prediction is we’ll start seeing not only the kind of thing that Jordan does in terms of incentives but I think we’re going to get to see some large employers actually levying fines against people that don’t engage in the-

Jordan Goldberg:
You mean the stickK?

Andy Sekel:
Pardon me?

Jordan Goldberg:
You mean stickK?

Andy Sekel:
stickK, instead of your carrot. Right. Because there really are some people that are just destroying their health when they know and have done the kind of average that you’re talking about. It’d be interesting to see how that progresses. I don’t think anyone’s really interested in doing that, but at some point, my guess is people are going to wind up paying deferentially. They already are because of the high deductibles.

Jordan Goldberg:
We’re starting to see it. Yeah. I think you bring up a great point. For us, the engagement comes down to also really good incentive design to make sure I have carrots and sticks. On our consumer side, it’s all based on the stickK approach where users can risk their own cash against their goals. On the corporate, we have a more carrot-based model but we use a lot of principles and behavioral economics to nudge people and use different framing techniques to make them feel like the stick is still in play even though it’s all based on a points currency. We can take away points when you’re not doing as well. You can earn points as you are doing well but in some cases, we’re starting to see more of a pure stick with some of our clients where instead of offering a reward, a cash contribution to your premium for completing your HRA or your biometric screening, we’ll see it as a punishment if you don’t. It might be a financial penalty if you don’t.

You’ll see some clients where you have a smoking attestation form where if you say you’re not a smoker, you’ll get a reward. Now we’re starting to increasingly see some clients actually penalized people. What’s interesting, though, about the whole carrot and the stick is sometimes it’s as simple as a framing technique. It might not even be a different economic trade-offs for the employee. You could go to … If you’re an employer, for instance, to have our premium differentials in particular, to give an example, you can go to your employees.

Let’s say they have to contribute $3,000 a year towards their health care premium and you can say, “Hey, if you complete your HRA and your biometric screening and participate in one activity, we’re going to contribute $500 additional to your premium where now, you only have to contribute $2,500. That’s framed as a $500 carrot.” You can take that same set of trade-offs and frame it as a stick. You can go to the same employees and say, “Hey, everybody. You only have to contribute $2,500 a year to your health care premium but if you don’t complete your HRA or you don’t complete your biometric screening, then that’s $3,000.” Same choices. One is framed as a punishment, the other reward. You see a higher compliance rate when it’s framed as a stick. Just in general, the stick is more powerful than the carrot and there’s a lot of really compelling case studies on it. Please feel free to argue.

Cheryl Swirnow:
I will.

Jordan Goldberg:
At the end of the day, we offer more carrots than we do sticks not because we think that the carrot’s more effective but we have to operate within the culture and norms of our clients. The clients don’t want to be construed as being responsible for reaching of the pockets of their employees, so they’re not comfortable with the stick approach. That’s why we have a carrot-based model and we have to do our best to leverage the behavioral economic principles to use the carrot-based model. They’re still really effective but at a pure sort of theoretical level, if you go to one person and you say, “I’m going to give you 20 bucks if you do this,” or you say, “I’m going to take away $20 that you have in your pocket if you don’t do this,” the threat is, generally speaking, more powerful.

Catherine Clifford:
Interesting.

Cheryl Swirnow:
I’ll be super fast. My feeling is if somebody isn’t participating, you have to find out why they’re not participating and not sort of penalize them for not. One thing in this, and I’ll be very fast, but in super-simple level, whenever our doctors are going to make a prescription for something, we give … We actually put it into the hands of the user and we say, “Hey, you have this issue and we want to prescribe this drug. Do you accept? If you accept, that actually costs us the e-prescription to be sent but if you decline, there’s a series of reasons as to why.” “This is drug is too expensive. I’ve used it before and it doesn’t work.” We give them a series of reasons.

You need to have buy-in. That is when you’re going to take the drug. Otherwise, we’re just writing a script and who knows what’s going to happen. I think, generally speaking, like I said before, if you want people to engage, you need to get them as part of the plan. If they’re not engaging, you have to understand why and then make changes. We see 65% utilization across our book of business, which for a telehealth product is initially leading. I think that’s really because our ethos is let’s work together and let’s build a plan as opposed to penalizing you for not participating. Let’s find out why you don’t want to participate.

Catherine Clifford:
Okay. Well, we have some controversy. At least, that’s good.

Cheryl Swirnow:
We told you we’ll do it.

Catherine Clifford:
Okay, so we actually … We’re down to about six minutes. Does anyone have a question? There are microphones that we can bring … Who has the microphone? Okay, good. We’ll bring a microphone around. Okay. Well, let’s start right here.

Audience Member 2:
Hi. Thank you very much. A question I have is, all the companies you work for, do any of them talk about providing benefits for talk therapy online? Right now, if you are in Medicare, Blue Cross Blue Shield, Aetna, Optum, whatever, you have to go one to one for therapy and that’s how you use your benefits. Are any of the companies talking about making, paying for talk-based or therapies like that, that you know of? Do you see that happening?

Andy Sekel:
I don’t think this kind of therapy, the text therapy, is well known enough for that decision to be ever made. If you look at telehealth, there’s huge resistance with all of the large insurers for years as well as some medical associations and insurance departments. That’s pretty much changed, so most of the large insurers now use telehealth, companies like American Well or Teladoc or in many those of companies, including Optum, and I think the future of this kind of therapy will be the same.

I think it will take some time, and I think people have to adjust and look at the research and look at the outcomes. I think you’ll see it changed to where there’s going to be more adoption. You have to remember, the adoption happens because employers want it. If Apple said, “I know people aren’t leaving campus to go see one-to-one therapy and I like this available to him,” then an insurance company will do it for them. Then that tends to … That’s what happened with telehealth. A couple large companies decided they wanted it as part of their benefit package. It actually turned out to save everyone a lot of money and get good results and then it just started rolling.

Catherine Clifford:
What’s an example of telehealth here?

Andy Sekel:
A telehealth is like video telehealth or telephone telehealth. You wake up and you have a soar throat and you can’t get into see a doctor and you call Teladoc and you might do it on video. You might do it mostly by phone actually, so I think there’s a good future for it. I think they’ll take some time.

Terrence Cummings:
Okay. To take a slightly, a different approach from the employer is, because of the market that we’re in, we actually deal with a lot of large independent contractor audiences. We partnered with Uber, Etsy, Care.com, like Intuit self-employed and Postmates, kind of name those types of organizations. I’ll say those are employer. Because for them, they’re not providing benefits, right, but we are a platform that can provide benefits on behalf of their contractors. Those folks are actually very interested in this kind of thing because they’re building it with us from the ground up. They aren’t packages that they’re putting together. It’s more like when we think about the right framework for health plan, like what does that look like? When we think about the right framework for dental insurance, how should we frame it? When we think about, as I told you, a lot of people will come back and say that depression is an issue and so that’s one that we’re actively talking about right now. It’s like they can choose anything because they’re not restricted or mandated, right, to do anything. With those audiences, it’s incredibly interesting to look at everything, to be honest.

Andy Sekel:
We need to get you together with the BD guy for Talkspace.

Terrence Cummings:
I’m not scared.

Catherine Clifford:
Maybe we have time for one more question. Okay, right over here. Can you use the microphone? Okay.

Audience Member 3:
Hi. Sorry. I work for Talkspace. I’m the staff writer and one issue I’ve discussed is like mental health, the conversation of mental health and illness in the workplace so I wanted to ask where all of you see that going, so like our … Will people become more open to discussing it in the workplace to the point where having a conversation about, like, “Oh, I forgot to take my insulin today at work,” is similar to, “Oh, I left my antidepressants at home,” and employees having that conversation with their employers and not being scared to bring that up?

Andy Sekel:
I’ll say my version of it, which is I’m not sure that, and I’ve worked in large companies that, that many people said, “Oh, gee. I forgot to take my insulin today.” I mean, I think we all have a certain amount of privacy around our health care issues, and I think you’re right, mental health has had a specific kind of stigma. I don’t think we can expect to go the other way that people are just going to talk about it when they don’t talk about, “Oh, I had a stent put in last week and that’s why I was out of work.” I think we need to calibrate our expectations where there’s less stigma to how people think about and share and their general health care condition versus thinking there’s stigma now and someday we’ll all be talking about, “Gee, I had an anxiety attack last night so I didn’t sleep so well.” I think we have to calibrate back if we expect to be similar to regular health, what people do with their regular health conditions.

Catherine Clifford:
Yeah.

Jordan Goldberg:
Yeah, I would agree. I don’t think we’re quite there yet, and we have a ways to go. I think it’s … Especially when it comes to mental health, there is this stigma and it’s slowly being destigmatized. I think it’s a long journey. I don’t know if we’ll ever get quite to that level where people will completely relinquish their privacy. I think there’s always going to be a setup and it’s going to be down to personality traits as well. There are going to be people who are comfortable and there’s going to be people who aren’t. It’s also about making them feel okay that they don’t need to share everything as well. I think it’s about choice.

Terrence Cummings:
In the workplace, it’s especially a sensitive this place to talk about that. I mean, that’s a … You can interpret, let someone say it in so many ways and you think about any that’s meeting with them when they don’t do … I mean, that’s a really sensitive place so I think even as people open up, the workplace is probably the last place that they’ll start to open up with that kind of thing about.

Catherine Clifford:
All right. We’re now going overtime so I want to thank everybody on this panel. Let’s give them a round of applause.