The Mental Health Continuum: A Conversation with Gyre Renwick, COO of Modern Health
Care Navigation Conference 2023 Health Tech Mental Health
Gyre Renwick is the Chief Operating Officer at Modern Health. He has over 20 years of industry and leadership experience, and has developed and scaled enterprise healthcare departments at some of the world’s fastest-growing companies and enabled healthcare access to some of the most vulnerable. Gyre spent five years at Lyft as Vice President and Head of Healthcare for Lyft Business. An early employee of Google, he spent more than a decade as Head of Industry for Healthcare, growing the tech giant’s healthcare department and enabling healthcare organizations to use Google’s full suite of products. Renwick was also responsible for creating and launching the Google Grants program to help non-profits grow through technology, which later became Google.org.
The Pulse: We would love to hear you describe, in your own words, your impressive career trajectory. How did you come to become COO of Modern Health?
Gyre Renwick: Going back in time – when I was in undergrad, I thought I wanted to go to medical school. I had gone all the way through the process and was about a month away from starting. At the same time, I was working at a nonprofit focused on addressing challenges faced by the “working homeless” in the Bay Area. It’s amazing how many people work a 9-5 job but can’t afford to pay rent in this area, often stemming from mental health or substance abuse challenges or other life events that occur to people living so close to the poverty line here. I realized that I actually wanted to leave my spot in medical school to be part of hands-on solutions-building.
Back in 2003, I joined Google when it was still a small startup – at the time maybe 350 people. As we grew, we started to segment ourselves by industry, including what became the healthcare team at Google. We realized there’s a lot more you could do within healthcare other than just promoting ads and selling products, and started looking at how to use healthcare industry expertise and partnerships to build hopefully amazing products. For example, we were able to bring health content curated by our partners like Mayo Clinic or Cleveland Clinic to the top of Google search results for flu, etc., We were really focused on innovative ways to bring together healthcare and technology.
A pivotal point for me was working on a project looking at how you could help blind and disabled populations get better access to healthcare appointments through autonomous vehicles. We got really excited about how important transportation was for people to remove barriers within healthcare. This gave me the idea to go to Lyft in 2016 with a business plan to build out a team focused on getting better access to care for low-income and elderly populations. When I joined Lyft, there was no healthcare business, so I started as a team of one and got to build out a truly amazing group. People don’t realize the volume of Lyfts’ rides done by organizations paying for them, with almost half coming from healthcare. It’s pretty powerful to see how meaningful it was for someone to get rideshare access to treatment, and how that can decrease your mortality rate and cost of care. There’s a powerful opportunity to get people the treatment they need while saving the healthcare ecosystem significant dollars.
I did a quick stint outside of health care after Lyft, but I realized that I missed health care too much. That was what brought me to Modern Health, almost a year and a half ago. Healthcare, to me, is mission driven and has purpose behind it – which is exactly what I wanted back in non-profits. There are a lot of big problems to solve, and mental health was a really exciting space for me because as a society, we just don’t do a lot to care for this facet of people’s health.
The Pulse: We’ve seen Modern Health described in recent press as a robust “one-stop shop for employee mental health benefits” – can you elaborate on Modern Health’s product offering and how it’s broken away from being solely a point solution?
GR: This is exactly what we were trying to solve for. We felt like there were a lot of different point solutions out there in the space, and unfortunately there was not a single platform that could cohesively bring people along their mental health journey as needs change over time. I’ve talked to customers today that work with multiple point solutions across different mental health providers. As a result, there’s a disjointed experience where a member doesn’t have the ability to move from one step to the next seamlessly when their needs change. Our general view is that mental health operates on a continuum, and we all fall somewhere on this spectrum as we move through various life events. We talk about this spectrum in terms of moving from green to yellow to red. If you’re in the red, you need therapy, possibly medication, and, overall, a strong clinical intervention. As your life fluctuates, you may move back to the yellow where perhaps coaching or group work become more appropriate for you. Even if you fluctuate all the way to green, and you’re doing a good job of managing mental health, there are preventative interventions that you can do to continue keeping yourself well-managed.
I like to use the analogy that you should have services to help you manage your day-to-day mental health just as you manage your dental health prior to acute events, like brushing your teeth and flossing daily, going to the dentist every 6 months, and going in when you have an acute issue like a cavity or pain. As a society, we wait until the moment of crisis to actually add mental health services. At Modern Health, we focus on building a full-spectrum, stepped-care model, where we bring you in wherever you are on that spectrum or wherever your willingness is to get care that you need, given that there’s still some societal stigma. Our data shows that about 40% of the population that comes to Modern Health that is triaged to therapy through our step-care model doesn’t actually want to get that help that they need. If you only offer a therapy solution, you’re actually, in some ways, turning your back on 40% of the population that actually needs help. Our model is a connection of therapists, coaches, group activities, and digital content. I think group activity is a really powerful option to provide because it’s an easier entry point than 1:1 care for some populations. Essentially, we’re trying to create a platform that actually addresses people’s mental health, reaches them with the right level of care when they’re available to receive it, and then helps navigate them up or down that spectrum as their life events change.
The Pulse: What are some of Modern Health’s long-term goals in this industry? What type of future do you see yourselves moving towards?
GR: Our model today is primarily selling direct-to-employers, frankly because it’s how the majority of the US population receives health care. We believe mental health is going to become that fourth pillar of people’s benefits in the future, alongside medical, dental and vision. The reason for that is that unfortunately, most health plans today do a pretty poor job of actually supporting mental health needs. If you call them asking for services, they’ll likely give you a long list of providers to call, half of whom no longer accept your insurance, and the other half who have a six or more-month waitlist. Even if you find someone, most people can’t afford to spend $150-200 an hour out-of-pocket to see a therapist to get the help they need.
The Surgeon General put out a report recently that said almost 75% of the US workforce has had a mental health need, and around 80% of those said their employer did not support them to get what they needed. The report also said around 85% of employees expect their employer to add these types of services for them as part of their benefits and will look for employment that provides mental health services. So now, there is an interest from an employee perspective, leading to an interest from an employer perspective. That’s why we are selling direct-to-employers and have seen a substantial amount of growth and attention there. Especially given COVID-19, it’s becoming a tough benefit to ignore and some of the stigma is starting to change. We want to be at the forefront of this conversation in building out this fourth pillar by working with employees and employers towards this future.
The Pulse: Our theme for WHCBC this year is about the empowered healthcare consumer and we know that’s a big part of Modern Health’s mission around “empowering customers to be change agents”, i.e., the employers fostering better mental health cultures for employees. How do you think about building an aligned product for both of these stakeholders?
GR: I think the way that we think about our business for selling to employers today, a lot of our most are payers, or health care, or benefits leaders. We provide support so they can be change agents across their employee base. What I love about the employer market is that you have a single-entry point where you can reach tens of thousands or more employees at a single organization. If you can champion a benefits leader and senior leadership to want to make a change in the culture of mental health, you can really change stigma. Outside of our member/employee-facing platform, we do a lot to build tools specifically for the employers themselves. While it’s more of an employer analytics platform, they can pull digital and provider content to distribute to their employee workforce. Lastly, we do also support our employers with promotion, adoption, and engagement of our product.
When you look at most traditional EPs, they have less than 5% engagement. With Modern Health, we’re seeing an average engagement of around 25%. We’ve built the analytics to help employers understand the well-being of their workforce too. They see, across different parts of their population, how employees are driving engagement, what type of services they use, and what type of content they’re looking at on an aggregated level. That becomes really powerful to help employers understand their employee base, beyond an annual or biannual survey. For example, we can help employers understand if new managers entering an organization are struggling as they make that transition, and customize our member experience based on specific employer situations.
The Pulse: How do you think about external partnerships at Modern Health?
GR: We built a really successful partnership with Naomi Osaka, as she’s been a strong advocate for mental health. Through that partnership, we’re trying to change the narrative around mental health. We recorded meditations and content within the Modern Health platform narrated by Naomi. It’s powerful when you see people like Naomi or other public folks talk about mental health openly. The adoption or engagement with those has probably been the strongest we’ve had. Apart from just her brand and success, the actual meditations she’s put together around talking about stress or anxiety and her personal struggle is some of the strongest content we’ve seen.
We also focus a lot on partnering in communities right now. We’re a global platform, and we have providers and employees all across the world. The Circles product is an area we’re investing a lot in right now. Circles is the experience around a group activity: it could be that we’re on camera and can see each other, or it can be a provider-to-many experience where you don’t see everyone, but you see there are other people participating. Circles can be a powerful experience within the mental health space to bring other people together who are going through the same struggles or challenges, especially in today’s world where we may be isolated working from home. We can build Circles for closed organizations, meaning we can partner with an organization or employer and bring in certain demographics or folks together. It can also be an open community Circle for people across organizations that are going through similar challenges or struggles at the same point. So I think investing in Circles at an international scale is a really strong area of focus and growth.
The Pulse: How do you think about bridging the gap between the other three pillars of “physical health” benefits and mental health?
GR: We’re doing a lot of work right now to tie those together. You can imagine if people take better care of their mental health, at a high level, they may eat better, exercise more, and take their medications. We’re trying to help organizations connect those two points together by looking at medical claims data to show that every dollar invested in mental health decreases downstream physical health costs.
The number of primary care visits tied back to depression or anxiety is incredibly high today. Often, people can’t get the help they need through traditional mental health means, resulting in visits to their primary care physician with anxiety or depression-related costs. Therefore, you’re paying the money to a primary care physician who is likely not providing ongoing continuous mental health care. Our general belief is if we can actually help organizations show that for every dollar spent on Modern Health, you are saving X dollars downstream of physical health costs, there’s a really strong ROI in terms of physical health costs. In the short term, we’re also looking at productivity costs. How many additional days is someone calling out sick? What’s their productivity level? Can investing in mental health boost employee retention rates? We’re seeing support for our hypotheses here. We’re really excited about this area now that we have three to four years of data across organizations. We can start to tell that story and we’ve already started to publish some research showing how powerful mental health investments can be to decrease people’s physical health costs. At the end of the day, physical health costs are still the lion’s share of an employer’s budget.
The Pulse: Is there anything else recently that you’ve been really excited about as an opportunity for your team?
GR: I think the other area to touch on is coaching. Today, a lot of solutions out there rely purely on therapy. And if you look at the world’s population, there are not enough therapists to support every single employee. On top of that, therapy is not the most appropriate option for everyone. It’s significantly more expensive and if you push everyone to therapy, many people that actually need therapy can’t get the help they need. We’ve invested a lot into broad spectrum coaching, including relationship, financial, mental well-being, etc. We’ve been able to show that adding mental health coaches to folks who are triaged to yellow but not necessarily appropriate for therapy had the exact same clinical outcomes as a person who sees a therapist. Leveraging coaching is much more cost-effective to an organization. Coaching also creates additional entry points for thinking about one’s mental health. It’s interesting to see many people start coming to Modern Health to invest in career coaching first, and over time, maybe they’ll transition to needs for other aspects or triage states of mental health.
The Pulse: What advice do you have for MBA students or professionals trying to find their way in healthcare?
GR: #1: I always believe you need to invest in relationships. I’ve met an amazing network of people throughout my career, and every single role I’ve received has been based on some relationship, or an introduction from a connection. Every week, I try to meet with someone I used to work with, for, or beside and really try to cultivate my relationships.
#2: Try to find what excites you and really drives you forward. I gravitate to mission and purpose-driven companies. I tried to take a different path outside of healthcare and quickly realized it didn’t feel authentic to me and what I wanted.
#3: I think it goes back to some of my early Google days but set goals and milestones that seem completely unattainable to you at the time – moonshots, challenges, etc. This also goes for your personal life. I set a goal of completing an Ironman and I’d never run more than three miles at a time, been on a road bike, or swam more than a couple of laps. A year later, I finished my first one, and since then I’ve completed almost ten more. I think challenging yourself and taking leaps of faith in believing you can do it are really important all throughout your life.
Interviewed by Kavya Bodapati, January 2023.
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On Feb 16-17, 2023, Wharton is excited to feature more expert perspectives at our annual Wharton Health Care Business Conference. This year’s theme is ‘The Empowered Health Care Consumer’. Conference details and tickets are available here.