Homelessness is a growing and worrisome public health phenomenon, and it has long been documented that people experiencing homelessness face an earlier and greater risk of developing health problems. That alarming pattern, combined with the COVID-19 pandemic and the fact that nearly 40% of Americans delayed care last year due to cost, highlights a serious need for health solutions for the homeless population in the U.S..
Last week, Sesame co-founder and president Mike Botta spoke at a panel in New York City to discuss practices for improving mental health services for the unhoused. The event, sponsored by HELP USA and hosted by City & State, aimed to address how digital health-related technology developed during the COVID-19 pandemic can now be used to increase health stability for homeless New Yorkers.
Botta, who holds a Ph.D. in Health Economics and Policy, shared several key insights that he’s learned since creating Sesame, and discussed how new health technology can increase access to affordable mental health services for all populations, including those who are experiencing homelessness.
First and foremost, the accessibility created by telehealth technology is critical. The advantage of telehealth services and virtual healthcare marketplaces is that people can access care from whenever at any hour of the day. “People have access to incredibly powerful devices now,” says Botta. “Even an old android cell phone is more than powerful enough to drive a video health care visit. We underestimate the capability of both clinicians and patients to use their existing technology effectively to deliver and receive care.”
The importance of marketplace dynamics is also a salient factor in improving the quality, price and accessibility of healthcare. Economic forces like supply, demand and variable pricing make care more convenient, accessible and affordable. Sesame has used this model to help patients side-step the cost, confusion and frustration that typically accompany the traditional American healthcare model of long wait times, insurance co-pays and surprise bills.
Applying solutions like these could prove extremely effective in improving the quality of care and decreasing the cost of care for everyone, and the benefits aren’t just limited to patients. When healthcare providers have control over their schedules and pricing, it unlocks more availability.
“That’s been a major benefit of Sesame,” says Botta. “Clinicians practice at times around the clock, across time zones, because they can price their services appropriately for peak and off-peak times. For partners like government agencies that need access to clinicians at times that may not fit the standard work day, this is a massive benefit.”
The affordability and stigma of mental health services, especially for those who are uninsured or who have high-deductible health coverage, has also posed a serious threat to those in need of care. Unhoused populations are often forced to avoid care due to the high out-of-pocket cost of care at a doctor’s office or emergency room, a distressing trend that also impacted a record-high number of Americans in 2022. The solution? Virtual care.
Telehealth offers a more affordable way of delivering care, and can also lower the anxiety and social stigma that some patients associate with in-person mental health treatments.
Direct-to-consumer healthcare marketplaces like Sesame, in which patients and providers are able to connect directly and virtually without the complication of third-party insurance prices or office operating costs, are able to drive the cost of care down.
“It’s one that clinicians and patients both really like, and in many cases prefer,” says Botta. “For mental health care, there are real documented benefits to openness and continuity of care when using video visits as the modality.”
The key takeaway? Utilizing technology to promote health and well-being is a viable way of expanding access to mental health services to socially excluded people. “Technologies like telehealth, and like marketplaces in healthcare, can help us get there,” says Botta, “but we need to work as a team.”
Image courtesty of HELP USA
