Headway

Charlie Health

Headway

Headway makes money by taking a percentage of the insurance reimbursement for each session facilitated through the platform. When a patient sees a Headway-credentialed therapist and pays their copay, Headway processes the insurance claim and takes a service fee from the reimbursement before paying the therapist.

The model aligns incentives well. Headway only makes money when therapy sessions actually happen, which means they're incentivized to help therapists see more patients and reduce no-shows.

Therapists make more than they would on their own (because Headway's negotiated rates are often better than individual therapists can get), and patients pay only their insurance copay ($0-$50 typically) instead of full out-of-pocket rates.

Scale creates a data and negotiation advantage. With 40,000+ therapists on the platform, Headway can negotiate better reimbursement rates with insurers.

More therapists attract more patients. More patients justify better rates.

The flywheel spins.

Charlie Health

Insurance-reimbursed virtual intensive outpatient care. Patients attend group therapy sessions three to five days a week for three hours a day, combined with individual therapy and family therapy.

Charlie Health contracts with major insurance carriers — Aetna, UnitedHealthcare, Blue Cross, Cigna — so patients pay standard copays, not cash-pay rates. The company earns per-session reimbursement from insurers.

This is not the $200-per-session cash-pay therapy app model. It's real clinical care billed through real insurance, which makes it accessible to people who actually need it and sustainable as a business.

Headway

Andrew Adams and Jake Sussman founded Headway in 2019 after watching people in their lives struggle to access affordable mental healthcare. The problem was specific and structural: most therapists operate as solo practitioners who don't accept insurance.

Not because they don't want to — because the process of getting credentialed with insurance companies, submitting claims, and chasing reimbursements is so bureaucratically painful that most therapists give up and go cash-only.

The result is a two-tier mental healthcare system. People with money pay $150-$300 per session out of pocket.

People without money either can't afford therapy or wait months for the few in-network providers available. Meanwhile, therapists who only accept cash are leaving money on the table — insurance pays reliably once the system works, and the patient pool is vastly larger.

Headway's solution was to build the infrastructure layer that makes insurance billing painless for therapists. They handle credentialing (getting the therapist accepted into insurance networks), claims submission, payment processing, and compliance — all the administrative work that therapists hate.

The therapist shows up, does therapy, and Headway handles everything else.

Charlie Health

Carter Barnhart was a senior at Vanderbilt when a close friend experienced a severe mental health crisis. The friend needed more than a weekly therapy session but didn't need to be locked in a hospital.

That middle ground — intensive outpatient care — barely existed, and what did exist was in-person, expensive, and had six-month waitlists. Barnhart started Charlie Health in 2020 at age 22, right as COVID obliterated any remaining access to in-person mental health care.

She built a virtual intensive outpatient program (IOP) specifically for teens and young adults, the demographic that was falling apart fastest. The timing was accidentally perfect.

The product was intentionally necessary.

Headway

Headway grew by solving the supply-side problem first. If you can get enough therapists on the platform and credentialed with insurance, patients will come because affordable therapy is in massive demand.

They recruited therapists with a compelling pitch: "keep doing therapy, we'll handle the business side."

Insurance partnerships were the growth unlock. Headway partnered with major insurance companies (Aetna, Cigna, United Healthcare, Anthem) to become an authorized credentialing partner.

This meant Headway could get therapists in-network faster and with less friction than the traditional process.

The mental health destigmatization wave amplified demand. Post-COVID, demand for therapy skyrocketed.

The conversation around mental health became mainstream. Headway was positioned perfectly to absorb that demand by connecting patients with affordable, insurance-covered therapists.

Charlie Health

Referral partnerships with emergency rooms, schools, pediatricians, and existing therapists who need somewhere to send patients too acute for weekly sessions. When a therapist realizes their patient needs more care than they can provide, Charlie Health is the place they call.

The company also built relationships with insurance carriers early, making it one of the few virtual IOPs that's actually in-network. Word of mouth among parents of struggling teens drives organic growth.

They've expanded state by state, getting licensed in each one — now operating in all 50 states. The crisis itself is the growth engine.

Youth mental health emergency visits doubled between 2019 and 2023.

Headway

Therapist retention is a challenge. Solo practitioners are independent by nature, and some leave the platform once they've built a full patient roster through Headway.

The platform needs to continuously demonstrate value beyond initial credentialing to keep therapists from going direct.

Insurance reimbursement rates are notoriously low. Therapists who accept insurance often earn 30-50% less per session than cash-pay rates.

While Headway negotiates better rates than individual therapists typically get, the fundamental economics of insurance-based mental healthcare remain challenging.

Regulatory complexity varies by state. Each state has different licensing requirements, insurance regulations, and telehealth rules.

Expanding to all 50 states means navigating 50 different regulatory frameworks, each with their own credentialing requirements and compliance standards.

Charlie Health

Maintaining clinical quality while scaling fast. Virtual group therapy only works if the groups are well-matched and the clinicians are excellent.

Hiring hundreds of licensed therapists across 50 states while keeping standards high is genuinely hard. Insurance reimbursement rates for mental health are notoriously low compared to other specialties, so margins are tight even at scale.

The regulatory landscape is a patchwork — every state has different licensing requirements, telehealth rules, and insurance mandates. And there's the fundamental challenge of treating the sickest patients virtually.

Charlie Health has to prove outcomes data that shows virtual IOP works as well as in-person, because skeptics exist and they're loud.

Headway

Headway Provider Platform — the core system where therapists manage their practice: scheduling, credentialing, claims submission, payment tracking, and patient communications. Headway Patient Matching — a directory and matching service that connects patients with in-network therapists based on insurance, location, specialty, and availability.

Insurance Credentialing Service — Headway handles the months-long process of getting therapists accepted into insurance networks, reducing what typically takes 6-12 months to weeks. Claims and Billing Engine — automated insurance claims submission and tracking that eliminates the paperwork therapists dread.

Practice Management Tools — scheduling, intake forms, session notes, and telehealth capabilities integrated into one platform.

Charlie Health

Virtual IOP (Intensive Outpatient Program) — three-hour group therapy sessions three to five times per week, combining CBT, DBT, and trauma-focused modalities. Individual therapy sessions with licensed clinicians weekly.

Family therapy integration that treats the whole system, not just the patient. Specialized tracks for specific conditions: substance abuse, eating disorders, self-harm, trauma, and crisis stabilization.

Supported age groups from 11 to 30, covering the exact demographic where mental health crises peak. Care coordination with referring providers so patients don't fall through the cracks between levels of care.

Headway

Andreessen Horowitz led the Series C at a $2.3 billion valuation. Accel and Thrive Capital invested in earlier rounds.

GV (Google Ventures) and Spark Capital also participated. The company has raised approximately $226 million total.

Charlie Health

Investors include General Catalyst, Forerunner Ventures, Greylock Partners, and Metamorphic Ventures. Series C was led by Apogee and brought total funding past $400 million.

The company reached unicorn status in early 2024.