Compare / Spring Health vs Charlie Health
SPRING HEALTH
April Koh was a Yale undergrad doing depression research when she realized the mental health system was matchi…
CHARLIE HEALTH
A 22-year-old who watched a friend nearly die from a mental health crisis built a virtual intensive outpatient…
AT A GLANCE
FUNDING HISTORY
Spring Health
Charlie Health
BUSINESS MODEL
Spring Health
B2B employer benefit — similar model to Lyra Health but with a sharper focus on precision matching. Companies pay Spring Health a per-employee-per-month fee.
Employees take an initial assessment and Spring Health's algorithm recommends a care pathway: therapy, medication management, coaching, digital self-care, or a combination. The key differentiator is the precision — the algorithm claims to reduce treatment time by 50% by getting the right match first instead of cycling through options.
Spring Health also provides a therapist network, psychiatric services, and crisis support. Revenue scales with employer contracts and employee utilization.
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.
HOW THEY STARTED
Spring Health
April Koh was studying computational neuroscience at Yale when she encountered research on precision medicine for depression — the idea that you could use data to predict which patients would respond to therapy versus medication versus a combination. The existing system was essentially trial and error: try an antidepressant for six weeks, and if it doesn't work, try another one.
Meanwhile, patients suffer. Koh co-founded Spring Health in 2016 with Adam Chekroud, a Yale neuroscience PhD, to build a platform that uses machine learning to match employees to the right mental health treatment on the first try.
They started by publishing peer-reviewed research showing their algorithms could predict treatment response better than chance, then turned that research into a product that employers would pay for.
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.
HOW THEY GREW
Spring Health
Enterprise sales to large employers, competing directly with Lyra Health, Headspace Health, and traditional EAP providers. Spring Health leads with outcomes data — publishing research showing faster recovery times and higher clinical improvement rates than industry benchmarks.
Celebrity advisor Apolo Ohno and high-profile board members gave early credibility. Series C at $2.5 billion valuation generated press coverage that opened doors.
International expansion to serve global workforces. Strategic investment from Kinnevik gave European distribution relationships.
Partnership with health plans to offer Spring Health as the behavioral health component within existing benefits.
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.
THE HARD PART
Spring Health
Direct competition with Lyra Health, which is larger and better-funded. The employer mental health benefit space is crowded and increasingly commoditized — every startup claims better outcomes and faster ROI.
Therapist supply is the binding constraint across the entire industry. Proving that ML-driven matching actually produces better outcomes than simply having a good therapist network is a difficult clinical claim to substantiate at scale.
Employee engagement is everything — if employees don't take the initial assessment, the precision matching engine can't work. And the macro headwind: employer benefits budgets are under pressure, and mental health benefits are easier to cut than medical benefits when money gets tight.
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.
THE PRODUCTS
Spring Health
Precision mental health platform — ML-driven assessment that predicts optimal treatment pathway for each individual. Therapist matching engine connecting employees to the right provider by specialty, approach, and predicted fit.
Spring Health Moments — bite-sized digital exercises based on CBT for mild symptoms. Medication management through in-house psychiatric providers.
Manager and HR tools for supporting teams without violating privacy. Work-life coaching for non-clinical needs like stress and work-life balance.
Family support extending benefits to dependents. Crisis support including 24/7 access for emergencies.
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.
WHO BACKED THEM
Spring Health
Investors include Tiger Global Management, Kinnevik, Northzone, William K. Warren Foundation, and Able Partners.
Series C in 2022 valued the company at $2.5 billion.
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.