What inspired you to focus specifically on ADHD care for youth, and what gap in the mental health system were you most determined to address?
Tom: The focus on youth ADHD care was directly inspired by my own family experience, as three of my five children have ADHD. I observed that despite their diverse presentations, they were initially all recommended the same stimulant treatment. Furthermore, their significant co-occurring concerns were often unaddressed or misunderstood. The current process for diagnosing and treating mental health is heavily reliant on the DSM-5, which can frequently overlook the underlying root cause of symptoms, resulting in treatments that act as “blunt instruments.” This led to my core determination to establish a model based on a higher level of precision—understanding the root drivers of symptoms and delivering an integrated treatment plan to address them holistically.
Your hybrid care model combines virtual-first services with strategic in-person clinics. How did you determine this was the right approach for serving young people with ADHD and co-occurring conditions?
Tom: The decision to adopt a hybrid care model was driven by consistent feedback from parents, schools, and pediatricians who expressed a need for in-person options, particularly given the post-COVID climate. While our model is virtual-first and approximately 70% of our care is delivered virtually, we recognize that specific clinical situations, circumstances, and parental preferences require an in-person component. Additionally, local clinics are vital for establishing community trust and relationships. This hybrid approach successfully balances the flexibility of virtual care—essential for rapid access and diverse provider specialties—with the necessity of providing in-person options.
Family-based care is central to your treatment protocols. Why is involving families so critical to achieving positive outcomes for youth with ADHD?
Tom: Addressing a child’s mental health and behavioral concerns requires involving the entire family, as these behaviors are rooted in family systems. Focusing solely on the child misses the opportunity for the family to reinforce a positive environment, model healthy behaviors, and address potential family dynamics that may be exacerbating the problems. Therefore, our comprehensive approach includes parent therapy (e.g., DBT) and parent coaching (e.g., SPACE training for anxiety), and we are launching a behavioral training program focused on ADHD and executive function for parents.
Many behavioral health providers struggle with low Medicaid reimbursement rates, leading to smaller provider networks and longer wait times for Medicaid beneficiaries. Blackbird Health currently works with CHIP patients and is working with Medicaid payers in some markets. How have you maintained a sustainable business model while serving these markets, and what does that mean for the field?
Tom: Blackbird Health views accepting Medicaid as a mission-critical step to improve the standard of care for all children. To maintain a sustainable model, the strategy focuses on:
- Efficiency and Capacity: Operating efficiently in care delivery (using AI responsibly, not for direct care) and optimizing available capacity for government programs.
- Payer Partnerships: Establishing strong partnerships with payers who value their whole-child care model.
- Phased Expansion: Expanding into Medicaid on a market-by-market basis, ensuring each partnership provides support for both rates and social determinants of health.
