Confidant Health’s Arsenault Wilson is Unlocking Value-Based Addiction Care
I had the pleasure of interviewing Sam Arsenault Wilson, Chief Quality Officer and Co-Founder of Confidant Health, a digital health company redefining addiction and mental health care. Confidant Health’s proprietary technology platform and interdisciplinary care team aim to reach the 90% of people with substance use disorders who go untreated today.
Before Confidant Health, Sam led the development of ATLAS, the nation’s first public-facing quality measurement system for addiction treatment facilities. This experience, as well as work on state and federal addiction policy and research made her realize that, as she puts it, evidence-based behavioral healthcare should be as easy to access as drugs and alcohol. Sam has been featured as an addiction treatment expert guest on NPR, the TODAY Show, Inside Edition and more. When Sam isn’t working to increase access to addiction treatment she enjoys hiking and is currently living as a digital nomad. Let’s jump in.
Thank you so much for joining us!
What motivated you to launch your startup?
It’s common knowledge that the US healthcare system has major flaws, but the injustices surrounding addiction are absolutely devastating. Only about 1 in 10 people with a substance use disorder get treatment, and among those who do, many receive care that is not effective, not for a sufficient duration, or not compassionate. On my last project we worked with countless patient advocates and caregivers, over 20 health plans across the country, and thousands of addiction treatment providers and no one was happy with how the system works.
People with drug and alcohol use disorders face tremendous stigma and dehumanizing treatment. When they are ready to get help, high-quality treatment is nearly impossible to find. While caregivers are tragically losing loved ones, health insurers are spending tens of thousands of dollars on care that is not evidence-based and even more costly hospital stays. Providers who dedicate their lives to serving others feel dehumanized in their jobs, beholden to systems and policies that limit them and result in burn out.
My team and I at Shatterproof built ATLAS to alleviate these issues and to start to uphold a standard of quality for addiction treatment providers. This was a huge step in the right direction and is helping people find care that will put them on a path to recovery, but this standard is ultimately setting the floor for quality, not the north star.
At the same time I met my now co-founder, Jon Read, and we riffed about what it would be like to forget the quality floor and design something based on first principles. We knew all too well the gaps and issues that plagued the addiction treatment system and both believed that technology could be used to design something that was based on evidence and delivered value to the individuals involved. Something that helped people find meaningful healing and be able to thrive, that was fiscally sustainable, and fulfilling to the care team. That’s how Confidant Health was born and we’ve been building on that idea ever since.
Wow, that makes a lot of sense. What is it that excites you most about Confidant Health?
That’s hard to say because there are a lot of things that we are working on that I’m really excited about, but I think it’s the feedback we’ve been receiving from the individuals we serve. Hearing people tell you that your company has changed their life, not just from continuing on a dangerous path, but making their goals and hopes a reality — that is just so powerful. We recently had feedback from a new client in Virginia who said our team made them feel seen for the first time in a long time. This motivates us every day, we always put the people we serve at the center of our decisions, we say they are the center of their care team, and it’s our job to empower them.
From a nerdy perspective though, I get really excited about the ways in which we are doing this. The systems we’re building are on the cutting edge because we’re using data to inform both the user’s experience and to inform clinical decisions. This means we can support our providers in continuous quality improvement and give people a personalized experience which research shows would be most effective for someone with their characteristics. A data-centric environment like the one we are constructing lends itself to leveraging AI to make predictive suggestions. That’s where we’re headed once the data reaches proper scale.
The other element is how the care is paid for, we’re not interested in fee-for-service, which basically means getting paid for each line item of care provided, because this incentivizes the wrong things. Instead, we’re building for value-based care, where we are compensated for actually helping people achieve the outcomes they want, thus aligning the incentives and goals of the patients, providers, and payers.
What has been your biggest challenge about designing value-based addiction care?
We’re focused on high quality which has meant slower growth. That can be tough when most of the publicity on other startups is about how much capital they are raising and how quickly they are expanding. It takes discipline to build something that strikes the balance of efficiency and high-quality, especially when this involves therapeutic and medical interventions, a high-fidelity user experience, and relatively sophisticated data systems. But we are dealing with people’s lives here, and we take that very seriously.
So we’ve put in a lot of work on our clinical operations and technical infrastructure. During this time we weren’t focused on marketing at all, just getting enough people into the system that we could care for diligently. Now that we have promising outcomes we’re ready to ramp up. That means working with insurance partners to implement value-based contracts as well as expanding our digital and on-the-ground marketing efforts, and footprint of state licenses.
What are your future plans for your startup?
We’re working to expand Confidant Health’s Care Team Model, which pairs individuals with substance use disorders and / or mental health conditions with a team of highly-skilled and compassionate professionals, including a prescriber, therapist, coach, care navigator, and our digital interventions. This model is designed to meet the needs of the individual to help them recover in a meaningful way. While we are currently serving Connecticut and Virginia, we’re working to grow in those markets and expand to other states.
Our goal is to grow at a pace that meets demand without falling short on the promises we make to our customers and our team. Our system will be a big factor in this, helping providers be efficient and effective in supporting individuals on their paths to recovery. We also have to recognize our team members, who regularly go above and beyond. A testimonial we highlighted at our team meeting just this week said “never in my life has anyone made me feel like they cared like this, Confidant treats you like family,” and that Confidant was “like having an angel on your recovery journey.” This is the kind of care we are going to deliver at scale.
If you had to share, “words of wisdom,” with a Founder who’s about to start their own startup, what would they be?
Founders get a lot of advice, but I think it’s important to be true to yourself. It’s really easy to get swept up in everything you read and feel like you need to be doing something one way or another. Now, I’m not saying to ignore the wisdom of the people around you, it’s critically important to constantly be learning, especially from the people you serve. But remember to nurture your voice as well and be proud of your growth. Even when you feel small or feel like an imposter there are people looking up to you so stick with it.
Also, as a founder it can feel like everything is critical and you should be working 24/7 — unfortunately this is the reality for many entrepreneurs, and maybe it works for some people, but I’m a mental health advocate and I know this doesn’t work for me, or for most people in the long-term. So I try to lead by example at my company and take time off when I need to, and to make myself available for the things that are of high priority — my own mental, physical, and spiritual wellbeing, and the people in my life. Does it cause internal conflict sometimes to step away? Every time, but it’s worth it because it reassures the people on my team that this is a marathon and not a sprint, and that we are creating a culture that is dedicated to wellbeing.
How can our readers follow you and Confidant Health?
Check out Confidant Health at confidanthealth.com, we’re also on IG and twitter at @confidanthealth and on LinkedIn, Facebook, and TikTok. You can also find me one twitter at @arsenaultwilson and on LinkedIn at https://www.linkedin.com/in/samarsenault/.
This was very insightful. Thank you so much for joining us!
Thank you for having me!
