Talkspace Inc. (Nasdaq: TALK) gave dozens of national provider practice (NPP) therapists a choice: work as a 1099 contractor or find work elsewhere.
The NPP included roughly 250 members of the staff therapists before the reclassification. A Talkspace internal source told Behavioral Health Business this move impacts less than 2% of the company’s 3,000-strong therapist network, after deeming certain members a poor fit for the NPP.
Unlike a full-time position, 1099 workers are not always entitled to benefits, such as health insurance and paid time off.
Digital mental health startup Cerebral Inc. made a similar move in 2021. It changed the pay structure of its W-2 clinicians from salaried to hourly pay, and required them to log 30 hours of work a week for a period of 90-days – or lose their health benefits.
Talkspace over the last few months has rolled out new, higher-workload standards for its NPP therapists. Interim CEO Doug Braunstein and CFO Jennifer Fulk teased new initiatives to drive better productivity in the NPP during a 2022 first-quarter earnings call.
Fulk added that efficiency efforts at the NPP were “our largest opportunity,” without elaborating further.
The new efficiency standards require NPP therapists to perform 30 hours of work a week, with flexibility to account for specific therapists’ circumstances, according to the internal source.
Talkspace declined to specify exactly how many people are affected by the NPP employment shift. It also did not comment on how it decided which therapists should be moved from the NPP or when the moves would be effective.
In response to BHB questions, Varun Choudhary, chief medical officer of Talkspace, said in a statement that Talkspace identified therapists that “would perform better as part of our independent contractor network.”
“We have given these therapists the opportunity to continue on the Talkspace platform as independent contractors in order to facilitate the ongoing delivery of care,” Choudhary said. “Or, they can choose not to move to the contract network, and to leave Talkspace altogether.”
Choudhary added that Talkspace “will continue to hire full-time providers, particularly with a focus on important geographies.”
Some permanent new hires at the NPP will start with the Talkspace NPP in September, Braunstein told members of the NPP during a group-wide meeting Aug. 1.
During the same meeting, he said that the people being pushed out of the group “didn’t have any interest in engaging in trying to improve the level of engagement with clients” to meet the new 30-hour standard.
“I’ve been very disappointed by the level of engagement from some individuals in the therapist network around how they are managing and coping with these changes,” Braunstein said.
Several therapists with the NPP who BHB has communicated with said that the new 30-hour standard was too high. Additionally, some of the interviewed NPPs said Talkspace was defining “billable hours” in a way that’s different from standard industry practices.
In many instances, a billable hour represents time spent with a patient and administrative work on the patient’s behalf to get compensated by a health plan.
Therapists and documents obtained by BHB show that Talkspace is alternatively defining billable hours as time spent communicating directly with patients, or reading and returning text and audio messages.
“Talkspace’s expectations for full-time salaried therapists earning competitive salaries plus benefits is approximately [30] hours of billable work a week, which leaves [10] or more hours for administrative tasks, which we believe is consistent with industry standards,” the internal source said. “Thirty hours is not a hard and fast number, and Talkspace offers flexibility, especially for therapists’ wellbeing and for the many therapists that have family commitments.”
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