Jia Jia Ye, Springtide Child Development, on scaling autism care that supports the entire family

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Jia Jia Ye, CEO & Co-Founder of Springtide Child Development

In this episode, we sat down with Jia Jia Ye, CEO & Co-Founder of Springtide Child Development, a company that provides integrative, evidence-based, and family-centered care for children with autism spectrum disorder, or ASD. With four clinics open across Massachusetts and Connecticut, and a fifth coming soon, Springtide’s rapid growth is enabling families to better plan for the future, providers to focus on patient care in a coordinated environment, and payors to see what value-based behavioral care for ASD looks like.

In this episode, we discussed:

• How Jia Jia developed a passion for working in healthcare and how the industry’s mission-orientation and the complexity of its problems have kept her engaged over time
• The elements of Springtide’s clinical model that differentiate it from how care for ASD typically looks
• The superior clinical outcomes and expanded access to care that Springtide is demonstrating as a result of its intentionally-designed care model
• What the future of Springtide holds and why the company is focused on closing the gap between behavioral and medical care
• Jia Jia’s leadership style, why it works for her, and what she enjoys most about being the CEO of high-growth company

Beginning to 5:00: Jia Jia’s career in healthcare

• From aspiring physician to systems thinker: As a kid, Jia Jia wanted to be a doctor, which to her seemed like a great profession for helping others. Taking a break from her premed work in college, she took a health care economics course with Harvard professor, David Cutler. That experience expanded her thinking on how she could impact larger populations by looking at the healthcare system more broadly. She became interested in the systemic issues that plague the US healthcare system, and she has built her career around working to fix these problems.
• Passion for healthcare: Jia Jia and I discussed the two main reasons she loves working in healthcare:

1. Mission orientation: Jia Jia wants to feel proud of what she does each day, and she finds this working in healthcare. Specifically, in her work at Springtide, she enjoys telling people that she’s building a company to support children with autism and sharing the superior outcomes that the company is achieving for this patient population.
2. Complexity of the problems: Healthcare certainly isn’t the only industry with challenging problems, but healthcare involves a unique combination of many stakeholders — patients and families, for example — combined with a complex web of moral, ethical, and equity concerns. Jia Jia finds that the historic lack of transparency in healthcare further complicates the industry but also makes the prospect of solving these problems more exciting.

5:00 to 10:30: Challenges in ASD care

• Early experiences: Jia Jia grew up in Salt Lake City, and her family had close family friends with a child with autism. She recalls that there were zero therapists in the entire state of Utah, so the family flew their therapist out from Boston to Salt Lake once a month. Receiving this care was difficult but extremely important for the family.
• Discovering challenges: While Jia Jia hadn’t planned to start a company in autism care following this childhood experience, years later, it struck her as an industry still in dire need of change. Despite the scientific advancements for ASD management, the decrease in stigma, and increase in the prevalence of autism (almost 2% of kids are diagnosed with ASD today) and insurance coverage for ABA therapy, little felt different from 30 years ago in terms of the patient experience and clinical outcomes. Families were still struggling to figure out where to turn for care or how much it would cost.
• Industry fragmentation: The fragmented structure of the autism care industry is a key reason for this stunted progress. Mom and pop businesses primarily own and run therapy sites, leading to fragmentation. This, combined with the fact that 80% of people with autism have comorbidities that require them to receive frequent medical care, complicates care coordination between these different sites and providers.
• A new model: After digging into questions about what was missing from the industry, Jia Jia realized that her prior experiences delighting customers at One Medical and using technology to simplify the care journey and develop clarity around value-based care at Oscar had set her up well to build Springtide. In traditional care models for ASD treatment, most children undergo an intensive therapy schedule — 30 to 40 hours — each week. Despite the enormous time investment, there isn’t sufficient focus on what the future, progress, and integration back into the school system look like. Furthermore, insurance companies often throw up additional roadblocks, alerting families that they have surpassed the number of authorized therapy hours and leaving them with few options and little guidance on how to move forward. In contrast to the status quo, Springtide provides a place that patients and families can turn to for integrative and evidence-based ASD care that is customized to each family’s unique situation.

10:30 to 25:00: Building Springtide

“​​One of our values is to assume it’s possible. And really, that’s so important. A lot of times families will come in and say, you know, my kid can’t do this. And what’s really powerful is when we’re able to show them your kid can. And let’s actually change that thinking and think about what can they do and where can they get to. And then let’s figure out what might be different in the classroom environment versus the home environment. And then once you’re able to [get a] diagnosis, you can really get to a point where the families can also start to see the same outcomes and sort of engagement even in the home as well.”

• The Springtide experience: Providing visibility and a map into what a child with ASD’s future looks like is a major differentiator for Springtide. This helps families realize the potential of their child and hold providers like Springtime accountable for outcomes. Springtide’s model also emphasizes parent engagement because research shows that it’s the most important factor in driving better outcomes. Therefore, Springtide regularly and frequently works with families to monitor progress towards goals aimed at better supporting and understanding their child’s progress. Beyond improved engagement, Springtide provides ABA, speech, and physical therapy all in one place, coordinates with childrens’ schools, and prepares patients and families to get the most out of their upcoming medical visits.
• 2021 in review: Springtide reached many exciting milestone in 2021, including:

1. Expanding from two sites in Connecticut to two additional sites in Massachusetts, with a fifth location in Massachusetts opening soon
2. Receiving the highest accreditation from BHCOE, a national accrediting body for ABA providers, making Springtide the only autism provider in CT to achieve this rating
3. Reaching exceptional clinical outcomes

• Attaining superior outcomes: Jia Jia explained the three main ways that Springtide thinks about clinical outcomes:

1. Learning gains track a child’s progress towards the goals set by the child, therapist, and the child’s family, which are measured against an assessment every six months
2. Unlike many fee-for-service practices where billable hours and retention are the key success metrics, Springtide wants to see their throughput improve over time since it’s indicative of high-quality clinical outcomes that allow a child to reduce their therapy hours and return to school. Springtide captures this in its efficiency metric. Increasing throughput also opens up access, which is a problem in autism care, evidenced by the 6–12 month waitlists for appointments. In summary, better efficiency means better throughput means better access.
3. Parent satisfaction and readiness reflect levels of parent engagement, which is critical to superior clinical outcomes. To score high, parents need to reinforce what a child does and learns in the clinic in the home, so instilling confidence in parents is essential.

• Patient demand: Springtide acquires patients through a number of channels including health plan and employer partnerships, a go-to-market strategy that many startups are taking. Word of mouth is also an important channel for Springtide due to the tightly knit nature of the autism community. Physician referrals are another strategy that Springtide has found particularly successful, likely due to the company’s strong clinical orientation and close engagement with the medical community.
• Provider supply: Just like how mission matters to Jia Jia, it also matters to Springtide’s therapists. The company’s intentionally designed clinical model along with comprehensive training programs are points of differentiation for Springtide’s therapists and main reasons team members decide to join and stay at the company. Jia Jia and her team are building a culture where people are hired for their potential rather than rejecting them for something that’s missing. The company puts a lot of thought into their hiring process to ensure they’re hiring people who can grow alongside Springtide. The result: better retention than the industry average and a workforce who finds their work meaningful.

“It’s an industry that has really had access gaps across the country. And so being able to hire, retain, [and] train the best therapists is super important. And for us, it really starts at the mission and the approach that we take. So because of our outcomes focus, and because of our sort of focus on training and retention, it really stands apart [from] a traditional practice.”

25:00 to 29:00: ASD market dynamics

• Startup activity: Jia Jia explains how the major investments we’ve seen in ASD behavioral care and pediatric mental health companies more generally have a fairly simple explanation: there’s a huge need. With almost 2% of kids in the US having autism and average 6–12 month waitlists for ABA therapy, there’s an urgency to do better for this patient population and their families. Furthermore, she shares that we should expect to see ripple effects on child development in the years to come due to the Covid-19 pandemic’s disruption on young people’s environments, routines, and social exposure. Jia Jia shared additional reasons for the major investments in ASD care, including:

1. States have mandated that ABA therapy be covered by insurance, leading to more children and families seeking care
2. The growth of advocacy organizations like Autism Speaks and Birth to Three programs, which make screening and early diagnosis more available
3. Growing pediatrician awareness and support

29:00 to 38:00: The future of Springtide

• Value-based care: Jia Jia sees three tenants of value-based care, and Springtide delivers on all of them: 1) Improved quality and clinical outcomes, 2) Improved efficiency and cost management, 3) Improved experience for patients and families. Payors are also asking that providers deliver on all three of these, and especially on outcomes, which is Springtide’s north star. ABA therapy alone costs $50k per patient, which constitutes 2% of MLR, and children with ASD typically cost another $50k in medical spend. This high cost makes it a population that matters a lot to payors. Looking ahead, Springtide is planning to provide some medical care directly to its patients, acting as a bridge between the behavioral and medical sides. The company sees this as a critical area of strategic growth in order to maximize its clinical outcomes and the value it drives for patients and payors.
• Advancing healthcare equity: Jia Jia explains how insufficient access is a key reason for inequities in care delivery and outcomes, and how the ASD market is not immune to this force. Springtide tackles this challenge by returning to its core: achieving better outcomes to enable better throughput, which to Jia Jia, is the ultimate way to build access in the system. Springtide also expands access by taking all types of insurance (Medicaid, commercial), and the company’s Chief Clinical Officer is leading the effort to ensure that culturally sensitive care is a pillar of the care model. Springtide’s close relationships with children’s families makes cultural competence even more essential since not only does the child need to trust their care team, but so does the child’s family.

38:00 to end: Leadership lessons

“The only way to do the things we want to do requires a lot of team collaboration. My leadership style is focused a lot on building the right team, building enough structure and air traffic control for the team to be effective, and then really leaning very heavily on the team to be able to work together. I think this is important because it really allows for a lot of ownership and pride and authorship throughout the organization. I think it is much more scalable. And I honestly think it gets to the best outcomes and the best answers because decisions can be made at the right local level where people have the most information.”

• A team-centric leadership style: Jia Jia sees collaboration, building the right team, and establishing structure and the right air traffic controls as key ingredients for team scaling, ownership, and authorship. She shared how finding an organization that welcomes your distinct style is also important to being successful (i.e. a mismatch can be detrimental). Jia Jia has found that while her style is adaptable, it is particularly well suited for businesses with intricate operations and local nuances like healthcare services.
• The CEO role: When I asked Jia Jia what she loves most about being a CEO, she shared that it’s having a front row seat to some of the best thinking and creativity out there. Her leadership team includes Springtide’s Chief Clinical Officer (an expert in ASD care with experience at leading academic medical centers), Chief Business Officer (former leader of value-based care for MassHealth), and CFO (expert in scaling behavioral health companies). This team is composed of individuals with vastly different ways of thinking, and Jia Jia finds joy in understanding and integrating this diversity of perspectives into a coherent strategy.
• Last but not least, Springtide is hiring!

We are so appreciative to Jia Jia for joining us on this episode of The Pulse Podcast! Subscribe for our new releases on Twitter, Spotify or Apple podcasts.