Independent mental health practices are paid about 20 percent less than primary care in network and have no leverage to change it. A solo practice negotiates with a national insurer one contract at a time.^[1]

Payers, for their part, can't see what they're buying. Claims data "doesn't give you any insight into the care delivered," as Aetna's chief psychiatric officer put it, and they can't contract on outcomes with a practice of ten when their value-based deals start at 50,000 attributed members.^[8]

Other specialties consolidated through acquisition: private equity and health systems bought practices with sites, equipment, staff and contracts that produce cash flow whether or not any one doctor stays. A typical mental health practice is one clinician, a lease and a laptop. Nothing in it holds value if the clinician leaves, so there was nothing to buy, and roll-ups never got past a handful of employed groups like LifeStance.^[16] Allia's EHR makes consolidation possible without acquisition: a practice already running on it joins the group in about two weeks, keeps everything it owns, and nobody writes a check.^[3]

Behavioral health has become a big enough line item that payers are acting on it: treatment spending went from $41 billion in 2000 to $140 billion in 2021, almost all of it from more people in treatment.^[10] Cigna, Optum and Aetna are repricing behavioral care and building their own networks; Evernorth's employed group grew from 1,000 providers in 2024 to 5,000, with a target of 15,000 by the end of 2026.^[11] And AI agents now do the coordination, billing follow-up and chart review that used to need staff at every site, which makes a national group cheap to run.^[3][4]

The EHR covers intake, eligibility, scheduling, AI documentation, e-prescribing, telehealth and billing, and it's free for practices with up to 20 clinicians.^[12] Practices that join the medical group keep their offices, staff and software. Allia holds the payer contracts, submits the claims, and pays each practice more than it collected independently.^[3] The group spans therapy, psychiatry, psychology and TMS, with telehealth in all 50 states.^[4]

Mental health services cost about $280 billion in 2020, and treatment spending has more than tripled since 2000.^[1][10] Allia's pitch deck sizes the outpatient market at 400,000 providers earning about $200,000 each, or $80 billion, and published workforce counts put that in the right range.^[4][13][14]

Using the rates in Allia's contracts, a provider doing 1,200 visits a year at a blended $150 collects about $180,000, and Allia keeps roughly 39 percent of it.^[4] At 2,000 providers, the founders' 12 to 18 month target, that's about $360 million in collections and over $100 million in revenue, which matches what they told us.^[3] For comparison, Privia keeps 3.6 percent of collections as adjusted EBITDA after fifteen years, and LifeStance, which owns its clinics, keeps 11 percent.^[15][16]