Post-Acute, Home and Behavioral Care

Cerebral was founded in San Francisco in 2019 to sell psychiatric medication management and therapy online for a monthly subscription, launched at $85 a month. A pandemic-era federal waiver let clinicians prescribe controlled substances by video without an in-person visit, and Cerebral grew nationally on it, with heavy marketing and many patients seeking treatment for ADHD. In December 2021 a $300 million round led by SoftBank's Vision Fund 2 valued it at about $4.8 billion. Within six months press investigations described pressure on clinicians to prescribe and short visits (reported); in May 2022 its pharmacy partner Truepill paused filling some stimulant prescriptions, and CVS and Walmart said they would stop filling Cerebral's controlled-substance prescriptions. The founder-chief executive was removed that month. In 2023 Cerebral disclosed that tracking pixels on its sites had sent data on 3,179,835 people to advertisers. In 2024 it agreed an FTC order of about $7 million and, in November, a Justice Department non-prosecution agreement with a $3.65 million forfeiture and a permanent end to controlled-substance prescribing.

Talkspace, founded in New York in 2012, took the other road. It went public through a SPAC in June 2021 at a ~$1.4 billion valuation, lost more than 90% of that value within a year as consumer acquisition costs soared, and under chief executive Jon Cohen from November 2022 rebuilt itself as an in-network provider paid by health plans, Medicare, employers and city governments. In 2025 its revenue was about $228.9 million, about 75% from payers, with net income of about $7.8 million, and in August 2026 Universal Health Services completed its purchase for $5.25 a share in cash, about $835 million. One company scaled on cash and controlled substances and was stopped by regulators and pharmacies; the other scaled more slowly on insurance claims and found a buyer. This chapter covers three markets where care happens outside the hospital and the doctor's office, and where the care equation is unusually hard to balance.