06/10/2026
Do you know who controls and sees your mental health care?
Four things happened this spring, and together they tell one story.
Aetna cut what it pays therapists on Alma — the VC-owned platform 24,000 clinicians bill through. A doctorate now pays the same as a master's; a 53-minute session the same as a 38-minute one. Then, eight days later, Aetna launched its own in-house therapy service: Aetna's clinicians, Aetna's website, AI writing the notes. The insurer is becoming the provider.
Meanwhile CAQH — the database holding nearly 5 million providers' personal data — dropped its nonprofit status, rebranded, and quietly rewrote its privacy policy to share provider info with "customers and other third parties." And Headway now makes patients and providers hand over a facial scan and ID to keep using it. No opt-out except leaving. Your face, tied to your diagnoses and session notes.
Step back and it's one company becoming the payer, the referral source, the provider, and the data owner all at once — with your most private information running underneath all of it.
The leverage providers have: these platforms only work because we supply them. Drop the VC middlemen, credential directly, and insurers have to pay fairly again.
If you're a patient: you can choose your own provider. When you can pick a plan, pick for freedom — PPO and POS plans cover out-of-network care; HMOs lock you to a list. And it's not data vs. money: many providers offer reduced cash-pay rates to skip the gatekeeping entirely. Ask where your data goes. Appeal denials — coverage decisions are not clinical decisions. And "comply or lose your care" is not a fair choice.
For the record, in my own practice: protecting client data is a priority I take seriously, and I don't use VC platforms or AI for clinical care. The clinical work stays human, and it stays private.
I've been watching this consolidation take shape for a while. Ask the questions. Protect your care, and your privacy, while it's still yours to protect.
Separately these look like unrelated headlines so I want to connect some dots. Together they tell one story — who controls your mental health care, and who profits from it.
