Therapists in Alma’s network were recently hit with some disheartening news: reimbursement rates are being decreased starting in 2025, particularly affecting providers under major umbrella insurance companies like Optum, United Healthcare, UMR, and Surest. 
The change has left therapists questioning their future on the platform and considering alternatives to sustain their practices.
This article aims to explore the context of Alma’s decision, the impact on therapists, and possible steps for mental health providers in light of the reimbursement rate reduction.
The Decrease in Reimbursement Rates: A Breakdown
Alma, a platform that helps therapists with insurance billing and client management, recently announced a reduction of $7 per session in reimbursement rates for therapists under Optum and related insurance plans.
For many, this represents a significant loss in income, especially given the rising costs of running a practice and living expenses.
The decrease is expected to take effect in early 2025, leaving therapists struggling to reassess their financial strategies.
The platform, which originally attracted providers with rates higher than other credentialing services, is now facing backlash as the reduced rates approach those of competitors like Headway.
Adding to the frustration, a recent Town Hall meeting with Alma was described as a “complete bust” by attendees.
According to reports, the CEO abruptly left the meeting, adding to the uncertainty providers already feel.
What was once seen as a supportive network now seems to be taking a step backward, jeopardizing the stability of the services therapists provide to their clients.
Therapist Reactions: Concerns and Challenges
Therapists, especially those on social media and platforms like Reddit, have expressed mixed emotions—ranging from disappointment to outright anger.
Many therapists initially chose Alma because of its attractive rates compared to other platforms, along with its promise to ease the burden of insurance billing.
Now, these therapists feel let down by the unexpected shift.
One therapist on Reddit shared, “I switched to Alma because their rates were higher, but now I’m questioning if the subscription fee is even worth it.”
Another noted the challenges of trying to go it alone: “Not everyone is in a privileged position to start a private practice and get credentialed independently. There are upfront costs—both time and financial—that many can’t afford.”
Some providers are considering leaving Alma to set up independent contracts with insurance companies.
While doing so provides more control over billing and client management, it also comes with the burden of negotiating contracts and dealing with administrative headaches—tasks many therapists were hoping to avoid by using Alma.
What’s Happening at Headway?
Similar trends are also emerging at Headway, another platform that connects therapists with clients and handles insurance billing.
Just recently, Headway informed therapists that they would no longer be able to serve Aetna members with Individual and Family Plans beginning in January 2025, forcing providers to either switch their clients to private pay or face losing them entirely.
The reduced transparency in negotiations, combined with abrupt announcements, has left providers scrambling to make arrangements.
One therapist commented, “The lack of transparency and control we have over these decisions is incredibly frustrating. These changes directly impact our ability to serve our clients effectively.”
Broader Industry Trends: Venture Capital and Wage Suppression
The mental health industry has increasingly attracted venture capital investments, with platforms like Alma and Headway seeking to scale their operations quickly.
However, as these companies grow, they seem to be shifting to a “wage suppression” phase—cutting costs to maintain profitability once venture capital funds dry up.
Therapists have compared this to the gig economy, where initial enthusiasm and competitive rates have slowly turned into reduced compensation and increased financial pressure.
Just as Uber and Lyft drivers once benefited from appealing rates, therapists now face the reality of diminishing returns for their services.
One therapist remarked, “It feels like we’re just another gig worker now, except our job is providing crucial mental health services. It’s incredibly demoralizing.”
General Tips for Navigating These Changes
For therapists affected by these changes—or worried about similar issues in the future—here are some practical tips:
- Don’t Rely on One Platform: Therapists should avoid building their entire practice around platforms like Alma or Headway. Consider what would happen if these platforms went under—how could you continue operating?
- Set Up Insurance Contracts Independently: If feasible, therapists can consider getting independently paneled with insurance companies. While this route involves upfront effort, it also provides more control and could be more sustainable in the long term.
- Diversify Services and Codes: Therapists can explore using different CPT codes (such as 90834 instead of 90837) when applicable, to maximize reimbursement within ethical guidelines. It might also be beneficial to diversify the services offered.
- Learn New Marketing Strategies: Take advantage of tools like Google Ads and Google My Business to market your practice. Expanding beyond insurance-driven clients might help reduce dependence on these fluctuating reimbursement rates.
- Reconsider Which Insurances You Accept: It may be worthwhile to reconsider the insurance plans you accept and focus on those offering better reimbursement rates or less administrative burden.
Looking Forward: What Therapists Need
The recent changes at Alma and Headway have prompted therapists to consider what’s truly needed for sustainability.
Many believe that there needs to be a focus on legislation that prevents venture-backed platforms from exploiting healthcare workers—a system akin to what gig workers faced with companies like Uber.
Ensuring fair compensation and support for mental health professionals will ultimately benefit not just therapists, but also the clients who rely on their care.
One of the therapists summed it up well: “We’re trying to make therapy accessible and focus on the quality of care, but it’s hard when we’re constantly struggling to make ends meet ourselves. We need better support, transparency, and a system that doesn’t always put profits before people.”
As these challenges continue to unfold, therapists must take steps to safeguard their practices, whether that means diversifying their client base, expanding private pay options, or getting independently credentialed.
The mental health field deserves platforms and policies that truly value the work being done—without the looming fear of unexpected reimbursement cuts.
The reimbursement rate decrease at Alma is a stark reminder of the instability that often accompanies third-party platforms in healthcare.
Therapists are essential to mental health care, and their compensation should reflect the critical nature of their work.
As the mental health industry continues to attract venture capital, it’s crucial that both therapists and clients aren’t left bearing the cost of profitability-driven decisions.
To all the therapists out there: stay adaptable, advocate for fair treatment, and remember that the value of your work goes beyond what any platform is willing to pay.
