Why Helio Health's Marcus Liu is betting employer behavioral health pivots to outcomes contracts in 2026
The virtual-first behavioral health category is crowded, margins are compressing, and Liu thinks the survivors will be the ones who can price on outcomes rather than utilization.
Three years into a Series B and four years into a category that has gone from white-hot to skeptical, Helio Health founder Marcus Liu is making a counter-cyclical bet. The company is rebuilding its commercial contracts around outcomes, not utilization, and Liu argues the rest of the virtual behavioral health market will follow within twelve months.
The pitch is straightforward. Self-insured employers, who footed the bill for the post-pandemic surge in behavioral health investment, have grown tired of paying per session or per member-per-month with no tie to whether anyone actually improves. Liu's read of the market is that procurement teams now want pricing tied to validated outcomes scales (PHQ-9 movement for depression, GAD-7 for anxiety) measured at intake and again at 90 days.
Helio's bet is operational, not philosophical. The company spent two years instrumenting its clinical workflow to capture standardized scales at every visit and built a contracting team capable of negotiating performance corridors that share risk with employers. "Most of the category cannot do this yet," Liu said. "Not because the model is hard. Because the data plumbing is not there."
“Employers are tired of paying for access. They will pay for someone getting better.”
Skeptics point to the obvious risk: outcomes contracts reward providers who treat patients likely to improve and create selection pressure against the patients who most need help. Liu acknowledged the concern directly. "You build the contract with floors. You measure subgroup outcomes. If you cannot show your model works for the harder cases, you do not get to grow."
Whether the rest of the field follows is an open question. For Liu, the more important point is that the employer purchasing conversation has already changed. "Employers are tired of paying for access," he said. "They will pay for someone getting better."