More effective depression treatments exist—so why aren’t they used? Everbright on TMS, esketamine, and the barriers to prescribing | Ben Kuhn

Psychiatry still relies heavily on medication management and talk therapy, leaving many patients—especially those with treatment-resistant depression—cycling through SSRIs without response, despite FDA-approved options like TMS (approved 2008) and Spravato/esketamine (approved 2019) that show roughly twice the effectiveness versus standard treatments. 

Ben Kuhn, co-founder and CEO of Everbright Health, explains why these interventions haven’t become routine in independent practices: complex, frequently changing payer eligibility criteria, provider discomfort discussing specialized treatments, onerous prior auth, and the operational/compliance burden of running a new service line. 

Everbright Health positions itself as an AI-enabled MSO partner (not an acquirer), promising implementation in ~60 days by identifying eligible patients, managing education, prior auth/billing, and operations. The conversation also covers emerging therapies (psilocybin, PTSD treatment “Prism,” remote monitoring) and growing payer interest in outcomes/value-based models, citing data suggesting up to 50% total cost-of-care reductions when treatment resistance resolves.

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