Refresh Mental Health Scaled to 300+ Locations. PIMSY Kept Up.
Refresh Mental Health Scaled to 300+ Locations. PIMSY Kept Up.
Case Study Stats
Website: www.refreshmentalhealth.com
Users: 4,000+
Location: HQ in Florida (multiple locations)
Customer: 6+ years with PIMSY
PIMSY features used: Multi-org administration, custom reporting, billing matrix, API integrations, IOP/PHP automation, HR/payroll modules, FHIR/HIE interoperability, ePrescription
Introduction
When Refresh Mental Health launched in 2018, Steve Gold wasn’t building a single clinic. He was building a network: acquiring established local behavioral health brands across the country and operating as their parent company.
The model was smart. Refresh provided operational oversight, revenue cycle management, and technology infrastructure while clinical partners focused on care. But the EHR problem surfaced fast.
Every acquisition came in with its own workflows, billing setups, and clinical documentation habits. Trying to standardize across agencies in different states, with different service lines and different payers, was exactly the kind of complexity most EHR systems can’t handle. They stall out, require expensive custom builds, or force every brand into the same rigid mold regardless of how they actually operate.
Refresh needed a single platform that could support everything from outpatient therapy to IOP, PHP, and medication management while still adapting to each brand’s workflows. It also needed to onboard new practices fast. Sometimes six in a single month.
Objectives
Refresh Mental Health needed an EHR partner that could keep pace with one of the most ambitious behavioral health expansions in the country. The plan was straightforward in concept and demanding in execution: acquire established local behavioral health brands, layer on operational and technology infrastructure, and let clinical partners focus on care.
The EHR sat at the center of that thesis. It had to onboard new acquisitions quickly, standardize operations across very different clinical environments, and surface real-time performance data to the corporate team.
Refresh was looking for a partner with:
- Scalability: a single platform that could absorb new acquisitions every month without custom builds or system replacements.
- Multi-org administration: centralized oversight of dozens of brands operating in different states, with different payers and regulations.
- Clinical flexibility: support for outpatient therapy, IOP, PHP, SUD, eating disorders, medication management, TMS, and neurofeedback in the same system.
- Interoperability: open API access to connect Tableau, ADP, FHIR/HIE systems, and the rest of a growing tech stack.
- Implementation support: WhiteGlove onboarding and on-site Go Live help to bring new locations live without disrupting patient care.
Challenges
Before partnering with PIMSY, scaling a network this large carried real operational risk across a multi-state, multi-brand footprint:
- Fragmented EHR systems: every acquisition arrived with its own software, workflows, and billing setups. Standardizing across them was a constant drag on growth.
- Multi-state regulatory complexity: operating across 37 states meant different licensing rules, payer mixes, and clinical documentation requirements in every market.
- Acquisition velocity: onboarding up to six new practices per month would break most EHR implementation timelines.
- Clinical service line diversity: outpatient therapy, IOP, PHP, SUD, eating disorders, medication management, and ancillary services each demanded different documentation, billing, and compliance workflows.
- Corporate visibility: without real-time data across every location, leadership couldn’t manage performance, catch problems early, or report to investors with confidence.
Solutions
Refresh selected PIMSY after a competitive evaluation. They’d already seen what PIMSY could do: Comprehensive MedPsych Systems (CMPS), a 146-person practice spanning two states and multiple time zones, had gone live with PIMSY in record time.
PIMSY built a standardized Refresh instance that each new acquisition could onboard into. Custom reporting gave the corporate team real-time visibility across all locations simultaneously. The billing matrix handled the complexity of multiple payers, state regulations, and contract structures without requiring a custom build for each new market.
On the clinical side, PIMSY’s flexible note builder and global treatment plan library let therapists and prescribers document consistently across different brands. IOP/PHP automation handled group documentation for intensive programs. Integrated ePrescription with EPCS and PDMP kept medication management compliant in every state Refresh entered.
The API made the rest possible: PIMSY connected to Tableau for centralized analytics, ADP for payroll, and FHIR/HIE systems for interoperability as Refresh’s tech stack grew. New acquisitions plugged into an existing system. White-glove onboarding and on-site Go Live support meant each location launched without disrupting patient care.
Conclusion
In 2022, Optum acquired Refresh, citing operational efficiency and mission success. It’s a rare outcome for a behavioral health company, and the infrastructure underneath it told a clear story.
Over four years, Refresh grew from 9 behavioral health organizations to 300+ locations across 37 states. Users on the PIMSY platform grew 453.5%. Services performed grew 431.7%. Clients served grew 236.8%. Claims paid grew 46.5%. PIMSY onboarded 60+ brands during that run, supporting up to six acquisitions per month without breaking clinical or billing workflows.
“We needed an EHR partner that was scalable, cost-effective, and flexible. Something else that set PIMSY apart was their dedication to our success early on. Their role in our successful nationwide expansion highlights the power of a strategic partnership.”
— Steve Gold, Founder and former CEO, Refresh Mental Health
“PIMSY improved the user and clinicians’ experience, productivity, and KPIs and built out a universal API to partner with existing software.”
— Kristen Scheel, COO, Refresh Mental Health
