Community Spotlight: How Amast Health Is Building for the Next Wave of Psychedelic Medicine

Two psychiatrists set out to build a different kind of Spravato (esketamine) practice—one centered on therapy and the patient experience, not simply the medication. Michael Dinh, MD, and Jack Buchanan, MD, built Amast Health around a time-limited, therapy-forward model for patients with treatment-resistant depression, partnering with Osmind to handle the infrastructure behind the scenes so they could stay focused on clinical care.

What you'll learn

• Amast Health's course runs one week of intake and preparation, four weeks of twice-weekly Spravato, four weeks of weekly treatment, and a transition visit at the end.
• Psychotherapy runs at the beginning and end of each Spravato session, and the model treats symptom relief as a window of opportunity for rebuilding routines rather than the endpoint of treatment.
• The founders adapted the Montreal model of ketamine-assisted therapy, after training with the researchers at the University of Montreal and McGill University who developed it.
• Taking insurance was a deliberate access decision, and the most common surprise among referring clinicians and patients is that Spravato is covered at all.
• Amast Health runs on Osmind 360, Amast Health is collecting 98.7% of what it's actually owed from payers, against a behavioral health average closer to 85%, and getting paid in about 10 days on average, roughly a third of the 30-to-40-day industry standard.

Michael Dinh, MD, grew up on his family's poultry farm in rural Virginia, in a long line of farmers going back generations in Vietnam. It's a background he describes as rare in medicine, and one that led him fairly directly to psychiatry.

"Growing up, I saw a lot of the consequences of unaddressed or undertreated trauma in my community," he says. Depression, PTSD, anxiety, "all these things that come as a consequence of events that happen over the course of a lifespan."

Jack Buchanan, MD, took a different route. Before medical school he completed a PhD in environmental philosophy, work that pulled him toward questions of consciousness and the relationship between brain and mind.

"I found the philosophy of mind stuff, and what's often called the hard problem of consciousness, to be just fascinating," he says. "For me, psychedelics were an amazing lens to bring to that." When the second wave of psychedelic research began producing compelling durability data, the pieces came together. "It just sort of clicked for me."

The two trained together at UCSF and are now co-founders and medical directors of Amast Health, a San Francisco practice offering Spravato (esketamine) alongside psychotherapy for people living with treatment-resistant depression, and an Osmind partner practice.

A Spravato program built for the patients nothing else has worked for

Both founders ran into the same wall: patients who did everything asked of them and still didn't get better.

"A lot of people try all the treatments we have available right now, conventional medications, talk therapy, and those things don't work for them," Dr. Dinh says. "Not for a personal failing by the patient or any fault of theirs, but because no one thing works for everyone."

The practice uses its own adaptation of the Montreal model of ketamine-assisted therapy, developed by researchers at the University of Montreal and McGill University, where both founders underwent a focused training module. It's a structured, time-limited course: one week of intake and preparation, four weeks of twice-weekly treatment, four weeks of weekly treatment, and a transition visit at the end. Psychotherapy runs throughout, at the beginning and end of each Spravato session.

The design is deliberate. Rather than treating symptom relief as the endpoint, the model treats it as a window of opportunity, a period in which patients can rebuild the routines that depression had made impossible.

Pausing the medication is part of that design. "If we never end a treatment course, patients never get a chance to see how much of the benefit is actually coming from sustainable approaches like a healthy lifestyle and routine," Dr. Dinh says. He's careful that this isn't a judgment about effort. "Patients are not depressed because they're making bad choices. Depression itself is an illness."

Dr. Dinh describes one patient who had identified creativity and agency as values he'd stopped expressing. A vintage car he loved had sat in a garage for months, needing work he couldn't bring himself to start. Over the course of treatment he took it on piece by piece, and by the end of this time-bound treatment model he took the car out for a spin.

"You're telling me you're living in a way that's making you depressed, and you're not doing the things that bring you meaning and joy," Dr. Dinh says. "What are some of those things we can help get you back to doing?"

He's clear about where the credit belongs. "At the end of the day, it's not us or the medication changing people's lives. It's people changing their own lives."

Taking insurance as an access decision

Amast Health takes insurance, which in interventional psychiatry is still a choice rather than a default. For the founders it followed from the mission.

"It really matters to us to be accessible and affordable to as many people as possible by taking insurance, and to take the time to provide high-quality treatment in a safe and effective way," Dr. Dinh says.

Building the referral base has meant a lot of education. Amast Health's clinicians spend real time with psychiatrists, therapists, and primary care clinicians in the Bay Area, and the same surprises come up again and again.

"A lot of people aren't aware that there's an FDA-approved, very safe, very well-tolerated medication with several years of post-market evidence," Dr. Dinh says. "Two, that it's covered by insurance. A lot of people are surprised by that, because of how commonly these interventional psychiatry treatments aren't covered. The fact that we're willing to work with insurance companies and make sure patients can afford the treatment and access it is something that surprises people."

Collaboration with a patient's existing team is built into the model. **Because the course is time-limited, Amast Health actively encourages patients to keep working with their therapists and psychiatrists during and after treatment, and sends summaries back to referring clinicians.

"One reason we started this clinic is that we wanted to make that a pillar of our care, strong collaboration with the patient's whole team," Dr. Dinh says. "Depression doesn't suddenly go away or suddenly get cured. It requires a lot of ongoing hard work on both the patient's part and their care team's part."

That continuity extends to Amast Health itself. Ending a course doesn't end the relationship.

"I envision maintaining ongoing care relationships with patients even if they aren't actively receiving psychedelic-assisted therapy from us," Dr. Dinh says. "Just like they remain in care with their psychiatrist or primary care doctor, they can remain in care with us as their psychedelic-assisted therapy specialists. The door remains open for continued treatment or eventually trying different psychedelic medication options once FDA-approved, so long as it is safe and effective to do so."

Why Amast partnered with Osmind instead of building in-house

Neither founder wanted to spend their time on billing or on the phone with insurance companies. That was close to a founding principle.

"We wanted to focus on clinical care delivery, clinical outcomes, effective treatment, patient safety," Dr. Dinh says. "Anything that isn't directly related to that is something we can partner with someone on. So we wanted to partner with someone who was the industry leader and had expertise in that, especially in interventional psychiatry."

Dr. Buchanan cared most about fit.

"Osmind had already positioned itself as the EHR for interventional practices. I knew they'd built out their system very well," he says. "In a lot of ways, it was the purpose-built infrastructure for our industry." He also knew Osmind was moving into revenue cycle management and working directly with payers, "a big part of what we needed done, the niche we needed filled in our practice that we weren't wanting to devote much of our time to."

"The things we didn't have a plan for yet were exactly the things Osmind was going to take care of," he says. "It was just a really good fit."

Amast Health implemented Osmind 360, which combines the Osmind platform with Osmind's revenue cycle management, claims, and analytics services. Amast Health is collecting 98.7% of what it's actually owed from payers, against a behavioral health average closer to 85%, and getting paid in about 10 days on average, roughly a third of the 30-to-40-day industry standard.

For a young practice, that has meant not building a back office at all.

"We feel good about the level of support we've gotten, including face-to-face time with really talented staff at Osmind," Dr. Dinh says. "That has freed us up to focus on building out our clinical model and providing high-quality treatment to patients."

A team, not a ticket queue

Dr. Buchanan is candid that the first months involved everyone learning at once.

"There's been no lack of support. I've never felt like I haven't gotten a timely response, or haven't gotten to the bottom of a big issue that came up," he says. "Early on there was a lot of all of us figuring things out, but that's the growing pains of being a new practice. Now it's starting to feel a lot more like autopilot. The attention to detail Osmind has put into making this workflow easy for everyone in our situation is really starting to pay off."

What surprised Dr. Dinh most wasn't the software.

"The most surprising part has been how high-touch it's been, getting face-to-face time with real people, even months into our working relationship," he says. "It's really hard to get people's time nowadays. And not just time with people, but time with very talented, clearly passionate, caring people. That has really helped us grow."

"We have our insurance contracts, but Osmind is a big part of making sure our patients can get the most out of their insurance and their benefits to get the treatment they need."

Building for psychedelic treatments coming next

Amast Health was designed with more than Spravato in mind. The founders chose a time-limited, therapy-forward structure partly because they expect the next generation of psychedelic treatments to work that way: fewer sessions, longer experiences, more time spent with each patient, more durable effect.

"Part of the reason we chose Osmind is that we were envisioning not just the first year or the second year. We were choosing a partner we could grow with as more psychedelic medications become FDA approved," Dr. Buchanan says. These two founders expect the landscape to get more complex, in a good way, as more options become available to patients. Should psilocybin or MDMA reach approval, Amast Health wants the clinic, staff, training, and clinical model ready on their side, and the contracts, revenue structures, and regulatory work ready on Osmind's.

Growth is the goal. So is restraint.

"There's so much we can't control about when or if these medications ever get FDA approved, or what reimbursement structures will look like," Dr. Dinh says. "What we can control is that we practice with integrity and in a high-quality way, with the patient and their wellbeing as the highest priority."

In practice, that means staying physician- and therapist-led, and offering a treatment only when it's safe and appropriate, a discipline he considers essential precisely because these treatments are powerful.

Dr. Buchanan puts the ambition plainly, and puts trust at the center of it. Amast Health wants to become a household name in psychedelic-assisted therapy nationally, and he doesn't think that happens any other way. "The trust we build with our referral partners and with our patients, we don't have anything without that. We can't add more services. We can't expand. We can't really do what we do without that trust."

Amast Health built a clinical model worth protecting, then found a partner to carry everything that wasn't clinical. If your practice is spending hours on claims, denials, and prior authorizations instead of patients, Osmind's psychiatric billing team can take that off your plate. Let's talk. Book a consultation today.