Ten Years, Ten Questions with evolvedMD Co-Founder Steve Biljan

Ten years ago, Co-Founders Erik Osland and Steve Biljan sat down and made a bet. A bet on each other, on an idea, and on the belief that behavioral health could be done differently.

That bet paid off in countless ways, and after ten impactful years, Steve has closed his chapter with evolvedMD. To mark the moment, EVP and Chief of Staff Sentari Minor sat down with him for a candid conversation on what the hardest moments taught him, what he hopes we carry forward, and the value of being your true self.

Learn from an accomplished leader lessons in perseverance, culture, and the power of doing the right thing below:

1. Take us back to the beginning. What made you say yes to Erik when he came to you with the idea for evolvedMD?

When I started looking into it, I found two stats from the NIH and CDC: that more people suffered from depression than diabetes, and that regardless of severity, even people who were severely depressed, more than half were not getting any treatment at all.

The existing solutions were not working. Research from Milliman showed the system could save billions if we integrated behavioral and medical care effectively. Then I discovered the Collaborative Care model out of the University of Washington AIMS Center, very well regarded clinically, with the financial data to back it. Kaiser, Mayo, and Intermountain were already delivering it, even when there weren’t CPT codes to pay for it.

It just felt like the right time to take a leap and see what happens.

2. Industry experts told you repeatedly that this model would never work. What kept you going?

If we want a good healthcare system, you have to embed behavioral health into primary care in a way that actually solves the needs of PCPs. Erik and I shared a conviction that we would be the ones to do it, with what Chris Molaro of NeuroFlow once described as the “delusional optimism” many entrepreneurs have. We just wanted to show people it could be done.

3. You went from helping three providers in one office to a company serving tens of thousands of patients across five states. What was the hardest part of that journey?

Honestly, the hardest part was carrying the weight, the gravity of the company. You feel responsible for people’s mortgages, their car payments, their student loans, their lives. When things got scary, like during COVID when we weren’t sure customers would pay us and if we could make payroll, you can’t just close up shop and say, “Good luck, everybody.” That doesn’t feel right. Thank goodness Erik was there to carry it with me.

4. You’ve helped shape the culture at evolvedMD. What do you look for in a new employee that tells you they’re a fit?

An old boss of mine looked for three things: Do they take pride in delivering high-quality work? Do they take ownership? And do they have enough smarts—not book smarts, but if there’s a curveball, can they figure it out?

It says on the side of the evolvedMD scooter at HQ: “Radically changing the way people are treated.” That’s not just about patient care. It’s how we treat our employees, our customers, and our stakeholders. I look for people who are drawn to that and are inspired by doing something nobody has done before.

5. You’re notorious for asking new hires whether they prefer Michael Jackson or Prince. Why do you ask?

We all have our own personalities and personal lives. I think you should bring that with you to work. The question helps to get past the title of “co-founder” and reminds employees that I am just another person, same as you. At the end of the day, we are all just regular people, and that is where good culture and real teamwork come from.

For the record, I don’t judge anyone for saying Michael Jackson. But I do get a little sparkle when someone says Prince. The answer is Prince. It has always been Prince.

6. You’ve said that helping people who are emotionally hurting is what you’re most proud of. Can you share a moment you’ll carry with you forever?

We were trying to land our second customer and did a pilot at a clinic screening their patients for depression. During that pilot, one of the providers, a longtime physician, was meeting with a longtime patient. They were about to wrap up the appointment, looked at the PHQ-9, and saw the patient had circled the highest response on the self-harm question, nearly every day. The physician asked what was going on and the patient shared they had been sleeping with a loaded gun under their pillow every night for the last month, with suicidal thoughts daily. The physician got them into treatment, and there was a good outcome.

Less than a year after we launched at HonorHealth, they unexpectedly lost a key physician executive over a weekend, a mentor to so many people. They reached out to us to help their leaders and staff through the grief. We had never done anything like it, but our clinical team set up group grief sessions, because it was the right thing to do. I’m as proud of that as anything we have ever built.

7. Outside of the patients and the model, what’s one of your favorite evolvedMD memories?

Lydia and I were reminiscing about our first office, where you had to walk outside the complex to reach the bathroom, in the Arizona summer, with shoddy air conditioning. Put those together and it was not a pleasant experience.

I remember sitting next to Sarah when we made our very first screening calls. I had put together a little call script, and we dialed the first name on the list just to see what would happen. Someone answered, said yes, and took the first slot, 8 a.m. on Tuesday. First patient, first phone call. I looked at Sarah and said, “They are not all going to be this easy.” They were not.

And the all-team gatherings, driving little four-wheel karts around Old Town Scottsdale. Our manager retreat last fall, where Leslie had the whole table laughing so hard I told my partner Michelle that Leslie deserves a Netflix special. I will treasure every one of those.

8. What do you want the next generation of evolvedMD employees, partners, and champions to learn from your ten-year story?

Erik and I used to drive past billboards, “Health System ABC, Health System ABC, best patient, patient this, patient that.” Everybody says they’re about the patient, yet we never stop complaining about costs and outcomes. So, are we actually about the patient? If you sit with it, you realize good patient care comes from treating your people and your partners well, too.

The other thing I’d say is don’t solve the problem a few times in the easiest way. It’s usually the hardest path that’s the most impactful. During and after COVID there was pressure to go all in on virtual, and I remember sitting in that heated meeting with our ELT and landing on something simple: who we are is who we are. A purely virtual provider has no connection to the physician or the staff, which makes them easy to displace. We chose the harder, stickier path on purpose, and I would not trade that.

9. What chapter are you most excited to write next? What’s next for Steve?

I’m most excited about spending more time at home and being more available for my family. My partner Michelle’s son has significant medical complexities, and this past year has been hard on his health and on her as a caregiver. It has gone from part-time to full-time, and we are navigating a lot of uncertainty and a lot of ups and downs. Being away for a long time has been tough. And honestly, it’s also the right time for the company to move past what I can offer and take things to another level.

10. Full circle. If you could go back and tell the Steve who showed up on day one anything, what would it be?

It would be something Erik likes to say. When someone is scared or unsure, you go around the table, put your arm around them, and say, “you know what, it’s going to be okay. We got this.”

Going back to day one, I would tell myself to trust the process. We are doing the right things, with great people, for the right reasons. Be persistent, do not worry so much, and trust the process. The outcomes will be whatever they are going to be.

Thank you for everything, Steve!