1 00:00:00,320 --> 00:00:02,319 Hi, everyone. This is Lucas Voss with Becker's 2 00:00:02,319 --> 00:00:04,000 HealthCare. Thanks so much for tuning in to 3 00:00:04,000 --> 00:00:07,379 the Becker's HealthCare podcast series, Happy New Year. 4 00:00:07,519 --> 00:00:10,000 And today, we're joined by doctor Katharine Hopps, 5 00:00:10,000 --> 00:00:11,219 CEO of AuthorHealth, 6 00:00:11,759 --> 00:00:14,544 to discuss the evolving dynamics of payer provider 7 00:00:14,544 --> 00:00:15,044 collaboration 8 00:00:15,505 --> 00:00:18,625 in health care. Doctor Hobbs, thanks so much 9 00:00:18,625 --> 00:00:20,144 for being here today. It's great to have 10 00:00:20,144 --> 00:00:20,644 you. 11 00:00:21,425 --> 00:00:23,025 Great. I'm I'm excited to be here and 12 00:00:23,025 --> 00:00:26,320 appreciate this opportunity to to talk further. Yeah. 13 00:00:26,320 --> 00:00:27,839 Absolutely. We have we have a lot to 14 00:00:27,839 --> 00:00:30,000 talk about, like you've mentioned, but I wanna 15 00:00:30,000 --> 00:00:32,000 give folks an idea of of who you 16 00:00:32,000 --> 00:00:34,239 are. Could you introduce yourself and just give 17 00:00:34,239 --> 00:00:36,000 us a little bit of your background in 18 00:00:36,000 --> 00:00:36,739 health care? 19 00:00:37,119 --> 00:00:37,619 Sure. 20 00:00:38,320 --> 00:00:41,215 I'm an adult and child psychiatrist, and I've 21 00:00:41,215 --> 00:00:44,175 worked in basically every setting from inpatient to 22 00:00:44,175 --> 00:00:47,615 outpatient emergency department, built several integrated behavioral health 23 00:00:47,615 --> 00:00:48,835 and primary care programs. 24 00:00:49,375 --> 00:00:51,695 For about the last 15 years, I've worked 25 00:00:51,695 --> 00:00:52,755 in health insurance, 26 00:00:53,109 --> 00:00:56,149 And so doing core insurance functions, so behavioral 27 00:00:56,149 --> 00:00:56,810 health network, 28 00:00:57,829 --> 00:00:58,649 case management. 29 00:00:59,109 --> 00:01:01,049 But also always focused on, 30 00:01:01,429 --> 00:01:03,850 bringing high quality evidence based treatment, 31 00:01:04,629 --> 00:01:07,109 to people. So doing that through innovative care 32 00:01:07,109 --> 00:01:08,010 delivery models, 33 00:01:08,655 --> 00:01:11,295 and also by measuring quality and outcomes and 34 00:01:11,295 --> 00:01:13,234 really pushing the system to, 35 00:01:13,534 --> 00:01:14,495 to where we deliver, 36 00:01:14,814 --> 00:01:16,674 value based payment models as well. 37 00:01:17,055 --> 00:01:19,055 I joined author health about two and a 38 00:01:19,055 --> 00:01:19,954 half years ago. 39 00:01:20,990 --> 00:01:22,350 We focus on, 40 00:01:22,670 --> 00:01:25,310 treating serious mental illness, substance use disorders, and 41 00:01:25,310 --> 00:01:25,810 dementia, 42 00:01:26,590 --> 00:01:29,390 in mainly a Medicare advantage and special needs 43 00:01:29,390 --> 00:01:30,290 plans populations. 44 00:01:31,069 --> 00:01:32,850 We deliver health care services, 45 00:01:33,314 --> 00:01:36,114 and also wraparound services that are community based, 46 00:01:36,114 --> 00:01:38,754 and we participate in these value based contracts 47 00:01:38,754 --> 00:01:39,334 as well. 48 00:01:40,114 --> 00:01:41,848 And that's certainly I think that's a a 49 00:01:41,848 --> 00:01:43,715 a great pivot too because you have both 50 00:01:43,715 --> 00:01:46,290 perspectives, which is fantastic, both the insurance side 51 00:01:46,609 --> 00:01:48,069 and the provider side itself. 52 00:01:48,849 --> 00:01:51,250 And we know that payment models are very 53 00:01:51,250 --> 00:01:54,629 quickly evolving. There's new care delivery strategies coming. 54 00:01:54,770 --> 00:01:55,989 Payor provider collaboration 55 00:01:56,290 --> 00:01:58,930 is is is really key. They need to 56 00:01:58,930 --> 00:02:01,250 work together. It needs to happen it needs 57 00:02:01,250 --> 00:02:02,025 to happen together. 58 00:02:02,984 --> 00:02:05,084 To get us started here, what opportunities 59 00:02:05,465 --> 00:02:07,965 do you see for greater collaboration 60 00:02:08,585 --> 00:02:10,185 as we had into the New Year and 61 00:02:10,185 --> 00:02:12,344 certainly beyond that as well? And and how 62 00:02:12,344 --> 00:02:15,004 will this impact patient outcomes and costs? 63 00:02:15,969 --> 00:02:19,090 Yeah. So especially in in behavioral health, we 64 00:02:19,090 --> 00:02:22,129 are seeing much greater progress on quality and 65 00:02:22,129 --> 00:02:23,590 outcome measurement and also, 66 00:02:24,129 --> 00:02:26,449 transition to value based payment models. And so 67 00:02:26,449 --> 00:02:28,870 we expect for that, trend to continue. 68 00:02:29,825 --> 00:02:32,145 Core to that is the importance of of 69 00:02:32,145 --> 00:02:32,645 integration 70 00:02:32,944 --> 00:02:35,764 and and data sharing. So there are certain 71 00:02:36,064 --> 00:02:37,925 sort of information about patients, 72 00:02:38,544 --> 00:02:40,784 that only health plans have. So things like 73 00:02:40,784 --> 00:02:42,085 historical health care utilization, 74 00:02:42,865 --> 00:02:44,885 information about benefits or 75 00:02:45,689 --> 00:02:46,590 caregivers, etcetera, 76 00:02:47,209 --> 00:02:48,110 that are actionable 77 00:02:48,409 --> 00:02:50,810 and really important for a provider to be 78 00:02:50,810 --> 00:02:52,909 able to deliver high quality care, 79 00:02:53,289 --> 00:02:55,449 in the community. And so being able to 80 00:02:55,449 --> 00:02:59,069 deliver those actionable insights using data to providers 81 00:02:59,129 --> 00:03:00,349 from from from payers 82 00:03:01,264 --> 00:03:01,925 is a critical 83 00:03:03,025 --> 00:03:05,604 capability. Additionally, for providers. So, 84 00:03:05,905 --> 00:03:08,224 in order to participate in value based payment 85 00:03:08,224 --> 00:03:10,004 models, we need to be able to report 86 00:03:10,224 --> 00:03:12,384 our outcomes. And there's certain data that only 87 00:03:12,384 --> 00:03:14,060 we have access to that the payers, 88 00:03:14,519 --> 00:03:15,879 don't, and that we need to be able 89 00:03:15,879 --> 00:03:17,400 to aggregate and be able to send back. 90 00:03:17,400 --> 00:03:20,039 So things like person reported health outcome measures. 91 00:03:20,039 --> 00:03:21,739 These in these are one of 92 00:03:22,039 --> 00:03:24,360 the main ways that we measure outcomes in 93 00:03:24,360 --> 00:03:26,439 behavioral health are things like the PHQ 9 94 00:03:26,439 --> 00:03:29,364 or GAD 7. These are basically symptom rating 95 00:03:29,364 --> 00:03:32,724 scales, that we use, to collect data on 96 00:03:32,724 --> 00:03:33,864 basically the baseline 97 00:03:34,324 --> 00:03:37,364 symptom burden, but also improvement in those symptoms 98 00:03:37,364 --> 00:03:38,104 over time. 99 00:03:39,044 --> 00:03:41,125 Especially as many behavioral health providers are still 100 00:03:41,125 --> 00:03:43,689 on pen and paper, don't actually have robust 101 00:03:43,689 --> 00:03:46,169 electronic health record systems. It's really hard to 102 00:03:46,169 --> 00:03:46,669 collect 103 00:03:47,209 --> 00:03:49,930 those outcomes and report them to participate in 104 00:03:49,930 --> 00:03:53,209 value based contracting. And so that support around 105 00:03:53,209 --> 00:03:56,250 data collection and also data aggregation for your 106 00:03:56,250 --> 00:03:57,069 patient population, 107 00:03:57,574 --> 00:03:58,555 and then a scalable 108 00:03:59,094 --> 00:03:59,594 and, 109 00:04:00,694 --> 00:04:02,614 systematic way to be able to send those 110 00:04:02,614 --> 00:04:04,775 outcomes back to payers to participate in a 111 00:04:04,775 --> 00:04:06,875 value based, payment model is critical, 112 00:04:07,254 --> 00:04:08,794 in order to do this work well. 113 00:04:09,254 --> 00:04:11,594 This case, sharing is really caring. 114 00:04:12,239 --> 00:04:14,239 Correct. Well, you have to be able to 115 00:04:14,239 --> 00:04:16,479 measure the outcomes. Right? And then once you 116 00:04:16,479 --> 00:04:17,919 actually do that, you need to be able 117 00:04:17,919 --> 00:04:20,419 to report it and share that information exactly 118 00:04:20,720 --> 00:04:22,720 to show that you're actually improving health as 119 00:04:22,720 --> 00:04:24,845 you deliver care for for patients. Yeah. 120 00:04:25,464 --> 00:04:26,824 And you've touched on on a couple of 121 00:04:26,824 --> 00:04:28,745 these factors too that that play into this. 122 00:04:28,745 --> 00:04:32,264 Right? Patient population, different networks. It's very variable. 123 00:04:32,264 --> 00:04:32,745 There's 124 00:04:33,144 --> 00:04:36,045 people measure quality in different ways. That's right. 125 00:04:36,264 --> 00:04:37,785 Can you share a little bit some of 126 00:04:37,785 --> 00:04:39,889 the examples that you might have of how 127 00:04:39,889 --> 00:04:42,050 you're innovating in this space, how you're trying 128 00:04:42,050 --> 00:04:43,649 to improve this, and and what are some 129 00:04:43,649 --> 00:04:45,269 of the results that you're seeing? 130 00:04:46,290 --> 00:04:49,250 Yeah. So so there's 2 major ways that 131 00:04:49,250 --> 00:04:51,189 that we're innovating. So one, 132 00:04:52,055 --> 00:04:52,794 is addressing 133 00:04:53,175 --> 00:04:55,194 many of the barriers to delivering 134 00:04:55,574 --> 00:04:56,555 a high quality, 135 00:04:57,334 --> 00:04:59,014 behavioral health care to people. And so what 136 00:04:59,014 --> 00:05:00,774 I mean by that is, I say this 137 00:05:00,774 --> 00:05:02,535 all the time. I at at Alder Health, 138 00:05:02,535 --> 00:05:05,409 we're not inventing a new treatment for serious 139 00:05:05,409 --> 00:05:07,589 mental illness, substance use disorders. In our field, 140 00:05:07,729 --> 00:05:09,810 we have treatments that work. I can't give 141 00:05:09,810 --> 00:05:12,709 you a better treatment than than buprenorphine 142 00:05:13,169 --> 00:05:16,050 to treat opioid use disorder. Cognitive behavioral therapy 143 00:05:16,050 --> 00:05:18,745 to treat depression, anxiety, tons of evidence that 144 00:05:18,745 --> 00:05:21,464 these are effective treatments to improve health and 145 00:05:21,464 --> 00:05:22,605 keep people in the community, 146 00:05:23,145 --> 00:05:24,524 and and reduce costs. 147 00:05:25,145 --> 00:05:28,045 The problem is that these effective treatments don't 148 00:05:28,185 --> 00:05:30,490 reach people in a timely manner. And so 149 00:05:30,490 --> 00:05:32,410 what I mean by that, when when people 150 00:05:32,410 --> 00:05:34,250 need them, they're not able to access these 151 00:05:34,250 --> 00:05:34,750 services. 152 00:05:35,290 --> 00:05:37,850 Many people wait months, even years to actually 153 00:05:37,850 --> 00:05:39,790 access, evidence based care. 154 00:05:40,410 --> 00:05:42,830 And it's also not delivered in a convenient 155 00:05:42,970 --> 00:05:44,904 manner. So good example is, 156 00:05:45,464 --> 00:05:47,225 in person therapy. A lot of times that's 157 00:05:47,225 --> 00:05:49,705 only offered during working hours. Well, that doesn't 158 00:05:49,705 --> 00:05:51,785 work for an hourly worker. Right? A person 159 00:05:51,785 --> 00:05:53,944 receiving sort of hourly wages. Right? They'd have 160 00:05:53,944 --> 00:05:55,944 to get off work every week, go to 161 00:05:55,944 --> 00:05:56,605 a therapist. 162 00:05:57,319 --> 00:05:59,240 And and it's not possible to to do 163 00:05:59,240 --> 00:06:00,139 that. And so 164 00:06:00,600 --> 00:06:01,580 using technology, 165 00:06:02,439 --> 00:06:05,000 using innovative ways that we've developed our care 166 00:06:05,000 --> 00:06:05,500 team, 167 00:06:05,800 --> 00:06:09,180 addressing social social issues, so things like transportation, 168 00:06:09,319 --> 00:06:10,139 housing, etcetera. 169 00:06:10,485 --> 00:06:12,725 These are all of the barriers that that 170 00:06:12,725 --> 00:06:15,044 people experience to be able to engage in 171 00:06:15,044 --> 00:06:16,024 high value care 172 00:06:16,404 --> 00:06:18,725 that our company is is is working to 173 00:06:18,725 --> 00:06:19,225 address, 174 00:06:19,685 --> 00:06:21,604 so that we can actually get these these 175 00:06:21,604 --> 00:06:23,944 evidence based treatments to people in a convenient 176 00:06:24,004 --> 00:06:25,620 and a in a scalable manner. 177 00:06:26,100 --> 00:06:27,860 The other thing that we're doing is is 178 00:06:27,860 --> 00:06:30,419 changing payment. So I've also said many times 179 00:06:30,419 --> 00:06:32,819 that fee for service payment breaks behavioral healthcare 180 00:06:32,819 --> 00:06:34,899 really breaks all of healthcare, but certainly behavioral 181 00:06:34,899 --> 00:06:37,220 healthcare. And the reason for that is that 182 00:06:37,220 --> 00:06:39,560 some of the most impactful things we do 183 00:06:40,205 --> 00:06:41,585 are are are not 184 00:06:42,045 --> 00:06:44,125 based on a billable visit with a clinician. 185 00:06:44,125 --> 00:06:45,564 So all those things that we do in 186 00:06:45,564 --> 00:06:47,345 between those clinic visits. So 187 00:06:47,645 --> 00:06:50,365 addressing again health related social needs, calling the 188 00:06:50,365 --> 00:06:53,004 patient to check on, you know, side effects 189 00:06:53,004 --> 00:06:53,745 of a medication, 190 00:06:54,399 --> 00:06:56,800 working with caregivers, doing care coordination with other 191 00:06:56,800 --> 00:06:59,139 providers. A lot of those types of interventions 192 00:06:59,680 --> 00:07:02,479 are not funded in fee for service and 193 00:07:02,479 --> 00:07:04,419 therefore are hard to scale. 194 00:07:05,039 --> 00:07:06,959 And so one of the major ways that 195 00:07:06,959 --> 00:07:08,899 we're working with payers and insurance companies 196 00:07:09,254 --> 00:07:11,514 is to move towards more of a population 197 00:07:11,574 --> 00:07:13,975 based approach. And so we, we work with 198 00:07:13,975 --> 00:07:15,194 payers to identify 199 00:07:15,574 --> 00:07:18,295 a patient population with serious mental illness, substance 200 00:07:18,295 --> 00:07:20,795 use disorder in the geographies where we're live. 201 00:07:21,014 --> 00:07:21,754 We receive 202 00:07:22,375 --> 00:07:24,240 prospective payments to manage 203 00:07:24,540 --> 00:07:26,079 the health and the social needs 204 00:07:26,379 --> 00:07:28,220 of this patient population. And then we go 205 00:07:28,220 --> 00:07:29,680 at up and downside risk 206 00:07:30,300 --> 00:07:31,919 and have to report on quality 207 00:07:32,220 --> 00:07:34,139 to show that we're actually helping this patient 208 00:07:34,139 --> 00:07:36,860 population get better, and that we're managing the 209 00:07:36,860 --> 00:07:39,774 costs through the clinical treatment and the social 210 00:07:39,774 --> 00:07:42,254 services that our that our company provides. And 211 00:07:42,254 --> 00:07:43,935 that is a very different I I know 212 00:07:43,935 --> 00:07:45,714 that this is, sort of, 213 00:07:46,574 --> 00:07:48,654 old hat, and the rest of health care 214 00:07:48,654 --> 00:07:49,794 is very new, 215 00:07:50,400 --> 00:07:52,340 in behavioral health. And and 216 00:07:52,720 --> 00:07:54,259 and I'm so grateful to 217 00:07:54,639 --> 00:07:55,139 payers, 218 00:07:55,759 --> 00:07:56,259 providers 219 00:07:56,720 --> 00:07:59,139 that are really coming together and thinking 220 00:07:59,520 --> 00:08:01,600 on how how we build these models and 221 00:08:01,600 --> 00:08:03,774 how we actually deploy them and and and 222 00:08:03,774 --> 00:08:05,535 deliver them at scale. Because I really think 223 00:08:05,535 --> 00:08:08,355 that's a key piece to transforming overall, 224 00:08:09,214 --> 00:08:11,394 health care for people with behavioral health conditions. 225 00:08:11,855 --> 00:08:13,615 Yeah. And that in conjunction, as you mentioned, 226 00:08:13,615 --> 00:08:16,610 sort of with that holistic look at care 227 00:08:16,610 --> 00:08:18,769 and being able to integrate everything into each 228 00:08:18,769 --> 00:08:20,930 other so that there's a a picture that 229 00:08:20,930 --> 00:08:22,709 is created that encompasses 230 00:08:23,169 --> 00:08:25,810 everything, not just pieces here and there that 231 00:08:25,810 --> 00:08:27,970 that are important. And and I think especially 232 00:08:27,970 --> 00:08:30,835 for for value based models and and value 233 00:08:30,835 --> 00:08:31,975 based care, this 234 00:08:32,274 --> 00:08:34,274 is incredibly important. And and one of the 235 00:08:34,274 --> 00:08:36,434 things that you've you've noted at at our 236 00:08:36,434 --> 00:08:40,215 payer issues roundtable and almost quoting you exactly 237 00:08:40,355 --> 00:08:42,409 here. Right? Untapped potential 238 00:08:43,029 --> 00:08:45,350 in value based payment models. That's really what 239 00:08:45,350 --> 00:08:48,009 you're seeing. You're seeing untapped potential there, 240 00:08:48,389 --> 00:08:50,629 and the importance of, as you've said, fully 241 00:08:50,629 --> 00:08:53,289 integrating mental health services like you've talked about. 242 00:08:53,434 --> 00:08:54,334 How can organizations 243 00:08:54,954 --> 00:08:58,154 successfully transition to value based models and and 244 00:08:58,154 --> 00:09:00,794 really meet these standards, these aims that that, 245 00:09:01,115 --> 00:09:02,654 would make a difference potentially, 246 00:09:03,195 --> 00:09:05,294 and what strategies would you highlight there? 247 00:09:05,949 --> 00:09:09,149 Yeah. So number 1 is is integrating payment. 248 00:09:09,149 --> 00:09:11,089 And so what I mean by that is 249 00:09:11,230 --> 00:09:13,389 currently today and and over the last several 250 00:09:13,389 --> 00:09:13,889 decades, 251 00:09:14,589 --> 00:09:15,329 in general, 252 00:09:16,029 --> 00:09:19,070 payment and management of physical health services is 253 00:09:19,070 --> 00:09:21,105 done separately from behavioral health services. So a 254 00:09:21,105 --> 00:09:23,664 lot of times the behavioral health payment and 255 00:09:23,664 --> 00:09:26,164 management is carved out to a separate organization 256 00:09:26,384 --> 00:09:28,705 that manages it, you know, apart from physical 257 00:09:28,705 --> 00:09:31,664 health. What we know is that people with 258 00:09:31,664 --> 00:09:33,825 behavioral health conditions and especially people with more 259 00:09:33,825 --> 00:09:36,669 severe and complex illness, almost all of them 260 00:09:36,809 --> 00:09:38,669 have co occurring physical health, 261 00:09:39,450 --> 00:09:42,429 chronic medical conditions. So things like diabetes, cardiovascular 262 00:09:42,649 --> 00:09:43,470 disease, COPD. 263 00:09:43,850 --> 00:09:46,410 And when you separate out the payment and 264 00:09:46,410 --> 00:09:49,210 the management of their behavioral health conditions separate 265 00:09:49,210 --> 00:09:51,914 from their physical health, it leads to misaligned 266 00:09:52,054 --> 00:09:53,595 incentives. And it also 267 00:09:54,294 --> 00:09:55,355 leads to substantial 268 00:09:56,294 --> 00:09:57,195 lack of coordination 269 00:09:57,735 --> 00:09:59,815 in the in the care that that's being 270 00:09:59,815 --> 00:10:00,315 provided. 271 00:10:00,695 --> 00:10:02,714 And so number 1 is to 272 00:10:03,809 --> 00:10:06,450 stop creating that division and figure out how 273 00:10:06,450 --> 00:10:09,410 to integrate. And to be clear, behavioral health 274 00:10:09,410 --> 00:10:10,070 card companies 275 00:10:10,690 --> 00:10:11,190 absolutely 276 00:10:11,730 --> 00:10:15,009 can integrate payment. And so we did that 277 00:10:15,009 --> 00:10:16,769 at Blue Cross, North Carolina, where I worked 278 00:10:16,769 --> 00:10:18,470 before at United and Optum. 279 00:10:18,855 --> 00:10:20,855 So even at places where you have carve 280 00:10:20,855 --> 00:10:24,075 outs, you can still work with providers to, 281 00:10:24,695 --> 00:10:25,434 pay them, 282 00:10:25,815 --> 00:10:27,815 from sort of like a single source for 283 00:10:27,815 --> 00:10:30,455 their for for delivery of integrated behavioral health 284 00:10:30,455 --> 00:10:33,330 and and physical health services. And also hold 285 00:10:33,330 --> 00:10:34,710 them accountable for, 286 00:10:35,570 --> 00:10:39,190 integrated quality measures. So hold behavioral health providers 287 00:10:39,250 --> 00:10:41,190 accountable for diabetes management, 288 00:10:41,809 --> 00:10:44,389 and other medical conditions. And similarly, hold PCPs 289 00:10:44,450 --> 00:10:46,930 and hospital systems accountable for screening and treatment 290 00:10:46,930 --> 00:10:49,205 of depression. That's totally appropriate for them to 291 00:10:49,205 --> 00:10:51,205 be doing. And then similarly hold each group 292 00:10:51,205 --> 00:10:52,504 accountable for total, 293 00:10:53,044 --> 00:10:53,544 costs 294 00:10:54,164 --> 00:10:54,985 and and MLR. 295 00:10:55,605 --> 00:10:58,004 And so examples where we've done that really 296 00:10:58,004 --> 00:10:59,684 well was this was more when I was 297 00:10:59,684 --> 00:11:00,565 on the payer side. 298 00:11:01,125 --> 00:11:03,059 We work we had robust 299 00:11:03,379 --> 00:11:05,080 ACO contracts where, 300 00:11:05,539 --> 00:11:07,620 we made sure that the ACO that that 301 00:11:07,620 --> 00:11:10,179 the behavioral health payment was also included in 302 00:11:10,179 --> 00:11:11,960 the delegated risk to these ACOs. 303 00:11:12,820 --> 00:11:14,580 And then additionally, like I said, we put 304 00:11:14,580 --> 00:11:15,080 in, 305 00:11:15,700 --> 00:11:19,394 behavioral health quality measures to incentivize them to 306 00:11:19,394 --> 00:11:21,794 address things like depression. So screen for depression, 307 00:11:21,794 --> 00:11:24,115 treat treat depression, and then also held them 308 00:11:24,115 --> 00:11:26,034 accountable for the for the total cost of 309 00:11:26,034 --> 00:11:28,375 care, including the behavioral health spend as well. 310 00:11:28,595 --> 00:11:31,574 Similarly, author and other providers like us, 311 00:11:32,379 --> 00:11:34,779 we we partner really closely with primary care 312 00:11:34,779 --> 00:11:37,980 groups. Many providers like us also deliver what 313 00:11:37,980 --> 00:11:39,199 we call reverse integration. 314 00:11:39,500 --> 00:11:41,980 So primary care services delivered from a behavioral 315 00:11:41,980 --> 00:11:43,759 health home. Very similarly, 316 00:11:44,220 --> 00:11:46,595 you know, insurance companies can pay those behavioral 317 00:11:46,595 --> 00:11:48,595 health providers for both the physical and the 318 00:11:48,595 --> 00:11:50,995 behavioral health services, and then hold them accountable 319 00:11:50,995 --> 00:11:52,834 for the physical health quality measures and the 320 00:11:52,834 --> 00:11:55,154 total cost of care. But it really, though, 321 00:11:55,154 --> 00:11:57,894 starts with integrating the payment and the management 322 00:11:58,034 --> 00:11:59,975 with which then flows downstream 323 00:12:00,570 --> 00:12:03,049 to how providers are incentivized to deliver that 324 00:12:03,049 --> 00:12:04,269 care and and really, 325 00:12:05,049 --> 00:12:08,509 treat patients holistically and and and and improve, 326 00:12:09,129 --> 00:12:12,009 population health, across the full spectrum of physical 327 00:12:12,009 --> 00:12:13,309 and behavioral health care. 328 00:12:14,044 --> 00:12:16,365 Certainly, the integration that you've mentioned is is 329 00:12:16,365 --> 00:12:17,804 is a big piece to this, like you 330 00:12:17,804 --> 00:12:19,904 said. You you've mentioned accountability 331 00:12:20,284 --> 00:12:22,284 quite a bit in this. Right? And and 332 00:12:22,284 --> 00:12:23,824 and I feel like to be accountable, 333 00:12:24,125 --> 00:12:25,565 you have to have something to go back 334 00:12:25,565 --> 00:12:27,410 on. You have to have data. You have 335 00:12:27,410 --> 00:12:29,649 to have information that you can use. You 336 00:12:29,649 --> 00:12:31,330 have to have some sort of system that 337 00:12:31,330 --> 00:12:33,570 that gives you an idea, okay, where is 338 00:12:33,570 --> 00:12:35,570 my accountability at? And and one of the 339 00:12:35,570 --> 00:12:38,210 things that you've talked about, previously at our 340 00:12:38,210 --> 00:12:39,889 page, Shus Ron Teo, which I think is 341 00:12:39,889 --> 00:12:42,134 is very important, is the and and our 342 00:12:42,134 --> 00:12:44,294 conversation today is the challenge that a lot 343 00:12:44,294 --> 00:12:46,215 of these folks, like you said, pen and 344 00:12:46,215 --> 00:12:49,575 paper. Right? Yeah. EHR capabilities just aren't there. 345 00:12:49,575 --> 00:12:51,095 There is a system, but it might not 346 00:12:51,095 --> 00:12:52,235 be great. Right? 347 00:12:52,950 --> 00:12:54,549 It just makes it hard. It makes it 348 00:12:54,549 --> 00:12:57,269 incredibly hard to collect data, measure outcomes, what's 349 00:12:57,269 --> 00:13:00,389 the quality, where's the accountability. Right? Can you 350 00:13:00,389 --> 00:13:02,470 touch a little bit on how you support 351 00:13:02,470 --> 00:13:04,950 these providers in in creating that efficiency and 352 00:13:04,950 --> 00:13:07,044 being able to say, okay. We can help 353 00:13:07,044 --> 00:13:09,524 you, especially from from a from from a 354 00:13:09,524 --> 00:13:11,684 data collection perspective and and also from a 355 00:13:11,684 --> 00:13:12,584 systems perspective. 356 00:13:13,924 --> 00:13:16,644 Sure. Yeah. And and the fact is, you 357 00:13:16,644 --> 00:13:19,710 know, many behavioral providers were were left out 358 00:13:20,029 --> 00:13:23,170 of meaningful use support and the high-tech act. 359 00:13:23,309 --> 00:13:23,970 And so 360 00:13:24,429 --> 00:13:24,929 we 361 00:13:25,710 --> 00:13:28,210 need to find a way to go back 362 00:13:28,429 --> 00:13:31,330 and increase that support for behavioral health providers 363 00:13:31,710 --> 00:13:32,769 to move from 364 00:13:34,144 --> 00:13:36,625 pen and paper, more analog approaches to to 365 00:13:36,625 --> 00:13:39,205 data informed and tech tech enabled approaches. 366 00:13:39,904 --> 00:13:42,865 And we'll see that transition very similarly to 367 00:13:42,865 --> 00:13:44,384 how we saw the transition over the last 368 00:13:44,384 --> 00:13:46,544 several decades with that support in the rest 369 00:13:46,544 --> 00:13:47,365 of health care 370 00:13:47,709 --> 00:13:50,610 At different payers where I've worked, we have 371 00:13:51,230 --> 00:13:53,870 delivered, like, direct support for that kind for 372 00:13:53,870 --> 00:13:55,250 for technology. So we've, 373 00:13:55,789 --> 00:13:58,269 you know, worked with different technology companies that 374 00:13:58,269 --> 00:14:01,709 are, measuring and reporting outcomes. We provided funding, 375 00:14:01,950 --> 00:14:04,955 to support providers to actually, move to 376 00:14:05,654 --> 00:14:08,414 EHRs and other electronic support. It's critical. It's 377 00:14:08,414 --> 00:14:10,875 a, it's a, it's a core foundational 378 00:14:11,335 --> 00:14:14,054 capability that's required to participate in value based 379 00:14:14,054 --> 00:14:15,975 arrangements. And so if we really want to 380 00:14:15,975 --> 00:14:17,975 move the behavioral health system to a value 381 00:14:17,975 --> 00:14:19,879 based approach, we have to figure out how 382 00:14:19,879 --> 00:14:21,740 to support providers to make that transition, 383 00:14:22,519 --> 00:14:23,740 to use more technology. 384 00:14:24,360 --> 00:14:26,200 Yeah. It has been a must for for 385 00:14:26,200 --> 00:14:28,120 many, many years, and it certainly will remain 386 00:14:28,120 --> 00:14:29,180 a must in 2025 387 00:14:30,200 --> 00:14:31,095 and beyond, I think. 388 00:14:32,294 --> 00:14:34,375 Looking ahead to to this year certainly and 389 00:14:34,375 --> 00:14:36,534 then and then beyond as well, what are 390 00:14:36,534 --> 00:14:38,855 some of the most significant changes in in 391 00:14:38,855 --> 00:14:40,074 how payers and providers 392 00:14:40,375 --> 00:14:43,095 work together? What are you seeing, ahead here 393 00:14:43,095 --> 00:14:45,514 for the future? And and how should 394 00:14:46,289 --> 00:14:47,750 systems how should leaders 395 00:14:48,289 --> 00:14:51,649 prepare now, today? Yeah. You know, one thing 396 00:14:51,649 --> 00:14:52,549 that's been delightful, 397 00:14:53,250 --> 00:14:55,809 over the last 1 to 2 years at 398 00:14:55,809 --> 00:14:58,610 various conferences and also as as our company 399 00:14:58,610 --> 00:15:00,470 is working with with insurance companies, 400 00:15:00,954 --> 00:15:02,794 there's an acceptance that we have to measure 401 00:15:02,794 --> 00:15:04,654 quality. We have to report quality. 402 00:15:05,434 --> 00:15:06,654 And there's, 403 00:15:07,034 --> 00:15:10,475 there's real progress being made on delivering and 404 00:15:10,475 --> 00:15:13,210 participating in in value based payment models. We 405 00:15:13,210 --> 00:15:15,450 did not see that even 2 3 years 406 00:15:15,450 --> 00:15:17,690 ago. So there's been major progress made made 407 00:15:17,690 --> 00:15:19,129 in that way. So and I expect that 408 00:15:19,129 --> 00:15:19,789 to continue. 409 00:15:20,409 --> 00:15:22,649 The other is technology. So we had a 410 00:15:22,649 --> 00:15:26,190 huge and rapid and important transition to telehealth 411 00:15:26,250 --> 00:15:27,149 and tech enabled 412 00:15:27,995 --> 00:15:30,254 services during covet that was necessary. 413 00:15:31,274 --> 00:15:34,075 And while we've had, you know, some movement 414 00:15:34,075 --> 00:15:36,715 back to in person services, we are still, 415 00:15:36,715 --> 00:15:39,274 you know, light years beyond, where we were 416 00:15:39,274 --> 00:15:41,460 pre COVID in terms of the integration of 417 00:15:41,460 --> 00:15:44,019 technology, and I expect that to continue. It's 418 00:15:44,019 --> 00:15:46,580 it's made a substantial difference in terms of 419 00:15:46,580 --> 00:15:48,980 access to care, really overcoming a lot of 420 00:15:48,980 --> 00:15:50,740 the barriers that I talked about earlier in 421 00:15:50,740 --> 00:15:54,120 terms of convenience for people. It's overcoming transportation 422 00:15:54,259 --> 00:15:56,264 issues, things like that, so that we can 423 00:15:56,264 --> 00:15:57,964 actually deliver this high quality 424 00:15:58,504 --> 00:16:00,504 evidence based care with fidelity. That's the other 425 00:16:00,504 --> 00:16:02,424 really important with fidelity to the to the 426 00:16:02,424 --> 00:16:05,225 evidence based model. Through technology, we're able to 427 00:16:05,225 --> 00:16:06,845 get those services to people, 428 00:16:07,304 --> 00:16:09,485 in a more sustainable and efficient manner. 429 00:16:10,089 --> 00:16:12,750 And addressing one of the most important issues 430 00:16:12,809 --> 00:16:15,450 in health care across the country, I think, 431 00:16:15,450 --> 00:16:17,529 for the future. I believe that what not 432 00:16:17,529 --> 00:16:19,289 only within health care, but also for our 433 00:16:19,289 --> 00:16:20,889 society. And you see it Yes. It's through 434 00:16:20,889 --> 00:16:22,394 everything, through employment, through 435 00:16:22,795 --> 00:16:23,295 education, 436 00:16:24,154 --> 00:16:26,634 in our in our justice system. You know, 437 00:16:26,634 --> 00:16:29,434 behavioral health has has major impacts on all 438 00:16:29,434 --> 00:16:30,575 aspects of our society. 439 00:16:31,274 --> 00:16:33,195 And so we have to figure out a 440 00:16:33,195 --> 00:16:35,054 way to pull these pieces together 441 00:16:35,549 --> 00:16:38,509 and also overcome, you know, limited workforce and 442 00:16:38,509 --> 00:16:40,110 and and figure out how to deliver these 443 00:16:40,110 --> 00:16:42,029 services at scale so that so that people 444 00:16:42,029 --> 00:16:44,190 can actually engage in them and and and 445 00:16:44,190 --> 00:16:45,870 reach a quality of life and a function 446 00:16:45,870 --> 00:16:47,090 that's meaningful for them. 447 00:16:47,485 --> 00:16:49,565 Absolutely. Doctor Hobbs, this was a delightful conversation. 448 00:16:49,565 --> 00:16:51,165 Thanks so much for taking the time today. 449 00:16:51,165 --> 00:16:52,945 Great great insights. Thank you. 450 00:16:53,404 --> 00:16:54,845 Yeah. Great to talk with you, and thank 451 00:16:54,845 --> 00:16:56,684 you so much for the opportunity to speak 452 00:16:56,684 --> 00:16:59,245 together. Absolute absolutely. And we also want to 453 00:16:59,245 --> 00:17:01,860 thank our podcast sponsor, Author Health, and you 454 00:17:01,860 --> 00:17:03,620 can tune in to more podcasts from Becker's 455 00:17:03,620 --> 00:17:05,700 Health Care by visiting our podcast page at 456 00:17:05,700 --> 00:17:06,200 beckershospitalreview.com.