Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast. Thrilled today to be
joined by doctor Tracy Gajewski, who's the chief
health officer at Catalite. Tracy, thank you so
much for taking the time to be with
me on the podcast today.
Thank you so much for having me. It's
a pleasure to be here. Yeah. Absolutely. And
before we dive into everything we wanna talk
with you about, Tracy, can you talk to
us a little bit more about your self,
your background in health care, and what it
is that you do today at Catalyte?
Yeah. So I'm a licensed clinical neuropsychologist.
I have more than twenty years of experience
in the field of developmental disabilities,
something I'm pretty proud of. I also have
an MBA specializing in health care management.
But as the
chief health officer at Adelaide, I oversee day
to day clinical operations, administrative,
operations, also our provider network, which is a
very large provider network,
and then our research institute.
So,
we're we're pretty big. We have we serve
more than 20,000
families,
a day. And so we have a sort
of a scope and scale that I feel
really excited about being a part of.
What drives me and why I'm in the
role that I'm in, I've been in this
role at Catalite for for seven years. Prior
to that, I was in large health care
organizations.
But what really drives me is creating systems
of care that supports our clients and families
in different ways. Right? And so
really,
understanding
our industry of serving people with developmental
disabilities, how we can how we can do
this better, how we can make change in
our industry to really have better outcomes and,
support those families in different ways. So
my passion and purpose,
I I really are filled at Catalyte because
we are paying such close attention
to how we can focus on well-being of
these clients and families,
and really,
you know, pay attention to how we break
down barriers and biases for a more equitable
world for people with developmental disabilities. So this
is this is what I do and and
what I'm passionate about and why I'm I'm
really excited to be here talking with you
all.
Fantastic. Well, we're really looking forward to all
the insights you're gonna tell us, especially for
our audience listening in, Tracy.
In that vein, you mentioned you've been in
your role at Catalyte for seven years now.
Talk to us about what you're seeing in
terms of the major obstacles out there in
providing care for individuals with autism and other
intellectual and developmental disabilities.
Yes. So, I really see three main obstacles
that we are always looking at, always pagan
paying attention to
and trying to to bring down. So one
is access. Right? Access to care, access to
the diagnosis, and access to treatment once that
diagnosis is made
and, in a timely way. Right? So what
we know is that I I'll say at
Catalite,
we pay very close attention to it, and
our accesses is quite good. We have, clients
that want when when they, come into our
services,
we see them with, you know, less than
ten days, more like five to seven days.
And we make sure that they're getting into
services very quickly.
But that is not the case for everywhere.
You know, one area in Northern California, but
then as we start looking at,
The United States and then we look at
the world, access really changes.
I will say we we know that the
the new CDC report just came out.
So nationally, it's one in thirty one children
are diagnosed with autism. In California, it's one
in nineteen.
So we will continue,
to see and and feel that that challenge
with access.
And it's something I I think is really
important to continue to pay attention to.
Second,
serious outcomes. So this is not something in
our industry that we we, you know, we're
still figuring out how to do.
What are we measuring in order to understand
if a client or a family is making
meaningful progress in their treatment? What does that
look like? What are those outcomes? At Cadillac,
we have very clear outcome measures that we
look at and focus on. But as an
industry, I think we
are challenged by aligning
to what those outcomes are,
and having, you know, a standardized way of
looking at quality of care.
And then lastly,
I'm gonna talk a little bit about value
because you have to talk about value. Right?
We we need to pay attention to cost
of services.
High hours, which translates into high cost, doesn't
always mean better care, and so we need
to pay attention to that. So it's another,
obstacle
think
can get in our way sometimes. Certainly. And
let's stay on that topic, Tracy, the the
second point that you mentioned,
how to measure success in this space. What
are the most meaningful ways to measure success
when it comes to autism and IDD care?
Yeah. So
my focus, our focus,
everything rolls up to well-being. So well-being of
the client and family.
I'll also put in there well-being of our
industry, well-being of our providers who are,
you know, serving our clients and our industry,
but well-being in general. But specifically, when we
look at measuring success
of a treatment plan or a client in
care,
looking at how they are doing
in terms of their well-being scale, you know,
score. So we have a scale, a well-being,
scale that we utilize,
and it's pretty important. But let me also
pause and say, what is well-being? Right? Well-being
could mean a lot of things to a
lot of different people. But, ultimately, we we
see this as the ultimate measure of success,
and it's it's different for every person. Right?
So every family, every client that comes into
us, we need to sit down and understand
for that family what is well-being.
We have such a heterogeneous population
that we need to understand from an individual
basis for that family, what does that mean?
Is it having greater independence? Is it having,
you know, strengthening family relationships?
I'll give a very
easy quick example,
which when we look at treatment plans, we
look at lots of treatment plans, and we'll
see a goal on that treatment plan
such as tying shoes.
And that goal stays on that treatment plan
for a long time. And the question that
we ask that our clinicians ask is, why
why are we focusing on tying shoes? Is
is that
actually
contributing to a better well-being in that for
that client or family? Or should we just
get some Velcro shoes or some slip on
shoes and move on to something that will
actually increase the well-being in that family, which
might be better communication,
lowering challenging behaviors. Right? So they can go
out to a family dinner.
So, again, getting real focused on well-being and
the measure of well-being
is important. And then the last piece I'll
I'll add to the well-being piece is affordability.
So, looking at the we look at the
whole family, right, holistically.
Cost share can be really challenging and debilitating
for a family.
So in my mind, we really need to
pay attention to,
you know, what is the cost for this
family and how does that impact that whole
family,
and making sure that we have the right
treatment,
so that they really can move through treatment
swiftly,
and have meaningful progress,
but also pay attention to the impact of
that entire family.
Sure. And I I wanna come back to
something you had said about serving a heterogeneous
population.
Catalyte is a growing company. How do you
ensure that the care you're providing
remains deeply individualized while operating at scale across,
the diverse populations that you serve?
Yes.
So what's really important here is having
different treatment options. So, again, this is something
that our our industry
historically doesn't really do,
but,
one size truly does not fit all in
terms of treatment for autism,
or developmental disabilities for that matter.
So, again, in the past, we've had this
sort of one form of treatment. We we
do the same thing for all of our
families, and it just it doesn't it doesn't
make sense.
So at Catalyte, what what we do is
we've really expanded the treatment options.
You know, that that's how we can do
this at scale. So, individually,
we'll sit down with a family when they
first come into treatment. That first appointment is
really important
to understand
what that client needs, what that family needs,
and then ensure that as we build their
their
their care path,
that we're really paying attention to those individual
needs and treatment and then have different treatment
options. Right? So for one family, it might
mean one thing. For another, it might mean
something else.
But having those options to care
at a large scale,
and ensuring that we have access to those
different options, treatment options,
is is, I think, what sort of the
secret sauce is there. Right? It's it's really
about driving individualized care and getting it right
right from the beginning of of treatment so
that that client can really,
again, so we see meaningful progress.
So, Tracy, I wanna ask you about something
that we're constantly hearing about from insurers, and
it's their their their want and their need
to address better
social determinants of health, among their membership.
Can you talk to us a little bit
about how Catalyte is designing care models to
address SDOH, and and how are you responsive
to individual emotional or geographic needs among among
those that you're serving?
Yeah. So
it's a great question and is absolutely one
that, gets, I think, asked often. So, again,
I'm gonna go back to this different options
of of care delivery that is so important.
So,
understanding addressing
those individual needs of our population
is really important. So what we do and
what is, I think, really important is in
that first meeting that I was just talking
about in that last question,
we are looking we are asking questions
about what is needed for that holistic,
you know, for the whole family. Right? So
understanding those social determinants of health, understanding
access for transportation,
food insecurity, economic stability.
All of these things will impact care and
impact how
the best delivery for care for that family
will be. So, again, now let's talk about,
you know, is it having telehealth? Is telehealth
actually just a much,
better care delivery for a family or coming
into a clinic or
having a mixture of that or having,
the the treatment team going into the home.
Again, going back to what are those individual
needs,
and then designing the care path around those
needs,
and ensuring that we're paying attention to to
what they are for that that family. It's
a crucial step in the beginning of treatment
that so then we can design that care
path with the treatment options and all and
service delivery options
that will really help tailor it to that
family.
So, Tracy, earlier in our conversation, you were
talking about how affordability
often remains a a key challenge for patients
in this space. And, you know, I think
affordability often gets framed as cost cutting. So
how how are you defining affordability in a
way that supports both sustainable and high quality
care for your patients with autism or or
other intellectual and developmental disabilities?
Yes. So, when I think about affordability
or defining affordability,
with high quality care for clients, really, what
what we're talking about in my mind is
value based care. We at Catalyte believe and
operate under a large valley based care model,
and,
it's it's quite important. In fact, I
I believe that high quality care, which is,
you know, a part of this,
you know, valley based care, actually
drives lower costs,
and it opens up access. So those three
things, as we talked about in the beginning
of this podcast, are really,
really important to pay attention to. So high
quality care is really about that client,
you know, being able to achieve their goals,
and,
have meaningful progress in their treatment. In order
to do this, we have to get it
right from the beginning. So we've talked about
that. Right? It's really important to understand what
the right care path is and the right
recommendations for that family.
And in doing that,
what we'll see
is we'll see a client attaining their goals
and treatment. So then we'll see this engagement
in front of the caregiver.
Caregiver engagement is really important. When a caregiver
is truly engaged in in the treatment, what
we'll see is we'll see stress levels come
down in the family.
We'll see confidence levels go up in the
family in terms of caring for that that
client, and then we'll see,
goal attainment. We'll see goals really, being achieved.
And then we'll see, you know, ending of
an episode of care,
because,
that family that, has integrated
those parenting strategies,
those interventions in their everyday life. And so
we'll see all of these things working together,
and and then we can end the episode
of care.
What that translates
into is
lower cost.
Right?
And so that first pillar of of a
value based, you know,
care is high quality,
meaningful outcomes happening quickly,
which then, will translate into
lower costs.
So it's important to get it right right
from the beginning to be able to do
that, but I think it's it's really the
way that we should be caring for our
clients and families.
Absolutely. It's such a good point that providing
this high quality care isn't just good for
the patient. It's good for their families, those
around them, and that trickles down to affecting
the the entire system.
I think that's that kind of leads me
to ask more of a philosophical question here,
Tracy.
You've been in this space, for so long.
You have so much expertise here. If you
could redesign this system and and how we
care for individuals with autism and other IDDs
from the ground up.
What are some of the first things that
you would build differently?
Yes. So I'm gonna tell you four things.
These are four things that I feel pretty
passionately about, and you've heard me mention some
of these. So one is different treatment options.
Right? So, again, one size does not fit
all. We have to have different treatment options
for our clients and families
that can,
you know, really help them be able to
tailor
the needs to that family. So that's the
first one. Number two
is,
supporting caregivers
in different ways so that they really feel
empowered
and their their active
role in supporting their child
rather than this emphasis on a professional or
a paraprofessional
coming in and being the agent and change.
The caregiver, they they they know their child
best,
and helping them feel empowered and lowering their
stress, increasing their their confidence,
is really important.
Third,
respite services. So this is something that we
don't I don't think do enough of. So
a family does need a break. A caregiver
does need a break.
Sometimes we'll see treatment plans that honestly are
very, very high hours. And really what I'm
looking at is not necessarily the medical need
there, but, a caregiver needing a break. And
so I think that it what's really important
is weaving into
the care for this family
are more respite services
and fun respite services. Right? Ones that the
the client is really out there having fun
and the caregiver can relax and say, I'm
gonna actually take care of myself today.
While I know my my child is in
really good hands and actually having a good
experience themselves.
And then lastly,
and, again, I've talked about this throughout this
podcast, but I'm gonna say it again because
it's really important,
is our industry focusing on the well-being of
the client and the family.
I think we can sometimes overlook that.
And I think if we get back down
to the basics of asking ourselves what is
the best thing, what is increasing the well-being
of that client and family, I think that
a lot of the puzzle pieces fall into
place.
Understood. It's it's great list. And let me
just recap there for our audience, Tracy. You're
you're really recommending
different treatment options, better caregiver support, more respite
services, and,
just a reimagined
industry focus on the patient
and their family.
I I also wanna ask you something that,
you know, we hear about constantly from health
care leaders, and I I'd be remiss if
I didn't ask you as well.
How are you using artificial intelligence today, And
and what do you think that this will
continue to look like in this space,
two years from now?
Yes. I had so much fun at the
Becker's conference
hearing about and talking about AI. I think
every presentation had an element of AI in
it, and as it should because this is
this is something that we need to pay
very close attention to. It's something that I'm
wildly excited about, to be quite honest with
you, about client care, patient care because,
I I think
three things. It's gonna expand access. Right? Really
important. It's gonna enhance our care, and it's
gonna drive efficiency.
So, ultimately,
what we care about is more time using
AI, leveraging AI to have more
direct time with clients and families.
So a clinician does not come into this
field,
you know, to do chart notes, right, and
to do a lot of administrative tasks. Yet
that is a big piece of their day.
AI is something that we can leverage,
that we are leveraging, and I'll tell you
about that in a second. But to be
able to reduce
those administrative tasks and really for clinician
to spend that direct time with a client
and family, which is, you know, really where
their skill set is and really what what,
is is wonderful for them,
and for the client and family. So right
now at Adelaide,
last year, we rolled out, an Ambient AI
tool that is reduced note taking. It's, Nabla.
And so it reduced the note taking and
increases
rapport and connection with the clients. It reduces
burnout of our clinicians.
We also have a shortage of clinicians in
the industry, right, overall. And so taking care
of those clinicians and helping them really do
what why they're there, what, you know, what
what they're in the field for
is really important. So this is an, Ambien
AI documentation tool, and it transcribes the the
notes in real time and then really cuts
down on,
their them having to do that note taking
afterward that everyone sort of dreads.
So that is in full flight at Catalite,
which is is really wonderful, and we're seeing
a lot of the benefits there. But when
we talk about because because I think the
question, yep, was really around also looking forward.
What is it gonna look like in in
a couple of years? What are we gonna
you know, I think there's there's two other
areas that I'm pretty excited about. One is
really looking at how we can do assessments
and diagnostics in a different way that, again,
takes out
the administrative pieces of writing big long reports,
and helps to streamline that. So,
we can, have some more standardization
and, report writing that is more efficient. So
we're excited about this, ability to
really look at how we do assessments differently.
And then lastly,
using generative AI.
What we're what we're starting to really look
at and focus on is how do we,
optimize,
clinical recommendations
and outcomes
as well as looking at stratified risks enable,
proactive support. So
understand
from from the very beginning what this client
might need,
what the most optimal
recommendation is going to be that will bring
them to the most optimal outcomes,
and using generative
AI to do that. This is a really
sort of scalable, repeatable model of tech enabled
value based care is how how how we
see it, and I'm really excited about
it. Wow. I mean, clearly, really exciting things
to come in this space, Tracy, and and
from Catalite,
certainly as well.
Before we go, we've got a lot of
health plan and other health care leaders listening
in today from all over the country.
What else are we missing, Tracy? What do
you wanna tell them?
Yeah.
I think we covered a lot, but I
will just go back and say
caregiver
involvement,
treatment options,
individualized
care, looking at the whole family, and
system of that family
drives better outcomes and value.
So again, bottom line, everything rolls up to
well-being.
And if we can stay focused on
what matters to our clients and families, I
think we will
be able to,
sort of hit the mark and change our
industry.
Wonderful. Well, I think that's a great place
to leave things. Tracy, I wanna thank you
for taking the time to sit down with
us and for sharing your insights with our
listeners. We really appreciate it. Thank you so
much. It was a pleasure being here.
I'd also like to thank our podcast sponsor,
Catalite.
You can tune in to more podcasts from
Becker's Healthcare by visiting our podcast page at
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