1 00:00:00,000 --> 00:00:02,740 Evernorth brings the power of wonder and relentless 2 00:00:02,799 --> 00:00:05,599 innovation to create world class pharmacy, care, and 3 00:00:05,599 --> 00:00:06,580 benefit solutions. 4 00:00:07,200 --> 00:00:08,960 Barriers to care can lead to gaps in 5 00:00:08,960 --> 00:00:10,719 care, which can drive up the total cost 6 00:00:10,719 --> 00:00:13,839 of care. Our capabilities work seamlessly together to 7 00:00:13,839 --> 00:00:17,245 create innovative pharmacy care and benefit solutions for 8 00:00:17,245 --> 00:00:18,225 today and tomorrow. 9 00:00:18,765 --> 00:00:21,565 Our connected health services make the treatment, prediction, 10 00:00:21,565 --> 00:00:24,225 and prevention of health care's most complex conditions 11 00:00:24,685 --> 00:00:27,265 easier and more accessible as we drive organizations 12 00:00:27,404 --> 00:00:28,464 and people forward. 13 00:00:29,070 --> 00:00:31,149 This is Hailey Recker with the Becker's Payer 14 00:00:31,149 --> 00:00:32,909 Podcast, and we are recording live at the 15 00:00:32,909 --> 00:00:35,570 Becker's third annual spring payer issues roundtable. 16 00:00:36,109 --> 00:00:38,350 Today, I am joined by doctor Doug Henry, 17 00:00:38,350 --> 00:00:41,229 enterprise medical director of behavioral health at Highmark 18 00:00:41,229 --> 00:00:41,729 Health. 19 00:00:42,255 --> 00:00:44,015 Doug, thank you so much for joining us 20 00:00:44,015 --> 00:00:46,175 today. Can you go ahead and introduce yourself 21 00:00:46,175 --> 00:00:47,454 and tell us a little bit about your 22 00:00:47,454 --> 00:00:48,594 background and organization? 23 00:00:49,054 --> 00:00:51,695 Sure, Haley, and thanks for having me. Of 24 00:00:51,695 --> 00:00:52,195 course. 25 00:00:52,575 --> 00:00:55,155 My background is as a clinical psychologist, 26 00:00:56,229 --> 00:00:57,210 trained and educated, 27 00:00:57,989 --> 00:00:58,489 and 28 00:00:59,109 --> 00:00:59,609 began, 29 00:01:00,149 --> 00:01:02,869 my career in Southern California doing a lot 30 00:01:02,869 --> 00:01:06,069 of work in schools. I was a public 31 00:01:06,069 --> 00:01:08,489 high school counselor, and I worked at a 32 00:01:08,834 --> 00:01:11,015 shelter for runaway adolescents 33 00:01:11,795 --> 00:01:12,295 and, 34 00:01:12,995 --> 00:01:16,454 did inpatient unit work, detox work, locked, 35 00:01:17,234 --> 00:01:19,255 hospital based work, and, 36 00:01:19,635 --> 00:01:20,694 then got into 37 00:01:21,395 --> 00:01:21,895 the 38 00:01:22,439 --> 00:01:23,579 public apparatus 39 00:01:24,119 --> 00:01:26,619 and, spent many years working in a Medicaid 40 00:01:26,680 --> 00:01:27,180 clinic, 41 00:01:27,879 --> 00:01:30,280 in Southern Cal, and that was really a 42 00:01:30,280 --> 00:01:31,019 very formative, 43 00:01:32,039 --> 00:01:34,619 experience for me. And I say that because 44 00:01:35,265 --> 00:01:37,825 my experience of all of my years out 45 00:01:37,825 --> 00:01:39,444 there, we're seeing 46 00:01:39,745 --> 00:01:42,064 many, many patients. And on a good day, 47 00:01:42,064 --> 00:01:44,165 a psychologist sees about eight patients. 48 00:01:45,344 --> 00:01:45,844 And, 49 00:01:46,784 --> 00:01:48,245 again, on a good day, 50 00:01:48,579 --> 00:01:50,340 you're able to help, you know, five or 51 00:01:50,340 --> 00:01:52,920 six of those eight in a substantive 52 00:01:53,219 --> 00:01:55,239 way. And as I was, 53 00:01:56,579 --> 00:01:57,640 reading the data 54 00:01:58,019 --> 00:02:01,060 coming in about how ill The United States 55 00:02:01,060 --> 00:02:03,239 was becoming from a mental health perspective, 56 00:02:03,984 --> 00:02:05,204 even though I absolutely 57 00:02:05,504 --> 00:02:08,144 adored the psychotherapy and testing work that I 58 00:02:08,144 --> 00:02:10,064 was doing and diagnostic work that I was 59 00:02:10,064 --> 00:02:10,564 doing, 60 00:02:10,944 --> 00:02:13,104 it felt like it wasn't enough, like I 61 00:02:13,104 --> 00:02:14,705 had to make a bigger impact. And so 62 00:02:14,705 --> 00:02:15,764 I got into administration 63 00:02:16,730 --> 00:02:17,389 and began, 64 00:02:17,770 --> 00:02:19,710 laying out, mental health systems 65 00:02:20,169 --> 00:02:20,909 for cities, 66 00:02:21,210 --> 00:02:22,909 and then for counties in California, 67 00:02:23,530 --> 00:02:24,090 and then, 68 00:02:24,730 --> 00:02:26,430 moved back to the East, 69 00:02:27,689 --> 00:02:29,230 in 2007 70 00:02:29,514 --> 00:02:32,794 and worked as clinical administrator for psychiatry for 71 00:02:32,794 --> 00:02:36,094 University of Pittsburgh Medical Center for many years, 72 00:02:36,634 --> 00:02:37,614 and more recently, 73 00:02:37,914 --> 00:02:39,215 Allegheny Health Network, 74 00:02:39,834 --> 00:02:42,254 which is a wholly owned subsidiary of Highmark 75 00:02:42,314 --> 00:02:42,794 Health, 76 00:02:43,269 --> 00:02:44,469 since 2017. 77 00:02:44,469 --> 00:02:46,009 And I I just one last 78 00:02:46,549 --> 00:02:48,870 comment about that history. I was attracted to 79 00:02:48,870 --> 00:02:51,750 Highmark Health because of their focus on behavioral 80 00:02:51,750 --> 00:02:53,209 health, because of their commitment 81 00:02:53,669 --> 00:02:56,330 to making it an equal equal pillar 82 00:02:56,754 --> 00:02:58,375 of attention and investment 83 00:02:58,675 --> 00:03:00,675 with physical health. Well, it seems like you've 84 00:03:00,675 --> 00:03:02,354 been in the industry for quite a while 85 00:03:02,354 --> 00:03:02,854 now. 86 00:03:03,314 --> 00:03:05,074 Thank you so much for letting out your 87 00:03:05,074 --> 00:03:06,455 experience with us. 88 00:03:06,754 --> 00:03:08,915 Now to begin our conversation, I'd like to 89 00:03:08,915 --> 00:03:10,669 talk about balancing affordability 90 00:03:11,129 --> 00:03:13,870 and quality first. So how is your organization 91 00:03:14,010 --> 00:03:15,930 innovating to manage the cost of care while 92 00:03:15,930 --> 00:03:17,790 maintaining or improving member outcomes? 93 00:03:18,409 --> 00:03:19,469 What a great question. 94 00:03:19,930 --> 00:03:20,409 And, 95 00:03:20,810 --> 00:03:21,310 these, 96 00:03:21,849 --> 00:03:23,389 are not only not mutually 97 00:03:23,805 --> 00:03:26,205 exclusive motives. They actually go hand in hand 98 00:03:26,205 --> 00:03:27,824 even though people often think 99 00:03:28,125 --> 00:03:29,585 that they're at odds. 100 00:03:29,885 --> 00:03:31,564 And one of the things that I tell 101 00:03:31,564 --> 00:03:33,104 my team members is 102 00:03:33,645 --> 00:03:34,944 show me a substantial 103 00:03:35,485 --> 00:03:38,444 quality improvement, something that is a new service 104 00:03:38,444 --> 00:03:41,239 delivery model, a new therapeutic technique, 105 00:03:41,699 --> 00:03:45,000 a new aspect of evolving techno technology, 106 00:03:45,459 --> 00:03:45,959 neuromodulation, 107 00:03:46,819 --> 00:03:48,900 whatever it may be. If it really makes 108 00:03:48,900 --> 00:03:50,919 a difference in favor of quality, 109 00:03:51,715 --> 00:03:53,875 I will be able to create a business 110 00:03:53,875 --> 00:03:56,995 plan that shows that it is economical and 111 00:03:56,995 --> 00:03:59,555 it that it makes money or loses less 112 00:03:59,555 --> 00:04:01,734 money or avoids cost. 113 00:04:02,114 --> 00:04:04,354 So that's true in about ninety nine percent 114 00:04:04,354 --> 00:04:06,375 of cases. There are always cases 115 00:04:07,189 --> 00:04:09,270 like the case of orphan drugs where you 116 00:04:09,270 --> 00:04:11,590 have a very small and, you know, maybe 117 00:04:11,590 --> 00:04:14,090 a hundred people on planet Earth might have, 118 00:04:14,710 --> 00:04:15,370 a rare 119 00:04:15,669 --> 00:04:18,069 disease, and it costs millions of dollars to 120 00:04:18,069 --> 00:04:20,389 develop the therapy for that disease. Now those 121 00:04:20,389 --> 00:04:21,050 are instances 122 00:04:21,604 --> 00:04:23,524 where the economics don't work, 123 00:04:23,845 --> 00:04:26,084 but they are rare and very special. In 124 00:04:26,084 --> 00:04:29,204 those instances, you need other forces, usually the 125 00:04:29,204 --> 00:04:31,925 the government, to step in and support the 126 00:04:31,925 --> 00:04:33,305 development of those medicines, 127 00:04:33,925 --> 00:04:36,024 to so that they can have maximum 128 00:04:36,644 --> 00:04:37,144 access. 129 00:04:38,110 --> 00:04:40,689 But for all intents and purposes, a quality 130 00:04:40,750 --> 00:04:41,250 advance 131 00:04:41,709 --> 00:04:42,209 is 132 00:04:42,589 --> 00:04:43,730 not more costly, 133 00:04:44,430 --> 00:04:45,569 but less costly 134 00:04:46,110 --> 00:04:48,670 in the long run. And so one example 135 00:04:48,670 --> 00:04:50,189 of what we do, how we approach that 136 00:04:50,189 --> 00:04:50,850 at Highmark 137 00:04:51,685 --> 00:04:54,964 is we spent two years looking for a, 138 00:04:56,324 --> 00:04:56,824 telepsychiatric 139 00:04:57,444 --> 00:04:58,345 and a teletherapeutic 140 00:04:59,605 --> 00:05:03,365 partner, for behavioral health. And we interviewed more 141 00:05:03,365 --> 00:05:04,745 than 200 companies. 142 00:05:05,319 --> 00:05:08,060 And so it was a a very thorough 143 00:05:08,120 --> 00:05:09,480 process with a very, 144 00:05:09,960 --> 00:05:11,020 detailed rubric. 145 00:05:11,879 --> 00:05:12,360 And, 146 00:05:12,680 --> 00:05:14,620 at the end of that process, we chose 147 00:05:14,840 --> 00:05:15,660 Spring Health. 148 00:05:16,040 --> 00:05:18,139 And we really chose Spring Health, 149 00:05:18,935 --> 00:05:22,055 on the basis of, two things, their clinical 150 00:05:22,055 --> 00:05:22,555 quality 151 00:05:23,095 --> 00:05:23,995 and their willingness 152 00:05:24,454 --> 00:05:27,834 to share data on a very frequent basis 153 00:05:28,454 --> 00:05:28,954 demonstrative 154 00:05:29,415 --> 00:05:31,754 of the progress that our members were making 155 00:05:32,055 --> 00:05:33,115 under their care. 156 00:05:33,459 --> 00:05:35,539 Those two things combined and and it turned 157 00:05:35,539 --> 00:05:36,039 out 158 00:05:36,659 --> 00:05:38,839 spring was actually one of the more expensive, 159 00:05:39,779 --> 00:05:42,180 of the 200. If you know, to be 160 00:05:42,180 --> 00:05:44,360 honest, I think they were the second most 161 00:05:44,500 --> 00:05:45,000 expensive. 162 00:05:45,939 --> 00:05:48,120 So the point that I'm trying to make 163 00:05:48,180 --> 00:05:48,839 is that 164 00:05:50,415 --> 00:05:53,394 our attitude in behavioral health at Highmark is 165 00:05:53,694 --> 00:05:56,435 to go for quality because we know 166 00:05:56,814 --> 00:05:59,235 that that is going to drive down costs. 167 00:05:59,535 --> 00:06:02,095 The only thing that is more expensive than 168 00:06:02,095 --> 00:06:04,915 a lack of access to behavioral health services 169 00:06:06,069 --> 00:06:07,129 is are ineffective 170 00:06:07,589 --> 00:06:10,389 behavioral health services. And that's that's the the 171 00:06:10,389 --> 00:06:11,850 thing that you want to avoid. 172 00:06:12,310 --> 00:06:13,430 You know, I'd like to go a little 173 00:06:13,430 --> 00:06:15,350 bit deeper into that on the basis of, 174 00:06:15,350 --> 00:06:16,730 you know, member satisfaction. 175 00:06:17,189 --> 00:06:19,850 So what experience or engagement strategies 176 00:06:20,284 --> 00:06:22,604 have proven effective for your organization, and how 177 00:06:22,604 --> 00:06:23,904 are you measuring that success? 178 00:06:24,764 --> 00:06:27,564 So, when we talk about access to behavioral 179 00:06:27,564 --> 00:06:29,884 health services and and and most everyone knows 180 00:06:29,884 --> 00:06:32,144 in The United States that access has been 181 00:06:32,284 --> 00:06:35,180 an incredible problem since long before the pandemic. 182 00:06:35,180 --> 00:06:37,259 But during the pandemic, it just became so 183 00:06:37,259 --> 00:06:39,439 acute that everyone took notice, 184 00:06:39,899 --> 00:06:41,819 but we really have been challenged for some 185 00:06:41,819 --> 00:06:42,319 time. 186 00:06:42,860 --> 00:06:43,360 And, 187 00:06:43,899 --> 00:06:46,379 when you look at opening access, it is 188 00:06:46,379 --> 00:06:48,480 not just access. It is access 189 00:06:48,955 --> 00:06:51,615 to what and for whom. 190 00:06:51,995 --> 00:06:54,014 So do you have services 191 00:06:54,395 --> 00:06:54,895 for, 192 00:06:55,754 --> 00:06:58,235 the single mom who has a two year 193 00:06:58,235 --> 00:07:00,814 old just came home from visiting the pediatrician, 194 00:07:02,300 --> 00:07:05,500 and was encouraged to get an evaluation for 195 00:07:05,500 --> 00:07:06,560 suspected autism. 196 00:07:06,939 --> 00:07:08,800 You know, do do you have a service 197 00:07:08,939 --> 00:07:11,360 for that mom to get that evaluation 198 00:07:12,060 --> 00:07:13,519 in less than six months? 199 00:07:14,175 --> 00:07:17,074 Well, in most cases, the answer is no. 200 00:07:17,294 --> 00:07:18,415 So you have to, 201 00:07:18,814 --> 00:07:20,975 you have to provide the right kind of 202 00:07:20,975 --> 00:07:23,394 access to a broad array of services 203 00:07:24,014 --> 00:07:26,115 of the intensity that is appropriate 204 00:07:26,735 --> 00:07:29,670 to what the member wants and to the, 205 00:07:29,990 --> 00:07:30,970 member's clinical 206 00:07:31,589 --> 00:07:32,089 situation. 207 00:07:33,029 --> 00:07:34,329 So some examples, 208 00:07:35,589 --> 00:07:36,089 of 209 00:07:36,550 --> 00:07:39,529 actually, my favorite data point of all, 210 00:07:39,910 --> 00:07:42,069 that I've seen over the past couple of 211 00:07:42,069 --> 00:07:43,529 years at Highmark Health 212 00:07:44,685 --> 00:07:45,425 is that 213 00:07:46,045 --> 00:07:48,145 eighty percent of our members 214 00:07:48,524 --> 00:07:50,045 who have at this point completed about a 215 00:07:50,045 --> 00:07:51,504 140,000 216 00:07:52,125 --> 00:07:55,245 clinical visits with Spring Health over the past 217 00:07:55,245 --> 00:07:56,225 fourteen months, 218 00:07:56,569 --> 00:07:59,149 but many more visits to self guided 219 00:07:59,610 --> 00:08:00,110 meditations, 220 00:08:00,649 --> 00:08:01,870 self guided CBT, 221 00:08:02,649 --> 00:08:04,810 and behavioral health coaching. But a but a 222 00:08:04,810 --> 00:08:05,709 140, 223 00:08:06,649 --> 00:08:07,149 clinical, 224 00:08:07,689 --> 00:08:09,149 encounters or visits 225 00:08:10,004 --> 00:08:10,504 is 226 00:08:10,884 --> 00:08:12,105 that eighty percent 227 00:08:12,485 --> 00:08:13,225 of those 228 00:08:13,605 --> 00:08:17,145 were taken by first time mental health users. 229 00:08:18,004 --> 00:08:20,504 And what that tells me is that 230 00:08:21,205 --> 00:08:23,305 we have lowered the friction 231 00:08:23,685 --> 00:08:24,985 that people experience 232 00:08:25,689 --> 00:08:28,269 when they're trying to access mental health services 233 00:08:28,649 --> 00:08:29,550 to a degree 234 00:08:29,850 --> 00:08:30,829 that has enabled 235 00:08:31,449 --> 00:08:33,929 eighty percent first time users. Meaning, this is 236 00:08:33,929 --> 00:08:35,929 a group that most of which has tried 237 00:08:35,929 --> 00:08:38,429 for to get behavioral health appointments before 238 00:08:38,809 --> 00:08:40,429 and has become frustrated 239 00:08:41,054 --> 00:08:41,794 and failed. 240 00:08:42,335 --> 00:08:43,715 But with that ratio, 241 00:08:44,095 --> 00:08:44,595 really, 242 00:08:45,054 --> 00:08:46,995 we're we're accomplishing our mission 243 00:08:47,375 --> 00:08:51,315 to bring real access to behavioral health services 244 00:08:51,534 --> 00:08:53,375 to the people that want and need it. 245 00:08:53,375 --> 00:08:54,195 I'll give another, 246 00:08:55,294 --> 00:08:56,674 a a quick data point 247 00:08:57,029 --> 00:08:58,230 that, with, 248 00:08:58,629 --> 00:09:00,409 our partner, Spring Health, we have, 249 00:09:00,870 --> 00:09:02,070 a 65, 250 00:09:02,070 --> 00:09:03,449 35% 251 00:09:03,669 --> 00:09:04,169 split 252 00:09:04,789 --> 00:09:07,769 of women to men. And and men 253 00:09:08,070 --> 00:09:09,750 being as we are, we are a little 254 00:09:09,750 --> 00:09:12,284 bit reluctant often to seek mental health services 255 00:09:12,284 --> 00:09:14,764 more so than women, and that ratio is, 256 00:09:15,004 --> 00:09:17,024 across United States is very consistently 257 00:09:17,325 --> 00:09:20,625 three to one. So, you have 75%, 258 00:09:21,485 --> 00:09:23,725 usually are women. And so we have 65%, 259 00:09:23,725 --> 00:09:26,144 and that's that's nice. But once they enroll 260 00:09:26,524 --> 00:09:27,585 in Spring Health, 261 00:09:28,180 --> 00:09:29,560 the actual utilization 262 00:09:30,019 --> 00:09:30,759 and consumption 263 00:09:31,220 --> 00:09:31,960 of psychotherapy 264 00:09:32,660 --> 00:09:33,560 and psychiatric 265 00:09:33,940 --> 00:09:34,440 services 266 00:09:34,820 --> 00:09:35,560 is equivalent 267 00:09:36,100 --> 00:09:38,740 among men and women. And so really, really 268 00:09:38,740 --> 00:09:41,700 proud about that. I'll also add that ninety 269 00:09:41,700 --> 00:09:42,680 six percent 270 00:09:43,424 --> 00:09:43,924 of 271 00:09:44,465 --> 00:09:45,205 our members, 272 00:09:45,825 --> 00:09:46,884 that are paired 273 00:09:47,345 --> 00:09:48,404 with an initial 274 00:09:48,784 --> 00:09:50,865 therapist by Spring Health, and they have a 275 00:09:50,865 --> 00:09:52,404 very good pairing algorithm. 276 00:09:53,424 --> 00:09:55,845 Six months later, they're still seeing that individual 277 00:09:56,490 --> 00:09:58,730 therapist. So we're getting it right. The matching 278 00:09:58,730 --> 00:09:59,230 algorithm 279 00:09:59,769 --> 00:10:01,629 is working extremely well, 280 00:10:02,250 --> 00:10:05,529 and patients, tend to be, satisfied to an 281 00:10:05,529 --> 00:10:06,909 incredibly high degree, 282 00:10:07,610 --> 00:10:10,615 with their first provider. And and I'm sure 283 00:10:10,615 --> 00:10:11,975 we'll talk about that a little bit more 284 00:10:11,975 --> 00:10:14,294 in other questions, but the the matching, making 285 00:10:14,294 --> 00:10:16,235 sure that there's a right fit 286 00:10:16,934 --> 00:10:19,274 between patient and the psychotherapist 287 00:10:19,735 --> 00:10:22,394 and the psychiatrist is enormously important 288 00:10:23,029 --> 00:10:25,670 and very much impacts the outcome, whether someone 289 00:10:25,670 --> 00:10:27,370 is able to get well or not. 290 00:10:27,830 --> 00:10:29,750 That's amazing. Thank you so much for laying 291 00:10:29,750 --> 00:10:31,050 that out for all of us. 292 00:10:31,429 --> 00:10:33,670 Now looking ahead to the future of the 293 00:10:33,670 --> 00:10:35,529 payer space, what do you see 294 00:10:35,934 --> 00:10:38,175 as the biggest opportunity for payers to lead 295 00:10:38,175 --> 00:10:40,975 the charge in transforming care delivery and driving 296 00:10:40,975 --> 00:10:42,514 better outcomes for all stakeholders? 297 00:10:42,975 --> 00:10:45,715 Oh my goodness. Okay. Great question. 298 00:10:46,335 --> 00:10:49,860 There are many opportunities in behavioral health. It's 299 00:10:49,860 --> 00:10:52,039 a mistake to think. And I've heard executives 300 00:10:52,259 --> 00:10:53,480 say in the past, 301 00:10:54,019 --> 00:10:55,779 you know, we'd love to invest. There's just 302 00:10:55,779 --> 00:10:57,480 no money in behavioral health. 303 00:10:58,019 --> 00:10:59,700 And I know what they mean. They're you're 304 00:10:59,700 --> 00:11:01,940 not gonna make a positive margin like, 305 00:11:02,580 --> 00:11:05,294 medical systems often do and oncology 306 00:11:05,754 --> 00:11:09,134 care or orthopedic care or neurological care, 307 00:11:09,754 --> 00:11:11,615 but it's the cost avoidance. 308 00:11:12,235 --> 00:11:13,134 It's the fact 309 00:11:14,154 --> 00:11:16,315 that investing in mental health is one of 310 00:11:16,315 --> 00:11:17,375 the most inexpensive 311 00:11:17,835 --> 00:11:18,335 levers 312 00:11:18,830 --> 00:11:21,309 that a provider system or a payer system 313 00:11:21,309 --> 00:11:23,090 can pull to reduce 314 00:11:23,470 --> 00:11:26,269 total cost of care. In other words, the 315 00:11:26,269 --> 00:11:26,769 benefits 316 00:11:27,549 --> 00:11:30,690 of mental health as opposed to mental illness 317 00:11:31,475 --> 00:11:32,615 are manifest 318 00:11:32,995 --> 00:11:36,295 in lower health care costs, lower disease burden 319 00:11:36,435 --> 00:11:37,815 across the board. 320 00:11:38,274 --> 00:11:38,774 So 321 00:11:39,154 --> 00:11:39,654 to 322 00:11:40,514 --> 00:11:43,335 act on that fact and that awareness, 323 00:11:44,029 --> 00:11:46,509 What I'm really focused on are shared risk 324 00:11:46,509 --> 00:11:48,929 models, the use of shared risk models 325 00:11:49,629 --> 00:11:50,129 to 326 00:11:51,070 --> 00:11:51,570 revolutionize 327 00:11:52,029 --> 00:11:55,250 clinician behavior in favor of the patient 328 00:11:55,870 --> 00:11:58,590 and in favor of the patient's health and 329 00:11:58,590 --> 00:12:01,845 maintenance of health. And what this means is 330 00:12:01,845 --> 00:12:02,345 changing 331 00:12:03,044 --> 00:12:03,544 reactivity 332 00:12:04,644 --> 00:12:08,084 where someone decompensates and hits the emergency department 333 00:12:08,084 --> 00:12:10,964 in a in a difficult situation. Maybe they're 334 00:12:10,964 --> 00:12:12,105 admitted. Maybe they're 335 00:12:13,110 --> 00:12:15,850 arranged for ambulatory partial hospital care, 336 00:12:16,230 --> 00:12:18,230 or or whatever it may be. But things 337 00:12:18,230 --> 00:12:20,149 have gotten really bad to drive someone to 338 00:12:20,149 --> 00:12:23,370 the emergency department for a psychiatric problem, 339 00:12:23,910 --> 00:12:25,370 and we could be intervening 340 00:12:25,830 --> 00:12:28,914 long before that and keeping people healthy 341 00:12:29,375 --> 00:12:31,154 if the financial incentives 342 00:12:31,534 --> 00:12:33,075 are aligned properly 343 00:12:33,615 --> 00:12:35,855 in the patient's favor. And they have not 344 00:12:35,855 --> 00:12:37,934 been, quite frankly. They've been in favor of 345 00:12:37,934 --> 00:12:40,335 other interests. Sometimes they're in favor of the 346 00:12:40,335 --> 00:12:42,995 payer. Sometimes they're in favor of the partner. 347 00:12:43,399 --> 00:12:45,480 But they are not well aligned to the 348 00:12:45,480 --> 00:12:49,179 interests of health, community health, and individuals. 349 00:12:49,799 --> 00:12:52,379 And so a shared risk model really changes 350 00:12:52,519 --> 00:12:54,460 that, and it is, 351 00:12:54,919 --> 00:12:56,919 it gives the the sort of the power 352 00:12:56,919 --> 00:12:57,820 and the impact 353 00:12:58,514 --> 00:13:01,975 to really change providers' behavior very, very quickly. 354 00:13:02,035 --> 00:13:04,195 Providers want to do the right thing to 355 00:13:04,195 --> 00:13:06,754 keep their patients healthy. Right now, they, 356 00:13:07,235 --> 00:13:07,975 have not 357 00:13:08,355 --> 00:13:11,175 been allowed to, basically, because you're not generating 358 00:13:11,394 --> 00:13:13,709 the same amount of revenue in a fee 359 00:13:13,709 --> 00:13:16,589 for service system. So going to value based 360 00:13:16,589 --> 00:13:19,649 care and shared risk models where 361 00:13:20,110 --> 00:13:22,190 medical care becomes and when I say medical 362 00:13:22,190 --> 00:13:25,169 care, I mean psychiatric care too, becomes proactive. 363 00:13:25,629 --> 00:13:27,330 That's what where we need to go. 364 00:13:27,995 --> 00:13:30,154 Well, doctor, thank you so much for joining 365 00:13:30,154 --> 00:13:32,394 me today. Again, this is Haley Recker with 366 00:13:32,394 --> 00:13:33,695 the Becker's Payer Podcast 367 00:13:34,235 --> 00:13:36,715 recorded live at the Becker's third annual spring 368 00:13:36,715 --> 00:13:37,855 payer issues roundtable. 369 00:13:38,394 --> 00:13:40,715 Thank you so much. Haley, this was fun. 370 00:13:40,715 --> 00:13:41,455 Thank you.