Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast.
Thrilled today to be joined by Bill Harlan,
who's the vice president of behavioral health and
health engagement at Point thirty two Health. Bill,
thanks so much for taking the time to
be with me on the podcast today. Hey,
Jacob. Thanks for having me. Yeah. And before
we dive into everything we wanna talk with
you about, Bill, can you tell us a
little bit more about yourself, your background in
health care, and what it is that you're
doing today at point thirty two Health?
Yeah. Happy to and, excited for the opportunity
to talk with you today. So thank you
for,
letting us on.
So I am a licensed mental health counselor
by background.
I
spent a lot of my career,
as a clinician,
worked with at risk youth in residential placements,
worked at outpatient
therapy clinics, worked with veterans.
And,
I've been in the managed care space the
past fourteen
or so years,
most of which I spent at Carillon, formerly
Beacon Health Options,
worked in various markets supporting clinical
implementation,
operational
support.
And currently,
I serve as vice president of behavioral health
and health engagement at point three two Health,
the parent company of Harbor Pilgrim.
Fantastic. Paul, like I said, we really appreciate
you taking the time to be on with
us, for sharing your expertise with our listeners
and just get a feel for,
how you're thinking about the industry right now
and what's going on with your membership at
point thirty two Health.
You know, obviously, as you know, the demand
for behavioral health services continues to outpace supply.
It's something that we consistently hear about from
pretty much every insurer across the country at
this point, and certainly
these last few months. And then that really
seems to be especially true for youth and
for people living in rural communities. So
from your vantage point, both from your career
expertise, but now sitting
at point thirty two Health and Harvard Pilgrim,
what are some of the strategies you all
are employing right now that you're finding that
are are most effective to close these access
gaps while still maintaining that high quality of
care you're always striving for? That's a great
it's a great question and something that I
think we're
is top of mind for us.
And
I think any anybody, as you mentioned, who
has been following the behavioral health space, it's
been an unprecedented
past five years.
The demand,
we continue to see, we continue to see
net new consumers,
entering behavioral health,
working with new providers.
And we continue to see high rates of
depression, anxiety. And as you mentioned, particularly amongst
young people,
substance use still,
is is a
need of support that remains. So we also
are hearing from provider partners that we work
with that they're faced with workforce challenges,
pipeline planning, clinician burnouts,
and a lot of that is leaving
many clinicians to leave the field altogether.
This has resulted in fewer clinicians to meet
this growing demand and has
created this perfect storm in a way of
longer wait times to access to care,
that we're still finding ourself
in today,
even five years,
since the pandemic.
So we as as a as a payer
looked at what what are some pieces we
could do to address access. And,
you know, sometimes
the most,
innovative piece we can do is not the
most complicated. We needed to put,
a human touch to the experience, and we
heard feedback very clearly that people looking for
treatment are are often overwhelmed.
And it's hard to get a callback from,
a a clinician or to understand
what types of treatment
are are out there and
if there are alternative ways to
seek treatment that may be not the traditional
in person where
one would have to drive to a place
particularly if there's transportation concerns. So we started
a new program,
at our behavioral health service navigation program.
And what this really does is we have
a locally based,
team of service navigators,
who do incredible work that
works directly with members who outreach to us
looking for,
clinical support
and
work with that member to really understand what
is it that they are looking for. Is
there a specialty that's in need? Is there
a language or gender or cultural,
match that we can help identify within our
network?
And are they looking for in person or
or remote or a digital experience?
And what we find is that when we
can take the time to dissect what is
the,
need a person is looking for, we can
more often than not connect them to a
therapist or a behavioral health provider
in in pretty short order,
in most cases,
depending upon the type of specialty and type
of service. But in most cases,
we can, secure an appointment for our members
within a week of them contacting with us.
That's from the day they called to the
date of the first appointment,
which shocked
all of us, honestly,
and we were really excited by that result.
Another piece is that it's an opportunity for
us to have a conversation
with,
one of our members that might need additional
support
if there is a need for more social,
social supports that our community health worker team
can assist with,
if there is a transportation or housing or
food insecurity
need, we can then
engage that member more broadly
and help work with on the total picture
of what might be a barrier to care.
And
other pieces that have have worked out really
well for us is if the member is
is looking for a virtual,
clinician or open to telehealth,
we've partnered with a few,
providers that allow us to schedule on the
member's behalf so we can give the member
an appointment live on the phone when they're
calling us so that they get that in
real time.
Another piece to it is we follow-up with
every member that works with us to confirm
how it went,
if it was the right fit.
And if it wasn't,
we continue that
journey with the member to find them the
right clinician.
And because of that, the other
outcome that, again, surprised a lot of us,
but in a good way, ninety nine percent
of the members we work with in this
program
report being satisfied with the with the behavioral
health provider that they got matched with.
So we're really proud of of that work,
and the team that does this work particularly
is is does such a great job.
The it's part of our local,
neighbor helping neighbor approach that we believe helps
enable us to,
find that right match. And the last piece
I'll say to this is that we've also
had to have a network that can support
this work. So we were happy to add
about 30,000
new providers
in the past year alone.
And that has been an enabler for us
to help give members choice and help increase
access to care.
Wow. I mean, just that last part of
what you said, adding 30,000
providers to that network in one year, I
can't imagine just the the what it took
logistically to undertake something like that.
Lot of lot of time and a lot
of great hard work. And,
oh, it it was it was off of,
we we in source behavioral health
most as as partly a response that we
knew we needed to be closer to
the behavioral health care overall. And,
this has also allowed us to
work with providers more closely so that we
can have conversations about problems they're trying to
solve and then problems we're trying to solve.
And more often than not, many providers are
are very happy,
to receive referrals from us. And so we
we've taken that approach. Yeah. You know, one
thing when we've talking to individuals,
your colleagues across the country serving in similar
positions, Bill,
virtual behavioral health access has really been key
to, really building access,
for their members. And that's obviously, as you
know, something that's really grown rapidly these last
few years, especially post pandemic. So
when we are talking about these these types
of initiatives,
where we do hear about headwinds is engagement,
long term outcomes,
integration with in person primary care.
So talk to us a little bit about
those things from from your perspective of where
you sit. How do you see your virtual
and hybrid models evolving to meet some of
these concerns?
Absolutely. And, again, as most, you know, listeners
probably know behavioral health, I would say, is
what was one of the first disciplines to
adopt the
telehealth model,
the the fastest
post,
the pandemic, and
that
enabled the workforce to
relook at how we can deliver care in
a different way. So now that we are
further away from the pandemic,
what we're finding is that virtual care
is also a enabler for us to increase,
care access to care at like you mentioned.
One of the pieces that we're seeing and
as we look at claims data, we're finding
that there is a desire,
for more of a hybrid approach where,
someone may choose to go in person and
then have the option for
a
virtual experience,
as they as they move forward. And that's
been gaining popularity and something we hear about
from both our providers and our members.
I I think the pieces you raise about
engagement and outcomes are important.
And I I think a couple of pieces
that we see on this,
we see convenience and flexibility
is really
hand in hand with engagement.
If we can't make it simple and easy
for folks to access care,
they are more likely to continue to receive
treatment,
and,
improve their outcomes
if we can remove the barriers in in
doing so.
So we we really see the experience
connected together.
And we hear often from members that having
alternative options to,
an in person where every situation is different
and there may be clinical reasons that in
person or virtual,
may or may not be supported. Overall, I
think we do hear overwhelming feedback that,
having the flexibility
to schedule
and removing some of the barriers,
ensures people continue on in their care.
This also, what you mentioned with
integration with primary care,
the theme we hear constantly from our primary
care offices
who work with our members for referrals
is they're looking for ways to streamline the
process
in an often very,
busy and and and,
overwhelmed
office. So virtual providers and some digital solutions
do
at at times offer,
a way for that
process to be streamlined
and that we can also offer that convenience
for primary care offices as well.
And I and I think the other piece
with this as we look at long term
outcomes is recognizing
that all of our members and their treatment
needs are different.
And
for what what what may work for one
member may not be the right option for
everyone.
What we do know is that clinical rapport,
the relationship that's developed in treatment continues to
be one of the top predictors of successful
outcomes.
And what we hear is that,
members who have an option to
have in person,
sessions and have the convenience of going virtual,
seems to hit a sweet spot for a
lot of people,
so that they can develop that rapport and
then, continue on,
virtually.
I think the other piece on this is
that we know for a long time,
outpatient therapy often involves homework assignments. And I
can remember when I was working,
you know, with, with with with with veterans
and we would give assignments.
Now there are digital tools and apps that
both
brick and mortar and virtual providers have ways
to use and deploy.
And what we hear is that that really
helps give,
a better indication of engagement and are are
their clients,
doing the skills? Are they tracking
their mood?
And is that intervention working? And can they
use an assessment to really understand if the
treatment intervention is having the desired outcome?
So I I really think that all of
this together,
looking at the different modalities we have to
deliver care, the digital tools that people have
at their disposal,
it's something we need to embrace.
And it also means we have to prioritize,
our members' choice and what kind of care
they're looking for. And then as a payer,
working for our members to give them the
options to choose of what would work for
their,
for their situation and for people that have
very demanding and,
work hours. And then nine to the appointment
windows offered may not work for everyone. So,
we see it really as an integral.
Absolutely. No. That all makes a lot of
sense. And I I wanna circle back to
one thing you you mentioned about how digital
solutions are a key piece of of all
of this, and that's something that a lot
of your provider partners are really looking for.
So on on the hard news front, Bill,
you all recently announced a collaboration with MaruHealth.
Can you talk to us a little bit
about this, the nuts and bolts here, and
how you envision this this partnership complementing your
existing behavioral health network?
Absolutely.
And we're really excited about our,
our working with Meru and the work that,
we're gonna hope to,
do together moving forward.
I I think a piece of what drew
us to Meru was how it connects into
our mission, which is looking at whole person
care,
focusing,
on not just a specific illness, but the
overall,
well-being,
physical health, emotional health, social needs.
And the Meru model really fit into that
nicely for us. And we know that there's
such a correlation and we see it frequently
with members that are having the most severe
struggles that physical health and mental health
are so interconnected and
success in one domain can't really be considered
without looking at both. So,
looking at the MAIRU program, we also saw
an opportunity to
partner with a digital,
provider
that has a clinically validated
and therapist led,
digital program.
And this program is gonna be
open to Harvard Pilgrim members. It's a twelve
week,
intensive digital,
experience through a mobile app,
and it is based in evidence based care
that helps with a range of conditions including
depression and anxiety,
also supportive of emotional considerations
like work workplace burnout, caregiver stress, and lifestyle
changes.
What particularly is important to us, was the
clinician led,
distinction.
This this program allows members to schedule one
to one video therapy sessions
as they go along in the program,
so that a member who might want additional
support, supported by a clinician as you would
in traditional outpatient therapist, that's available
for a member that
is interested in learning some new skills and
can put that to use and then use
some of the peer support groups
or work with some of the wearable,
heart rate
variability
device for real time feedback
can be, worked in there as well.
Also, the modules that are tailored for adolescents,
along with the appropriate type of continent structure
for those age specific,
needs was also a piece that was exciting
for us as we wanna make sure we
have,
expanded options for,
for all of our members. So,
we we are really excited to work with
them. We feel it complements our our total
portfolio
of
behavioral health solutions for members in an area
that we are hearing a lot of feedback
of looking for digital solutions that, also give
flexibility,
and also can be accessed very quickly.
Care can be available in as little as
about two business days,
and it also continues to support our whole
person health strategy,
integrating
lifestyle tools like nutrition and sleep and mindfulness
and emotional regulation.
And we're confident this program is gonna be,
a a value add for our members and,
you know, working to we're excited about the
partnership.
Wonderful. Well, appreciate you filling us in on
what this partnership with Meru Health means for
your members. Before we go, Bill, what else
are we missing? Any other final bits of
advice you wanna share with the other industry
leaders listening in?
Yeah.
I I I hope I hope everybody is,
you know, taking care of themselves.
That's the first piece I think as as
leaders in this area.
We're in an unprecedented
time, and, you know, I think we're in
a moment that is exciting. If you've been
in behavioral health like I have for most
of your career,
there is certainly an
a a a piece that is,
validating in that we have always known behavioral
health was core and center to,
overall health,
care. That that idea seems to be gaining
more,
wide,
range acknowledgments, which is
exciting to see.
I think along with that is,
I think, advice to kinda share is that
now is a great time to get creative.
Every payer is facing,
headwinds in terms of how
we're seeing overall trends in medical costs overall.
Providers are also facing,
headwinds as well. So there is opportunity
in these in in this time,
even with those headwinds, to find
places where partnership can can come up. And
I would just encourage the the best,
ways we've been able to do that is
to make connections
and,
really define what problems we're trying to solve,
together
as how we're going through it all. I
think the other piece is
virtual care is here to stay. We don't
see this as
a a blip or a fad.
We we're consistently seeing utilization
remaining consistent.
What we're finding is that we need to
also use that as a tool in our
toolkit
and not something that we want to,
say as declarative across the board. This is
how care should be completed, and our role
as a payer
always needs to be figuring out how we
can how can we prioritize our members' needs
and access to care and have equitable access
to care. So as technology continues to emerge,
this is not something to,
I would say, run away from or fear,
but really try to lean in and think
about how we can start leveraging
a lot of this,
a lot of this technology for for everyone's
benefit.
Fantastic. I think that's a great place to
leave things. So, Bill, I wanna thank you
for taking the time to chat with us
and for sharing your insights with our listeners.
We really appreciate it. Thank you so much
for having us. I really enjoyed the conversation.
Yeah. Likewise. And and to our listeners, if
you'd like to listen to more podcasts from
Becker's Healthcare, you can visit beckershospitalreview.com.