Behavioral Health – The Race to Value Podcast™

On today’s episode of Race to Value, Ashley sits down with Mark Young, CEO of MyCHN to discuss how MyCHN launched a partnership with Wysa, an AI-driven mental health platform. We discuss how this collaboration aims to bolster the well-being and mental health of MyCHN’s Crisis and Behavioral Health patients by providing them access to Wysa’s innovative AI personal mental health companion at no cost.

Mark Young has worked in health services since 1989 and in community health since 1998. He has a Master’s in Business Administration from Trident University and a Master’s in Organization Management from the University of Phoenix. Over his career of 30-plus years, Mr. Young has worked with initiatives in the Rio Grande Valley, northeast Texas, and south Texas. Projects he has developed include outreach and engagement with colonia residents, residential treatment services for pregnant women and children, a tuberculosis intervention program, multiple chemical and alcohol dependency programs, behavioral health programs, and many outreach, education, and intervention projects.

Timestamps:

We have Dr. Omolara Thomas Uwemedimo as a guest on this week’s Race to Value! She is a healthcare social entrepreneur, board-certified pediatrician, community health equity consultant, career transition and business coach, public health researcher, and health justice advocate. She is currently the CEO and Co-Founder of Strong Children Wellness, a multi-award winning healthcare practice in New York City, providing integrated, physical, mental, and social health services for low-income communities of color.

Back in 2019, Omolara lost her ability to walk. She was diagnosed with Multiple Sclerosis, a chronic autoimmune condition. During her recovery, she became a staunch wellness advocate for women of color who in healthcare often experience disproportionally higher rates of chronic disease due to weathering – the deterioration of one’s health due to medical racism and toxic environmental stress in the workplace and in society.  In response, she founded “Melanin and Medicine”, a community health equity consulting and social entrepreneurship company that helps women of color thrive by building purposeful careers within healthcare enterprises.  She also has a weekly podcast called “Funding Your Healthcare Vision” that helps visionary leaders of health centers & practices to secure grants, contracts and other funding to strengthen, scale & sustain their vision, mission & impact to support under-resourced communities of color.

With her leadership insights, you too can break the barriers to health justice by building a healthcare social enterprise built on CBO partnerships and social impact innovation!

Episode Bookmarks:

01:30 Introduction to Dr. Omolara Thomas Uwemedimo (CEO and Co-Founder of Strong Children Wellness, founder of Melanin and Medicine, and host of Funding Your Healthcare Vision).

04:00 The intersection of Social Entrepreneurialism and Value-Based Care, where private profit creates public good.

06:30 The difference between “health equity” and “health justice”.

07:00 Creating health justice for a psychosocially complex Medicaid patient population dealing with social and mental health challenges.

07:30 Working with grant partners and Community Benefit Organizations (CBOs).

08:30 Closing the loop between physical health and social determinants of health (SDOH).

09:00 Overcoming a flawed business model by moving physical health care delivery into the CBO setting.

09:30 Aligning the public health interest in patient outcomes with economic incentives.

09:45 How healthcare capitation (PMPM reimbursement) merges with philanthropy dollars to drive holistic care delivery.

10:00 “The collective impact of capitation and philanthropy is the precipice of an integration model that makes an impact with payers and patients.”

11:00 The majority of healthcare organizations are not conducting place-based interventions to improve health equity and create health justice.

12:30 The fatigue of healthcare providers dealing with under-resourced communities.

13:30 Starting with the patient first by addressing the referral process in addressing social health needs.

14:00 Developing a social navigation workforce as a baseline to deliver primary care to Medicaid populations.

15:00 Funding a healthcare social enterprise through embedded CBO partnerships (“reverse integration”).

16:00 “We thought we were dealing with psychosocially complex patients until we integrated our care model with CBOs.  This in where the impact can be made in VBC.”

16:30 Identifying the right community organizations (e.g. homeless shelters) in creating a holistic care model.

17:30 Securing over $2 million in grant funding within a community health network and working with other BIPOC, women-led healthcare practices to create sustainable health justice.

19:45 “Human social organizations are an essential leader in health.  We must think beyond the delivery of care when building a mission-driven healthcare social enterprise.”

20:00 What is in your arsenal beyond just clinical care? (e.g. community health education, training staff in patient counseling).

21:30 Making the math “work” with your targeted patient population (e.g. underserved youth, undocumented immigrants).

22:30 Using your innovative advance primary care model to pitch potential funders.

24:00 An example of the largest Medicaid payer in New York offering a PMPM for patient navigation services.

26:30 The “interrogation phase” of a healthcare business model to identify strengths, values, virtues, vulnerabilities, and threats.

27:45 Finding operational gaps in the social and cultural responsiveness of staffing to address community needs.

28:45 Evaluation of profit margin and financial burn rate to best understand scale and impact in population health.

29:00 Leveraging technology for virtual care efficiency.

29:30 Progression to the “innovation phase” with verifiable frameworks developed in due diligence.

30:00 Focusing on optimizing one service line at a time (e.g. outsourced clinical delivery, consulting, provider training, decentralizing information).

31:00 The importance of an evidence-basis in developing a fundable community vision.

31:30 The “identification phase” within a community needs assessment to identify the right partners.

32:00 The Five M’s:  Market Buy-in, Mission Alignment, Money, Management focused on justice, and Missing services?.

33:00 Connecting with key stakeholders to make an elevator pitch for funding.

33:45 Co-creating a collaborative partnership and implementation of an integrated model.

34:00 Setting up a legal structure and the necessary agreements for a successful CBO partnership.

36:30 Conducting pre-visit screenings and risk assessments for social and behavioral needs to help families navigate the services enrollment process.

38:00 The ethical balance of conducting comprehensive screenings with the capability to actually implement the necessary SDOH interventions.

38:45 Supporting nurse educators and patient navigators in seeing SDOH in the same way as they see vitals.

39:30 “Knowing a BP is just as important as knowing that a patient is positive for a Food Insecurity screen. The navigators are the linchpin, and the care coordinators are the glue.”

41:00 Not a single CBO partner can handle everything for a patient. (The importance of having both a referral and a follow-up process.)

43:00 The Medicaid Health Home program in New York as a laboratory to pursue social impact innovation.

45:00 Negotiating a Medicaid PMPM model to deliver population health and subsidize navigation in FFS.

46:30 The New York 1115 Medicaid Waiver to provide subsidies to Regional Health Information Organizations (RHIOs).

47:00 An inflection point in VBC:  The people in clinical care are not always the ones to ensure population health justice.

48:45 Cultural competence as the bedrock of a great patient-provider relationship.

50:00 Referencing a recent study that shows that black patients receiving care from black residents had lower all-cause mortality rates and longer life expectancy.

51:00 How can white-owned or white-led healthcare organizations become more culturally responsive?

52:00 Diversity, Equity, and Inclusion (DEI) to best support patients and families in medical decision-making.

53:00 Preventing burnout with BIPOC Founders as a key to save Primary Care and build Health Justice.

54:00 The recent suicide of Dr. Nakita Mortimer, a black female Anesthesiologist, as a cautionary tale for BIPOC physician burnout.

55:45 A personal patient story that illustrates how social impact funding transformed the life of a child and his family.

60:00 How to reach out to Dr. Omolara to learn more about how to build a healthcare social enterprise.

In value-based care, we have both an economic and a moral imperative.  What’s at stake is so much more than saving our healthcare system. It is about ensuring the continued prosperity of our nation to ensure that we leave it better for future generations. The best indicator of whether our country is on the right path is the assurance that healthy mothers can give birth to healthy children. And those children, in turn, must be assured of good care and a sound education that will enable them to face the challenges of a changing world. If we could have but one generation of properly born, educated, and healthy children, many of the insurmountable problems in our country would vanish in our lifetimes.

This week on the Race to Value, you are going to hear from a value-based care leader who is boldly moving beyond with a call to action to serve our nation’s youth. Karen Wilding, the Chief Value Officer at Nemours, is on a passionate pursuit of the Quadruple Aim, and her health system is redefining children’s health in our country. Nemours Children’s Health is truly “leaning in” to the promise of population health by transforming the very definition of what it means for children to be healthy. And their value journey reflects a bold vision to create the healthiest generations of children that will take us beyond medicine by ultimately impacting the world. If you are looking for an example of inspirational leadership in value-based care, look no further than Karen Wilding and the Nemours Children’s Health System!

Episode Bookmarks:

01:30 “If we could have but one generation of properly born, educated, and healthy children, many of the insurmountable problems in our country would vanish in our lifetimes.”

02:30 Introduction to Karen Wilding, the Chief Value Officer at Nemours Children’s Health

03:00 Support Race to  Value by subscribing to our weekly newsletter and leaving a review/rating on Apple Podcasts.

05:45 Karen describes the whole-person care orientation at Nemours and how the mission of “Well Beyond Medicine” guides their value-based care journey.

06:45 Social Determinants of Health (SDOH) screening in underserved populations to expand care network and create community partnerships.

07:45 Driving “macro-system impact” as an anchor institution (e.g. best practice clinical research, cross-sector partnerships, health equity investments)

08:30 Health Equity opportunities in pediatric whole-person care (e.g. teen birth rates, preventative care access, infant mortality rates…and even household income).

09:00 “Well Beyond Medicine is a commitment to not just care for the medical aspects of children – we also care for the larger health ecosystem to create whole-child health and healthier generations.”

11:45 “Payment transformation is foundational to being able to create sustainability in value-based care.”

12:30 Karen explains how the fee-for-service infrastructure does not align incentives for healthy outcomes (e.g. asthma exacerbations with children in Delaware).

13:30 “Investing in children’s health is the single most important thing we can do as a society.” (balancing present-day economics vs. future economics).

14:45 Partnering with payers to pursue health equity transformation and the importance of community-based investments.

16:45 Nemours has been utilizing Community Health Workers to conduct SDOH screenings and individualized interventions through a culturally competent care model.

17:45 Karen explains how the interdisciplinary care team at Nemours works together to capture, assess, and address SDOH barriers.

18:45 The importance of enterprise-level buy-in when launching a SDOH population health strategy.

20:30 Overcoming fears and concerns of families in sharing personal information about their social barriers.

21:00 The creation of a national toolkit on whole-child population health and how Nemours is collaborating with policy stakeholders at the federal level.

23:30 “We want to be where children live, learn, play, and grow.  In order to address health in communities, you need partnerships.”

24:00 The role of virtual care and home health in a community-based ecosystem.

25:00 Karen describes how Nemours provides physical and behavioral health services in partnership with elementary schools.

26:00 Working with CBOs and faith-based organizations to address SDOH barriers in communities.

27:00 Partnering with government agencies (e.g. juvenile justice, CPS) to elevate the health of vulnerable children.

28:30 The focus of Nemours leadership in technology innovation to develop the system’s EHR infrastructure and digital, consumer-centric strategy.

30:45 Karen discusses the importance of technology enablement to drive population health through an omni-channel patient experience.

32:00 EHR optimization to drive clinical decision support at the point-of-care.

32:30 Leveraging analytics to bridge the clinical and claims data experience.

33:00 How the MSSP empowered healthcare organizations through the provision of claims data. (Medicaid data in children’s health is not the same.)

34:00 The need for national data standards to have consistency with all payers in the country.

35:45 1 of 6 children between the ages of 6 and 17 has a treatable mental health disorder, yet only around half ever receive treatment.

36:45 The pandemic created an increase in childhood Emergency Department utilization (25% increase in children 5-11, 30% increase in adolescents 12-17).

37:00 40% of children are living with anxiety and 45% are living with behavioral health disorders.

37:45 How Nemours is handling the pediatric behavioral health crisis through clinical integration, telepsychiatry, and digital mental health tools.

38:45 Behavioral health diagnoses is 17% more prevalent in a Medicaid population.

40:00 Referencing Daniel Dawes (“The Political Determinants of Health”): We would save over $300 billion per year if we were to eliminate American racial health disparities in our healthcare system.

40:30 Black children are 3X more likely to die in infancy than white children, 7X more likely to die from asthma attacks, and more than 3X more likely to die after elective outpatient surgery than white children.

41:00 Disparities in household income based on race and how that contributes to teen birth rates and health inequities.

42:00 Nemours commitment to equity through program development to ensure education and access.

43:00 The Chief Health Equity Officer role supports health equity transformation, community partnerships, and workflow process changes.

45:00 How payment disparities and demographical attributes between Medicaid and commercially-insured pediatric populations may contribute to health disparities (ex: asthma).

45:45 Designing a whole-person care model to ensure every child is given optimal treatment regardless of their health insurance status.

47:00 Integrated behavioral health in the primary care setting needed to make timely interventions.

49:30 Parting thoughts on the meaningful and impactful work of value-based care transformation and how that provides the passion for service-oriented leadership.

Implementing value-based care can help providers improve patient health and reduce care costs, but it also presents the opportunity to explore new and emerging areas of research in breakthrough treatments that can revolutionize healthcare as we know it today. Embracing such a paradigm shift is for the mindful, who acknowledge that certain aspects of medicine are not working as intended.  If we are to truly attain better patient outcomes at a lower cost, we must consider emerging areas of research that can create new knowledge in the practice of medicine. On this week’s podcast, you will learn about some of the research being done to further scientific rigor and expertise in the study of psychedelic therapy. In clinical research settings around the world, renewed investigations are taking place on the use of psychedelic substances for treating illnesses such as addiction, depression, anxiety and posttraumatic stress disorder. Psychedelics fell from medical grace nearly half a century ago, their reputation mired by associations with counterculture drug excesses and Cold War era enhanced interrogation, but now a new wave of research has returned to psychedelics as potential candidates to treat mental health disorders.

We are joined this week by Charles B. Nemeroff, M.D., Ph.D the Co-Director of The Center for Psychedelic Research and Therapy at Dell Medical School at The University of Texas at Austin. Dr. Nemeroff is one of the nation’s most influential psychiatrists and has published more than 1100 research studies, and his research is currently supported by grants by groups such as the Multidisciplinary Association of Psychedelic Studies (MAPS).  His research is focused on the pathophysiology of mood and anxiety disorders with a focus on the role of child abuse and neglect as a major risk factor. He has also conducted research on the role of mood disorders as a risk factor for major medical disorders including heart disease, diabetes and cancer. At the Center for Psychedelic Research and Therapy, he aims to advance the application of psychedelics for the treatment of mental health disorders through impactful clinical research.  Additionally, the center looks to improve the health of those suffering from severe depression, anxiety and PTSD through psychedelic-assisted psychotherapy and research focused heavily on military veterans and adults affected by early childhood trauma.

Episode Bookmarks:

01:30 “If we are to truly attain better patient outcomes at a lower cost, we must consider emerging areas of research that can create new knowledge in the practice of medicine.”

02:45 Introduction to Charles B. Nemeroff, M.D., Ph.D the Co-Director of the Center for Psychedelic Research and Therapy at Dell Medical School at The University of Texas at Austin.

04:00 Support Race to  Value by subscribing to our weekly newsletter and leaving a review/rating on Apple Podcasts!

05:00 The field of human-based research into psychedelic drugs has in the last ten years become a legitimate field of study, after decades of repression by governments around the world.

05:30 The renaissance of psychedelic research with renewed media and medical interest in LSD, psilocybin, MDMA, ayahuasca, DMT, and ketamine.

05:45 From the Woodstock generation to present day – Dr. Nemeroff provides an overview on this history of psychedelic research.

06:30 Early psychedelic research conducted by Timothy Leary and Ram Dass (formerly Richard Alpert) that created a spiritual awakening and captured a generation.

07:30 A research moratorium that persisted for decades until the Dr. Rick Strassmanundertook human research on N,N-dimethyltryptamine, also known as DMT.

08:00 Distinguishing recreational use for spiritual awakening vs. psychedelic-assisted treatment for serious psychiatric disorders.

08:30 How psychedelics can rip away defense mechanisms in the mind that prevent people from facing the certainty of death and other unpleasant realities.

09:30 Dr. Nemeroff discusses his medical practice specialty in the psychiatric treatment of severe PTSD and treatment-resistant depression.

10:00 Military veterans, victims of sexual trauma, victims of childhood abuse, and others with severe depression often do not respond to conventional FDA-approved treatments.

11:30 The Public Health Problem of Suicide: There are approximately 50,000 suicides each year in the United States (the only leading cause of death that is increasing in number!)

12:00 The Next Big Addiction Treatment: Substance Use Disorder (SUD) can also be effectively treated with psychedelic-assisted therapy.

13:30 The economic burden of major depressive disorder among U.S. adults is an estimated $236 billion, an increase of more than 35% since 2010!

15:00 Lack of access to care for patients with depression leads to under-treatment, whereby increasing ED utilization and driving up overall healthcare costs.

15:30 Depression is a risk factor for the development of heart disease and stroke (and is a major risk factor for poor treatment outcomes).

16:00 Carving out psychiatric treatment from most commercial health plans exacerbates access challenges.

16:30 Further access challenges posed by cash-only mental health practitioners (i.e. psychologists, psychiatrists).

18:00 Most mental health practitioners do not offer Cognitive Behavioral Therapy (CBT)(“rent a friend” mental health support is not evidence-based treatment!)

18:30 Two-thirds of patients with depression are treated in the primary care setting – lack of specialization in treatment leads to over-reliance of pharmacological interventions.

19:30 The lack of medical concordance in behavioral health therapy due to lack of familiarity with the current evidence base.

21:30 Dr. Nemeroff discusses his research in psychedelic-assisted therapy for treating military veterans and their families dealing with PTSD (see Heroic Hearts Project and The Mission Within).

23:30 How psychedelics have fundamentally changed the lives of military veterans.

24:45 The promising research from Multidisciplinary Association of Psychedelic Studies (MAPS) on MDMA treatment of PTSD.

25:00 Recent study on MDMA-assisted therapy for severe PTSD (“the largest magnitude effect benefit of the psychedelic in any psychiatric condition studied so far”).

27:00 The National Institutes of Health recently awarded a grant to scientists at Johns Hopkins University to study whether psilocybin can help people quit smoking tobacco.

27:15 Dr. Nemeroff discusses his interest in studying the use of psilocybin to treat alcohol use disorder.

28:30 Private foundation funding of study to evaluate treatment of severe depression using both psilocybin and transcranial magnetic stimulation (TMS).

30:00 The vast majority of those receiving moderate high doses of psilocybin have mystical experiences that are forever life-altering. 80-90% of people often report their psychedelic journey as one of the top 5 most meaningful and spiritual experiences in their entire life, comparing it to the birth of their first child or the death of a parent!

30:30 The classic psychedelics like mescaline, LSD, psilocybin, and DMT have effects that emerge from a particular type of serotonin receptor in the brain.

31:00 “Although psychedelics share a common pharmacological property, it is still unclear what the real mechanism of action of psychedelics actually are. We need to better understand this through research.”

31:45 “The psychedelic experience is not for the faint-hearted.  It is pretty intense.”

32:30 Can non-hallucinogenic psychedelic analogs be created that block the psychedelic experience but still provide the same therapeutic benefits?

33:00 Dr. Nemeroff discusses the effects of psychedelic neuroplasticity where the brain can actually become rewired to overcome incessant fear-based thinking associated with mental health conditions.

35:30 “Psychedelics can help those suffering from PTSD and depression overcome the ‘circle of hell’ associated obsessive thought storms and irrational fear generalization.”

37:00 Given the overlapping experiences of ego dissolution and expanded consciousness between meditation and psychedelics, should we consider meditation as a core component of psychedelic therapy?

39:00 The need for medical supervision in the administration of psychedelic medicines and the importance of identifying ideal candidates for treatment.

40:00 The adverse consequences of allowing the widespread use of psychedelics to proliferate without regulation.

40:30 The US psychedelic drugs market is projected to grow from $2 billion in 2020 to $10.75 billion due to research innovation and the increasing prevalence of treatment-resistant depression and mental health disorders.

41:30 Dr. Nemeroff discusses recent psychedelic company IPO activity and the drive to commercialization.

43:00 Most promising research that will lead to immediate commercialization opportunities are MAPS (MDMA for PTSD) and Compass Pathways (psilocybin for TRD).

44:00 How much will companies charge for these new psychedelic therapies once they are approved to make them commercially viable?

45:45 How will the FDA handle the approval of psychedelic therapy in conjunction with psychotherapy?

47:15 How will Psilocybin or LSD microdosing be treated in the context of approved therapies?

48:30 Mescaline, psilocybin, and ayahuasca have be used for thousands of years, administered in cultural contexts that are ritualized with use limited to religious or healing purposes.

50:00 The ethical concern for quality assurance to provide dosing consistency of psychedelic medicines.

51:30 Personality contraindications to taking psychedelics.

52:00 Psychedelics are not drugs of abuse – no one takes them every day.

52:30 Tragic outcomes will quickly change the dialogue on the treatment potential of psychedelics. We must be careful!

53:45 The potential to provide psychedelic medicines in a controlled palliative care setting to help cancer patients deal with end of life.

Our guest this week, Matt Miclette, is military veteran and a psychiatric and mental health board certified registered nurse. He is the Senior Director of Clinical Operations at NeuroFlow – a digital health company that provides an industry-leading solution for Technology-Enabled Psychiatric Collaborative Care.  Matt is also the Co-Founder and Executive Director of a nonprofit organization called Action Tank.  As a recipient of the prestigious Pat Tillman military scholarship, Matt is living with the passion that Pat Tillman spoke of, “Passion is what makes life interesting, what ignites our soul, fuels our love and carries our friendships, stimulates our intellect, and pushes our limits … A passion for life is contagious and uplifting.” Matt’s passion is bright and shines through in his service for people with mental health needs.

In value-based care, it is clear that primary care is at the tip of the spear in dealing with Ambulatory Care Sensitive Conditions like CHF, COPD, and diabetes that drive up costs. In that model for managing chronic disease, the position of primary care providers being upstream to specialists allows them to curb 80-90% of healthcare costs by preventing unnecessary specialist visits and avoidable inpatient stays and ED visits.  With behavior health, it is a little bit different though.  Behavioral health conditions (for the most part) can’t be addressed by specialists because there aren’t any access points for them to even be seen! Although 70% of primary care appointments include problems with significant psychosocial issues, less than half of those receive any mental health treatment at all, because there is a such a shortage of specialists. To put this in context, the Substance Abuse and Mental Health Services Administration estimates that by 2025, the U.S. will have a shortage of over 15k psychiatrists and 26k mental health counselors!

Research shows that a Psychiatric Collaborative Care Model (CoCM) is an effective and efficient way of delivering integrated care for more complex patient behavioral health needs – CoCM is a model that enhances “usual” primary care by adding two key services: care management support for patients receiving behavioral health treatment and regular psychiatric inter-specialty consultation to the primary care team. Join us as we consider this and other important solutions with Matt in this week’s race to value!

Episode Bookmarks:

04:45 “Passion is what makes life interesting, what ignites our soul, fuels our love and carries our friendships, stimulates our intellect, and pushes our limits.” – Pat Tillman

05:40 Matt discusses the inspiration of Pat Tillman and his passion into lifelong learning

06:00 How caring for wounded warriors recovering from combat trauma drove Matt’s future work in treating the “indivisible injuries” impacting behavior health

07:00 Realizing the stigma associated with behavior health from his time leading a military psych unit in Fort Hood

07:50 Making an impact through facility-level hospital policy, e.g. 75% reduction in restraint use

08:10 Matt discusses his experience working in public health policy related to substance use disorder

08:30 A shared passion for “changing the world” with Christopher Molaro, CEO/Co-Founder of Neuroflow

09:30 Alarming stats about behavioral health and SUD in our country!

11:10 Matt on the recent CDC report showing that the U.S. hit the highest level of annual overdose deaths ever recorded (93,000) – a 30% increase from prior year!

11:45 “The shortage of mental health providers is most acutely seen in rural communities. Over 50% of the counties in the U.S. don’t have a single psychiatrist.”

12:05 Understanding the population and identifying which individuals have the most acute behavioral health needs through upfront screening and measurement-based care

13:00 Matt explains how we can more effectively use primary care and interdisciplinary teams to treat behavior health issues

15:30 The Psychiatric Collaborative Care Model (CoCM) as an approach to enhancing primary care to deliver integrated care for patients with complex behavioral health needs

16:30 Implementation of integrated behavioral health and the importance of physician champions and C-Suite buy-in

18:00 “Psychiatric Collaborative Care is a stepped care model which means we get the right patient to the right level of care.”

18:55 Matt discusses the advantages of the CoCM in providing team-based care, outcomes measurement, goal setting, and behavioral health activation

22:00 The importance of structural measures like program enrollment and caseload size to assess the performance of integrated behavioral health models

23:30 Screening for social determinants (e.g. food insecurity, housing insecurity, loneliness) during the intake process for collaborative care

25:30 The cost savings impacts of effective integration of medical and behavioral services

27:20 The policy window for addressing behavioral health is open, and the time is now to lower healthcare costs (those with BH issues are 2-3X more expensive)

27:50 Referencing the IMPACT Trial (one of the most famous Collaborative Care studies) showing a six-fold ROI in CoCM implementation

28:30 Success stories in healthcare cost savings with behavior health integration

29:30 Leveraging FFS in the short-term as an incentive to stand up a CoCM program

29:50 Matt discusses how Health First is using universal screening and cloud-based registry solutions to ensure more effective delivery of Collaborative Care

32:00 Matt discusses the perceived risks of remote suicide screening and how technology can be used to link resources to patients in need

34:30 Setting yourself up for success in CoCM implementation through rapid deployment and a full patient registry

34:50 Remote screening for PHQ-9 assessments (Care Manager-led vs. Tech-enabled)

36:00 The importance of integrated BH technology to provide a hub for documentation, planned interventions, risk stratification, time tracking, and digital homework for patients

36:30 PCP workflow integration through EHR integration

38:40 Matt discusses important Neuroflow partnerships with Prudential, US Air Force, and Stop Soldier Suicide as examples of technology-enabled behavioral health integration

42:25 Matt reflects on his own experience with provider burnout while working at the Walter Reed National Military Medical Center

43:00 The need to care for the mental health of providers and how team-based care and technology can help

45:30 Matt provides his parting thoughts with involving the care team in the development of consumer technologies in the healthcare setting

Fixing the behavioral health crisis is an absolute imperative in the movement to value-based care. Currently, 1 out of 5 Americans (over 51 million) are living with a behavioral health condition, there are approximately 20 million individuals in the US with a substance use disorder, and 9 million people have had suicidal thoughts in the past year. The onset of a global pandemic has only exacerbated the behavioral health challenges in our country.  The solution is the integration of behavioral health with primary care.  Primary care is the “tip of the spear” as 70% of primary care appointments include problems with significant psychosocial issues, and less than half of those primary care patients receive any mental health treatment. Solving this crisis through integration, however, is simply not possible without digital health solutions that can facilitate coordination between behavioral and medical care. Innovation is our only gateway to value-based care at scale.

Mark Redlus, Chief Executive Officer of Tridiuum, is a venture-backed start-up executive with significant leadership experience in corporate management, M&A, strategy, and business development. His personal story aligns with the company’s transformational vision to advance behavioral-medical integration by delivering capabilities to identify those who need behavioral help, speed their access to care, and deliver a measurable impact on outcomes. Leveraging digital behavioral health solutions is key to winning this race to value.

Episode Bookmarks:

03:30 The inspiration of Apple and Steve Jobs on Tridiuum’s rebirth

04:30 “Digital intervention can make a difference in outcomes.”

05:40 Commercializing research to inform the development of new products in the behavioral health space

06:20 Challenging the status quo by designing digital behavioral health solutions with elegant design (Reference to Simon Sinek’s TedTalk)

06:50 The attempted suicide attempt of Mark’s daughter (Katherine) and how that informed his personal “Why” to improve behavioral health outcomes

08:20 Growing access problem for mental health services that has been exacerbated by COVID-19

08:50 The realization of the “inadequacy of care” in the immediate hours following Katherine’s attempt on her life

09:20 “We can do better about unlocking access to behavioral health services sooner.  People searching months for someone to talk to is unacceptable.”

10:45 1 out of 5 Americans (over 51 million) are living with a behavioral health condition, including 20 million SUD and 9 million with suicidal thoughts

12:50 “Technology is not the holy grail, but it has a role to play in a fully integrated behavioral health experience.”

13:20 The difference between co-located, multidisciplinary models and true integrated models of care

15:20 Integration of psychiatry and psychological counseling into primary care practices

15:40 Telepsychiatry and telepsychology in response to COVID-19

16:35 “Primary care is the tip of the spear where the broadest of array of behavior health demand is occurring.”

17:00 Only 14% of ACOs even have a behavioral health component in their care model

17:30 Patients who have a chronic disease have a 3-4X higher frequency of behavioral health comorbidities

18:00 Patients with a chronic disease and behavioral health comorbidity cost as much as 50 percent more and are likely to be noncompliant

18:30 $26-48 billion could be saved through behavioral health integration, representing a 5-10 percent decrease in overall healthcare costs

19:20 Partnership with Fresenius in managing behavioral health for CKD and ESRD patients to lower total cost of care

21:15 Projected 60-80% reduction in total cost of care per patient when ESRD patients are treated for behavioral health comorbidities

22:00 “Value-based contracts are difficult to justify if you can’t drive behavioral health access for members and patients.”

23:00 The need for user-friendly software design to integrate into provider workflow and support patient engagement

24:55 Measuring the effectiveness of behavioral health providers and how to encourage providers not in the top quartile of performance

26:50 “Providing data and insights is not enough – you also need effective storytelling to show providers the path towards performance improvement.”

27:50 Reinforcing provider storytelling to energize peers around technology enablement of behavioral health

29:30 The accelerated technology adoption from COVID-19 (video visits, mental health apps, and other asynchronous technologies)

30:45 Mark ponders the future of technology (e.g. AI, internet of things, 5G, digital therapeutics, wearables, and gamification of consumer health apps)

33:00 Hub and spoke capabilities of care delivery and technology enablement (“right care, right time, right place”)

34:00 Tridiuum’s development of a network effect-based model based on algorithms being shared across open APIs

35:00 Following patients across the care continuum is foundational to unlocking behavioral health care at a “galactic level”

36:00 HIPAA concerns related to democratizing data through open APIs and interoperability

38:45 Leveraging Artificial Intelligence to better assess the patient’s health condition, proximity, and availability of behavioral health providers

39:45 The difference between Deep Learning and Machine Learning

40:45 Feedback Informed, Machine Learning algorithms to create network effect in behavioral health treatment optimization

44:00 Employee Mental Health (200 million workdays are lost each year due to depression, costing employees between $17 and $44 billion)

46:00 Employees are in a class-based system since only large employers have the scale to leverage behavioral health programs

47:00 Tridiuum’s collaboration with Crossover Health to study mental health therapy in the workplace

48:40 Parting thoughts on consumer-centric solutions and technology innovation to help our country win this “Race to Value”

50:30 “Innovation is our only gateway to value-based care at scale.”