Latest / Becker’s Payer Issues Podcast / The Future of Integrated Care, and What Leaders Need to Do Now to Achieve This at Scale

Transcript

The Future of Integrated Care, and What Leaders Need to Do Now to Achieve This at Scale · Becker’s Payer Issues Podcast

• 0:00
  Hi, everyone. This is Erica Spicer Mason with
• 0:02
  Becker's Healthcare. Thank you so much for tuning
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  into the Becker's Healthcare podcast series.
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  So today we're going to talk about the
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  future of integrated care and what leaders need
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  to do now to achieve this at scale.
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  And joining me for this discussion today is
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  Shana Hoffman, the president and CEO of Lucid.
• 0:19
  Shana, welcome. Thank you so much again for
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  joining the podcast today. Thanks so much, Erica,
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  for having me on.
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  We're thrilled to have you with us. And
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  before we get into our discussion about integrated
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  care, wanted to just check-in with you to
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  see if you could share a little bit
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  more about yourself, your work in health care,
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  whatever you think is helpful for our listeners
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  to know.
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  Sure. Well, again, great to be here with
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  you. Shana Hoffman, president and CEO here at
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  Lucid. So I've spent my whole career, in
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  health care. I always joke when people talk
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  to to me that I'm,
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  somewhat jaded for my age in health care,
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  but I feel like I've I've sort of
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  seen it all. I was at DaVita for,
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  a couple years then sort of in the
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  VC backed
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  tech space,
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  working on patient access and sort of very
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  small early stage companies, and then spent the
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  better part of the last probably close to
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  ten years now in the behavioral health space,
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  a mix of private equity backed players.
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  And then here,
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  at Lucid, which is a unique, payer owned
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  company
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  and really have been passionate about how do
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  we get behavioral health to the forefront. And
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  we're really excited, and we'll talk about this,
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  I'm sure, today. We believe really, and I
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  believe through sort of throughout my career that
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  behavioral health is the unlock. And if you
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  can actually unlock
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  behavioral health needs for an individual patient member,
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  that's what's gonna allow you to really transform
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  their health care journey broadly across all the
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  different dimensions.
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  Oh, what a great quote. Behavioral health is
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  the unlock. I I I think that is
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  so well said, Shana. So thank you for
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  sharing a bit more about your background and
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  kind of this ethos that's guiding you and
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  your work at Lucid.
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  And just in that same vein as of
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  behavioral health being,
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  you know, getting it to the forefront, acknowledging
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  its importance, I think there is a growing
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  recognition that
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  chronic disease overlaps with behavioral health needs in
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  many cases.
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  And and while that acknowledgment, it seems to
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  be there increasingly,
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  care can be frustrating for patients and for
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  providers and payers, especially because we're seeing a
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  lot of fragmentation
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  between the two
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  care journeys. So what do you see as
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  the most significant risks and the consequences of
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  fragmentation like this?
• 2:22
  Yeah. I mean, Erica, it's a great point.
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  I think for for a long time, we've
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  known that behavioral health and
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  chronic, you know, medical conditions are intersected.
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  To your point around fragmentation though, it's very
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  interesting when you talk
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  to anyone that's sort of bearing risk, whether
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  that's a payer, whether that's a risk bearing
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  primary care organization,
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  they look at high cost needs claimants, and
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  they generally look at those folks in two
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  buckets. Right? They look at folks on the
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  medical side and sort of high risk, high
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  needs, and then they're also looking at people
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  that are high utilizers from a behavioral health
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  perspective.
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  What I've, you know, noticed throughout,
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  the years is that if you actually look
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  at the percentage of people that are utilizing
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  behavioral health services within
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  the high risk, high needs and working to
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  drive up those members that are connected into
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  care,
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  there's a much lower percent of those people
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  that are in behavioral health care. And so
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  it's it's sort of long been this question
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  in my mind of why are we not
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  trying to drive up behavioral health care and
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  looking at it at the intersection of those
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  things.
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  But to your point, this sort of system
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  of care doesn't actually put behavioral health and
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  medical health together in a lot of cases.
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  And that's why I'm super excited about the
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  work that we're doing at Lucid. So we've
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  been, you know, purpose built behavioral health company
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  for twenty seven years
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  now knowing that we were trying to get
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  as many people screen triage and connected into
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  behavioral health care. And that was our mission
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  and purpose is how do we do that
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  reliably, repeatedly at scale. But now because of
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  this knowledge that, again, behavioral health is the
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  unlock and the force multiplier on medical expense,
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  we've actually brought a medical care delivery company
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  into the fold at Lisette.
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  So now we're able to actually put that
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  behavioral health at the forefront and break down
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  some of that fragmentation because we actually have
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  a company that delivers care in the home.
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  And so now you can think about sort
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  of that tip of spear for us of
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  that looking at that patient. Yes. We know
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  their medical needs, but we're looking at every
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  patient through a behavioral health lens
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  and being able to say, how do we
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  make sure that their behavioral health needs are
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  met? Because that's gonna allow us to then
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  unlock on the medical side. So I think
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  you're right that a lot of that fragmentation
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  exists in the industry. I think we were
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  trying to break through it in the form
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  of, hey. We have a great behavioral health
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  solution that can help you. I think now
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  we've said, hey. We're gonna take matters into
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  our own hands,
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  and bring that medical care delivery asset into
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  the fold. And I'm incredibly excited about some
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  of the outcomes we're already seeing and what
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  we can actually drive and deliver that to
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  the system to be that integrated care solution
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  where I think,
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  execution has been challenging in the past, and
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  we're seeing really great opportunities to actually drive
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  that integration.
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  Mhmm.
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  Shana, what an exciting development. Thank you so
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  much for sharing about how your how Lucid
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  is bringing medical care delivery kind of into
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  the fold as you've described. I'm looking forward
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  to hearing about some some of those outcomes
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  that you're seeing as well.
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  But just wanna say too that it's a
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  fascinating approach because I think sometimes or I
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  I would say most times we hear about
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  the reverse approach. It's normally medical providers bringing
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  behavioral health into the fold, but, you know,
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  you're I I think this is certainly, it
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  seems like Lucent must be a front runner
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  in this position. So really exciting to hear
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  this development. And it reminds me of what
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  we hear about a lot in health care
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  today, which is this whole person approach to
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  care. So combining medical, behavioral health, social supports,
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  and I know that that can have a
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  big impact on health outcomes. So from your
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  perspective,
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  what role do multidisciplinary
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  teams and community based interventions play in making
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  care both effective and also accessible?
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  Yeah. I mean, I think it's a multidisciplinary
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  approach and team is, you know, a huge
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  part of the solution.
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  Again, I think, you know, the hallmark really
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  of Lucid has been how do you break
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  down to sort of execution some of these
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  things that we all talk about. Right? Everyone,
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  I think, has known multidisciplinary
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  care teams being able to weave in social
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  determinants of health, being able to kind of
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  bring a holistic solution to the patient. But
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  it's not as simple. In a lot of
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  cases, the way that then manifests in the
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  system is that you have a care manager
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  from your health plan. Maybe you're in a
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  particular chronic disease program through that health plan.
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  So now you might have a care manager
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  through that specific kidney care, for example,
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  disease program, then you go to your primary
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  care provider. If they're in a risk,
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  arrangement, you might also have a care manager.
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  Right? You might have one through the eight.
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  So the everyone's, I think, recognize
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  the importance and and critical nature of those
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  different systems of care, But then kind of
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  it's where the rubber meets the road in
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  the execution that I think things struggle. Because
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  if you're a patient on the other side,
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  and this is where, you know, we've been
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  very focused on being member centric or patient
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  centric now sort of in the in the
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  world of both living in payer and care
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  delivery.
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  But how do you
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  really make that into a reality that if
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  it's your mom or your dad on the
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  other side
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  of that paper that they're not getting four
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  or five calls and outreach because they're trying
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  to engage that individual. Right?
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  And so, you know, to me, I think
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  there's again, this is one of those times
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  when there's been such strong recognition,
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  really about multidisciplinary care teams as well as
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  kind of the need to integrate behavioral health,
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  but it's all kinda comes down to the
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  execution. And so I think that's gonna be
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  really for Lucid and for other organizations is
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  how do you start to say
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  what is really best for that member patient
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  and break down some of those workflows. Again,
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  it's really challenging when it's five different companies
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  that are all out for their own, you
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  know, financials and economics, and they need to
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  engage that patient. But we've been able to
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  sort of simplify some of that because we're
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  doing this kind of handhold
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  with the payer, and there's been more trust
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  and willingness if you're taking kind of the
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  medical and behavioral
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  to be kind of that one central partner
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  and really quarterback that care in a really
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  meaningful way,
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  that that can integrate and and really deliver
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  on that promise, from a from a multidisciplinary
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  approach.
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  Yeah, Shana. A really helpful overview. And so
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  I wanna go a little bit deeper there,
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  and then also we'll we'll be sure to
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  touch on some outcomes too. But, you know,
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  you're saying that to really bring this whole
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  person approach to life, it sounds like it's
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  complex. And at the same time, it it
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  requires a lot of simplification too, making things
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  simpler for payers as they're navigating the space.
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  So I wanna talk a little bit about
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  scaling this model. You know, what's really needed
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  from health plans and providers to deliver integrated
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  care at scale? And if you could ask
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  leaders to make one change right now to
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  head in that direction, what would it be?
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  Yeah. I mean, I think a lot of
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  the work that we're doing is around operational
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  and clinical transparency.
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  And what I mean by that is everyone
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  kind of sitting at the table,
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  and sharing what they are uniquely positioned to
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  do well and not. I think again and
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  and we've sort of benefited in in not
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  being, you know, a VC backed company that's
• 8:56
  sort of trying to raise the next round
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  and having to kind of promise on on
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  certain outcomes, but really deeply rooted in the
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  execution and and delivering results. And so coming
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  to the table and saying, hey. If you
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  pass me a population, I'm gonna cut that
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  population and look at it in all these
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  different ways,
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  and I'm gonna see where I can actually
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  drive impact. So if I have chronic disease
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  members in a certain condition type and they
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  have underlying behavioral health needs, we're gonna, one,
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  look at those things together. And then, two,
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  we're gonna pick where we know we can
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  drive impact and actually have
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  a both product
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  sales
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  pricing model that matches to that. And so
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  having a very
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  transparent conversation to a health plan around, this
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  is where I can drive impact with with
• 9:40
  your members.
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  This is where I think maybe you can
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  drive impact with your members. And then, of
• 9:44
  course, we need to bring the provider piece
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  into the fold as well in terms of
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  where, you know, the role of of those
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  particularly the risk bearing primary care players in
• 9:52
  that. But really sort of dividing up that
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  population to drive impact, that is different from
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  kind of the, hey. Give me everybody,
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  and
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  I'm gonna have some sort of arbitrage opportunity
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  where there's some people that are not gonna
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  need care, and I'm gonna be able to
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  sort of make it
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  up on that and maybe or maybe not
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  be well positioned to deliver for those acute
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  populations. So I think it's this very,
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  I know everyone always talks about sort of
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  the data sharing and sort of why hasn't
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  value based care kind of come to fruition
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  in the way that everybody wants it to
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  and that being a data problem. I'm seeing
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  something slightly different, which is it's around kind
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  of taking that data and then having a
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  very transparent approach. And even in in the
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  operational side too in terms of what can
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  you drive actually from an engagement metric perspective,
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  not having the what's the promise of what
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  it is, but what what is actually
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  possible relative to staffing and outcomes. And I
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  think the more that those conversations happen, you
• 10:46
  start to be able to sort of divvy
• 10:47
  up the work to where the impact and
• 10:49
  outcomes can be driven. And that also simplifies
• 10:51
  things for the patient because, essentially, you don't
• 10:53
  have
• 10:54
  five different parties trying to engage that patient
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  to remember.
• 10:59
  So interesting, Sheena. What you're saying here about
• 11:01
  in value based care from your point of
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  view, it's not necessarily a data problem making
• 11:06
  it hard for this model to really come
• 11:08
  to life to the full extent. It's about
• 11:10
  taking a transparent approach with that data operationally
• 11:13
  speaking. It sounds almost like a surgical approach,
• 11:16
  what you described earlier. It was such a
• 11:17
  great,
• 11:18
  great way that you described it, and I
• 11:20
  appreciate you sharing that with our listeners. And
• 11:21
  it sounds like two bidirectional communication is really
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  important,
• 11:25
  for payers and providers in this in this
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  way.
• 11:28
  But before we wrap, this has been such
• 11:30
  a great conversation. I I did wanna give
• 11:32
  you the chance to just highlight any
• 11:34
  outcomes you're seeing either at the patient or
• 11:36
  population level with this approach of truly integrating
• 11:40
  care. You know, bringing medical care into the
• 11:42
  fold or whatever you'd like to highlight or
• 11:44
  any metrics that you're proud of, would love
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  to hear about those two.
• 11:47
  Yeah. So, it's been really exciting. You know,
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  your comments are are right around sort of
• 11:51
  that surgical approach. I am an engineer by
• 11:53
  background, and so we've taken a very sort
• 11:55
  of methodical approach to this, actually, both on
• 11:57
  the behavioral health side and now on the
• 11:58
  integrated care side. So,
• 12:01
  you know, many of folks in the market
• 12:02
  may know Lucid for,
• 12:04
  our access to care product, the navigate connect
• 12:07
  product, and it's been an interesting sort of
• 12:08
  evolution
• 12:09
  of the company where we've been, you know,
• 12:11
  focused on innovating on the behavioral health offerings
• 12:14
  for health plans and bringing this Navigate Connect
• 12:17
  product that was focused on getting
• 12:19
  patients connected quickly to high quality care. And
• 12:22
  so that's been the, you know, starting point.
• 12:25
  So we have now that product up and
• 12:27
  running. Eighty three percent of patients are booked
• 12:29
  into care within seven days. There's been a
• 12:32
  a really significant increase, five point two days,
• 12:34
  the average time between booking,
• 12:37
  and care. And then the really exciting thing
• 12:39
  is eighty one percent of those patients that
• 12:41
  we are connecting to,
• 12:43
  the initial visits are actually going for a
• 12:44
  second visit. And so we've seen in the
• 12:46
  data that the patients that are coming to
• 12:49
  us through the various channels that we deploy
• 12:51
  this through, one, actually have a higher acuity
• 12:54
  on the medical side. So, again, this is
• 12:55
  sort of the starting point of that integration
• 12:57
  piece,
• 12:58
  but also are continuing on into care.
• 13:01
  And it's actually interesting on the behavioral health
• 13:03
  side. You don't need that many,
• 13:05
  outpatient interactions in many cases to actually start
• 13:09
  to bend both the patient outcomes and the
• 13:11
  cost curve, but it is really critical that
• 13:13
  you get beyond that first visit. We've also
• 13:16
  done over 15,000,000 assessments, and so we actually
• 13:18
  have one of the largest repositories of sort
• 13:21
  of provider agnostic behavioral health assessment data in
• 13:23
  the country.
• 13:24
  And then, you know, we've seen again in
• 13:27
  the data from getting those numbers connected into
• 13:29
  high quality care,
• 13:31
  a $227
• 13:33
  PMPM children medical expense savings. So all of
• 13:35
  that data on the behavioral health side is
• 13:37
  what then led us to say, hey. If
• 13:39
  you bring together
• 13:41
  the medical piece kind of, again, into the
• 13:43
  fold. And so it's early days for us
• 13:45
  on that, but we know from the the
• 13:47
  we acquire a company called EMCARA and now
• 13:49
  have relaunched,
• 13:51
  that Lucid at Home product that the EMCARA,
• 13:53
  Lucid at Home product delivers 26% reduction in
• 13:57
  admission, 6% reduction in emergency department visits. And,
• 14:01
  again, this is without really that BH at
• 14:03
  the forefront component. And so we're really excited.
• 14:06
  Hopefully, next time, you know, I come on
• 14:08
  in in a year or so, we'll have
• 14:10
  the,
• 14:11
  data because we're already starting to really combine
• 14:13
  those pieces together in the product to say
• 14:16
  what's gonna be the impact if you layer
• 14:17
  in those outcomes I've, you know, shared on
• 14:19
  the behavioral health side, couple that up with
• 14:21
  the medical side, and look at what you
• 14:23
  can drive as far
• 14:25
  as the, you know, healthy days at home,
• 14:26
  which we look at, which is obviously the
• 14:28
  human element of providing that as well as
• 14:31
  on the, you know, financial measures. So I
• 14:33
  think super exciting what has already been delivered
• 14:36
  on both behavioral and medical.
• 14:38
  And, of course, we, you know, spend a
• 14:40
  lot of time figuring out what to measure
• 14:42
  here.
• 14:44
  But to me, you know, there's gonna be
• 14:46
  a a a significant multiplier effect when you
• 14:48
  combine these pieces together.
• 14:51
  Yeah. Shana, I appreciate everything that you just
• 14:53
  shared. Some really impressive metrics. And
• 14:56
  as you said, if we we hopefully speak
• 14:58
  again a year from now, I can't wait
• 15:00
  to see how those numbers change and and
• 15:01
  what's on the horizon for Lucid with this
• 15:03
  new approach.
• 15:04
  It's been a great time talking to you
• 15:06
  today, Sheena. Just wanted to give you the
• 15:08
  space to share any final thoughts or takeaways,
• 15:11
  before we close our time together.
• 15:13
  No. I really appreciated the the time today.
• 15:15
  Again, I think
• 15:17
  excited to start to have, you know, the
• 15:19
  market talk about BH at the forefront. I
• 15:21
  think you pointed it out well that most
• 15:23
  times we think about medical primary and BH
• 15:25
  secondary,
• 15:26
  or tertiary in some cases. And so the
• 15:28
  idea of putting
• 15:29
  behavioral health primary, again, we're leading the charge
• 15:32
  on that, but excited to see, the market
• 15:34
  come along because I think, obviously, that, you
• 15:36
  know, from my perspective is is better for
• 15:38
  patients
• 15:39
  if we take that approach. So really appreciated
• 15:41
  the time today and excited to to keep
• 15:43
  in touch over the next, coming months. Well,
• 15:46
  Shana, thank you so much again for your
• 15:48
  time and your insights today. It's been a
• 15:49
  great conversation.
• 15:50
  And, of course, we'd also like to thank
• 15:52
  the sponsor for today's podcast episode, Lucid.
• 15:55
  Listeners, you can tune in to more podcasts
• 15:57
  from Becker's by visiting our podcast page at
• 16:00
  beckershospitalreview.com.