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Building Integrated, Measurement Based Behavioral Health at Scale with Shannon Werb of Array Behavioral Care · Becker's Healthcare Behavioral Health

0:00
Hello, everyone. This is Jacob Emerson with the
0:02
Becker's Behavioral Health Podcast.
0:04
Thrilled today to be joined by Shannon Werb,
0:06
who is the Array Behavioral Care CEO. Shannon,
0:10
thank you so much for taking the time
0:11
to be with me on the podcast today.
0:13
Hi, Jacob. Thank you for making the time.
0:15
I'm really looking forward to it. Likewise. And
0:18
before we dive into everything we wanna talk
0:19
with you about, Shannon, can you first tell
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us a little bit more about yourself, your
0:23
background in health care, and what it is
0:26
that you do today at Array?
0:28
Yes. I'd be happy to, Jacob. Thank you.
0:30
So I've spent my career,
0:33
really focused on
0:35
scaling tech enabled health care services
0:38
organizations.
0:40
Early on, that was in the radiology space.
0:43
I've spent
0:44
a number of years also in the acute
0:46
care space, and most recently,
0:48
I joined Array in 2023,
0:52
in in the mental health space.
0:54
Most of the time, this focus has been
0:56
on, telehealth or virtual care,
0:59
but sometimes also,
1:00
leveraging hybrid models where we might have some
1:04
virtual capabilities along with on premise capabilities.
1:08
You know, really, I I view,
1:12
Array and the behavioral health industry at this
1:15
inflection point, this opportunity, I think, for us
1:18
to start thinking about
1:20
an integrated set of capabilities
1:23
where I think historically,
1:26
organizations have attempted to address behavioral health through
1:28
point solutions.
1:30
There's many organizations
1:32
out there that deliver great products and services.
1:35
Unfortunately, oftentimes,
1:37
not well integrated,
1:38
and that puts the patients in a position
1:40
where they have to figure out how to
1:41
navigate that inconsistent
1:43
system. And so I really think there's this
1:46
unique opportunity for us to try to figure
1:48
out how to begin really bringing together,
1:51
clinical services for behavioral health or in in
1:54
our world focused on mental health patients.
1:57
You know, I think about that really as
1:59
this need for truly integrated service capabilities.
2:03
When you think about Array Behavioral Care,
2:06
we're a national,
2:08
all virtual behavioral health provider, again, in the
2:11
mental health space.
2:12
We deliver care across the full continuum.
2:16
So we deliver acute services.
2:18
Think about patients that enter the hospital usually
2:22
through the ED in crisis.
2:24
We deliver care virtually to in an outpatient
2:27
environment. Oftentimes, those are outpatient services associated with
2:31
the hospitals and health systems we deliver acute
2:33
services to, but they might also be independent,
2:37
community health clinics,
2:38
FQHCs,
2:39
tribal communities, correctional facilities.
2:42
And we also deliver care virtually to patients,
2:45
in their home.
2:46
We do this today now all on an
2:49
interoperable epic based clinical platform. So our electronic
2:53
health record is epic. We believe that that
2:56
patients,
2:57
oftentimes
2:58
originate or usually end up back within a
3:01
health system. And so making sure we have
3:03
an
3:04
interoperable advanced platform is really important to
3:08
how we enable our clinicians to practice, but
3:10
also the experience that our patients receive.
3:12
And so when you kind of add all
3:14
this up, we really
3:15
view our mission at Array to transform
3:19
behavioral health care,
3:21
the landscape of BH,
3:23
in a way that we're continually innovating these
3:25
care models to define new standards of excellence
3:28
for patients that are in need and pulling
3:31
together the various capabilities that Array has to
3:34
offer in an integrated fashion on an epic
3:37
based platform
3:38
for patients where they are, meeting them where
3:41
they are.
3:42
Absolutely. No. I appreciate that breakdown, Shannon, about
3:45
the company. And and one thing that I
3:47
think is really great about Array is your
3:49
direct employment model of your of your clinicians
3:52
rather than a contracting
3:53
network.
3:54
And I know we've heard you all describe
3:57
that as really being critical to the consistency
4:00
and to the high health outcomes,
4:02
that you achieve on behalf of you the
4:04
patients that you serve.
4:06
So getting to the heart of your your
4:08
career expertise, which you detailed for us at
4:10
the start of this conversation,
4:12
I wonder
4:13
what you would say in terms of what
4:15
you've learned about building a tech enabled clinical
4:18
workforce in the behavioral space
4:20
at national scale?
4:23
Given, like I said, the the background, the
4:26
career you've had,
4:27
and then looking at that through the context
4:29
of leading Array,
4:31
What do you think are some of the
4:32
key lessons you've learned there?
4:34
Yeah. Jacob, great question. You know, I we
4:36
we approach this,
4:38
intentionally
4:38
using,
4:40
words to describe our practice model as a
4:43
practice.
4:44
I'm air quoting there
4:46
versus a network of clinicians.
4:48
We're really trying to create this environment that
4:52
embraces the fact that we think behavioral health
4:54
is,
4:55
a relationship driven field and therefore consistency
4:59
and accountability
5:00
really matter in the clinicians that show
5:03
up every day to take great care of
5:05
patients.
5:06
But to your point, over decades and working
5:09
in multiple
5:10
clinical service areas,
5:12
this is an opportunity for an organization
5:14
to invest in an employee model,
5:17
w two based employees, those employees when they
5:20
practice with us full time, which most of
5:22
them do, receive benefits as well,
5:25
allows us to think about things like building
5:28
culture and standardizing the practice that our clinicians,
5:32
deliver their services around, training our clinicians
5:35
on our care pathways. I know we'll we'll
5:37
talk about the,
5:39
those here later. And really making sure that
5:41
we're delivering consistent quality across every single
5:45
patient interaction.
5:47
I think these contracted marketplaces
5:49
really struggle with turnover,
5:52
variable training
5:53
models, inconsistent practice patterns. Don't get me wrong,
5:56
they're they're trying to do a great job,
5:59
but I really think an employed model where
6:01
the clinicians can
6:03
call Array their home, where we invest in
6:06
them more broadly than the income they earn
6:09
from any given patient encounter,
6:11
creates an environment where we can have clinicians
6:15
practicing at the top of their license and
6:17
really ensuring that,
6:19
you know, these,
6:20
patients are getting the best possible outcome and
6:23
the best possible services. And so that's why
6:25
we think about this as a practice versus
6:27
a network model. That means we offer w
6:30
two and,
6:32
employment,
6:33
contracts with our clinicians.
6:35
We offer benefits to our clinicians when they
6:37
join our practice.
6:38
Today, about 90% of the clinicians that are
6:42
with Array,
6:43
are w two employed,
6:44
and about 80% of them, are actually full
6:48
time, which means they practice with us for
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greater than thirty hours per week.
6:53
Wow. Understood. So it makes a lot of
6:55
sense why you do that in that way.
6:58
I wonder, Shannon, if you were talking directly
7:00
to a lot of the health system leaders
7:02
that are listening in, these are the individuals
7:04
who oversee
7:06
the behavioral
7:07
piece of large health systems across the country.
7:10
If you're talking directly to them, what's some
7:12
of the advice that you would give in
7:14
terms of
7:15
that this battle that they're constantly trying to
7:17
decide between
7:19
building,
7:20
buying, or partnering,
7:22
to build out behavioral health capacity. It's obviously
7:25
it's a it's
7:26
a key topic for this for this,
7:28
for this audience right now, and it's something
7:31
we hear about constantly across the country of
7:33
systems
7:34
working to continue to build out this these
7:36
services to meet the high demand for them.
7:39
So what would be your advice to them
7:40
on how to how to figure out what
7:41
the best path is to go down?
7:44
Yeah. Jacob, let's start first with
7:47
what what do I think this means? What
7:49
what do we think a a practice model
7:53
means, for a hospital partner? And I think
7:55
about that along the lines of a handful
7:57
of pillars. One,
7:59
reliability. I think this enables hospitals to get
8:02
access to a more stable team, maybe
8:05
not an environment where there's a revolving door
8:07
of clinicians coming in and out of the
8:09
practice.
8:11
Alignment, I think, is really important when we
8:13
work with hospitals and health systems.
8:16
We need to make sure that we train
8:17
our clinicians on partner workflows,
8:20
documentation standards,
8:22
escalation expectations,
8:24
the quality programs,
8:26
of the
8:27
systems that we are working with. And I
8:29
think a stable workforce allows us to do
8:32
that.
8:34
Continuity,
8:35
our our
8:36
clinicians are practicing our care pathways. Again, I
8:39
know we'll talk about those here in a
8:40
little bit, but that means that
8:42
each of our clinicians
8:44
will deliver consistently like the others that are
8:47
in the practice.
8:48
I also think, finally, that gives you a
8:50
much more scalable approach,
8:52
in ensuring that we can appropriately
8:55
offer a competitive solution to these clinicians
8:58
so we can recruit them, credential them, manage
9:01
them,
9:02
supervise that workforce. We do that on behalf
9:05
of our hospital health system partners, and I
9:07
think that works better in this employed model.
9:09
So then when I think about
9:11
that question of
9:13
buy versus build,
9:15
I, you know, I covered this, I think,
9:17
on a a a Becker's webinar we did
9:19
earlier in the year. I'm not sure I
9:21
would look at it necessarily,
9:23
black and white where you have to choose
9:26
one
9:27
versus the other. I think,
9:30
you know, the the recruiting psychiatrists and therapists
9:33
is harder than ever.
9:35
Internal models in health systems often
9:38
are make it difficult or more difficult than
9:41
an organization like ours who really we're experts
9:44
in
9:45
recruiting, employing, ramping, and engaging
9:48
clinicians long term in a telehealth model, I
9:51
think that enables us to,
9:53
augment the health system,
9:56
more than just,
9:58
you know, a clinician that fills a shift
10:00
as an example. We can bring clinical leadership.
10:03
We can bring,
10:05
workflows. We can bring technology to the table.
10:08
So in some sense, the health system is
10:11
building the things that are important to them.
10:14
And in another sense, they're partnering or buying
10:16
the things that a partner like Array might
10:19
be able to bring to the table. So
10:21
again, I'm not sure I would call that
10:23
necessarily a black and white decision. I think
10:25
it's a little bit of both
10:26
deciding what pieces of it you really want
10:29
to own and then partnering with someone who
10:31
can
10:32
integrate
10:32
directly
10:33
and bring the capabilities
10:35
that augment the services you're trying to build
10:38
on your own.
10:39
Sure. I I appreciate you reframing that, Shannon,
10:42
because it's a great point. This isn't a
10:44
black and white decision. It should really be
10:45
a multi factored
10:47
strategy, it sounds like, when making these kinds
10:49
of decisions.
10:51
You mentioned care pathways, and I did wanna
10:53
dig into that a little bit because, as
10:55
you know, of course, Array launched that this
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year with a focus on measurement based care,
11:00
which, of course, you know, we've heard across
11:02
the industry for a long time,
11:05
that that it's been
11:06
about for years. It's it's it's something a
11:08
lot of companies and and health systems are
11:11
chasing,
11:12
but they've struggled to implement it at scale.
11:14
And so
11:15
what do you think is actually making it
11:17
possible
11:18
now for you all? And and what do
11:20
you think, What does it take for hospitals,
11:23
and for payers to to move from treating
11:26
this more of as a as a nice
11:27
to have to to an operational standard?
11:31
Well, you you obviously could tell, Jacob, I
11:34
was looking forward to talking about this, bringing
11:35
it up in the previous two questions.
11:37
Questions. But,
11:39
you know, we we think of care pathways
11:41
as making measurement based care and behavioral health
11:44
real or or capable.
11:47
We think of EPIC, our electronic health record
11:50
as making it scalable.
11:51
And so let let me talk a little
11:53
bit about what we think care pathways are,
11:55
how we're using them,
11:57
you know, how they how they deliver against
11:59
measurement based care goals, and
12:02
why we think EPIC is such a key
12:04
part of enabling this to occur and maybe
12:06
part of the reason why the industry in
12:07
general has struggled with it because
12:09
a lot of these infrastructures
12:11
just don't exist
12:13
in many other places.
12:14
So for us, care pathways are a structured
12:18
evidence based clinical pathway
12:20
that guides how we match patients to the
12:24
right level and intensity of care.
12:26
We do this based on risk acuity and
12:29
clinical presentation and so every new patient
12:32
receives an assessment as part of their intake
12:35
process,
12:37
that allows our clinician
12:39
facilitated through Epic to match the patient to
12:43
the right level
12:44
and right intensity of care. We have a
12:47
phrase we call the right care at the
12:49
right time and the right dose, and dose
12:51
isn't meant to be medication. It's really meant
12:54
to be intensity of care. How frequent and
12:57
what type of care does patient actually need
12:59
to receive.
13:01
We really think this matters
13:03
because it reduces
13:05
unwarranted variation in care. I think that's one
13:08
of the biggest drivers of poor outcomes.
13:11
It's also
13:12
allows us to ensure that, we're avoiding
13:16
unnecessary cost, in the behavioral health space.
13:20
And so these these care pathways connect to
13:23
measurement based care.
13:26
It's really not just about us collecting data.
13:29
We are using the data we collect
13:32
on top of the data that's produced as
13:34
part of the the care episodes to inform
13:38
the paths that a patient follows.
13:40
Those paths can change over time.
13:43
And so therefore, the adjustments to care that
13:46
the patient might need to receive
13:48
at one point or another,
13:50
they allow us to evaluate things like dosage
13:52
or intensity, whether a patient needs higher level
13:55
care or lower level care. And we have
13:57
those. They're just a different path.
14:01
And so that ultimately means we're really tracking
14:03
the impact of the care or the outcomes
14:05
of the care and adjusting along the way
14:08
as we need to. And so the final
14:10
the final point I'll I'll make about care
14:12
pathways is really why is Epic or a
14:15
mature modern electronic health record so important in
14:18
this environment?
14:20
Because we run on,
14:23
Epic, this really enables us to have real
14:26
time data,
14:27
shared
14:28
documentation,
14:30
automatic templates,
14:31
decision support for our clinicians.
14:34
And then, of course, we have, Epic's care
14:36
everywhere in every exchange and every interaction we
14:39
have with patients. We essentially have a
14:42
custom built solution,
14:44
from Epic for behavioral health through a partnership
14:47
we have with an organization called KeyCare.
14:50
So Epic gives our clinicians the information workflows
14:53
they need to consistently
14:54
apply pathways at scale.
14:56
We have a high ninety percentile adherence rate
15:00
to patients that are assigned to the right
15:02
path. This allows us to collaborate with our
15:04
partners.
15:05
We can support transitions across the path and
15:08
then across settings. So think a patient in
15:10
the ER
15:11
is discharged safely and transitioned to care in
15:13
the home.
15:14
Ultimately allowing us to make sure we're closing
15:17
the fragmentation gap by enabling this cross setting
15:20
visibility,
15:21
which I think back to my original opening.
15:24
It's something that point solutions or other telehealth
15:28
platforms
15:28
really have a hard time offering is making
15:31
sure that as a patient's setting of care
15:34
or levels of acuity changes,
15:36
how do we make sure we integrate that
15:38
capability across the environment?
15:40
So we are very excited about care pathways.
15:43
We are excited to announce them,
15:45
this year. We've had patients on the paths
15:48
now for about thirteen months, and we're beginning
15:51
the process of publishing some of the data
15:54
we're learning around care pathways. So watch out
15:56
for more to come in that area, Jacob.
15:59
Yeah. You're you left us with a cliffhanger
16:01
at the end there. Shannon. You'll have to
16:02
keep us posted on on the data here
16:04
because I know our team on the behavioral
16:06
side of things would certainly love to to
16:08
cover that in terms of what you're what
16:10
you're seeing, what you're achieving there,
16:12
over these last thirteen months.
16:15
I did wanna ask you more of a
16:17
an open faced question about the year that
16:19
just occurred for the behavioral health industry because
16:23
it's been it's been massive, and it's been
16:26
incredibly impactful, especially in terms of what comes
16:30
next, I
16:31
think. We we saw the telehealth policy cliff
16:34
come and go. HR one was signed into
16:37
law, and I know pretty much every health
16:39
care organization around the country right now is
16:41
is preparing for the effects of that.
16:44
There's obviously the continued workforce shortage,
16:47
across the industry. Nothing new there.
16:50
And then there's the growing pressure on hospital
16:52
systems all over the country to keep integrating
16:54
behavioral services across the care continuum.
16:58
Shameless plug, but it certainly led us to
17:00
to hosting our first behavioral health executive conferences
17:04
this year, because of just the demand we've
17:06
been hearing about from around the country. So
17:08
I wonder for you, Shannon, as you look
17:10
back on this year,
17:12
what
17:13
what maybe surprised you about how the industry
17:15
evolves?
17:16
And what do you think are some of
17:18
the biggest gaps or some of the biggest
17:20
needs
17:21
you still see out there, that need to
17:23
be addressed heading into next year?
17:26
Yeah. Jacob, great great question, and I I
17:28
will compliment Becker's. I think you all did
17:31
a great job in the,
17:32
behavioral health focused conferences. I know there's gonna
17:35
be more of that coming in the future
17:37
and ensuring
17:38
the right content is there and the right
17:40
speakers are there. You know, when I look
17:42
back on 2025,
17:43
there's a handful of, like,
17:46
you know, things that we hear about regularly
17:48
and maybe a handful of themes as well.
17:51
Growing ED volumes and higher acuity presentations.
17:55
We've worked really hard to continue to staff
17:57
up to ensure consistent service delivery to our
18:00
partners. And interestingly enough,
18:02
the customers that were with us at the
18:03
beginning of the year, those same customers for
18:06
the same hours at the same site are
18:08
sending us nearly 15 or 16%
18:10
more volume.
18:11
They're seeing more volume. They're sharing more of
18:14
that volume with us. I think
18:17
that
18:18
contributes to this pressure around improving patient flow,
18:21
but not compromising safety.
18:24
Really this desire for
18:26
system wide integrated capabilities rather than point solutions,
18:30
as I mentioned earlier,
18:32
and ensuring that health systems
18:34
are talking to us now about
18:37
a real reliable
18:39
integrated
18:39
partner. Again, not the the black or white
18:42
buy versus build, but how do we do
18:43
something in the middle? So we're just not
18:45
another,
18:47
telepsych service? We're really somebody that can bring,
18:50
yes, staffing, but clinical models, technology, and data
18:53
to to the table. So I think the
18:55
themes there are
18:56
really
18:57
integration is no longer optional. We need to
19:00
make sure that these services are data enabled.
19:03
They they cross multiple settings.
19:06
This really is becoming the expectation.
19:09
I think accountability is becoming much more of
19:11
a differentiator. Their
19:13
systems, health systems are looking for
19:16
clinically
19:17
accountable organizations
19:18
with employed clinicians,
19:20
quality programs, real pathways,
19:22
real measurement, again,
19:24
more than staffing.
19:27
And, you know,
19:28
in 2026,
19:29
as we move forward,
19:31
I really think you're gonna see many of
19:32
the organizations that have focused their services on
19:35
direct to consumer
19:36
to be those organizations
19:38
that are now thinking about the hospital space
19:41
a whole lot more
19:42
and recognizing
19:43
the need and opportunity
19:45
that it is for them to really partner
19:47
with hospitals and health systems to try to
19:49
get upstream,
19:50
solve some of these challenges that they may
19:52
see in a direct to consumer model. So
19:54
we're really excited about 02/2026.
19:57
We're we think we're really well positioned around
20:00
a number of our capabilities.
20:01
We've been in hospitals and health systems,
20:05
for years. We really started there. It was
20:07
really our origin.
20:08
Acute care is is what we do really,
20:11
really well.
20:12
We also have care pathways for lower acuity
20:15
patients, oftentimes
20:16
caring for them in their home.
20:18
And so therefore, we think we're really built
20:20
for some of this hospital level care and
20:22
and where the puck is going. We think
20:24
we're we're there and we're ready. We think
20:27
we have a really great option around integrating
20:29
our platform
20:30
technology and data.
20:32
Again, back to the fact that we're deployed
20:34
on Epic. And so, you know, we really
20:36
think that we're a clinically accountable partner,
20:39
that can help,
20:40
hospitals and health systems think about that buy
20:43
versus build equation and bring the right resources
20:45
to the table as they continue to invest
20:48
in behavioral health programs.
20:50
Fantastic. Well, Shannon, what else are we missing?
20:53
You've got the ears of a lot of
20:54
those health system leaders from all over the
20:56
country right now. Any other wrap up thoughts,
21:00
final bits of advice you wanna offer them?
21:02
Well, Jacob, again, thank you very much for
21:05
the time. Really appreciate the partnership with Becker's.
21:08
Really have appreciated the conferences and the educational
21:11
material and the opportunity to come together and
21:14
interact with,
21:15
partners,
21:16
as well as we can,
21:18
through through the Becker's experience.
21:20
As I mentioned earlier, we're really excited about
21:22
the innovation that we're working hard to bring
21:24
to the table.
21:25
We really think about the fact that,
21:28
we have this opportunity to take care of
21:31
patients across multiple levels of acuity,
21:34
multiple settings of care.
21:36
We do that leveraging measurement based care pathways
21:39
and we do that on
21:40
a modern electronic health record that ensures patients
21:44
don't fall through the cracks and we can
21:45
communicate our work
21:47
safely and correctly back to the health systems
21:50
that we partner with. So we're really looking
21:52
forward to next year. And Jacob, again, I
21:54
thank you very much for your time.
21:56
Thank you, Shannon, for taking the time to
21:58
be here with us on the podcast
22:00
and for sharing your expertise with our audience.
22:02
We really appreciate it. And to our audience,
22:05
if you'd like to listen to more podcasts
22:06
from Becker's Healthcare, you can visit beckershospitalreview.com.