Latest / Becker’s Payer Issues Podcast / Expanding Behavioral Health Access with Bill Harlan of Point32Health

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Expanding Behavioral Health Access with Bill Harlan of Point32Health · Becker’s Payer Issues Podcast

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Hello, everyone. This is Jacob Emerson with the
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Becker's Payer Issues podcast.
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Thrilled today to be joined by Bill Harlan,
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who's the vice president of behavioral health and
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health engagement at Point thirty two Health. Bill,
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thanks so much for taking the time to
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be with me on the podcast today. Hey,
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Jacob. Thanks for having me. Yeah. And before
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we dive into everything we wanna talk with
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you about, Bill, can you tell us a
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little bit more about yourself, your background in
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health care, and what it is that you're
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doing today at point thirty two Health?
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Yeah. Happy to and, excited for the opportunity
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to talk with you today. So thank you
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for,
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letting us on.
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So I am a licensed mental health counselor
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by background.
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I
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spent a lot of my career,
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as a clinician,
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worked with at risk youth in residential placements,
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worked at outpatient
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therapy clinics, worked with veterans.
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And,
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I've been in the managed care space the
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past fourteen
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or so years,
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most of which I spent at Carillon, formerly
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Beacon Health Options,
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worked in various markets supporting clinical
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implementation,
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operational
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support.
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And currently,
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I serve as vice president of behavioral health
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and health engagement at point three two Health,
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the parent company of Harbor Pilgrim.
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Fantastic. Paul, like I said, we really appreciate
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you taking the time to be on with
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us, for sharing your expertise with our listeners
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and just get a feel for,
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how you're thinking about the industry right now
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and what's going on with your membership at
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point thirty two Health.
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You know, obviously, as you know, the demand
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for behavioral health services continues to outpace supply.
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It's something that we consistently hear about from
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pretty much every insurer across the country at
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this point, and certainly
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these last few months. And then that really
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seems to be especially true for youth and
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for people living in rural communities. So
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from your vantage point, both from your career
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expertise, but now sitting
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at point thirty two Health and Harvard Pilgrim,
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what are some of the strategies you all
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are employing right now that you're finding that
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are are most effective to close these access
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gaps while still maintaining that high quality of
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care you're always striving for? That's a great
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it's a great question and something that I
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think we're
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is top of mind for us.
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And
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I think any anybody, as you mentioned, who
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has been following the behavioral health space, it's
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been an unprecedented
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past five years.
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The demand,
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we continue to see, we continue to see
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net new consumers,
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entering behavioral health,
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working with new providers.
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And we continue to see high rates of
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depression, anxiety. And as you mentioned, particularly amongst
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young people,
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substance use still,
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is is a
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need of support that remains. So we also
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are hearing from provider partners that we work
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with that they're faced with workforce challenges,
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pipeline planning, clinician burnouts,
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and a lot of that is leaving
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many clinicians to leave the field altogether.
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This has resulted in fewer clinicians to meet
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this growing demand and has
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created this perfect storm in a way of
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longer wait times to access to care,
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that we're still finding ourself
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in today,
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even five years,
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since the pandemic.
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So we as as a as a payer
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looked at what what are some pieces we
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could do to address access. And,
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you know, sometimes
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the most,
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innovative piece we can do is not the
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most complicated. We needed to put,
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a human touch to the experience, and we
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heard feedback very clearly that people looking for
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treatment are are often overwhelmed.
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And it's hard to get a callback from,
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a a clinician or to understand
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what types of treatment
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are are out there and
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if there are alternative ways to
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seek treatment that may be not the traditional
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in person where
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one would have to drive to a place
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particularly if there's transportation concerns. So we started
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a new program,
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at our behavioral health service navigation program.
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And what this really does is we have
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a locally based,
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team of service navigators,
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who do incredible work that
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works directly with members who outreach to us
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looking for,
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clinical support
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and
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work with that member to really understand what
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is it that they are looking for. Is
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there a specialty that's in need? Is there
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a language or gender or cultural,
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match that we can help identify within our
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network?
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And are they looking for in person or
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or remote or a digital experience?
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And what we find is that when we
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can take the time to dissect what is
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the,
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need a person is looking for, we can
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more often than not connect them to a
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therapist or a behavioral health provider
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in in pretty short order,
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in most cases,
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depending upon the type of specialty and type
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of service. But in most cases,
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we can, secure an appointment for our members
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within a week of them contacting with us.
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That's from the day they called to the
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date of the first appointment,
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which shocked
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all of us, honestly,
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and we were really excited by that result.
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Another piece is that it's an opportunity for
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us to have a conversation
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with,
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one of our members that might need additional
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support
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if there is a need for more social,
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social supports that our community health worker team
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can assist with,
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if there is a transportation or housing or
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food insecurity
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need, we can then
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engage that member more broadly
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and help work with on the total picture
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of what might be a barrier to care.
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And
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other pieces that have have worked out really
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well for us is if the member is
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is looking for a virtual,
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clinician or open to telehealth,
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we've partnered with a few,
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providers that allow us to schedule on the
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member's behalf so we can give the member
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an appointment live on the phone when they're
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calling us so that they get that in
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real time.
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Another piece to it is we follow-up with
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every member that works with us to confirm
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how it went,
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if it was the right fit.
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And if it wasn't,
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we continue that
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journey with the member to find them the
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right clinician.
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And because of that, the other
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outcome that, again, surprised a lot of us,
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but in a good way, ninety nine percent
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of the members we work with in this
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program
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report being satisfied with the with the behavioral
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health provider that they got matched with.
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So we're really proud of of that work,
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and the team that does this work particularly
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is is does such a great job.
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The it's part of our local,
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neighbor helping neighbor approach that we believe helps
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enable us to,
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find that right match. And the last piece
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I'll say to this is that we've also
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had to have a network that can support
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this work. So we were happy to add
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about 30,000
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new providers
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in the past year alone.
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And that has been an enabler for us
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to help give members choice and help increase
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access to care.
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Wow. I mean, just that last part of
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what you said, adding 30,000
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providers to that network in one year, I
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can't imagine just the the what it took
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logistically to undertake something like that.
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Lot of lot of time and a lot
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of great hard work. And,
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oh, it it was it was off of,
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we we in source behavioral health
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most as as partly a response that we
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knew we needed to be closer to
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the behavioral health care overall. And,
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this has also allowed us to
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work with providers more closely so that we
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can have conversations about problems they're trying to
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solve and then problems we're trying to solve.
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And more often than not, many providers are
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are very happy,
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to receive referrals from us. And so we
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we've taken that approach. Yeah. You know, one
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thing when we've talking to individuals,
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your colleagues across the country serving in similar
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positions, Bill,
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virtual behavioral health access has really been key
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to, really building access,
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for their members. And that's obviously, as you
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know, something that's really grown rapidly these last
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few years, especially post pandemic. So
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when we are talking about these these types
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of initiatives,
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where we do hear about headwinds is engagement,
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long term outcomes,
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integration with in person primary care.
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So talk to us a little bit about
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those things from from your perspective of where
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you sit. How do you see your virtual
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and hybrid models evolving to meet some of
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these concerns?
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Absolutely. And, again, as most, you know, listeners
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probably know behavioral health, I would say, is
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what was one of the first disciplines to
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adopt the
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telehealth model,
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the the fastest
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post,
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the pandemic, and
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that
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enabled the workforce to
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relook at how we can deliver care in
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a different way. So now that we are
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further away from the pandemic,
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what we're finding is that virtual care
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is also a enabler for us to increase,
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care access to care at like you mentioned.
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One of the pieces that we're seeing and
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as we look at claims data, we're finding
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that there is a desire,
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for more of a hybrid approach where,
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someone may choose to go in person and
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then have the option for
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a
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virtual experience,
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as they as they move forward. And that's
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been gaining popularity and something we hear about
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from both our providers and our members.
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I I think the pieces you raise about
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engagement and outcomes are important.
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And I I think a couple of pieces
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that we see on this,
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we see convenience and flexibility
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is really
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hand in hand with engagement.
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If we can't make it simple and easy
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for folks to access care,
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they are more likely to continue to receive
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treatment,
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and,
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improve their outcomes
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if we can remove the barriers in in
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doing so.
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So we we really see the experience
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connected together.
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And we hear often from members that having
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alternative options to,
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an in person where every situation is different
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and there may be clinical reasons that in
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person or virtual,
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may or may not be supported. Overall, I
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think we do hear overwhelming feedback that,
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having the flexibility
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to schedule
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and removing some of the barriers,
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ensures people continue on in their care.
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This also, what you mentioned with
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integration with primary care,
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the theme we hear constantly from our primary
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care offices
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who work with our members for referrals
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is they're looking for ways to streamline the
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process
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in an often very,
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busy and and and,
11:34
overwhelmed
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office. So virtual providers and some digital solutions
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do
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at at times offer,
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a way for that
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process to be streamlined
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and that we can also offer that convenience
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for primary care offices as well.
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And I and I think the other piece
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with this as we look at long term
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outcomes is recognizing
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that all of our members and their treatment
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needs are different.
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And
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for what what what may work for one
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member may not be the right option for
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everyone.
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What we do know is that clinical rapport,
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the relationship that's developed in treatment continues to
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be one of the top predictors of successful
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outcomes.
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And what we hear is that,
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members who have an option to
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have in person,
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sessions and have the convenience of going virtual,
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seems to hit a sweet spot for a
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lot of people,
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so that they can develop that rapport and
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then, continue on,
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virtually.
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I think the other piece on this is
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that we know for a long time,
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outpatient therapy often involves homework assignments. And I
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can remember when I was working,
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you know, with, with with with with veterans
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and we would give assignments.
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Now there are digital tools and apps that
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both
12:58
brick and mortar and virtual providers have ways
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to use and deploy.
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And what we hear is that that really
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helps give,
13:07
a better indication of engagement and are are
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their clients,
13:12
doing the skills? Are they tracking
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their mood?
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And is that intervention working? And can they
13:18
use an assessment to really understand if the
13:21
treatment intervention is having the desired outcome?
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So I I really think that all of
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this together,
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looking at the different modalities we have to
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deliver care, the digital tools that people have
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at their disposal,
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it's something we need to embrace.
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And it also means we have to prioritize,
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our members' choice and what kind of care
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they're looking for. And then as a payer,
13:45
working for our members to give them the
13:47
options to choose of what would work for
13:50
their,
13:51
for their situation and for people that have
13:54
very demanding and,
13:55
work hours. And then nine to the appointment
13:58
windows offered may not work for everyone. So,
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we see it really as an integral.
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Absolutely. No. That all makes a lot of
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sense. And I I wanna circle back to
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one thing you you mentioned about how digital
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solutions are a key piece of of all
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of this, and that's something that a lot
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of your provider partners are really looking for.
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So on on the hard news front, Bill,
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you all recently announced a collaboration with MaruHealth.
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Can you talk to us a little bit
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about this, the nuts and bolts here, and
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how you envision this this partnership complementing your
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existing behavioral health network?
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Absolutely.
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And we're really excited about our,
14:37
our working with Meru and the work that,
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we're gonna hope to,
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do together moving forward.
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I I think a piece of what drew
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us to Meru was how it connects into
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our mission, which is looking at whole person
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care,
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focusing,
14:53
on not just a specific illness, but the
14:56
overall,
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well-being,
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physical health, emotional health, social needs.
15:02
And the Meru model really fit into that
15:04
nicely for us. And we know that there's
15:07
such a correlation and we see it frequently
15:10
with members that are having the most severe
15:12
struggles that physical health and mental health
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are so interconnected and
15:18
success in one domain can't really be considered
15:21
without looking at both. So,
15:23
looking at the MAIRU program, we also saw
15:26
an opportunity to
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partner with a digital,
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provider
15:30
that has a clinically validated
15:33
and therapist led,
15:36
digital program.
15:38
And this program is gonna be
15:41
open to Harvard Pilgrim members. It's a twelve
15:44
week,
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intensive digital,
15:47
experience through a mobile app,
15:50
and it is based in evidence based care
15:53
that helps with a range of conditions including
15:56
depression and anxiety,
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also supportive of emotional considerations
16:01
like work workplace burnout, caregiver stress, and lifestyle
16:05
changes.
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What particularly is important to us, was the
16:10
clinician led,
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distinction.
16:14
This this program allows members to schedule one
16:17
to one video therapy sessions
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as they go along in the program,
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so that a member who might want additional
16:25
support, supported by a clinician as you would
16:28
in traditional outpatient therapist, that's available
16:31
for a member that
16:33
is interested in learning some new skills and
16:35
can put that to use and then use
16:37
some of the peer support groups
16:40
or work with some of the wearable,
16:42
heart rate
16:44
variability
16:45
device for real time feedback
16:47
can be, worked in there as well.
16:50
Also, the modules that are tailored for adolescents,
16:54
along with the appropriate type of continent structure
16:57
for those age specific,
16:58
needs was also a piece that was exciting
17:01
for us as we wanna make sure we
17:03
have,
17:04
expanded options for,
17:06
for all of our members. So,
17:08
we we are really excited to work with
17:10
them. We feel it complements our our total
17:12
portfolio
17:13
of
17:14
behavioral health solutions for members in an area
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that we are hearing a lot of feedback
17:19
of looking for digital solutions that, also give
17:23
flexibility,
17:24
and also can be accessed very quickly.
17:27
Care can be available in as little as
17:30
about two business days,
17:33
and it also continues to support our whole
17:35
person health strategy,
17:38
integrating
17:39
lifestyle tools like nutrition and sleep and mindfulness
17:42
and emotional regulation.
17:45
And we're confident this program is gonna be,
17:48
a a value add for our members and,
17:50
you know, working to we're excited about the
17:52
partnership.
17:53
Wonderful. Well, appreciate you filling us in on
17:55
what this partnership with Meru Health means for
17:58
your members. Before we go, Bill, what else
18:01
are we missing? Any other final bits of
18:02
advice you wanna share with the other industry
18:05
leaders listening in?
18:07
Yeah.
18:09
I I I hope I hope everybody is,
18:12
you know, taking care of themselves.
18:14
That's the first piece I think as as
18:16
leaders in this area.
18:18
We're in an unprecedented
18:19
time, and, you know, I think we're in
18:22
a moment that is exciting. If you've been
18:25
in behavioral health like I have for most
18:27
of your career,
18:29
there is certainly an
18:31
a a a piece that is,
18:33
validating in that we have always known behavioral
18:36
health was core and center to,
18:39
overall health,
18:41
care. That that idea seems to be gaining
18:44
more,
18:46
wide,
18:47
range acknowledgments, which is
18:50
exciting to see.
18:51
I think along with that is,
18:54
I think, advice to kinda share is that
18:56
now is a great time to get creative.
18:59
Every payer is facing,
19:01
headwinds in terms of how
19:04
we're seeing overall trends in medical costs overall.
19:07
Providers are also facing,
19:09
headwinds as well. So there is opportunity
19:12
in these in in this time,
19:14
even with those headwinds, to find
19:16
places where partnership can can come up. And
19:19
I would just encourage the the best,
19:22
ways we've been able to do that is
19:24
to make connections
19:25
and,
19:27
really define what problems we're trying to solve,
19:29
together
19:30
as how we're going through it all. I
19:32
think the other piece is
19:35
virtual care is here to stay. We don't
19:37
see this as
19:38
a a blip or a fad.
19:41
We we're consistently seeing utilization
19:44
remaining consistent.
19:46
What we're finding is that we need to
19:48
also use that as a tool in our
19:50
toolkit
19:51
and not something that we want to,
19:55
say as declarative across the board. This is
19:57
how care should be completed, and our role
19:59
as a payer
20:00
always needs to be figuring out how we
20:02
can how can we prioritize our members' needs
20:04
and access to care and have equitable access
20:07
to care. So as technology continues to emerge,
20:11
this is not something to,
20:13
I would say, run away from or fear,
20:14
but really try to lean in and think
20:17
about how we can start leveraging
20:19
a lot of this,
20:21
a lot of this technology for for everyone's
20:23
benefit.
20:24
Fantastic. I think that's a great place to
20:26
leave things. So, Bill, I wanna thank you
20:28
for taking the time to chat with us
20:30
and for sharing your insights with our listeners.
20:32
We really appreciate it. Thank you so much
20:34
for having us. I really enjoyed the conversation.
20:36
Yeah. Likewise. And and to our listeners, if
20:39
you'd like to listen to more podcasts from
20:41
Becker's Healthcare, you can visit beckershospitalreview.com.