Latest / Becker’s Healthcare Podcast / Behavioral Health Innovation and Expanding Access Across Communities with Dr. Manish Sapra

Transcript

Behavioral Health Innovation and Expanding Access Across Communities with Dr. Manish Sapra · Becker’s Healthcare Podcast

• 0:02
  - Heightened demand for behavioral health services isn't simply
• 0:05
  - a trend. It represents a structural shift in
• 0:08
  - what patients need and what health systems are
• 0:10
  - expected to deliver. And the space between that
• 0:13
  - expectation
• 0:14
  - and most organizations' current capacity is where the
• 0:16
  - hardest leadership questions live. How to recruit and
• 0:19
  - retain clinicians in a historically thin labor market,
• 0:22
  - how to build sustainable financial models around services
• 0:26
  - that have been chronically under funded and how
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  - to integrate care in ways that actually improve
• 0:30
  - outcomes rather than just check a box.
• 0:33
  - Becker's Fall Behavioral Health Summit is where more
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  - than 300 executive level attendees
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  - and 30 plus speakers spend two days working
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  - through exactly those questions with the kind of
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  - candor that only happens when the right people
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  - are in the room. Join us November fourth
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  - and fifth at the Hyatt Regency Chicago. For
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  - the agenda and event details, visit beggars hospital
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  - review dot com and click on the events
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  - tab in the upper right.
• 0:58
  - Welcome to the Becker's Behavioral Health Podcast. I'm
• 1:00
  - Ella Reuter, your host. Today, I'm joined by
• 1:03
  - Manish Sapra, system vice president of behavioral health
• 1:06
  - services at CommonSpirit Health. He recently joined the
• 1:10
  - system's national leadership team to help guide behavioral
• 1:13
  - health strategy across one of the largest
• 1:16
  - health systems in the country.
• 1:17
  - Doctor. Sapra, thank you so much for joining
• 1:19
  - us today.
• 1:21
  - Thank you for having me. It's really exciting
• 1:23
  - to be here, and, I hope you have
• 1:25
  - a good conversation.
• 1:27
  - Yes. I'm looking forward to it. Well, can
• 1:29
  - you start us off by telling us a
• 1:31
  - little bit more about yourself, your leadership background,
• 1:34
  - and how you ended up at CommonSpirit?
• 1:37
  - Sure. Yeah. I I joined CommonSpirit
• 1:39
  - last November,
• 1:41
  - and so it's been about eight months in
• 1:43
  - the organization.
• 1:45
  - I was hired to be the system vice
• 1:48
  - president for, behavioral health services
• 1:51
  - overseeing a new strategic service line in the
• 1:53
  - system,
• 1:55
  - which is,
• 1:56
  - remarkable for the system to actually invest in
• 1:59
  - a national behavioral health service line.
• 2:01
  - As far as my background,
• 2:03
  - I I was recently with another health system
• 2:05
  - in New York, called Northwell, where I ran
• 2:08
  - their behavioral health service line there
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  - for several years. And,
• 2:13
  - part of that, I have had experience of
• 2:15
  - working in,
• 2:17
  - in in Pittsburgh,
• 2:18
  - at UPMC,
• 2:19
  - and then
• 2:20
  - in rural,
• 2:22
  - settings in Central Pennsylvania
• 2:24
  - and community settings within Connecticut. So lot of
• 2:27
  - experience of working community based organizations,
• 2:30
  - community hospitals, which is really relevant right now
• 2:33
  - in in this role, at Crown Spirit.
• 2:36
  - And then, you know, over the years, I
• 2:38
  - would say I've had sort of the,
• 2:41
  - front row seat looking at health care consolidation
• 2:44
  - and as large health systems build, you know,
• 2:47
  - structures to
• 2:48
  - connect their programs and,
• 2:51
  - become more organized. I've had the pleasure of
• 2:54
  - of creating that service line strategy, which is
• 2:57
  - what brings me to common spirit as as
• 2:59
  - the system is looking to do the same.
• 3:02
  - Yes. Well, thank you so much for that
• 3:03
  - brief overview there,
• 3:05
  - especially with your leadership background. Again, thank you
• 3:07
  - for touching on everything and showing just your
• 3:09
  - breadth of work there.
• 3:11
  - We talked with you, Beckers did, last November
• 3:14
  - when you took on this position,
• 3:16
  - and you told us how you were spending
• 3:18
  - your first few months understanding the work that
• 3:20
  - was already happening
• 3:21
  - across CommonSpirit
• 3:23
  - before,
• 3:24
  - implementing any major changes.
• 3:26
  - When you look across
• 3:28
  - a system
• 3:29
  - of this size like CommonSpirit,
• 3:31
  - what opportunities do you see to standardize behavioral
• 3:34
  - health strategy,
• 3:35
  - and where do you believe standardization
• 3:38
  - can have the greatest impact on quality,
• 3:41
  - patient outcomes, and operational performance?
• 3:45
  - Yeah. You know, before making any big changes,
• 3:48
  - especially for a system this this big,
• 3:51
  - it's it's really crucial to take a step
• 3:53
  - back and get to know each market, each
• 3:57
  - clinical setting that we are working on.
• 3:59
  - And that's where I've invested my time. You
• 4:02
  - know, because of our size, every community has
• 4:04
  - such different needs, resources.
• 4:07
  - There are different regulations that affect care.
• 4:10
  - So I've spent the first few months just
• 4:12
  - mapping out,
• 4:13
  - what's already happening on the ground.
• 4:16
  - We want to find those bright spots, the
• 4:18
  - the practices that that are already working well
• 4:22
  - and figure out how to scale them up
• 4:24
  - so that the whole system can benefit.
• 4:27
  - Now regarding standardization,
• 4:28
  - you know, it's a huge opportunity for us
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  - to
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  - boost, both our quality and efficiency and and
• 4:35
  - bring the economies of scale to to those,
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  - initiatives.
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  - My vision is really that
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  - we are able to
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  - centrally
• 4:47
  - consult over what consistent guidelines should be,
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  - you know, whether it is working with our
• 4:54
  - quality folks on building some peers,
• 4:57
  - scorecards,
• 4:59
  - to track our work,
• 5:02
  - or to really sharpen how we use our
• 5:04
  - electronic medical records. You know, we're we're doing
• 5:07
  - a lot of work right now on
• 5:09
  - admission auto sets and other auto sets and
• 5:12
  - and, you know, what kind of analytics we
• 5:13
  - can get from our from our electronic medical
• 5:16
  - records. So
• 5:17
  - those kind of initiatives give us an approach
• 5:20
  - and a and a hope that we can
• 5:22
  - actually,
• 5:23
  - deliver some consistent message,
• 5:26
  - centrally from the system
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  - about what it means to get being get
• 5:31
  - getting better and how can we
• 5:33
  - measure
• 5:34
  - that success or or just keep an eye
• 5:37
  - on how our operations are going.
• 5:40
  - On top of that, if we standardize think,
• 5:42
  - we are looking at our acute care models.
• 5:45
  - Right? We're looking at EV throughput. We're looking
• 5:48
  - at, efficiency in our inpatient care model, our
• 5:51
  - crisis intervention model. We have set up some
• 5:54
  - crisis
• 5:55
  - stabilization units, in the system.
• 5:58
  - How are those things working out? Whether we
• 6:00
  - wanna enhance, expand that, that is, something
• 6:04
  - the the service line, looks to
• 6:07
  - advise the rest of the system on how
• 6:09
  - to to build that.
• 6:11
  - We're talking about expanding access to care, so
• 6:14
  - cutting down on redundant processes. And this is
• 6:16
  - a big one, like reducing those frustrating wait
• 6:19
  - times for patients in the ER.
• 6:21
  - So we're working on looking at ways to
• 6:24
  - enhance
• 6:25
  - our assessment
• 6:27
  - in the emergency departments. We have several pockets
• 6:29
  - of really good work that's going on in
• 6:32
  - the system, and we're looking to
• 6:34
  - to learn from that and bring it to
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  - the rest of the system. So this means
• 6:39
  - giving,
• 6:40
  - more comprehensive,
• 6:41
  - evaluations
• 6:42
  - and then,
• 6:44
  - helping out with behavioral health transfers. We're starting
• 6:46
  - to use some technology, some inbuilt, and some
• 6:49
  - with our external partners
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  - on helping with those referrals,
• 6:54
  - both internally and externally.
• 6:56
  - So that's that's some work that we are
• 6:58
  - focusing on.
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  - We're also looking to identify
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  - proactively,
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  - and preemptively
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  - using,
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  - you know, technology, analytics, even AI
• 7:09
  - within
• 7:10
  - our emergency departments as soon as patient, is
• 7:12
  - showing up
• 7:14
  - or within our broader,
• 7:15
  - you know, patient population using,
• 7:18
  - concepts like registries and
• 7:21
  - identifying patients who are at risk so that
• 7:23
  - we can have a more proactive approach in
• 7:26
  - in reaching out
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  - and a timely approach in reaching out to
• 7:29
  - those patients.
• 7:31
  - See, ultimately, the goal is to balance everything.
• 7:34
  - So we wanna maintain those high quality
• 7:36
  - standards across the entire ministry, but we have
• 7:39
  - to make sure that every region
• 7:42
  - still gets that flexibility.
• 7:44
  - You know, every market
• 7:46
  - can develop a tailored toolkit
• 7:48
  - that actually fits their unique patients and the
• 7:50
  - resources they have on the hand. So
• 7:52
  - it's,
• 7:54
  - it's kind of work that that can start
• 7:56
  - centrally, but it really is delivered,
• 7:59
  - at a market or a site level, within
• 8:02
  - our organization.
• 8:04
  - Can you talk more about how you're thinking
• 8:06
  - about balancing system wide behavioral health priorities and
• 8:09
  - quality standards
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  - while still giving individual markets, you know, the
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  - flexibility
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  - to address unique patient populations
• 8:17
  - and workforce realities
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  - and community partnerships as well?
• 8:22
  - Yeah. That is such a perfect question. Right?
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  - It especially for an organization of this size,
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  - it
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  - really gets to the heart of the challenge.
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  - Honestly, the work always has to start locally,
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  - right at the site level.
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  - We are incredibly fortunate to have such great
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  - leaders,
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  - across the system,
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  - you know, behavioral health leaders.
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  - Many of them who have been deeply embedded
• 8:47
  - in their communities and, and within our ministry
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  - for years,
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  - their firsthand knowledge is invaluable.
• 8:54
  - So we lean heavily on their insight and
• 8:56
  - judgment. And and how we get them
• 8:59
  - engaged is, through building an extensive collaborative network.
• 9:03
  - So we we have we have had a
• 9:04
  - behavioral health collaborative for several years within the
• 9:07
  - system, which has led to the right foundation
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  - to develop
• 9:11
  - a a more,
• 9:12
  - a robust behavioral service line structure.
• 9:16
  - So this collaborative invites active participation from every
• 9:19
  - single site. From there, we move up to
• 9:22
  - the market level in the system, and the
• 9:24
  - markets then report up to the region. So
• 9:26
  - it's so so we move up to the
• 9:28
  - market level where it's crucial to have our
• 9:30
  - clinical operations and strategy leaders at the table,
• 9:34
  - along with input from regulatory compliance, patient experience
• 9:37
  - teams, and other stakeholders,
• 9:40
  - that we have to work on, especially in
• 9:41
  - behavioral health. There's advocacy, there's,
• 9:45
  - philanthropy.
• 9:46
  - And this process helps us,
• 9:48
  - find that common ground across markets and regions
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  - as we look to develop,
• 9:53
  - you know, strategic,
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  - plans.
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  - We've also,
• 9:58
  - established,
• 9:59
  - operational work groups focusing on everything from ambulatory
• 10:04
  - care and inpatient services to patient experiences to
• 10:07
  - work,
• 10:08
  - in developing policies. So these work groups are
• 10:11
  - within the behavioral health service line,
• 10:14
  - and they also have participation from each of
• 10:16
  - the local sites where this work is relevant.
• 10:20
  - So once any of the initiatives
• 10:22
  - are worked on within these groups,
• 10:25
  - we bring it
• 10:26
  - for feedback,
• 10:27
  - to all our sites before anything is finalized,
• 10:30
  - but let it be,
• 10:33
  - you know, a a decision for
• 10:36
  - developing a new program or if it's a
• 10:37
  - new policy or if it's maybe a new
• 10:39
  - order sets within our electronic medical record.
• 10:43
  - One area that I'm really passionate about supporting
• 10:46
  - in
• 10:47
  - a in a more system wide strategy is
• 10:49
  - for community partnerships.
• 10:51
  - Right now, that's working well,
• 10:54
  - in patches, but perhaps it's not that uniform
• 10:56
  - or perhaps we've not had
• 10:59
  - the the resources to work on it. So
• 11:02
  - I was actually speaking with, one of our,
• 11:04
  - rural hospitals recently, and they had done such
• 11:07
  - a fantastic work collaborating with local psychiatric facilities
• 11:12
  - that, you know, when we sat down with
• 11:13
  - them to discuss how we could provide some
• 11:15
  - national support, it became clear that they only
• 11:18
  - had the right approach. They just needed the
• 11:20
  - validation.
• 11:21
  - That's exactly
• 11:23
  - the kind of practices that I'll lift up
• 11:24
  - and share across the rest of the organization
• 11:27
  - so that, you know, as we're building our
• 11:29
  - community partnerships, there's also focus on behavioral health,
• 11:32
  - which is so much
• 11:34
  - needed, especially when it comes to, you know,
• 11:37
  - know, any strategy to enhance access to care.
• 11:40
  - Mhmm.
• 11:41
  - And is there anything that you look for
• 11:43
  - specifically within these community partnerships?
• 11:46
  - How do you approach these conversations
• 11:48
  - and find that mutual understanding?
• 11:51
  - Well, I think,
• 11:53
  - if the
• 11:54
  - community partners are also looking to solve the
• 11:57
  - same problems that we are,
• 11:59
  - and if they have,
• 12:01
  - programs and services that fill the gaps,
• 12:04
  - then those conversations
• 12:06
  - become really easy.
• 12:08
  - Then it's really about a set of values,
• 12:11
  - you know, if if those align or not
• 12:13
  - and on where where does that count ground
• 12:15
  - where we can meet?
• 12:17
  - So
• 12:18
  - it's it's really about keeping the patient
• 12:21
  - in the center
• 12:22
  - and seeing what part of that patient's journey
• 12:25
  - can be enhanced
• 12:27
  - by that community partnership. That's at least what
• 12:29
  - I, look for the most.
• 12:32
  - Thank you so much. And
• 12:34
  - a huge focus in behavioral health and especially
• 12:37
  - for leaders has been behavioral health integration, and
• 12:40
  - it just remains a major priority across health
• 12:42
  - care in general. But operationalizing
• 12:45
  - it across inpatient,
• 12:47
  - outpatient, ambulatory
• 12:48
  - settings is often easier said than done.
• 12:51
  - How is CommonSphere approaching behavioral health integration today,
• 12:55
  - and what opportunities
• 12:57
  - do you see to strengthen
• 12:59
  - those connections between behavioral health, primary care, specialty
• 13:03
  - care, emergency departments, and acute care settings?
• 13:08
  - Yeah. I mean, I think this is going
• 13:09
  - to be a very
• 13:11
  - significant,
• 13:12
  - approach
• 13:13
  - for us, and it has been, in the
• 13:15
  - organization.
• 13:17
  - So I'll start with
• 13:19
  - perhaps go through clinical settings, and I can
• 13:21
  - start with when patients show up in our
• 13:23
  - our hospitals.
• 13:24
  - First, in the emergency departments,
• 13:27
  - several of our markets,
• 13:29
  - have done
• 13:30
  - really great work in building,
• 13:34
  - peer recovery coaches or substance use disorder navigators,
• 13:38
  - or community health workers,
• 13:40
  - embedded within the emergency
• 13:42
  - departments
• 13:44
  - to, you know, do the screening,
• 13:47
  - some interventions,
• 13:49
  - and, referral to treatment. We have,
• 13:53
  - also, in many of our markets, work with
• 13:55
  - our emergency medicine colleagues in
• 13:58
  - initiating, bridging treatment,
• 14:00
  - for substance use disorders, MAT,
• 14:03
  - and and other strategies. So that has been
• 14:06
  - a a focus of,
• 14:08
  - our system in many markets, and I certainly
• 14:10
  - want to,
• 14:12
  - enhance that.
• 14:13
  - Almost all hospitals have some kind of a
• 14:16
  - psychiatric
• 14:18
  - support,
• 14:19
  - whether it's in person or
• 14:22
  - or,
• 14:23
  - where our teleservices
• 14:25
  - or with our with our external partners in
• 14:27
  - bringing the psychiatry
• 14:29
  - into the,
• 14:31
  - physical health settings, whether it's ED or med
• 14:33
  - surg floors. And this is something
• 14:36
  - that I'm actively looking at at
• 14:38
  - at both the,
• 14:41
  - the strength of the work that is already
• 14:43
  - there and what needs to be enhanced,
• 14:46
  - and and how's the quality and and how
• 14:48
  - we are working on that. So this is,
• 14:51
  - something
• 14:52
  - that, the service line can really
• 14:54
  - deliver on.
• 14:56
  - There are,
• 14:58
  - many approaches on behavioral health integration beyond the,
• 15:03
  - acute care side as as you know
• 15:05
  - and and many of the listeners would know.
• 15:08
  - And we have, across the system,
• 15:10
  - use varying approaches depending on and this goes
• 15:13
  - back to, you know, what is centralized and
• 15:15
  - what is what can be standardized and what
• 15:17
  - needs to be local.
• 15:19
  - So there have been multiple approaches on behavioral
• 15:21
  - health integration
• 15:23
  - across the system.
• 15:25
  - Some of the pockets where we have medical
• 15:27
  - groups,
• 15:28
  - that have, you know, strong
• 15:30
  - outpatient
• 15:31
  - behavioral health presence,
• 15:33
  - and we do that in Pacific Northwest,
• 15:36
  - in California,
• 15:37
  - especially in Northern California markets. We are looking
• 15:40
  - to
• 15:41
  - use those resources to embed services
• 15:45
  - in our, medical practices and our subspecialty
• 15:48
  - practices.
• 15:50
  - In Arizona, we've built a collaborative care model,
• 15:53
  - by the book, and and, you know, we
• 15:55
  - use collaborative care billing. And,
• 15:57
  - and and that model is being expanded to
• 16:00
  - other, re
• 16:01
  - markets within that region.
• 16:04
  - Similarly, we built behavioral health embedded care model
• 16:06
  - virtually in Nebraska and Iowa markets.
• 16:09
  - So there have been different approaches and, all
• 16:12
  - good and all working, and we're looking to
• 16:15
  - to work on how to enhance that. We've
• 16:17
  - also worked with external partners
• 16:19
  - in building,
• 16:21
  - behavioral health integration, whether it is
• 16:24
  - just, you know, collaborative care or even specialty
• 16:27
  - care, like in eating disorders and other programs,
• 16:30
  - where we bring in behavioral health resources
• 16:33
  - with our external vendors into our,
• 16:36
  - primary care site.
• 16:38
  - So it's a long winded answer, but it
• 16:39
  - is,
• 16:40
  - basically an all of the above approach.
• 16:43
  - But an important approach,
• 16:45
  - of improving access, improving,
• 16:48
  - behavioral health
• 16:50
  - care, and and one that will be central
• 16:51
  - to our service line strategy.
• 16:54
  - Yes. Well, thank you. I know integration is
• 16:56
  - a very complex,
• 16:58
  - question to answer and navigating, so I appreciate
• 17:01
  - you taking that question on. And
• 17:03
  - speaking of integration,
• 17:05
  - I'd love to know more about how Commisphere
• 17:08
  - is approaching
• 17:09
  - substance use disorder care
• 17:11
  - across the nation.
• 17:13
  - Yeah.
• 17:14
  - So I,
• 17:16
  - spoke about I work with peer recovery coaches
• 17:19
  - and SUD navigators, which primarily, you know, was
• 17:23
  - done in California where we
• 17:25
  - all of our hospitals,
• 17:26
  - almost in California, and I believe we have
• 17:28
  - 27, 28 hospitals in California,
• 17:30
  - where we, brought in substance use disorder navigators.
• 17:34
  - And we've had a really,
• 17:37
  - strong champion
• 17:38
  - in that,
• 17:39
  - region,
• 17:40
  - from our emergency medicine services.
• 17:44
  - And that physician,
• 17:45
  - has, worked a lot in
• 17:47
  - bridging care,
• 17:49
  - to these, patients. That program has been going
• 17:52
  - on more than five years now.
• 17:54
  - We've also done other work in our mountain
• 17:56
  - region
• 17:57
  - in, which is, you know, primarily Colorado, Utah,
• 18:02
  - and Kansas markets where we have,
• 18:04
  - worked on enhancing
• 18:06
  - MAT,
• 18:07
  - in acute care settings. So we're really proud
• 18:10
  - of that work, and we're looking to expand
• 18:12
  - that further.
• 18:14
  - We do not do a lot of substance
• 18:16
  - use disorder on the acute care side as
• 18:19
  - such,
• 18:19
  - except for in couple
• 18:21
  - of couple of our markets.
• 18:24
  - But,
• 18:24
  - there is a lot of substance use disorder
• 18:26
  - that we see obviously across the system
• 18:29
  - as as comorbid conditions in our acute care
• 18:32
  - facilities.
• 18:34
  - You know, one of the things that I'm
• 18:35
  - really proud of, that the system has done
• 18:37
  - is, working on an anti stigma campaign.
• 18:41
  - We have done,
• 18:43
  - and it's not been a one approach. There
• 18:45
  - have been several approaches. We've done a lot
• 18:47
  - of educational work. We've done
• 18:50
  - awareness
• 18:52
  - campaigns, including, you know, some short form videos,
• 18:55
  - some
• 18:56
  - CME,
• 18:58
  - grade, trainings,
• 19:00
  - that are available
• 19:01
  - for,
• 19:02
  - folks who are interested.
• 19:04
  - And we've also collaborated with,
• 19:07
  - EHA,
• 19:08
  - on their anti stigma campaign for broader mental
• 19:11
  - health issues.
• 19:13
  - And and,
• 19:14
  - so those those things have really been very
• 19:17
  - helpful working just internally within the organization
• 19:20
  - to
• 19:21
  - to attack,
• 19:23
  - you know, stigma related to substance use disorders.
• 19:27
  - I think this will be a significant,
• 19:30
  - strategy again for for our service line to
• 19:32
  - work and,
• 19:33
  - you know, to support
• 19:35
  - the good work that has gone on in
• 19:37
  - some several of our markets and bringing that
• 19:39
  - to the rest of the system.
• 19:42
  - So a lot to be still done, but
• 19:44
  - I'm very happy with what I've seen, has
• 19:46
  - been done so far.
• 19:48
  - Wonderful. And I think that's a perfect transition
• 19:50
  - into our next question of where are the
• 19:52
  - biggest growth opportunities that you're seeing in behavioral
• 19:55
  - health services over the next several years?
• 19:58
  - Yeah. I mean, well, the biggest opportunity for
• 20:01
  - growth are really in filling the gaps that
• 20:03
  - exist in our continuum of care.
• 20:05
  - You know, whether that's expanding access to comprehensive
• 20:08
  - care in the EDs like we talked about,
• 20:10
  - building care navigation
• 20:12
  - transfers at at Southern markets. The other places
• 20:14
  - might be, you know, building integrated care,
• 20:18
  - and, expanding integrated care, if it already exists,
• 20:24
  - improving the quality of services,
• 20:27
  - that we are able to provide,
• 20:28
  - on our, med surge floors.
• 20:31
  - And I'm also working with other other
• 20:33
  - service lines.
• 20:36
  - Wisconsin Spirit has a great, women's and infant
• 20:38
  - service line. We're working a lot on perinatal
• 20:41
  - mental health and how, we know we're doing
• 20:43
  - great work in screening
• 20:45
  - now for perinatal care, but also now working
• 20:48
  - on,
• 20:49
  - with our OB GYN colleagues,
• 20:51
  - to build integrated care.
• 20:54
  - So that'll be a new initiative,
• 20:56
  - that we'll work on, but that's a great
• 20:58
  - area
• 20:59
  - of opportunity
• 21:00
  - just to give you an example.
• 21:02
  - And then,
• 21:04
  - you know, we're not above the financial realities
• 21:06
  - and regulatory environment.
• 21:08
  - So, you know, things that that are,
• 21:11
  - just anyways barriers to grow behavioral health. But
• 21:13
  - I think the our approach will have to
• 21:15
  - be innovative.
• 21:17
  - We'll focus on, you know, disseminating the psychiatric,
• 21:20
  - the behavioral health expertise,
• 21:23
  - any way we can. We talked a lot
• 21:24
  - about, you know, for example,
• 21:27
  - integration,
• 21:28
  - which is a great way of doing that.
• 21:31
  - And where there'll be a lot of focus
• 21:33
  - on really on efficiency and improving,
• 21:36
  - quality of care. And,
• 21:39
  - these,
• 21:40
  - approaches
• 21:41
  - are are, you know, all an opportunity to
• 21:44
  - build a better behavioral health care
• 21:47
  - culture.
• 21:48
  - We're also looking,
• 21:49
  - to create that internal infrastructure so that,
• 21:53
  - various parts of the organization can get quick
• 21:55
  - consultation
• 21:56
  - on, you know, any strategic program they wanna
• 21:59
  - grow or any quality improvement efforts they wanna
• 22:02
  - take on or any technology related to behavioral
• 22:05
  - health that they wanna bring on.
• 22:07
  - So I that will be another area
• 22:10
  - for the service line to work on.
• 22:13
  - We're looking at our payer strategy and opportunities
• 22:16
  - there. I'm working closely with our, you know,
• 22:18
  - population health, organization to seeing opportunities
• 22:21
  - where value based care,
• 22:23
  - which could be,
• 22:25
  - especially,
• 22:26
  - you know,
• 22:27
  - a great opportunity for behavioral health to grow,
• 22:30
  - especially in areas of care,
• 22:32
  - coordination, care management,
• 22:34
  - and treating patients with,
• 22:36
  - severe mental illness,
• 22:38
  - also in primary care and
• 22:41
  - integrated care. So I think pop health will
• 22:43
  - be a significant,
• 22:45
  - area of, focus for the behavioral health service
• 22:48
  - line.
• 22:49
  - So, yeah, I hope,
• 22:50
  - it's given you a good good view of,
• 22:52
  - like, where there are some of those opportunities
• 22:55
  - exist. But, yeah, I mean, if the central
• 22:57
  - thing is to be innovative and and look
• 22:59
  - at areas which really improve our efficiency.
• 23:03
  - Well, wonderful.
• 23:05
  - Doctor Sopra, thank you so much for joining
• 23:07
  - us and sharing your insights on common spirit
• 23:09
  - health, behavioral health strategy and transformation efforts.
• 23:13
  - And thank you to our listeners for tuning
• 23:15
  - into Becker's Behavioral Health Podcast. We'll see you
• 23:17
  - next time.
• 23:19
  - Great. Thank you.