Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Stanley Williams, Director of Integrated Health at The Harris Center for Mental Health

Transcript

Dr. Stanley Williams, Director of Integrated Health at The Harris Center for Mental Health · Becker’s Healthcare - Clinical Leadership Podcast

• 0:05
  - This is the Becker's Healthcare Podcast, created
• 0:07
  by the team of Becker's Healthcare,
• 0:08
  a multimedia company devoted to the people
• 0:10
  who power us healthcare.
• 0:11
  Four new 15 minute episodes are released daily containing
• 0:14
  industry news analysis and thought leadership.
• 0:16
  From powerful healthcare decision makers Support our show
• 0:19
  by leaving it a five star rating and review on Apple Podcast
• 0:22
  or other platforms you use.
• 0:24
  It's a chance to tell us what you like about the show
• 0:26
  and act on your feedback.
• 0:27
  Thanks for listening. Now here's the episode.
• 0:30
  - Welcome everyone,
• 0:31
  to the Becker's Healthcare podcast series.
• 0:33
  I'm Mariah Mohammed, writer
• 0:34
  and moderator with Becker's Healthcare,
• 0:36
  and I'm absolutely thrilled to have
• 0:38
  with me today Dr. Stanley Williams, director
• 0:40
  of Integrative Health at the Hair Center
• 0:42
  for Mental Health Houston.
• 0:44
  Dr. Williams, it's very nice
• 0:45
  to have you on the podcast today.
• 0:47
  To get us started, would you mind please introducing
• 0:49
  yourself and telling us a bit about your background?
• 0:52
  - Yes. Um, I'm very excited to be here, um, on, on this call
• 0:56
  with you, Mariah, Dr. Stanley Williams.
• 0:58
  I have a PhD in psychology, a master's in counseling,
• 1:01
  a bachelor's in healthcare management.
• 1:04
  I worked in, um, different places like Georgia.
• 1:07
  I worked with the Carter Center,
• 1:09
  with the Georgia Association Primary Health Centers.
• 1:12
  I was facilitating, uh, integrated health
• 1:15
  with the FKC partners with mental health centers.
• 1:18
  Um, I've worked in mental health, both private and public
• 1:21
  and also private practice.
• 1:23
  Also teach and, um, you know, see myself sort of
• 1:26
  as a thought leader in senior management
• 1:29
  and developing integrated systems of care.
• 1:34
  - Perfect. Thank you so much for giving us that background.
• 1:37
  So to jump right into our conversation today,
• 1:40
  you hear a lot about value-based care when it comes
• 1:43
  to hospitals, but can you provide an overview for us
• 1:46
  as it relates to community-based behavioral health?
• 1:50
  - Yeah, a that's, that's a really good question, Ryan.
• 1:53
  So when you think about, um, you know, uh,
• 1:56
  community mental health, uh,
• 1:58
  community behavioral health services, um, a lot of, a lot
• 2:02
  of those facilities operate, um, from a fee for service, uh,
• 2:06
  kind of a traditional payment model
• 2:08
  where the providers are reimbursed
• 2:10
  for each individual served, uh, they deliver,
• 2:13
  uh, to a patient.
• 2:15
  And so, uh, under that construct, um, the, uh,
• 2:19
  provider received payment based on the, uh, quantity
• 2:22
  of services rendered, um, not necessarily based on quality
• 2:26
  or outcomes achieved.
• 2:27
  And even though a lot of like, um, state organizations
• 2:31
  or semi-state organizations, um, uh, we, we have a contract
• 2:36
  with the, uh, state of Texas
• 2:38
  and, uh, we have some additional outcomes.
• 2:40
  But for the most part, traditional models really just, um,
• 2:44
  are based on that fee for service model.
• 2:46
  Um, associated quantity of services.
• 2:49
  Now, uh, compare that to value based, um, care.
• 2:52
  Uh, it's a payment model that focuses more on achieving, um,
• 2:56
  better outcomes for the patient.
• 2:58
  And so, you know, you're looking at different types
• 3:00
  of measures, uh, to try to get certain points.
• 3:03
  A lot of times the value-based care is connected
• 3:06
  with a managed care company in terms of a partner,
• 3:09
  and, um, you're really focused on, um, uh, quality of care.
• 3:15
  - Wonderful. Thank you so much for giving us that insight.
• 3:19
  Um, the discussion mentions the, the challenges in, uh,
• 3:22
  transitioning from a fee for service model to value, uh,
• 3:26
  value-based model.
• 3:28
  Can you elaborate on these challenges
• 3:30
  and how healthcare organizations
• 3:31
  can address them effectively?
• 3:35
  - Yes. Um, so when you, when you think about, um,
• 3:38
  transitioning to, um, from a fee for service
• 3:41
  to a value-based model, there's some real, um, you know,
• 3:46
  serious challenges I think, um,
• 3:48
  within traditional mental health centers.
• 3:50
  When you think about, um, do you have a, you know,
• 3:54
  change in management capacity?
• 3:56
  And that's a whole methodology of
• 3:59
  how do you move an organization, um, from doing one type
• 4:03
  of service and, um, transforming them to a different type
• 4:06
  of way of delivering services, as I explained earlier,
• 4:09
  from fees, uh, fee for service versus value-based care.
• 4:14
  And, um, and that creates some real challenges.
• 4:16
  Uh, for instance, like, um, you know,
• 4:20
  in traditional models, um, they may not look at claims data
• 4:25
  or population health, um, kind of management
• 4:28
  where you look at populations.
• 4:30
  And a lot of that has to do with another challenge
• 4:32
  of not having access to, uh, data.
• 4:35
  Um, oftentimes the data is really related to, um, you know,
• 4:40
  people served the diagnosis and so forth.
• 4:43
  It may not get into, um, data such as claims data,
• 4:47
  which a lot of mental health centers may not have access to.
• 4:50
  And that's where managed care companies come in
• 4:53
  where they can help support that to be able
• 4:55
  to provide claims data and a partnership, um,
• 4:58
  because that's actionable data.
• 5:00
  So if a person, uh, was not, um, taking their medications,
• 5:04
  you'll know through the claims data
• 5:06
  if they didn't get a refill.
• 5:07
  That's a good example for that.
• 5:09
  And so there's some other challenges associated with it is
• 5:12
  where traditional mental health centers have maybe looked at
• 5:16
  just pathology or,
• 5:17
  or, um, diagnosis in terms of mental illness,
• 5:22
  and they may not look at a whole care approach, uh, to begin
• 5:25
  to look at, um, non-medical drivers
• 5:28
  or social determinants of health, um, that actually impact,
• 5:32
  uh, overall wellness.
• 5:35
  - Got it. Got it. Thank you so much for explaining that.
• 5:38
  Um, switching over a little bit, the partnership
• 5:41
  between the Harris Center
• 5:42
  and Optum is highlighted as a very successful example
• 5:46
  of collaboration revolutionizing behavioral healthcare, um,
• 5:50
  which is absolutely amazing.
• 5:52
  What specific strategies
• 5:53
  or tools have contributed
• 5:55
  to the success of this partnership?
• 5:57
  - I think a big part of that is understanding our why and,
• 6:00
  and we actually worked with, uh,
• 6:03
  Optum on understanding the why.
• 6:05
  And, uh, for example, the National Association
• 6:08
  of State Mental Health Program directors has some, some
• 6:13
  fascinating data out that talks about that people
• 6:15
  with s severe
• 6:17
  or serious mental illness died 25 years earlier than
• 6:20
  the general population.
• 6:21
  Um, and two thirds of that premature deaths are due
• 6:24
  to preventable, treatable medical conditions
• 6:27
  that are underserved
• 6:29
  or undertreated by this population, uh, related to, uh,
• 6:33
  cardiovascular or infectious diseases.
• 6:36
  Diseases. A number
• 6:37
  of this population have real challenges also
• 6:40
  with like high blood pressure, VMI and so forth.
• 6:44
  And so sitting down with, um, with Optum, we were able
• 6:48
  to kinda look at some of that data.
• 6:50
  Uh, for instance, folks with, um, like arthritis or asthma.
• 6:55
  Um, you know, when you look at their annual cost of care,
• 6:59
  um, if you add a mental health condition, it, um,
• 7:04
  multiplies, um, sometimes triples
• 7:05
  in terms of the cost of care.
• 7:07
  Um, sometimes the mental health centers may
• 7:10
  not even look at that.
• 7:12
  And so in our conversations with Optum, we also
• 7:16
  recognize that is is a, um, a patient experience challenge.
• 7:22
  You know, when you think about having to go to the hospital,
• 7:25
  um, where you don't have to go to the hospital, if you sort
• 7:28
  of do these kind of upstream models
• 7:31
  and looking at social determinants.
• 7:33
  So talking with, um, Optum,
• 7:38
  they kinda shared with us this model
• 7:39
  that actually came from the Affordable Care Act.
• 7:42
  Um, it talks about, uh, behavioral health homes.
• 7:45
  And so that's kind of the model that we developed with them
• 7:48
  of a behavioral health model, um,
• 7:51
  through a kind of a health home.
• 7:53
  And within the health home we look at
• 7:55
  these different measures.
• 7:57
  Some of those measures include what we call,
• 7:59
  um, HEDIS measures.
• 8:00
  Those are healthcare effectiveness data, uh,
• 8:03
  and information sets.
• 8:04
  And so you look at things like seven day
• 8:07
  and 30 day follow up at the hospital, um,
• 8:10
  all cause readmissions.
• 8:11
  Uh, it means that you do a up upstream kind
• 8:15
  of diabetes screening, uh, on people with schizophrenia
• 8:18
  and all those kind of things helps us
• 8:21
  to improve the overall wellness with the individual.
• 8:24
  And, um, so that's been very important for us to, to be able
• 8:28
  to have access to data through, uh, through Optum's, uh,
• 8:32
  portal that gives us that claims data to see
• 8:35
  where people are at in their overall care.
• 8:38
  And then we dispatch our care navigators, which we had
• 8:41
  to train differently, uh, to be able
• 8:43
  to have some actionable data, um,
• 8:46
  and actually look at care Pathways
• 8:49
  to actually improve that data.
• 8:53
  - Got it. Got it. Thank you so much for explaining that.
• 8:56
  And you know, you emphasized the importance
• 8:58
  of addressing social, um, determinants
• 9:01
  of health and value-based care.
• 9:03
  Can you share examples of
• 9:04
  how this approach has positively impacted
• 9:07
  patient outcomes and behavioral health?
• 9:09
  - Yeah, so social determinants of health
• 9:11
  and in Texas we call 'em non-medical drivers.
• 9:14
  Um, there was some research that came out that said that,
• 9:17
  um, these factors actually, um, you know,
• 9:22
  impact overall wellness
• 9:24
  and is one of the main reasons for, uh,
• 9:27
  poor health status for folks.
• 9:29
  And, and when you think about these drivers of poor health,
• 9:32
  these are kind
• 9:33
  of everyday kinda lived experiences that we have.
• 9:37
  Like for instance, do we have transportation
• 9:40
  to go from point A to point B?
• 9:41
  Well, you know, folks, um, with poor, um, access
• 9:46
  to care, uh, means that they don't meet with their provider,
• 9:50
  uh, either primary care or behavioral health.
• 9:53
  Um, that means they don't get their medication refills.
• 9:56
  That means that their conditions get poor.
• 9:59
  Um, also a big area when you look at, um, these determinants
• 10:03
  has to do like with food insecurity.
• 10:05
  So we found out a lot of our clients, um, don't have access
• 10:10
  to, um, high quality food, you know, um,
• 10:14
  vegetables and so forth.
• 10:16
  And some actually live in food deserts, you know,
• 10:19
  where there's only convenience stores that have, um,
• 10:23
  you know, food that would has high as sodium
• 10:25
  or sugar content in it.
• 10:27
  And folks will gain weight, uh, from that.
• 10:30
  Well, when you think about taking a psychiatric medication,
• 10:33
  um, sometimes those psychotropic medications
• 10:37
  actually increase your weight.
• 10:38
  Um, you add on top of that sodium
• 10:40
  and you know, foods with high sugar content, um,
• 10:45
  and then you're gonna actually gain either more weight, um,
• 10:49
  or it's gonna affect things like your blood pressure
• 10:51
  and, uh, your overall BMI.
• 10:54
  And so these types of things that actually have impacted,
• 10:58
  um, you know, folks with mental health conditions, it's one
• 11:01
  of the reasons why they die earlier than a than
• 11:04
  a general population.
• 11:06
  And so for us, we wanna be able
• 11:07
  to look at a whole care approach,
• 11:09
  not just a specialty care approach
• 11:11
  of just looking at the diagnosis
• 11:13
  or deal with the pathology of mental illness.
• 11:18
  - Thank you so much for giving us that insight.
• 11:20
  And Doctor, before I let you go, the last thing I wanted
• 11:22
  to ask you is looking ahead,
• 11:25
  what do you believe are the key steps
• 11:27
  and considerations for healthcare providers
• 11:29
  and organizations really looking
• 11:31
  to fully embrace an integrated health approach
• 11:34
  to value-based care, um, in the behavioral health sector?
• 11:39
  - Yes, Mariah,
• 11:40
  that's a a really good question about looking ahead.
• 11:42
  I I believe that, um, yes, to know your why, I,
• 11:46
  I think you have to take a step back and as an organization
• 11:49
  and look at, do we want to do just specialty care, uh,
• 11:53
  knowing that, uh, our population with severe, uh,
• 11:57
  mental illness died 25 years, um,
• 11:59
  earlier than the general population
• 12:01
  because of untreated health conditions,
• 12:03
  or you wanna do kind of this whole care approach.
• 12:06
  And so that's your why.
• 12:07
  And then looking at some of the data
• 12:08
  that I had mentioned earlier, um, what it means also is
• 12:12
  that you have the capacity for change management.
• 12:14
  Are you able to work with your team and identify champions
• 12:18
  and create care pathways, um, that are associated with those
• 12:22
  ADIs measures and being able to look at, um, the client
• 12:27
  satisfaction in terms of are they improving their condition?
• 12:31
  Um, do they feel like it's a better situation for them?
• 12:34
  Um, in addition to retaining, um, retraining the, um,
• 12:38
  the care coordinators, um, you have to have kind of the,
• 12:42
  that methodology of looking at data
• 12:44
  and being able to make, um, decisions,
• 12:47
  clinical decisions based on data, um, associated with,
• 12:52
  um, what you're able to get through a,
• 12:54
  a portal like we were able to get from, uh, from Optum
• 12:58
  to be able to look at are they actually improving?
• 13:01
  And then when you identify some of those risks, uh,
• 13:03
  are you able to dispatch your team, uh, to begin
• 13:07
  to look at things related to health coaching, begin
• 13:10
  to address those gaps in social determinants
• 13:13
  and lowering those non-medical drivers.
• 13:17
  Um, are you able to do kind of
• 13:18
  that integrated care management approach, um,
• 13:22
  and incorporating a whole care approach to individuals.
• 13:28
  - Thank you so much, doctor, for your final thoughts
• 13:30
  and for your time today.
• 13:32
  This has definitely been an amazing
• 13:34
  and informative, informative discussion.
• 13:36
  So again, I wanna thank you so much
• 13:37
  for coming on Beckers Healthcare
• 13:39
  and I look forward to connecting with you again soon.
• 13:42
  - Thank you so much. Thank you for having me.
• 13:44
  - Yes, absolutely. - It's so important
• 13:47
  for leaders at the top of organizations to keep learning,
• 13:50
  stay sharp, grow their networks
• 13:52
  to help our audience better do this in a more simplified,
• 13:54
  personalized, and meaningful way.
• 13:57
  Becker's Healthcare has launched my BHC,
• 14:00
  it's your trusted Becker's healthcare experience
• 14:01
  and more with content, connections, events
• 14:04
  and learning opportunities.
• 14:06
  Join the community free of charge at
• 14:08
  www.my.beckerhospitalreview.com and we'll see you there.