Latest / Becker's Healthcare Behavioral Health / From Siloed to Seamless: Reimagining Behavioral Health with evolvedMD

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From Siloed to Seamless: Reimagining Behavioral Health with evolvedMD · Becker's Healthcare Behavioral Health

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  Hello, everyone. This is Jacob Emerson with the
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  Becker's Health Care podcast.
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  Thanks so much for tuning in today where
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  we're gonna be talking about how to bridge
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  the gap and expand behavioral health access through
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  collaborative care. Joining me for today's discussion is
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  Steve Biljohn, who's the chief commercial officer at
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  EvolveMD.
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  Steve, thank you so much for taking the
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  time to be with me on the podcast
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  today. Yeah. Hey, Jacob. Thanks for having me.
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  Absolutely. And, Steve, before we dive in everything
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  we wanna talk with you about, can you
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  tell us a little bit more about your
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  background in health care and what it is
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  that you do today at EvolveMD?
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  Yeah. So background in health care, I spent
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  years developing national growth strategies for a medical
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  device company,
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  about ten years. And
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  through that, you know, towards the end of
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  my journey there, I really kind of came
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  out across behavioral health as a consumer, as
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  a person for the first time. So dealing
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  with grief, depression, burnout,
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  some trauma resurfacing from childhood.
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  And at that point, like, having had to
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  suddenly, like, try to access behavioral health through
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  my own journey really kind of helped solidify
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  the desire to get involved more in this
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  in this category.
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  My cofounder,
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  similar sorts of stories for him. We used
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  to work together at a medical device company.
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  And after I left that company, he said,
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  hey. I've got this idea. What do you
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  think? And this was back in 2016.
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  And because of my personal journey, was like,
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  yeah. It's very clear that,
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  you know, when I interacted with primary care,
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  I never got screened for depression. Nobody ever
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  asked anything.
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  When I tried to find some behavioral health
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  resources at the time, it was really challenging
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  as it I'm sure most people know
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  access to care is challenging. So that really,
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  inspired me alongside my cofounder to fund EvolvedMD.
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  That's fantastic. So this is both professional and
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  a personal issue for you. Yeah. Of course.
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  Yeah. Let me let me read you a
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  stat, Steve, and I wanna get your take
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  on it. One in five US adults are
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  experiencing mental illness each year.
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  So we know the behavioral health needs across
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  the country. They're intensifying. The need is growing.
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  So talk to us about why you personally
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  why EvolvedMD
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  believes that it is so important to integrate
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  behavioral health services in a primary care, and
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  what you think some of the key benefits
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  are for organizations, and then, of course, patients
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  themselves. Yeah. I mean, primary care really is
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  the front door to mental health. So many
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  symptoms of, say, something like depression or anxiety,
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  they really manifest themselves physically,
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  whether that's racing heart,
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  trouble sleeping,
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  eating changes,
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  lots of different things that, like, spur somebody
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  to show up at their primary care.
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  Depending on the research you wanna believe, there
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  might be somewhere between one half to two
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  thirds of all primary care visits are actually
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  behavioral in nature.
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  Not to mention kind of a really
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  heart wrenching one is suicide. So
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  fifty percent of patients who die by suicide
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  see their PCP within thirty days. And so
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  there's a huge, you know, clinical and heart
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  piece around why integrate behavioral health in the
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  primary care. There's also all these other ancillary
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  effects around
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  provider recruitment and retention,
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  staff burnout and moral injury,
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  a ton of, you know, consumer brand awareness.
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  There's a lot of reasons to integrate behavioral
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  health into primary care. Absolutely. No. It makes
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  complete sense. And, you know, one thing that's
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  really been shown to improve outcomes across a
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  range of conditions,
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  as you know, is collaborative care. I wonder
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  if you could share any data or results
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  that really stand out to you in terms
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  of, supporting
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  that thought.
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  Yeah. Collaborative care has been, you know, heavily
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  researched, more than a 100 randomized control trials.
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  It's been reviewed by Cochrane.
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  Milliman's reported on it extensively
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  for the years. You know, recently, we completed
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  an engagement with the actuarial consulting team at
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  Optum Advisory
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  and found some really great results.
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  Patients that are seen by EvolvedMD collaborative care
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  are ten percent less likely to have a
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  psychiatric inpatient admission.
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  They utilize
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  fifteen percent fewer
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  psychiatric outpatient
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  visits.
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  They're also riskier
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  and more complex than your traditional behavioral health
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  patient.
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  We see
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  more prevalence of chronic comorbidities
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  like cardiovascular
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  disease or depression.
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  Those are also higher on their complexity, and
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  we have better outcomes not just on dealing
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  with their behavioral health
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  compared to, say, traditional behavioral health, but we
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  have better outcomes on cardiovascular
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  disease management, better outcomes on diabetes.
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  All told, when you add it up, it's
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  a total cost of care savings that Optimum
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  Advisory has found for EvolveMD
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  of plus 15%,
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  lower than traditional behavioral health. So a 15%
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  savings.
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  It's amazing some amazing stats you just quoted
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  for us as well. And I wonder any
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  other specific
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  on the ground examples you can share in
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  terms of illustrating the impact of this model
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  in action?
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  Yeah. I mean, EvolveMD is in five states,
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  contracted with more than 1,700 primary care providers,
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  and we're not the only ones that do
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  collaborative care. Sure. Penn Medicine has a really
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  robust program. It's been well researched with Independence
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  Blue Cross Blue Shield.
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  Kaiser has been doing integrated behavior. I've been
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  doing collaborative care and integrated behavioral health for
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  a long time. That's also been well researched.
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  I would advise people, like, they're curious about
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  some of this stuff, go to the Bowman
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  Family Foundation, and they have a lot of
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  this, compiled in an issue brief. So it's
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  not you know, we're not unique and alone.
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  There's a lot of health systems and medical
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  groups that are tackling this. Absolutely.
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  You know, we're hearing a lot from behavioral
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  health leaders this week, Steve, here live at
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  our behavioral health summit of, the the key
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  barriers that are really keeping collaborative care from
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  from taking off within certain health care systems
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  or or within clinics. So I wonder, you
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  know, what do you think some of those
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  are? And, ultimately, what's needed to really keep
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  the momentum going across the the health care
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  system?
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  Yeah. You know, I think that the the
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  main barriers that we seem to come across
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  are there's two, I would say, structural in
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  the sense that we have a health care
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  system that bifurcates
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  behavioral health separate from medical, kinda starting at
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  the payer level, which that means you've got
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  different networks to navigate, different benefits. And so
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  behavioral health as a delivery model has sort
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  of bifurcated as well.
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  There are some payers that are doing a
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  lot of great things to try to, like,
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  bring in and combine
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  the two together. Great efforts by, like, doctor
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  Caroline Carney from Magellan, doctor Mike Franz from
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  Cambia.
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  So I think that's, like, a big challenge
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  of trying to, like,
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  talk to one person, if you will, or
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  division, one p and l on their side
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  who's looking at things at a total cost
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  care whole person perspective.
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  And the other big barrier is just change.
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  You know, changing how you practice medicine is
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  easier said than done. And habits,
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  ways of of acting, and I think collaborative
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  care, while really great and really the best
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  way to deliver behavioral health, it does require
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  change, and it's a team based approach. And
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  sometimes when you have providers
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  of services, whether it's behavioral health or medical
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  that are used to being
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  independent, if you will, having to work and
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  collaborate together as a team can be a
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  bit of a cultural change. And so structurally
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  and culturally are kind of the biggest barriers,
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  but they are definitely one concern about them.
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  Absolutely. And that really backs up what we've
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  been hearing from leaders this week, getting the
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  system out of its old ways and and
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  reimbursement challenges. Yeah.
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  What else are we missing, Steve? Steve? I
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  mean, you've got the ears of a lot
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  of behavioral and and health system leaders right
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  now from all over the country. What else
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  do you wanna tell them? What what do
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  they need to know about, navigating this space
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  right now? Yeah. I'd say collaborative care as
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  a model is highly viable to do. It's
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  highly efficacious.
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  There's a lot of momentum legislatively at the
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  federal level and in a lot of different
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  states to to do this model. And I
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  would just say, doing something is better than
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  nothing when it comes to behavioral health. But
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  the benefit of collaborative care, you know, when
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  you think about thirty percent of of Americans,
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  I know your statistic was 20 looking inside
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  of Arizona and
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  also in some other states. You know, payers
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  are saying it's thirty percent of patients
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  that are utilizing behavioral health services.
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  And if you have an approach that combines
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  behavioral and medical and it saves 15%
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  on total cost of care for thirty percent
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  of a panel, I mean, that's significant.
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  So I would say if you haven't started
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  the journey yet, start the journey. If you're
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  on the journey,
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  end at full integration, team based, on-site,
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  in person, plus hybrid virtual,
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  to deliver it. Fantastic. Well, I think those
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  are some great parting words, some great last
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  piece of advice. So, Steve, I wanna thank
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  you for taking the time to sit down
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  with us and for sharing your insights with
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  our audience. Yeah. Really appreciate it. Thank you,
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  Jacob. I also would like to thank our
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  podcast sponsor, EvolvedMD.
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  You can tune into more podcasts from Becker's
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  Healthcare by visiting our podcast page at beckershospitalreview.com.