Latest / Becker’s Payer Issues Podcast / Building the Behavioral Health Workforce and Expanding Access to Recovery Care with Matthew Hurford

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Building the Behavioral Health Workforce and Expanding Access to Recovery Care with Matthew Hurford · Becker’s Payer Issues Podcast

• 0:02
  - GLP ones, Medicare Advantage Headwinds, a Medicaid landscape
• 0:06
  - that looks different
• 0:07
  - every quarter.
• 0:09
  - Their leadership right now means making durable decisions
• 0:11
  - in an environment that keeps moving, and the
• 0:13
  - organizations pulling ahead are the ones that stopped
• 0:16
  - waiting for stability
• 0:18
  - before acting.
• 0:19
  - Becker's fifth annual fall payer issues roundtable convenes
• 0:22
  - more than 500
• 0:24
  - executive level attendees
• 0:25
  - and 70 plus speakers November second and third
• 0:28
  - at the Swiss Hotel Chicago.
• 0:30
  - Two days of senior level dialogue on affordability,
• 0:33
  - benefit design, value based care, and the strategies
• 0:36
  - shaping how care gets financed
• 0:39
  - and delivered, featuring a celebrity keynote from pro
• 0:43
  - football hall of famer, Emmitt Smith. Agenda and
• 0:46
  - registration at beckerspayer.com.
• 0:48
  - Click events in the upper right.
• 0:50
  - Hello, everyone. This is Jacob Emerson with the
• 0:53
  - Becker's Behavioral Health podcast.
• 0:55
  - Thrilled today to be joined by doctor Matthew
• 0:57
  - Hereford from UPMC.
• 0:59
  - Doctor Hereford, thank you so much for taking
• 1:00
  - the time to be with me on the
• 1:02
  - podcast again. Thank you very much, Jacob. It's
• 1:04
  - great to be back with you. Likewise. And
• 1:07
  - before we dive into everything we wanna talk
• 1:09
  - with you about,
• 1:10
  - hopefully, to get some updates on some initiatives,
• 1:13
  - going on under your leadership at UPMC,
• 1:15
  - can you first,
• 1:16
  - tell our audience a little bit more about
• 1:19
  - yourself
• 1:19
  - and
• 1:20
  - a little bit about your roles at UPMC
• 1:23
  - today?
• 1:24
  - Sure. Happy to. So I'm Matt Hereford. I'm
• 1:27
  - the president and CEO of Community Care Behavioral
• 1:30
  - Health at UPMC.
• 1:32
  - That's a
• 1:33
  - Medicaid behavioral health managed care organization,
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  - that works across Pennsylvania
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  - to support the wellness and recovery of over
• 1:42
  - a million
• 1:42
  - Medicaid beneficiaries.
• 1:44
  - And I also serve as the vice president
• 1:46
  - of behavioral health for UPNC insurance services division.
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  - So I work across
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  - commercial, Medicare, and our other lines of business
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  - to provide strategic leadership around behavioral health.
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  - Psychiatrist by training and have been with the
• 2:01
  - organization for over ten years.
• 2:04
  - Wonderful. Appreciate that intro there, Matt. And,
• 2:07
  - I was hoping to get an update from
• 2:09
  - you,
• 2:10
  - about how UPMC Health Plan and Community Care
• 2:14
  - have been expanding your work recently,
• 2:16
  - with youth mental health clubs in your area.
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  - As I understand that you're you're working with
• 2:21
  - them to help build a future behavioral health
• 2:23
  - workforce.
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  - So can you can you tell that for
• 2:27
  - us a little bit more how UPMC is
• 2:29
  - thinking about
• 2:30
  - workforce development as a as a business strategy
• 2:33
  - right now, and any other new updates there?
• 2:36
  - Absolutely. And I'm really excited about this work
• 2:40
  - and our opportunity
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  - to
• 2:42
  - partner with, schools, training programs, and community organizations,
• 2:47
  - to help build a robust and vibrant pipeline
• 2:50
  - for behavioral health workforce in the future.
• 2:53
  - But before delving in, I
• 2:55
  - wanna start with some sobering statistics that I
• 2:58
  - think for us at EPMC
• 3:00
  - really drive the urgency around why this is
• 3:03
  - such a critically important investment to be making
• 3:06
  - in the field. So if we we look
• 3:09
  - at the health resources and services administration,
• 3:12
  - the HRSA, the federal level,
• 3:14
  - their projections
• 3:16
  - are that by the year 2035,
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  - The United States is gonna be short,
• 3:21
  - somewhere between a hundred and twenty and two
• 3:22
  - hundred thousand mental health counselors,
• 3:25
  - short about 90 to a 120,000
• 3:28
  - substance use disorder counselors.
• 3:31
  - In terms of psychiatrists,
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  - looking at a shortfall of somewhere between forty
• 3:35
  - five and eighty five thousand.
• 3:37
  - And on the child and adolescent psychiatry side,
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  - we're coming up short 10 to 20,000
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  - in terms of
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  - what the anticipated
• 3:46
  - need will be
• 3:47
  - in just nine short years.
• 3:49
  - So the demand is
• 3:52
  - growing, and the supply, unfortunately, is not keeping
• 3:55
  - pace.
• 3:56
  - So in some ways,
• 3:58
  - this issue is becoming or becoming a victim
• 4:00
  - of our own success. I think over the
• 4:02
  - last couple of decades,
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  - tremendous amount of work has gone into raising
• 4:06
  - awareness around the importance of behavioral health,
• 4:10
  - of, helping to reduce the stigma, and then
• 4:13
  - helping to encourage people
• 4:15
  - both to ask about behavioral health, but also
• 4:17
  - to seek out care.
• 4:19
  - And so the
• 4:20
  - the success story here is that demand is
• 4:23
  - up. People are taking their mental health seriously.
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  - Practitioners from other fields and disciplines like primary
• 4:30
  - care are asking more frequently about mental health
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  - and substance use disorders, and that's driving a
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  - lot of the increased demand.
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  - So our responsibility collectively as a as a
• 4:39
  - system and and UPMC as a leader in
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  - this area is really to say, how can
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  - we help ensure
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  - that the workforce will be there in 2035
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  - and beyond?
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  - And one of the cornerstones
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  - to our strategy in that area
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  - is to
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  - work
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  - earlier
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  - in individuals'
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  - kind of career journeys. And that means working
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  - with middle schools and high schools to help
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  - not just raise awareness about mental health, but
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  - also to help model out and demonstrate what
• 5:07
  - a career in behavioral health can look like.
• 5:11
  - So we've had the pleasure and privilege of
• 5:13
  - working with, a fantastic organization
• 5:16
  - called Avidum,
• 5:18
  - which
• 5:19
  - means, I've got your back. And
• 5:21
  - these Avidum clubs,
• 5:23
  - which are in high schools and middle schools,
• 5:26
  - help to
• 5:28
  - not only raise awareness around health issues, but
• 5:31
  - have provided forums
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  - for organizations like UPMC
• 5:35
  - to come in and do trainings and seminars
• 5:39
  - and on-site conferences,
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  - with young people
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  - to show what careers and behavioral health are
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  - like. So earlier this year,
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  - we held a conference in Central Pennsylvania
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  - at hundreds of kids from schools all over
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  - the Commonwealth.
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  - And we had, workshops and classes
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  - on careers and behavioral health
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  - and got fed not only a fantastic
• 6:01
  - turnout, but we did pre post surveys and
• 6:04
  - got
• 6:06
  - response rates upwards around eighty five percent,
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  - demonstrating that these young people were excited about
• 6:12
  - the field that they were considering
• 6:16
  - entering mental health and substance use disorder careers.
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  - And we can use that
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  - enthusiasm
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  - to then help connect them with internships,
• 6:26
  - training programs,
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  - information about local area schools and colleges that
• 6:30
  - offer training programs in behavioral health. So we
• 6:34
  - can take that interest and channel it into
• 6:37
  - future career choices if that aligns with their
• 6:39
  - goals.
• 6:40
  - Absolutely. That makes a lot of sense. And
• 6:42
  - I I appreciate you explaining the context there
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  - for us
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  - of why this,
• 6:47
  - strategy around youth mental health clubs is a
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  - part of your cornerstone to
• 6:51
  - to meet the demand there is for mental
• 6:54
  - health services and the workforce that isn't keeping
• 6:56
  - up to meet that demand.
• 6:58
  - And I I know doctor Hofer, last time
• 7:00
  - we had spoke, you had also mentioned your
• 7:03
  - telemedicine bridge clinic.
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  - And I believe you had stated for us
• 7:06
  - that it has grown to more than 16,000
• 7:09
  - encounters
• 7:10
  - across Pennsylvania.
• 7:11
  - It's been it's been a few months since
• 7:13
  - we had talked. So any updates there on
• 7:15
  - how that program has evolved? Maybe you could
• 7:17
  - fill our audience in on exactly how long
• 7:19
  - that program has been around, what you all
• 7:21
  - do with it, any other data that that
• 7:23
  - it's, showing you at this point.
• 7:26
  - Yeah. Happy to. Since we last spoke, Jacob,
• 7:29
  - the the telemedicine
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  - bridge clinic has worked with another 6,000 unique
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  - individuals,
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  - bringing to 23,000
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  - the total number of encounters since the clinic
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  - launched back in 2020.
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  - And and under the
• 7:44
  - leadership of doctor Mike Lynch,
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  - the emergency medicine physician,
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  - and an expert in
• 7:51
  - in treatment engagement
• 7:52
  - around the substance use disorder
• 7:56
  - population. Really been proud to support this program
• 7:59
  - that provides that vital linkage for individuals
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  - presenting in places like emergency departments
• 8:06
  - in rural, urban, and suburban communities,
• 8:09
  - helps with, an overdose
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  - or inactive
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  - use,
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  - that are seeking the opportunity to get connected
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  - with care, not in a couple of weeks
• 8:19
  - or a couple of months, but
• 8:21
  - at the moment and point of contact and
• 8:23
  - within that critical next twenty four hours. And
• 8:26
  - the telemedicine bridge clinic,
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  - helps to ensure that there is that, hot
• 8:31
  - hand off, that warm hand off to the
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  - next level of care and ensuring that people
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  - don't fall through
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  - critical gaps in the continuum
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  - right at the moment that they most need
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  - the support.
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  - And what we've seen with this program is
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  - just tremendous response
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  - from, area health care providers and from the
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  - community.
• 8:53
  - Cameras have been rising every year of operation
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  - over the last six years.
• 8:57
  - To give
• 8:58
  - folks a sense, it serves about,
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  - 60%
• 9:02
  - or so of Medicaid
• 9:04
  - funded and about 30%
• 9:05
  - uninsured individuals.
• 9:07
  - The other 10% would be a mixture of
• 9:10
  - various,
• 9:12
  - payer mix.
• 9:13
  - And from a geographic standpoint,
• 9:16
  - it's been
• 9:18
  - a critical
• 9:19
  - addition to the continuum of care, particularly for
• 9:23
  - our rural population.
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  - In Pennsylvania,
• 9:27
  - some people may know the state,
• 9:29
  - because of cities like Philadelphia and Pittsburgh, but
• 9:32
  - the truth is that over a quarter of
• 9:34
  - Pennsylvania's population
• 9:35
  - lives in rural communities or rural counties.
• 9:38
  - And when we take a look at the,
• 9:42
  - population certified by the telemedicine bridge clinic, over
• 9:45
  - 40% of those encounters
• 9:47
  - involve individuals
• 9:49
  - coming from those rural counties.
• 9:51
  - So we know that it's helping to address
• 9:53
  - one
• 9:54
  - of our nation's most significant
• 9:57
  - health disparities, which is the rural health care
• 9:59
  - disparity
• 10:00
  - that exists in many states, including Pennsylvania.
• 10:03
  - We also were encouraged to see that, there
• 10:07
  - are higher engagement rates among African American Pennsylvanians
• 10:11
  - within this program.
• 10:12
  - We also know from national data that health
• 10:15
  - care disparities,
• 10:17
  - impact
• 10:18
  - various racial and ethnic groups. So this has
• 10:20
  - been, very encouraging to show as a effective
• 10:23
  - strategy to promoting,
• 10:25
  - health equity. You know, another population that that
• 10:28
  - has been a particular
• 10:29
  - concern and interest,
• 10:31
  - has been the individuals
• 10:33
  - involved in the criminal justice system.
• 10:35
  - So the telemedicine,
• 10:38
  - clinic, bridge clinic, and EPMC health plan have
• 10:41
  - worked with county and state prisons, jails,
• 10:44
  - as well as criminal justice organizations and courts
• 10:46
  - to help support the transition of individuals who
• 10:49
  - are,
• 10:50
  - leaving incarceration.
• 10:52
  - And about five percent of
• 10:54
  - the individuals served in the bridge clinic,
• 10:57
  - come from the criminal justice system.
• 10:59
  - And we know from that data, you know,
• 11:01
  - the that first thirty days or so post
• 11:04
  - release from,
• 11:07
  - incarceration
• 11:08
  - are associated with very high rates of overdose.
• 11:12
  - And so any opportunity to intervene with that
• 11:15
  - population in that critical time window,
• 11:17
  - really translates to saved lives.
• 11:21
  - Absolutely. So it sounds like the the program
• 11:23
  - of itself is working, and it and it's
• 11:25
  - growing. 23,000
• 11:27
  - encounters,
• 11:28
  - in Pennsylvania is amazing growth to hear. So
• 11:31
  - appreciate you sharing,
• 11:32
  - all the updates there with us. I I'd
• 11:34
  - also be remiss if I didn't ask you
• 11:36
  - about,
• 11:37
  - September being National Recovery Month.
• 11:40
  - And I know,
• 11:41
  - you know, that UPMC offers free public trainings
• 11:43
  - throughout the month on substance use disorder recovery.
• 11:47
  - So talk to us about this from from
• 11:49
  - a business perspective,
• 11:50
  - what the strategic value of those kinds of
• 11:53
  - public facing investments,
• 11:55
  - mean both from from where you sit on
• 11:57
  - the health plan side, but for for the
• 11:59
  - wider health care system as a whole.
• 12:02
  - Do does the data show that these kind
• 12:04
  - of investments really move the needle on things
• 12:06
  - like intervention rates, member engagement,
• 12:09
  - downstream, cost avoidance. How are you all thinking
• 12:11
  - about this?
• 12:13
  - Well, the good news is that the data
• 12:15
  - definitely shows a positive impact. And,
• 12:18
  - but even before getting to the the analysis,
• 12:22
  - this is the right thing to do. It's
• 12:23
  - the right thing to do in terms of
• 12:24
  - caring for the communities that we serve. You
• 12:27
  - know, whether the trainings that we offer at
• 12:29
  - UPMC are oriented towards our providers around evidence
• 12:32
  - based practices, for example,
• 12:34
  - these things build and improve the treatment capacity.
• 12:39
  - Or some of our trainings,
• 12:41
  - that are really targeted
• 12:43
  - towards members, people in recovery, helping to promote
• 12:47
  - resilience and and wellness techniques
• 12:50
  - so that people can navigate their own individual
• 12:52
  - recovery journeys along with their families and their
• 12:54
  - communities.
• 12:55
  - You know, regardless, we feel that that these
• 12:58
  - are
• 13:00
  - strategic investments
• 13:01
  - that support our mission, and they help do
• 13:05
  - help and positively impact our bottom line.
• 13:08
  - And we know that both from,
• 13:10
  - from our analysis of this work, but also
• 13:12
  - from the available research and data in the
• 13:14
  - field.
• 13:15
  - In the substance use disorder
• 13:18
  - world, for example, the single best determinant of
• 13:21
  - long term
• 13:22
  - recovery is engagement in treatment over time. And
• 13:25
  - so by offering these trainings,
• 13:27
  - we are aligning towards improving
• 13:30
  - the
• 13:31
  - outreach,
• 13:32
  - engagement,
• 13:33
  - and retention in treatment,
• 13:36
  - by helping providers
• 13:38
  - level up their skills in each of those
• 13:40
  - three areas.
• 13:41
  - And we're seeing the results of that as
• 13:44
  - retention rates,
• 13:46
  - increase. People are staying in treatment for longer
• 13:49
  - periods. They're getting
• 13:51
  - evidence based treatments like medication assisted treatment
• 13:54
  - for opioid use disorder at higher rates,
• 13:58
  - for longer periods of time. And so that's
• 14:00
  - translating into
• 14:02
  - fewer emergency department visits,
• 14:04
  - fewer inpatient
• 14:05
  - rehabilitation
• 14:06
  - stays,
• 14:07
  - shorter
• 14:08
  - residential
• 14:09
  - stays,
• 14:10
  - and lower total costs of care as their
• 14:13
  - other physical health conditions and wellness needs are
• 14:16
  - better managed.
• 14:18
  - And so,
• 14:19
  - of course, the
• 14:20
  - we need,
• 14:22
  - a workforce that to talk about sort of
• 14:24
  - the earlier topic about the importance of keeping
• 14:27
  - a a robust and vibrant workforce.
• 14:29
  - You know, part of our strategy to link
• 14:31
  - these two
• 14:32
  - strategic
• 14:33
  - goals together here, you know, part of our
• 14:35
  - strategy has been to grow the pipeline,
• 14:38
  - engaging young people to come into the field.
• 14:40
  - But we also need to hold on to
• 14:43
  - the people that are in the field, folks
• 14:45
  - with lots of experience, institutional
• 14:48
  - knowledge that have hard clinical skills, but also
• 14:51
  - the soft system and people skills.
• 14:53
  - That is invaluable
• 14:55
  - and,
• 14:57
  - talent and wisdom, and we don't wanna lose
• 14:59
  - it. And so one of the single best
• 15:01
  - ways, again, turning to the literature and the
• 15:03
  - evidence,
• 15:04
  - one of the single best ways to keep
• 15:06
  - people well engaged in their career
• 15:09
  - is to
• 15:11
  - help them feel
• 15:12
  - that they are impacting in a positive way
• 15:15
  - that people are working with. And so when
• 15:18
  - we help empower them with new tools or
• 15:20
  - training
• 15:21
  - or show ways that their work can be
• 15:23
  - enhanced
• 15:24
  - and whether it's working with a new population,
• 15:27
  - helping to improve a specific outcome,
• 15:30
  - learn a new technology
• 15:31
  - or skill to be able to do their
• 15:33
  - work more efficiently with less, you know, paperwork
• 15:36
  - or overhead. All of those things together
• 15:39
  - increases
• 15:40
  - the level of impact that people feel. And
• 15:43
  - as a result,
• 15:44
  - burnout goes down, turn
• 15:46
  - turnover goes down.
• 15:48
  - And
• 15:49
  - taken together, that means that providers
• 15:52
  - are better able to staff their programs, their
• 15:55
  - units, and their clinics.
• 15:57
  - That helps to improve the affordability and sustainable
• 16:00
  - sustainability
• 16:01
  - of care for everyone.
• 16:04
  - Absolutely. No. It's a great call out to
• 16:05
  - our to our listeners, Matt. So I appreciate
• 16:07
  - that. And in that vein,
• 16:09
  - before we go, anything else that we're missing
• 16:12
  - or any other final bits of advice you
• 16:14
  - would wanna offer them today?
• 16:16
  - Well, you know, taking September out to shine
• 16:20
  - a light on recovery
• 16:22
  - is so helpful. What I would say is
• 16:24
  - that, people need recovery. They are in recovery
• 16:28
  - 12 out of the year. And so anything
• 16:30
  - that your system, your clinic, your organization
• 16:33
  - is doing,
• 16:35
  - should not expire,
• 16:37
  - at the end of September.
• 16:38
  - And so as you know, here at UPMC,
• 16:41
  - we think about recovery month, every month of
• 16:44
  - the year.
• 16:45
  - Use this, of course, as an opportunity in
• 16:47
  - our communities to take advantage of opportunities and
• 16:50
  - forums like what Becker's provides for this podcast,
• 16:54
  - to help raise awareness.
• 16:56
  - But it's just critical that organizationally,
• 16:59
  - as behavioral health leaders, that we are championing
• 17:03
  - the importance of behavioral health across population health,
• 17:07
  - every month of the year.
• 17:09
  - Wonderful. Well, doctor Hofer, I can't thank you
• 17:11
  - enough for taking time as always to chat
• 17:13
  - with our audience and for sharing your insights
• 17:16
  - with them. We really appreciate you doing so.
• 17:18
  - So thank you. Thanks for having me, Jacob,
• 17:20
  - and happy recovery.
• 17:22
  - Yeah. Absolutely. And to our listeners, if you'd
• 17:24
  - like to listen to more podcasts from Becker's,
• 17:27
  - you can visit beckershospitalreview.com.