Latest / Becker's Healthcare Behavioral Health / Dr. Matthew Hurford & Dr. Michael Lynch of UPMC

Transcript

Dr. Matthew Hurford & Dr. Michael Lynch of UPMC · Becker's Healthcare Behavioral Health

0:00
Hello, everyone. This is Jacob Emerson with the
0:02
Becker's Behavioral Health Podcast.
0:04
Thrilled today to be joined by doctor Matthew
0:06
Hereford, who's the president and CEO of Community
0:09
Care Behavioral Health Organization
0:11
and the vice president of behavioral services at
0:13
UPMC Health Plan, and doctor Michael Lynch, who's
0:16
the senior medical director of quality and substance
0:19
use disorder services
0:21
at UPMC Health Plan. Doctor Hartford, doctor Lynch,
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thank you so much for taking the time
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to be with me on the podcast today.
0:28
Great to be with you, Jacob. Yeah. Thank
0:30
you for having us.
0:31
Absolutely. And before we dive into everything we
0:34
wanna talk with you both about, can you
0:35
each tell us a little bit more about
0:37
yourselves and what it is that you each
0:39
do today at UPMC?
0:41
Michael, do you wanna start us off?
0:43
Sure. Happy to. So as you said, I'm
0:45
a senior medical director for quality and substance
0:47
use disorder services at UPMC Health Plan.
0:51
Also,
0:51
triple board certified in emergency medicine, medical toxicology,
0:55
and addiction medicine,
0:57
and practice at multiple
0:59
hospitals in at UPMC,
1:01
primarily in Pittsburgh, but we do offer telehealth
1:04
addiction and toxicology services to all UPMC hospitals
1:08
throughout Pennsylvania.
1:09
Also founded and directed
1:11
a telemedicine bridge clinic,
1:14
to fill in gaps, with people with substance
1:16
use disorder, particularly opioid use disorder, maybe experiencing
1:20
in their care,
1:21
to ensure that we don't lose them and
1:22
we can help connect them back to, long
1:25
term local treatment.
1:27
So work in the emergency department,
1:29
as well as inpatient toxicology services where we
1:32
manage overdoses, withdrawal, addiction, and a variety of
1:35
other, poisonings, envenomations,
1:37
etcetera.
1:38
Thanks, Michael. How about you, Matt?
1:40
Yeah. Again, happy to be with you. My
1:42
name is Matt Hereford. I'm a board certified
1:44
psychiatrist,
1:46
and I am the VP of behavioral health
1:49
at UPMC insurance services where I provide
1:53
executive
1:54
clinical whole strategic oversight
1:56
across
1:57
our
1:59
array of insurance products.
2:01
UPMC insures over 4,000,000
2:04
people nationwide,
2:06
across Medicare, Medicaid,
2:08
commercial insurance.
2:09
We work closely with
2:11
Friends at Work partners and employee assistance programs
2:15
nationally.
2:16
In addition, I'm also the President and CEO
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of Community Care Behavioral Health, one of UPMC's
2:22
Medicaid insurance plans. We cover
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just over 1,000,000 Pennsylvanians,
2:27
and cover their Medicaid behavioral health benefits, working
2:30
with 43 of Pennsylvania's 67 counties.
2:34
Wonderful. Well, Matt, Michael, we really appreciate you
2:36
both taking the time out of your schedules
2:38
to talk with us today.
2:40
Matt, I wanna talk with you first about,
2:42
some recent news from UPMC Health Plan. You
2:45
opened a new neighborhood center in Erie, Pennsylvania
2:48
this past summer,
2:50
with food, job navigation support that's being provided
2:53
to that community. So So talk to us
2:55
a little bit about this.
2:57
Explain for our listeners who aren't familiar with
3:00
what these centers are. What are these services
3:02
gonna look like on the ground, and, ultimately,
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what are you hoping to achieve in the
3:05
long term?
3:07
Well, we're really thrilled, about opening this neighborhood
3:09
center in the Lower East Side Of Erie.
3:13
We have
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opened
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a neighborhood center in
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Pittsburgh that has been up and running now
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for a few years.
3:21
And this center in Erie is really modeled
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after that very successful program.
3:26
And for us, it's really just another piece
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in a kind of ongoing
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mosaic of support for the Erie and Northwestern
3:35
PA community.
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As you mentioned,
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this goes well beyond kind of support for
3:40
traditional health needs
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and supports
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folks, whether they're members of our health plan
3:46
or not, members of the community around, all
3:49
sorts of health related social needs, like food
3:52
security,
3:53
job searching activities, and just navigating health and
3:56
human services systems in general.
3:59
And so while we have a physical location,
4:02
they are great building where there's meeting spaces
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and
4:06
opportunities and places for private consultation,
4:10
there's so much more going on because of
4:12
the over 50
4:14
partnerships we have with various community based organizations
4:17
across Erie and Northwestern PA. So whether folks
4:21
come in looking again for a job, we
4:23
can help navigate
4:25
that through our UPMC Pathways to Work Programme,
4:28
whether they're seeking employment with us at UPMC
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or elsewhere in the community,
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or if they're looking for,
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access to affordable, low cost or free healthy
4:41
nutritious food, we have a fantastic partnership with
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the Second Harvest food pantry
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and created this Second Harvest marketplace where folks
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can make an appointment and come in and
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have access
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to,
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healthy and fresh produce, meats, dairy items, as
4:56
well as shelf stable foods, all with the
4:59
idea that, you know, food really is medicine.
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And there's so much more,
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lots of opportunities for individualized
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understanding of what people and their families might
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need. And this community center provides a front
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door,
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to this community so we can better support
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them.
5:16
Well, it's great to hear that another community
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in the state has access to these types
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of services, Matt. And Michael, anything that you
5:22
would add on this topic?
5:24
I think Matt covered it really, really well,
5:27
the the variety and diversity of services. And
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I think just really emphasizing the point that
5:33
health and well-being
5:34
don't only need to be addressed in the
5:36
doctor's office, in the hospital,
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or from
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the payer headquarters.
5:41
We really I think this just reflects UPMC's
5:44
commitment to being a part of the communities,
5:47
where our patients and our members are and
5:50
our desire to be parts of those communities,
5:53
be available,
5:54
be present and partner, not just on traditional
5:58
medical needs, but on all the other factors
6:01
that contribute
6:02
to health, but also to both physical and
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mental well-being,
6:06
understanding that all of that
6:08
is part of our mission. So I think
6:10
the neighborhood centers really are just
6:12
a demonstration
6:13
of that commitment
6:14
of being physically in the community and not
6:16
sort of just waiting for people to come
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to us, but going out to find ways,
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to help anyone,
6:22
in these areas to access
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incredible resources
6:34
and really cool programs
6:37
to help with education and not just helping
6:40
people right now, but really teaching them to
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fish
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through training and job acquisition.
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So, really, really proud of the work that
6:48
the health plan has done and our partners
6:49
who oversee those programs.
6:52
Yeah. No. It's really great to hear all
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about this. And I hear you loud and
6:55
clear that, a lot of needs can be
6:58
met outside the four walls of a hospital.
7:00
But, Michael, if we are sticking to some
7:02
new recent developments this year, within UPMC Hospitals,
7:07
We're seeing that you've added behavioral inpatient capacity
7:10
this year at different facilities,
7:12
more intensive outpatient programs,
7:15
behavioral health pods in emergency departments.
7:19
So how are you all thinking right now
7:21
about balancing your investments across inpatient, outpatient, and
7:25
community based recovery supports?
7:28
What are some lessons learned this year that
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the other behavioral health leaders listening in can
7:33
really take away from, where UPMC is leading?
7:37
I think it's just so important to break
7:38
down the walls and the barriers.
7:40
You know, too long physical health and
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behavioral health, have kind of worked in silos,
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and a lot of that has been structural,
7:47
not necessarily by desire.
7:51
And I think most in both worlds recognize
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the
7:55
integration or the need for integration of services
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that each
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influences the other. You can't treat behavioral health
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without
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managing physical health and vice versa.
8:05
And so to try to treat them in
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separate places
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and treat them separately,
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you're going to be bound for
8:13
worse outcomes. So I think that's really at
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the foundation.
8:16
And beyond sort of integrating that care and
8:18
trying to partner
8:20
with physical health and behavioral health providers and
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payers and resources,
8:23
I think another driving
8:26
force for us is continuity. We really want
8:26
to think about those connections of care.
8:28
We really want to think about those connections
8:30
of care.
8:32
I think for too long, we have looked
8:34
at the structure of healthcare and looked at
8:36
nodes,
8:37
stopping points, whether it be the hospital or
8:39
ED or the outpatient office or the therapist's
8:41
office or
8:43
social services
8:45
provider and those kinds of things. Instead of
8:47
thinking them as we should, as sort of
8:48
a web or a net that's connected,
8:51
where each one
8:52
should kind of have an easy and obvious
8:54
pathway to the other and back and forth,
8:57
both through communication for us, but also navigation
8:59
for the patients.
9:00
You know, because for
9:02
most just laypeople,
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navigating the system is incredibly
9:06
challenging. It's confusing.
9:08
It's complicated.
9:10
Who needs what? Where do you need to
9:11
be?
9:13
What paperwork needs to be signed? All of
9:15
those kinds of things
9:16
are all opportunities
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to lose somebody to the care that we
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know they need. And the better we can
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connect those things,
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and start the process in one place, and
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then hand it off to the next place,
9:30
all with the patient at the center
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of that journey. And so it's you know,
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the pathway is easy for them. Those are
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all things that are going to help us
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get people the care that they need and
9:40
long term, hopefully prevent them from needing those
9:43
more acute
9:44
or urgent
9:45
care kinds of services that we see at
9:47
the hospital. So while a lot of the
9:49
investment occurs at the hospital, the fundamental goal
9:51
is actually to reduce the need
9:54
of hospital and emergency care because we've connected
9:57
people to those community,
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both healthcare,
10:00
behavioral health, and social service resources that they
10:03
need. So, I think still a lot of
10:04
work to do.
10:06
It's a complicated
10:08
space. But, you know, the first step in
10:11
doing it is to do it, is to
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prioritize it and make sure that
10:15
we demonstrate through our actions and through our
10:18
behaviors that that is what we think is
10:19
important. And so I think that's really fundamental
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and at the heart of that work.
10:24
Absolutely. No. It's a great call to action
10:26
for everyone listening in. And, Matt, I would
10:28
extend the same question to you in terms
10:30
of for our leaders,
10:33
hearing from from you both right now. And
10:35
when you're thinking about some of the investments
10:37
I mentioned that the system has made in
10:39
this space over the last year or so,
10:41
what would you say in terms of lessons
10:43
learned?
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Well, Mike absolutely nailed the
10:47
answer, I think, and and and
10:50
right to the heart of the matter, which
10:52
is
10:53
not only you have to think about this
10:54
in terms of a continuum of care,
10:57
but actually think about it as a web
10:59
of support or a safety net. And,
11:03
that net is only as strong as its
11:06
weakest
11:08
portion.
11:09
And so the when we think about the
11:11
investments and what lessons learned that we can
11:14
take away from working in particularly high needs
11:17
communities,
11:18
it's to
11:20
constantly remind ourselves of that fact. And so
11:23
to think about a concrete example here, if
11:26
I'm somebody with a serious mental illness,
11:28
I know that I can go into UPMC's,
11:31
Western Psychiatric Hospital and get world class
11:34
inpatient
11:35
care for my schizophrenia or bipolar disorder or
11:39
or other diagnoses.
11:41
But if I'm discharged to a community where
11:43
I don't have access to,
11:46
you know, food or I have to make
11:48
a decision between spending money on transportation
11:51
to get to my follow-up appointment
11:56
or my medicines or my food, then those
11:59
choices put people in impossible situations.
12:02
And so when we think about these investments,
12:04
we have to take the blinders off and
12:06
recognize that we cannot look at this
12:09
in silos,
12:10
and that the partnerships
12:12
that are so important and pivotal in people's
12:15
daily lives,
12:17
round out and complete that safety net of
12:19
support. And that's why things like the
12:22
neighborhood center in Erie are these partnerships,
12:25
with food pantries, transportation providers, legal aid, and
12:29
other community based organizations
12:31
are so essential
12:33
because everything falls
12:35
apart when people don't have that full safety
12:38
net and the set of supports available to
12:40
them.
12:41
And so the important thing is that we
12:43
don't stop our investments
12:45
at the four walls of our hospitals, our
12:47
clinics,
12:48
or our emergency departments. And we recognize that
12:51
the vast majority of time that our members
12:55
and our patients are spending are outside of
12:58
our campuses.
12:59
They're in their homes, they're in their churches,
13:01
at their workplaces,
13:02
in their communities.
13:04
And that's where we need
13:05
to be partnering and supporting. So that that
13:08
has been a major focus of UPMC for
13:10
some years, and I think it will only
13:12
increase
13:13
relevance and importance
13:15
in the years ahead.
13:17
Certainly. And so these these services, they're they're
13:19
so important to continue to invest in, and
13:21
it sounds like UPMC is really committed there,
13:25
looking forward.
13:27
In terms of where both of you sit,
13:28
you know, you're really leading efforts at the
13:30
intersection of emergency care, toxicology,
13:33
behavioral
13:34
managed care as as an insurer.
13:37
So what do you both think right now
13:39
are some of the most scalable strategies for
13:41
continuing
13:42
to,
13:43
see more investment
13:48
in across the populations
13:50
that you serve?
13:51
Matt, do you wanna go start us off
13:53
there?
13:54
Yeah. Happy to.
13:56
You know, I think it comes down to,
13:58
in in my mind, a single word, and
13:59
that's network. And that's in both senses
14:02
or multiple senses of that word.
14:05
We have just talked about the importance of
14:06
having a network of partnerships out in the
14:08
community to help close those practical,
14:12
logistical gaps for individuals like, you know, trans
14:16
getting to care, transportation, child care, mobility, etcetera.
14:20
But, you know, there's also an opportunity through,
14:24
tele and digital networks and growing out the
14:27
offerings that we can do virtually
14:29
to help people also close those gaps to,
14:33
access to care, whether, again, that's because they
14:35
have personal mobility issues
14:37
or because they simply, they're a single parent
14:39
and they can't take the,
14:41
the risk of, having their child not in
14:44
a safe place while they go take care
14:46
of their own health. The ability for us
14:48
to use virtual Intelli options,
14:50
has greatly expanded our ability to meet people
14:53
where they are. And so when we think
14:55
about what what can we truly scale and
14:57
in some environments, we're gonna have to continue
14:59
to do more, with with less,
15:02
then we have to look to these scalable
15:04
solutions.
15:05
And so in my mind, it really does
15:07
come down to,
15:09
leveraging technology
15:10
and leveraging
15:12
partnerships with those community based organizations,
15:15
other providers, payers, policymakers,
15:18
human service organizations
15:20
to think about where,
15:21
can we help support their efforts, where can
15:23
they support ours, all with this idea of
15:26
keeping the person at the center of what
15:28
we do.
15:29
And and, Michael, let you weigh in on
15:31
what you think are the most scalable strategies
15:33
right now in this space, but also how
15:36
you're thinking about measuring the business impact and
15:38
and the clinical impact,
15:40
in ways that resonates with your other payer
15:43
partners, with your state partners.
15:46
How are you thinking about that?
15:48
Absolutely. And and it the measurement is so
15:51
critical. It it's can be challenging, but it's
15:54
necessary.
15:55
And I fully I think you can maybe
15:57
not surprise that Matt and I frequently agree
15:59
with each other.
16:00
But I absolutely agree. I think from
16:03
a scalable perspective,
16:05
you know, digital and that can mean things
16:07
like EHR integration,
16:10
information, kind of communication,
16:12
and being at at our fingertips so we
16:15
can get more rapid,
16:17
integration of
16:18
community based information,
16:20
whether it be drug availability, what's happening,
16:23
you know, local pressures,
16:25
things like that that can be integrated, the
16:27
digital space in the EHR so that, you
16:30
know, we spend less
16:31
time, looking for information, but just having it
16:34
there and coming to us, I think that's
16:36
going to be really important, even to the
16:37
degree of artificial intelligence being able to take
16:40
over not a lot of the care duties,
16:41
but some of the tasks, the administrative
16:44
burdens, I think, you know, that allow us
16:46
to spend more time with people. So people
16:48
are taking care of people and the things
16:50
that are tasks can get handled in the
16:53
background. I think those are all opportunities.
16:55
And from a telehealth perspective, and I will,
16:58
use that as an example to answer your
17:00
question regarding measurement.
17:02
In my own personal experience, you know, running
17:04
a telehealth bridge clinic, we've seen,
17:06
continuous growth. We operate throughout all of Pennsylvania.
17:09
We've managed more than 16,000 encounters across 66
17:13
of the 67 counties in Pennsylvania.
17:16
And, you know, so that's rural, that's urban,
17:18
that's suburban. And I think really that supply
17:20
demand mismatch,
17:22
you know, is really scalable, not just in
17:25
behavioral health and substance use, but in medicine
17:27
in general, where maybe you have a concentration
17:29
of certain types of providers in one area,
17:32
but not so many in another area, but
17:34
there are people there who need those services.
17:36
How do we make those connections,
17:38
whether through econsulting or professional consultations,
17:41
direct telemedicine?
17:42
I think there's all sorts of,
17:44
possibilities there to scale and meet those needs.
17:49
With capacity that exists in the system, it
17:51
just doesn't always exist where the needs are.
17:53
And so I think that is, really an
17:55
exciting opportunity.
17:57
But to your point, we need to make
17:59
sure that when we're doing that, we don't
18:00
just do it because we think it's a
18:02
good idea,
18:03
but that we're able to show that not
18:05
only is it feasible
18:06
and is the quality of care sufficient,
18:09
and appropriate to meet people's needs, but is
18:12
it making sense, from a business perspective? Because
18:15
in the end, to support those, particularly to
18:17
get those things started and expanded and scaled,
18:21
it takes some degree of upfront investment,
18:24
to stand it up. And so part of
18:26
what we've done through our telemedicine bridge clinic
18:28
is we have done that with not only
18:30
UPMC health plan data analytics,
18:33
we've worked with the, with the Pennsylvania Department
18:35
of Human Services and Medicaid Review Committee to
18:38
do analyses where we look at what the
18:40
utilization is,
18:41
what are the quality outcomes we care about?
18:43
So are people getting on medication? Are they
18:45
following up with outpatient treatment providers? Are we
18:49
reducing the amount
18:50
of unplanned care utilization
18:52
and total cost of care and those types
18:54
of things? Are we engaging them in other
18:57
preventive treatments,
18:58
that we want to see? And so those
19:00
are some of the analyses we've actually done
19:02
and published, and we have been able to
19:04
show that. And just to take that one
19:06
step further, I've been able to use
19:08
those analyses and those data to go back
19:11
to
19:11
payers and other stakeholders to demonstrate and say,
19:15
this is what we're doing. This is what
19:17
the potential value is. And actually get additional
19:19
buy in, of resources
19:21
and investment
19:23
to continue and increase that work. And so
19:25
I think that's always going to have to
19:27
be the way that it works. I think
19:29
of it as like a ratchet,
19:31
you know, where you start to do something
19:33
and then you need to scale it, so
19:34
you have to show some outcomes. You do
19:36
that. You get some more investment. You scale
19:38
it further. You get, a more robust set
19:40
of outcomes and so on and so forth.
19:43
And that's what we really need to do
19:44
to ensure that we're not implementing
19:46
lots of digital or
19:48
application based or telehealth programs that aren't good
19:50
quality,
19:52
but are offering the services people need where
19:54
they need them, and the outcomes are what
19:57
we want them to be from a quality
19:59
and a cost efficiency perspective. And so that
20:01
is really important. It is hard work and
20:03
there is cost itself in the evaluation.
20:06
But I think in the long run, it
20:08
becomes well worth it.
20:10
Yeah. No, it seems like such a fine
20:12
balance between making those investments that you both
20:15
mentioned,
20:16
growing those physical and and virtual
20:18
networks, but then also bringing it back to
20:20
the sustainable business piece and and meeting those
20:23
measures you've set internally and with your external
20:25
partners.
20:27
Gentlemen, before we go, I I do wanna
20:29
mention, of course, I I'm sure most of
20:32
our listeners are aware that September is National
20:35
Recovery Month, which really observes, the gains that
20:38
individuals like you all over the country have
20:41
made in terms of, making progress in mental
20:44
health and substance use recovery efforts. So,
20:47
as as your final,
20:49
thoughts or final piece of advice you wanna
20:51
offer to the audience, can you each take
20:52
a minute within the context of a national
20:54
recovery month and and share for us, anything
20:57
else we might have missed today? Matt, you
20:59
wanna start us off?
21:01
Sure. Well, obviously, at UPMC,
21:03
we're all about recovery twelve months out of
21:05
the year. But the fact that as a
21:07
nation, we take September to shine a special
21:11
light on
21:12
on recovery, whether that's from substance use disorders,
21:16
or other mental health conditions,
21:18
I do think it has tremendous value to
21:21
raise people's awareness
21:23
around the importance of recovery and behavioral health,
21:26
generally speaking,
21:27
as well as reducing the stigma associated
21:31
with these conditions and seeking help for them.
21:34
So I wanna
21:36
thank Becker's for trying helping to shine a
21:38
light
21:39
on recovery month, this year. And it's so
21:43
important, I think. We've coming out of the
21:45
COVID pandemic, we have certainly seen a dramatic
21:47
increase in the demand for behavioral health services.
21:50
I do think a lot of that has
21:52
to do with the kind of education and
21:54
public awareness that
21:56
increased
21:57
during
21:58
COVID and
22:00
it's a positive sign that people are more
22:02
willing to
22:04
ask questions about and check-in with themselves and
22:07
loved ones about their health and overall wellness,
22:10
including
22:11
behavioral health. So as we go into, you
22:13
know, National Recovery Month, certainly UPMC is going
22:17
to continue to provide support and offerings. We've
22:20
got trainings, for example, that are available,
22:23
free and open to the public, whether you're
22:25
a UPMC provider member or not. You can,
22:28
for example, go to Community Care Behavioral Health's
22:30
website, ccbh.com,
22:32
and there's information on,
22:33
seven training sessions throughout the month of September,
22:37
all about substance use disorder recovery,
22:40
and how to support individuals on that journey.
22:43
I know that Doctor. Lynch has been doing
22:45
trainings in this area as well around empowering
22:48
providers on substance use disorders. It's just one
22:51
of the ways at UPMC that we wanna
22:53
continue to support,
22:55
the provider community. And as,
22:58
mister Rogers said, it's helping the helpers.
23:01
And great. Last message and sentence for me
23:03
there, Matt. I really love that. Michael, anything
23:06
else you'd like to add?
23:07
Yeah. I just wanna echo the appreciation for
23:10
the discussion and shining a light. You know,
23:13
a major
23:14
barrier and challenge,
23:16
in this space is stigma,
23:18
you know, both real and perceived, conscious and
23:20
unconscious.
23:22
I think it it limits
23:24
the the work that could otherwise be done
23:26
because people are concerned about how others are
23:30
gonna feel about them when they seek help.
23:32
When people seek help, they sometimes encounter
23:35
negative,
23:36
you know, circumstances. And so the more we
23:38
can talk about it and just recognize,
23:41
that these issues are out there, they're common,
23:43
they're a disease, they're not a moral failing
23:46
or a choice and those kinds of things,
23:49
you know, it seems like an obvious thing
23:51
to say, but I think it bears repeating,
23:54
because we the more we focus on it
23:56
and then think about what are the real
23:59
solutions, what are the available therapies that work,
24:02
what is the evidence, just like we would
24:03
if we were talking about diabetes or hypertension
24:06
or coronary artery disease.
24:08
I think that really just helps to put
24:09
it in the framework,
24:11
of other,
24:13
you know, kind of
24:14
processes
24:15
and,
24:16
and procedures that we use in in,
24:19
health care all the time. And finally, with
24:23
that, I think the other part, and I
24:25
like to emphasize this particularly during recovery month,
24:27
because recovery month is really about the hope
24:30
and the promise
24:31
that recovery is there, recovery is possible.
24:35
It doesn't just happen.
24:36
It has to be worked at,
24:38
but it is absolutely possible. And another quote
24:42
that I love as well from Joel Barker,
24:44
we're thinking about hope and vision and looking
24:46
at what our plans are is vision without
24:49
action. Is merely a dream. Action without vision
24:51
just passes the time, but vision with action
24:54
can change the world. And I think that's
24:56
what we need to do is have our
24:57
mission, have our vision,
24:59
focused on recovery,
25:00
on saving lives. And if we act and
25:02
work on that,
25:03
then we can change the world, and that's
25:05
our goal every day.
25:07
Wonderful. Well, doctor Lynch, doctor Hereford, I wanna
25:10
thank you both for taking the time to
25:12
sit down with us and for sharing about
25:14
the work that's going on under both of
25:16
your leadership at UPMC. We really appreciate it.
25:19
And to our listeners, if you'd like to
25:21
listen to more podcasts from Becker's Healthcare, you
25:23
can visit beckers hospital review dot com.