Latest / CareTalk: Healthcare. Unfiltered. / Unlocking the Front Door to Digital Mental Health with Brad Kittredge & Doug Nemecek, MD

Transcript

Unlocking the Front Door to Digital Mental Health with Brad Kittredge & Doug Nemecek, MD · CareTalk: Healthcare. Unfiltered.

• 0:00
  More than one in five adults have a diagnosed behavioral health condition, yet only about half are in active treatment.
• 0:07
  And it takes an average of 11 years from the onset of symptoms before a patient seeks care.
• 0:12
  Our guests, Brightside Health CEO Brad Kitteridge and Evernorth Chief Medical Officer for Behavioral Health, Dr.
• 0:18
  Doug Nemecek, are opening multiple front doors to let patients in.
• 0:30
  Welcome to Care Talk, America's home for incisive debate about healthcare business and policy.
• 0:35
  I'm David Williams, president of Health Business Group.
• 0:38
  And I'm John Driscoll, the president of Walgreens Health.
• 0:41
  Check out the Care Talk newsletter.
• 0:43
  It's the source for trending healthcare industry News links to the latest podcast episodes and highlights and original blog posts that dive even deeper into our podcast topics.
• 0:53
  Subscribe today@caretalkpodcast.com slash newsletter.
• 1:00
  Well, Brad and Doug, welcome to Care Talk.
• 1:04
  It's great to be here.
• 1:05
  Thanks so much for having us.
• 1:06
  Yeah.
• 1:07
  Thank you very much.
• 1:09
  So you said that the, the path to mental health care is long and complex.
• 1:13
  And what does that mean?
• 1:15
  And why is it the case?
• 1:16
  I mean, I mentioned 11 years to get into treatment in the intro is, I mean, is that what we're talking about?
• 1:23
  So what we see at Evernorth and unfortunately across the United States, it Access to care has, has been difficult and the journey has been very confusing for people, most individuals and families don't know where to go or how to get help when a mental health issue arises and uh, and it, and it's hard to get their, them to understand when it's an emergency or, or how can we get them into care sooner.
• 1:51
  So what we, at Evernorth, one of the things we're really focused on is how do we make this journey.
• 1:56
  Simpler for individuals.
• 1:58
  How do we help help them understand and connect sooner in their course before things get really difficult?
• 2:05
  And then how do we help navigate them and make sure we can get them to the right provider who is going to help?
• 2:09
  And that's why we've really worked hard with partners like like Brad and bright side to help make sure that we're able to connect people to care sooner, more more easily and allow them to get the care that they need.
• 2:25
  Yeah, we just add to that that.
• 2:26
  Yeah.
• 2:26
  You know, if we talk about people's front door into health care and the various ways they may engage with health care, uh, if people are waiting 11 years, they've obviously walked past a lot of front doors.
• 2:36
  Um, you know, the health care system has been trying for a long time to deliver mental health care to people and this, this stat clearly shows us that it just hasn't been working, that people need a new way to be able to enter, um, need different needs to be met and, um, that there's a lot of work for us to do there.
• 2:52
  I mean, Brad or maybe Doug, I'm not quite sure who knows this stat better, but I think untreated mental illness is in, is sort of almost a cluster for unmet needs across the entire healthcare continuum that, you know, if you can actually isolate and treat mental health.
• 3:16
  Um, and get it and diagnose it early.
• 3:18
  It can be a pretty dramatic impact on people's total health care.
• 3:23
  There's a tendency, I think, historically to kind of manage it outside of the traditional system or the traditional system, not necessarily to take mental health as seriously as one should.
• 3:33
  And I don't know whether you're seeing those show up in the, in, in the statistics that Evernorth dug, but they're.
• 3:40
  They're, they're pretty, pretty, pretty terrifying when I looked at them last.
• 3:45
  Well, we know, and it was mentioned, half of people aren't getting the mental health care they need.
• 3:50
  One of the studies we published about a year ago at Evernorth really did show that connection and the importance of getting people into behavioral health care, uh, and the, and the value that brings across.
• 4:03
  their total health status.
• 4:04
  We can't treat people's emotional health and wellness separately from their physical health and wellness.
• 4:09
  We're all total human beings.
• 4:11
  And what we found was, for those people who do engage in behavioral health care and have You know, three or more visits with a therapist or psychiatrist.
• 4:25
  Not only did they get better from a mental health perspective, but we saw their overall health care costs go down, whether that was, you know, lower emergency room visits, less medical admissions.
• 4:37
  their, whether they had cancer or heart disease or diabetes, their ability to be healthier when we can actively and effectively treat their, uh, behavioral health conditions all gets better.
• 4:51
  Yeah, John, I mean, the truth is that for many decades, um, I would argue that mental health has been a bit of an afterthought in large parts of the health care system.
• 5:00
  And um, you know, it's only in more recent years that we've seen payers like Ever North and others really start to lean in and to fundamentally believe in the interconnection between physical health and mental health, not only from a clinical standpoint.
• 5:14
  But a financial standpoint and start to really think about how do we make sure people get not only timely care, but great care.
• 5:21
  Um, and so you're right that that is one of the biggest needs and opportunities of looking at the total cost of care and the impact that both, you know, diagnosed and treated as well as undiagnosed and untreated.
• 5:33
  Behavioral health conditions have on people's ability to effectively manage heart disease, diabetes, asthma and the full gamut and the impact it has both on their clinical outcomes and their costs.
• 5:46
  Brad, I think, Brad, yeah, well, just let me follow up on that.
• 5:50
  So, Brad, when you think about that, is that tied to the traditional stigma of mental health?
• 5:56
  Or does it, is it tied to kind of structural gaps in the system that, that we can, that we can, or you and Doug and teams are addressing?
• 6:06
  Like anything in mental health, the answer is not simple, um, but I think, of course, uh, we have to look at stigma and cultural context as, as one primary barrier of why people walk by so many front doors into care and, and sort of struggle in silence for so long.
• 6:21
  Fortunately, it seems like the tide is really shifting there and that people have become much more open and forthcoming about challenges with mental health conditions and the opportunity to seek care.
• 6:32
  Um.
• 6:32
  I think the other part is that for a long time, mental health care has been looked at as more art than science, um, and to some degree, you know, uh, as not standing up with the same rigor that, uh, care for other chronic conditions has had, and so I think, you know, health care providers in some cases have not put as much emphasis as we might think they should into ensuring that patients, uh, that might have a mental health comorbidity are getting care.
• 7:00
  Thank you.
• 7:00
  Um, patients are saturated with just, you know, appointments and clinical needs, and it doesn't leave them a lot of time or, or emotional energy to seek additional parts of their care needs.
• 7:11
  Um, and, you know, the truth is that, that generally at payers, the budgets are separate.
• 7:16
  You've got a group that's focused on medical and a group that's focused on behavioral, and there are, of course, organizational reasons to do that.
• 7:22
  Um, but sometimes, you know, in large companies, that means some of the efforts aren't as in sync as you would ideally want sort of the care on the ground to be.
• 7:31
  So, you gave a talk at Health that was about unlocking these multiple front doors, which I understand about access to care, and as, as you've indicated, that is a very important first step, but then you have to have good coordination of care, and Brad, you mentioned the concept also of, of quality, and Doug, the importance of, you know, if you're gonna lower overall cost, it can't just be by saying, okay, here, we have any, any, any old person who's gonna be a provider.
• 7:54
  How do you actually go on the right path to ensure once that front door is open that there's seamless coordination of care?
• 8:03
  I think one of the one of the real keys and that we've focused on and Brad and I talk about together a lot is just the importance of measurement.
• 8:12
  If we measure it, that's the way we're going to know if something's actually getting better and being done.
• 8:17
  And so we want to measure.
• 8:18
  Every step along this behavioral health care pathway and journey to know that the individual got an appointment and kept the appointment, that they engaged and really built a therapeutic alliance with their, with their provider and the person that they're working with, that they're getting better along the way, that we're measuring their symptoms, that we're ultimately measuring their outcomes.
• 8:42
  and how well they're functioning.
• 8:44
  Uh, and our ability to both share that back and forth between a payer and a provider for the for the therapist to be able to share that data and outcomes with the patient themselves.
• 8:55
  So the patient can see and feel that they are improving and getting better and getting what they need.
• 9:01
  And then ultimately sharing this with the rest of the health care system that disconnect.
• 9:07
  So how do we share information back?
• 9:09
  with a primary care physician or other physician who may be helping care for the individual as well.
• 9:15
  Putting that all together, it's that measurement at the base and having that data that we can share, uh, that allows everybody, uh, to see that the, that the individual patient ultimately is getting better.
• 9:28
  Yeah.
• 9:28
  And I think to Doug's point, just, just one question about this and you raised it earlier and I want to just follow up on that.
• 9:35
  Doug, what's changed from the health plan side that now plans really care about this?
• 9:40
  Because historically it was, you know, a lot, there were a lot of silos of, of, of, of, uh, claims management, and it would be separated to your point earlier, but both of you have made the point in different ways.
• 9:52
  What's changed from a health plan perspective that, you know, you and Cigna and others, United are leaning in to this as a category for care.
• 10:01
  And for support.
• 10:03
  So I'm a psychiatrist, and so I have been paying attention to this my entire career, right?
• 10:09
  And the last 20 of that have been with the health plan.
• 10:12
  Uh, I think the difference today is to, as Brad mentioned earlier, there's there's a decrease in the stigma associated with this, and we've we now have more of the data in the research that really shows not just that costs are higher.
• 10:29
  Uh, and people do worse with a whole from a holistic health perspective if they're not getting their emotional wellness and behavioral health needs met, but that we can actually impact that, uh, by providing appropriate and timely.
• 10:45
  Mental health care and substance use care, and that those individuals are going to be more productive at work.
• 10:50
  They're going to be more productive at home, able to take care of their families and more productive in their community as well.
• 10:58
  That's right.
• 10:59
  And, and, you know, I think just to add on to Doug's prior point.
• 11:03
  If we look historically at studies and the best estimates of the proportion of mental health practitioners who are practicing measurement based care and actually collecting data on how patients are progressing through care and whether they're actually improving.
• 11:18
  It's unfortunately been extremely low, um, you know, sub 20 percent for sure, and perhaps even sub 10 percent of practitioners consistently doing that.
• 11:28
  And if we're not measuring outcomes, we're flying blind.
• 11:30
  We have no idea whether care is working for a given individual across a population or different types of interventions for the right people.
• 11:37
  And so in many ways, the industry has sort of stagnated in this, in this sort of perception of, of.
• 11:42
  Uh, more art than science, and that's held back our opportunities to lean in and collaborate together, um, to actually develop better, more impactful programs that are not only going to help people get access to care and fill appointment slots, but actually get benefit from that care and a measurable impact on, on both the clinical and financial side.
• 12:02
  So by starting to, uh, as a company and as an industry, make sure that we measure outcomes consistently and thoroughly, um, across everybody we treat.
• 12:12
  allows us to ensure our care model is effective, allows us to demonstrate to partners like Evernorth that our care is effective, and to lean in to build and develop new programs that just haven't been possible before without that foundation of real data to inform them.
• 12:29
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• 12:38
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• 12:45
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• 12:54
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• 12:57
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• 13:03
  You know, John, it was great fun having the digital diagnostics founder Seth Ray talk that by the way, that, that, that digital re that's a major big deal.
• 13:13
  It's a very cool technology and it's, uh, as, as, uh, the doctors all know that, uh, you know, that it's, it's a major problem with the explosion of diabetes.
• 13:23
  It's incredibly exciting that there are sponsors.
• 13:26
  And John, you know what, it's interesting that they actually have a way of, is FDA approved to get the actual definitive diagnosis without a physician, uh, involved.
• 13:33
  So take that.
• 13:34
  Listen, as long as they don't start doing podcasts without a podcast host, I think I'm all in favor of it.
• 13:38
  Well, we'll just, we'll just be working with all the docs like Doug and we'll just create a sub market.
• 13:45
  Yeah.
• 13:45
  Um, health care always grows, David, that's, that's the blessing and curse.
• 13:48
  We don't have to worry about that, John.
• 13:50
  You know, and if anybody wants to hear that episode directly, there's a link in the episode description below.
• 13:54
  Brad, what did you learn at 23andMe that you're bringing to the product design and the build of your current company?
• 14:02
  Oh, great question, John.
• 14:03
  Uh, one of my favorite topics, uh, I was really fortunate and excited to join 23andMe in 2013 when the company was at an exciting inflection point, and I had a ton of enthusiasm for this idea of Building consumerism in healthcare for helping people be armed to, to drive their own health and healthcare decisions with their own genetic information.
• 14:24
  And really excited about the vision that, and we're just, he had built the company around.
• 14:30
  And so I joined to build the product team there as the VP of product and came.
• 14:35
  And on my third day of work, we got a letter from the FDA.
• 14:38
  Saying that we, that's right.
• 14:42
  They considered the product a medical device.
• 14:45
  Um, and they required us to stop selling the health product and to bring it through the FDA approval process.
• 14:51
  Oh, Jeff's a great guy.
• 14:52
  And the whole team there at the FDA, you know, there, there was of course, tension between the company and the FDA at that point.
• 14:58
  Um, and, um, but everyone had the right intentions and, um, you know, there had been miscommunications.
• 15:04
  Uh, and in the company, uh, handled it really well and essentially said, okay, let's, let's really understand this.
• 15:10
  I think we've been, uh, speaking two different languages and we've got to figure out where the, the, uh, signal losses and what we can do about it.
• 15:19
  And we really hunkered down, um, and brought the 23 and May product through the FDA and got the first clearance of a direct to consumer genetic test.
• 15:27
  leading the product team.
• 15:28
  You know, our core focus as a contribution to that was ensuring that everyone would understand the information being presented.
• 15:36
  The FDA is worried was that someone may misinterpret a result and take an uninformed and potentially harmful health action there.
• 15:45
  And even if that was extremely unlikely, of course, that's a reasonable consideration.
• 15:49
  So We did qualitative and quantitative testing on tens of thousands of people to ensure that at an eighth grade reading level, 90 percent of people could understand the core concepts of each test, and that was a core part of the approval.
• 16:01
  So it was the collision course between disruptive consumer centric Silicon Valley mentality and traditional safety and quality and health care.
• 16:11
  And while that process was extremely painful to be a part of in the short term, uh, in the long term, it was certainly extremely edifying.
• 16:19
  And for me, uh, really informed the way that I see building great and meaningful and, uh, Uh, sort of lasting products in health care, which is you've got to do it from the inside out, not from the outside in, you've got to respect and account for the way care is delivered, paid for and regulated and introduce consumerism into that and try to iterate within those bounds because there's a lot of meaningful and valuable infrastructure that's been built up for so long.
• 16:49
  And sometimes it's a little more conservative and slow and frankly, frustrating than we'd like.
• 16:54
  Um, But also, you know, we've got to continue to prioritize safety and quality above all else.
• 17:00
  You know, John has this habit of digging deep into the, uh, the resumes of the guests.
• 17:04
  Now, Doug, you're excused because we actually do make exceptions for psychiatrists.
• 17:07
  John doesn't try to analyze them.
• 17:09
  But I know that, uh, that Brad also before that was at Jawbone and at Complex DX.
• 17:14
  So he knows a little something about the diagnostics too.
• 17:16
  And also.
• 17:17
  Something about water polo, Brad, I remember from our last conversation, there was something crazy there for that one as well.
• 17:22
  You're, you're really bringing out the old stuff for me here.
• 17:25
  So I was a proud water polo player at, uh, at Cal Berkeley, uh, go bears.
• 17:30
  And, um, you know, I had a lot of fun, very edifying experience.
• 17:34
  Um, notably actually my, my.
• 17:36
  Coach, my senior year died of glioblastoma.
• 17:38
  So, uh, really challenging, uh, encounter with cancer in my life and really impactful there.
• 17:43
  Um, but you know, of course, jawbone after that is a really, you know, a, a big Silicon Valley story of wearable technology focused on health, but a big failure and a big challenge.
• 17:55
  And so between jawbone and, uh, 23 and me, I worried whether it was better looking much than the one you got on, dude.
• 18:02
  That's right.
• 18:03
  That's right.
• 18:04
  I'm going old.
• 18:04
  Your designs were beautiful.
• 18:06
  That's right.
• 18:06
  The designs are beautiful.
• 18:08
  Jawbone is phenomenal at design, uh, Hossain, the CEO, uh, really great eye, Yves Behar and Fuse Project and a lot of design there.
• 18:16
  Could not do it, have done it better.
• 18:18
  And that was really, um, foundational for me and really understanding consumer centric design and how you, Uh, account for, you know, behavior change, uh, using design and actually try to drive that in the way you build and deliver experiences to this broader aim of health benefit.
• 18:35
  So, uh, I learned so much and I'm so grateful for that.
• 18:39
  As you think about that, you know, the, the, the, the team there really was exceptional at understanding how to through design, cut through the category and make a distinctive product.
• 18:50
  And really at the time, really, I think leading edge, uh, the.
• 18:55
  How does that affect, you know, your approach to kind of consumers and mental health?
• 19:01
  Yeah.
• 19:01
  I mean, I think it's really Manifested in this empowered patient trends that that so quickly caught hold of health care, you know, in the past 10 years, and I think really made major progress that traditionally health care has had this reputation for factoring in everyone but the patient in the way that experiences and interventions are designed, and it took Silicon Valley and some of these cases to really introduce this consumer first mentality.
• 19:29
  And Jawbone was phenomenal at that and saying not only how do you help Deliver something to somebody, but make it fit into their lives.
• 19:35
  Make them want it and want to engage with it.
• 19:38
  Behavior change is the hardest and most lasting problem in health care.
• 19:42
  And we're not going to do it if we don't understand people, if we don't build experiences that people want to use and want to come back to to have the opportunity to benefit from.
• 19:50
  Uh, and so to that degree, we've tried to carry that forward and everything we do at Brightside.
• 19:55
  Um, and, and we know that that's a big part of helping people activate and engage in their care, uh, and get the clinical benefit that we know we can deliver.
• 20:04
  So Doug, no water polo questions for you, but, um, I wanted to ask you about, uh, the pandemic, which seemed to really radically boost the incidence of mental health problems, especially for, for younger people.
• 20:15
  Haven't heard an update on that.
• 20:17
  Uh, what are you seeing in terms of, uh, you know, the pandemic and it's, it's lasting, uh, impact and, you know, how that's affecting just sort of the overall amount of mental, uh, health care that's required?
• 20:28
  Yeah, I think the pandemic gave us a couple lessons.
• 20:31
  One is that absolutely every one of us was impacted enough by stress and it allowed us all to, to, to help decrease that stigma we talked about before.
• 20:40
  I'd start talking a little bit more.
• 20:42
  We saw huge increases in, in, uh, demand for outpatient behavioral health care and resources.
• 20:50
  And, uh, I think a lot of people thought that would go away when the pandemic ended.
• 20:55
  But we haven't, that has not happened.
• 20:57
  We've continued to see, uh, you know, even this year, another 10 to 15 percent increase in the, in the number of visits that people are getting.
• 21:06
  And that's, More people accessing behavioral healthcare as well as those that are accessing care, using it more, uh, than people did on average prior to the pandemic.
• 21:17
  The other lesson from the pandemic that I think was really important was that it forced us to start to look at different ways to deliver behavioral healthcare because we couldn't go to the doctor's office anymore and, and couldn't, couldn't make those trips.
• 21:30
  And so that, that development of digital care and virtual care, uh, that makes it more.
• 21:36
  Uh, convenient for individuals.
• 21:38
  They don't have to take a half a day off of work and drive all the way across town to go see a therapist.
• 21:44
  They can do it from home or from their car or wherever they're at and the privacy piece of that and especially in in smaller Areas where, you know, people still because of the stigma might not want their car seen in the parking lot at that where they where that therapist office is that all of that goes away with with these, uh, these new digital and virtual care platforms.
• 22:08
  And that's helped a lot.
• 22:10
  So we continue to see demand continue to increase, uh, and new innovative ways to deliver care.
• 22:17
  Doug, is that, is that, is that demand across every age category, or is it primarily in certain subsets?
• 22:25
  I mean, obviously, being since the invention of the like button, you know, self harm in teens has got, has rocketed.
• 22:31
  Um, there's obviously a lot of, a lot of, uh.
• 22:35
  you know, undiagnosed anxiety and depression among surviving seniors.
• 22:39
  I mean, there's a Are there particular categories or do you see it across the board?
• 22:44
  Well, we've seen increase in demand across the board at all age groups, but some stand out.
• 22:50
  So, so when we think about Adolescents, adolescents, uh, we've seen some of the biggest increases in demand for mental health care, young adults, those 20 to 26, right?
• 23:03
  Large increases in the number of suffering from anxiety, depression, substance use issues and seeking care.
• 23:09
  We've seen adolescent suicide rates.
• 23:12
  really continue to increase across the board.
• 23:15
  And, uh, and so really that demand, and we started looking at how do we get more care and more services to them?
• 23:21
  And again, using digital, using other, other means and innovative programs to engage them the way that they want to be engaged and are willing to be engaged to access care really important.
• 23:33
  But we're seeing that across the, you know, across all age groups.
• 23:37
  I think, you know, Brad, I'm, I'm excited that you're doing consumer first.
• 23:41
  I think that the thing in healthcare is even if you think the consumers or patients are relevant, that's a step forward where a healthcare system has treated people more like transactions and scheduling problems.
• 23:53
  and billing problems than, than, than therapeutic interventions for, for, for, for, uh, for a healthy life.
• 24:00
  So that I, I appreciate that.
• 24:02
  How do you guys distinguish yourself among the thousands of other digitally assisted, uh, Behavioral health, emotional support, you know, dot, dot, dot.
• 24:15
  Like there's a lot of great innovation in this category, but probably too many startups.
• 24:22
  How, how do you, what, what, what, what's your distinctive advantage in that, in the category?
• 24:27
  Yeah, there's been a lot of investment that's gone into digital behavioral health over the past number of years.
• 24:32
  And, um, you know, I think we should all welcome it.
• 24:35
  You're right.
• 24:35
  That not all the companies are going to last, but there are a lot of different needs across the market and companies doing different things where Brightside really stands out.
• 24:44
  is the highest level of clinical quality care, um, across the full spectrum of needs for mood and anxiety disorders.
• 24:51
  And where that really stands out and manifests, um, is particularly at the high end of severity and acuity.
• 24:57
  So, think about people that have, you know, moderately severe or worse depression or anxiety.
• 25:02
  About, uh, half of our members start with suicidal ideation.
• 25:06
  Um, and we uniquely have a crisis care program that we can handle people with elevated suicide risk, which has been a major gap in the market.
• 25:13
  Um, so if somebody not only has hit the pause, hit the pause button there, but that is a major social problem that is, that is that we don't have a solution for.
• 25:23
  That's, that's awesome.
• 25:24
  I appreciate that.
• 25:25
  Yeah.
• 25:25
  And the truth is we talk about access problems a lot, but if somebody not only has suicidal ideation, but they start to think about the details of a plan of how they may follow through, they've got really timely needs for specialized care and not just any mental health provider is comfortable or trained to handle those specific cases.
• 25:44
  And so the people who need timely care the most end up being kind of a hot potato and the least likely to get care that among.
• 25:51
  You know, many other drivers has driven rapid increases of, uh, you know, emerge or mental health complaints at the emergency department, which we know is an ineffective and inefficient way to try to get mental health care.
• 26:02
  And it's just created this, this really negative cycle at that, that high end of severity and acuity.
• 26:06
  So.
• 26:07
  We really stand out there.
• 26:08
  Um, and we've, you know, one of the things that's unique about bright side is we've published 10 papers in peer review now showing our methods and outcomes.
• 26:15
  We know that the trust in this industry is earned by showing your work.
• 26:19
  And, uh, we stand behind our outcomes as our primary measure of success.
• 26:23
  And then the way that we go build and deepen relationships with, with, uh, uh, our payer partners like ever North.
• 26:30
  Last question.
• 26:31
  A lot of times when this sort of care has been available, it's been mostly for commercial patients.
• 26:37
  You've been speaking more recently about Medicaid and Medicare patients.
• 26:40
  How do they fit in and what do you do to help them?
• 26:44
  The truth is that when I started Brightside, I looked at Medicaid and I said, wow, you know, the it's the biggest payer for mental health services in the U.
• 26:53
  S.
• 26:54
  Anyone who uses Medicaid knows that it's really hard to get an appointment and that most providers don't want to participate in Medicaid because the rates are low.
• 27:01
  And so you're, you're, you're sort of have an adverse selection problem with providers.
• 27:05
  And I said, I don't think our mission is gonna be complete until we conserve Medicaid, but I had no idea how we would do it.
• 27:11
  Um, and so, you know, we've been building bright side for 6 years now and have built a really robust platform and a phenomenal provider network and a great amount of technology and data to help us reliably deliver.
• 27:23
  Uh, really great carrot scale and have built up the ability now to actually start to serve Medicare and Medicaid.
• 27:29
  So we'll be launching our Medicare offering in the next couple of weeks and Medicaid in the next month or so, um, and finally be able to start to serve that market.
• 27:38
  And it's really a function of a few things that allow us to do that.
• 27:41
  Um, first, we actually looked at our prior patient populations that we were treating, and we were Pulled out our results just for low income individuals and for seniors and published papers showing that, um, we knew we were delivering great care in those sub populations, consistent with the care for, for our general population.
• 27:58
  So we know we can deliver good care.
• 28:00
  Um, and then, you know, the next step is really to go partner with the payers that are, um, you know, overseeing those programs, whether it is CMS.
• 28:08
  or Medicare Advantage plans and managed Medicaid plans.
• 28:12
  Um, and so we've been able to take our quality and our focus on, um, and, and differentiation and that sub portion of the patient population really driving a lot of cost and risk with ED visits and inpatient hospitalizations and readmissions.
• 28:26
  Um, and work to partner with those plans to really target, intervene and support those patients who really need that impact the most.
• 28:34
  And so really excited for us to go and expand out that footprint and really fill a major, major gap that's, that's been holding back behavioral health delivery for so long.
• 28:45
  Well, that's it for yet another episode of Care Talk.
• 28:47
  Our guests today have been Evernorth Chief Medical Officer for Behavioral Health, Dr.
• 28:52
  Doug Nemesek and Brightside Health CEO, Brad Kittredge.
• 28:56
  I'm David Williams, President of Health Business Group.
• 28:59
  And I'm John Driscoll, the President of Walgreens Health.
• 29:01
  If you liked what you heard in this video, please subscribe on your favorite service.