/ en Mon, 28 Apr 2025 03:07:51 -0500 Mon, 20 May 24 08:05:00 -0500 /advancing-health-podcast/2024-05-20-leadership-dialogue-series-behavioral-health-solutions-jeremy-musher-md-lifepoint-health <p>Across the country, hospitals and health systems are moving to fully integrate behavioral health treatment as a core part of patient-centered care. In this conversation, Joanne M. Conroy, M.D., CEO and president of Dartmouth Health and 2024 AHA board chair, talks with Jeremy Musher, M.D., chief behavioral medical officer at Lifepoint Health, about common obstacles in the behavioral health field, including access and reimbursement, as well as ways to approach mental health stigmas.</p><hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00;00;01;03 - 00;00;23;00<br> Tom Haederle<br> Health care providers coast-to-coast have seen a significant rise in the past several years in the demand for behavioral health services. Broadly speaking, behavioral health encompasses those things that affect overall well-being, including mental health issues and substance use disorders. Many hospitals and health systems want to fully integrate behavioral health treatment as a core part of patient centered care. </p> <p> 00;00;23;05 - 00;00;37;15<br> Tom Haederle<br> But there are barriers that often stand in the way and make it more difficult. </p> <p> 00;00;37;18 - 00;01;14;19<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the 黑料正能量 Association. I'm Tom Haederle with AHA communications. In this month's Leadership Dialogue Series podcast, Dr. Joanne Conroy, CEO and president of Dartmouth Health and 2024 Board Chair of the 黑料正能量 Association, explores how hospitals and health systems can best meet the need for behavioral health services with Dr. Jeremy Musher, chief behavioral medical officer at Lifepoint Health in Brentwood, Tennessee. They discuss how to overcome some common obstacles to effective treatment, including access issues, reimbursement challenges, and the stigma of receiving treatment. </p> <p> 00;01;14;21 - 00;01;18;15<br> Tom Haederle<br> And, they offer possible solutions. Let's join them. </p> <p> 00;01;18;17 - 00;01;46;28<br> Joanne M. Conroy, M.D.<br> Thank you for joining us for another deep dive into a very important topic on the Leadership Dialog series. It's great to be with you. I'm Joanne Conroy, CEO and president of Dartmouth Health and the current chair of the 黑料正能量 Association Board of Trustees. Today's discussion is critically important and it impacts all of us. It can be our own experience or the experience of a family member or a friend. </p> <p> 00;01;47;00 - 00;02;20;09<br> Joanne M. Conroy, M.D.<br> And the issue is mental health. We know concerns around mental health have only worsened over the past few years. Those needing mental health services have long been stigmatized, and unfortunately, reimbursement for their care has been lagging for decades. Access to adequate mental health is perhaps the single most challenging obstacle that we all face as health care professionals at this moment in time. And finding these services is even more difficult in rural areas. </p> <p> 00;02;20;11 - 00;02;50;14<br> Joanne M. Conroy, M.D.<br> With the mental health crisis worsening, hospitals and health systems are finding themselves more active in developing an advocating for solutions. At Dartmouth Health, like other organizations, we're working to build a stronger infrastructure to meet our patients behavioral health needs. Across the continuum of care. And we are super fortunate today to have our guest, Dr. Jeremy Musher, who's chief behavioral medical director at Lifepoint Health. </p> <p> 00;02;50;17 - 00;03;14;19<br> Joanne M. Conroy, M.D.<br> Lifepoint Health is a health care delivery network with facilities in 31 states. The system includes 60 community hospitals, but also more than 60 behavioral health or rehab hospitals, along with hundreds of other sites of care that span the health care continuum. Jeremy, before we jump into our discussion, I know that the audience really likes to get to know our guests a bit. </p> <p> 00;03;14;22 - 00;03;31;23<br> Joanne M. Conroy, M.D.<br> So I'm going to ask you to please share a little bit more about yourself and your journey into health care, specifically towards behavioral health. And I also wonder if our paths may have crossed the South Carolina when you were at the University of South Carolina, because I was in Charleston for a long time. </p> <p> 00;03;31;25 - 00;03;58;13<br> Jeremy Musher, M.D.<br> I don't recall our paths crossing, but, we may have. I was there for a while. Actually, I started, doing my residency. I completed that in the Navy. So I was, Armed Forces scholarship student and, did my residency in the Navy and then was on active duty for a total of about six years. As you mentioned, I've worked in academia. </p> <p> 00;03;58;15 - 00;04;28;08<br> Jeremy Musher, M.D.<br> I was, the residency training director or vice chair of the Department of psychiatry and associate dean for student affairs at the University of South Carolina. And in more recent years, I was the medical director for the psychiatric emergency services at Western Psychiatric at the University of Pittsburgh. I've also in the past been a psychiatric surveyor for CMS under the conditions of participation. </p> <p> 00;04;28;11 - 00;04;58;05<br> Jeremy Musher, M.D.<br> And then for about 25 years had a private consulting company working with psychiatric hospitals and systems to ensure compliance with regulatory guidelines. I've also represented the American Psychiatric Association as the advisor to both the CBT panel and the RV Update Committee for about 15 years. About eight years ago, I joined the national psychiatric company Springstone as the chief medical officer and chief clinical officer. </p> <p> 00;04;58;07 - 00;05;09;14<br> Jeremy Musher, M.D.<br> And then we were acquired, a year ago February, by Lifepoint Health. And now we are the Lifepoint Behavioral Health within Lifepoint. </p> <p> 00;05;09;16 - 00;05;38;07<br> Joanne M. Conroy, M.D.<br> So behavioral health has become an incredibly important aspect of delivering care, not just at a facility level, but at a system level, which is probably behind the acquisition of Springstone by Lifepoint, really understanding that they had a gap in their services that they had to fill. But that gap has gotten wider during the pandemic and the economic challenges of the last few years. </p> <p> 00;05;38;07 - 00;05;48;21<br> Joanne M. Conroy, M.D.<br> And I think people believe that, you know, access is still very, very difficult. What trends have you observed as you kind of look from a national level? </p> <p> 00;05;48;23 - 00;06;26;05<br> Jeremy Musher, M.D.<br> According to the World Health Organization. in the first year of Covid, the global prevalence of anxiety and depression increased by about 25%. And in the United States, before the pandemic, about 8.5% of adults experienced elevated depressive symptoms. But in the early months of the pandemic in 2020, that number climbed to almost 28%. 2021 it was about a third of all U.S. adults, about 33%. Among young people aged 10 to 24 </p> <p> 00;06;26;07 - 00;07;03;29<br> Jeremy Musher, M.D.<br> suicide is the second leading cause of death in the US., with rates rising for decades. Between 2016 and 2022, children's hospitals saw 166% increase in ER visits for suicide attempts and self-injury among children 5 to 18. Youth suicide during Covid increased. The median monthly overdose deaths among persons age 10 to 19 increased over 100%, with 90% of those involving opioids, most of which were fentanyl. </p> <p> 00;07;04;01 - 00;07;25;22<br> Joanne M. Conroy, M.D.<br> So you are looking at this from a national level, though, and I'm sure you say, why? As a group of leading health professionals, especially around pediatrics, those are scary statistics. As leaders, how do you devise a solution for that? Or how do you create a safety net for that? It seems an incredibly difficult problem to put your arm around. </p> <p> 00;07;25;24 - 00;08;12;28<br> Jeremy Musher, M.D.<br> It is. And it really takes coordination and cooperation amongst, both the health care providers as well as the government. Right now and for some time, part of the difficulty in gaining access for patients has been because there aren't enough psychiatrists, there aren't enough behavioral health providers. Part of that is reimbursement issues...the barriers to access that CMS has, because of rules that haven't changed over many years, including Medicare, has a 190 day limit to lifetime mental health admissions. </p> <p> 00;08;13;00 - 00;08;59;29<br> Jeremy Musher, M.D.<br> The institutions of mental disease, the IMD exclusion prohibits Medicaid from paying for psychiatric admissions and freestanding psychiatric hospitals for people aged 21 to 64. And something we struggle with all the time is the inpatient documentation and staffing requirements CMS has under the two special conditions of participation. All of these things, along with the payers and their authorization limits that psychiatry has that are different frequently than acute care, make it difficult to provide the services that so many people need. </p> <p> 00;09;00;03 - 00;09;24;06<br> Joanne M. Conroy, M.D.<br> So let's talk a little bit about that pediatric population. We had a seminar for adolescent behavioral health a couple of years ago, I think. It was after the first wave of the pandemic when we thought it was safe, even though it really wasn't over. But we, you know all met in a ballroom, really kind of talking about the issues that adolescents and kids were facing. </p> <p> 00;09;24;09 - 00;09;51;10<br> Joanne M. Conroy, M.D.<br> And what amazed me was the burden that we put on school nurses, and probably the lack of infrastructure to support them. Because they're kind of on the front line in the school systems, identifying some of these needs. It's a kind of a really robust kind of health system, or the alternative sites where you can actually identify these kids early and maybe get them help. </p> <p> 00;09;51;12 - 00;10;02;03<br> Joanne M. Conroy, M.D.<br> Is that on the radar screen? It's almost like not just giving care within your facilities, but what are you doing in the community to really identify these kids early on? </p> <p> 00;10;02;05 - 00;10;41;18<br> Jeremy Musher, M.D.<br> Well, we do work in some of our locations with local school systems, for instance Most of the work we do is, unfortunately, after they've been identified and come to the hospitals. But with the education that goes on, both we provide and many others provide in the communities, it is that identification comes earlier. We have in all of our freestanding psychiatric hospitals, an assessment area, sort of like, mini emergency room. </p> <p> 00;10;41;20 - 00;11;23;02<br> Jeremy Musher, M.D.<br> And we see adolescents come all the time where we're able to give a screening and an evaluation and determine if their services are needed and if so, what level of care. So that helps get adolescents and sometimes younger kids into the system of care. We also work with primary care providers and pediatricians in terms of providing the kinds of backup and expertise that sometimes they need in order to treat more severely ill, kids. </p> <p> 00;11;23;05 - 00;11;50;08<br> Joanne M. Conroy, M.D.<br> You know, we've invested heavily in telehealth, and we offer a lot of tele psychiatry, both to our emergency rooms, but even to our primary care clinics, if they have questions about resources or a diagnosis or a child where a telesite visit can actually help. How prevalent is that across the industry and is it something that we should invest more heavily in? </p> <p> 00;11;50;08 - 00;11;58;07<br> Joanne M. Conroy, M.D.<br> Or if you had money to invest, where would you invest it to help kids in the best possible way? </p> <p> 00;11;58;09 - 00;12;32;00<br> Jeremy Musher, M.D.<br> Definitely telehealth would the high on the list. We've been doing telehealth and psychiatry for years before the pandemic. But it really took off during the pandemic. And we've found that we can do groups, via Telehealth, as you said, we can consult with ERs. Even CMS has seen, there are so many advantages to the use of telehealth, predominantly from an access standpoint. </p> <p> 00;12;32;03 - 00;13;03;28<br> Jeremy Musher, M.D.<br> They have lowered the barrier to access on telehealth and particularly for behavioral health, going forward. So the site of service won't matter anymore the way it used to. Telehealth makes a big difference. What we've found in our system is the patient satisfaction is, in most cases, equivalent to in-person visits. </p> <p> 00;13;04;01 - 00;13;24;25<br> Jeremy Musher, M.D.<br> Plus, you don't have the difficulties of transportation. And so long as the insurers paid for it, that doesn't become a barrier. So, yes, telehealth, for sure would be one of the important areas to increase access going forward. </p> <p> 00;13;24;27 - 00;13;51;18<br> Joanne M. Conroy, M.D.<br> Almost 80% of our behavioral health visits are virtual now, and the no-show rate is almost zero. And, you know, we don't always, think about the stigma that was associated with seeing a psychologist or a psychiatrist for not only a child, but even an adult. You all remember where you would enter one way and you'd exit another way. </p> <p> 00;13;51;20 - 00;14;18;14<br> Joanne M. Conroy, M.D.<br> It was like reinforcing the stigma, although I totally understand why people did it, but it kind of validated that for everybody. There was a stigma to going to see a behavioral health expert. You know, we are doing some things up here at the college that are really interesting, where people can sense from how a adolescent actually interacts with their phone in terms of texting, identifying behavioral health issues early on. </p> <p> 00;14;18;17 - 00;14;31;22<br> Joanne M. Conroy, M.D.<br> Have you heard of a lot of research in that realm, like how do we take a technology that we think causes isolation and try to use it to identify diagnoses before they actually manifest in different ways? </p> <p> 00;14;31;24 - 00;15;24;19<br> Jeremy Musher, M.D.<br> Actually, there's been some, I think really interesting research going on. It's not out in the wild so much yet, but, there are apps, that they are working on, on iPhones and other phones, that use, for instance, the accelerometer in the phone to measure movement of the individual. And by using algorithms and AI you can use that information and other information - calls, texting, use of online access, etc. - to say, for instance, this individual has been reducing their movement over this period of time. </p> <p> 00;15;24;21 - 00;15;58;06<br> Jeremy Musher, M.D.<br> Maybe they're depressed or other use of the phone to help identify. And then, the apps can proactively reach out to the individual and ask, are you feeling okay? Would you like to reach out to your therapist? Would you like to find a therapist? Those kinds of things. So yeah, we are seeing technology start to be used in ways that I think will make a huge difference. </p> <p> 00;15;58;08 - 00;16;21;29<br> Jeremy Musher, M.D.<br> We're also seeing CBT - cognitive behavioral therapy is an evidence based form of therapy for anxiety and some forms of depression, etc.- and there are apps that you can use on your phone or online that help walk through some CBT treatment. </p> <p> 00;16;22;02 - 00;16;51;17<br> Joanne M. Conroy, M.D.<br> Wow. And so with technology, although the cause of isolation may be some of the answer to isolation for many individuals in the future, Lifepoint acquired your organization for probably a specific purpose. What do they want to achieve at the Lifepoint health system level, and what would they like to achieve at the community level by adding you to their portfolio of health care services? </p> <p> 00;16;51;19 - 00;17;25;19<br> Jeremy Musher, M.D.<br> Before we were acquired, Lifepoint Health had acquired Kindred Rehab about a year before us, and kindred had a couple of behavioral health hospitals. They had just started some interest in, behavioral health hospitals. But by acquiring Springstone, we brought to the table, 18 freestanding psychiatric hospitals, as well as about 35 outpatient clinics, across nine states. </p> <p> 00;17;25;21 - 00;18;04;16<br> Jeremy Musher, M.D.<br> So it was a way for Lifepoint to essentially jump start their development of behavioral health resources. In addition, they already had, behavioral health units in many of their acute care hospitals. And so now across...we have about 2,500 inpatient psychiatric beds when you combine the behavioral health units in acute care hospitals with now 24 freestanding psychiatric hospitals across 31 states. </p> <p> 00;18;04;19 - 00;19;01;22<br> Jeremy Musher, M.D.<br> So the idea in acquiring us was to get more involved in meeting needs in the communities of patients who needed behavioral health services and they weren't getting them. And part of the model going forward has been to develop joint ventures with predominantly med surge hospital systems who don't have enough behavioral health resources. And so by forming a joint venture with Lifepoint, we together can build a freestanding psychiatric hospital, for instance, or, work in the communities and bring those much needed behavioral health resources to the communities, particularly to more rural communities. </p> <p> 00;19;01;24 - 00;19;12;01<br> Jeremy Musher, M.D.<br> The mission for Lifepoint is making communities healthier. And that's what we're moving to do as quickly as we can. </p> <p> 00;19;12;04 - 00;19;37;08<br> Joanne M. Conroy, M.D.<br> Well thank you. You know, this topic is one that I think everybody will benefit listening to. And I want to encourage anyone who is struggling with feelings of anxiety or depression to please reach out to someone who can help. You can also visit the AHA.org or AHA's Physicians Alliance website for additional resources that are focused on stress, coping and mental health for health care workers. </p> <p> 00;19;37;11 - 00;19;46;29<br> Joanne M. Conroy, M.D.<br> Thank you again, Jeremy. And until next time, thank you everyone for joining us today. I hope you'll be back for next month's Leadership Dialog. </p> <p> 00;19;47;01 - 00;19;55;12<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Mon, 20 May 2024 08:05:00 -0500 Value Analysis /role-hospitals-butler-hospital-rhode-island-hospital-meets-teens-needs-behavioral-health-care <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-5"><p><img src="/sites/default/files/2024-05/ths-RhodeIsland-Teen-Therapy-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Butler Hospital. Teen sits on a sofa facing a female therapist" width="700" height="532" class="align-left"></p></div><p>The number of adolescents reporting poor mental health, according to the Centers for Disease Control and Prevention, has been increasing. According to a <a href="https://www.cdc.gov/healthyyouth/mental-health/index.htm" target="_blank" title="CDC Report">recent CDC report</a> from its Division of Adolescent and School Health, in 2021 more than four in 10 students said they felt persistently sad or hopeless; and nearly one-third (29%) reported experiencing poor mental health. Also in 2021, more than one in five students (22%) seriously considered attempting suicide, and one in 10 made a suicide attempt. </p><p>Providence, R.I.鈥檚 Butler Hospital, a part of Care New England, is reaching out to teens as part of its mission as the state鈥檚 only nonprofit, freestanding psychiatric hospital. Butler now offers two behavioral health programs for teens, providing psychiatric treatment and support for young people ages 13 to 17 who are experiencing depression, anxiety, addiction and other mood disorders.</p><ul><li>The <a href="https://www.butler.org/services/inpatient/teen" target="_blank" title="Inpatient Teen Treatment Unit">Inpatient Teen Treatment Unit</a> offers brief, intensive treatment for teens experiencing depression, suicidal thoughts, self-harm, addiction and other mental health concerns. Clinicians support the teen鈥檚 entire family or guardians to address the symptoms of mental illness. This program offers a collaborative, resiliency-based approach and specializes in creating trusting partnerships and positive experiences with families less familiar with the behavioral health system. Family-based assignments may include working on a family journal, family safety plan or family relationships packet. </li><li>The <a href="https://www.butler.org/services/programs/partial/teen-program" target="_blank" title="Partial Teen Hospital Program">Teen Partial Hospital Program</a> provides care and treatment for teens who do not require inpatient hospitalization but are experiencing anxiety, irritability, mood fluctuations and other life-stage concerns. This day program is five days a week, for six hours a day, and also offers specific expertise in LGBTQ+ affirming treatment and adjustment-related issues. Part of this treatment is creating a plan that will support continued improvement and stabilization for the teen after discharge from the program.</li></ul><p><a class="btn btn-wide btn-primary" href="https://www.butler.org/services/teen-programs" target="_blank" title="Read the full story">Learn more</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/center/population-health">Improving Health and Wellness</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Fri, 17 May 2024 17:13:03 -0500 Value Analysis /role-hospitals-eastern-idaho-regional-medical-center-teen-mental-helth-outpatient-program <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-5"><p><img src="/sites/default/files/2024-05/ths-EasternIdahoRMC-TeenTherapy-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Eastern Idaho Regional Medical Center. Teen girls talk in a therapy group" width="700" height="532" class="align-left"></p></div><p>For teens struggling with mental health setbacks, there has historically been an uncovered gap in services for adolescents who may not need an elevated level of inpatient care but who are trying to maintain healthy functioning, while only seeing a professional once a week in an outpatient setting.</p><p>Eastern Idaho Regional Medical Center has moved to address that gap. Its new intensive outpatient program is designed to support young people dealing with issues such as anxiety, depression, stress, trauma and suicidal ideation that impact their school, relationships, family and/or community.</p><p>The program fills the niche for adolescents who need a higher level of care than traditional outpatient therapy, offering a few more hours of support each week to manage their lives.</p><p>Teens ages 12-17 attend group therapy several times per week with peers experiencing similar challenges.</p><p>Treatment focuses on creating new coping skills to effectively manage stress, anxiety and depression; developing social skills, self-awareness and self-esteem; and building healthy communication and boundaries.</p><p> </p><p><a class="btn btn-wide btn-primary" href="https://eirmc.com/about/newsroom/bhc-launches-teen-intensive-outpatient-program" target="_blank" title="Read the full story ">Learn more</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/center/population-health">Improving Health and Wellness</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Wed, 15 May 2024 16:34:29 -0500 Value Analysis /news/chairpersons-file/2023-05-22-chair-file-leadership-dialogue-addressing-behavioral-health-crisis-jesse-tamplen-john-muir <p>On this episode, I talk with Jesse Tamplen, vice president of behavioral health services at John Muir Health, located east of San Francisco, and a member of the AHA Committee on Behavioral Health. Jesse and I discuss behavioral health challenges in the U.S. and how hospitals and health systems are actively developing and advocating for solutions to help patients, families and health care professionals.</p> <p>Jesse emphasizes the increased need for more acute care behavioral health beds for children, adolescents and adults. For example, in California, there are fewer than 100 acute psychiatric beds for children under age 12, and John Muir Health has 10 鈥� or 10% 鈥� of those beds, Jesse notes. He stresses the importance of ensuring that 鈥渨hen kids need to access that critical, lifesaving care, they can remain in their community.鈥�</p> <p>Hospital and health systems are playing an increasingly more important role in providing behavioral health care, whether in their own facilities or by helping patients connect with community resources. 鈥淭his is an exciting area,鈥� Jesse observes. 鈥淎fter the pandemic, some of the stigma and discrimination of mental health decreased 鈥� and [it] allowed more innovation to come forward.鈥� John Muir Health partnered with local and state organizations to create a behavioral health navigator program so people receive appropriate care and treatment as well as preventive services.</p> <p>Jesse and I also discuss how hospitals are better integrating behavioral health care services with physical health services 鈥� and the need for adequate reimbursement to cover the cost of care. The 鈥渃hallenge of low reimbursement puts a huge impact on our ability to recruit [behavioral health care workers],鈥� Jesse explains.</p> <p>I hope you find these conversations interesting and insightful. Look for them once a month as part of the Chair File.</p> <p>Watch the episode.</p> <p></p> <p>Listen to the podcast.</p> <hr /> <p></p> <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> 路 <a href="https://soundcloud.com/advancinghealth/leadershipdialogue-may-mixdown" target="_blank" title="Leadership Dialogue Series: Addressing the Behavioral Health Crisis with John Muir Health">Leadership Dialogue Series: Addressing the Behavioral Health Crisis with John Muir Health</a></div> <p> </p> <details class="transcript"><summary> <h2 title="Click here to open/close the transcript."><span>View Transcript</span><br />  </h2> </summary> <p>00;00;00;28 - 00;00;39;05<br /> Tom Haederle<br /> Hospitals and health systems are playing an increasingly important role in providing behavioral health care, whether in their own facilities or by helping patients connect with community resources. It's a positive trend, but the need for behavioral health resources is great, and the gap between needs and resources remains wide. Welcome to Advancing Health, brought to you by the 黑料正能量 Association.</p> <p>00;00;39;15 - 00;01;09;14<br /> Tom Haederle<br /> I'm Tom Haederle with AHA Communications. In this leadership dialog series podcast, John Haupert, president and CEO of Atlanta-based Grady Health System and the 2023 chair of AHA鈥檚 board, is joined by Jesse Tamplen, vice president of Behavioral Health Services at John Muir Health. That's near San Francisco. Tamplen notes that in all of California, our most populous state, there are fewer than 100 acute psychiatric beds for children under the age of 12.</p> <p>00;01;09;26 - 00;01;32;06<br /> Tom Haederle<br /> John Muir Health has 10% of those beds. It's a nationwide situation. The two leaders discuss how hospitals are working with local and state organizations to create new pathways to appropriate care and treatment, as well as preventive services. And they review the role of adequate reimbursement to cover the cost of behavioral health services. With that, let's join John and Jesse.</p> <p>00;01;33;11 - 00;02;03;28<br /> John Haupert<br /> Good afternoon and thank you, everyone for joining me today for another leadership dialog session. I'm John Haupert, president and CEO of Grady Health System in Atlanta, Georgia, and also chair of the board of trustees of the 黑料正能量 Association. I'm very much looking forward to our conversation today as we talk about the critical issue of behavioral health, an issue that has only worsened during the past few years since the pandemic, but has long been  stigmatized as well as underfunded.</p> <p>00;02;04;28 - 00;02;32;21<br /> John Haupert<br /> With the mental health crisis in our country worsening, the hospital field is finding itself more active in developing an advocate for solutions to help patients and families, as well as also our own caregivers who have seen increased rates of anxiety and burnout. At Grady, like other organizations, we are working to build a stronger infrastructure to meet all behavioral health needs of those we serve.</p> <p>00;02;33;06 - 00;02;54;15<br /> John Haupert<br /> And as a matter of fact, Grady Health System is the largest provider of mental health services in the state of Georgia outside of the prison system. I am very pleased to introduce my guest today, Jesse Tamplen, an expert in this area, who will offer his insights on some of the most pressing challenges currently facing our behavioral health system.</p> <p>00;02;55;29 - 00;03;27;07<br /> John Haupert<br /> Jesse is the vice president of Behavioral Health Services at John Muir Health, a not for profit health system organization east of San Francisco. John Muir Health offers both inpatient and outpatient treatment programs across the entire spectrum of care for children, adolescents and adults who have psychiatric or behavioral problems. And Jesse also serves on AHA's Committee Behavioral Health. Welcome, Jesse.</p> <p>00;03;27;07 - 00;03;30;03<br /> John Haupert<br /> It's an honor to have you join us today.</p> <p>00;03;30;23 - 00;03;34;09<br /> Jesse Tamplen<br /> Good morning, John. It's a pleasure to be here and have this conversation with you.</p> <p>00;03;34;27 - 00;04;03;12<br /> John Haupert<br /> So, Jesse, let's go ahead and dive into a few questions so that you can share your views on several different issues surrounding mental health, behavioral health, and how health systems are bridging the gap. We know that the pandemic only worsened the longstanding challenges our nation faces around access to adequate behavioral health services. What trends have you seen over the past few years, particularly in the period post-pandemic?</p> <p>00;04;04;08 - 00;04;37;19<br /> Jesse Tamplen<br /> Thank you. As you mentioned, we know that there is a behavioral health challenge with people, children, adolescents and adults receiving care in the United States pre-pandemic. Post the pandemic, we've seen the incidence rates of self-harm, suicide, substance abuse, anxiety, depression, eating disorders increase dramatically. Where we're seeing that impact many times within the system the most is in our primary care settings. </p> <p>00;04;37;19 - 00;05;03;12<br /> Jesse Tamplen<br /> When it becomes very acute, it comes into our emergency rooms and then our med surge acute care hospitals. If a hospital emergency room is fortunate enough to be associated with an acute psychiatric hospital, they're able to get patients the care that they need. But many times that I think people have seen throughout the country that we have a lack of acute care, behavioral health beds in the United States.</p> <p>00;05;03;20 - 00;05;30;28<br /> Jesse Tamplen<br /> And unfortunately, when people become acute, they often stay in our emergency rooms waiting to get care. We do everything we can to make sure that people can go back to either their primary care provider or find specialty mental health providers. But we know that we're in short supply within that workforce. So those have been some of the clinical challenges that have been impacting the the community and the patients that we serve.</p> <p>00;05;31;22 - 00;05;47;00<br /> John Haupert<br /> I was really pleased to see that you all offer psychiatric behavioral health services to children and adolescents as well. What are your views on the availability of mental health services for children and adolescents?</p> <p>00;05;47;19 - 00;06;21;14<br /> Jesse Tamplen<br /> There's opacity for children and adolescents. The Children's Hospital Association for America mentioned that we are just at a, you know, a crisis in youth mental health. In California, one of the largest states, there's less than 100 acute psychiatric beds for kids under 12 years old. John Muir Health has ten of those. So we represent 10% of all of the states, the ICU level of care for youth.<br />  <br /> 00;06;21;14 - 00;06;46;22<br /> Jesse Tamplen<br /> We have 24 adolescent beds and John Muir, 20 years ago made the commitment to youth and adolescent mental health to make sure that kids would not be sent out of their communities to receive treatment. So we're very fortunate in our local community that when kids need to access that critical lifesaving care, they can remain in their community. Across the country and through the state of California,</p> <p>00;06;47;04 - 00;07;18;09<br /> Jesse Tamplen<br /> many times you don't have those services within your community or your health system. So those kids who need care, who need to be as part of their family are many times sent four or five hours away from home. John Muir is a local nonprofit where we serve our community. But when it comes to our acute psychiatric hospital, we are an anchor institution for all of Northern California and many times the state for our youth and adolescent specialized psychiatric inpatient treatment.</p> <p>00;07;18;25 - 00;07;45;16<br /> John Haupert<br /> Wow. Know, that's a stunning number to hear that in a state the size of California, there's 100 beds available for those services. But at the same time, as you and I know, we shouldn't be stunned because nationwide, the amount of inpatient care available for pediatric and adolescent patients is woefully underfunded and available. So let's move on to another question.</p> <p>00;07;45;27 - 00;08;09;20<br /> John Haupert<br /> Hospitals and health systems are playing an increasingly more important role in providing behavioral health care, whether in their own facilities or by helping patients connect with the resources available in their community. Can you share with us any short term collaborations you've seen that are successful in meeting the behavioral health needs of a community or even longer term solutions we should be talking about?</p> <p>00;08;10;10 - 00;08;37;27<br /> Jesse Tamplen<br /> Yeah, this is an exciting area. After the pandemic, some of the stigma and discrimination of mental health decreased in talking about it and allowing people to really share their behavioral health. And I think and the pandemic really allowed more innovation to come forward where we've had some very exciting partnerships with our state in California and locally, our local health jurisdiction, is we've created...</p> <p>00;08;38;10 - 00;09;01;27<br /> Jesse Tamplen<br /> it started off as a substance abuse, a navigator in our emergency room just supporting the opioid crisis. And then that really evolved into a behavioral health navigator. We know that there's not enough preventative services in the community. And so no matter where people are getting services, many times when they become acute, you hear everybody say, if you become acute, go to your local emergency room.</p> <p>00;09;02;04 - 00;09;28;10<br /> Jesse Tamplen<br /> And our emergency rooms are already strapped with the care that they're providing and COVID 19. So we've created a behavioral health navigator that supports those patients, both substance abuse and psychiatry. Many times they're people with lived experience or they have professional education, working with the emergency room team, the family and the community to get the person that care that they need to be able to access care.</p> <p>00;09;29;03 - 00;09;54;08<br /> Jesse Tamplen<br /> Not only do we keep them in the emergency room, but they're able to float up into our medical hospital. And many times, if they are following up with our own primary care, they will go support that individual into primary care. It's been incredible to have that that behavioral health navigator for our patients because we're meeting them anywhere they are in our health care system and helping them navigate the complexity of getting services.</p> <p>00;09;54;22 - 00;10;26;24<br /> Jesse Tamplen<br /> One of the challenges in behavioral health, you may know the service that somebody needs, but they're are significant waitlists. It doesn't exist in your community. So you really need an expert navigator to support the patients. And so that's one area that we have been using are behavioral health navigators. And then we partner with our fire departments. Right now we're doing an innovative project with one of our local fire departments where they're looking to not have a police first response, but a fire response to behavioral health care.</p> <p>00;10;26;24 - 00;10;35;06<br /> Jesse Tamplen<br /> So we're working with them to create a new clinical pathway. So those are two innovative programs that we're currently working on.</p> <p>00;10;35;26 - 00;10;58;10<br /> John Haupert<br /> I thank you, Jessie, and I'm so pleased to hear you bring up the topic of navigators and behavioral health, particularly navigators that have a lived experience with behavioral health issues, have been there, done that. So not only are they navigating for the patient and getting the care that the patient needs, but they're also also serving as a peer support individual for that person.</p> <p>00;10;58;10 - 00;11;13;22<br /> John Haupert<br /> And that's really great. So I know top of the list for many is better integrating and coordinating behavioral health services with physical health services. Any thoughts, advice or maybe wishes that you can share on this type of integration?</p> <p>00;11;14;19 - 00;11;44;23<br /> Jesse Tamplen<br /> This is where I'm passionate about. I think for us to really move the needle on the health inequities in behavioral health, we need to treat physical medicine and psychiatric medicine the same. We need to treat it clinically, which many people want to do, but we also need to treat it economically. The reimbursement in those areas. One area that I would love to share with you is that in hospitals, John Muir has two acute care medical hospitals and one acute care psychiatric hospital.</p> <p>00;11;44;23 - 00;12;10;14<br /> Jesse Tamplen<br /> And we have a transfer center. And as you know, the transfer centers, when you need a bed, when you need specialized care, referring provider calls up the transfer center to find the best care for them within the hospital. Over the last year and a half, we wanted to make sure that we integrated both physical and psychiatric medicine. So we integrated the transfer center with our acute care psychiatric hospital.</p> <p>00;12;10;20 - 00;12;39;12<br /> Jesse Tamplen<br /> So now there's one number for anybody to call to get inpatient treatment. And not only does it create easier access and decreases the stigma and discrimination for people seeking care and providers seeking care, but it's an upstream area where we're working with our workforce also to say we're not treating physical medicine and psychiatric medicine different because we know that we don't have enough beds in California for psychiatric patients.</p> <p>00;12;39;21 - 00;13;02;10<br /> Jesse Tamplen<br /> We are so we know they end up in our emergency rooms, which is not the best care or in our medical hospitals, which is not the best care, but we're still going to treat that. So if we start with a transfer center, develop those clinical pathways, it's part of the education model that we're increasing care clinical protocols no matter what setting you are within that, within the hospital needing care.</p> <p>00;13;02;19 - 00;13;13;24<br /> Jesse Tamplen<br /> So that is an area that I'm very excited about and we've had unbelievable success over the last year with integrating our transfer centers, both physical and psychiatric.</p> <p>00;13;14;11 - 00;13;39;13<br /> John Haupert<br /> Well, that that's a fantastic approach. And it's interesting in the evolution of health care in our country that we have separated those two mental and physical health aspects of an individual, when I always refer to it as whole person care. If I'm a primary care physician, I need to be able to evaluate not only the physical, but are there mental health issues at present as well.</p> <p>00;13;39;13 - 00;14;11;21<br /> John Haupert<br /> And let's treat all of that together. And I so appreciate the work you're doing around that. There have been long been issues around inadequate reimbursement, as you just mentioned, for behavioral health services, as well as significant shortages of behavioral health workers. Those challenges have likely only worsened over the past few years. Can you explain for our audience how poor reimbursement drives shortages of behavioral health workers, and how does that have an impact on inequities within our health system?</p> <p>00;14;12;10 - 00;14;36;02<br /> Jesse Tamplen<br /> Thank you. And when you get into behavioral health economics, it's almost like you have to have a Ph.D. in economics because it's not a simple: two plus two equals four. I wish it was. And so what we know is many times behavioral health is either capitated or their stringent authorizations, or in physical medicine, you can show up to any emergency room and be treated.</p> <p>00;14;36;10 - 00;15;08;00<br /> Jesse Tamplen<br /> But many times, if you're on government insurance, especially at a local health jurisdiction, you have to go to your county of origin to receive care. So your zip code is determining your access and ability to receive care. We also know if your zip codes determining that it's increasing health inequities. And so one of the challenges that we have is the mental health reimbursement does not cover the cost of care, especially in a hospital system that wants to provide whole person care as you mentioned.</p> <p>00;15;08;00 - 00;15;32;04<br /> Jesse Tamplen<br /> I'm a big proponent that to integrate physical and psychiatric medicine, you need to be part of a hospital system that runs emergency rooms, that runs surgery, that runs primary care, specialty cardiology, because that's where you're going to be taking care of the patients and you're going to have a system and a leadership group and clinicians who know how to take care of the whole person.</p> <p>00;15;32;22 - 00;16;00;16<br /> Jesse Tamplen<br /> When you carve that out, then you start having standalone behavioral health programs, which there's nothing wrong with that. But when you look at the health inequities that you are talking about  - when you're diagnosed in the United States with serious mental illness, you're dying 25 years younger than the average population. And it's not due to your mental illness, it's due to preventable health conditions, obesity, diabetes, cardiovascular care.</p> <p>00;16;00;27 - 00;16;24;04<br /> Jesse Tamplen<br /> How we carve out our reimbursement and we say we want to treat all person care. When you carve out that reimbursement and your providers and your workforce are just focusing solely on behavioral health, but then they're excluded from providing that primary care, that whole person care. Making sure you're managing somebody's diabetes or obesity or you're not part of a system that has that knowledge.</p> <p>00;16;24;12 - 00;16;55;14<br /> Jesse Tamplen<br /> You see the impact of that stigma and discrimination. And it's one of the reasons why people are dying 25 years younger in the United States with a serious diagnosis. When we look at reimbursement behavioral health providers, you look at our BSN, our Bachelor of Science in nursing, large education, financial investment of time investment becoming a psychiatrist, significant financial time investment, becoming a social worker, a psychologist, a marriage, a family counselor.</p> <p>00;16;55;22 - 00;17;17;01<br /> Jesse Tamplen<br /> So people want to follow their passion, provide whole person care. They've taken out the student loans. They made the time investment. And then when they're looking at where do they want to practice? They look at the level of reimbursement and they're like, I may not be able to pay off my student loans because of the reimbursement. So many of them will go into private practice.</p> <p>00;17;17;10 - 00;17;39;19<br /> Jesse Tamplen<br /> So in behavioral health, you really see kind of a two tier system where you have private practice, where people are taking cash because they don't want to deal with the carve out reimbursement in private practice, which we want to support. But being part of a hospital, we're looking to recruit our professionals. Our professionals are on call 24 hours a day, seven days a week, providing critical care.</p> <p>00;17;39;23 - 00;18;02;22<br /> Jesse Tamplen<br /> And the challenge of reimbursement puts a huge impact on our ability to recruit. We know recruiting for health care workers across the country is a challenge now. In behavioral health it's even more exacerbated not only because of the low reimbursement, but additionally, after the COVID 19 pandemic, there was a huge investment in digital health specifically and behavioral health.</p> <p>00;18;03;01 - 00;18;35;00<br /> Jesse Tamplen<br /> Behavioral health, many times it's not a procedure medicine. It's cognitive medicine. Cognitive medicine goes nicely, virtually. So there's a huge drain on the behavioral health workforce. If you're a psychiatrist or if you're a nurse, if you're a counselor, to be able to provide online therapy counseling, which is incredible for a work life balance. But when you're providing ... when you're an anchor psychiatric institution, not only in your community, but across the state for children and adolescents, that exacerbates the workforce.</p> <p>00;18;35;08 - 00;18;55;15<br /> Jesse Tamplen<br /> And a lot of that drop is driven by the reimbursement that we're getting for behavioral health, which is vastly underfunded. I think in March of last year, 2022, the General Accountability Office just highlighted how mental health reimbursement is underfunded in the United States.</p> <p>00;18;56;17 - 00;19;39;27<br /> John Haupert<br /> Well, Jesse, thank you for that answer. You touched on so many important points. And I'll be honest, I had not heard before that significant lifespan difference for patients with chronic mental health conditions, that really is tragic. And it really points to the issue of having separated the two and underfunding mental health across the board. So one last question, Jesse, a challenge I'm hearing more and more about is the growing administrative burden, a huge piece of this, as in prior authorizations. Some state Medicaid programs are trying to reduce the burden behavioral health workforce teams face, and there's talk of other efforts.</p> <p>00;19;40;13 - 00;19;50;14<br /> John Haupert<br /> But how are you managing that? Are there solutions you all have been able to work through with your state Medicaid program or commercial insurers to to reduce that burden?</p> <p>00;19;51;15 - 00;20;36;29<br /> Jesse Tamplen<br /> That is a great question. And many times to patients, it is an offstage challenge that they don't know until they face it. Prior authorization for behavioral health is significantly overburdened. Then you are is significantly overburdened because of the carve out. And I'm going to highlight some of the challenges that people may not be aware of, and I'll tell you what we're working on with the 黑料正能量 Association, California Hospitals Association with our local municipalities ... is one of the areas that I try to bring education to is when somebody comes to our emergency room, we know our emergency rooms, they're our to support the most vulnerable and their most critical time of need.</p> <p>00;20;37;08 - 00;21;04;05<br /> Jesse Tamplen<br /> And when any other outpatient service can't take care of somebody, they send them to our emergency room to see that receive that care because we're there 24 hours a day, seven days a week to care for the members of our community. Well, if you have a cardiac condition and you go into the emergency room and it's a life threatening condition, regardless of your payor, socioeconomic status, race, ethnicity.</p> <p>00;21;04;28 - 00;21;33;16<br /> Jesse Tamplen<br /> If you have urgent and emergent care, you get admitted into the psychiatric hospital and then you work on all of the authorizations. If they have insurance, not insurance afterwards. We have a federal law, Empala, that really supports that level of care and that level of access. The challenge with reauthorization and behavioral health is many times when it comes to Empala people don't feel that Empala oversees behavioral health.</p> <p>00;21;34;09 - 00;22;02;27<br /> Jesse Tamplen<br /> We know that it does from the Centers for Medicaid and Medicare Services. But when an individual comes into an emergency room and they need care, many times it's requiring pre-authorization, but it's an emergency care. And that reauthorization could take five, six, eight, nine hours. And so people are talking about the lack of beds in the community for psychiatric beds, behavioral health, which is true.</p> <p>00;22;03;07 - 00;22;29;21<br /> Jesse Tamplen<br /> But they also what what they're not talking about is the burdensome of pre-authorization where we're delaying care, because if it is a Medicaid program, a local health jurisdiction or a commercial insurance program, they're requiring authorization or they're going to deny that care. Many times we will the hospital or admit that person. But then on the back end, we get denials.</p> <p>00;22;29;21 - 00;22;54;01<br /> Jesse Tamplen<br /> We have to fight with authorization because we said that's the right thing to do because we need to get the person to the specialized care that they need. And so for me, when I really look at what are things that we can do to really help provide whole person care, integrate physical and psychiatric medicine, many of it is following the guardrails that the regulations are already in there and making sure that they are enforced.</p> <p>00;22;54;08 - 00;23;24;02<br /> Jesse Tamplen<br /> That's also what the General Accountability Office mentioned last March in their report is that there's regulations on the books. But when it comes to behavioral health, not everybody always follows those rules. So I've been working with the California Hospital Association, our local health jurisdiction and the state, to really make sure that we know that when somebody comes into our emergency room, we do not look at their financial status and we get them to the specialized care that they need in-patient.</p> <p>00;23;24;15 - 00;23;50;18<br /> Jesse Tamplen<br /> And for people who are not familiar with this, they may say, wait a minute, this is what's always supposed to happen. But there's been a long precedent, a community standard where people require pre-authorization, which backs up our emergency room. But most importantly, it delays critical lifesaving treatment to people with acute psychiatric or addiction medicine challenges. And the worst situations of this is what is called the ping-pong effect.</p> <p>00;23;51;00 - 00;24;09;26<br /> Jesse Tamplen<br /> I don't know if you've heard of the ping-pong effect before in behavioral health, but somebody comes into your emergency room. They're like, oh, we're not quite sure if this person needs inpatient treatment. Our attending ED physician says, yes, they do. Then somebody says, send them to our psychiatric emergency services. And so we're like, but we have an open bed available.</p> <p>00;24;10;09 - 00;24;30;21<br /> Jesse Tamplen<br /> But they say, send them to ours. We send them to theirs. They're like, oh, we agree with you. And then they send them back to your acute psychiatric hospital. Not only is it a burden on that patient and delaying care, but you're using ambulances, you're using people's times. The cost is coming up. But because behavioral health is carved out, the costs are in different domains.</p> <p>00;24;30;27 - 00;25;04;09<br /> Jesse Tamplen<br /> So people are not seeing that total cost or focusing on that total care. So I'm kind of a zealot when it comes to making sure that we have access in our emergency rooms to lifesaving care for acute psychiatric hospitals. And I've been in the field for over 25 years. I've made some progress, but it's still a fight. And I think right now, with behavioral health being in the spotlight after the COVID 19 pandemic, we can really start driving some of those quality measures which we have in the physical health side many times.</p> <p>00;25;04;15 - 00;25;18;07<br /> Jesse Tamplen<br /> But I feel all parties are mainly government health insurance, are coming together to really drive for, you know, drive that forward. So I'm hopeful, but we're not quite there yet on the issue.</p> <p>00;25;19;06 - 00;25;49;05<br /> John Haupert<br /> Well, Jessie, you really have done a fantastic job today in getting the points across that we need to be focused on. There's a very real reason that HHS has has targeted specific issues within society and health to assure funding for and behavioral health is one of those. I want to thank you for joining us today. I appreciate you sharing your insights on how we can best support behavioral health services and integrate treatment and the whole person care.</p> <p>00;25;49;29 - 00;26;16;07<br /> John Haupert<br /> I know this is a topic that can benefit everyone listening, and I encourage anyone who may be struggling with feelings of anxiety or depression to please reach out to someone who can help. You can visit AHA.org and AHA's Physician Alliance website for additional resource is focused on stress coping and mental health for health care workers. Until next time.</p> <p>00;26;16;07 - 00;26;23;09<br /> John Haupert<br /> Thank you, everyone, for joining us today. I hope you'll be back next month for our next leadership dialog. 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padding: 0 5px; } /*.CenterCallout_a .CenterCallout_a_Wrapper p .CenterCallout_a .CenterCallout_a_Wrapper ul { display: none; }*/ } @media (max-width:991px) and (min-width:568px){ .CenterCallout_a CenterCallout_a_ul{ width: 75%; margin: auto; } } </div> <div> .Banner_Title_Overlay_Bar.TT_Banner img{ float: right; max-height: 250px; } .Banner_Title_Overlay_Bar.TT_Banner h1{ max-width:calc(100% - 225px); bottom:0px } @media (max-width:567px){ .Banner_Title_Overlay_Bar.TT_Banner h1{ display: inline-block; position: relative; max-width:calc(100% - 200px); } } @media (max-width:567px){ .Banner_Title_Overlay_Bar.TT_Banner h1{ display: inline-block; position: relative; max-width:100%; background-color: #f6f6f6 } .Banner_Title_Overlay_Bar.TT_Banner img{ float: none !important; margin: auto; display:block ; position: relative ; } } <header class="Banner_Title_Overlay_Bar TT_Banner"><img alt="Banner Image" src="/sites/default/files/2020-12/AHA_TT_thumbnail_300x173.jpg" /> <div> <h1 class="tth1">Leveraging Outcomes-based Data to Excel in a Value-based World</h1> </div> </header> </div> /* CntMenuSub */ .CntMenuSub{ margin:20px 0px; padding-bottom: 5px; color: #afb1b1; letter-spacing: 1.5px; font-weight: 400; font-size: 11.2px; } .CntMenuSub .CntMenuBar{ border-bottom: 1px solid lightblue; } /* if includes a logo */ @media (min-width:361px){ .CntMenuSub.CntMenuSubLogo .CntMenuBar{ margin-top: 10px; float: left; width: calc(100% - 425px); } } @media (max-width:767px) and (min-width:361px){ .CntMenuSub.CntMenuSubLogo .CntMenuBar{ float: left; width: calc(100% - 0px); } .CntMenuSub.CntMenuSubLogo img{ width: auto; } } /* // */ .CntMenuSub .CntMenuBar a:after{ content: "|"; padding: 0 3px 0 6px; color: #555; } .CntMenuSub .CntMenuBar a:last-child:after{ content: ""; } .CntMenuSub .CntMenuSubHome, .CntMenuSub .CntMenuSubParent{ text-transform: uppercase; color: #555; opacity: .9; } .CntMenuSub .CntMenuSubParent{ } .CntMenuSub .CntMenuSubChild{ } .CntMenuSub .CntMenuSubCurrent{ opacity: .7; } .CntMenuSub .CntMenuSubHome:hover, .CntMenuSub .CntMenuSubParent:hover{ text-transform: uppercase; color: #d50032; } /* CntMenuSub // */ <div class="row CntMenuSub"> <div class="CntMenuBar"><a class="CntMenuSubParent" href="./" id="CntMenuSubParentOnly"></a> <span class="CntMenuSubChild" id="CntMenuSubChildz"></span></div> <div> </div> </div> var url = window.location.pathname; var path = url.split('/').slice(1, 2).join('/'); var pathreplace2 = path.replace(/-/g, " "); document.getElementById("CntMenuSubParentOnly").innerHTML =(pathreplace2); var y = document.getElementsByTagName("h1"); document.getElementById("CntMenuSubChildz").innerHTML = y[0].innerHTML; <div class="row"> <div class="col-md-6"> <div class="embed-responsive embed-responsive-16by9">View on YouTube.</div> <p>Sponsored by: <a href="https://www.3m.com/3M/en_US/health-information-systems-us/" target="_blank"> <img alt="3M Modal Logo" src="/sites/default/files/2022-09/Logo_3MModal_834x313.jpg" /> </a></p> </div> <div class="col-md-6 center_body"></p> <p class="center_Lead"></p>--> <p><strong>Today, it鈥檚 essential to provide nurses and other front-line caregivers with the tools to support clinical workflows while reducing cognitive burden associated with documentation and navigating digital health devices and platforms.</strong></p> <p>Simplifying clinical workflows and making caregivers鈥� jobs easier by deploying technologies like smart beds that can sense patients鈥� conditions and unified mobile communications and nurse call platforms can go a long way toward shaping whether nurses will be able to work smarter, not harder.</p> <p>Amid this shifting landscape, health care leaders are challenged to deliver a more connected, interoperable digital health ecosystem to collect information, improve nursing communications, and provide more time for patient engagement.</p> <li>xxxxxx</li> </ul>--> .TTreadmore{ font-weight: 700; margin-top:50px; } <p class="TTreadmore">Download the <a href="/system/files/media/file/2022/09/TTalks_S2-Ep06_Abstract_Handout.pdf" target="_blank">Episode Abstract</a> >></p> </div> </div> <div class="container-fluid row"> <div class="row"> <div class="col-md-12"> /* CalloutBorderWrapper - aka SponsorMarketoForm */ .CalloutBorderWrapper { background-color: ; padding: 5px 25px 20px 25px; border: solid 2px #307FE2; margin: 25px 100px 25px; } @media (max-width:640px){ .CalloutBorderWrapper { margin: 25px 0px 25px; } } .CalloutBorderWrapper h3 { margin: 10x 0 0 0; color: #555; font-size: .7em; text-transform: uppercase; font-weight: 400; letter-spacing: 3px; max-width: 200px; /* Custom for the copy length */ background-color: #fff; padding: 5px 15px; position: relative; top: -35px } .CalloutBorderWrapper h2 { color: #002855; } .CalloutBorderWrapper .CalloutBorderWrapperHolder { background-color: ; padding: 15px; display: inline-block; margin-bottom: 25px; } .CalloutBorderWrapperHolder form { margin: auto; } /* CalloutBorderWrapper - aka SponsorMarketoForm // */ <div class="cta--image-container CalloutBorderWrapper center_body"> <h3>Key Take Aways</h3> <p>Here is what our experts had to say:</p> .sp_CTA5_holder { margin-top:50px; border-bottom: solid 1px #555; padding-bottom: 50px; } .sp_CTA5_holder_last { border-bottom: solid 0px #555; } .sp_CTA5_holder >div{ overflow: auto; } .sp_CTA5_holder ul { list-style: none; /* Remove default bullets */ padding-left: 0px; margin-bottom: 25px; } .sp_CTA5_holder ul li { margin-bottom: 7px; line-height: 1.5em; } .sp_CTA5_holder ul li::before { content: " "; font-size: 1em; margin-right: 10px; display: inline-block; height: 12px; background-color: #d50032; width: 12px; position: relative; top: 0px; } .sp_CTA5_holder ul li { padding-left: 23px; text-indent: -23px; } .sp_CTA5_holder h2 { color: #002855; /*! line-height: 2em; */ font-size: 2.15em; margin: 0 0 15px 0; /*! font-size: 30px; */ } .sp_CTA5_holder h3 { color: #002855; line-height: 1em; font-size: 1.5em; margin-bottom: 25px; margin-top:5px; } .sp_CTA5_section{ margin-top: 25px } .sp_CTA5_ImgShadow { /*background-color:green;*/ /* just a visual */ text-align: center } .sp_CTA5_ImgShadow { padding-bottom:75px; /* must match the padding on the img*/ margin: 0px; } .sp_CTA5_ImgShadow img{ width: calc(100% - 35px - 15px); -webkit-box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); -moz-box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); position: relative; top: 75px; max-width: 490px; } @media (max-width:990px){ .sp_CTA5_ImgShadow img{ max-width: 350px;} } @media (max-width:990px){ .sp_CTA5_ImgShadow { padding-bottom:75px; /* must match the padding on the img*/ margin: 0px; margin-right: 40px } } <div class="sp_CTA5_section row"> <div class="col-sm-1"> </div> <div class="col-md-10"> <div><img alt="icon" src="/sites/default/files/2021-03/TT_Icon_Ep5_PatientJourney_150x150.png" /> <p>Address health disparities by collecting and using actionable data, including race, ethnicity, language and social determinants of health.</p> </div> <div><img alt="icon" src="/sites/default/files/2022-09/TT_Icon_S2Ep6_Partner_150x150.png" /> <p>Partner with community-based organizations to address societal factors influencing health outcomes.</p> </div> <div><img alt="icon" src="/sites/default/files/2021-02/TT_Icon_Ep3_Success_150x150.png" /> <p>Improve understanding of outcomes data across the care continuum, including post-acute care and other care settings.</p> </div> <img src="xxxx" alt="xxxx"> <p>xxxx</p> !--<ul> <li>xxxx</li> </ul>-- </div>--></div> <div class="col-sm-1"> </div> </div> </div> </div> </div> </div> <div class="row"> <div class="col-md-1"> </div> <div class="col-md-10 center_body"></p> <p class="center_Lead"></p>--> <h2>Speakers</h2> /* people */ .people { margin-top: 50px; } .people img:nth-child(1) { border-radius: 200px; -moz-border-radius: 200px; -webkit-border-radius: 200px; margin-bottom: 10px; max-width:200px; /* for Transformation Talks */ display:block; /* for Transformation Talks */ margin:auto; /* for Transformation Talks */ } .people img:nth-child(1):hover { opacity: .7 } @media (max-width:991px) { .people { margin: auto; } .people p { text-align: center } } .ci_profile { margin-bottom: 30px; display: block; } @media (max-width:991px) { .ci_profile { text-align: center } } .ci_profile p { margin: 0 0 7px 0 } .ci_profile_name { font-weight: 700; font-size: 20px; } p.ci_profile_name { font-size: 1.5em; } .ci_profile_title { font-style: italic; line-height: 1.3em } .ci_profile_company { font-size: 1em; } p.ci_profile_award { font-size: .8em; text-align:center; color:#55555599; font-weight: 700 } .ci_profile_social { width: auto; } .ci_profile_social i { padding-right: 25px; font-size: 20px } .ci_profile_social a:last-of-type i { padding-right: 0px; } #ci_footer-social { font-size: 1.5em; padding-top: 0px; width: 100%; text-align: right; } @media (max-width:991px) { .ci_logo { margin-top: 25px } .ci_social p { text-align: center !important; } #ci_footer-social { text-align: center } } /* // */ /* .people3 .rowEqual_768 */ @media (min-width:769px){ .people3{ clear: both } .people3 .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .people3 .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ flex: inherit; /*flex*/ width: calc((100% / 3) - 2px) /*Adjust % for the number per row, will override the bootstrap - Also needed for Safari*/; } } @media (max-width:767px) and (min-width:361px){ .people3 .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .people4 .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ flex: auto; width: calc((100% / 1) - 2px) /*Adjust % for the number per row, will override the bootstrap - Also needed for Safari*/; } } /* .people3 .rowEqual_768 // */ <div class="row people people4"> <div class="row rowEqual_768"> <div class="col-md-4 col-sm-4 ci_profile"><img alt="Baligh Yehia" src="/sites/default/files/2022-09/Baligh_Yehia_300x300.jpg" /> <p class="ci_profile_name">Baligh Yehia, MD, MPP, FACP</p> <p class="ci_profile_title">Senior Vice President, Ascension</p> <p class="ci_profile_company">President, Ascension Medical Group</p> <p class="ci_profile_award"> </p> <div class="ci_profile_social"> </div> </div> <div class="col-md-4 col-sm-4 ci_profile"><img alt="Eric Evenson" src="/sites/default/files/2022-09/Eric_Evenson_300x300.jpg" /> <p class="ci_profile_name">Eric Evenson</p> <p class="ci_profile_title">Director, Emerging Business</p> <p class="ci_profile_company">3M Health Information Systems</p> <p class="ci_profile_award"> </p> <div class="ci_profile_social"> </div> </div> <div class="col-md-4 col-sm-4 ci_profile"><img alt="Akinluwa (Akin) Demehin" src="/sites/default/files/2022-09/Akin_Demehin_300x300.jpg" /> <p class="ci_profile_name">Akinluwa (Akin) Demehin</p> <p class="ci_profile_title">Senior Director, Quality & Patient Safety Policy</p> <p class="ci_profile_company">黑料正能量 Association</p> <p class="ci_profile_award"> </p> <div class="ci_profile_social"> </div> </div> </div> </div> </div> <div class="col-md-1"> </div> </div> <div class="container-fluid CenterCallout_a"> <div class="row"> <div class="col-md-1"> </div> <div class="col-md-10 CenterCallout_a-Center"> <h4>Fuel Your Transformation</h4> <p>Health care leaders are more in need of innovative solutions than ever before. The <a href="/aha-transformation-talks">AHA Transformation Talks series</a> of video discussions among health care thought leaders offers insights to help hospital and health systems navigate health care鈥檚 new, disruptive environment and prepare for what鈥檚 next. Each 10-minute video in this series focuses on a transformational topic explored by the <a href="/environmentalscan" target="_blank">2021 AHA Environmental Scan</a> and SHSMD's <a href="https://www.shsmd.org/futurescan" target="_blank">Futurescan 2021-2026: Health Care Trends and Implications</a>. Explore the videos on this page for fresh ideas and best practices to guide you through this time of tremendous upheaval.</p> </div> <div class="col-md-1"> </div> </div> <div class="row"> <div class="col-md-1"> </div> <div class="col-md-10"> <div class="row rowEqual_768"> <div class="col-sm-4 CenterCallout_a_Holder CenterCallout_a-Center"> <div class="CenterCallout_a_Wrapper"><a href="/system/files/media/file/2022/09/TTalks_S2-Ep06_Abstract_Handout.pdf" target="_blank"><img alt="icon" class="CenterCallout_a_Icon" src="/sites/default/files/2020-11/Speech_Bubble_icon.png" /> </a> <h2 class="CenterCallout_a_SectionTitle"><a href="/system/files/media/file/2022/09/TTalks_S2-Ep06_Abstract_Handout.pdf" target="_blank">Abstract Overview</a></h2> <p>Read this abstract to learn about how current demands are impacting the health care workforce.</p> </div> </div> <div class="col-sm-4 CenterCallout_a_Holder CenterCallout_a-Center"> <div class="CenterCallout_a_Wrapper"><a href="https://insideangle.3m.com/his/podcast-post/how-value-based-care-does-and-doesnt-improve-health-equity/" target="_blank"><img alt="icon" class="CenterCallout_a_Icon" src="/sites/default/files/2020-12/Tools_icon.png" /> </a> <h2 class="CenterCallout_a_SectionTitle"><a href="https://insideangle.3m.com/his/podcast-post/how-value-based-care-does-and-doesnt-improve-health-equity/" target="_blank">Sponsor Podcast</a></h2> <p>How value-based care does (and doesn鈥檛) improve health equity.</p> </div> </div> <div class="col-sm-4 CenterCallout_a_Holder CenterCallout_a-Center"> <div class="CenterCallout_a_Wrapper"><a href="/center/market-insights/leveraging-data/using-data-reduce-health-disparities-and-improve-health-equity" target="_blank"><img alt="icon" class="CenterCallout_a_Icon" src="/sites/default/files/2020-12/Documents3_icon.png" /> </a> <h2 class="CenterCallout_a_SectionTitle"><a href="/center/market-insights/leveraging-data/using-data-reduce-health-disparities-and-improve-health-equity" target="_blank">AHA Resources</a></h2> <p>Using Data to Reduce Health Disparities and Improve Health Equity.</p> </div> </div> <div class="CenterCallout_a_Wrapper"> <img alt="icon" class="CenterCallout_a_Icon" src="/sites/default/files/2020-12/Documents3_icon.png"> <h2 class="CenterCallout_a_SectionTitle">AHA Resources</h2> <p>xxxx</p> <ul> <li><a href="/">xxxx</a></li> <li><a href="/">xxxx</a></li> </ul> </div> </div>--></div> </div> <div class="col-md-1"> </div> </div> </div> <h3>Video Series Developed in Collaboration with:</h3> <a href="https://iprotean.com/"><img alt="iProtean VirtualEd" src="/sites/default/files/2022-04/Logo_iProtean_VirtualEd_834x313.jpg" /> </a> Thu, 15 Sep 2022 08:32:47 -0500 Value Analysis /news/headline/2022-06-06-study-hospital-community-benefits-far-exceed-federal-tax-exemption <p>Tax-exempt hospitals and health systems provided over $110 billion in community benefits in fiscal year 2019, almost nine times the value of their federal tax exemption, according to an <a href="/system/files/media/file/2022/06/E%26Y-Benefit-of-of-Tax-Exemption-Report-FY2019-FINAL-with-links.pdf">analysis</a> by Ernst & Young released today by the AHA. A separate <a href="/system/files/media/file/2022/06/aha-2019-schedule-h-reporting.pdf">analysis</a> by the AHA shows that tax-exempt hospitals and health systems provided total community benefits equal to 13.9% of their expenses, with over half of these benefits going to provide financial assistance to patients and absorb losses due to underpayments from Medicaid and other means-tested government programs. </p> <p>鈥淔or the past two and a half years, our nation has seen firsthand how America鈥檚 hospitals and health systems have cared for their patients and provided essential services to their communities in times of an unprecedented public health crisis,鈥� <a href="/press-releases/2022-06-06-new-ey-analysis-tax-exempt-hospitals-community-benefits-nine-times">said</a> AHA President and CEO Rick Pollack. 鈥淚n addition to providing critical care, hospitals and health systems of all sizes, types and locations deliver a wide range of tailored benefits, activities, services, programs and research to meet the varied health needs of those they serve. Today鈥檚 analysis shows that advancing health in their communities remains the North Star for America鈥檚 hospitals and health systems.鈥�  </p> <p>Learn more about how hospitals benefit their communities <a href="/community-benefit">here</a>. <span></span></p> Mon, 06 Jun 2022 15:07:26 -0500 Value Analysis /news/news/2022-02-23-podcast-popular-guests-return-conversation-building-value-through-partnerships <p>AHA is launching a special two-part podcast series featuring guests from the organization鈥檚 most downloaded podcasts. In <a href="/advancing-health-podcast/2022-02-23-part-1-value-catalyst-uniting-clinicians-and-hospital-leaders">Part 1</a> Priya Bathija, AHA鈥檚 vice president of strategic initiatives, talks with David Perlstein, M.D., president and CEO for SBH Health, and David Zaas, M.D., CEO for MUSC Health, about how hospital leaders and clinicians can come together to build value by scaling strategies that lower cost, improve outcomes and enhance patient experiences.</p> Wed, 23 Feb 2022 14:11:11 -0600 Value Analysis /aha-center-health-innovation-market-scan/2021-01-26-what-it-takes-create-disproportionate-value <div class="container row"> <div class="row"> <div class="col-md-8"> <p><img alt="What It Takes to Create Disproportionate Value in Challenging Times. An executive points to the highest of a series of financial arrows pointing up, creating a glow at the tip of the arrow." data-entity-type="file" data-entity-uuid="e56bbe7a-a946-433d-b5fb-1298411f29bd" src="/sites/default/files/inline-images/ms_012621_item1_Disproportinate_Value_620%5B2%5D_1803148.jpg" width="620" height="381"></p> <p>A complicated set of factors involving governmental and private-sector spending on health care will bring about significant changes over the next several years that will effectively flatten reimbursement levels, even as demand for services is expected to keep growing. While that鈥檚 generally bad news for providers, those who develop innovative new business models can create disproportionate value in this challenging market, notes a recent <a href="https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-future-of-healthcare-value-creation-through-next-generation-business-models" target="_blank">McKinsey & Co. analysis</a>.</p> <p>The formula for success varies across service lines, but common among these new models is alignment of incentives 鈥� better care integration and use of data and advanced analytics 鈥� typically involving risk bearing. Hospitals and health systems pursuing diversified business models that include a broader range of care delivery assets (e.g., physician practices, ambulatory surgery centers and urgent care settings) are generating returns above expectations.</p> <p>Providers that offer diverse settings of care also have been able to reduce costs, improve care coordination and patient experience while maintaining or enhancing quality. They often demonstrate the ability to ensure referral integrity and leverage scale to drive success, particularly in systems with greater market share.</p> <p><img alt="Outpatient Visits and Office Visits That Can Be Virtually Enabled. Commercial, Medicare and Medicaid 2020 estimated spend. Virtualization visits/spend: $247 billion. Virtual urgent care: $35 billion. Virtual office visits: $126 billion. Near-virtual office visits: $39 billion. Tech enabled home medication administration: $12 billion. Projected from 2018 commercial and Medicare spend, using National Health Expenditures data. Source: Anonymized claims data representative of commercial, Medicare and Medicaid utilization, McKinsey & Company, 2021." data-entity-type="file" data-entity-uuid="00b663ca-1d75-4ba7-9a36-32db0cb4b573" src="/sites/default/files/inline-images/ms_012621_item1_Disproportinate_Value_chart_620_1803150.jpg" width="620" height="307"></p> <p>Technology, especially telehealth, will play a pivotal role in new care models. About $250 billion of all Medicare, Medicaid and commercial outpatient, office and home health care spend could be virtualized, including 35% of home health visits and 24% of office visit/outpatient encounters, notes a <a href="https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality" target="_blank">May 2020 McKinsey report</a>.</p> <p>But with this increased efficiency and easier-to-access care, providers will face some challenges, not the least of which is how a rise in virtual visits may lead to a reduction of in-person visits. This has significant implications for providers with large, expensive facilities to operate.</p> <p>In some market segments, innovation and integration are driving change through greater use of data and analytics, better utilization management, network management and clinical information systems. Areas like behavioral health and social determinants of health have benefited from advanced data and analytics.</p> <p>Provider organizations that can effectively integrate new and existing technologies into their operations can create sustainable business models to generate greater value.</p> <p>This will require more than simply aligning with health care鈥檚 growth segments. The ability to innovate at scale will be a differentiator.</p> <h2>5 Business Innovation Questions for Leaders</h2> <ol> <li>How does our business model need to change to create value in the future health care world?</li> <li>How does our resource allocation approach need to change to ensure the sustainability of the future business model, so it鈥檚 funded (whether with capital or staffing) differently than our legacy business?</li> <li>How can we rewire our organization to innovate more quickly?</li> <li>How can our business model identify and take advantage of broader market innovations that can be adapted to our system? What partners will we need?</li> <li>How will we prepare our broader organization to adopt and scale new innovations?</li> </ol> </div> <div class="col-md-4"> <p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img alt="AHA Center for Health Innovation logo" data-entity- data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" type="file" class="align-center"></a></p> <a href="/center/form/innovation-subscription"><img alt data-entity-type data-entity-uuid src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png"></a></div> </div> </div> .field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 26 Jan 2021 20:48:18 -0600 Value Analysis /center/affordability-value Mon, 10 Aug 2020 17:09:28 -0500 Value Analysis /advancing-health-podcast/2020-07-23-standardization-results-enhanced-value-and-improved-outcomes <p>In this podcast, Julia Resnick, senior program manager for Strategic Initiatives with AHA, explores the care redesign process with Joe Landsman, president and chief executive officer at The University of Tennessee Medical Center; and Dr. James Shamiyeh, senior vice president and chief quality officer at UTMC.</p> <hr /> <p></p> <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> 路 <a href="https://soundcloud.com/advancinghealth/standardization-results-in-enhanced-value-and-improved-outcomes" target="_blank" title="Standardization Results in Enhanced Value and Improved Outcomes">Standardization Results in Enhanced Value and Improved Outcomes</a></div> <p> </p> Thu, 23 Jul 2020 10:58:10 -0500 Value Analysis