where is behavioral health going?

www.TheNationalCouncil.org

Contact: [email protected] | 202.684.7457 1

Where is Behavioral Health Going?


Contact: [email protected] | 202.684.7457



Corporate Corporate Partners/Partners/

Affiliate MembersAffiliate Members



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1. Assertive national and state advocacy that ensures access to treatment

2. Public education and communications that impact communities

3. Initiatives that position members as high-performing healthcare organizations

4. Programs that promote development of an effective workforce

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1. ADVOCACY

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The greatest danger intimes of turbulence is notthe turbulence. It is to act

with yesterday’s logic.Peter Drucker

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• Rapid expansion of Medicaid managed care • Health homes and ACOs• Dual-eligible initiatives• Rethinking substance use treatments –future

of residential • Fee-for-service to case rates, bundled

payments and capitation – risk• Health reform rollout:

Medicaid expansion Exchange enrollment

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• PCBHI Grant Program• Health Homes• Excellence in Mental

Health Act (S. 264)

• Mental Health First Aid Act (H.R. 274/S.153)

• Behavioral Health IT Act

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Contact: [email protected] | 202.684.7457Contact: [email protected] | 202.684.7457 9

2. PUBLIC EDUCATION



Sandy Hook

Grand Rapids

Tucson

Red Lake

Fort Hood

Virginia Tech

Columbine

Aurora

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Early Identification & Intervention•More than 100,000+ trained •3,000+ instructors •Youth version•Spanish version •President’s recommendations •Policy and media attention

Partnership withMaryland and Missouri

State Governments



3. HIGH-PERFORMING

ORGANIZATIONS



Vision without execution is a hallucination.

Thomas Edison

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• Rapid access/open accessBe there when I need you

• World-class customer serviceKind words are easy…echoes are truly endless

• Comprehensive whole-person careProvide or help me get the healthcare and services I need

• Outcomes-based careMake sure I receive the best possible health care

• Staff engagementBeing part of something bigger than themselves

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• Same day access• Co-occurring disorders learning community• Depression care collaborative• Contracting learning community• Advancing standards of care for bipolar

disorder• Trauma-informed care• Child conduct difficulties learning community• Early intervention in first episode psychosis

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• SAMHSA-HRSA Center for Integrated Health; NY State Geriatric Technical Assistance Center; and Ohio Training & Technical Assistance Center

• FQHC Look-alike learning community

• Consulting — state and local governments, organizations

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• Bosch Health Buddy System gathers vital signs and symptoms, educates, and reinforces positive behavior; data reviewed by provider to identify need for intervention.

• myStrength – Health Club for Your Mind – online help with anxiety and depression

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SPQM Dashboards

• Comprehensive quality management system• Supports data-informed decision making• Measures performance outcomes and

analyzes organizational practices• Provides essential information to

demonstrate program value• Increases quality, accountability, compliance,

efficiency of services

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4. WORKFORCE DEVELOPMENT



People want to be part of something larger

than themselves. -Howard Schultz

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• Staff feel they have the opportunity to do what they do best every day

• Committed to quality work

• Growth and development encouraged

• Physical and emotional wellness prioritized through group activities and employee development

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• Psychiatrist curriculum for integrated settings

• MSW integrated healthcare curriculum and field placements

• Case managers to care managers

• Whole Health Action Management (WHAM)

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• Middle Management Academy

• Addressing Health Disparities Leadership Program

• Executive Leadership Program

• Seasoned Leaders at Conference

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Partnership with Essential Learning, a Relias Company

• Leading provider of verticalized e-learning solutions

• Compliance with regulatory and accreditation requirements

• Continuing education solutions for employees

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• The healthcare system of the near future will not look much like the present.

• The implications for our members and those they serve are enormous.

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26Contact: [email protected] | 202.684.7457

Strategic planning is worthless – unless there is first a

strategic vision. John Naisbitt

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• Experimentation • Liberation of

information• Demand for impact• Monopoly economy

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• Eager to tap $2.6 trillion healthcare economy

• Fix impossibly inefficient & bureaucratic system

• Boost transparency and communication

• Digital healthcare receiving greatest share of total investment dollars — up 73% since 2011

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Doctor will see you now — ZocDoc

•Online service to research & schedule doc appointments•Doc ratings from patients•Addresses underused health supply •Free to patients, practices pay $300 a month•$50 million (of $95 million) raised from DST Global, Russian billionaire•1.5 million users a month in 20 markets

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Computer becomes exam room — HealthTap

•Army of docs online 24/7 — building reputation among patients and peers•15,000+ docs answering questions, online conversation for $9.99•Docs rate each other’s responses and algorithm direct questions to specialists

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Texting can make you healthier —CareSpeak Communications

•Simple mobile technology to encourage adherence (Noncompliance causes hospital re-admissions and even death)•2-way testing — reminders to patients and caregivers.•United Health hopes it will lower their costs.

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Big data myth busting to build better workers — Kenexa

IBM buys workforce science company for $1.3 billion

Myths busted•Supervisors’ communication skills and personal warmth more important than worker experience/attributes•Work history not a good predictor of future results•Most important salesforce quality is not extroversion but emotional courage•Those who score high on “honesty” stay 20-30% longer in their jobs

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Big chains thrive •Greater variety, better quality, lower cost •Buying power•Centralized common functions•Fast adoption and diffusion of innovations

4 airlines = 69% travelWalmart = 57% of all groceries

Intel = 85% of micro processing chipsDoctors = 75% are employees

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Cheesecake Factory Medicine — Steward Health Care System

•Cerberus, a private-investment firm, bought 6 failing Catholic hospitals in Boston area

•Cerberus has stakes in Chrysler, GMAC, Albertsons, Austria’s largest retail bank chains, and Freedom Group (world’s biggest gun-and-ammunition manufacturers)

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WHAT DOES THIS ALL MEAN FOR US?

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The measure of intelligenceis the ability to change.

Albert Einstein

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• Market power = Degree of influence one organization has over another

• Market power = Ability to raise prices without losing business

In the U.S. health system, the market power and market position of specialists is

shifting “downward”

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• Redefining “demand” for specialty care• Managing unit costs in an era of declines• Competing for ‘profitable’ consumer segments• Investing in new services• Marketing and business development• Maintaining competitive advantage in face of

New technology Rules-based treatment options Industry consolidation Health reform

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Elimination of ‘Safety Net’ Funding for Uninsured

Decrease of Fee-For-Service RatesMedicaid/Medicare Coverage of SPMI Moved to Managed Care/ACOs

Expanding Role of Urgent Care Clinics in CommunityPayers Increase Coverage of E-Health Services & Remote Monitoring

Responsibility for Health Outcomes and Costs of Defined Populations

Mandatory Adoption of EBP via Comparative Effectiveness Research

Medication Assisted Treatments for Addictive Disorders

Widespread Adoption of Neurotech (Scans, Avatars, Cognitive Retraining, Etc.)

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We must reorganize and prepare for new ways in which

services will be provided and paid for.

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• Competing for customers (consumers and payers) • Moving to highly regulated, any “willing provider” model• Participating in value-based purchasing arrangements• New management knowledge/infrastructure• Delivering services at market rates • Knowing costs and cost-cutting techniques • Integrating new technologies into service models

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Transactional LeadershipCoping with complexity — keep current system functioning and improve

Planning and budgeting Organization structure and staffing Organizational controls, monitoring, and problem solving

Transformational Leadership Coping with change — produce useful, non-incremental change system

Setting a direction Aligning people in the organization Motivating people in the organization

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Growth allows organizations to •Leverage expense •Diversify risk•Enhance talent recruitment and retention•Be competitive

Collaborations and consolidations are the future

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The pessimist complains about the wind.The optimist expects it to change.The realist adjusts the sails.

William Arthur Ward

where is behavioral health going?

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