Behavioral Health is a Nation's Health - 2022 Summit at MIT

On May 13th 2022, we hosted our first Behavioral Health Summit at MIT. We brought together leaders from the nation's largest payers, providers, investors, and innovators from the healthcare technology space at the Lecture Hall at MIT Media Lab to inaugurate the first of a multi-part series of meetings. Our goal is to arrive at a common understanding of this complex problem, and arrive at common sense, pragmatic solutions that will improve the nation's health - starting with behavioral health.

Professor Sandy Pentland and Professor Esteban Morro of MIT Connection Sciences kicked us off with a discussion around social determinants of health - It's clear that we have massive disparities in diagnosis, access and treatment of behavioral health in the country.

We then convened an expert panel comprised of Eva Borden - President of Evernorth Behavioral Health, Michael Dandorph - CEO of Tufts Medicine, William Furness - CEO of Thriveworks, Shana Hoffman - CEO of New Directions Behavioral Health, Secretary David Shulkin - the 9th Secretary of the Department of Veterans Affairs, and Tim Wentworth - former CEO of Express Scripts and former CEO of Evernorth.

We were very grateful for the incredible candor, insights, and willingness to engage one another and the audience from other competing payers, providers, and care organizations. Some of the discussion points were:

Prevention and treatment before getting to critical care are essential, however:

• Access remains a challenge - and we simply aren't leveraging primary care physicians and the role they can play in early identification and treatment referral.
• Even if we did leverage PCP's, they can't refer easily because they don't know what coverage the consumer is eligible for, and what treatment options are even available.
• In certain populations, first responders such as police and EMTs end up having to make snap decisions and are left to deal with mental health episodes in the communities they serve.
• To solve the capacity and access problem, we have to look outside of physicians and leverage master-level clinician therapists but they are typically not covered by Medicare / Medicaid.  

Incentive systems are not aligned:

• With reimbursement averaging around $40 per session, for a physician with $250,000 to $500,000 in medical school loans, behavioral health is not a specialty many opt to go into.
• In our current fee-for-service model, we as an industry often question the value of behavioral health when no one asks about the cost of cancer care.
• We focus too much on intervention instead of preventative - the evidence is clear that $2,000 in behavioral health treatments will avoid $20,000 in emergency room costs.
• Employers are rated by the American Health Association on the cardiovascular health of their employees. But not enough employers are asking the question about the behavioral health of their employees.

We need clearly defined outcomes - starting from the top at the Federal level for effective public policy that the private sector can adopt:

Examples of bold public policy that we can push for:

• Acknowledge the inequity in access across culture, neighborhoods, and languages and educate the public - remove the stigma without 'sickifying' the population.
• Same-day appointments
• Reimbursement changes to fix the incentive problem
• Relax cross-state licensure requirements to ease capacity and access issues
• Enforce evidence-based care practices
• Provider matching and continuity - this is not like picking a driver via Uber or even getting a hip replacement - consumers and patients need continuity and trust with a behavioral health clinician.

Technology Innovation Panel:

We then heard from healthcare technology companies who found their footing at MIT - Alon Joffe - CEO of Eleos Health (The global leader in Care Intelligence), Corey McCann - CEO of Pear Therapeutics (The global leader in Prescription Digital Therapeutics), and Carter Powers President of Dimagi. (The global leader in digitally enabling Frontline workers to deliver services to the communities in need).

Some of the key insights we learned:

• Breakthroughs in digital therapeutics have proven results in treating substance abuse disorders as well as chronic insomnia - leading to significantly better outcomes than traditional pharmaceutical interventions that can have severe side effects - because digital therapeutics works with the whole person.
• Mobile enablement of frontline workers is critical to accurate capture of data, onboarding patients and caregivers alike - Dimagi has successfully enabled over a million front line workers with the mobile capabilities they need.
• Eleos' Care Intelligence data reveals some startling facts:

1. During the midst of the pandemic, work and work-related issues were mentioned by consumers 3x more than any other topic, including health and family.  
2. High-performing clinicians used 7 evidence-based techniques in comparison to their less performant counterparts who only 4.5 techniques, a 55.5% decrease.

We want to thank all our panelists as well as our participants from Optum / United Healthcare, Humana, Ableto, The Advisory Board, Lifebridge Health, Lifestance, MDLive, Ontrak Health, Brewer Lane Ventures, Eight Roads, and Transformation Capital for their valuable contributions and participation - and look forward to our follow up meeting in September.