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Behavioral Healthcare Today

Behavioral Healthcare Today is my perspective on the state of this important, and rapidly changing healthcare service.
This information will be primarily presented by me (David Newton, MBA), Director of Operations for SCH (Play Video) a passionate believer in the shift from fee for service to value based care in behavioral health and also a relatively frequent user of both “medical” and “behavioral” healthcare services. This section is also open to additional contributors on an as appropriate basis. Some will be anonymous and some will be identified. I look forward to your comments and suggested topics.

More about David (below).

David Newton is an entrepreneur with over 25 years of experience in owning and operating several successful privately held businesses. His expertise includes strategy, operations and marketing. He finds particular pleasure in disrupting industries that are broken, inefficient, fragmented and ineffective. He is also interested in finding ways to create value rather than destroy it, particularly in healthcare where he currently sees a tremendous opportunity in almost all areas of the industry. He holds an MBA from Kellogg Northwestern where he did specific research on alternative reimbursement models in behavioral health under the direction of Professor Leemore Dafny. Subsequent to that, he studied under Professor Michael Porter and the value based healthcare team at Harvard Business School. David has become passionate about creating ways to apply a value based model to the behavioral space, particularly eating disorders and substance use disorders.

David recovered from Anorexia as a teen and has extensive family experience with substance abuse. He has seen first-hand just how devastating these deadly and costly diseases can be, and he brings his personal experiences, compassion and empathy to his latest venture, SunCloud Health. In his role as Director of Operations and Outreach at SunCloud, he is responsible for ensuring that we remain true to our core mission- moving the needle away from fee for service and toward a value based model.

Let’s connect on Linked In

Learn more about David, SecondChancesDavidNewton and check out his full video interview on SunCloud Health

An article by David:  REDESIGNING BEHAVIORAL HEALTHCARE DELIVERY IN THE FACE OF OBSTACLES87


Voice of the Customer.. Or is Voice of the Patient Better?
By: David Newton, Director of Operations

Since opening our doors a little more than a year ago, we have tried every day to create a special treatment center that people want to come to for exceptionally high quality, individualized care at an affordable cost. Built in to our DNA is a ferocious desire to continuously focus on getting better at what we do in order to achieve our goal. We believe this is the only way we will survive in a highly competitive market, particularly given our desire to remain independent of anything or anyone who could get in the way of a laser like focus on quality of care. We have to want to be the best at what we do every single day, and willing to make changes when changes need to be made if it means our patients will benefit.

Outcome surveys and measurements help us accumulate and respond to the data we need in order to operate in this manner. Another arguably more effective and much simpler “tool” is just listening and paying very close attention to our patients when they provide thoughts and feedback. “Add a water cooler, we need a process group on Fridays before the weekend, the group size is too big, we need more “skills” groups”… This is information we must have in order to remain focused on continuous improvement. Fortunately we have a culture which encourages and supports all of us who have thoughts and ideas which can make us better as a recovery community. Pray this never changes.

Our patients are our customers. They are the ones whose interests must always come first and they are the ones who will either make or break the future of SCH. We know this, and we respect this. Our relationship with our patients is a professional relationship where very specific and predetermined protocol guides the nature of what is expected from both parties in the exchange. We provide the service, they hopefully get better and they pay us ideally for the value we are providing to them and their families.

When collecting patient satisfaction surveys last week one of our patients was insulted when referred to as a “customer”. To this person, the word, “customer” seemed to imply that it was just about the money… It is not all about the money but money is being exchanged and with that comes responsibilities inherent in such an exchange. The word, “patient”, on the other hand, implies “they” are sick and “we” are not… Yes our patients are here for help and our clinical care team is here to provide that help but we are all in this together and at the end of the day we are all just people who are doing our best with what we were given to survive in what can often be a challenging and beautiful world.

There is a lot written on the pluses and minuses of using the words, “patient” or “customer” when referring to people who receive healthcare services. Attached below is something from Yale’s Business School of Management on the topic which is interesting. Read it HERE

Whether we use the word person, patient or customer, the fact of the matter is we all need input from those we serve in order to be the best that we can be. It is critical not only to our success as a business but more importantly for patients and their families, which at the end of the day is our guiding principle. Asking questions is only part of it. Having the courage to change the things we can is what makes the difference.


Eliminating Fraud in SA Treatment Is Critical For Our Patients. They Deserve Nothing Less
By: David Newton, Director of Operations

As I was enjoying time with friends and family last night in Boston, I was asked the following question by a woman who is a Chief Healthcare Economist for The Office of Inspector General, US Department of Health and Human Services:

How do we get rid of the fraud and abuse in the substance use treatment industry, particularly with the atrocities happening in many sober homes and the over prescribing of medically unnecessary (and addictive) drugs which are being prescribed to some of societies’ most vulnerable citizens (addicts)? READ MORE


Clinicians and Non-Clinicians…Mutual Trust and Respect
By: David Newton, Director of Operations

I listened to an interview this morning titled, “Building Clinicians’ and Non-Clinicians’ Trust and Respect”, by Thomas H. Lee, MD, MSc & Laura L. Forese, MD, MPH. It’s about building teamwork and trust within a healthcare organization, particularly between clinicians and non –clinicians at New York- Presbyterian Hospital. The article discusses the absolute need for high performing teams to have trust and mutual respect amongst all members of the team. Listening to this was not only insightful and right on point, but it helped put things in perspective for me as an Operations Director in a healthcare system that is tasked (and challenged) with a very similar initiative. READ MORE


Announcing a New Alliance called VMH, Value in Mental Health.
By: David Newton, Director of Operations

The team at SCH is looking to align with like-minded treatment centers, mental health professionals and business leaders as we form an alliance designed to enable close collaboration around patient care and quality improvement initiatives in the behavioral health space- specifically the addictions and mood disorders space in which SCH operates. The name of the alliance is VMH, for Value in Mental Health. We are seeking to create an atmosphere in which we as healthcare professionals are able to openly discuss outcomes data with each other in order to drive an increase in quality of care, a decrease in total cost and data which clearly shows the value that we in the mental health field provide to patients, their families and their payers. READ MORE


SCH participates in a visit to Congressman Roskam’s office to discuss the value of mental health.
By: David Newton, Director of Operations

On April 10, SCH was proud to send a representative to Congressman Peter Roskam’s office (US House of Representatives, Illinois’s 6th district) to discuss the value (financially, morally and otherwise) of providing people with mental health treatment. This topic is of particular importance in today’s political environment given the movement to overturn The Affordable Care Act and more specifically the discussion around eliminating what is referred to as “Essential Health Benefits” in some insurance policies. The discussion was initiated by Nancy Meier Brown, President of Meier Clinics Foundation, and we were joined by representatives from Timberline Knolls Residential Treatment Center, NAMI DuPage, Northwest Community Healthcare and Linden Oaks. READ MORE


The customer is always right…
By: David Newton, Director of Operations

“The customer is always right” is a slogan by which most successful businesses live and die. We learn early in our careers that we must listen to “the voice of the customer.” “No” is a word we don’t use when talking with customers, and a disappointed customer is one who will likely not be around for very long. Solving problems and providing solutions for customers is what lies at the essence of all successful business, and as we do so we want a happy customer whose interests are aligned with ours and who feels taken care of and listened to. Business people have entire departments (sales) dedicated to making sure that the customer is not only “always right” but also that they are never told “No” and that ultimately, they are happy. Success is optimized when there is alignment and a “Win-Win” dynamic in place. In this respect, medicine is not unlike any other business. We are solving problems by saving lives. We want positive outcomes for our patients and we do well if they do well. We too want happy patients, but not at the expense of quality of care, and this is where things differ. READ MORE


What Does Repeal and Replace Mean for Mental Health Treatment in America?
By: David Newton, Director of Operations

Despite all of the politicians involved, this really is not a political issue. It will be resolved through legislation and a lot of politicking, but at the end of the day this issue affects every single one of us, directly or indirectly. We all care about people who struggle with these diseases. We all have family members and friends who struggle with these diseases. Mental illness does not discriminate based on one’s political beliefs, religion, gender, class, ethnicity, or the color of one’s skin. It affects every single one of us, it can be deadly, and we all care, regardless of our political beliefs. READ MORE


Prevention and Early Childhood Trauma – from a dad who could have done better
By: David Newton, Director of Operations

Solving the addiction crisis in America is arguably one of the most challenging crises we have ever faced, particularly in recent decades. It is not the only one, but it is serious and wide spread. Like many other complex problems, we face as humans, we will likely never eradicate the world of addiction. There are cultural, biological, social, and genetic components to it which are all intertwined and which we are just now beginning to really understand. READ MORE


SINGLE CASE AGREEMENTS, SELECTIVE CONTRACTING, AND DOING WHAT IS RIGHT FOR THE PATIENT
By: David Newton, Director of Operations

Having spent nearly 25 years in a business completely unrelated to healthcare before studying under some brilliant minds at Kellogg Northwestern and Harvard Business School as I was earning my MBA, I feel I bring a fresh, albeit sometimes naïve, perspective to the business of healthcare. Wherever possible, I try to use this to our patient’s advantage. Our patients need and deserve as much advocacy as possible, to include from those who come from other industries and see best practices not being performed in healthcare. READ MORE


How Do We Make Decisions On Where To Go For Help When There Is No Reliable Data? OUTCOMES!
By: David Newton, Director of Operations

I read an article over the weekend which focused on helping the consumer find the right provider for mental health services when they may need it. READ MORE


A Disturbing Conversation with my 14 Year Old Son…
By: David Newton, Director of Operations

This is a kid who painfully and with a tremendous amount of sadness watched for years as his mom suffered/suffers from a major substance use problem, whose father was hospitalized for an eating disorder when he was a teen and whose step mother is arguably one of the nation’s most well respected psychiatrists in the field of treating substance abuse and eating disorders. This is a kid who has spent countless hours talking with his dad (and his step mom) about why he needs to be very careful with the choices he makes given his specific genetic predispositions for addiction as well as his the environmental and social factors he is faced with as he grows up on the Northshore of Chicago, a relatively affluent part of the city where much of the culture is ok with “some” use (of illegal and illicit substances) amongst teens so long as it is not “excessive”… Nearly every member on his maternal side of the family has a substance abuse and or fairly significant mental health issue and many on his paternal side have much of the same. He himself already shows signs of obsessive thinking and addictive behavior with relatively harmless behaviors such as his phone use, girls and food. READ MORE


A Little Bit of Clarification On What We Mean When We Use the Word, “Value”
By: David Newton, Director of Operations

Three months in and one thing we have seen is that some of our peers in the field of addiction either don’t understand what we are talking about when we use the word, “value” or they feel threatened by it because somehow they think it equates to less care or lower quality of care for our patients. In fact, this couldn’t be further from the truth. We are huge advocates for both increased access and more care for mental health. By shifting and re-framing the conversation from the “price” of siloed mental health care to one of total value delivered to the patient by providing integrated care, we feel we can realign the interests of payers, patients and providers in a way that ultimately results in higher quality of care at a lower TOTAL cost to the payer. READ MORE


A CASE IS MADE FOR INTEGRATION AND COORDINAATION OF CARE
By: David Newton, Director of Operations

When asked (almost every day) how behavioral health will ever be able to make the switch from volume based reimbursement to a more value based model, I often times find my head spinning with all sorts of unanswered questions; 1) How will we ever be able to properly risk adjust for this inherently unpredictable patient population who often present with what may look like one primary yet in reality have complex co-occurring diseases, and if we can’t properly risk adjust we can’t shift any of the risk to providers? 2) How will we be able to define an episode of care when many times these illnesses are life-long chronic diseases (meaning the “episode” is their entire lives)? 3) How can we as providers agree to share in the risk with these patients who, unlike many patient populations, do have more power to “cause” a relapse despite the best efforts of even a coordinated and highly integrated care team?…. I begin to try and answer some of this, and then I am reminded of just how complicated this journey is. Some days the path seems clear. Other days, however, I am tempted to pick up the phone and call Professor Porter and Dr. Lee and ask them how in the world we are going to make this happen. READ MORE


LET’S JUST START BREAKFAST WITH THIS.
By: David Newton, Director of Operations

Mental Health does not get the same treatment from payers as other medical issues, and it should…. “Let’s just start breakfast with that…”
As musician Ben Harper passionately said in a recent interview for radio station KEXP in Seattle when talking about ongoing racism and what inspired one of his most recent songs, “Call It What It is”, I too was “grabbed by the back of my neck” to write about something that isn’t right. READ MORE


SECOND CHANCES AND HOW I GOT “BACK HERE”
By: David Newton, Director of Operations

I graduated undergrad from an extremely small liberal arts school in Southern California called Pitzer College with a degree in Sociology and Third World Politics. I was an idealist with a desire to make a difference in a world I felt was plagued by greed, fear and capitalism. After a year of working for a non profit in Los Angeles making no money and not getting very far in trying to change the world from the outside, I got scared, I pivoted and shortly thereafter I took a job in the direct response business selling and buying commercial print. This move was the farthest thing from changing the world but I needed income and I made the choice at the time to sacrifice my ideals for what felt like a reality I could not change. READ MORE


Anonymous, A North Shore Teenage Perspective
By: David Newton, Director of Operations

What is it like being a sober kid on the North Shore?
Well to start off, it’s pretty messed up. All of the people around you or at least 95% are drunk every weekend, who knows probably high too, and despite that it is illegal to drink under 21, you are the one that is looked at differently. People either idolize you for having your own morals, not caring, and doing what you want, or they think that you’re unsocial, think you’re better than them, or blatantly a loser. Why it’s so messed up? Is because everyone knows who is drinking and who’s not. READ MORE


Anonymous, Teenage child of an alcoholic
By: David Newton, Director of Operations

My mom has been an alcoholic for as long as I could remember and it has not affected me in a positive way. I am terrified of being yelled at, I am scared to trust, and I have an extreme amount of stress. I love my mom but her partying at 3am in the morning has done no good for me or the rest of my family. The worrying began when I was much younger, when I would worry if my mom was coming home that night. The stress has continued throughout my life. READ MORE


REDESIGNING BEHAVIORAL HEALTHCARE DELIVERY IN THE FACE OF OBSTACLES- IMPROVING OUTCOMES WHILE REDUCING TOTAL COST
By: David Newton, Director of Operations

THE SCOPE OF THE PROBLEM: In 2013, it is estimated that Americans spent over $200 Billion treating Mental Health conditions, more than on any other medical condition including heart conditions, trauma, cancer and diabetes. (1) This does not include an additional $193.2 billion in lost earnings per year caused by those with serious mental illness (2). Approximately 1 in 5 adults in the US experiences mental illness in a given year (3), and approximately 1 in 25 adults in the US experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities (4). READ MORE


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