The Future Belongs To Organizations With The Data

By Monica E. Oss, Chief Executive Officer, OPEN MINDS

Creativity is thinking up new things. Innovation is doing new things – Theodore Levitt

For many executive teams in the health and human service field, future sustainability is dependent on innovation at scale. This includes digital transformation of the consumer and workforce experience, plugging into whole person care models, and performance-based reimbursement.

The challenge is that the many organizations have a portfolio of creative pilot projects that never make it to scale. And it is scalability that makes these new service lines profitable and allows them to contribute to the profitable margins needed for sustainability.

We recently got an inside look at a large health care organization that is taking innovation to scale from Sandra Stein, M.D., Chief Medical Officer for Banner University Health Plans (BUHP). In her keynote, The Behavioral Health Epidemic – How Banner University Health Plans Is Driving Innovation Through Integrated Care, SDOH & Technology, which kicked off our 2022 OPEN MINDS Care Innovation Summit, Dr. Stein provided an in-the trenches view of successful innovation designed to improve the health of—and reduce the spending of—high risk consumers with behavioral, cognitive, and physical health disorders.

BUHP is one of the largest non-profit health plans in the country and is part of Banner Health’s Insurance Division, which itself is part of the Banner Health System. BUHP, which has a 30-year affiliation with the University of Arizona, has 320,000 members in Central and Southern Arizona, including a sizable Medicaid population. For a number of years, Banner Health—in its health system and its health plan—has been testing new uses of technology that provide better engagement, access, and outcome data. Those pilot projects are now bearing fruit as integral components of their care delivery system.

Dr. Stein discussed three innovative initiatives to improve value—a tech-enabled care coordination program, a new eCBT initiative, and a clinically integrated network program. The first, and oldest, is a consumer engagement initiative. BUHP has created a consumer outreach program using a smartphone-based technology, Pyx Health. The mobile app facilitates 24/7 access with consumers to conduct screenings for loneliness, depression, anxiety, and social determinants of health (SDOH); monitors health status; and coordinates care. The initiative includes a call center that consumers can contact when feeling lonely or depressed, or are experiencing urgent SDOH needs. The program has a 97% member satisfaction level, and 83% say that Pyx has helped them to feel more connected to their health plan. This initiative has also helped BUHP see a 39% reduction in emergency department visits, 911/ambulance calls, and intervention by crisis teams.

BUHP is testing the use of eCBT in their service delivery system. To test the use of eCBT, which is provided through SilverCloud, BUHP created a digital formulary that allows prescribers to “order” eCBT for consumers. There are seven different intervention modules that address stress, anxiety, and depression, which are delivered to consumers through the patient portal or email. The pilot has seen significant improvement in PHQ9 and GAD7 scores, and has received a positive response from both consumers and clinicians. According to Dr. Stein, the eCBT initiative not only appeals to members, the app is also improving their lives. “Our members are utilizing SilverCloud, on average, over two hours in total and an average of 15 minutes at a time,” she said. “Before anxiety scores were about 50%, but now they’re approximately 25%. With depression, we’ve seen a 35% decrease with the use of SilverCloud.” While members use the eCBT program, data gets delivered automatically back to the clinician who prescribed it to assess the results. If a member scores low, clinicians consider if the member should receive more traditional therapy or be prescribed medications.

BUHP’s latest initiative is “Community Of Care”, the creation of a clinically integrated network (CIN) that leverages technology to provide consumers with a collaborative continuum of care. The goal is to provide a more integrated experience for the consumer. To do that, the CIN focus is on five core elements: behavioral health, physical health, peer support, crisis services, and social support. What differentiates the CIN initiative from “business as usual” at BUHP are features like remote consumer engagement, shared care coordination data for all participating providers, and a full suite of population health management data and tools.

In her closing, Dr. Stein shared that while there were many ways to bring innovation to care delivery, they are all compatible if they are focused on the quadruple aim. What they share is a focus on performance improvement and making health care easier. Or as Dr. Stein said in her final remark, “The future belongs to organizations with the data.”