Ahead of the marcus evans National Healthcare CXO Summit 2023, Joy Figarsky discusses the link between mental health costs and medical costs, and why hospitals should adopt a whole-person care approach.
“Whole-person care is not only the right thing to do for patients, but also the right thing to do fiscally,” says Joy Figarsky, President & COO, Signet Health Corporation. “If healthcare providers don’t address behavioral and mental health issues, people will show up in their emergency departments with medical problems on top of their mental health problems,” she adds.
Signet Health Corporation is a service provider at the marcus evans National Healthcare CXO Summit 2023.
What is challenging hospital leaders today?
There has been a huge increase in behavioral and mental health needs all over the world, while many healthcare systems have also been challenged with a staffing crisis since Covid. Coupled with rising costs and nurses leaving the field, running the ICU and emergency department has become a major focus and expense. We don’t have a magic bullet to solve these issues, but we live and breathe behavioral health and physical rehab. When hospitals are consumed with keeping the rest of the hospital running, they need a specialty solution provider that is entirely focused on this area. The staffing needs, compliance needs and billing for behavioral health services are different.
What are some of the pain points of hospitals that already have a behavioral or mental health program?
Compliance is a major pain point. The programs and regulations on the care environment are very specialized. CMS has very complex quality measures and requirements. Many hospitals have a problem with length of stay, which is a clinical management issue. They are spending millions of dollars, have made a promise to serve their community, but they are having a hard time keeping their doors open. It is never one thing that they need to change to stay financially viable.
In other cases, they don’t offer behavioral health, but patients keep showing up at their emergency department requiring such services. The hospital needs to assess bed demand and community need to determine whether having a program – and what kind of program – would be profitable given their community, payer mix, payer environment and state. Programs need to be sustainable. It is important for hospitals to make cost-effective decisions for the long-term. Being a family-owned business empowers us to focus on what the hospital truly needs rather than our quarterly earnings.
Should hospitals be more focused on whole-person care?
Whole-person care is not only the right thing to do for patients, but also the right thing to do fiscally. Medical costs for people with behavioral health comorbidities are estimated at more than USD 400 billion. It is estimated that about USD 50 billion of this can be saved with effective whole-person care. A severely depressed person will not take care of his diabetes or COPD, so they often end up at the emergency room with an event that is costly for everyone. One in four people will have a mental health issue at some point in their life. If hospitals ignore whole-person care, they will face all sorts of secondary problems and costs. Managing different populations and meeting patients where they are can bridge some of those gaps. Hospitals need to put in place systems and structures to back up telehealth, to make sure it is working for the hospital financially, clinically and in terms of compliance. The cost of bringing in a locum can be crippling for the hospital. Telehealth should not grow in a bubble but in concert with all services. Being the best provider comes down to meeting all needs, whether it is face-to-face or telehealth. When managed correctly, telehealth can help hospitals avoid the higher costs that would result from a crisis. Whole-person care is the most cost-effective approach for any payer, state and healthcare system.
Where do you see the most gaps in behavioral health programs? What are the opportunities hospitals are not tapping into?
When you look at the continuum of care, there are huge gaps everywhere in the system. In most communities, it can be very difficult to access inpatient care. People end up waiting in a bed for hours, costing the hospital money and valuable resources. Another huge gap is on the outpatient side. If you have a specialized need, you might have to wait 10-12 weeks to get in, which often turns into an inpatient emergency because you couldn’t access care soon enough. Behavioral integration in the primary care office, meeting patients where they are at, can minimize some of those costs.
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