"There is a finite number of resources available to treat people in this country,” stated Peter A. Ambrose, Jr., PhD, MBA. Finding a way to stretch those resources and transcend barriers to integrating behavioral health into the primary care setting was the impetus behind the launch of Franklin-based MindCare Solutions 18 months ago.
Ambrose, the telemedicine company’s CEO, is a licensed psychologist with a wealth of experience in population-based behavioral health. Previously, he served as regional vice president of Behavioral Health for Anthem Blue Cross Blue Shield where he was responsible for enterprise operations of behavioral health benefits for 20 million members. His experience also includes executive positions with behavioral health oversight for Barnes Jewish Christian Health System in Saint Louis and for Blue Cross Blue Shield of Missouri.
“Forty percent of people who have a chronic illness also have a psychiatric component to it,” Ambrose said. “For any chronic illness, we know if you don’t take care of the behavioral health condition, you won’t achieve optimal outcomes – health outcomes, quality of life outcomes or financial outcomes.”
Although the link between physical and mental health is well established, Ambrose said it hasn’t been easy to integrate care delivery in tandem for a number of reasons ranging from a shortage of providers to a historical separation of the disciplines to logistical barriers within some care settings such as correctional facilities.
For months prior to MindCare Solution’s launch, Ambrose said the leadership team, investors and industry insiders worked to develop the company’s concept to best address existing needs across the country. “We went through a design shop at Vanderbilt where one of my board members, Dr. Harry Jacobson, brought together 60 healthcare experts to vet the idea and then to solicit their ideas on what would be the important aspects (of the business model),” Ambrose recalled. Using technology as an integration tool emerged as a viable solution to overcome many cost, geographic and timing barriers that have hindered efficient access to care.
Ambrose noted while there is a general shortage of psychiatrists across the country, the deficit becomes more pronounced when drilling down into specialty areas such as pediatric or geriatric psychiatry. Replacing retiring physicians is another concern. “Currently, 60 percent of psychiatrists are 55 and older. Based on today’s numbers, in a generation, we’re going to lose 40 percent of psychiatrists,” he said. Since behavioral health issues have not shown a decline, the presumption is the need for services will stay steady or increase in the coming years creating a widening gap between demand and resources, which will be exacerbated in rural areas.
Telemedicine technology allows MindCare to provide broad geographic access in a timely manner. “We’re able to provide a virtual clinic so I can provide services to 25 different physician offices in one day without the psychiatrist having to leave his office,” Ambrose said. He added MindCare’s business model also has been able to dramatically cut appointment wait times for their clinical partners. “You’re able to get more hours in a day. You’re able to see more patients more efficiently,” he added.
From a cost perspective, which is increasingly important in the shift to value-based payment models, Ambrose pointed out spending a little could save a lot. “There is generally between a 30-40 percent increase in the medical spend if you don’t take care of the behavioral health issue,” he said.
Ambrose noted while it might take $1 to care for someone with diabetes, that same patient costs $1.40 if depression is also present. “If you address the behavioral health issue, you may spend a nickel, but you wind up spending $1.05 as opposed to the $1.40,” he said. In essence, Ambrose continued, “You can save money. You can increase someone’s health … they feel better. And you increase their quality of life.”
When establishing a relationship with a practice or institution, MindCare Solutions’ licensed, credentialed clinicians have the ability to transfer notes and data to populate patient records. “Not all electronic medical records by design speak to each other, but the fact is with some technology additions, they can. For the most part, the operational issues in telemedicine are becoming less and less an issue,” Ambrose said.
While the company has a robust technology platform, Ambrose was quick to stress MindCare isn’t a technology company. “We are providers of care. We use technology as a tool … not as what we do. We’re not reinventing the wheel,” he continued. “All we’re doing is taking the best practices available today and combining them with technology. We like being partners. We like providing care. We like improving outcomes,” he said of the company’s mission.
It’s a strategic model that seems to be resonating with providers across the United States. By the end of 2015, Ambrose said MindCare Solutions would be available in 28 states. “Five years from now, I venture we’ll be in every state,” Ambrose said. He added during that same timeframe, he foresees the company entering into risk-sharing agreements with their strategic partners as reimbursement models shift.
The company currently provides behavioral health solutions for a range of primary care, long-term care and correctional health institutions. Ambrose said that in their first 18 months of business, some partners have asked MindCare to add primary care to their customizable offerings. “Realistically, there are no cookie cuter solutions anymore. Clients want their needs met their way, and we’re able to do that,” he said of expanding the types of services and range of providers to address specific needs.
“We see our future … and the future of telemedicine … as providing a variety of specialty services to institutional clients,” Ambrose concluded. “This isn’t going to take over medicine, but it will be an important complementary piece to the health system.”
For more information, go online to: MindCareSolutions.com
RELATED LINKS:
American Telemedicine Association
ATA State Medicaid Best Practice Telemental & Behavioral Health: