.png)
Neil Leibowitz, MD, JD, is a dynamic and results-driven senior healthcare executive. Dr. Leibowitz shares his experience in the digital behavioral health space and adds insights into ways we can improve and innovate within the industry. There are many pockets of opportunity at a large scale to both innovate and pilot things.
Measuring success in behavioral health is often more complex than what we see for medical care. Typically, many companies utilize validated measures such as the PHQ-9 for depression and GAD-7 for anxiety. For behavioral health, success can sometimes be more nuanced. Success measures for someone are: What do they want to do that they’re not doing today? It could range from going to work, getting along with a family member, or getting out of bed. Unfortunately, these qualities are difficult to quantify and measure and can’t be captured by a survey. Dr. Leibowitz suggests recording occasional sessions as a quality measure. So what do you look for in these sessions? When reviewing these recorded sessions, technical proficiency is only a piece, but empathy is the most valuable metric. This ties in with the research that shows that a strong therapeutic relationship is the strongest predictor of a positive therapeutic outcome.
Finding a way to measure success can help providers understand what they can do better. Dr. Leibowitz shared, "for a payer, it becomes, who do I want to send the hardest people to? Am I willing to pay more for a great outcome? And that’s where I want to go. I want to pay people more if they’re doing great work." As we think about ways to innovate in behavioral health, rewarding providers for great outcomes may be difficult, but it’s a great way to move forward.
As a licensed Psychiatrist, Dr. Leibowitz mentions that all of the current innovation appears to be focused on outpatient care, but “for anyone who’s been in an inpatient unit in the last five years, their experience probably would have been just about the same as if they were in an inpatient unit in 1960.” And this isn’t surprising. The barrier to entry is much more difficult in terms of understanding, appreciating, and innovating in inpatient care.
Inpatient mental health care is really difficult to innovate. It requires a level of technical knowledge and expertise that not many people possess. Additionally, most people have no exposure to inpatient care, and those who may have visited relatives were only exposed an hour a day.
For current behavioral health companies to set up a practice or develop an app, you can go to market in six months. However, if you want to really change the thorniest most complex problem, it’s going to take a little more time and more money. Innovation in inpatient care will take a larger investment from all stakeholders in order to really see change.
Dr. Leibowitz makes it clear that the most important thing is that you have something that fits within a reasonable framework of what we do today. In other words, any digital behavioral health solution must be built for the current American healthcare system.
“Think about how your solution can work within the framework of healthcare. Whether we think healthcare in this country is delivered correctly or not is not the discussion to have. What the discussion to have is your version one. Explain to me how it’s going to work in the insurance-based system. How’s it going to get paid for? How does it get implemented?” While it’s great to have ambitious long-term goals and think creatively about how healthcare in America can be better, startups that think practically about how to work within the current healthcare system in terms of payment and implementation will be the most successful.
To hear more on this conversation, watch this conversation in our video library.
.png){kind=small}
.png)