The Reverse Mullet Healthcare Podcast

The Merits of Mental Health Crisis Management Models (and a Man Crush) w/Matt Miller

• BP2 Health • Season 1 • Episode 14

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Get ready to unravel the intricacies of care coordination with the keen insights of Matt Miller from Connections Health Solutions. Join BP2 Health with your hosts—Justin Politi, Dave Pavlik and Ellen Brown as we share hearty laughs, neighborhood tales and lay out the facts. On this episode we will dive into the behavioral health crisis management model where strategy meets development as well as a random rendition of “Walk on the Ocean by Toad the Wet Sprocket.

 Some of the key themes we cover include:

  • Expansion of crisis care legislation from only 6 states to over 30 in the past 18 months
  • A recent PBS segment that featured AZ system for handling crisis including the industry leading Connections Health Solutions model where Matt leads Growth and Development
  • SAMHSA 988 suicide and crisis line successes & opportunities
  • Understanding that in a crisis there three key items -someone to call, someone to respond and a place to go without judgement, stigma or fear
  • The phenomenon on boarding in the ER and the need to eliminate it
  • How to integrate with first responders as a mental health facility
  • Beyond mental health - the need for improved care coordination overall with the focus on the consumer
  • Meeting people where they are
  • The goal of making healthcare better for the consumer no matter the socioeconomic status of the person
  • Matt’s desire to leave a legacy or working to remove the stigma surrounding behavioral health
Ellen:

Welcome to the Reverse Mullet Healthcare Podcast from BP2 Health. Today we are talking with Matt Miller, chief Growth and Development Officer for Connections Health Solutions, about the importance of care coordination across the healthcare system. But first, why are we here and who are we? And why did we name our show the Reverse Mullet Healthcare Podcast?

Dave:

Well, because we want to be relevant and informative, but we also want to be entertaining and have fun. So it's like party in the front and business in the back.

Ellen:

Yes, I have to do the hands.

Justin:

So like a mullet, only reversed. Yeah, right, exactly.

Dave:

We are your hosts. Dave Pavlik, justin Politti.

Ellen:

Ellen Brown.

Dave:

We are passionate, innovative and collaborative and are committed to solving our industry's most important issues together with our clients. We have a combined 90 years experience.

Ellen:

And that doesn't even include Matt. I think we'll be well over the century mark, yeah, which makes us sound really old.

Dave:

In each episode we will dig into a hot healthcare topic and dig into each other a little bit. Be gentle on me.

Ellen:

No, ever Nope. I'm the only one that you have to be gentle with, you know.

Dave:

Matt. Well enough, we could dig into him some too.

Ellen:

So, without further ado, wait is there like a sound effect for this? Justin's so excited.

Justin:

Yeah, like you got to tee yourself up on this.

Ellen:

Okay, all right here's Justin, here's Johnny. No, uh, I am super excited um.

Justin:

Are you really? You had your favorite guest then topic uh, the last go around yes, I did right, and you were walking about food, you were walking on air and now I get to have mine today. Super excited to have Matt here, but I guess one of the things we always have banter to start right.

Justin:

Yes we do One of the things that I was thinking about as I was preparing for the episode was part of me wishes I could go back in time and go to the neighborhood that Matt's that currently lives in right, because I know I'd be that neighbor, you would. I'd be at your house, I'd be watching football games, we'd be doing barbecue challenges and we might even invite you if you were around, do you?

Dave:

have a man crush. He totally has like this is like his bestie that he wishes he.

Ellen:

Yeah. You might invite me too. I might invite you were around. Do you have a man crush? He totally has. Like. This is like his bestie that he wishes he yeah.

Justin:

You might invite me too. I might invite you maybe. Maybe, Ellen would be invited, but you know that she would. She'd go home by 5 o'clock.

Ellen:

Ready for bed.

Justin:

Get ready for bed.

Ellen:

Yeah, definitely. Maybe I'd stay till like 7.

Justin:

Maybe Right.

Ellen:

So yes, matt, you are clearly a favorite. Like we, all have our favorites, and there you go Well, it's a pleasure to be here.

Matt:

It's an honor, justin.

Justin:

Yes super happy.

Dave:

As you can see, I'm glowing. Keep a lookout for homes for sale.

Ellen:

Yeah, keep him posted.

Justin:

But a little background on Matt. He leads the strategy, the organization's business development and growth strategy. And prior to joining Connections and where I first worked or where I first met Matt, he served as senior VP of behavioral health at Magellan Healthcare, where he led the company's behavioral health business line. He has more than 25 years of experience in the healthcare industry, focusing on strategic planning and growth operations, business development and provider delivery system transformation. While at Magellan, matt served in progressive leadership roles in operations and network management, provider relations and business development, including director of business development for Magellan's public sector business unit. Vice president, public sector provider network, where his focus was on Medicaid and public sector delivery systems. National vice president, behavioral health network management and operations for both public sector and commercial network management. Vp of operations for Magellan's public sector programs and senior VP public sector. Impressive career Growing sweeter each season as you slowly grow old. What Do you get?

Matt:

Walk on the ocean? Yes, See.

Dave:

Whoa Toad the wet's market. Toad the wet's market. Yeah, can either of you sing that? Walk on the Ocean? Yes, see, whoa Toad the Wet's Market, toad the.

Ellen:

Wet's Market. Yeah, Can either of you sing that?

Dave:

Walk on the ocean. Oh yeah, step on the ocean.

Justin:

I had to layer in a 90s song. I didn't get this one. I always did that. You even said did someone get?

Ellen:

yeah, went right over. So much goes right over my head. I'm always focused on, like the yeah, Well welcome Matt.

Dave:

As you know, we always like to start with a little party in the front, so apparently you have a super competitive neighborhood, that-.

Ellen:

Justin wants to live in that.

Dave:

Justin wants to live in.

Ellen:

Yes, which is a little, I think you might be. It might be a little creepy now, I don't know. I think maybe we've crossed the line.

Dave:

Stalking much, yeah, when it comes to Halloween costumes, the annual Halloween costume contest.

Justin:

your motto is go big or go home.

Dave:

Can you tell us a little bit about this contest and the costumes you've sported?

Matt:

Sure can Well. First, I guess. Thank you for having me. This is great and congratulations on the podcast.

Ellen:

Thank you, it's fantastic.

Matt:

Thank you, big fan. First-time or long-time listener. First-time attendee Yay, thank you for it's fantastic. Thank you, big fan. First time or long-time listener. First time attendance.

Ellen:

Yay, I appreciate it. Thank you for coming.

Matt:

Yeah, so Halloween. Yeah, so we have the neighborhood that Justin is going to move into.

Justin:

He'll probably be at the party this year.

Matt:

Great neighborhood, have fantastic neighbors and friends, and a neighbor down the street has a big Halloween bash and the first year we were new neighbors and didn't really know what to expect and we kind of showed up ho-hum costume-wise and realized that we had to up our game.

Dave:

So were you Forrest and Jenny? No, that was this last year. Hanson Brothers.

Matt:

That's been done. That's been done. But the first year we really got into it three of my good friends in the neighborhood. We came as Kiss full costume.

Dave:

Oh, outstanding Outstanding.

Matt:

And we brought the show down and we just had to up our game every year. So sometimes we do it as a group, sometimes as couples and, as you said, this last year was Forrest and Jenny with my wife and I, so we had a blast with that as well, we got to get a picture of that yeah.

Ellen:

Yeah but wasn't there like some really epic middle? I thought you told us a story about like showing up at the like. Right, am I missing this so?

Matt:

before going to the party we were at a pre-party.

Ellen:

Okay, so this is really a thing. This is a thing. There's a pre-gaming for a Halloween party.

Matt:

This is a thing and my neighbor friend had a riding lawnmower and we thought it was a great idea if I make an entrance to this party on a riding lawnmower in full Forrest Gump attire and you know it was a good one.

Justin:

That is. It would be tough to one-up that that is outstanding. It's like Forrest Gump mixed with Can't Buy Me Love.

Ellen:

It's always something with you.

Ellen:

You've always got the sayings, so all right. So we also learned that you and your family love the beach, that you're big beach enthusiasts, and so you know, justin lives on the west coast of Florida and I live on the east coast of Florida, and so we sort of have this running debate. I think my water is better because we get that Caribbean. We're the closest beach to the Gulf Stream, so we get that blue Caribbean water. He's rolling his eyes at me, but we don't get red tide over there like you do.

Justin:

No, you don't, that is right so.

Ellen:

I'm just saying there's a difference in okay.

Justin:

But the clarity of the water and the beach sand in Siesta Key is second to none.

Ellen:

The clarity is on par. The clarity is on par. It is you got to come over.

Justin:

We got to get together more. There's going to be a throwdown.

Ellen:

There is so, but anyways, so clearly we're all vitamin D worshipers, because I understand. So what are your favorite beaches? And I think there's continental and then outside of the continental US. So curious.

Matt:

Well, so I grew up in Minnesota. I'm not sure you guys knew that, but I grew up in Minnesota, so completely landlocked.

Ellen:

Near a lake or Not. Near a lake, no.

Matt:

Spent a lot of time on the lakes but had good fortune of being able to go to Mexico, riviera Maya, a lot as a kid with parents and just kind of fell in love with beach life. And after we moved to the East Coast, after I moved to the East Coast and we had kids, we so quick story we went on a Disney cruise and we combined a Disney cruise with Disney itself and this first time we took the kids to Disney. And after we got done with the vacation we said to the kids would you rather go to the beach, because we stopped at a beach on the cruise, or would you rather go to Disney?

Ellen:

Did you go to Castaway Cay we?

Matt:

did yeah, and they said we'd much rather go to the beach. So that was music to my ears. I never have to go back to Disney again, at least not with children.

Ellen:

I'm happy to go back now.

Matt:

But yeah, we've been beach people ever since. We've been beach people ever since my wife's from the East Coast. We spend a week with some of those same neighbors at a little slice of heaven called Don't tell him where, don't tell him where He'll be there.

Ellen:

Sorry, just warning you. No, I'm just kidding.

Matt:

South of Virginia Beach, Sandbridge Island.

Ellen:

Sandbridge.

Dave:

Yeah.

Matt:

Sandbridge Yep, we've talked about Sandbridge. So yeah, we spend a week At least once a year. We try to get to the Caribbean somewhere. So love the Caribbean Jamaica, riviera Maya yeah, so the beach is good.

Ellen:

So I'm just going to throw out for you. So we, these guys know, and you know from last summer when we were working together I love to travel and I will tell you Corsica and Sardinia islands that you should seriously consider if you like the beach. And the cool thing is Corsica is French, sardinia is Italian, so you get to and both of them have like you feel like you're in a French country or on a French island, you feel like you're on Italian island and you can take a ferry between the two and it is very cool, and so my description of them is it's like being in Tuscany with the Caribbean, without the crowds. Now don't go in August, but like June, july, it's phenomenal.

Matt:

Okay, I'll get those names for you. Put them on the list.

Ellen:

I will, I will so anyways.

Dave:

Do you have to speak with a French accent? No, they'll do that. Stop now.

Ellen:

Please stop Okay.

Matt:

Yeah, it sounds like Pepe it out, no we don't need to edit it out.

Ellen:

That's what makes this show fun. Some people say All right.

Dave:

I guess we have to do that sound effect?

Ellen:

Which one?

Justin:

This one, yeah, it does remind me of the Muppet Show.

Ellen:

It's a little bit between the peanuts and the Muppet Show, because we're sadly transitioning from the party in the front to the business in the back.

Justin:

Yeah, All right, so let's jump into our topic for today, which is really going to focus around the need for improved care coordination and care management. But before we delve into that in particular, I really want to talk about where you're currently at with Connections Health Solutions. You're currently at with Connections Health Solutions and, for our listeners who haven't heard of Connections, the model they provide is 24-7 mental health crisis care, with no exceptions and no judgment. At each of their centers, they have resources and teams that provide personalized treatment and care for people with urgent and immediate mental health needs. Now, matt, can you give us a little bit of a background on Connections, the model of care itself and how you're working to help divert unnecessary utilization from emergency rooms and inpatient settings to Connections facilities? Yeah, absolutely, and thank you.

Matt:

So you went through a long history that I had on the payer side 22 years. You make me feel really old, so thank you.

Matt:

You know, and we did a lot of great things there on the payer side, especially work that we did in the public sector, medicaid business, and after, you know, getting a long career there, I wanted to think about what, what's next and be able to have more of a direct impact into the work that I was doing in the company that you know to work for was doing, and so came across Connections, which interestingly I knew of Connections, but by another name.

Matt:

So Dr Chris Carson and Dr Robert Williamson founded Connections. They were the co-founders, and actually the model of care which has come to be known as the 23-hour observation model of care was kind of created out of necessity by Dr Carson when he was actually in Texas in the 90s. And let me know if you've heard this story. But someone boarding in the ER for a really long time no inpatient bed available to go, sits in the ER for two to three days, finally gets transferred and really doesn't get treatment until that fourth day. So that was a problem in Texas in the late 90s. That's still the problem we Texas in the late 90s. That's still the problem we're having today throughout the country.

Dave:

When I was on the payer side.

Matt:

This was actually something that I was trying to do in any community, any state that I was doing business in, and it was a level of care, if you will, that just didn't exist and it still doesn't exist in a lot of communities. So it was comfortable to me and I knew that there was some tailwinds in the space from a regulatory perspective, from a licensure perspective, to really jump into this and help to grow and expand the model. So we are, as you said, 24-7 behavioral health, mental health or substance abuse, anyone at any time, regardless of demographic, regardless of insurance. It effectively serves as an alternative to the ER, an alternative to long-term inpatient hospitalization and, in some cases, alternative to jail and detention. So yeah, that's the history of the organization and we'll get into a little bit some of the expansion as we move forward.

Dave:

Super interesting background and model there. With the overwhelming volume of mental health crisis cases nationally, you must be getting approached by every state, I would imagine right, or federal agencies right, to bring your model into you know it's interesting, no one's ever said this was a bad idea.

Matt:

you know, in my time there, and even beforehand. So I started a little over two years ago and at that time there was six states that had regulation or legislation related to crisis care to the type of model that we have today. There's more than 30 states that are in the process of changing regulation or legislation to allow for this type of model.

Ellen:

And what period of time has it shifted to be 30 states?

Matt:

In the last 18 months. Wow, yeah, that's crazy, that's amazing. Pretty significant Catching on, fast Catching on fast, so you certainly saw some tailwinds. Definitely some tailwinds.

Matt:

There's a lot of tailwinds coming out of COVID. I mean, if there's anything good that came out of COVID other than ripping the bandage off of telehealth, it's a heightened emphasis on mental health and on behavioral health. So yeah, states are looking at this, local municipalities are looking at this, counties are looking at this really. Counties are looking at this really collectively to solve the same issue and thus provide more access, better care and better outcomes than what the alternatives are today.

Ellen:

Very cool. So recently PBS did a segment on the Arizona system for handling crisis care 988 availability which I also want you to give us a little bit about this 988 availability and the unique approach the state takes and highlighted the role that connections is at play here. And we'll provide Dave I feel like we say this and then we have to figure this out is we will provide a link to that PBS segment to our listeners in the show?

Dave:

notes yeah, absolutely, I just watched it.

Ellen:

It's really well done, it is actually, but you know Arizona feels like it's much further ahead from other states. Can you share why you think that's the case and just give us a little bit more background on that?

Matt:

Yeah, I mean, arizona definitely has been ahead of other states when it comes to crisis care and I think what they did originally was blend funding blended SAMHSA, block grant dollars, blended Medicaid dollars, non-medicaid dollars, county-based dollars to ensure that the uninsured were cared for, and there was a path to that to make programs sustainable. I think, like you said, that PBS piece just came out, I think last week, and it talks about some of the really good things that are available in the Arizona system in the crisis system and areas for need for continued improvement. It's evolved over time. Crisis services have evolved, expanded, moving, you know, past that, beyond the 23-hour observation model and into crisis stabilization. As it relates to, you know, samhsa 988 is where we're almost 18 months into 988. Maybe not that far, but it's definitely a year anniversary of 988 launching. If you don't know what 988 is, please research it. Everyone should know what the national hotline for suicide prevention is.

Dave:

It's like 911, but I don't remember the stats exactly. But in that documentary they talked about there was previously, right, an 800 number or toll-free number at National Suicide Law and the number of incoming calls increased by huge amounts when it went to 988. So just simply changing from an 800 toll-free to a 988.

Justin:

I don't remember the numbers, but it was staggering. The stats were amazing. Even with it, I still feel like people don't know.

Matt:

No, I totally agree it hasn't been rolled out consistently across the country.

Matt:

There are states and counties that have had a dedicated crisis call center in the past, quickly adopted 988. But there are still some challenges that I know SAMHSA is actively working through and others are working through to make sure that the you know it's rolled out, that there is no confusion, like when you're calling from a cell phone number that has a prefix of Nevada and you're actually in California, that they know that you're in California, not Nevada. So they're working through some of those details and I think you know there was a planned rollout of 988, and SANS has done a fantastic job with that and they're also it's part of the kind of this three-legged stool around crisis. So someone to call 988, someone to respond, which would be mobile crisis, and then someplace to go and that's where organizations like Connections come in is someplace to go without judgment, without stigma, without having to go to an ER, without fear of going, you know, being detained and ending up in jail because of a mental health or behavioral health issue.

Justin:

Can you explain how you work with the or how Connections works with first responders in each community?

Matt:

Yeah, very, very closely. You know we consider them a key constituent very, very closely. You know we consider them a key constituent and I say that specifically. We have a large percentage of people that are transported to our facilities via law enforcement or other first responders. And I say transport because they're not in custody. Sometimes they're in custody for their own safety, but when they're coming into our facility we have peer supports that will meet law enforcement at a back door and take the cuffs off an individual that they know that they're entering into a treatment environment, not a law enforcement environment. So working collaboratively with first responders and it kind of changed the culture of how law enforcement responds to behavioral health emergencies is really important to the work that we're doing in Arizona and elsewhere.

Justin:

So I'm going to have you step away from connections for just a second and we're going to go a little bit more personal level about what you think is needed to affect real change within the marketplace and the health care system as a whole. Can you give your thoughts and opinion on that?

Matt:

Yeah, you know, as we all have been here in health care for a really long time, you think you've got it figured out as we all laugh, right? I know, right Wait.

Dave:

There, it is there, you go, you got it right.

Matt:

And you know there's so much that you know can be done better in healthcare. There's so much that can be done better in health care and I think recent experiences, you think about that kind of first and foremost so care coordination, especially with an aging population. Systems don't talk to each other, health systems don't talk to each other, it systems don't talk to each other. It systems don't talk to each other. It's tough, especially in large rural parts of the country where healthcare does it healthcare shortages and just coordinating care generally for a consumer who's dealing with the healthcare, especially behavioral health. It's tough to coordinate care on behavioral health but coordinating care generally Just to you know, to have a better system, a better solution in place for that to help the consumer navigate the healthcare experience better. I mean, healthcare is for the consumer, right, I mean, and sometimes I think we forget about that and what it's really for. If we need to put the focus on the consumer, we're going to get better health outcomes.

Ellen:

But I love. So you know we had the pleasure of working with you and really got to dive into I really enjoyed learning not only the model but the value proposition of the model. And when you talk about care coordination, we think about primary care and how it integrates in with specialty care and then acute care and behavioral sort of. Is this ancillary? And what we realized and I think, like you said, covid really hit home that behavioral is part of it all. It's not an ancillary.

Ellen:

It shouldn't be stuck in a corner over there, which is what we have effectively done and I just loved how the model that you represent, that you're building and putting in different parts of the country, is.

Ellen:

It addresses behavioral at that care coordination level and it meets people where they are, because so many times things can be de-escalated really quickly just by somebody getting the right medication or just having someone to talk to.

Ellen:

And so the idea of having a physical location where somebody can come and just sit and and be heard, like you, without judgment, and that there are different levels of care, just for a behavioral health issue right Versus you come in, like you said, and I don't think people really I certainly didn't understand the need for care coordination at a behavioral health level. On its own right, it's still integrated in. And so I just, when we talk about care coordination I know we're going to talk about broader care coordination, but I just I think it's really cool that you get to work in taking a model that was working in Arizona and now bringing it to other parts of the country to say, look, behavioral health is a huge problem for our country, it's a huge challenge for health care. You know, like Justin joked, I got my food discussion. He is super passionate, as you know. That's how you all met about behavioral health and I just I think it's really remarkable and yeah, so, yeah, you know the behavioral health.

Matt:

I would put it in a different term Behavioral health is a huge opportunity for the country, right, yep, it is a problem that we haven't gotten it right yet, and I think that's the opportunity that's in front of us. You know your point around the care coordination aspect. Someone comes into a facility, a crisis facility and the goal is to stabilize and return your point around the care coordination aspect someone comes into a facility, a crisis facility and the goal is to stabilize and return, get that individual back to the community as quickly as possible, and that could just be an urgent care visit because there are meds and they are not able to see their psychiatrist to get a refill.

Matt:

It could mean a 23-hour you know less than 23-hour stay just to stabilize what's going on and really talking about not what the problem is, but what happened, that you got here and we're glad that you're here but how can we help address social, determinative health issues, other issues that you know cause the crisis or whatever is going on, and address that head on and then do the follow-up as well? You know we view ourselves as part of a system. We can't exist in a silo and we have to work with all other organizations and providers in the system, and I think that's something that we do really well and we need to do really well as we expand into new markets, on really helping to use our position to help coordinate the system in a better way so that it's more accountable to the consumers who are utilizing it.

Ellen:

And I'll put a plug to all the payers, all the people on the payer side. We talked in the episode previous to this about the sides that shouldn't really exist, right?

Justin:

But joking aside, Star Wars type of analogies that are used.

Ellen:

Yeah, it's like we could bring the lightsaber. I wish we had that sound effect right Like that buzz noise. That's like a cool, very like.

Dave:

Seems to me that there should be a connections facility in every community.

Justin:

Doesn't it feel like that?

Dave:

Well, I heard this. You know Matt's conversation about the borders in the emergency room. I know that happens in our local hospital all the time.

Ellen:

Well, your wife works there, Right.

Dave:

And there's borders. They're literally on a gurney in the hallway. They're not getting any treatment, they're not getting any quick care coordination. It feels third world, doesn't it? Yeah, absolutely, but so I'm not an expert in this topic like you are. But you often say, justin, that it used to be back in the day that we had this, so why did it go away?

Justin:

That's a good question. We didn't invest in those communities where these locations were. It became easier to push these individuals into the emergency room and it's unfortunate that we didn't invest in those things. But I'm interested in Matt's opinion on the dynamic.

Ellen:

So wait, because I lost my train of thought on the lightsaber.

Dave:

Oh, I'm so sorry.

Ellen:

It's okay. You were right to take over the conversation because I had gone down a bad rabbit hole, but where I was going to Now you're taking it back.

Ellen:

I am, and then I do want to go back to the question you posed, but if we can remember, it is value-based care is, I feel, like the opportunity. When we talk about opportunities, it is the opportunity to recognize this model of care delivery for behavioral health as part of care coordination at large, and I think that is one of the places that we have gone wrong. And I'll pose this.

Ellen:

Working with you all really opened my eyes to the fact that we're big proponents, as you know, of value-based care. That is something that I'm super passionate about. It's a legacy item for me in what I'm doing, and so I really was blind to the fact that value-based care largely ignored things like behavioral health right, and like we've talked about before, we've We've carved those things out and now we've kind of given the money away and we need to figure out how to bring the money back together, which is right. So my point was I was trying to plug the payers to say these models need to be recognized in value-based care for the inherent value that they bring beyond just the incidents, the services that come in your door.

Matt:

That's an excellent point. I think payers get it. I think conceptually they get it. I'm a recovering payer. I think the industry gets it, but there has to be more of an emphasis on it. You can think about it from many different aspects, but if you think about it just from a top line dollar aspect of an episode of someone in a traditional model, as we think about traditional, you're really not having a good day.

Ellen:

So walk us through that, because I do actually think it's a good education. We've kind of hit on it on the periphery here, but walk us through what the alternative to connections is for the healthcare system, because there are a lot of people that listen to this that don't have that background.

Matt:

Yeah, I mean, someone is suicidal, homicidal, really not feeling. Well, something's going on and they make the appropriate right call and say or hopefully they're calling 988 now, but previously they're just going directly to the er, where else are you gonna? Where else to go, right?

Ellen:

or they're brought right or they you know they call 9-1-1.

Matt:

Law enforcement comes out and law enforcement is bringing them to the er, bringing them someplace or the family or something, yeah so you you know. I don't know off the top of my head what the average boarding time, and it varies by, varies by community, but there's always someone boarding for a behavioral health issue in an ER.

Ellen:

Meaning that they're just staying Again. I'm—.

Matt:

They're waiting for a bed to open up, they're waiting for medical clearance. They're waiting for something. That's one of the things about our facilities. We do medical clearance. You don't have to go to an ER to be medically cleared, to be admitted into one of our facilities, but they're waiting for a bed to fill up. There's a shortage of beds, there's a workforce issue right, a shortage of beds and so they're boarding for 8, 12, 24 hours, not getting active treatment and then admitted to an inpatient facility, probably not getting active treatment until day two.

Matt:

So you're three days into a crisis and sitting in an ER is not a great place for anyone but someone that's experienced a behavioral health issue. So the alternative is you come to a crisis facility and your point early Dave about. You know it's happening in the hospital where your wife works. It happens every day and there are other alternatives to large-scale programs like ours. There are psych emergency services, there are other kind of. There's empath units that organizations you know largely rural community hospitals are looking at as an alternative to make it a more cost-effective alternative for those rural communities. But yeah, so the ER admission cost of the health care insurer inpatient admission cost of the health care insurer inpatient admission cost of the health care insurer.

Ellen:

And it's not even the appropriate place. And it's not the appropriate place. There's nobody there.

Matt:

And readmission rates aren't that great. And that's when the care coordination aspect comes in. Is really what is going on? Are we really addressing what caused the crisis and the individual to come in, versus call your PCP and follow up in seven days, right? So the alternative is to get effective, immediate treatment right away. So in models like ours we're a medical model, a full complement of medical staff that are treating the crisis as well as treating the psychosocial issues as well. We have a lot of techs, a lot of peers that support our program. So we're really addressing what cause the individual would come in and how can we help that not happen again and you know it will and we'll get you know. We continue to work with that individual and work with the outpatient provider or other community supports to make sure that they have the support that they need to remain in the community so, dave, are you going to ask your question, one of the questions we always ask yeah, sure um maybe we can sing yeah no, we, we always.

Ellen:

That's old enough, right, right you know that.

Dave:

You know the old commercial like to buy the world a Coke.

Ellen:

In perfect harmony.

Matt:

I remember that commercial. So thanks again, Justin, for writing on my email.

Dave:

Now you've got an earworm for the rest of the day. What would be your?

Matt:

buy the world a Coke moment For health care, for health care, make it easier for the consumer For healthcare, for healthcare. Make it easier for the consumer and you know so anything that could be easier for a consumer, especially vulnerable populations, you know, in the lens of care coordination and care management, how can we make it better? You know, I think there's a lot of fear about AI and what it's going to do to health care and what it's going to do to a lot of industries, but health care in particular, and I know enough about AI to get myself in trouble when talking about it.

Matt:

But this, you know, being able to link certain health care systems, and I recently had an experience where you know individuals was getting treatment in one health care system and received outpatient services in another healthcare system. Those systems didn't talk to each other because they didn't have the same medical management platform, the EMR, and they just didn't talk to each other generally and that just puts a patient in a bad situation of really trying to navigate on their own and I think for those of us just personally been in healthcare for a really long time, you think you got to figure it out. Until you are in the depths of actually trying to figure it out and, uh, then it becomes a lot more eyeopening.

Ellen:

Absolutely so you need. You made me think and this is a guest that we're going to have, probably sooner than later, but there's a company you should look into into it, called Lirio L-I-R-I O. You might have heard of them, but I think they're an interesting. When you talk about AI and the need for again behavioral health and behavior in general, they have an interesting approach that you that sort of new entree of being dangerous and AI Like. I think that's an interesting. I'll be very interested to see where Martin and company go, because I think it's a. It's a great concept. But so last question if you could leave a legacy in healthcare or feel like you made a big difference, what would it be?

Matt:

Legacy is a big term.

Ellen:

It is, but that's why we this is why it's our passion project, because it's like let's talk big, real.

Matt:

I'd probably answer that maybe three ways if that's okay.

Matt:

One is anything that I can do, or the company I'm working with can do, to continue to reduce stigma around behavioral health, mental health, stigma around behavioral health, mental health. And ultimately, if there could be a legacy, it would be someone saying you know, the same way, I've got to go to my PT appointment. Right Broke my arm going PT. I've got to go to my PT appointment Without shame. For someone to say I need to go to my behavioral health appointment without shame. So, as a country, for us to be able to get there and if we can influence legislation, if we can influence regulation, to be able to allow for new innovative services. You know, the behavioral health delivery system and services hasn't really changed. Probably the biggest change was deinstitutionalization and COVID helped just from a recognition standpoint that mental health is real and we need to talk more about it. We need to be more accepting of it, so getting it to be more commonplace and not as much of a stigma, right?

Ellen:

Not as much as a stigma and not being afraid to talk about it, so getting it to be more commonplace. And not as much of a stigma, right?

Matt:

Not as much as a stigma and not being afraid to talk about it and having it be. You know it's an illness, just like pneumonia is an illness right and get treatment and be able to treat it as an illness and not as something you know behind closed doors.

Ellen:

I would. Actually I will sort of throw a I don't want to say counter, because it's I agree with you, but I think this gets into just health in general. We talk about our physical health and the need to put energy towards it right what we eat, how we move our bodies, our sleep, and I think our mental health is just as imperative. And I think if, as a society, we talked more about how to keep our mental health at the top of its game, it would be a real game changer for so many different layers. I mean, it would remove stigma, it would allow us to be much more proactive, it would allow us to be honest with each other of you know, I'm just not feeling it today. Right, I'm a little cranky, I'm whatever and right, and like today, whenever I got off the plane and.

Ellen:

I was snippy. I don't know why, but well, well, I didn't get enough sleep. She yelled at me, but you get what I'm saying, Matt.

Dave:

Like.

Ellen:

I think there's such an opportunity of. I mean, I hope we have a lot more around behavioral health and mental health on our podcast, Because as much as I love food and could talk about health like that, I think the behavioral aspect and mental health in general is just largely not discussed and not recognized.

Matt:

And you know, the third thing I was going to mention comes back to that, right. So better mental health is going to be better overall health, which is better to the healthcare system, better to the healthcare dollar, right? There's a ton of not understood costs related to mental health, right? Whether it's workplace, whether it's just healthcare costs generally. If we're taking care of mental health, behavioral health, we're going to take care of the rest of the healthcare costs and I think, from a legacy standpoint, there's not a lot of value-based care in behavioral health very little, right. So that's one of the things that we're going to try to change connections as we continue. The work that we're doing across the country and expanding is really focusing on the value to the consumer. The value to address a health care issue that is directly getting better outcomes for the consumer in a much more cost-conscious way is good for the health care system.

Justin:

So I'm going to go off script real quick.

Ellen:

Because I haven't done that today.

Justin:

Where did your passion for behavioral health like the personally? Where did it come from? For behavioral health personally when did it come?

Matt:

from Most of my family's in health care. My mom was a LPN and then worked in a county-based WIC clinic. So I went to school, graduated with psychology and criminal justice. My eyesight was really crappy so I couldn't get into the FBI. So I kind of landed on the delivery system side and had always done things from a community-based behavioral health perspective. So I got my start in more community-based behavioral health programs partial hospital programs, group home programs, actually a crisis center Well, actually one of the first ones in Philadelphia way back in the day and as I moved into the managed care side I think I didn't know what managed care was.

Matt:

When I moved into managed care I was younger in my career and really kind of realized, gosh, I can glean so much for this from the administrative side and the payer side. To then bring that back to the delivery system side and um, so it's a long-winded say, a way of saying it's just kind of been innate um over the career that's why you guys are like soul brothers or something you know you're like like I said, I'm showing up at your house with the soul mates.

Ellen:

They are they're?

Justin:

they're like brothers I have to figure out my outfit. That's my For.

Ellen:

Halloween. Yes, you got to go big. Justin, you are forewarned? Yeah, he's been forewarned, yeah, yeah.

Dave:

What's Connection's footprint right now other than Arizona, and where are you going if you can say?

Matt:

Yeah, so we've been operating for 15 years in Arizona, so Phoenix and Tucson we see about 30,000 people a year between those two centers. That's a lot of people coming through the doors. In Arizona we're expanding to Washington State. This summer We'll have a large facility in Kirkland, washington. There's a lot of great things going on in Washington. The state and the county are taking some really proactive steps to address behavioral health issues generally. Virginia we're going to be launching in Virginia this year. We'll have two programs in Virginia Northern Virginia and then Pennsylvania as well. So Harrisburg will be our first program in Pennsylvania and a lot of tailwinds behind us and, as you said, there's just a lot of people looking at this of a much more effective and better outcome alternative to what's happening today or what's not happening today.

Ellen:

Well, after talking with Dr Elliott, our guest just now, I feel like Delaware is a perfect proving ground.

Matt:

It's on the map absolutely.

Ellen:

It sounds like it's a perfect microcosm.

Justin:

Every state. You've got to have one in every state. We do need to have one in every state.

Ellen:

Well, I'm so glad you came, Matt.

Matt:

It's a pleasure to be here. I'm so glad I was able to come.

Ellen:

It's fun to have a friend on the podcast.

Justin:

Yes, absolutely I appreciate your time, justin certainly

Ellen:

feels that way so sorry, I gotta give you a hard time I can't I know I get. Hey, it's coming back at me it's you exactly you dish it out at me, so I so I have to have thick skin. That's right, that's all right.

Matt:

We all should have told me this like two years ago, the house right next to me opened up. No, you you're glad you're glad.

Justin:

So I'm texting shan after my wife after this and I'm like I I told no.

Ellen:

So we were joking about this, because here in town, in Westchester, where we are, we're driving through town to get a coffee and Justin's like this place is great, I could be like the mayor. He literally said that I could be like the mayor here and I said, yeah, but you can't endlessly sit in the sun and go to the beach here. That's the problem. So it would not be it. So, anyways, well, thanks again. I'm Ellen Brown, I'm Dave Pavlik and I'm Justin Politti. We are the partners at BP2 Health your best chance for real change.

Dave:

As you can tell, we can talk about this all day long. Drop us a line through our website, bp2healthcom. This episode is produced by Mainline Studios in Westchester Pennsylvania.

Ellen:

Give Eric a shout, eric Pennsylvania. Give Eric a shout, eric, yeah, give Eric a shout this has been a guest studio for us and it has been fantastic.

Dave:

Yes.

Ellen:

Yeah.

Dave:

Thanks again.

Justin:

Thanks again. Have a great day, thank you.