Adding value is something that Turnbridge President and CEO David Vieau talks about regularly with his peers in the field.
“It’s been an interesting ride in this industry through the conferences and listening to other CEOs speak,” says Vieau. “I’ve been hearing ‘adding value’ for a long time. We’re talking about how a corporation can grow and expand. I’ve always thought this industry needed to treat adding value differently than the electronics industry or the IT industry. We have a unique responsibility that we’re treating people in what could be fatal situations.”
“Value” in the context of behavioral healthcare largely is defined by the priorities of the stakeholder, and creating added value in many instances comes down to speaking the language of various constituents and delivering measurable results that reflect their needs, says Siobhan Morse, division director of clinical services for Foundations Recovery Network.
Whereas providers want efficient operations, and payers might be most interested in rates of client readmissions, patients’ family members might care more about the number of times clients have had significant conflicts with loved ones within the past month.
Understanding ways to increase value for all parties can ultimately make the difference on providers’ bottom lines.
1 - Measure up
Basic economics will tell you that value is a function of price vs. quality, Morse says.
“When you talk about value, you have two options,” Morse says. “You can decrease the price, which no one wants to do, or you can increase the integer in that formula that is associated with quality. Given the current price, how can I improve the quality of my product? How can I add something that speaks to the quality of my product? What can I add that is going to, in effect, make the price seem lower?”
Morse says providers across the industry have been less than stellar in defining their quality of care and answering the questions of stakeholders by speaking objectively and answering questions in an empirical, fact-based manner.
Morse refers to the six domains of healthcare quality that have been established by the Institute of Medicine and are recognized by the Agency for Healthcare Research and Quality. The domains say healthcare should be:
For Turnbridge, which has 187 extended care beds at 16 facilities in the New Haven, Conn., area, analyzing its efficacy and efficiency begins with its robust system for monitoring its patient data.
Vieau estimates that Turnbridge employs between 60 and 80 staff members who are measuring data on an hourly basis, and sharing data with care team members. Patients’ responses to treatment are evaluated against others with a similar disorder acuity within the same socio-economic demographics.
2 - Increase accessibility and affordability
There is a slogan often repeated around the halls of The Abbey Addiction Treatment Center in Bettendorf, Iowa: “Our job is to help get people into treatment, not keep them out.”
Founder Joseph Lemon Jr. says the first way in which The Abbey looks to improve its value proposition is by prioritizing access and affordability of care because it believes taking in clients at the moment they are ready to enter treatment enhances their odds for successful outcomes.
“You want to strike while the iron is hot with their readiness to change,” Lemon says.
For The Abbey, that means accepting insurance and working with clients to structure payments over an extended period, defraying costs up front, if necessary.
Having well-measured results that can clearly demonstrate a program’s efficacy eases relations when working with insurers, Vieau says.
“Commercial insurance is saying, ‘Why should we pay X?’ ” Vieau says. “Efficacy is critical going forward.”
3 - Maintain engagement
While some value propositions appeal to a specific subset of stakeholders, offering complementary continuing care is one strategy that has proven beneficial for all parties in the treatment equation for The Abbey, Lemon says.
Several opportunities for alumni participation are baked into the provider’s programming. This keeps past clients engaged in their recovery and helps current clients see where their next steps can lead. Past clients are also welcomed to return for a day or two when they self-identify symptoms for a potential relapse. Alumni receive “a booster shot" of programming that reintroduces principles of their treatment to stave off a physical relapse, Lemon says.
He acknowledges that patients aren’t the only ones who find value in the complementary continuing care.
“It’s a much less expensive way to care for patients—they miss less work and time with their family if they can be with us for a day or two instead of a month or two,” he says, “And if we can do anything to enhance their success, it reflects well on our program.”
Tom Valentino is Senior Editor of Behavioral Healthcare Executive.
One size does not fit all
Turnbridge does not have call centers, and it spends just “a very small percentage” of its top-line revenue on marketing. Vieau says the organization has found better value in putting its money into research and developing efficacy that has resulted into targeted programming that fits a select population.
By design, Turnbridge works only with young people in gender-specific programs. Vieau says concentrating a targeted population instead of casting a wide net with a one-size-fits-all approach has directly correlated with success at its various sites.
“We look at it now as not only do we want the right program and the right fit, but also for the right people in the right places,” Vieau says.
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