Integrating Behavioral Health into Primary Care with Spencer Hutchins, CEO and Co-founder of Concert Health: Audio automatically transcribed by Sonix

Integrating Behavioral Health into Primary Care with Spencer Hutchins, CEO and Co-founder of Concert Health: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
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Saul Marquez:
Hey everyone, Saul Marquez is back, and welcome back to the Outcomes Rocket. Today, I have the privilege of hosting Spencer Hutchins. He is the CEO and co-founder of Concert Health, America’s leading behavioral health medical group with a turnkey solution designed for primary care and women’s health physicians. Concert Health’s exceptional team of clinicians, deliver collaborative care management and evidence-based model proven to treat anxiety, depression, and other behavioral health concerns. Obviously, during the pandemic, much of that has come up. Many are calling it the second wave. And so the timing couldn’t be better for having Spencer on the show to talk about what they’re doing and doing so well. So Spencer, thanks for joining us.

Spencer Hutchins:
Yeah, it’s great to be here. Thanks for having me on.

Saul Marquez:
Absolutely. So before we dive into concert health and the expertise that you guys are doing here in behavioral health for primary care, talk to us about you and what lights your spark in health care.

Spencer Hutchins:
Sure. I think I found health care kind of through a circuitous route, but I’ve always had two North stars in my career. Loved hard, complex industry problems particularly liked things that a lot of overlap with sort of regulation. Government service is a little bit earlier in my career, worked in political campaigns and government service. And so I always found that powerful. The second was I really wanted a place where business success would be aligned with making the world a little better place and really felt like, particularly in this last decade, that there’s an opportunity to create better outcomes, better experiences for people like me and my family, people I love across the country. And that presents an opportunity for big businesses. But each new dollar of revenue, each growth, each new hire is helping people. And that felt like a good reason to dig in and focus here.

Saul Marquez:
Amen to that, Spencer. And I love your drive for doing well by doing good. And you and your team have decided to focus on a really hot area. The time for mental health is here. And the acceptance of mental health as something that’s important we need to deal with is now among us. So talk to us a little bit about your company and how you’re adding value to the health care ecosystem.

Spencer Hutchins:
We’re excited to have some venture capital investors, excited about the technology platform we’ve built. But our core Concert Health is a behavioral health medical group. The vast majority of our employees are really talented behavioral health providers, licensure types like social workers, licensed professional clinical counselors, marriage therapists, and then nearly 20 psychiatrists and psychiatric nurse practitioners. And felt like this wasn’t an industry that just needed a new app or a new service or a new platform, but really needed to restructure. We architect America’s behavioral health system. And to do that, we needed to build a really big group.

Spencer Hutchins:
We’re standing on the shoulders of foundational research of a particular clinical model called Collaborative Care Management, which is an evidence-based form of integrating behavioral health into your primary care setting, where other physicians, which really take a principal role for their patients, like women’s health, particularly around pregnancy. And so what we do is partner with sign agreements with those and deliver care together. How we add value to patients is that our behavioral health services are integrated right with your PCP. So we are working alongside her, documenting together in the same medical record, coming up with an integrated plan. So you don’t feel like you have your therapist doing one thing and your PCP working on your diabetes is something totally separate. It’s integrated because we all know that was a mistake we made a long time ago to treat your depression and your weight or your diabetes or your COPD separately because they so often co-mingle, they make each other worse. They often need to be treated together. The second is the collaborative care model. What we focus on is focused on your needs. And so that can look like full-on traditional therapy services, or it can be things that are more lighter touch goals set in medication management, understanding what people want and need, what they have time for their lives.

Spencer Hutchins:
But finally, with really owning the outcome along with our patients. So really focused on always constantly measuring the severity of their symptoms and being committed to getting them better, helping them get better, and that can be just helping their PCP manage anti-depressants. It can be full-on courses of therapy, or it could be acting as a bridge to identify specialty care that they need to get into with a less common or specialty condition, like an eating disorder or opioid use disorder. As an example to our medical group partners, the PCP’s we work with, we work now with about forty-six medical groups and health systems that range from small independent offices through some of the biggest health systems in the country.

Spencer Hutchins:
For all of them, the first value is to help them be better doctors. Get outcomes for patients that they care about and they really want to work on effectively. Second is to try to save them a bunch of time. We can take referrals same day. So we’re measuring access in terms of hours, not days or weeks or months, and helping them, the referral coordinators, everybody, feel like they can get patients connected to care and that they really have support in developing that care plan. And then finally help them build a new service line. This model is now a covered benefit by almost all the health plans in the country, Medicare, nationally, most commercial health plans, and Medicaid in about 18 States. And so really helping them together, deliver care together and make money together, build a service line that supports that, makes them a little bit of margin in their old revenue model, what we often call fee for service and hopefully set some really well up for their value-based, outcome-based measures that everybody’s jumping into it one one degree or another and really helping to be their partner to be successful in those models.

Saul Marquez:
Yeah. Thank you, Spencer. Really appreciate that thorough overview, the multistakeholder approach, making sure that you’re really hitting on all of the stakeholders, I think is critical and also just kind of hearing you speak about it. It’s a unique approach. There’s been a lot of efforts in mental health to really push technology as the solution or be the bridge builder. But you guys are really taking the provider approach or saying, OK, before we get disrupted, why don’t we do something about it and own it? So I love to hear from you more about maybe some outcomes that you’re improving or things that you’re seeing as signs of, hey, this is working.

Spencer Hutchins:
Yeah, so first is access. We try to measure speed to get a referral into our health providers in hours, not days or weeks or months. We always commit to same-day next day. Often a median is reaching out to patients within three or four hours of their primary care visit and measure that in minutes. If they have acute risks like suicidality, that can be really critical because a lot of people maybe aren’t going to search out therapy or fight through a referral cubit if their PCP says, hey, I’d like Jennifer to call. Jennifer really helps support me with my patients, they’re willing to do that. But acting fast can get people into the help they need and get them to make sure they don’t sort of backtrack and say, never mind, maybe I’ll work on this myself.

Spencer Hutchins:
Second, that we focus on symptom reduction. And so what we measure is an outcome measure called the 90-day improvement rate. And so within 90 days we’re able to get 60 percent of our patients to see a half reduction in their symptoms of depression or anxiety as measured by an evidence-based tool. And really proud of that. We think it’s industry-leading many more we can get to hit that metric eventually. But focus a lot on rapid in that first three months, because for a lot of people, you can make real improvements in their life quickly if you focus on it. And then finally, really working on being a great partner for those primary care teams, like you mentioned, really multistakeholder approach. Our most important person that we focus on is our patients and doing great care.

Spencer Hutchins:
But almost as important to them is really being a great partner to our primary care teams who had kind of invited us on to their care team. And so what does that mean? It means saving the doctor and the referral coordinator precious minutes every day. They don’t have to fight to get into access. They can know that’s the same place in a person that can pick up and support them and then help them realize that behavioral health can be sort of a sustainable value-added service line for their group. And I think a lot of it is also focusing really on two ends of the spectrum. Obviously, most importantly, there can be those really acute patients, those folks that they’re worried are going to die by suicide or really have a crisis and sort of say, hey, someone’s there in the trenches with me helping that because those are the people that stay with you for your whole career. Also on the other side, there are those people that maybe they’re not worried about or they don’t realize they have really bad symptoms, but they get lost to follow up.

Spencer Hutchins:
It’s like if the patient doesn’t come in and say, hey, I’m still feeling a little bit better, but not all the way better, it’s too hard for the PCP to manage. And we really provide them with a more systematic approach that says, listen, concert is in charge of tracking this person until we’re sure they’re better until their symptoms are reduced. We’ve got a relapse prevention plan in place. They’ve got the coping skills that they can manage themselves and a pass to raise their hand again to sort ff their PCP if they’re undue stress in their life, whether it’s weeks, months or years down the line.

Saul Marquez:
Well, yeah, Spencer the turnaround time is amazing. I mean, you’re talking hours to at latest tomorrow. It’s just like huge. So kudos to you and your team for being able to do that in a field where it’s not done. It’s just not that fast. It doesn’t happen. So talk to us a little bit about scalability. I know one of the common obstacles to scalability has been that inability to do this remotely and now COVID maybe changed it. But this is a good opportunity for us to learn from you changes in how these services could be delivered. Curious to hear your take on that.

Spencer Hutchins:
Yeah, there’s already a strong evidence-base that this model, collaborative care management, could be provided remotely. Already prospective randomized studies have shown that even when the behavioral care manager, that licensed behavioral health provider, is physically in the primary care office, often 70, 80, 90 percent of the care is remote, it’s part of the models to talk to people more frequently, but often for shorter bursts. And so if you’re going to let’s say we’re working on behavioral activation, exercising more, if we set a goal to go running in the morning, you don’t need to trek in 30 minutes, drive, way to pay for parking to see your therapist to say, hey, did you go running yesterday? Great. Let’s celebrate that together. But that should be is a 90-second phone call that says, man, that’s great. Are you sure that feels good? Let’s try it again tomorrow and let’s get in that habit again because you know that that’s going to be better behavior is leading to better feelings. And so it’s already like that. Probably with not quite a majority, but many of our partners pre-COVID, we had some level of colocation. So some of our care managers grew up right on site on the primary care office, maybe when they had an open exam room because they had a provider and it doesn’t work that day. During COVID, we’ve moved to just about a totally remote model in which all of our interactions with patients or our video visits or phone calls. And that works phenomenally and it’s way more convenient for patients. We’re certainly looking forward to the day when we could do a little bit more of that hybrid approach because sometimes it can be great. Some patients just want to be in the same room. They want to meet their provider. They want to shake their hand. When once that’s safe again, or elbow bump or namaste from six feet away now. But also, it helps us really feel like we’re part of that primary care team that they know the care manager supporting them and they understand we really are a team joined at the hip, not a referral service or a call center or somewhere that picks up their patients.

Saul Marquez:
Thank you for that, Spencer. Really appreciate understanding that better. And so as folks are listening today, what’s your call to action here for folks? And are you looking to partner with more providers? Are you looking to partner with health systems? I just want to kind of build a bridge here and see what type of connections and opportunities can be made.

Spencer Hutchins:
Saul, so I appreciate that. I mean, you’ve just got so many inspiring presenters and the audience that you’ve built here. So thank you for letting me be a part of it. And I’ve been inspired by some of their stories. Yeah, I’d say for anybody in your audience that helps run a medical group or health system that really wants an easy button for behavioral health, whether or not those are large primary care teams, women’s health, oncology, other specialties like that that realize, hey, we know we need to manage people’s depression, anxiety, behavioral health, and we need a way to do it and we don’t know how to start. We think we can be a great partner to do that. Yeah, please have them reach out. Folks that think this is a fun place. This might be a fun organization to join. We’re hiring like mad. Most focused on that, on those initial clinical roles, behavioral care managers and psychiatric consultants, but a whole bunch of administrative, operational, and business roles as well. Folks see open jobs just at our website ConcertHealth.io. That’s also a great place to get in touch with us. If you’re interested in learning more about our services, even just get in touch with me. We’re growing, which is exciting, but I’m still the one that sees the incoming web form off of the website. So that can be a pretty direct way. Our folks can always get me on Twitter. I’m @sphutchins or on LinkedIn. You can go find me at the concert health website. And those are also great ways that hopefully both to follow what we’re doing. And if there’s a reason you want to get in touch with me personally, ping me either of those places. I try to be as responsive as I can.

Saul Marquez:
I love it, Spencer. Great, great opportunity here. And so I jumped the gun on and getting the bridge built there because there’s an opportunity here. I want to have people take advantage of it. There’s a lot of need here. So I appreciate you sharing those contact pathways. Let’s get back to the discussion. So really around setbacks. One of the things that we learn most from as entrepreneurs and leaders is set back. So talk to us about a setback that you had, that you’ve learned a ton from, that you feel has made you guys even better.

Spencer Hutchins:
Sure. One I’d say is a setback before Concert that’s helped shape how we’re built Concert. My last company I founded, Reflexion Health, was a pure we really conceptualize ourselves as a software business, built a great FDA-cleared platform to help people do their physical therapy at home with an early focus on people recovering from joint replacement surgery. So we took the camera, the technology underneath Microsoft’s Kinect camera that they used to make fun video games and built an FDA-cleared product that help you do your rehab at home. And we were really proud of the work, had great clinical engagement, clinical data, but we had really conceptualized ourselves, oh, we’ve started a software company, because that’s what you do. It’s a digital health company. The software and health care stinks. And Marc Andreessen said it had to sell for — the world. And that’s what venture capital is back. And that’s what you do when you’re in California. And we did that but kept saying, oh, man. But you know what’s stopping this? We really need to get the physical therapists and the surgeons to engage with the platform like we want. Oh, and the reason they’re not is because the physical therapists are paid per visit. And our value proposition is to reduce 80 percent of the visits. So that’s not very impressive. I can understand why they don’t log into this thing or why they’re hesitant to it. And recognizing that, yes, absolutely, the software needs to get better, but I think we learned over time and it took us a while and we had some growing pains, we eventually found a lot of great success. But it’s so often the case that the problem you’re trying to solve is not just that the apps are good, there’s something deeper, the culture, the organizational model, the revenue model, all of that sort of stuff. And I think we really took that focus at Concert. And that was the reason we decided not just to build a care management platform, not just to build the data interchanges, or not just to build a group of ten, ninety-nine therapists, right? What so often gets referred to as your network. But we said no, we need to create exceptional career experiences for amazing clinicians and really bring them on. That’s why we decided to build this sort of, I guess the jargon to be a full-stack offering. And that was painful. It took us some time. But Reflexion, I think, has really served us in good stead as we as I started this next adventure.

Saul Marquez:
Good for you, Spencer. And a great lesson to be learned. Now you’ve got to provide our focus. I like that.

Spencer Hutchins:
Yeah. It’s not you know, it’s not always true. I think sometimes you find great organizations that really just do need better software, or something that can often be it. But I think a lot of times it’s to say what’s the value I’m going to create in the world. And then how do you do that? And a big part of it in healthcare is always how to get paid for it. How do you make these money flows work and those things? But you’ve got to be anchored on solving the problem. And that’s what we figured out, is, you know, most importantly, solving that patient problem, almost as importantly as solving the primary care problem. And also, I think it’s also created a really great career, opportunities for talented clinicians. And that’s another part of what we need to do to really grow and continue to scale from our one hundred and ten people on the team now to what will take thousands and thousands to solve the need, even our existing partners, much less as we continue to grow.

Saul Marquez:
That’s awesome, Spencer. Really appreciate that lesson learned and how you’ve turned it into into something very exciting with Concert health. So if you look into the horizon today, what are you most excited about?

Spencer Hutchins:
You know, it’s a fun part of the business. It’s mostly just hiring people that are way smarter than me and getting them to do great work. So, you know, just this morning before this, I was on our internal webinar on board in I think ten new people. Seven of them were clinicians, senior software engineer, our first outside sales rep, some operational folks. And it’s just super exciting to be joining those. It’s an exciting moment on any early startup when you realize that you’re not just this idea anymore, but people are joining you because it’s a company and you give health benefits and they could do great work. And hitting in that inflection point is exciting. And it’s just so amazing to watch people solve problems that I didn’t even realize existed and offer solutions before I had even thought of it. And so I think that’s really exciting. In particular, just incredibly talented social workers, licensed professional clinical counselors, marriage and family therapist. I think they are too often some of the most under looked superpower’s of our health care system, the incredibly talented, not just empathetic, but incredibly smart, driven and really focused on solving problems for patients. And if we can do a little bit to unlock that talent, use it more effectively across people that really need it, I think will have done or have done a good and important thing. And a Delta big business doing it.

Saul Marquez:
I love It. Spencer, fantastic work. I want to give you just tremendous kudos and your team, your growing team, for those of you listening that want to join a growing team, Spencer’s hiring, definitely check them out. He shared his contact info mid podcast so hit rewind. Otherwise, just go to OutcomesRocket.Health, type in Concert Health, and you’ll find all of the details on how to get in touch with him. And otherwise, concerthealth.io is the platform. Spencer, what a privilege to have you on here. Any closing remarks before we conclude?

Spencer Hutchins:
No, just it is an exciting year for us and I just reemphasize this sounds like a fun journey at our website and see if there are ways you can come join the team.

Saul Marquez:
Awesome. Spencer. Hey, thanks for jumping in with us today. It’s fun.

Spencer Hutchins:
Thank you.

Saul Marquez:
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