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Meeting People Where They Are in Their Addiction Recovery Journey
Episode

Corbin Petro, CEO at Eleanor Health

Meeting People Where They Are in Their Addiction Recovery Journey

Corbin is the CEO and co-founder of Eleanor Health. In this episode, she talks about how her company provides comprehensive whole-person treatment for addiction and substance use disorder. She shares her viewpoints on having a long-term relationship with patients, the need for full psychiatric evaluations, community partners, the impact of Covid-19 in the health practice, and more. Tune in and listen to our full interview with Corbin.

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Meeting People Where They Are in Their Addiction Recovery Journey

About Corbin Petro

Corbin Petro is the CEO and Co-Founder of Eleanor Health. Previously, Petro was the founding CEO and President of Benevera Health, a first-of-its-kind payer/provider joint venture (JV) encompassing two businesses: Harvard Pilgrim Healthcare’s New Hampshire insurance business and a newly formed population health services company. Petro has an extensive background in healthcare including as Chief Operating Officer (COO) of the Massachusetts Department of Medicaid (MassHealth), a $13 billion agency providing health care to 1.4 million Massachusetts residents, advising a US Senator on health reform, and roles at Bain and Company, Goldman Sachs, Deloitte Consulting, and American Management Systems.

Petro was honored as one of fifteen healthcare executives under 40 named 2018 Up and Comer by Modern Healthcare. She received a BA from Yale University and an MBA from the Wharton School at the University of Pennsylvania. She is married, has two sons, and resides in the greater Boston area.

 

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Saul Marquez:
Welcome back to the Outcomes Rocket. Saul Marquez is here, and today I have the privilege of hosting Corbin Petro. She’s the CEO and co-founder of Eleanor Health. If her name sounds familiar, that’s because she’s been on the podcast before previously, two, three years ago on the podcast, when she was the CEO of Benevera Health. If you haven’t had a chance to listen to that podcast, extraordinary podcast by Corbin, she is now focused on expanding access to an integrated, evidence based outpatient care and addiction recovery platform for opioid and other substance use disorders. Previously, as mentioned, she was a CEO at Benevera Health. First of its kind, payer provider joint venture encompassing two businesses, Harvard Pilgrim, Health Care’s New Hampshire insurance business and a newly formed population health services company. Petro has an extensive background in health care, including being the CEO of the Massachusetts Department of Medicaid, a 13 billion dollar agency providing health to one point four million. Massachusetts residents advising a U.S. senator on health reform and roles at Bain and company Goldman Sachs. Deloitte Consulting and American Management Systems. I’m excited to have her on the podcast again to talk about her work in this space of mental health and substance abuse and how they’re doing it in a risk sharing way, caring for populations. So with that intro, I want to welcome you back to the podcast, Corbin.

Corbin Petro:
Thank you, Saul. Great to be here again. Great to see you and hear you. So thanks for having me on.

Saul Marquez:
Likewise. Likewise. And so, you know, for those that haven’t had a chance to know, you share a little bit about what inspires your work and health care. Before we dive into the work that you’re doing, you and your team are doing at Eleanor Health.

Corbin Petro:
Sure. Well, particularly during these times around the coronavirus, there’s a lot that’s that’s inspiring. So I just want to flag that right off the bat that, you know, every day when I see folks on my team are committed to the mission of the organization, committed to meeting the needs of our community members and showing up for them. It’s incredibly inspiring across the board and health care. And obviously we see a lot of people putting their lives at risk. And I find that just incredibly inspiring. I think, you know what? What got me into health care was really that the services component of health care. We talked a little bit about that. Maybe you the example that I gave of growing up in a public service oriented family in Ohio where, you know, we spent a couple years focused on the political side. I think I talked about their 88 counties in Ohio. And I went to something like seventy five county fairs where I got to meet folks of all walks of life. And I think the service component of health care, the fact that health care is the ultimate equalizer is something that we all face, but that the outcomes are often very different depending on where we live. Urban, rural, suburban and our economic background, our educational background. And so I think it’s the service component of health care that it crosses in private and public sector is really what inspires my work and is particularly relevant to the work that we do in mental health and addiction, our health.

Saul Marquez:
Yeah. Corbin, I remember your story and to this day I still it still sticks with me, you know. I mean seventy five counties in one summer. I think everybody should do that. You know, the appreciation that it would give you for that equalizer that you call health care. And you’re right. You know, there’s an opportunity for us to do a lot more there and covid it or not. You know, mental health care and substance abuse, opioid use management. I mean, all that stuff was relevant before and will continue to be relevant and even more so here in the new era post covered. How are you and Eleanor Health adding value to the ecosystem with what you do?

Corbin Petro:
Sure. Well, you know, for decades, health care has viewed the brain as separate from the body and prioritized acute interventions over long term whole person care. So when you think about addiction, it’s been stigmatized, been perceived as a moral failing, and in many instances, treatment has existed in an unregulated environment without evidence. So what we know now about. About addiction is that addiction is a chronic condition. It’s a disease. And it requires long term management. Just like diabetes or any other chronic condition. But there aren’t many providers who are getting that. So the thing that we bring to the health care ecosystem is we provide comprehensive whole person treatment for addiction and substance use disorder. We do it in a compassionate way in our warm and welcoming clinics as well as virtually, and we go out into patients homes. So we have an incredibly comprehensive care model where we’re addressing all co-occurrence, psychiatric conditions. We’re providing therapy and medication management. And we do it in a very comprehensive delivery model where we’re able to meet patients, where they are. The final sort of value that I would say we’re adding to that health care ecosystem is that we you know, we built our organization on a value based payment model. In order to really achieve what we want to achieve with patients, it’s important that we provide a number of services that typically aren’t fee for service reimbursable. So a core tenant of addiction recovery and retaining oneself in recovery is creating meaning and purpose in your life and creating community. There’s no fee for service CBT code for creating community and meaning and purpose. So it’s important that we build our model on a value based payment structure. And we’re so committed to our outcomes. And we’ve seen such positive outcomes across total cost of care and quality that we were willing to to take downside risk, which is incredibly unique in this space.

Saul Marquez:
I agree. And, you know, it’s certainly, I think, a big testament to your experience in many aspects of the health care environment. Your knowledge about how plans work, how health systems work. Having spent some time at Benevera in between both your leadership, your perspective around what these communities and also the communities that they serve value are critical to the business model. Help us understand a little bit more about how you guys take advantage of how you deliver care to not have to worry about that fee for service model that most are trying to enter the market with.

Corbin Petro:
Sure. Well, you know, typically requires finding strong partners so we usually don’t enter into a market unless we have a strong partner, a payer, a hospital system, an employer, somebody who’s at risk for total cost of care and who believes in mental health and the benefits that providing the right services for folks and treating addiction as a chronic condition will have on the total cost of care. So we and we we’re in North Carolina, where in New Jersey, we’ve entered into North Carolina through a partnership with Blue Cross of North Carolina, where we have a very rich payment model. Rich, in terms of the robustness of it, meaning that we take we take downside risk for patients and we proactively look to engage patients who are showing signs of abuse and look to be ones who would benefit from our treatment model. So really, that’s an important component of our model. We know we go into communities. We try to serve as many patients in that community, even if they aren’t aligned with our payor partner. But being able to provide that full model that we have is really we we need to have a partner who believes in what we’re doing. We’re lucky that we found several who do and who want to enter into markets with us.

Saul Marquez:
Love it. Fantastic. Appreciate the highlight there. And you’re listening to this and you’re thinking, man, you know, I am at risk for a total cost of care here. And I believe mental health is real. People need help. This is an opportunity for you to take a look at a very unique team and their approach to solving these problems. Eleanorhealth.com is where you’ll find more information. Obviously, we’re going to dive more into this today. You know, one of the unique things about what you guys do, Corbin, is community work. And you, you know, discuss community recovery partners. Can you can you help us understand that a little bit more and how that particular aspect of what you guys do makes you different?

Corbin Petro:
Yeah, absolutely. And I’ll start by just describing our full care model. So first and foremost, we believe in evidence. And so our entire care model is based on what the evidence shows, is effective in retaining somebody in recovery. And we look to have long term relationships with patients over five years. And so that may not sound standard and it’s not. But the data would tell you that after a year in recovery, your risk of relapse goes down significantly after five years your risk of relapse becomes that of the general public. And so that’s really where we feel like, you know, our work is is done or close to done. And that’s when somebody becomes part of the Eleanor alumni community. But what the evidence tells you is that medication is critically important for many people to stay in recovery. So we provide medication. We do a full psychiatric evaluations and address all co-occurrence, psychiatric conditions for patients in our care. About 80 percent of people who have a substance use disorder have an underlying co-occurrence psychiatric condition, depression, anxiety, trauma. We diagnose those and we treat those within our care. You’re not treating an underlying psychiatric condition and trying to treat a substance use disorder. You’re not going to be effective in treating that. We provide therapy, individual group telehealth delivered therapy. So really getting at the root challenges around substance use disorder, it’s important that you wrap the medication with those services. And then the third leg that you asked about are recovery services delivered by our community recovery partners in Community Recovery Partners are essentially peers and they have a live recovery experience. They serve as coaches. They serve as the glue really to retaining our community members in recovery through their high touch engagement. And they go out into patients homes if necessary. They go out into the community. They build that longitudinal relationship to help establish that meaning and purpose in our patients lives. And so that those are those are really, really critical and important to our model that said, you know, they typically are not resources and services that are reimbursable on a fee for service environment. And so, again, highlights again how important it is to have had that value-based payment model as a mechanism to be able to support those folks as well as the rest of some of our our wrap services.

Saul Marquez:
Yeah, it makes sense. And, you know, this model is, I think, going to be a model that is a must as we take a look at care within communities. Social determinants of health, how we actually address some of these things that need addressing that. To your point at the beginning of the podcast, don’t have CBT codes. There’s no CBT codes for community and meaning and purpose. But they’re so important. And I think, you know, having leaders like yourself craft these very unique business models to tackle the issues is important. What is it that inspired you to do this?

Corbin Petro:
Well, some of the threads in my career that we’ve talked about are, you know, working with vulnerable populations, working with, you know, creating unique payment and care delivery models, leveraging technology and data to improve health care. I found that there was just a need in this space. I partnered with some of the founders, Doctor Zanga Harrison, Drishti Mirchandani, as well as some of our investors. So we were incubated within an investor, Oxiana Partners. And then we were able to take those learnings and really create a space here that hadn’t existed.

Saul Marquez:
Yeah, that’s fantastic. Kudos to you and your team for what you’ve done thus far and in the traction that you guys are getting and the results. Maybe it’d be great to hear a little bit more about how you guys have created results, better outcomes, better business models. Share with us a couple of stories around that.

Corbin Petro:
Sure. Well, you know, I talked a little bit about sort of the various services that we provide and some of those wrap services. But a key component of our clinical model is one of harm or use reduction. So last time we talked, we talked about population health, which is really improving the the outcomes and the care for a population. Harm reduction use reduction has the same approach where, you know, we’re not looking at hard and fast measures. We’re looking to improve one’s health and their outcomes in this space. In addiction, it’s typically been abstinence based. Patients are fired from treatment. You know, if you relapse. But what we know about addiction is that it’s it’s chronic, it’s progressive, it’s relapsing. And so relapse is part of the disease. So often we’ll accept patients into our practice who they know they might be on heroin and they might also smoke weed and drink beer on the weekend with their friends. And, you know, they want to get off heroin, maybe want to get off weed. They still want to have a beer with their friends on the weekend. Most treatment providers would say, well, well, you’re not ready and you can’t we won’t accept you into our program. We accept those patients into our program. A great example is one of our our first patients came in with exactly that story. One didn’t want to be on heroin, but didn’t want to give up that beer, that socialising with his friends on the weekend. So we said, OK, well, we’ll work with you brought him into our practice. He also said he didn’t want to take medication. So didn’t want to be on medication assisted treatment, which is, you know, the evidence shows that your your outcomes will be a lot better and your ability to stay in recovery is significantly improved with medication. But, you know, we we accept it and we continue to ask him if you would consider medication assisted treatment. And he you know, he didn’t he didn’t want to. He had a bad experience with Suboxone, which is the key medication in this space. And so didn’t didn’t want to go on Suboxone. And we said, you know, we came to an agreement. He said if he relapsed, he would then consider Suboxone. Well, you know, take us three weeks in and he relapsed and had an overdose. And, you know, a couple things that that that highlights, you know, many treatment providers would then have had fired him from treatment, wouldn’t have welcomed him back. We, of course, told him it’s you know, it’s OK if you relapse. Come back to us. So in doing so, he reached out to us as opposed to going to the emergency room where historically he turned in and out of the emergency room. We got him then started on medication and he’s been with us ever since. And he kept having that beer on the weekend for a while. But now he’s stopped having that beer on the weekend prior to coming and working with us. He had been going to the E.D. on average two times a month. He hasn’t been to the emergency room since he’s been working with us about the past eight months. He his quality of life is much higher. He’s moved in with his girlfriend. They’re just a lot of positive things that have happened with his with his life. So that’s that’s a patient’s story. What we see in the data is, you know, I love data. You know, our member reported E.D. inpatient and residential treatment center utilization is for it for patients and our care goes down about 80 percent when they come into treatment. With us, our NPS. So our net promoter score with our patients is about eighty three. Which is incredibly high in that in the health care space. And so we’re just we’re seeing really positive outcomes. We have we have incredibly high retention. So patients who stay with us in treatment much higher than the average in this space as well. So those are some of the key things that we look at. You know, we want to delight our community members. We look at that. NPS., we want to reduce total cost of care. And we want we we want to retain patients. So retention in our program is really important.

Saul Marquez:
What a great story, Corbin and I just think about looking in the rearview mirror and that image of you kind of taking a stroll around the 75 counties, seeing it. Seeing is believing. And that’s why I think it’s so important for if everybody did that right. And now you’re adding so much value. And this is one example of many. So kudos to how you guys did it. And you know, that beer, you know, just going for that beer, putting it just I guess it’s hard to it’s hard to cut it out if you want to hang out your friends. I mean, social, social and the challenges that it all kind of comes together and maybe it’s that social circle that ends up getting you back in trouble. And so, I mean, just really interesting how you guys have decided to not go down an abstinence road and yet still have success. Why do you think that works?

Corbin Petro:
Well, there’s no other part of health care, particularly in management of chronic conditions, where if, you know, if you have health but you think about diabetes and, you know, you might have to use more insulin or less insulin, we don’t then fire patients. Right. We don’t say, oh, I’m not going to treat you anymore. So from from that perspective, it’s sort of ludicrous that we have ever even had an abstinence based program. But when you think about sort of the human aspect, you know, asking somebody to make drastic changes to their life typically doesn’t work. You think about New Year’s resolutions. How many of those are successful over time? And so what we try to do is we try to, you know, again, it’s it’s a population health approach. It’s improving as opposed to looking at at stark measures. So, know, we try to improve the care of our populations. We also try to build trust. Right. So this is a you know, often a population that’s been vulnerable, stigmatized and lots of feelings of shame because we’ve viewed substance use disorder, addiction, substance abuse as a moral failing. And so building that trust in the population is really important. And you do that by welcoming and accepting people how they are.

Saul Marquez:
That’s powerful and that’s really powerful. And I appreciate the approach. And certainly this gentleman story is is a powerful one that shows the works. What would you say is one of the setbacks you guys have experienced then a key learning that that came from it?

Corbin Petro:
It’s a great question. I think, you know, the way I think about setbacks, you know, in many ways failure is just when reality doesn’t meet expectations. And that can be because of unrealistic expectations falling short. Mistakes a lot of times in our lives. I think we feel failure when we don’t meet expectations. And there’s certainly been many, many cases in my life that that have been failures or setbacks. But I think the most relevant right now, when you think about just setbacks and situations, has been the corona virus and what it’s the impact that it’s had on businesses, on startups, on on everyone, and how you have to quickly augment your business to meet the needs of a changing environment. So I think our team has done an incredible job at adjusting our business. You know, when things hit and a lot of the precautions were put in place, you know, we have brick and mortar clinics. And prior to Corona virus, we we built our model built on technology. And so we were always able to provide a fully virtual ongoing model of care. But about 10 percent of our visits were were virtual. And so we you know, we quickly had to adapt and figure out how to do how to move a lot of our patients to virtual or at least introduce it to them as an option. And because of some of the regulatory changes in this space, historically, you you were not able to initiate treatment with a patient unless it was a face to face interaction. And so that regulation is called the Ryan Hate Act that was suspended during the crown of virus and continues to be suspended. And so that meant that we were now able to do it in induction and an intake of patients virtually. So we quickly put in a process there which, you know, there is a supply chain component to get a urine, urine drug screen to a patient to be able to monitor their vitals as you move them onto a medication. So we quickly implemented that and we were now serving about 90 percent of our patients virtually. And we have been for about the past five weeks, that’s been that’s been the number of.

Saul Marquez:
Amazing.

Corbin Petro:
We we’ve kept our clinics open. And for many for many people are our clinics as it is a safe space. And it’s part of their recovery journey. And it’s incredibly important. We didn’t want to take that away from them, so we kept those clinics open. We’ve done a ton of fully virtual inductions of patients, so we’ve accepted them into our practice fully virtually. So I think that, you know, that setback because of our ability to move quickly, has has turned into a strength for us now. We’re able to serve a much larger geographic area and continue to you know, our growth has has actually increased during this time period. So it was a setback to start, really had to focus on our team, making sure that they felt safe. You know, when when Corona virus started the first couple of weeks on any given day, it was really just trying to keep the business stabilized. 50 to 60 percent of our clinic based teams were out because of medical necessity or other coronavirus related issues. So, you know, I think just stabilizing the business and now I think that we’ve sort of come to more of a stabilization. We’ve tried to make it a positive and tried to, again, really tried to adjust our model so we can meet the needs of our community.

Saul Marquez:
And it’s awesome. I mean, just an incredible shift. I mean, the inverse Right. from 10 to 90 percent virtually. Yeah. I mean. And so what are your thoughts around the new normal, as a lot of us are calling it? I mean, do you think that this virtual piece will you know how much of it’s going to stick?

Corbin Petro:
Well, there’s a lot of things at play, right? So in our space, the regulations prohibited a fully virtual models. So, you know, there’s a question on whether some of these regulations, suspensions will stay in place. There’s reimbursement. So, you know, telehealth and virtual visits weren’t always reimbursable. So will these reimbursement policies. That’s always really, obviously important in health care. Well, will these be reimbursable? And then the third is patient preference. And now that patients have adopted these and we know that many of our patient. Love the virtual visits. Yeah. Do I think it’s going to be 90 percent going forward? No. Do I think it’s gonna be 10 percent? No, it’s going to be something in between. I don’t know the answer to that. But that’s really where our model shines, is, you know, the comprehensive way in which we’re able to deliver care, whether that’s in our clinic going invitation’s homes or virtually really allows us to pivot, whether it’s, you know, 70 percent, 30 percent, whatever it is we’re able to deliver what what our community needs.

Saul Marquez:
Sure. Sure. The comprehensive approach also shows your commitment to meeting patients where they are. And I think that that in itself speaks volumes for the mission and commitment you guys have. What would you say you’re most excited about today, Corbin?

Corbin Petro:
Well, I’m and I’m excited about our growth. Our team continuing to be able to serve our patients. And when I tell people that I work in that substance use disorders and addiction space, they often say, you know, that must be so hard. And that couldn’t be further from the truth. Every day is actually really uplifting space. Many of you know, I shared a patient’s story that, you know, I get emotional just just thinking about because it’s such a positive change that we can have in people’s lives so quickly. So I’m excited about continuing to expand our model, continuing to meet the needs of more and more folks in the community. I’m excited about getting things back to normal and seeing what that new normal is. You know, we’ve we’ve all been struggling in these challenging times. And I think, you know, our team has been nothing short of amazing in how we’ve we’ve dealt with it. And I think the future holds a lot of promise, hopefully, for the changes in health care, for the changes in mental health, and hopefully for continuing to move the needle on on how we treat substance use disorder and addiction.

Saul Marquez:
Now, that’s outstanding, Corbin. Thank you for that. It’s certainly promising work and great to know that you and your team are behind this effort. Before we conclude, I love if you could just share a closing thought with us and the best place for the listeners could learn more about you and the company.

Corbin Petro:
One of the closing thoughts is, you know, I think during these unprecedented times and we talked a little bit about coronavirus during this week, we’ve heard that the second wave of the of virus will be are our mental health. And so I encourage folks to think about their mental health. And we’ve also heard from our community and from others that people are using substances a lot more to cope with uncertainty, isolation, anxiety. And those patterns that we’re developing today through this period of time that that hasn’t been short could be establishing unhealthy patterns, addictive patterns moving forward. And so I just encourage people to to think about the patterns that they’re establishing and to think to think about their mental health during these times and to take time for themselves and for their mental health. I think it’s it’s really important as we move out of this hopefully into a more stable period. But recognize that this may know this this time period will be unique for some time.

Saul Marquez:
That’s such a great column, Corbin. And, you know, think about what you guys are going through right now. Your organizations, your employees, your members. Certainly a great call out for all of us to think about as leaders. What are you going through right now and what patterns are you establishing? Because they’ll be formative. Such a great call. Corbin,

Corbin Petro:
Thanks, Saul. And then where people can get in touch with me for a while. If you want to learn more about Eleanor, of course, check out our Web site Eleanorhealth.com. I can be reached at Corbin@eleanorhealth.com. And, you know, I’m always happy to hear from folks. And, you know, we I would just put a plug as well that we were always hiring. We’re looking for great talent. I think the culture of our organization really, really came through during these times three. And we put forth a lot of new initiatives and efforts to expand transparency. And, you know, my view is that the organization as a whole has really come together. Our internal net promoter score has has absolutely soared. And so, you know, it’s we’re a great organization to be part of and welcome new talent.

Saul Marquez:
So what kind of talent are you looking for? Just to kind of clue in the listeners?

Corbin Petro:
Well, we’re always looking for practitioners, mental health practitioners, social workers, psychiatry, medical professionals, always in in the markets that we’re in. We’re also looking for a number of folks on our national team around growth, business development and operations. So all those are on our on our Web site. But really, we continue to grow and we continue to look for for people who are our mission driven, who believe in what we’re doing, who hopefully don’t hold stigma. And that’s one of the things that we know is really important in this space, is the language that we that we use and so encourage folks to reach around.

Saul Marquez:
That’s fantastic. Thanks for that, Corbin. So it’s some role that Corbin mentioned aligns with what you’re doing and you believe in what the team at Eleanor Health is doing. Check them out to great opportunity to join a fantastic leader in Corbin and the entire team there at Eleanor health. So, Corbin, thanks again for jumping on such a pleasure to learn more about what you and your team are doing and to connect with you again.

Corbin Petro:
Thank you, Saul. Thanks for having me again. It was great to great to see you and great to great to talk with you.

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Things You’ll Learn :

  • Learn more about addiction and long term management.
  • How to deliver value
  • Eleanor Health’s full care model
  • How to augment your business to meet the needs of a changing environment