Download the “HLTH_Suzanne Kunis audio file directly.
HLTH_Suzanne Kunis: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everybody! This is Saul Marquez with the HLTH Matters podcast. Welcome back once again and thank you for spending some time with us here. These interviews are short, sweet, but man, are they filled with value and all of them happen straight from the HLTH conference right on the show floor. This year was in Las Vegas, if you’ve had a chance to attend, you know what I’m talking about, it is good. And if you haven’t, definitely consider next year’s, but in the meantime, we’re going to feed you some content straight from the conference. So, so glad you’re here. Subscribe if you haven’t, this is how you get all the new ones into your podcast feed. And today I’m excited to share the interview with Suzanne Kunis. She’s the founder, president, and CEO of NovaWell, as well as vice president of Behavioral Health Solutions at Horizon Blue Cross Blue Shield of New Jersey. She’s an incredible woman and just brings over 30 years of experience in healthcare with significant focus on behavioral health. Suzanne is a registered nurse and moved from care delivery to healthcare management early in her career. Suzanne is a nationally recognized industry expert and leads NovaWell, an organization born out of her success at Horizon. She was recruited to Horizon March of 2017 to develop and lead Horizon’s first-ever internal behavioral health strategy and team. Suzanne is responsible for all behavioral health, strategic development, and execution, including the organization’s commitment to the integration of physical and behavioral health. Suzanne led the successful in-sourcing of behavioral health, and cultural, and philosophical shift, and commitment of integration within Horizon. NovaWell will be helping other health plans to achieve similar results. Suzanne is the ultimate behavioral health champion. The opioid crisis and continued battle to eliminate mental health stigma are priority items on her agenda, and she works tirelessly to drive the message that mental health is health nationwide. She shares some personal stories that are truly inspiring and steps that we can all take to incorporate mental health as part of our overall health in this interview. So with that intro, I want to welcome you to the podcast, Suzanne, thanks for being with us.
Suzanne Kunis:
Oh, it’s a thrill for me. Thank you for having me.
Saul Marquez:
Yeah, so we’re having a lot of really great discussions here at the HLTH event and the HLTH podcast, so such a privilege to have you here. Suzanne, you have such a broad just experience on both payer as well as a provider side. Talk to us about what inspires your work in healthcare.
Suzanne Kunis:
Sure, so every one of us is touched in this behavioral health world with a family member, colleague, friend, somebody who’s been either having some depression or anxiety or substance use disorders or just general challenges with life, and every one of us, I’m no exception. So I’m one of eight children that was in a lovely Irish Catholic family, and what you hear about that in terms of the stereotype, in terms of substance use issues in my case was right on. So my dad had some serious alcohol problems, and quite honestly, growing up it was not good, but at the time I didn’t think of it as a disease like I know now as I’m older, it really was so stigmatized and we were not allowed to have people into the house and we were afraid people were going to find out, and it was just the classic situation of what we’re dealing with today in terms of stigma. Fast forward that two generations, I have a niece who is ten years old and she lost her mother to a drug overdose at the age of three, and then last year she lost her father. It was drug related motorcycle crash, and so here she is now struggling with the fact that she has no parents, being bullied at school because she has parents who died of drug overdoses, and so it’s just, you think about how could we live in an age today when things are like that? So that’s why I’m here.
Saul Marquez:
Oh, my God, Suzanne, thank you for sharing that, first of all, it just breaks my heart to think that she’s going through that and so many people are going through that, she’s not alone, and so thank you for sharing that with us. Your mission is palpable and I feel it, and so what you’re doing is powered by this.
Suzanne Kunis:
Exactly.
Saul Marquez:
And so you’re a force to be reckoned with. How are you in the business adding value to the healthcare ecosystem with all of these things in life?
Suzanne Kunis:
So when you think about all the things that are going on out there, because our system in this country on the mental health side is broken, I mean, I don’t know, why aren’t, there any other more politically correct way to say it, it’s broken. And we look at all the challenges that are out there and it’s things like stigma, as I mentioned, 67% of people who are not getting care because of stigma, that’s not good, and it’s definitely going to show up somewhere else in your health history. The fact that quality, there’s still a lack of evidence-based treatments that are actually being employed in the treatment world. Quality again, goes along with evidence, evidence-based treatments, and outcomes, and demonstrating that we’re doing all the right thing for things for people. Access is huge, we’ve all heard stories about people that are waiting three, six, nine months to see a psychiatrist. And the fact is there are not enough behavioral health treatment providers out there to be able to take care of the need. So, it’s the supply and demand, right? When you look at child and adolescent care in particular, there are a couple of years ago, I read the statistic, there were 8300 child and adolescent psychiatrists in the country, and at that time, pre-COVID, there were 15 million plus kids needing care. Now you bring COVID into the picture and that is like exponentially changed. So we have to find something different, and that’s what we’ve been attempting to do, is really try to find solutions that can help people from an access perspective and really give them a shot at getting care when they need it, where they need it, and how they need it.
Saul Marquez:
Thank you for that. So, Suzanne, you know, there is a huge need and as I understand, there’s a huge step that you guys are taking at Blue Cross and Blue Shield. Do you want to share that with us?
Suzanne Kunis:
Sure, so I was hired there about five and a half years ago, and I was fortunate enough to be set, told, hey, look, we don’t have a behavioral health strategy and the world has changed, and we need somebody with your experience and background to come in here and really develop that for us. And at the time I said that I would love to. There are two important things for me. One is we have to invest in behavioral health, because for far too long it’s kind of been a stepchild in terms of people look at it and say, oh, it’s only 4 to 6% of the premium dollar, but the fact is it can impact well in excess of 20% of the total medical cost, so that was very important factor for me. And the second piece of it was don’t be afraid to try something different. You know, health plans are not notorious for doing innovative things, trying out a lot of things. So that was really important. So what we did was put together a team of people who, which I’m thrilled to have this amazing group of people that I was able to assemble, and they are from people that are within the managed behavioral health industry, providers. We wanted to make sure that whatever we did had the voice of the provider inside so that every product that we developed, everything we did was including that viewpoint, if you will. So we actually implemented three programs, if you will, on the state. One is we start off by saying, you know, when you, … we had an outsourced vendor. When you insource it, you’re insourced, you’re not integrated, it’s just another unit within a health plan. The fact is you have to really change the entire culture and philosophy of that health plan, from the top to the bottom, to think about behavioral health is just like physical health. Your brain is part of your body, like your heart, your lungs, your liver. We have to start thinking differently about that. We have to make certain that every time a person comes into us looking for some help, that no matter what door they come through, we’re looking at it from a behavioral health lens or through a behavioral health lens. So even if you’re a cardiac patient or a diabetic who’s trying to live with their disease and the challenges that go along with that, but a behavioral intervention can really make a huge difference. So we worked around integrating internally as really our first priority because you have to believe in it to actually make it happen, so that was first. The second piece was access is a huge issue, as I mentioned a moment ago, we actually developed, we started and we were, fortunately, we started this before COVID. We were really lucky, I guess, kind of, but I think we like to think we’re a visionary, and we started looking at, in probably four years ago, all the new startups that were coming out. And that time there were not a ton of them, but there were some amazing startups coming through. And so we started vetting them all, and quite honestly, to this day we’ve probably vetted over 400 point solutions and have come up with an ecosystem of about 15 provider organizations that were partnering with. Some of them are brick and mortar, some of them are telehealth, some of them are both and also digital solutions. So we’ve developed a platform that is actually the basis for, and you can come in anywhere. You can be a provider coming in a primary care doc, you can be a pediatrician, you can be a member, you can be a parent, you can come in and see lots of information on this platform, educational research, podcasts, if you will, but also their assessment tools on there. And if you take an assessment, the result of that assessment will actually point you to one of three options. It will point you to, hey, I’ve got a relationship with someone who is perfect to fit your need, they’re one of my point solutions that I’ve contracted with, and they can make an appointment right from that spot to get into care. And those providers are turning people around, if you will, in terms of appointment availability. The max has been like five days, many, many cases, same and next day.
Saul Marquez:
That’s unheard of.
Suzanne Kunis:
The second option is we have a network of providers because we’re not trying to replace the local network of providers, we need to augment to that, and we have great providers in the community, so it’s giving people an option to get into their directory for the provider so they may want to make their own choices. And then thirdly, the option is, do you want to talk to somebody to help make that decision? And then we will give the number of our care managers. So that was the second piece of it here, and we have just been thrilled with the results. We have some amazing partners who are working with us, we have an amazing platform and a partner along with that, and outcomes have just demonstrated that this is really going to make a difference. So then the third piece of it is, all right, if we’re going to re-imagine the health system here, who are we most worried about? We’re worried about the people who fall through the cracks every day, people with substance use disorders, people with serious mental illness. And we said the solution for them isn’t like everybody else, we need to really embrace those individuals because they need help in their journey. So it’s not like you can’t do it yourself, you need the village. And so we actually established a program, we piloted in one county in New Jersey, and it was centered around identification of patients that lived in that area that could have been referred in through a whole bunch of different options, and it’s essentially saying, we’ve hired a quarterback in the community who is a community mental health provider. Their job is not necessarily to treat the patient, they are to make sure that patient gets what they need. So if it’s physical health issue, behavioral health issue, if there are housing issues or job-related issues or can’t get to treatment, so I can’t commit to an outcome here, it’s really trying to integrate in the community and make all that happen there. So we thought we were going to do a one-year pilot and then we were going to review it over the course of time with claims. Six months in, the patient feedback was so incredible that we committed to rolling it out across the state and we have.
Saul Marquez:
What was some of the feedback?
Suzanne Kunis:
The feedback, so we used a couple of tools that were standardized tools, just like there’s a survey that the federal government uses when they’re actually giving grants out to community health providers and say, we don’t want to make this hard, so let’s use that tool. And so its patients were reporting, when was the last time that I used drugs, when was the last time I smoked, when was the last time I drank alcohol, what’s my quality of life at this point? And we started seeing these like uptick incredibly. So then we said, all right, we’re doing this, we’re going to do it. And we had the, fortunately, the company was really right behind us all the way in supporting it. And by the way, every arrangement we have is a value-based arrangement, which is also very unlikely to happen in the behavioral health world today. We’ve made the plunge and we have all kinds of interesting financial arrangements throughout there with our providers to let them do the job that they need to do. Quite honestly, if I have a substance use issue, I really don’t care if that provider is sending you to yoga twice a day. Just do what you need to do to get them into recovery and keep them in recovery, and the outcomes, when the claims data was run against it, shortly thereafter, we saw a 51% reduction in patient admissions, 27% fewer emergency room visits, total cost of care for all physical health and behavioral health as well as pharmacy was down 20%. So we’re like, okay, this is pretty good. So now we’ve got this compendium of three things that we’re working so beautifully with great outcomes. We said, okay, what’s next? And we’ve still got a lot of work to do there, but we’re actually going to take our show on the road and take it out to other clients across the country.
Saul Marquez:
I love it, and that is NovaWell.
Suzanne Kunis:
That’s NovaWell.
Saul Marquez:
Fantastic. Congratulations on the launch of NovaWell. Congratulations on the results that you guys are getting and the difference that you’re making in patients’ lives.
Suzanne Kunis:
Thank you, we just could not be happier. We didn’t start off as this being our journey, but once you see what you can do, it’s why not. And really, our group is a very passionate group. Everybody’s in this for a reason, whether it’s a child or a parent or a family member or whatever, everybody’s in it for a reason, and so launching this is just a dream and we really think we can change things up.
Saul Marquez:
That is so amazing, Suzanne, I’m glad you’re in charge of this.
Suzanne Kunis:
Me, too.
Saul Marquez:
Your passion for it, your belief, it is what is needed to make the leaps necessary to give the care that is needed in behavioral health. With so many behavioral health solutions available in the market, what would you say in a nutshell sets NovaWell apart?
Suzanne Kunis:
So one of the things that we’ve done as we have, as I’ve mentioned we were doing over the past 4 to 5 years, is literally vetting hundreds of solutions out there. And what was important to us, it was important that the leadership represented a mission that was similar to what we’re after and not just their mission, but that the treatment that was being provided by these organizations was evidence-based. And that, even though some of these were very new and didn’t have a long track record, as you got to know them, we, you know, we started off with one person actually vetting at the high level, and then we’d bring our entire clinical team and then we’d sit down there and put these folks through their paces and kick the tires and come out with who the best of the best from where we sit, because it was really hard to look at it, there was really no history. We are so blessed with the decisions that we’ve made. These organizations are absolutely incredible, and I have zero concerns about the fact that we’re going to make a difference here. There are some that we chose not to go with, for lots of reasons. But the fact is we’ve got this great panel and we’re all excited about it. And what I advise people to do, because honestly, every day, and one of the benefits to us actually with this new company is, every health plan is going through the same thing we are. Every day they’re getting the last shiny tool coming through to us saying, let me talk to you, let me talk to you, let me talk to you. There aren’t enough hours in the day. So I advise folks like that, just be, you know, when you come in with your story, make sure that it’s got all those pieces do it, evidence basis and etc, etc, and don’t be afraid to tell the truth. What is reality of your offering versus what’s an aspiration? We need to know the facts and we’re with you for aspiration. So that’s really how we’re actually working through this.
Saul Marquez:
Thank you, Suzanne. So, in essence, if I’m understanding this correctly, you’ve vetted most options out there and you’ve distilled it to a few that are the best, and those are the ones that have formed the core of the offering for renewal.
Suzanne Kunis:
Well, we have a little over 15 providers that are that, again, brick and mortar as well as telehealth, which has been a godsend. We have ten in the pipeline that we vetted. So now we just have to get through the process. It’s not easy, right? You have to, especially when you’re doing value-based arrangements, most health plans in this space are not doing that historically, so it’s really, lots of changes inside that have to happen. But we’re so excited and we will continue to vet every single day. I mean, when we came here to the conference, I think I heard from probably 400 people myself as well as my team members. And it’s just we want to do the right things for our members and we are going to pick those solutions that are going to have the greatest impact and we’ll just keep moving through and continuing to add where it makes sense.
Saul Marquez:
That’s fantastic. Well, thank you so much, and congratulations on these moves that you’re making. It’s going to make a difference for everyone out there. And folks, you know, I mean, either you’re experiencing it yourself, somebody in your family, somebody that you know, is experiencing the need for help in this area, so now’s the time to take action. And I’m so glad Suzanne and team are doing something to make a difference in all of our lives. Where do you hope the health system and by extension, patients, will be in their behavioral health journey this time next year?
Suzanne Kunis:
So this time next year, I think that one of the number one things I’m focused on and we’ve started to make progress with it, with COVID is stigma, because the only way we’re actually going to get people into care is to realize that it’s okay not to be okay and that mental health is health, and the whole story of integration is the important thing to think about. So if we can make an indent in the stigma and really get people to feel comfortable around what, that it’s, okay, I think that would be a win and then the rest of it will all follow behind.
Saul Marquez:
I love that, yeah, making it clear, you know, somebody offered an example one time, Suzanne, that we look at chronic conditions and we don’t think that it’s our fault, but mental health, … all of a sudden, like it’s the person’s fault.
Suzanne Kunis:
Exactly, and you know what? It’s.
Saul Marquez:
Got to flip that around.
Suzanne Kunis:
Exactly, and it affects so many people. I mean, we, I just talked to folks yesterday about, that they had recently had babies, and these women were sobbing and worried and scared and thinking that they were just really losing it and weren’t good mothers and they weren’t bonding. It’s all this stuff that we have told ourselves, everybody, you have to be perfect. There is no perfect and we’re all in the same boat. And so that’s why I tell everybody I know, you’re not that different. You are different, but you’re not that different in that you’re not alone, there are so, so many others. When we … Family Foundation did a survey mid-COVID and it showed that over 40, I think was between 40 and 50% of people that were adults, actually had a diagnosable mood disorder, that’s huge. So it’s all of us. So everybody just kind of sit back and, you know, let’s really try to absorb this, really have empathy for people who are living this life that is difficult many days, and just be there to support and help them get what they need.
Saul Marquez:
That’s fantastic, Suzanne, thank you for that. Now, I’m going to zoom out for a second and ask, so we’re talking to a national and global audience, mostly national, who can access the solutions that NovaWell provides?
Suzanne Kunis:
So our immediate first tier that we’re recruiting too, if you will, are commercial health plans. And so that, a commercial health plan includes Medicare and Medicaid. We can also have these programs available in Medicaid. Medicaid has so many wonderful things that are happening, but a lot of challenges that need to, we kind of have to kind of sort all that out. Some of these could be good solutions. And we are excited to be working with organizations that are actually trying to create that kind of change at the federal level.
Saul Marquez:
Amazing, so across the country.
Suzanne Kunis:
Yes, across the country.
Saul Marquez:
No limits?
Suzanne Kunis:
No limits.
Saul Marquez:
Oh, wow.
Suzanne Kunis:
I’m already looking at NHS and all these other ones say, hey, you never know what tomorrow’s going to bring, but.
Saul Marquez:
Wow, what an opportunity, folks. This is an opportunity for you to seize the moment and make change happen. If you’ve been wondering about how to make an impact in mental health, look no further. The show notes of this podcast. we’re going to leave a link to our amazing Suzanne Kunis and the website to NovaWell, as well as all the resources that she and the team there are really ready to share with all those that want to make a difference. Suzanne, thank you for being here today.
Suzanne Kunis:
Oh, my pleasure.
Saul Marquez:
This has been such a privilege to have you here. What closing thought would you leave the listeners with?
Suzanne Kunis:
I think that I would want people to know, again, let’s normalize the conversation, and especially with kids. Kids, I feel really hopeful for the future because when you start looking at high school and college kids, they’re actually willing to talk about things that we never would have talked about. And so I’m really hopeful for that, but let’s be open. Let’s embrace, don’t be afraid to let your kids be who they are.
Saul Marquez:
Yes.
Suzanne Kunis:
And support them everywhere. You don’t have to always agree, but you have to let them be who they are, and just support them, love them and always be there, and I think we’ll see great success in the future if we put all these tools together.
Saul Marquez:
Amazing, well, you’re a beautiful person, it was a beautiful message. I want to thank you so much on behalf of all of us listening. And then the last question is, where do they go to learn more?
Suzanne Kunis:
They can come to the NovaWell website. We’ll also make sure that there’s information there about the person who runs our business development area, and we’re happy to have more conversations and send information out.
Saul Marquez:
Beautiful. Thanks for the opportunity, Suzanne. And folks, make sure you check the show notes for how to get in touch with NovaWell, you’re not going to want to miss out an opportunity to make change. Thank you, Suzanne.
Suzanne Kunis:
Thank you so much.
Sonix has many features that you’d love including collaboration tools, generate automated summaries powered by AI, upload many different filetypes, automated subtitles, and easily transcribe your Zoom meetings. Try Sonix for free today.
