The Hazelden Betty Ford Foundation has announced the roll-out of a new integrated care model that combines mental health and substance use disorder (SUD) treatment. The project aims to push the envelope on whole-person care adoption among behavioral health providers, with plans to eventually even scale its “next-generation” approach to partnerships with other systems.

Across its 17 treatment centers spanning nine states, the nonprofit provider told Behavioral Health Business that this model will be used to standardize care with the end goal of personalizing care by capturing real-time data monitoring metrics — such as substance use, medication adherence, and reduction in mental health symptoms during and after treatment — as a foundation for its continuous improvement. Metrics related to indicators of staff embracing the new model and using the curriculum for care are also tracked.

Propelled by intensifying patient needs, with 80% of its patient population experiencing more than one treatable mental health condition as well as addiction, the idea is that using multidisciplinary care teams to address co-occurring conditions in treatment with evidence-based tactics and data is supposed to enhance patient outcomes. It also minimizes operational inefficiencies.

In pilot testing, the rigorous training model achieved 90% accuracy, per the company’s internal data. By training 37% of its counselors in-house, it’s an approach that simultaneously targets one of the industry sector’s biggest issues: staffing shortages. The new integrated care model is one that Hazelden’s president and CEO, Dr. Joseph Lee, hopes will really prove quality through robust data — a care metric that has been a longstanding challenge to appraise in behavioral health medicine.

The following transcript has been edited for length and clarity.

Behavioral Health Business: How does this new model position Hazelden Betty Ford competitively within the behavioral health market, especially as demand for integrated care increases?

Lee: I think many of the people who are in the behavioral health field want to overcome stigma. We all want a seat at the table with mainstream health care. I think one of the barriers is proving quality, not just saying you have quality, but really proving it through the data. In that realm, behavioral health is way behind general health care. 

I think patients and families seeking care feel that burden, and they don’t know what good quality is. So co-occurring care should be the norm and not the exception.

What’s special about what we’re doing is the “how,” because we’re changing the standard for the field to really prove quality.

What we have as a field is a lot of cherry-picked data, and a lot of care is, unfortunately, somewhat arbitrary, and they call it individualized care, but it’s one of one. You can’t replicate it, you can’t produce it, and it’s not where the rest of health care is. That’s the problem that we’re trying to solve.

As an organization that’s now 76 years old, we felt we should create a platform to really raise the bar for the field, to say, “this is our quality.” We have fidelity we can prove and a foundation for a continuous improvement model.

Standardized care is what leads to personalized medicine. It sounds like a contradiction, but it’s not, because once you standardize the care, and have a continuous improvement model, you can measure the data. Then you can build specialty tracks, you can measure outcomes so you can reproduce what you’ve done for a past patient, and the model will continue to improve.

How are you measuring quality and consistency of the new model?

There are different ways to do it. The part that’s really unique is our combination of a few things. One: our training. We don’t just hire people — 37% of our counselors come from our graduate school. We have a training mentality within our organization with rigor that is pretty unmatched.

Then, we have our data set and our center for research, which has set up the fidelity measures and the outcomes. When we piloted this track, we had 90% fidelity per patient ratings.

We also have outcomes tracking to know that this model is actually working. We measure quality through our research. Our intellectual property is also very unique because it’s a mountain of proprietary products that are evidence-based. Then we use our peer-reviewed research models to mine the data and that is what ensures quality.

This is really a living, breathing model that’s informed by data — one that is always improving, always evolving.

What are the multidisciplinary care teams involved in this new curriculum?

The multidisciplinary teams are really there to offer non-fragmented care to people. Our psychiatrists, nurse practitioners, psychologists and counselors all work together in an integrated way, and the data helps us get there.

Is this model being explored for licensing or expansion into partnerships with other behavioral health providers or systems nationwide?

We hope. We can help them set up the data tracks and look at research and the quality improvements as our own product improves. We hope to develop products that inform the field. The rising tide lifts all boats. That’s kind of what we had in mind.

If we really want to see the table level for parity, for quality and for stigma, we have to prove quality, which is hard to do. We’ve been doing it now. We’re doing it in a way that is replicable.

This is a big deal for the field. It’s not done like this. I think, for whatever reason, people get caught up in that we have kind of overlooked ways to gauge very foundational qualitative measures across the field. You wouldn’t go to a hospital where they do routine medical procedures 15 different ways, but that’s the world that our patients are facing now.

How are payers and insurance providers responding to this next-generation model?

We haven’t gone to the negotiating table with it. But what has made a difference for us is that we have the best data in the industry, and our outcomes are not cherry-picked. We actually peer-review our research, and so that’s what we transmit.

With our insurance partners, we hope that they also take this on because that’s what the goal needs to be.

What has been the financial or operational lift or investment required to implement this system-wide?

Actually, not that much, because we already have the business units up and running.

Since we already had those pieces, all we had to do was connect the dots and create opportunities for people seeking help. What we’ve done is really created this manifestation of our ecosystem: our grad school, research center, publishing and our clinical lines. This product is going to help the entire field.

You mentioned that this new model will help Hazelden Betty Ford create new products that empower better patient outcomes. What products do you anticipate will come from this in the future?

We want to develop specialized tracks based on all this. Maybe other products in the future, such as special needs, trauma and other mental health disorders that come along with it, maybe the treatment of certain subpopulations for some of the tracks. We’ll learn that from our data. So it’ll be a matter of picking the data up, then we’ll try something out, and see if it works.

As this living, breathing model, are you anticipating any upcoming changes to the model? Or how are you looking at evolving it in time?

Yeah, it will evolve. I think we’ll need to make some priority decisions on what kind of specialty tracks to do next, based on it, what kind of services people need and where the gaps are. We’ll also need time to see what’s really enhancing outcomes for people, but we can analyze all that through our data set, and the beauty of it is we’re not waiting for a research paper to come out. Week to week, we can use the data to see if we need to go in this direction or that or if there’s something else we need to think about.

Nationwide, if behavioral health service providers could have this kind of platform, they could do a world of good. I’m reading some papers that are coming out that claim access to mental health is improving, but mental health is not improving—and that just re-stigmatizes our field. We don’t want to be in that boat. We want to be part of the tide toward changing that conversation.