Geode CMO: Behavioral Health Industry Consensus Critical to Advancing Value-Based Care

Geode CMO: Behavioral Health Industry Consensus Critical to Advancing Value-Based Care
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The conversation around outcomes data for behavioral health is decades old. But new advancements in data collection and interest in value-based care is bringing outcomes to the forefront.

“Clinical outcomes are difficult in all of health care,” Dr. Ravi Shah, chief medical officer of Geode Health, told Behavioral Health Business. “I think it’s especially difficult in mental health care. One of the really great things we’re seeing with this big boom in mental health technology startups is an emphasis and focus on measuring outcomes.”

Geode Health was founded in 2021 by global investment firm KKR. The Chicago-based startup provides in-person and virtual outpatient treatment across the country.

Shah noted that nearly all venture-backed startups are measuring some type of metric in order to prove traction to investors. But these efforts may also move the dial for traditional brick-and-mortar operators.

“Because of this, traditional providers are starting to think this way about measuring outcomes,” Shah said. “Here at Geode, we’re in a really nice position because we’re trying to take the best of a traditional model such as in-person care and combine it with technology-enabled care.”

As part of the company’s model, it teams up with clinical practitioners including psychiatrists, nurse practitioners, physician assistants, psychologists and therapists to provide mental health services for adults and children.

Shah joined Geode in May, after previously founding Mantra Health, a digital mental health company focused on college students. He noted that several meta analyzes show measures-based care is superior to regular care, even if you have the same providers.

Additionally, Shah said there are several hypotheses for these results, including boosting provider confidence in treatments and being more assertive in treatment.

“My hope is that in the next 10 years, we’ll start seeing measurement-based care and measuring outcomes become the standard,” Shah said. “It’s still not the standard objectively, but I think that’s one paradigm shift we’ll see across the mental health care landscape.”

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In order to provide measurement-based care, Geode has partnered with a technology vendor called mirah. Through this partnership, Geode is able to collect patients’ anxiety and depression data, as well as information about their substance use at the start of every treatment. This data can then be collected at a regular cadence throughout treatment.

Despite being armed with those insights, Geode doesn’t tell its clinicians what to do, per se. Instead, the company provides them with up-to-date data, so they can make “smart clinical decisions.”

The importance of stakeholder buy-in

Reimbursement could help drive the industry towards measurement-based care, as insurers are beginning to integrate outcomes-based care into coding.

“I’m really pleased to see that we now have a CPT [Current Procedural Terminology] code to bill measure-based care and behavioral health … to align that financial incentive with what we know is best for outcomes,” Shah said.

The ability to track outcomes is key to the move towards value-based care. However, there is still not a consensus among stakeholders about which outcomes need to be measured.

“The only way we can get to value-based care is if we start to agree on the metrics around value,” Shah said. “We have to agree that the patient’s experience of their care and how they’re rating [their experience] on these scales will be a key component of measuring care.”

Being able to prove cost saving could help get the payers on-board for value-based care, Shah said. For example, if a provider has data to demonstrate to a payer that it is reducing the number of emergency room visits for patients, that could be a game changer.

“I think that’s going to get payers more excited about a value-based care opportunity because we’re going to be able to show not just improved outcomes from a quality of care perspective, but also the cost savings,” Shah said.

But payers aren’t the only stakeholders that need buy-in to measurement-based care. It’s important to help give clinicians the best tools to improve care, Shah explained.

“I think another way to improve quality is giving clinicians tools to help them provide evidence-based treatment,” Shah said. “There’s always tension between clinical policies and professional autonomy. I like to think of those protocols as guardrails for keeping people within bounds. That way, we know what’s happening and can give clinicians access to high-quality materials.”

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