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Chief Strategic Innovation Officer

In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates. About Rich Roth:  Mr. Roth leads CommonSpirit Health’s innovation efforts, which seek to create and test novel services, programs, partnerships, and/or technologies – from within and outside of healthcare – that challenge the status quo and have the potential to reduce the cost of care, improve quality, and/or increase access to services. ﻿Working in concert with CommonSpirit Health employees and physicians, Mr. Roth works to anticipate emerging trends and technologies with the goal of incubating, studying, and scaling efforts to improve care.

COVID-19 Updates with Rich Roth

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Chief Commercial Officer and General Manager

Women make up more than <a href="https://www.census.gov/quickfacts/fact/table/US/LFE046220" target="_blank">half of the U.S. population</a> and about <a href="https://www.pewresearch.org/fact-tank/2022/09/26/women-now-outnumber-men-in-the-u-s-college-educated-labor-force/" target="_blank">half of the college-educated workforce</a>. Although women make up the majority, women’s health is still overlooked.  Creating a workplace where mothers can thrive changes whole companies — studies show that <a href="https://www.forbes.com/sites/karstenstrauss/2018/01/25/more-evidence-that-company-diversity-leads-to-better-profits/?sh=35a9cedd1bc7" target="_blank">organizations with better gender equity are more successful</a>. However, when women and families don’t get the healthcare and support they need, businesses suffer, too — through lower productivity and preventable healthcare costs as well as the lost knowledge and added expense of training new workers when women move on to jobs with better benefits.  Overlooking women’s health is an epidemic Women’s health has been overlooked for years with serious repercussions. Consider this: the U.S. has the <a href="https://www.npr.org/2017/05/12/528098789/u-s-has-the-worst-rate-of-maternal-deaths-in-the-developed-world" target="_blank">worst maternity outcomes of any developed nation</a>. As of 2020, our maternal mortality rate was <a href="https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm" target="_blank">23.8 deaths per 100,000 live births and rising</a>, even as maternal mortality is declining in other developed countries. According to a recent report from the CDC, <a href="https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html" target="_blank">80% of our pregnancy-related deaths are preventable</a>. Data has clearly shown this crisis is most urgent for BIPOC (Black, Indigenous, and people of color) mothers. Black women are <a href="https://www.cdc.gov/healthequity/features/maternal-mortality/index.html" target="_blank">three times more likely to die of pregnancy-related complications</a> than white women.  We’re also failing to provide the support women need to thrive as they become mothers. As many as <a href="https://www.ccjm.org/content/87/5/273" target="_blank">one in five women experience perinatal depression</a>, and many go undiagnosed and untreated.  The problem doesn’t start or end with pregnancy. Across the board, women are often dismissed when they need health support — even at the doctor’s office. In a recent survey by Ovia, nearly 85% of our members said they’d experienced medical gaslighting; they were told by healthcare providers that their symptoms were imagined or exaggerated. 63% of respondents said the experience delayed their ability to get an accurate diagnosis and necessary treatment.  Similarly, women’s health needs around menopause are often downplayed or ignored. In a <a href="https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/menopause-what-employers-need-to-know.aspx" target="_blank">2021 survey</a> of more than 5,000 women around the age of menopause, 3 of 5 struggled with difficult symptoms while working, and 1 of 3 actively hid their symptoms from colleagues and managers. In <a href="https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/menopause-what-employers-need-to-know.aspx" target="_blank">another survey</a>, half of women said they were afraid they’d be stigmatized if people knew they were going through menopause at all.  The high cost of ignoring women’s healthThese trends are concerning, with real implications on our communities. The cost of neglecting women’s health issues adds up — for employers, payers, and women themselves. Let’s look at a few of the numbers. In the U.S., payers and families spend <a href="https://pubmed.ncbi.nlm.nih.gov/21318294/" target="_blank">$75.8 billion each year on maternal and postpartum health</a>. That’s 1 of every 5 healthcare dollars employers spent! Much of this goes toward health crises we could reduce or avoid with better care, including:<ul><li><a href="https://www.marchofdimes.org/mission/the-economic-and-societal-costs.aspx" target="_blank">$26 billion for preterm births</a></li><li><a href="https://pubmed.ncbi.nlm.nih.gov/28708975/" target="_blank">$1.03 billion for preeclampsia</a></li><li><a href="https://www.liebertpub.com/doi/pdf/10.1089/pop.2009.12303#" target="_blank">$636 million for gestational diabetes</a></li></ul> While there’s less research on the costs of menopause, studies estimate that menopause-related productivity losses for businesses are as high as <a href="https://www.mindsethealth.com/matter/workplace-menopause-leave" target="_blank">$150 billion per year</a>. This is the case, even though menopause symptoms are treatable. Women’s health and wellness impact retentionSince the beginning of the pandemic, the U.S. workforce has <a href="https://nwlc.org/wp-content/uploads/2021/01/December-Jobs-Day.pdf" target="_blank">lost more than 5.4 million women</a>, putting us at a <a href="https://www.cnbc.com/2021/02/08/womens-labor-force-participation-rate-hit-33-year-low-in-january-2021.html" target="_blank">33-year low for women’s labor force participation</a>. And the trend continues — women are still leaving their jobs at a <a href="https://www.cnbc.com/2021/11/17/women-are-quitting-at-higher-rates-than-men-during-the-great-resignation.html" target="_blank">higher rate than men</a>. Each time a woman leaves, an employer loses skills and accumulated knowledge, and bears the expense of finding and training a replacement. The costs add up. So why are <a href="https://www.oviahealth.com/blog/the-great-reassessment/" target="_blank">women leaving the workforce</a>? During the pandemic, many working mothers faced two nearly impossible demands: figure out childcare without schools or daycare and perform at a job without family-friendly benefits. Many simply couldn’t balance the two.  The pandemic was unprecedented, but the truth is that women have always paid a “motherhood tax” at the office. Most of the time, work is simply not set up to work for mothers. Some key drivers are:<ul><li>Women either don’t have paid maternity leave, or don’t have enough. </li><li>Lacking support through the family-building process by their Employers.</li><li>Childcare costs are high, and there’s little help to cover this critical care.</li><li>Employers fall short when it comes to return-to-work planning and support for new parents balancing work and family.</li></ul> While pregnancy and the early parenting years can be one of the most challenging times for women at work, the lack of support is consistent across life changes and health challenges. Let’s consider menopause again. There’s so little support that nearly <a href="https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/menopause-what-employers-need-to-know.aspx" target="_blank">20 percent of women in menopause have considered leaving a job due to symptoms</a>.   Making women’s health and wellness a priority at workSupporting the health and wellbeing of women and families is critical and must be addressed. Women and communities are bearing the burden and suffering unnecessarily. When employers and payers support women, they save on healthcare costs, improve health outcomes, and retain working mothers.  To learn more about how payers and employers can support women’s health and working mothers with family-friendly benefits and a culture shift, join Ovia’s Chief Commercial Officer and General Manager, Dr. Jenny Carrillo, for Ovia’s session on the Women at HLTH Impact Stage at 2:50 pm ET on Monday, November 14th. About OviaOvia Health, a Labcorp subsidiary, has served more than 17 million family and parenthood journeys since 2012 and is on a mission to make a happy, healthy family possible for everyone. Ovia Health is the only family health solution clinically proven to effectively identify and intervene with high-risk conditions. The company&#39;s 50+ clinical programs, including predictive coaching and personalized care plans, help prevent unnecessary health care costs, improve health outcomes, and foster a family-friendly workplace that increases retention and return to work. For more information visit www.oviahealth.com.

Supporting Women’s Health is Good for Business

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Founder & CEO

We know the <a href="https://mhanational.org/sites/default/files/2022%20State%20of%20Mental%20Health%20in%20America.pdf" target="_blank">statistics</a>: More than half of the nearly 50 million adults living with mental health conditions in the U.S. do not receive treatment. Neither do more than 60 percent of children and adolescents with major depression. This treatment disparity is often characterized collectively as “lack of access” to mental health services, but several distinct factors contribute to the problem. They include: <ul><li>A shortage of behavioral health specialists. By 2024, analysts expect the U.S. to be at a deficit of as many as <a href="https://www.aamc.org/news-insights/growing-psychiatrist-shortage-enormous-demand-mental-health-services" target="_blank">31,000 psychiatrists.</a></li><li>Geographic disparity. The behavioral health specialists we do have are concentrated disproportionately across the country, leaving some high-risk populations without any access to services. <a href="https://abcnews.go.com/Health/americas-mental-health-care-deserts-hard-access-care/story?id=84301748" target="_blank">570 counties</a> in the U.S. have no mental health care providers at all.</li><li>Financial barriers. Despite mental health parity laws enacted in 2008, insurance companies continue to reimburse mental health services less favorably than medical and surgical benefits. The Departments of Labor, Treasury, and Health &amp; Human Services jointly issued a <a href="https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/mental-health-parity/report-to-congress-2022-realizing-parity-reducing-stigma-and-raising-awareness.pdf" target="_blank">report</a> in 2022 that signaled increased enforcement of the Mental Health Parity laws.</li></ul> Regardless of the reason, lack of access to mental health care results in mental health crisis: Patients with no other options seeking late-stage care in the ER. <a href="https://www.usnews.com/news/health-news/articles/2023-02-13/suicides-rise-again-in-the-us-increases-highest-among-minorities" target="_blank">Suicide rates are on the rise</a> again, particularly among communities of color. According to the <a href="https://afsp.org/suicide-statistics/" target="_blank">latest CDC data</a>, 1.2 million Americans attempted suicide in 2020, and <a href="https://www.datocms-assets.com/12810/1649682186-14296_afsp_2022_national_fact_sheet_update_m1_v4.pdf" target="_blank">90% of them</a> had a diagnosable mental illness that could have been treated before it escalated to a crisis. In this environment, how can we provide access to care and make a meaningful difference in patient outcomes? We must think more creatively about care delivery, working together to provide unified programs across the entire state. A fragmented approach Currently, government entities are addressing specific populations through targeted access programs.  This is working best in the area of pediatric primary care. The Health Resources &amp; Services Administration (HRSA) is funding <a href="https://mchb.hrsa.gov/training/pgm-pmhca.asp" target="_blank">pediatric programs</a> in more than 40 states so far to provide consultations and resources to pediatric primary care providers. Thanks to the formation of the <a href="https://www.nncpap.org/" target="_blank">National Network of Child Psychiatry Access Programs </a>(NNCPAP), an organized coalition of clinical and health agency leaders, primary care access has for the most part moved to a single model across the country, with standardization, coordination, and a unified infrastructure to treat children in the primary care setting. However, there are other types of access programs for children and adolescents, most notably school-based crisis management programs, that would benefit from the single-model approach. Unlike the coordinated effort in primary care, school districts around the country are designing and delivering their own mental health programs. <a href="https://www.pewresearch.org/fact-tank/2022/08/10/just-over-half-of-u-s-public-schools-offer-mental-health-assessments-for-students-fewer-offer-treatment/" target="_blank">Statistics show</a> that just over half of public schools are providing just diagnostic mental health assessments and 42% are providing treatment. They are fragmented, disjointed programs with limited connection to each other, few ways to collaborate on best practices, and no standardized way to measure impact across the entire community.  Similar challenges exist with other types of access programs, including maternal mental health and substance abuse. Individually, each effort is laudable, making great strides to address needs in a specific area. Taken together, however, they paint a picture of a fragmented approach to mental health care, where each initiative plugs a hole, but the boat still leaks.  What will it take to address access as a whole rather than in pieces?  A unified model for mental health care We must redefine what it means to provide access, working toward standardized care and unifying programs under fewer umbrellas.  The NNCPAP has played an extraordinary role in helping to shepherd and standardize Child Psychiatry Access Programs across the country. What could be learned from a unified approach? The <a href="https://tcmhcc.utsystem.edu/" target="_blank">Texas Child Mental Health Care Consortium</a>, for example, administers several types of access programs under one governing body. What if other states followed this model, delivering not just primary care access programs but also school-based crisis management and even addiction and substance abuse treatment for adolescents from within a shared structure? They are all psychiatry access programs, after all. Although they initiate in different environments and may provide differing levels of intervention, they serve similar populations, and they often deliver care in the same manner through telehealth technology. This consolidated structure would offer the ability to integrate the entire ecosystem around each child—from primary care, to school, to specialty and behavioral health—ultimately providing a truly patient-centered approach. An integrated system would then yield the critical outcomes data needed to drive real change and transform mental health care. We believe it is possible to deliver an effective unified approach to mental health care delivery that will address the mental health crisis. The first step is for government and clinical leaders to integrate and standardize access programs at the state and, ultimately, the national level. Only then will we be able to accurately measure program effectiveness and be assured that we’re making a real impact on patient health outcomes. -- Malekeh Amini is founder and CEO of Trayt.Health, a data analytics and clinical workflow platform that expands access to mental health care and measures patient health outcomes. Designed exclusively for behavioral health, Trayt is the first application of its kind with the scale and functionality to fully address the needs of statewide behavioral health access programs. <a href="https://trayt.health/" target="_blank">Learn more</a>

Redefining Access: Disrupting the Fragmented Approach to Mental Health Care

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In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates. About Stacy Lindau, MD: Dr. Stacy Lindau, MD, MAPP, is NowPow’s founder and Chief Innovation Officer, a practicing physician and tenured professor at the University of Chicago. She is an experienced principal investigator with 15 years of continuous funding from federal sources, including the National Institutes of Health (NIH), the Center for Medicare and Medicaid Innovation and the Agency for Healthcare Research and Quality. Her scientific work is published in the highest impact medical literature and she is internationally known as an expert in women’s and population health across the life course. Stacy earned her medical degree from Brown University and a master’s degree in public policy from the University of Chicago where she was a Harris Child and Family Fellow. She was a Robert Wood Johnson Foundation Clinical Scholar (and served on the National Advisory Committee) and is an Aspen Institute Health Innovation Fellow and serves the Health Innovators Fellowship Board of Overseers. She has a BA from the University of Michigan Honors College in secondary education and political science and worked in broadcast journalism at Dow Jones and Company’s Wall Street Journal TV. Dr. Lindau is also president of MAPSCorps, a nonprofit community asset mapping organization that has employed more than 2,000 youth in 6 urban and rural geographies.

COVID-19 Discussion with NowPow

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