A comprehensive approach to the urgent need for behavioral health services

The COVID-19 pandemic has brought to light another public health emergency in the US: the pervasiveness of mental health disorders across all demographic groups and regions. Fueled by isolation and economic uncertainty, the statistics are staggering, with significant increases in depression, anxiety, substance use and suicidal ideation. The impact of these marginalized healthcare needs is made more complicated by insufficient patient care capacity and access to treatment.

Similar to the hope generated by the coronavirus vaccines that reduce the risk of this physical disease, there, too, is hope for an improved national response to mental illness. Recent parity enforcement actions, identification of generally accepted standards of care (see Wit v United Behavioral Health) and public-private partnerships to address mental health and addiction treatment needs are encouraging advancements toward a better mental healthcare system.  

Section 9007 of the Affordable Care Act requires that non-profit hospitals, in order to maintain their tax-exempt status, must conduct a community health needs assessment at least once every three years and adopt an implementation strategy to meet the community needs identified through the assessment. The need for broad and accessible behavioral health services consistently ranks as of one the major issues raised by respondents. 

Integration of behavioral health resources into the larger hospital or health system’s strategic business plan can assist in sustainable growth, as well as strengthen and improve existing service lines through cross-referrals and enhancement of patient navigation.

It is more important than ever to strategically offer a continuum of behavioral health services into a service delivery network. Patients presenting with a chronic or serious mental illness, given the high correlation with other medical comorbidities (CHF, COPD, diabetes, obesity, etc.), account for a significantly higher cost-per-patient-day than non-psychiatric patients, as well as more frequent utilization of limited emergency services’ resources.  

Properly developed and overseen by experts in the field, access to a continuum of behavioral health services offers providers and their patients the following benefits:

1. Addresses community needs
2. Improves clinical operations and outcomes
3. Improves patient throughput, staff workflow, and labor productivity
4. Enhances employee and provider satisfaction and retention
5. Generates a stable revenue stream. 
    

Components of such a continuum of care may include a combination of inpatient psychiatric beds (whether in a freestanding pavilion or a renovated unit within a general hospital), complementary outpatient programs, emergency services triage protocols, consultation and liaison services, a telehealth platform and specialty resources available to or embedded in primary care offices.

A state-of-the-art clinical program with passionate, highly trained physicians, nurses and allied health staff can reach optimal performance levels with the highest-quality hospital/unit design and materials. To achieve these desired results, it is critical that hospital leaders have the right partners during this period of profound change to the healthcare market.

Partnering with experts in the field who can provide comprehensive, working knowledge of licensing, regulatory and accreditation standards, as well as design, construction and financing of this specific real estate product, provides the relevant expertise to navigate the complexities from “concept” to “ribbon cutting” to operational excellence. Together, Anchor Health Properties and Behavioral Health Advisory Group have the unique capability and combined expertise to conduct strategic, operational, market and financial analyses to help guide providers and investors gain consensus on a go/no go decision with regard to the viability of a proposed project. In addition to our ability to assess the viability of a behavioral health hospital or service, we have the skills and resources to structure the financial arrangements, and execute on the design, construction and operational oversight of these facilities.

On a macro level, a successful approach to vetting a potential behavioral health project requires the following:

1. Confirming its long-term viability
2. Matching the vision with a plan
3. Delivering on the plan
4. Overseeing operations
    

The key benefits of this approach to hospitals and healthcare systems are:

• National scope and customized local design to meet both business and community missions
• Comprehensive market insight and financial analyses backed by “boots on the ground” leading industry experts
• Strategic vision and plan developed in collaboration with key leadership and stakeholders, coupled with successful construction execution and delivery options
• Focus on quality and cost-efficiencies from planning to project execution
• Market analysis informs the project proforma inclusive of real estate and financing solutions
• Ongoing oversight of program operations to monitor actual versus projected results

With clearly defined goals, and an operational roadmap to achieve these objectives in the planning, development and oversight of behavioral health pavilions and services, hospitals and health systems can succeed in this competitive market.
 

Richard I. Feldman brings over 30 years of C-Suite experience to healthcare providers seeking strategic vision, operational excellence, and strong financial performance in the behavioral healthcare space. His expertise in strategic planning, business and organizational development, finance, and leadership training, has helped over 200 hospitals and healthcare systems across the US achieve their community and business goals.

Katie Jacoby is an experienced real estate professional with more than 15 years at Anchor Health Properties developing and leasing innovative outpatient healthcare facilities. She leads the company’s development team and implements corporate strategic initiatives across the country and has extensive experience managing all aspects of the development process – from project concept through building opening.